Au collège, en France, l’apprentissage des usages de l’ordinateur désormais piloté par la certification du B2i (Brevet Informatique et Internet) mais sans formation clairement identifiée, est en filigrane d’usages scolaires multiples souvent distincts des usages non scolaires. Chaque collégien est alors au centre d’une tension entre entre les univers d’usage apparemment inconciliables de la sphère scolaire et de sa sphère privée. Sans guidage ni étayage, il se livre à une sorte de butinage numérique, sans pouvoir transférer les acquisitions qu’il réalise dans chacune des sphères. Le problème didactique que cette recherche cherche à résoudre consiste à identifier et à caractériser des éléments et structures propices à l’émergence d’une cohérence à la globalité des rencontres avec les ordinateurs ou systèmes informatisées et des activités numériques du jeune. dans cette perspective, une première analyse propose une possible organisation scolaire qui tiendrait compte de toutes les activités du collégien, sans exception. Une seconde analyse consiste à objectiver ses rencontres numériques pour qu’elles constituent un objet d’étude pertinent. Enfin, sont examinés des éléments structurants communs, porteur de cohérence. Cette triple investigation permet de proposer un cadre d’interprétation et d’analyse comme outil d’intelligibilité du référent empirique constitué par toutes les rencontres. Cet outil pour l’enseignement est organisé par les tâches, leur technicité… Pour mettre à l’épreuve cette suggestion, une série d’enquêtes a été menée auprès de 203 élèves d’un même établissement. Les usages des outils informatisés ont été repérés ainsi que les conditions de l’opérationalisation de la proposition de cette recherche. Les résultats révèlent qu’il est possible d’adapter l’outil conceptuel d’interprétation des rencontres afin d’aider l’élève à construire, à l’échelle d’un curriculum, son propre itinéraire balisé par des étapes structurantes collectives. / In France, at middle school level, teaching for the uses of computer is now driven by the B2i certification (Brevet Informatique et Internet). Meanwhile, it doesn’t exist clearly identified training. So, each pupil stand in the center of tension between two worlds of uses from scholar sphere and the private sphere, that do not seem to go together. Without guidance or support they engage in a sort of digital gathering, without being able to transfer what they acquire in each sphere. The didactic issue that this research aims at solving is to identify and characterise components and structures ideal for the emergence of a consistency in all the digital practices of the pupils. To do that, a first study is conducted on a possible school organisation that would take into account all the activities of the pupils, without any exception. A second one is to objectivise their digital encounters so that they form a relevant object of study. Finally these two studies are challenged in order to reveal common, coherent structural elements. This threefold investigation enables to offer a framework for interpretation and analysis as a tool for the understandability of the empirical referent comprising every encounter. In order to test this study a series of surveys was conducted among 215 pupils attending the same school. Uses of pupils were identified, as well as the terms of the operationalisation of what this research suggests. Results show that the conceptual tool of the interpretation of the encounters can be adapted in order to help pupils build – at curriculum scale – their own path controlled by structuring and collective steps.

Si le procédé de traitement des eaux usées urbaines par bioréacteur à membranes est en plein essor depuis quelques années, il ne reste pas moins plusieurs verrous technologiques qui ralentissent l'expansion de sa commercialisation. Ce travail de thèse s'attache à apporter des éléments de réponse sur quelques uns des freins à sa progression. Le premier réside dans la détermination d'un âge de boues adapté permettant une épuration maximale de l'azote et de la matière organique, par une biomasse active où le colmatage est limité et la production de boues faible. Le choix s'est porté sur 50 jours qui rempli l'ensemble de ces critères. Une autre barrière se situe dans le manque de données permettant l'extrapolation des informations obtenues en laboratoire à celles engrangées sur site. Une des étapes clés est de déterminer les conséquences du changement d'effluent (synthétique ou réel) sur les performances et le colmatage du procédé. L'utilisation d'une méthode de fluorescence récente a permis la détermination de l'implication des protéines et substances humiques-like extraits des polymères extracellulaires solubles dans le colmatage. / For several years, membrane bioreactor for urban wastewater treatment has been booming. Nevertheless some issues still slow down its expansion. This work tries to answer some of the brakes to its progression. First one concerns the choice of the suitable sludge adge which guarantee maximal removal rates of ammonium and organic matter, by an active biomasse where fouling is limited and slude production low. 50 days is fulling all the criteria. An other concern is about the lack of data allowing extrapolation from laboratory to wastewater treatment plant. One key step is to detremine the impact of influent nature (synthetic or real) on process results and fouling. Use of recent fluorescence method allows determining the implication of proteins and humic substances-like from soluble extra polymeric substances on fouling.

Aim of the thesis The main aim of this thesis is an analysis breakouts by extraliga junior team, selection the most effective variant and their subsequent comparison with the Canadian national team to 20 years. Constituent part is to create a complete overview of the theoretical knowledge which can be used in the analysis breakouts. The analysis can serve as an inspiration for coaches of youth cathegory during training and acquisition in this phase of the game. Methods In the thesis tracking method was used, which was used in the analysis breakouts. The analysis was performed by using the method of direct observation of the game, but also indirect observation of video recordings provided by videocoaches or assistant coaches of selected teams. Results During analyzing domestic literature, it was found that it is not paid enough attention to the breakouts and there is no methodology developed compared to a foreign literature. Of the reporting teams and their variants for the breakout and development of the attack, three of the most effective were selected. For comparison, there were also mentioned variants of the breakouts of the Canadian national team under 20 years, which was followed at the World Cup to 20 years. The best breakouts from DHL Extraliga junior teams has HC Plzeň 1929, HC Sparta Praha...

L’anormalité est associée de lege lata à diverses conditions du droit de la responsabilité civile comme la faute, la chose anormale ou le trouble anormal. Plus qu’une condition, elle apparaît davantage comme le fondement de la responsabilité civile extracontractuelle. Toutefois, l’anormalité est progressivement devenue une véritable source de confusion : se multiplient les situations dans lesquelles la responsabilité civile existe sans anormalité et celles dans lesquelles l’anormalité s’épanouit en dehors des frontières de ce droit. En quête d’unité, la responsabilité civile doit connaître des changements majeurs. Recentrer l’anormalité dans le fait générateur de responsabilité permettrait d’en révéler la singularité. Dans cette nouvelle présentation du droit de la responsabilité civile, l’anormalité du fait générateur ne constituerait pas uniquement le critère général de la matière extracontractuelle, elle deviendrait également le principal outil de sa mise en œuvre tant dans la désignation du responsable que dans la détermination de l’étendue de la réparation. L’anormalité, en sa qualité de standard juridique, constitue un instrument de mesure à la fois souple et normatif qui permettrait une adaptation constante de la responsabilité civile aux évolutions sociales et qui guiderait ses principales fonctions normative et indemnitaire. L’anormalité serait l’outil privilégié du juge grâce auquel il rendrait une décision équitable et proportionnée aux intérêts divergents du responsable et de la victime. Néanmoins, l’anormalité au service de la responsabilité civile met ce droit à l’épreuve : si elle présente d’indéniables forces, elle peut aussi être une source d’imprévisibilité face au déploiement de la casuistique. Cet instrument de mesure devra donc faire l’objet d’un encadrement rigoureux afin d’en assurer la solidité et l’immutabilité. L’anormalité pourrait ainsi devenir le repère du droit de la responsabilité civile extracontractuelle. / Abnormality is associated de lege lata with various conditions of civil liability law such as fault, an abnormal thing or abnormal disorder. More than a condition, it appears more as the basis of extra-contractual civil liability. However, the abnormality has gradually become a real source of confusion : there are many situations in which civil liability exists without abnormality, others in which abnormality spreads beyond the boundaries of this field of law. For the sake of homogeneity, civil liability must be significantly revised. Refocusing abnormality as the triggering event of civil liability would reveal its singularity. In this new presentation of the civil liability law, the abnormality of the triggering event would not only constitute the general criterion of the non-contractual matter, it would also become the main tool for its implementation both in the designation of the person responsible and in the determination of the extent of the compensation. Abnormality, as a legal standard, forms a measuring instrument that is both flexible and normative, allowing civil liability to be constantly adapted to social developments and guiding its main normative and compensatory functions. Framed that way, abnormality would be the judge's privileged tool by which he would make a decision that is fair and proportionate to the divergent interests of the person responsible and the victim. Nevertheless, the abnormality in support of civil liability have some flaws : despite its strengths, it may make the civil liability law unpredictable since case-by-case judgment becomes the norm. This tool will therefore have to be supervised by strict rules to ensure its solidity and immutability. Abnormality could become in this context the reference point of the extra-contractual civil liability law.

A experiência adquirida na realização de estudos epidemiológicos sobre o líquen plano oral associado à infecção crônica de hepatite C nos faz acreditar que as lesões atróficas/erosivas associadas ao vírus C tendem a apresentar características clínicas atípicas, por vezes exacerbadas e com resposta piorada à terapêutica proposta. Acreditando que existiria uma contrapartida histopatológica que justificasse o comportamento clinico evidenciado, o presente estudo propôs-se a estudar as populações de células T CD8+ e Foxp3+ no líquen plano oral associado à infecção crônica de hepatite C e compará-las com as populações do líquen plano oral idiopático. Foram selecionados 11 blocos de líquen plano oral associado à infecção crônica de hepatite C (Grupo 1) e 19 blocos parafinados de líquen plano oral idiopático (Grupo 2) dos arquivos do Laboratório de Patologia Cirúrgica da Disciplina de Patologia Bucal da Faculdade de Odontologia da Universidade de São Paulo e do Laboratório de Patologia Bucal, do Departamento de Patologia, da Universidade Federal de Santa Catarina. Para ambos os grupos foram realizados ensaios imunohistoquímicos com marcação dos anticorpos anti-CD8 e anti-Foxp3. As células marcadas foram contabilizadas e os resultados tratados estatisticamente. No Grupo 1, 64% dos pacientes eram do sexo feminino; 82% leucodermas e a média de idade era de 59 anos (variação 46 aos 75 anos). No Grupo 2, 63% dos pacientes eram do sexo feminino; 71% leucodermas e a média de idade era de 50,2 anos (variação 32 aos 66 anos). Quando os dados entre os Grupos 1 e 2 foram comparados, não houve correlação estatisticamente significante entre as contagens de células T CD8+, contagens de células T Foxp3+ ou na relação CD8+/Foxp3+ por mm2. As lesões atróficas/erosivas do Grupo 1 apresentaram densidade aumentada de células T CD8+ (p=0,034) e aumento na relação CD8+/Foxp3+ por mm2 (p=0,018), em relação ao Grupo 2. O estudo realizado não encontrou diferenças nas densidades de células T CD8+ e Foxp3+ no infiltrado do líquen plano oral associado ao vírus C em relação ao líquen plano idiopático. Por outro lado, as diferenças encontradas na quantidade de células T CD8+ e na relação CD8/Foxp3, em lesões atróficas/erosivas, parecem justificar as características clínicas evidenciadas em estudos prévios. / Our previous studies with oral lichen planus associated with chronic hepatitis C virus infection leads us to believe that atrophic/erosive forms of oral lesions tend to present unusual clinical features, sometimes exacerbated with a worsened response to treatment. Considering that this exacerbated aspect could indicate a similar exacerbate histopathological feature, the aim of this study was evaluated the populations of CD8(+) and Foxp3(+) T cells in oral lichen planus associated with chronic hepatitis C virus infection and correlated the findings with idiopathic forms of these lesions. The sample consisted of 11 cases of oral lichen planus associated with chronic hepatitis C virus infection (Group 1) and 19 cases of idiopathic oral lichen planus (Group 2) obtained from the Laboratories of Oral Pathology of the University of São Paulo and the Federal University of Santa Catarina. In both groups immunohistochemistry staining were performed using anti-CD8 and anti-Foxp3 antibodies. Positive cells were counted per area and the results were subjected to statistical analysis. In Group 1, 64% of the patients were female, 82% caucasian with mean age of 59 years (range from 46 to 75 years). In Group 2, 63% of the patients were female, 71% caucasian with mean age 50.2 years (range from 32 to 66 years). When Groups 1 and 2 were compared, no significant correlation between the frequencies of CD8(+), Foxp3(+) T cells and the ratio of CD8(+)/Foxp3(+) counts per mm2 was found. The atrophic/erosive lesions in Group 1 showed an increased frequency of CD8(+) T cells (p = 0.034) and an increased ratio of CD8(+)/Foxp3(+) counts per mm2 (p = 0.018) compared to Group 2. In conclusion, our data indicated no differences in the frequencies of CD8(+) and Foxp3(+) T cells in the inflammatory infiltrate of oral lichen planus associated with chronic hepatitis C virus infection compared to idiopathic lesions. However, the differences in the counts of CD8(+) T cells and the ratio of CD8(+)/Foxp3(+) in atrophic/erosive lesions seemed justify the clinical features in previous studies.

A translação da regeneração pulpar com células tronco para a clinica requerirá o uso de scaffolds injetáveis. O objetivo foi estudar o comportamento de células tronco obtidas de dentes decíduos exfoliados (SHED) injetados em canais radiculares de pré-molares humanos com ápice aberto com scaffold de colágeno recombinante humano tipo I (rhC-I) e a base de nanofibras auto-organizáveis (SA). Para determinar a viabilidade e potencial de diferenciação de SHED in vitro, raízes nao instrumentadas foram posicionadas com o ápice em meio de cultura. SHED ressuspendida em rhC e SA foram injetadas nos canais (n=24, 5X105 células/mL). Os controles foram SHED e scaffolds sozinhos. Marcadores para diferenciação odontoblastica (DSPP, DMP-1 e MEPE) foram avaliados semanalmente por RT-PCR por 28 dias. Para avaliar a diferenciação odontoblástica e formação de tecido in vivo, SHED transuzida com GFP foram injetadas em canais radiculares (n=8, 106 célulass/mL) utilizando os mesmos grupos e implantadas subcutaneamente em camundongos imunodeprimidos. O controle (C+) foi um pré-molar humano extraído. Analise estatística foi feita com ANOVA (=0.05). Os marcadores de diferenciação odontoblástica aumentaram para SA e rhC-I mas nao nos controles. Crescimento de tecido pulpar-símile ( do que 60% do comprimento da raiz) foi observado em 75% dos implantes para SA e rhC-I e 0% nos controles. Analise de imunohistoquimica para GFP confirmou a origem tecidual a partir de SHED. PCNA e ensaio de TUNEL mostraram alta ativiade proliferativa e poucas células apoptóticas. Injeções de tetraciclina evidenciaram neoformação de dentina. A densidade microvascular e nomero de odontoblastos delineando a dentinta foi similar em rhC-I, SA e C+. A associação de SHED com scaffolds injetáveis foi capaz de originar um tecido pulpar capaz de produzir dentina e constitui um passo a mais frente ao objetivo de regeneração pulpar em pacientes humanos. / The translation of dental pulp regeneration with stem cells to the clinic will require the use of injectable scaffolds. The aim was to study the behavior of stem cells from exfoliated deciduous teeth (SHED) injected in the root canal of opened-apex human premolars with either recombinant human collagen I (rhC-I) or selfassembling nanofiber (SA) scaffolds. To assess in vitro SHED viability and differentiative potential, non-instrumented roots were set with the apex in culture media. SHED were mixed in rhC-I or SA and injected into canals (n=24, 5X105 cells/mL). Controls were SHED or scaffolds alone. Odontoblastic differentiation markers (DSPP, DMP-1 and MEPE) were assessed weekly by RT-PCR for 28 days. To evaluate odontoblast differentiation and tissue formation in vivo, SHED transduced with GFP were injected in canals (n=8, 106 cells/mL) using same groups and implanted subcutaneously in immunodeficient mice. Positive control (C+) was extracted premolar. Statistic was done with ANOVA (=0.05). Odontoblastic differentiation markers increased in SA and rhC-I but not in controls. Pulp-like tissue growth ( than 60% of root length) was observed in 75% of implants for SA and rhC-I and 0% in controls. GFP staining confirmed SHEDs tissue origin. PCNA staining and TUNEL assay showed high proliferative activity and few apoptotic cells. Tetracycline injections showed newly formed dentin. Microvessel density and odontoblastic-like cell number lining dentin were similar in rhC-I, SA and C+. Injectable scaffolds and SHED allowed for the engineering of a pulp-like tissue and constitute one step forward towards the goal of dental p ulp regeneration in human patients.

O objetivo deste trabalho foi avaliar, por meio de microscopia eletrônica de varredura (MEV), a presença de microrganismos sob a forma de biofilme na região do ápice radicular de dentes decíduos de humanos, com diferentes graus de patologia pulpar e periapical. Dezoito dentes foram selecionados em três situações clínicas específicas: dentes decíduos portadores de vitalidade pulpar (Grupo I), portadores de necrose pulpar sem lesão periapical visível radiograficamente (Grupo II) e portadores de necrose pulpar e nítida lesão periapical visível radiograficamente (Grupo III). Após exodontia, os dentes foram lavados com solução salina e imersos em solução de tripsina a 0,03 g/mL por 20 minutos. A seguir, foram lavados com solução tampão de cacodilato de sódio a 0,1M e armazenados em solução de Karnowsky modificada. Após cinco dias, os dentes foram seccionados e desidratados em soluções crescentes de etanol e submetidos à secagem no ponto crítico, fixados em \"stubs\" e metalizados para análise em MEV. Nos dentes do Grupo I e II, a superfície radicular estava recoberta por fibras colágenas, sem a presença de bactérias, em 100% das amostras. Nos dentes portadores de necrose pulpar e nítida lesão periapical visível radiograficamente (Grupo III), o ápice radicular apresentava ausência de fibras e presença de áreas de reabsorção com microrganismos em seu interior, representados predominantemente por cocos e bacilos, porém filamentosos e espiroquetas também foram observados, em 100% dos casos. Assim, observou-se que houve a presença de microrganismos sob a forma de biofime apical na região do ápice radicular apenas nos dentes decíduos portadores de necrose pulpar e nítida lesão periapical visível radiograficamente. / The purpose of this study was to evaluate, by scanning electron microscopy (SEM), the presence of microorganisms organized as biofilms in the apical root third of vital and nonvital human primary teeth. Eighteen teeth were selected in three clinical situations: Group I - pulp vitality, Group II - pulp necrosis without periapical lesion and Group III - pulp necrosis with well defined radiographically visible periapical lesion. After extraction, the teeth were washed with saline and immersed in 0.03 g/mL trypsin solution during 20 minutes. Next, the teeth were washed in 0,1M sodium cacodilate buffer and stored in receptacles containing modified Karnovsky solution. After 5 days, the teeth were sectioned, dehydrated in an ethanol series, critical-point dried with CO2, sputter-coated with gold and examined by SEM. The results showed that in the teeth of Groups I and II, the root surface was covered by collagen fibers, without the presence of bacteria in all specimens (100%). In the teeth with pulp necrosis with well defined radiographically visible periapical lesion (Group III), the root apex showed no collagen fibers and presence of resorption areas containing microorganisms (cocci, bacilli, filaments and spirochetes) in all cases (100%). The presence of microorganisms organized as biofilms was detected only in the primary teeth with pulp necrosis and radiographically visible periapical lesion.

O sistema Holter é considerado padrão ouro para detecção de arritmias cardíacas, possibilitando o seu diagnóstico e sua relação com os sintomas do paciente. As novas gerações de marcapassos (MP) detectam e registram eletrogramas intracavitários e poderiam dispensar o Holter no seguimento dos pacientes. Os diferentes MP dispõem de algoritmos de detecção de arritmias ventriculares (AV) que variam de acordo com o modelo e sua correlação diagnóstica com Holter foi pouco estudada. O objetivo desse estudo foi avaliar 1. a correlação entre o monitor de eventos dos MP e do Holter na detecção de AV e 2. a concordância das AV detectadas nos dois sistemas. Foram estudados129 pacientes portadores de MP com função de detecção de arritmias, com idade média de 68,6+19.1 anos (entre 19 e 94), 54,8% do sexo feminino. Os pacientes foram submetidos à monitorização com Holter por 72 horas. Assim que o sistema foi ligado, os contadores de eventos dos marcapassos foram reiniciados e os relógios sincronizados, para que ambos os sistemas detectassem os eventos simultaneamente. Os MP foram programados para detecção de eventos com o menor valor de frequência ventricular (FV) e o menor número de batimentos sequenciais (BT) possíveis. Depois de 72 horas, os sistemas Holter foram retirados e os registros analisados, assim como os registros simultâneos dos gravadores dos MP. Foram qualificados como eventos arrítmicos no Holter e MP, respectivamente: EV isoladas e \"PVC\"; extra-sístoles em pares e \"couplets\"; TVNS (> 3BT) e \"triplets\"(3BT), \"runs\"(3 a 8 ou > 8 BT) e \"HVR\" (3 ou 4 BT). As correlações de Spearman foram utilizadas para avaliar se o marcapasso acompanha a detecção dos parâmetros do Holter. Os coeficientes de correlação intraclasse e os respectivos intervalos com 95% de confiança, calculados para avaliar a concordâncias entre os parâmetros equivalentes do marcapasso e do Holter. Foram calculados os coeficientes Kappa para avaliar a concordância na detecção de > 10 \"PVC\"/h com > 10 EV/h. Resultados: Os monitores dos marcapassos subestimaram o Holter. Os registros de \"PVC\", \"triplet\" e \"HVR\" por TVNS apresentaram correlações positivas em relação aos parâmetros do Holter, sendo a mais alta aquela entre \"PVC\" e EV (r=0,501). Porém, a concordância entre os tipos de arritmias detectadas foi baixa (CCI < 0,5), exceção feita à concordância de \"triplet\" com TVNS de três batimentos (CCI=0.984). A concordância na detecção de mais de 10 PVC/h e mais de 10 EV/h foi moderada (kappa= 0,483), embora para os MP da Medtronic, o coeficiente de concordância foi alto (kappa=0.877). Para os MP com algoritmo de detecção de sequências de três batimentos com FV menor que 140bpm ( < 140/3), a correlação entre HVR e TVNS foi expressiva (r = 1), sendo a concordância entre esses parâmetros também bastante alta (CCI = 0,800). Conclusões: A correlação e a concordância na detecção de AV registradas nos MP e no Holter foram inconsistentes. Padronização dos algoritmos de detecção de AV, semelhantes os do sistema Holter, é necessária para que os pacientes portadores de dispositivos implantáveis possam se beneficiar dessa função para seguimento clínico e estratificação de risco / The Holter monitoring is considered the gold standard method for detection of cardiac arrhythmias, enabling its diagnosis and its correlation with the patient\'s symptoms. New generations of artificial pacemakers can detect and record intracavitary electrograms and, theoretically, could discard the Holter during the follow-up of the patients. Pacemakers have different ventricular arrhythmias (VA) detection algorithms, varying according to the model. Their diagnosis capacity comparing to Holter monitoring has been poorly studied. The aim of this study was to evaluate 1. the correlation between the event monitor of the pacemaker and the Holter in VA detection and 2. the agreement between the VA detected in both systems. We studied 129 patients with implanted pacemakers, which had arrhythmia detection function, mean age of 68.6 + 19.1 years (19 to 94), 54.8% female. The patients underwent Holter monitoring for 72 hours. Once the system was connected, event counters of pacemakers were reset and the clocks synchronized, so that both systems could detect the arrhythmic events simultaneously. The pacemakers were programmed to detect events with the lowest ventricular rate and lowest number of sequential beats allowed for each model. After 72 hours, Holter systems were removed and the records analyzed, as well as the simultaneous records of the pacemakers. Were considered as arrhythmic events: PVC isolated (in the pacemaker described as \"PVC\"); premature beats in pairs (pacemaker described as \"couplets\"); NSVT (pacemaker described as \"triplets\"- 3beats, \"runs\"- 4 to 8 or > 8 beats and \"HVR\"- 3 to 4 beats). Spearman rank correlations were used to assess whether the pacemaker and Holter identified the same parameters. The intraclass correlation coefficients and the respective intervals with 95% confidence were calculated to evaluate the concordance between the equivalent parameters of the pacemaker and Holter. Kappa coefficients were calculated to assess the agreement in the detection of > 10 PVC/h by the pacemakers and by the Holter. Results: The pacemakers underestimated the arrhythmias detection of Holter. Records of \"PVC\", \"triplet\" and \"HVR\" by NSVT showed positive correlations with the Holter parameters, and the highest one was among \"PVC\" and EV (r = 0.501). The agreement between the types of arrhythmias detected was quite low (CCI < 0.5), except for \"triplet\" detected by pacemakers and three beats NSVT by Holter (ICC = 0.984). The correlation detection for more than 10 PVC /h was moderate (kappa = 0.483), except for Medtronic pacemakers (kappa=0.877). When the pacemaker was programmed to detect sequences of three beats with heart rate lower than 140bpm ( < 140/3), the correlation between HVR and NSVT was perfect (r = 1) and the agreement between these parameters was also quite high (ICC = 0.800). Conclusions: The correlation and agreement between pacemakers and Holter monitoring in the detection of VA were not consistent. A standardization of the pacemakers\' detection algorithms is necessary before using this function for clinical follow-up and risk stratification of the patients

År 2014 kom en ny lag gällande arbetet med extra anpassningar. I lagen tydliggörs den undervisande pedagogens skyldighet att sätta in extra anpassningar i ett skede där eleven inte ses nå målen. Ändringen i skollagen har medfört direkta och indirekta effekter på arbetet med extra anpassningar inom skolor i Sverige. Utifrån ramfaktorteorin såsom den skrivs fram av Dahllöf och Skritics teori om byråkratiska och adhocratiska organisationer var syftet med studien att undersöka olika professioners syn på arbetet kring extra anpassningar inom skolan som organisation. Utifrån en fenomenologisk kvalitativ intervjustudie med åtta deltagare fick vi några rektorers, lärares, speciallärares och specialpedagogers samt specialpedagogstudenters syn på fenomenet extra anpassningar sett utifrån den egna professionen. Resultaten tolkades mot bakgrund av Skrtics teori om att specialpedagogiska system kan uppstå inom skolan som organisation trots skollagens intention om inkluderande och tillgängliga lärmiljöer för alla elever inom skolan. Resultaten visade att medvetenheten och kännedomen om extra anpassningar som begrepp och fenomen kändes till av samtliga deltagare och att lagändringen år 2014 påverkade deltagarnas syn på sitt arbete med extra anpassningar. Deltagarnas olika syn på att organisera och leda arbetet med extra anpassningar tydde på att lagändringen tolkades olika beroende på profession och skola.

Trinta novos membros de Tc85 (superfamília das gp85/trans-sialidases) foram clonados e seqüenciados (30-90% identidade), mostrando um intenso polimorfismo entre os genes e levantando a hipótese de que a família possui propriedades multi-adesivas, que garantem ao Trypanosoma cruzi sucesso na invasão. Para verificar os distintos padrões de interação de diferentes membros de Tc85, duas proteínas recombinantes, Tc85-12r e Tc85-45r, foram testadas frente à matriz extracelular (MEC) e células LLC-MK2. As duas proteínas ligam-se dose-dependentemente à MEC imobilizada e apresentam ligação em laminina e fibronectina. Também foi observado um ligante de 60kDa, não identificado, de ambas Tc85 na MEC. Ensaios de ligação destas proteínas à células LLC-MK2 mostram que Tc85-45r têm ligação maior que Tc85-12r. Se a ligação é inibida com o tripeptídeo RGD, (presente somente na seqüência de Tc85-45r) observamos uma redução de 98% na adesão de Tc85-45r em LLC-MK2 contra 60% em Tc85-12r. No ensaio de invasão de tripomastigotas em LLC-MK2, RGD exógeno e Tc85-45r foram as que mais contribuiram para a inibição da invasão, mostrando a importância de RGD. Os resultados ressaltam as diferenças em motivos de adesão putativos e a capacidade de ligação de proteínas recombinantes tanto em célula hospedeira quanto em MEC, que podem ser importantes para o parasita durante a colonização do hospedeiro. / Thirty new members of Tc85 (gp85/transialidases supergene family) were cloned and sequenced (30-90% of identity), showing an intense polimorfism between the genes and raising the hypothesis that the family has multi-adhesive properties that assures the success of the invasion process of Trypanosoma cruzi. Two recombinants proteins, Tc85-12r and Tc85-45r, were assayed in order to verify the distinctive patterns of interaction between different members of Tc85 and extra cellular matrix (ECM) or LLC-MK2 cells. Both proteins exhibit a dose-dependent binding to immobilized ECM, laminin and fibronectin. We also noticed an unidentified 60 kDa ligand in the ECM that can bind to both Tc85. Binding assays of both proteins to LLC-MK2 cells show that Tc85-45r exhibit a higher number of bound cells at the saturation point than Tc85-12r. If the binding is inhibited with the RGD tripeptide (present just in Tc85-45r sequence), there is a 98% reduction of LLC-MK2 cells adhesion to Tc85-45r against a 60% reduction of adhesion to Tc85-12r. The tripomastigotes invasion to LLC-MK2 assay showed that both exogenous RGD and Tc85-45r were the most efficient inhibitors in the process thus confirming the importance of RGD. The results point out the difference between putative adhesion motifs and the recombinants proteins binding capacity to host cells and ECM, two characteristics that might be important to the parasite during the host colonization.