Orientador: Carmino Antonio De Souza / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T04:16:36Z (GMT). No. of bitstreams: 1 Miranda_ElianaCristinaMartins_D.pdf: 1801629 bytes, checksum: b4c847d7141a9b207af7438bdef8c791 (MD5) Previous issue date: 2013 / Resumo: O estudo analisa duas metodologias que estão sendo usadas para estimar a probabilidade de eventos. Um método é a inversão do Kaplan-Meier (1-KM), o qual não considera eventos competitivos, e o outro método é a função da incidência cumulativa (FIC). O estudo contemplou a definição do conceito de risco competitivo e a aplicação dos métodos citados em um conjunto de dados de pacientes submetidos ao transplante de células-tronco hematopoiéticas (TCTH). Os critérios de inclusão foram pacientes consecutivos transplantados no período de Janeiro de 1994 a Dezembro de 2010, com diagnóstico de leucemia aguda (LA) ou leucemia mieloide crônica (LMC). O evento de interesse foi a doença do enxerto contra o hospedeiro (DeCH) crônica, enquanto os eventos competitivos foram: recaída e morte prévia a DeCH crônica. O resultado após a aplicação do método 1-KM para o grupo de pacientes com LA foi de 52% e estratificado pelo tipo de enxerto foi 44% para medula óssea (MO) e 77% para sangue periférico (SP) p= 0.003. Quando aplicado o método FIC a probabilidade geral foi de 45% e por tipo de enxerto foi 17% para MO e 33% para SP, p= 0.00002. No grupo de pacientes diagnosticados com LMC, usando a mesma racional os resultados foram similares. Não há comparações entre os métodos estatísticos, principalmente porque o pressuposto de se considerar o evento competitivo é aplicado somente na metodologia FIC. A fonte de células SP cotejada com fonte de células MO conduzem a uma incidência cumulativa maior de DeCH, independente da doença de base. Os resultados apresentaram, na grande maioria, diferenças grandes entre os testes, indicando a importância de se averiguar os detalhes no momento da aplicação / Abstract: This study presents two methodologies that have been used to estimate the probability of events. One method is the Kaplan-Meier inversion (1-KM), which no consider the competitive events, and another one is the cumulative incidence function (CIF). The study showed the definition of competitive risk concepts and its application in the database of patients submitted to the hematopoietic stem cell transplantation (HSCT). Inclusion criteria were consecutive transplanted patients in the period between January 1994 to December 2010, with acute leukemia (AL) or chronic myeloid leukemia (CML). The interest event was chronic graft versus host disease (GVHD), insofar, competitive events were relapse or early death previous to chronic GVHD. The results after 1-KM application in the AL group was 52% and stratified by source of graft was 44% in bone marrow (BM) and 77% in peripheral blood (PB) with p=0.003. When CIF test applied the results was 45% and by source of graft was 17% in BM and 33% in PB, p= 0.00002. In the CML group the results were similar. There is no comparison between the statistical tests, mainly because their assumptions are not the same. PB as source of graft induces a higher incidence of chronic GVHD, independent of disease. All results presented, in the mayor, huge differences among the tests, indicating the importance to check the details at time of application / Doutorado / Clinica Medica / Doutora em Clínica Médica

Geringe Wasserlöslichkeiten kleiner organischer Wirkstoffkandidaten, sogenannter Leitstrukturen, sind in der Medikamentenentwicklung häufig für das Scheitern vielversprechender Projekte verantwortlich. Um diese Kandidaten dennoch zur Marktreife bringen zu können, wurden verschiedene Strategien entwickelt. Neben der kostenintensiven Strukturoptimierung rücken Formulierungsadditive in den Fokus, die in der Lage sind, Wirkstoffe zu solubilisieren, transportieren und gezielt freizusetzen. In dieser Arbeit wird eine Hochdurchsatz-Screening-Methode präsentiert, die eine schnelle und arbeitsextensive Identifizierung maßgeschneiderter Binder für wasserunlösliche, niedermolekulare Wirkstoffe ermöglicht und mithilfe derer Löslichkeitsvermittler in Form von Peptid-Polymer-Konjugaten mit definierten Solubilisierungs- und Freisetzungseigenschaften realisiert werden können. Dazu werden Peptidbibliotheken in einem zweistufigen Prozess auf Wirkstoffbindung und auf Wirkstofffreisetzung durchsucht. Das Screening kann aufgrund einer innovativen on-chip Immobilisierung der Peptidbibliothek und der intrinsischen Fluoreszenz der niedermolekularen Wirkstoffe halbautomatisiert durchgeführt werden. Vielversprechende Peptidsequenzen können anschließend direkt on-chip mittels MALDI-ToF-MS/MS bzw. fragmentierungsfrei sequenziert und löslichkeitsvermittelnde Peptid-PEG-Konjugate hergestellt werden. In einem Testsystem wurden maßgeschneiderte Peptid-PEG-Konjugate mit unterschiedlichen Freisetzungseigenschaften für einen potentiellen Alzheimer-Wirkstoff realisiert und sowohl Solubilisierungseigenschaften, als auch die Freisetzungseigenschaften in einem vereinfachten Blutplasmamodell mittels Fluoreszenzanisotropie und Fluoreszenzkorrelationsspektroskopie bestätigt. In Zelltests mit einer Neuro-2a-Zelllinie konnten durch Zugabe der Wirkstoff-Transporter-Komplexe effektiv die Ausbildung der bei einer Alzheimer-Erkrankung auftretenden Tau-Protein-Aggregate bis zu 55 % reduziert werden. / Low water solubility of promising small organic drugs is one of the main reasons for failures during early drug development. Solubilizers promise to overcome these difficulties by solubilization, improved transport and final release of the potential drug candidates, which may result in an approval as a commercial drug. Here, a high-throughput screening method is presented, which is capable of identifying tailor-made peptide-polymer conjugates binding small molecule drugs, which can be used to act as solubilizers with precisely defined drug uptake and release properties. The screening is based on a two-dimensional process, which in a first step identifies strong binders and in a second, characterises their drug release. Due to its innovative on-chip immobilization of the peptide library and the intrinsic fluorescence of the small molecule drugs, the screening can be performed semi-automatically. Promising peptides can be sequenced directly by on-chip fragmentation-free or via MALDI-ToF-MS/MS and subsequently peptide-PEG conjugates can be synthesized. A screening against a high potential Alzheimer´s disease drug resulted in several tailor-made peptide-PEG conjugates with various drug uptake and release characteristics, which were confirmed in additional experiments. Here, loading capacities were determined and release properties analysed with a simplified blood plasma model utilizing fluorescence anisotropy and fluorescence correlation spectroscopy. Cell tests with a Neuro-2a cell line confirmed the effectiveness of the drug-transporter aggregates by reducing the tau-protein concentration by 55 % and inhibiting their aggregation, which is one of the key issues in Alzheimer´s disease.

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Current society is facing the crisis of the family, for many people the family is losing its value and we are witnessing frequent family break-up. On the background of the current difficulties of families, this thesis tries to investigate the function of the family, its individual relationships and their importance for family members. The ethics of the family relationships is analyzed in terms of children's needs and complementarity of partnership and parenthood.

Malariakontrolle ist von Resistenzen gegen Malariamedikamente wie Chloroquin (CQ) und Artemisininderivaten (ART) bedroht. Hier untersuchten wir das Ausmaß dieser Resistenzen in Fünf Feldstudien in Nigeria, Ruanda und Südwestindien unter Beurteilung der Prävalenzen Arzneimittelresistenz-assoziierter Mutation der Plasmodium-Parasiten (P. falciparum: K13, dhps, dhfr, mdr1 und P. vivax: mdr1) z.T. in Korrelation mit klinischen Patientendaten und ex-vivo Überlebensraten (ÜLR) unter Zugabe von ART. K13 wurde in 360 zwischen 2010-2018 gesammelte ruandischen P. falciparum Isolaten genotypisiert. Erstmals fanden wir dort niedrige Frequenzen der mit ART-Resistenz assoziierten K13-Mutation. Jedoch lassen Mutation mit niedrigen ÜLR, sowie ein Isolat mit hohen ÜLR aber ohne K13-Mutation eines Patienten der die Infektion unter Therapie nicht eliminieren konnte, Fragen offen. Ca.100 indische P. falciparum und P. vivax Isolaten aus 2015 wurden auf Mutationen in P. falciparum Markern für die Resistenz gegen Sulfadoxin-Pyrimethamin (SP) (d.h. pfdhps/pfdhfr), Artesunat (AS) (d.h. K13) und Lumefantrin (d.h. pfmdr1) sowie P. vivax Marker für CQ-Resistenz (pvmdr1) untersucht. Der Großteil der Isolate zeigt Mutationen die SP-Resistenz hervorrufen, daher könnte die Effizienz der AS+SP-Therapie begrenzen sein. Außerdem eignet sich Lumefantrin nicht als alternatives Medikament auf Grund der beobachteten Dominanz des pfmdr1-Haplotyps „NFD“. Die Abwesenheit der pvmdr1-Mutation Y976F und erfolgreiche Behandlungen zeigen, die Wirksamkeit von CQ gegen vivax Malaria im Studiengebiet. Auch Isolate von nigerianischen Schwangeren mit asymptomatischer P. falciparum Infektion zeigten hohe Prävalenzen von pfdhfr/pfdhps Vier- und Fünffachmutanten darum ist die Wirksamkeit der präventiver Therapie Schwangerer mit SP in Nigeria ernsthaft gefährdet. Die Daten spiegeln die Häufigkeit der Resistenzen gegen Malariamittel in diesen Gebieten wieder mit großen Unterschieden zwischen Regionen und Medikamenten. / The spread of resistance to antimalarial drugs such as chloroquine (CQ) and artemisinins (ART) is a great threat to malaria control. Here, we investigated the extent of such resistance in Nigeria, Rwanda and south-western India. We assessed the prevalence of mutations in few Plasmodium parasites’ markers of resistance, namely P. falciparum genes K13 (ART), pfdhps/pfdhfr (sulfadoxine-pyrimethamine, SP) and pfmdr1 (lumefantrine) as well as P. vivax gene pvmdr1 (CQ) in 5 field studies conducted in 2010-2018, and partially correlated the results to patients’ clinical outcome. Few isolates from Rwanda, were also evaluated for their parasite ex vivo survival rates (SR) upon exposure to ART. We tracked ART resistance in Rwanda by genotyping K13 in 360 P. falciparum isolates from 2010-2018. We showed for the first time that K13 mutations associated with ART resistance are present here, thus in Africa, at a low frequency. However, mutations occurred in patients who recovered and/or had low SR. Of note, one patient with high SR but no K13 mutation was still parasitemic after ART treatment. Moreover, we assessed the presence of mutations in K13, pfdhps/pfdhfr, pfmdr1 and pvmdr1 in ca 100 P. falciparum and 100 P. vivax isolates from south-western India. Most of P. falciparum isolates carried pfdhfr/pfdhps mutations conferring SP resistance, menacing the efficacy of SP-ART treatment. Also, the high prevalence of pfmdr1 haplotype “NFD” advised against the introduction of lumefantrine. The low rates of P. vivax pvmdr1 Y976F and patients’ successful parasite clearance, indicated that CQ remains effective in the area. Finally, a high rate of pfdhfr/pfdhps quadruple and quintuple mutant was observed in Nigerian pregnant women with asymptomatic P. falciparum infection, hence the effectiveness of preventive treatment with SP in pregnancy might be threatened. The data reflected the abundance of antimalarials resistance in these areas with important differences between regions and drugs.

Although cloud network flows are similar to conventional network flows in many ways, there are some major differences in their statistical characteristics. However, due to the lack of adequate public datasets, the proponents of many existing cloud intrusion detection systems (IDS) have relied on the DARPA dataset which was obtained by simulating a conventional network environment. In the current thesis, we show empirically that the DARPA dataset by failing to meet important statistical characteristics of real-world cloud traffic data centers is inadequate for evaluating cloud IDS. We analyze, as an alternative, a new public dataset collected through cooperation between our lab and a non-profit cloud service provider, which contains benign data and a wide variety of attack data. Furthermore, we present a new hypervisor-based cloud IDS using an instance-oriented feature model and supervised machine learning techniques. We investigate 3 different classifiers: Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM) algorithms. Experimental evaluation on a diversified dataset yields a detection rate of 92.08% and a false-positive rate of 1.49% for the random forest, the best performing of the three classifiers. / Graduate

The world is jeopardized by several social and environmental threats. The limited resources are being used at a rapid rate which contributes to negative effects on global warming. Along with increased poverty, human rights are being violated and labor is exploited. Therefore, sustainability is perhaps a more urgent topic than ever. CSV is proposed as an answer to these environmental and social threats, which is identified by a gap in the concept of CSR. Sweden is a leading country in terms of sustainability, and therefore the purpose is to gain knowledge on how Swedish companies work with shared value creation in their sustainable practices. This study follows an interpretive philosophy through a qualitative study, and semi-structured interviews are conducted with six companies. The empirical data is analyzed through coding where four themes are evolved. This study develops existing concepts through an inductive approach and further proposes that the companies pursue CSV by the mediating role of CSR. Sustainable innovation, innovative raw materials, and digitalization are the major contributors to shared value creation. Sustainable development goals and science-based targets are essential tools to guide companies toward a sustainable future. However, two barriers to pursuing shared value creating activities are being a small company and adapting to the local context.

There is nothing fundamentally wrong with the premise that a pianist like Clara Wieck/Schumann ‘speaks’ in her song compositions. This, however, raises a number of epistemological questions that will be discussed in this article. First of all, an explicit distinction is made between the examination of the ‘technical’ aspects of her compositional practice – in German: Praktik – (which may allow conclusions to be drawn about the pianist’s implicit knowledge) on the one hand, and the social aspects of her discursive practice – in German: Praxis – on the other. Thus, it is also necessary to discuss the criteria that the structural-analytical methodology must satisfy, as well as to consider to whom the pianist is actually speaking: to us music researchers of the 21st century? Or should we ask ourselves whether our analysis is not rather a “reading of traces” in the sense of Sybille Krämer, through which we invent the ‘producer’ of the analyzed ‘trace’ in the first place? Or to put it another way epistemologically: how do we make the pianist speak? What function does our ‘speaking’ of her compositions – namely the piano parts in her songs – have in scholarly argumentations?

Malaria Impfstoffkandidaten, welche Sicherheit und Wirksamkeit gegen prä-erythrozytische Stadien bieten, sind nach wie vor in der Entwicklung. Experimentelle Immunisierungsstudien mit genetisch attenuierten Parasiten (GAP), welche die Entwicklung über das klinisch asymptomatische Leberstadium hinaus verhindern, erwiesen sich als sicher und effizient. ΔSLARP GAP-Sporozoiten arretieren vollständig in der Leber, bieten jedoch keinen langanhaltenden Schutz. Hingegen zeigen Immunisierungen mit ΔP36p/P36 Sporozoiten einen langanhaltenden Schutz, führen jedoch während der Immunisierung gelegentlich zu Blutstadieninfektionen. Diese Studie liefert eine systematische vorklinische Bewertung eines dreifachen KO GAP-Parasiten, durch die Kombination von ΔSLARP und ΔP36p/P36. KO Parasiten arretierten vollständig in vitro und in vivo, aber der zeitnahe Blutinfektionsbeginn nach einer Sporozoiteninfektion in Mäusen zeigte eine verminderte Wirksamkeit des Impfstoffs. Während ein besserer Schutz durch einen späten Leberstadien Entwicklungsstillstand erreicht werden kann, bleiben die zugrundeliegenden molekularen Mechanismen unklar. Eine Vorrausetzung für die Leberzellen Antigenpräsentation ist die Präsenz von parasitären Antigenen im hepatozyten Zytoplasma. Der Proteinexportkomplex PTEX ist in Leberstadien nicht vollständig funktionstüchtig, da das essentielle Hitzeschockprotein 101 (HSP101) nicht exprimiert wird. Um die Rolle von HSP101 für den Leberproteinexport zu klären, wurden transgene HSP101 exprimierende Parasiten erzeugt. Transgene Parasiten weisen in vitro und in vivo schwere Wachstumsstörungen im Leberstadium auf und bieten keinen Impfschutz. Die Ergebnisse legen nahe, dass die Expression von HSP101 streng kontrolliert wird und der Export im frühen Leberstadien nicht wiederhergestellt werden kann. Insgesamt können prä-klinische Studien und die Weiterentwicklung von GAP-basierten Impfstoffkandidaten die laufenden humanen Impfstoffstudien beeinflussen und vorantreiben. / Malaria vaccine candidates providing both safety and efficacy against pre-erythrocytic stages remain largely elusive. Experimental immunizations with live genetically attenuated parasites (GAPs) preventing the development beyond the clinically silent liver stage have proven safe and efficacious. GAP vaccine candidate ΔSLARP, provides the most robust life cycle arrest, however, immunizations do not elicit long-lasting immunity. In contrast, ΔP36p/P36 sporozoites elicit long-lasting immunity, but lead to breakthrough infections during immunizations. This study gives a systematic pre-clinical evaluation of a triple knockout (tKO) GAP by combining ΔSLARP and ΔP36p/P36. Complete arrest of tKO parasites in cultured hepatoma cells and sporozoite-infected mice was confirmed, but time to blood infection after a sporozoite challenge revealed reduced efficacy of the tKO vaccine. While superior immunity can be achieved by a late developmental arrest at liver-to-blood stage conversion, the underlying molecular mechanisms remain elusive. An important question is whether parasite antigens are exposed to the hepatocyte cytoplasm. Protein translocation into the host cell cytoplasm mediated by PTEX, a protein translocon, is absent during liver stage maturation as a core component of PTEX, Heat-shock-protein 101 (HSP101), is not expressed. To clarify the role of HSP101 in liver stage protein export transgenic HSP101 expressing Plasmodium berghei parasites were generated. Parasites expressing elevated levels of HSP101 show severe liver stage growth defects in vitro and in vivo, lack early liver stage export and inferior protection in immunized animals. Our results suggest that HSP101 expression is tightly controlled and PTEX dependent early liver stage export cannot be restored solely by HSP101 overexpression. Overall, pre-clinical analysis and improvement of GAP-based vaccine candidates can inform on-going human vaccine trials and boost malaria vaccine development.

Sarajevo is a city in which, for centuries, people of different religions and ethnicities have lived together. But the war in the early 1990s partitioned the country into almost ethnically homogenous parts. The aim of this work is to find out, how young people between the ages of 18 - 29 years old perceive the identity of contemporary Sarajevo and to what extent they identify with the official narrative of Sarajevo as a multi-ethnic city. An online survey was conducted in March 2016 by a sample of 66 young Bosniaks, Bosnian Serbs, and Bosnian Croats. The research examines how they identify with the Sarajevan urban identity and the influential factors, such as ethnic categorization, religious beliefs, origin, or dominant information sources. To provide a deeper insight, the online survey was extended to include 15 in-depth interviews with young Sarajevans. There, the author uses a metaphor of a bridge to analyze the young Sarajevans' point of view regarding inter-ethnic relations and identity of their city. The outcome of the research is recognition that young Sarajevans often deny the ethnic categorization and perceive the every- day contact between different ethnic groups as non-problematic. As a consequence, the participants see Sarajevo as a unique city in the Bosnian context and typically distinguish...