Introdução: A Doença Hepática Gordurosa Não Alcoólica (DHGNA) tem como causa principal a obesidade. Atualmente não existe tratamento medicamentoso específico para DHGNA. A cirurgia bariátrica surge como uma alternativa de tratamento em pacientes morbidamente obesos. Objetivos: Analisar, através de biópsia hepática intra-operatória, o grau de comprometimento hepático em obesos submetidos à cirurgia bariátrica, correlacionando os achados histopatológicos com o estado glicêmico dos pacientes. Métodos: Estudo de coorte prospectivo incluindo 521 pacientes submetidos à cirurgia bariátrica de julho de 2001 até dezembro de 2016. Os pacientes foram classificados em três grupos de acordo com o status glicêmico basal: 167(32,05%) diabéticos tipo 2 (G1), 132 (25,33%) pré-diabéticos (G2) e 222 (42,61%) obesos normoglicêmicos (G3). Foram obtidas biópsias hepáticas transoperatórias, as quais foram classificadas conforme os critérios de Brunt e do NASH-CRN. As variáveis clínicas e bioquímicas e histológicas foram comparadas antes da cirurgia e durante o seguimento pós-operatório. Resultados: A prevalência de DHGNA nesta coorte foi de 95%. Não houve diferença quanto ao gênero e IMC entre os grupos. Observaram-se taxas mais altas de fibrose (56,4% G1 vs 29,2% G2 vs 28,6% G3 p<0,001) e Esteatohepatite Não Alcoólica (EHNA) (59,4% G1vs 49,2% G2 vs 36% G3 p <0,001) nos pacientes diabéticos. Apenas 1,5 %, dos diabéticos apresentaram histologia normal (vs 7,76% G2 vs 15,7% G3). / Introduction: Obesity is the main cause of nonalcoholic fatty liver disease (NAFLD), for which there is currently no specific medical treatment. Bariatric surgery is a treatment alternative for morbidly obese patients. Objectives: Use an intraoperative liver biopsy to analyze the degree of liver damage in obese patients submitted to bariatric surgery and correlates the histopathological findings with glucose status. Methods: Prospective cohort study of 521 morbid obese patients undergoing bariatric surgery from July 2001 to December 2016, classified into three groups according to their baseline glucose status: 167 (32.05%) type 2 diabetes (G1), 132 (25.33%) pre-diabetic (G2) and 222 (42.61%) normoglycemic obese (G3). Patients using potentially hepatotoxic medications and a history of ethanol consumption or viral hepatitis were excluded. Intraoperative liver biopsies were obtained and classified in accordance with Brunt and NASH-CRN criteria. Clinical, biochemical and histopathological variables were compared before surgery and during postoperative follow-up. Results: The prevalence NAFLD was 95%. There was no intergroup difference for sex and BMI. Higher rates of fibrosis (56.4% G1 vs. 29.2% G2 vs. 28.6% G3 p<0.001) and nonalcoholic steatohepatitis (NASH) (59.4% G1vs 49.2% G2 vs. 36% G3 p <0.001) were observed in the diabetic patients. Only 1.5 % of diabetics showed normal histology (vs. 7.76% G2 and 15.7% G3).

The theoretical part of the thesis includes introduction of Riemann integral and its qualities, introduction of function of more variables, introduction of double and triple Riemann integral and physical applications of integral. The practical part includes derivation of general area formulas for different shapes and volume formulas for different solids, in some examples there are shown different ways of solution. The practical part also includes the use of Riemann integral for the determination of centre of mass, of statical moments and moments of inertia of objects.

Embora os direitos de Propriedade Intelectual (PI) sejam supostamente instituídos de forma a fomentar a inovação e o bem-estar em longo prazo, seu uso pode ensejar comportamentos oportunistas e abusivos como os Artigos 8.2 e 40 do TRIPS expressamente admitem. Sempre que tal tipo de comportamento afetar a concorrência em determinado mercado excluindo concorrentes, impondo barreiras à entrada, prejudicando consumidores por meio de aumento de preços ou redução da oferta o Direito de Concorrência será chamado a intervir. Considerando tais questões, o objetivo desse trabalho é identificar um quadro de trabalho brasileiro para tratar de questões envolvendo questões de Direito de Concorrência relacionadas à Propriedade Intelectual. O autor buscou delinear os conceitos de uso abusivo de direitos de Propriedade Intelectual, Dominação de Mercado por meio de uso da Propriedade Intelectual e de abuso de posição dominante, considerando o novo quadro regulatório introduzido pela Lei 12.259/2001. / While intellectual property (IP) rights are usually claimed to be designed to foster innovation and welfare in the long run, their use may give rise to opportunistic, abusive behavior - as Articles 8.2 and 40 of TRIPS openly admit. Whenever such sort of behavior affects competition in a given market - whether by dislodging competitors, imposing barriers to entry, harming costumers, raising prices or reducing output - competition law is called to intervene. Considering these issues, the purpose of this paper is to identify a Brazilian legal framework for dealing with IP related competition issues. The author sought to draw the legal concepts of abusive of IP rights, market domination and abuse of dominant position considering the new regulatory framework introduced by Law 12.259/2011.

This master thesis has been carried out in collaboration with Saab, Avionics Systems in Jönköping, Sweden, during the spring of 2017. The thesis investigates unidirectional rectifier topologies in aircraft and the focus has been on evaluating the power quality requirements according to the aircraft standards, in the course of the More Electric Aircraft concept. Both passive and active power factor correction topologies are considered, discussed and compared. Simulation models are designed in MATLAB/Simulink and the procedures are presented. A modular concept regarding components is discussed where different power supplies and loads are considered. The simulations present both a passive 12-pulse auto-transformer rectifier unit and an active Delta-switch rectifier fulfilling requirements for aircraft such as the total harmonic distortion of the supply current. In addition, the input power factor is close to unity and an efficiency greater than 97% is obtained. Lastly, future aspects of each topology are discussed and necessary improvements to obtain realistic simulation models are presented.

Listen. If I ask you to listen, what is it that I ask of you—that you will understand, or perhaps obey? Or is it some sort of readiness that is requested? What occurs with a body in the act of listening? How do sound and voice structure audio-visual-spatial relations in concrete situations? This doctoral thesis in fine arts consists of six artworks and an essay that documents the research process, or rather, acts as a travelogue as it stages and narrates a series of journeys into a predominantly sonic ecology. One entry into this field is offered by the animal “voice” and attempts to teach animals to speak human language. The first journey concerns a specific case where humanoid sounds were found to emanate from an unlikely source—the blowhole of a dolphin. Another point of entry is offered by the acousmatic voice, a voice split from its body, and more specifically, my encounter with the disembodied voice of Steve Buscemi in a prison in Philadelphia. This listening experience triggered a fascination with, and an inquiry into, the voices that exist alongside us, the parasitic relation that audio technology makes possible, and the way an accompanying voice changes one’s perceptions and even one’s behavior. In the case of both the animal and the acousmatic, the seemingly trivial act of attending to a voice quickly opens up a complex space of embodied entanglements with the potential to challenge much of what we take for granted. At the heart of my inquiry is a series of artworks made between 2012 and 2016, which constitute a third journey: the performance Limit-Cruisers (#1 Sphere), the praxis session Limit-Cruisers (#2 Crowd), the installations Therapy in Junkspace, Fluorescent You, and “Then, ere the bark above their shoulders grew,” and the lecture performance Articulations from the Orifice (The Dry and the Wet). The relationship between what is seen and heard is being explored and renegotiated in the arts and beyond. We are increasingly addressed by prerecorded and synthetic voices in both public and private spaces. Simultaneously, our notions of human communication are challenged and complicated by recent research in animal communication. My work attempts to address the shifts and complexities embodied in these developments. The three journeys are deeply entwined with theoretical inquiries into human-animal relationships, technology, and the philosophy of sound. In the essay, I consider as well how other artistic practices are exploring this same complex space. What I put forward is a materialist and concrete approach to listening understood as a situated practice. Listening is both a form of co-habitation and an ecology. In and through listening, I claim, one could be said to perform in concert with the things heard while at the same time being changed by them. / <p>Avhandlingen är även utgiven i serien: Malmö Faculty of Fine and Performing Arts, Lund University: DoctoralStudies and Research in Fine and Performing Arts, 16. ISSN: 1653-8617</p>

波松分配（Poisson Distribution）常用在單位時間或是區間內，計算對有興趣之某隨機事件次數（或是已知事件之頻率），例如：速食餐廳的單位時間來客數，又或是每段期間內，某天然災害的發生次數，可以表示為某一特定事件X服從波松分配，若lambda為單位事件發生次數或是平均次數，我們稱lambda為此波松分配之母數，記作Poisson(lambda)，其中lambda屬於實數。 今天我們若想要探討由兩個服從不同波松分配抽取的隨機變數，如下列所述：令X={(X1,X2)}為一集合，其中Xi為X(i,1),X(i,2),...,X(i,ni)~Poisson(lambda(i)),i=1,2。欲探討兩波松分配之均數是否相同或相差小於某個常數d時，考慮以下檢定:H0:lambda2-lambda1<=d與H0:lambda2-lambda1>d，對於此問題可以使用的檢定方法有Przyborwski和Wilenski(1940)提出的條件檢定（Conditional test,C-test）或K.Krishnamoorthy與Jessica Thomson(2002)提出的精確性檢定（Exact test,E-test），其中的精確性檢定為一個非條件檢定（Unconditional Test）；K.Krishnamoorthy與Jessica Thomson比較條件檢定與精確性檢定的p-value皆小於顯著水準(apha)，而精確性檢定的檢定力不亞於條件檢定，因此精確性檢定比條件檢定更適合上面所述之假設問題。 Roger L.Berger（1996）提出一個以信賴區間的p-value所建立的較強力檢定，而目前只用於檢定兩二項分配（Binomial Distribution）的機率參數p是否相同為例，然而Berger在文中提到，較強力檢定比非條件檢定有更好的檢定力，而且要求的計算時間較少，可以提升檢定的效率。 本篇論文我們希望在固定apha與d時檢定的問題，建立一個兩波松分配均數顯著水準為apha的較強力檢定。 利用Roger L.Berger與Dennis D.Boos(1994)提出以信賴區間的p-value方法，建立波松分配兩兩母均數差的較強力檢定；研究發現此較強力檢定與精確性檢定的p-value皆小於apha，然而我們的檢定的檢定力皆不亞於精確性檢定所計算得出的檢定力，然而其apha及虛無假設皆需要善加考慮以本篇研究來看，當檢定為單尾檢定時，若apha<0.01，我們的較強力檢定沒有辦法找到比精確性檢定更好地拒絕域，換言之，此時較強力檢定與精確性檢定的檢定力將會相等。 / Poisson Distribution is used to calculate the probability of a certain phenomenon which attracted by researcher. If we want to test two random variable in an experiment .Therefore ,let X={(X1,X2)} be independent samples ,respectively ,from Poisson distribution ,also X(i,1),X(i,2),...,X(i,ni)~Poisson(lambda(i)),i=1,2. The problem of interest here is to test: H0:lambda2-lambda1<=d and H0:lambda2-lambda1>d, where 0<apha<1/2 ,and let Y1 equals sum of X1 and Y2 equals sum of X2, where apha ,lambda,d be fixed. In this problem of hypothesis testing about two Poisson means is addressed by the conditional test.However ,the exact method of testing based on the test statistic considered in K.Krishnamoorthy,Jessica Thomson(2002) also commonly used. Roger L.Berger ,Dennis D.Boos(1994) give a new way to calculate p-value,which replace the old method ,called it a valid p-value .In 1996, Roger L.Berger used the new way to propose a new test for two parameter of binomial distribution which is more powerful than exact test. In the other hand, Roger L.Berger also explain the unconditional test is more suitable than the conditional test. In this paper,we propose a new method for two parameter of Poisson distribution which revise from Roger L.Berger’s method. The result we obtain that our new test is really get a much bigger rejection region.We found when the fixed increasing ,the set of more powerful test increasing, and when the fixed power increasing ,the required sample size decreasing.

Dans le domaine aéronautique, la dernière décennie a été marquée par une augmentation constante et progressive du taux d’électrification des systèmes embarqués. L’avion plus électrique est aujourd’hui vu comme un axe d’amélioration majeure pour l’industrie aéronautique permettant d’atteindre des objectifs toujours plus ambitieux : réduction de l’impact environnemental, rationalisation des coûts de maintenance… Dans ce contexte, le réseau de distribution électrique joue un rôle majeur. Les architectes doivent imaginer de nouveaux concepts architecturaux afin d’assurer le « service » de fourniture d’électricité tout en minimisant la masse et le coût. Ainsi les travaux de cette thèse proposent des méthodes d’aide à la conception pour les architectes de réseau. Le manuscrit se divise en 2 parties pouvant être vues comme 2 études distinctes et qui sont introduites dans le chapitre 1.La 1ère partie, traitée dans les chapitres 2 et 3, développe des méthodes et outils afin de résoudre de manière automatique et optimale 2 tâches de l’architecte : la définition des reconfigurations du réseau et l’identification de l’allocation des charges. La formalisation de ces 2 problématiques met en lumière une caractéristique commune : l’explosion combinatoire. Ainsi les résolutions sont réalisées à l’aide de méthodes issues de la recherche opérationnelle. Un processus général est défini afin de traiter les 2 tâches de manière consistante. Les aspects liés à la reconfiguration sont traités à l’aide de : la théorie des graphes pour modéliser la connectivité du réseau, un système expert capturant les règles métiers et la programmation linéaire sélectionnant les reconfigurations les plus performantes. La méthode a été appliquée avec succès sur des réseaux avions existants (A400M et A350) ainsi que sur des réseaux plus électriques prospectifs. La deuxième tâche consistant en l’allocation des charges a été résolue à l’aide de méthodes stochastiques. L’algorithme génétique utilisant une méthode de nichage se révèle être le plus performant en proposant à l’architecte réseau des solutions performantes et variées. La 2ème partie, traitée dans le chapitre 4, s’intéresse à un nouveau concept le « cœur électronique modulaire et mutualisé ». Cet organe de distribution, étroitement lié à l’avion plus électrique, se caractérise par la mutualisation de « m » modules électronique de puissance pour « c » charges électriques. Les méthodes développées dans le chapitre 4 vise à concevoir de manière optimale ce nouveau cœur en ayant 2 degrés de liberté : le nombre « m » de modules et les reconfigurations entre les « m » modules et les « c » charges. De nouveau, la formalisation du problème met en évidence l’explosion combinatoire à laquelle est confronté le concepteur. Le principal objectif de cette étude est de proposer un cadre méthodologique pour la résolution de ce problème de conception. Ainsi une heuristique a été développée pour résoudre ce problème combinatoire. Une attention particulière a été portée pour développer des modèles de composants simples et génériques dans une procédure générale organisée. Enfin une cartographie a été réalisée afin de dégager d’une part les formes de solutions les plus performantes et d’identifier les éléments ayant les impacts les plus significatifs sur la masse du système complet. / In the aeronautics field, the last decade has been marked by a constant and gradual increase of the electrification rate of the embedded systems. Today, the More Electric Aircraft (MEA) is seen as a major axis of improvement for the aviation industry to achieve increasingly ambitious objectives: reducing environmental impact, rationalisation of maintenance costs...In the more electrical aircraft concept, the electrical network plays a major role. Today engineers must imagine new architectural solutions to ensure the electricity supply while minimizing weight and cost. In this context, the PhD work consists in providing new methods to support the design of electrical network architectures. The PhD work is divided into 2 parts which can be seen as 2 separate studies which are introduced in the chapter 1.The 1st part, treated in the chapters 2 and 3, develops methods and tools to solve problems automatically for 2 architecture tasks: the definition of the network reconfiguration and the identification of the electrical load allocation on busbars. The formalization of these two issues highlights a common characteristic: the combinatorial explosion. As the consequence, methods from operational research area are selected to solve the 2 tasks in the frame of a general and consistent design process. The reconfiguration aspects are solved by a methodology coupling together: graph theory to model the network connectivity, an expert system capturing know-how rules and linear programming selecting the most efficient reconfiguration. The approach was successfully applied on existing aircraft electrical networks (A400M and A350) and on future architectures. The second task, related to the electrical load allocation, is solved using stochastic methods. The genetic algorithm using a niching method is the best assessed optimization method. It provides good and diversified load allocations to the electrical network architect. The 2nd part, treated in the chapter 4, focuses on a new technological concept the « modular and mutualised power electronics center ». This distribution system, closely linked to the more electrical aircraft, aims at sharing « m » power electronics modules to « c » electrical loads. The methods developed in this PhD aim at carrying out an optimal design of this new power center with 2 design variables: the number « m » of modules and the reconfigurations between the « m » modules and the « c » loads. Again, the formalization of the problem highlights that the designer must deal with a combinatorial explosion. The main objective of this study is to propose a methodological framework for solving this design problem. A heuristic-based algorithm is developed to solve this combinatorial optimization problem. A particular attention is paid to develop an organized weight estimation procedure using generic sizing models. Finally a mapping is performed to identify the best solutions and to highlight the technological elements having the most significant impact on the complete system weight

Our understanding of the physical world has evolved drastically over the last century and the microstructure described by subatomic physics has been found to be far stranger than we could previously have envisaged. However, our corresponding model of experience and its structure has remained largely untouched. The orthodox view conceives of our experience as made up of a number of different simpler experiences that are largely independent of one another. This traditional atomistic picture is deeply entrenched. But I argue that it is wrong. Our experience is extraordinarily rich and complex. In just a few seconds we may see, hear and smell a variety of things, feel the position and movement of our body, experience a blend of emotions, and undergo a series of conscious thoughts. This very familiar fact generates three puzzling questions. The first question concerns the way in which all these different things are experienced together. What we see, for example, is experienced alongside what we hear. Our visual experience does not occur in isolation from our auditory experience, sealed off and separate. It is fused together in some sense. It is co-conscious. We may then ask the Unity Question: What does the unity of consciousness consist in? The second question is the Counting Question: How many experiences does a unified region of consciousness involve? Should we think of our experience at a time as consisting in just one very rich experience, in a handful of sense-specific experiences, or in many very simple experiences? How should we go about counting experiences? Is there any principled way to do so?The third and final question, the Dependency Question, concerns the degree of autonomy of the various different aspects of our unified experience. For example, would one's visual experience be the same if one's emotional experience differed? Is the apparent colour of a sunset affected by the emotional state that we are in at the time? I offer a new answer to the Unity Question and argue that it has striking implications for the way that we address the Counting Question and the Dependency Question. In particular, it supports the view that our experience at a time consists in just one very rich experience in which all of the different aspects are heavily interdependent.

Orientador: Aparecida Mari Iguti / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T08:15:35Z (GMT). No. of bitstreams: 1 Castro_ThiagoFigueiredo_M.pdf: 3221194 bytes, checksum: d79cd1511dcb239d46ed687486593eb9 (MD5) Previous issue date: 2015 / Resumo: Saúde é um direito social conquistado, e a efetivação deste direito só se cumpre com o enfrentamento dos seus dois principais entraves: financiamento em saúde e gestão dos recursos humanos em saúde. O Brasil tem lidado com a questão dos recursos humanos em saúde através de programas governamentais que têm por finalidade o provimento de profissionais e a melhoria da qualidade da formação destes. O PROVAB ¿ Programa de Valorização do Profissional da Atenção Básica e o Programa Mais Médicos são os dois mais recentes programas na área. O presente trabalho objetiva refletir e analisar, a partir da experiência do Sujeito-Pesquisador como Supervisor do PROVAB e do Programa Mais Médicos, sobre o papel da supervisão prática nestes programas, e também sobre suas potencialidades e limites como ferramenta pedagógica. Trata-se de um estudo de natureza qualitativa e exploratória, baseado em relatos de experiências do Sujeito-Pesquisador, ocorridas no período de 2013 a 2015. Realiza-se um estudo descritivo dos programas, em seguida são relatadas as experiências selecionadas de supervisão, e por fim realiza-se a construção de categorias de análise. São delimitados três grupos de categorias: supervisão em contexto, papel da supervisão e ferramentas de supervisão. A pesquisa encontra seus limites na contemporaneidade aos fatos, que dificultam o encontro de dados e fontes distintas às fornecidas pelo governo federal, além da própria escolha metodológica, que remete os achados ao olhar implicado do autor. Com este trabalho, verifica-se que a prática de supervisão no PROVAB e no Programa Mais Médicos tem grande potência pedagógica, e que uma melhor definição do papel do supervisor, assim como a incorporação de novas ferramentas, tal qual o Grupo Balint-Paidéia e a Supervisão Ampliada, são algumas das propostas para o avanço dessas políticas. Novos estudos são necessários, para ampliar o olhar dos profissionais, gestores, equipe, usuários sobre os programas e, verificar as mudanças ocorridas, e a influência/potência da supervisão nestas mudanças / Abstract: Health is a conquered social right, and the fulfillment of this right only occurs with the confrontation of its two main obstacles: financing and management of the health workforce. Brazil deals with the issue of human resources for health through government programs to provide professionals and improve the quality of training. The PROVAB - "Professional Enhancement Program Primary Care" (Professional Improvement Program Primary Care) and (More Medical Program) "More Doctors Program" are the two most recent programs in this field. This article aims to reflect and analyze, from the experience of the subject-researcher as a Supervisor on the role of practical supervision in these programs on their potential and limits as a pedagogical tool. This is a study of qualitative and exploratory nature, based on reports of subject-researcher experience, during the period from 2013 to 2015. The author develops a descriptive study of the programs and reports selected supervisory experiences, and finally performs the construction of analysis categories, organized into three groups: supervision in the context, the role of supervision and supervision tools. The research finds its limits in the contemporaneity to the facts, making it difficult to collect different data and sources provided only by the federal government, also in from the specific methodological choice, referred the findings to the implicated author's look. With this work, it seems that the practice in supervision on the PROVAB "More Doctors Program" has great educational power, and that a better definition of the role of the supervisor as well as the incorporation of new tools, such as Balint-Paideia¿s Groups and the "enhanced supervision" are some of the proposals for the advancement of these policies. More studies are needed to broaden the perspectives of professionals, managers, team members about the programs and verify the changes occurred, and the influence / power of the supervision in these changes / Mestrado / Política, Planejamento e Gestão em Saúde / Mestre em Saude Coletiva

The city of Brno has always been a center of Moravian wine. The new draft of wine center responds to this reality and represents the grandeur of wineries in its full glory. Respect for nature, love for traditions and love for order/system are the main aspects of the design. The proposal is essentially open to the public, however, the necessary modesty is preserved. Conversely taciturnity of production part of buliding holds the secrets of the deep traditions of Viticulture and Enology. Designed buildings are used for production, wine storage, administration associated with the production, tasting and selling wine, conferences, accommodation and, finally, wellness and other activities. The size of the building is the result of an optimal design that does not interfere with nearby historical buildings. The emphasis is on minimizing costs both during construction and during operation. Flor plan shape resembling the letter L is oriented towards the west courtyard. This raises a unique viticultural area court with a wide staircase. The amphitheater can be used for seasonal exhibitions, pilgrimages or feast of local entertainment. The yard is connected with the street Hlinky, which paraphrases the historic entrance portals into winecellars. The northern part of the building bites into the ground and connects the original winecellars with new facilities. Small narrow windows reflects the desired taciturnity, just as it was with winecellars in South Moravia for centuries.