Classification of the severity of diabetic neuropathy: a new approach taking uncertainties into account using fuzzy logic

OBJECTIVE: This study proposes a new approach that considers uncertainty in predicting and quantifying the presence and severity of diabetic peripheral neuropathy. METHODS: A rule-based fuzzy expert system was designed by four experts in diabetic neuropathy. The model variables were used to classify neuropathy in diabetic patients, defining it as mild, moderate, or severe. System performance was evaluated by means of the Kappa agreement measure, comparing the results of the model with those generated by the experts in an assessment of 50 patients. Accuracy was evaluated by an ROC curve analysis obtained based on 50 other cases; the results of those clinical assessments were considered to be the gold standard. RESULTS: According to the Kappa analysis, the model was in moderate agreement with expert opinions. The ROC analysis (evaluation of accuracy) determined an area under the curve equal to 0.91, demonstrating very good consistency in classifying patients with diabetic neuropathy. CONCLUSION: The model efficiently classified diabetic patients with different degrees of neuropathy severity. In addition, the model provides a way to quantify diabetic neuropathy severity and allows a more accurate patient condition assessment.

Global interannual trends and amplitude modulations of the sea surface height anomaly from the TOPEX/Jason-1 altimeters

This study uses the global Ocean Topography Experiment (TOPEX)/Jason-1 altimeters` time series to estimate the 13-yr trend in sea surface height anomaly. These trends are estimated at each grid point by two methods: one fits a straight line to the time series and the other is based on the difference between the average height between the two halves of the time series. In both cases the trend shows large regional variability, mostly where the intense western boundary currents turn. The authors hypothesize that the regional variability of the sea surface height trends leads to changes in the local geostrophic transport. This in turn affects the instability-related processes that generate mesoscale eddies and enhances the Rossby wave signals. This hypothesis is verified by estimates of the trend of the amplitude of the filtered sea surface height anomaly that contains the spectral bands associated with Rossby waves and mesoscale eddies. The authors found predominantly positive tendency in the amplitude of Rossby waves and eddies, which suggests that, on average, these events are becoming more energetic. In some regions, the variation in amplitude over 13 yr is comparable to the standard deviation of the data and is statistically significant according to both methods employed in this study. It is plausible that in this case, the energy is transferred from the mean currents to the waves and eddies through barotropic and baroclinic instability processes that are more pronounced in the western boundary current extension regions. If these heat storage patterns and trends are confirmed on longer time series, then it will be justified to argue that the warming trend of the last century provides the energy that amplifies both Rossby waves and mesoscale eddies.

The State as Part of the Republic

The State as Part of the Republic The main objective of this article is to analyze an ideal of civic life, the Republic, based on the form of the sovereign state. Historically, the convergence between Republic and sovereign state has been truncated by the former's commitment to the thesis of royal absolutism. However, as the democratic issue (translated in the values of equality and pluralism) was absorbed by sovereignism, such convergence became more plausible. As viewed in this article, the theoretical bridge of that passage is the concept of political representation. The issue is thus to show in what way a certain vision of the political form (that of the state) can fit into a theory of political representation that contemplates the above-mentioned values.

Ontogenetic and evolutionary change of external morphology of the neotropical shrimp potimirim (Holthuis, 1954) explained by a molecular phylogeny of the genus

A phylogenetic analysis of a fragment of the mitochondrial gene 16S was used to test the monophyletic status of Potimirim. Existing doubts on the taxonomic status of brasiliana (once P glabra) and P potimirim (once P mexicana) were clarified. Potimirim mexicana and P potimirim are distinct species according to molecular data and appendix masculina morphology. A new species (Potimirim sp. 1) from Puerto Rico was revealed with molecular data, and it is evolutionarily related to P potimirim and P mexicana according to our analysis. We found out three distinct species under the name P glabra. Then, we recommend the application of the name P glabra for the populations of the Pacific slope of Central America and revalidation of P brasiliana for the Brazilian ones. The need for a new name to those "P glabra" of the Caribbean is highlighted, and it was provisionally referred as Potimirim sp. 2. The ontogenetic (juveniles to adults) development of the appendix masculina of P brasiliana was observed and compared to the other species of Potimirim (adults). In the light of our phylogenetic hypothesis, we postulate a pattern of character addition for the evolution of the appendix masculina of Potimirim. This hypothesis is plausible for two key reasons. First. Potimirim is a monophyletic group according to our hypothesis. Second, the shape of appendix masculina found in adults of P. americana is similar and comparable to those found in the earliest juvenile stages of P brasiliana, a derived species according to our phylogeny (P americana, ((P mexicana, Potimirim sp. 1. P potimirim), (P glabra, (brasiliana, Potimirim sp. 2)))). As so, the basal P americana retain the ancestral morphological state of the appendix masculina when compared to the other species of Potimirim. In our interpretation the ontogeny of the appendix masculina recapitulated the proposed phylogeny, giving further support to it.

Multi-criteria analysis in the strategic environmental assessment of the sugar and alcohol sector

The Strategic Environmental Assessment (SEA) of the sugar and alcohol sector guides a territorial and sectoral planning that benefits most of the local society and supports this economic activity in all its stages. In this way, the present work aims to determine an index of aggregation of the indicators generated in the baseline of the SEA process, called Index of Sustainability of Expansion of the Sugar and Alcohol Sector (IScana). For this, it was used the normalization of the indicators of each city by the fuzzy logic and attribution of weights by the Analytic Hierarchy Process (AHP). Then, the IScana values had been spatialized in the region of 'Grande Dourados'-Mato Grosso do Sul State. The northern portion concentrated the highest values of IScana, 0.48 and 0.55, referring to the cities of Nova Alvorada do Sul and Rio Brilhante, while, in the central portion, the city of Dourados presented the lowest value, 0.10. The selection of the set of indicators forming the IScana, and their relative importance, was satisfactory for the application of fuzzy logic and AHP techniques. The IScana index supplies objective information regarding the diagnosis of the region for the application of SEA.