M.Tech. (Biomedical Technology) / Despite the introduction of prophylactic treatment for Rh negative females, Rhesus Haemolytic Disease of the Foetus and Newborn (HDN) remains a problem. The serological diagnosis of this disease is mainly by maternal antibody identification and titration and the estimation of the optical density deviation (ODD) at 450 nanometers of the amniotic fluid. The correlation of these two results is not always good. The advent of molecular biology techniques such as the Polymerase Chain Reaction (PCR) and the sequencing of genes heralded the start of prenatal diagnosis of genetically inherited diseases and also enabled the prediction of the Rhesus group of the foetus. It would be advantageous to be able to predict with certainty the RhD status of a foetus suspected of having HDN without subjecting the mother and foetus to the risk of multiple invasive procedures such as Chorionic Villus Sampling (CVS) and Foetal Blood Sampling(FBS). The amniocentesis performed initially on a mother suspected of carrying an affected foetus would provide the sample necessary for the extraction of foetal DNA for prenatal Rh determination. Two PCR assays were used to determine the RhD group of the foetus: one using two primers amplifying a section ofIntron 4 and the other using four primers, two specific for Exon 7 and two specific for Exon 10 of the Rh gene. In 85.7% (18/21 cases) there was complete correlation between the molecular and the serological methods for RhD determination. One White foetus presented a unique profile, that of RhD negative in both molecular assays and RhD positive serologically. In the non-White group there were discrepancies between the two molecular methods as well as between the molecular and the serological methods used. This study shows that great care should be taken in the interpretation of RhD status prenatally using molecular biology techniques especially in the non-Caucasian population of South Africa in which there are many polymorphisrns in the Rhesus blood group system. For the moment, the results should be used in conjunction with serological results and clinical parameters for the diagnosis and treatment of Rh HDN.

Orientador: Ricardo Barini / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T02:14:25Z (GMT). No. of bitstreams: 1 Sarno_ManoelAlfredoCurvelo._M.pdf: 343850 bytes, checksum: b057fda92ddc57699305f785589b98fb (MD5) Previous issue date: 2004 / Resumo: Objetivo: avaliar diferentes padrões da Dopplervelocimetria da artéria cerebral média na predição da anemia fetal. Sujeitos e Métodos: este é um estudo retrospectivo do tipo validação de teste diagnóstico, no qual foram avaliadas gestantes isoimunizadas submetidas à cordocentese e Dopplervelocimetria da artéria cerebral média no período de janeiro de 2003 a agosto de 2004 no Serviço de Medicina Fetal do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas. Foram comparados dois parâmetros do pico sistólico da artéria cerebral média (PS-ACM), 1,5 desvio padrão e 1,5 múltiplo da mediana (MoM) na predição da anemia fetal, pelo teste de McNemar. O padrãoouro para anemia foi o resultado da medida da hemoglobina fetal (Hbf) abaixo de 0,65 MoM . Foi avaliado o melhor ponto de corte do PS-ACM antes e depois das transfusões intra-uterinas através da plotagem dos resultados na curva Receiver Operating Caractheristic (ROC). Resultados: das 36 gestantes isoimunizadas, 17 foram submetidas a amniocenteses seriadas. Em três foram identificados anticorpos contra antígenos irregulares que não causavam hemólise, uma perdeu o seguimento e outra evoluiu para parto antes do procedimento. Foram analisados os dados de 14 gestantes e 15 fetos (uma gestação gemelar), com o total de 64 cordocenteses. A média da Hbf antes da primeira transfusão foi 8,1 g/dl (variação de 3,8 a 14) e após a primeira transfusão 11,6 g/dl (variação de 9 a 16,1). A média do PS-ACM antes da primeira transfusão foi 51,9 cm/s (variação de 30 a 86) e após a primeira transfusão 33,1 cm/s (variação de 21 a 59). As gestantes foram submetidas em média a 3,1 transfusões (variação de 1 a 6). Nos fetos analisados antes da primeira transfusão, a área sob a curva ROC foi 0,9821 e o melhor ponto de corte do PSACM foi 36 cm/s. Analisando o total de cordocenteses (64), antes e depois das transfusões, a área foi 0,7537 e o melhor ponto de corte do PS-ACM foi 44 cm/s. Comparando os valores de sensibilidade, especificidade e valores preditivos dos pontos de corte de 1,5 MoM e 1,5 DP do PS-ACM , não houve diferença estatística. Conclusão: a velocidade do PS-ACM medida pela Dopplervelocimetria demonstrou bom desempenho para predizer os fetos com anemia e este desempenho diminuiu após a primeira transfusão. Não houve diferença entre a análise de 1,5 DP e 1,5 MoM do PS-ACM para predição de anemia moderada ou grave / Abstract: Objective: to evaluate the performance of different parameters of middle cerebral artery Doppler velocity for prediction of fetal anemia in Rh isoimmunization. Subjects and Methods: a retrospective study was conducted to validate a diagnostic test, assessing all isoimmunized pregnant patients who underwent cordocentesis and middle cerebral artery Doppler velocity (MCA-PSV) from January 2003 to August 2004 in the Fetal Medicine Unit at Universidade Estadual de Campinas, Brazil. Two different MCA-PSV cut offs were compared to predict fetal anemia, using McNemar test. The gold standard to fetal anemia was hemoglobin below 0.65 multiples of the median. The best cut off value to predict fetal anemia was obtained by Receiver Operating Characteristic curve (ROC), before and after transfusion. Results: thirty-six isoimmunized pregnant patients were selected. eventeen had undergone serial amniocentesis, 3 were isoimmunized by non-hemolytic antigens, one was lost to follow-up and other delivered before the procedure and all were excluded. Data from 14 pregnant patients and 15 fetuses (one twin pregnancy) were studied with a total of 64 cordocentesis. Mean fetal hemoglobin was 8.1 g/dl (range, 3.8-14), and 11.6 g/dl (range, 9-16.1) before and after the first transfusion, respectively. Mean MCA-PSV was 51.9 cm/s (range, 30-86) and 33.1 cm/s (range, 21-59) before and after the first transfusion, respectively. Pregnant patients were submitted to an average of 3.1 transfusions during pregnancy (range, 1-6). Value for the area under the ROC curve for fetuses analyzed before the first transfusion was 0.9821, and the best cut off value was 36 cm/s. From a total of 64 cordocentesis, before and after transfusions, the value under the area of ROC curve was 0.7537 and cut off value of 44 cm/s. Comparing sensitivity and specificity, there was no statistical difference between 1.5 MoM and 1.5 DP of MCA-PSV. Conclusion: MCA-PSV measured by Doppler velocity showed a good performance for prediction of fetal anemia in Rh isoimmunized pregnancy and this performance was poorer after the first fetal transfusion. There was no difference between 1.5 MoM and 1.5 DP of MCA-PSV to predict moderate and severe fetal anemia / Mestrado / Tocoginecologia / Mestre em Tocoginecologia

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People for long term exposed to an air-conditioned but highly humid environment are vulnerable to hyper-sensitivity or asthma triggered by fungi or dust mites. This thesis aims to develop a high-linearity and low-hysteresis capacitive relative humidity (RH) microsensor to more precisely accommodate the humidity of living spaces. To reduce the hysteresis and enhance the linearity, this research uses not only one polyimide (PI) thin film as a humidity sensing layer but also utilizes another PI thin film as a protecting layer of the top electrodes. To improve further the RH sensitivity and responding speed, interlacing out-of-plane electrodes are designed in the RH microsensor. The main processing steps of the RH sensor developed in this study involve at least five photolithographic and four thin film deposition processes. The influences of sensing area, number of electrode pairs and testing temperature on the sensitivity and sensing linearity of humidity microsensors were investigated. Based on the measurement results, the sensitivity apparently increase as well as the sensing area (2 mm ¡Ñ 2 mm: 0.12 pF/%RH, 3 mm ¡Ñ 3 mm: 0.48 pF/%RH, 5 mm ¡Ñ 5 mm: 1.09 pF/%RH), and decrease with the number of electrode pairs (40 pairs: 0.51 pF/%RH, 20 pairs: 0.4 pF/%RH) and increase with the testing temperature. The thesis has demonstrated that the capacitance of the RH sensor vary from the relative humidity with a very linear relationship (linearity: 98.8%~99.99%) over the range of 30~70%RH. Finally, to increase effectively the surface area and to reduce further the hysteresis, three-dimensional (3D) moisture entrances and exits were designed and a very low hysteresis value (0.5%RH) can be achieved.

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Developing asymmetric C-H bond activation methods in order to achieve enantiopure products is crucial for the advancement of the field and for the production of novel chiral compounds. Therefore, we tried to develop this area of organic chemistry by presenting metal catalyzed stereoselective C-H bond activation utilizing chelation-assisted tools. The first section of this study involves Rh(I) catalyzed asymmetric C-H bond activation of a series of ketones via an intermolecular procedure. By this method, we examine ortho-alkylation of aromatic ketones and β-functionalization of α-β unsaturated ketones with a series of prochiral olefins. In the second section, we present an efficient three steps method for stereoselective intramolecular C-H bond activation of indol-3-carboxaldehyde with tethered prochiral olefins. The catalytic system in both methods involves a joint chiral primary amine and Rh(I) catalyst. Chiral primary amines can serve to induce enantioselectivity as well as acting as a useful directing group which has shown appropriate coordination to the transition metal catalyst, providing high regioselectivity. / February 2017

OBJETIVO: Identificar las principales complicaciones fetales y del recién nacido así como los factores de riesgo de la Isoinmunización Rh. DISEÑO: Estudio Descriptivo Analítico Retrospectivo. LUGAR: Instituto Especializado Materno Perinatal, MINSA. MATERIAL Y MÉTODO: 116 gestantes Rh negativo que se atendieron el 0000maternas y neonatales para determinar las diferencias entre los casos de grupo control se utilizaron las pruebas de significación estadísticas Chi2 y prueba t de Studen. RESULTADOS: De 54,418 partos atendidos en la institución durante este período, se obtuvieron 116 (0,21%) madres Rh negativo que cumplieron con los criterios de inclusión, de las cuales el 12,1%(14) presentaron isoinmunización Rh. La edad promedio de las madres sensibilizadas fue de 30 años, se observo una mayor incidencia en multíparas (50%) y un menor número de control pre natal (1-3) en comparación de las madres sensibilizadas (>4). El 50% de las madres sensibilizadas presentaron antecedentes de aborto, 14,3% antecedentes de óbito y de transfusión y el 21,4% antecedente de hidrops y kernicterus; Siendo estas variables factores de riesgo de presentar isoinmunización. La tasa de cesárea fue de 78,6%, se encontró mayor porcentaje de partos prematuros en la madres sensibilizadas. El Apgar promedio en los recién nacidos fue de 6 al minuto y 8 a los 5minutos. Las complicaciones fetales más frecuentes fueron: ictericia anemia e hidrops y la mortalidad fetal fue de 7,1%(1). CONCLUSIONES: Es necesario evaluar la prevención mediante los estudios de los factores de riesgo teniendo en consideración que los niños que presentaron isoinmunización Rh se encontraron en el grupo en el cual la madre no recibió gammaglobulina anti-D profiláctica y que por lo tanto no tuvieron un adecuado control prenatal en anteriores embarazos ya sea por el factor económico, por el factor ignorancia o por la poca cobertura de éste. Por ello es necesario establecer políticas dirigidas a la promoción y prevención. Palabras claves: isoinmunización Rh, factores de riesgo, complicación fetal y neonatal.

Ce travail doctoral s’intéresse aux effets du système RH performant d’un sous-traitant sur la performance de l’échange avec le donneur d’ordre. Les théories des ressources et de l’échange social sont mobilisées conjointement afin d’étudier la combinaison complexe entre le système RH performant du sous-traitant, la qualité de la relation entre donneur d’ordre et sous-traitant et la performance de leur échange. Pour tester ce modèle, une étude quantitative multi-sources a été réalisée auprès de cinq grands donneurs d’ordre des secteurs aéronautique et spatial et de leurs principaux sous-traitants. Les résultats issus des analyses de modération montrent que le système RH performant améliore la performance de la relation uniquement lorsque certains aspects de la qualité de la relation avec le donneur d’ordre sont défavorables. En particulier, nos résultats montrent que l’effet du système RH performant est significatif dans trois situations : une justice inter-organisationnelle faible, un pouvoir du donneur d’ordre élevé et une dépendance conjointe faible. Les résultats de cette étude et ses limites sont discutées et des implications managériales à l’intention des donneurs d’ordre et des sous-traitants sont proposées. / This doctoral work focuses on the effects of a high performance work system of a supplier on the exchange performance with the buyer. Drawing on resources and social exchange theories, we study the complex combination of a supplier’s high performance work system, buyer-supplier relationship quality and their exchange performance. To test this model, a quantitative multi-source study was conducted with five major buyers in the aeronautical and spatial industry and their main suppliers. Results from interaction analysis indicate that a high performance work system improves relationship performance only when some aspects of the relationship with the buyer are negative. In particular, our results show that the effect of a high performance work system is significant in three situations: low interorganizational justice, high buyer power and low interdependence. These findings and their limitations are discussed and managerial implications for buyers and suppliers are proposed.