Smart Alerts: Development of Software to Optimize Data Monitoring

Dherte PM, Negrao MPG, Mori Neto S, Holzhacker R, Shimada V, Taberner P, Carmona MJC - Smart Alerts: Development of a Software to Optimize Data Monitoring. Background and objectives: Monitoring is useful for vital follow-ups and prevention, diagnosis, and treatment of several events in anesthesia. Although alarms can be useful in monitoring they can cause dangerous user`s desensitization. The objective of this study was to describe the development of specific software to integrate intraoperative monitoring parameters generating ""smart alerts"" that can help decision making, besides indicating possible diagnosis and treatment. Methods: A system that allowed flexibility in the definition of alerts, combining individual alarms of the parameters monitored to generate a more elaborated alert system was designed. After investigating a set of smart alerts, considered relevant in the surgical environment, a prototype was designed and evaluated, and additional suggestions were implemented in the final product. To verify the occurrence of smart alerts, the system underwent testing with data previously obtained during intraoperative monitoring of 64 patients. The system allows continuous analysis of monitored parameters, verifying the occurrence of smart alerts defined in the user interface. Results: With this system a potential 92% reduction in alarms was observed. We observed that in most situations that did not generate alerts individual alarms did not represent risk to the patient. Conclusions: Implementation of software can allow integration of the data monitored and generate information, such as possible diagnosis or interventions. An expressive potential reduction in the amount of alarms during surgery was observed. Information displayed by the system can be oftentimes more useful than analysis of isolated parameters.

Simple telemedicine for developing regions: Camera phones and paper-based microfluidic devices for real-time, off-site diagnosis

This article describes a prototype system for quantifying bioassays and for exchanging the results of the assays digitally with physicians located off-site. The system uses paper-based microfluidic devices for running multiple assays simultaneously, camera phones or portable scanners for digitizing the intensity of color associated with each colorimetric assay, and established communications infrastructure for transferring the digital information from the assay site to an off-site laboratory for analysis by a trained medical professional; the diagnosis then can be returned directly to the healthcare provider in the field. The microfluidic devices were fabricated in paper using photolithography and were functionalized with reagents for colorimetric assays. The results of the assays were quantified by comparing the intensities of the color developed in each assay with those of calibration curves. An example of this system quantified clinically relevant concentrations of glucose and protein in artificial urine. The combination of patterned paper, a portable method for obtaining digital images, and a method for exchanging results of the assays with off-site diagnosticians offers new opportunities for inexpensive monitoring of health, especially in situations that require physicians to travel to patients (e.g., in the developing world, in emergency management, and during field operations by the military) to obtain diagnostic information that might be obtained more effectively by less valuable personnel.

Acessibilidade em ambiente universitário: identificação de barreiras arquitetônicas no campus da USP de Bauru

A acessibilidade é um direito do cidadão assegurado por lei para que portadores de deficiência tenham a possibilidade de usufruir de recursos e ações no âmbito social. Barreiras arquitetônicas interferem na vida destes podendo deixá-los a parte da convivência e vida social. Os objetivos deste estudo foram: identificar, descrever e mapear barreiras físicas no Campus da Universidade de São Paulo de Bauru e apresentar as intervenções realizadas, durante o período de outubro de 2001 a dezembro de 2005. O estudo foi descritivo-quantitativo, no qual a coleta de dados centrou-se na análise das condições arquitetônicas das três unidades que compõe este campus, observada as normativas da Associação Brasileira de Normas técnicas e realizada intervenções. Foram identificados: 72 pontos de guias não rebaixadas, 21 pontos de acessos com diferenças de níveis sem rampas; 220m² de escadas/rampas sem corrimãos; 658m² de escadas/rampas com corrimãos em discordância com as normas vigentes; 03 rampas com inclinações superiores às determinadas nas normas técnicas; 10 banheiros parcialmente adaptados para deficientes; 02 vagas de estacionamento parcialmente adaptadas e 02 elevadores existentes. Foram executados, em 19 pontos, rebaixamentos de guias, somando 115 m², com linhas de piso tátil, pintados; 8 rampas; 14 pontos de escadas e rampas externas instaladas com corrimãos e guarda-corpos, 5 vagas exclusivas no estacionamento; instalado 2 centrais de atendimento telefônico para surdo e adquiridas 3 cadeira de rodas. As intervenções realizadas contribuíram para melhorar a acessibilidade de portadores de deficiência no campus favorecendo a utilização dos recursos existentes neste espaço público.

A feasibility study of cell phone and landline phone interviews for monitoring of risk and protection factors for chronic diseases in Brazil

The study objective was to evaluate the feasibility of interviews by cell phone as a complement to interviews by landline to estimate risk and protection factors for chronic non-communicable diseases. Adult cell phone users were evaluated by random digit dialing. Questions asked were: age, sex, education, race, marital status, ownership of landline and cell phones, health condition, weight and height, medical diagnosis of hypertension and diabetes, physical activity, diet, binge drinking and smoking. The estimates were calculated using post-stratification weights. The cell phone interview system showed a reduced capacity to reach elderly and low educated populations. The estimates of the risk and protection factors for chronic non-communicable diseases in cell phone interviews were equal to the estimates obtained by landline phone. Eligibility, success and refusal rates using the cell phone system were lower than those of the landline system, but loss and cost were much higher, suggesting it is unsatisfactory as a complementary method in such a context.

Hábitos relacionados ao descarte pós-consumo de aparelhos e baterias de telefones celulares em uma comunidade acadêmica

Cada vez mais a sociedade contemporânea incorpora em seu cotidiano equipamentos elétricos e eletrônicos, muitos deles contendo substâncias perigosas, que representam ameaças ao meio ambiente e riscos à saúde humana. Este artigo apresenta os resultados de uma pesquisa exploratória com o objetivo de relacionar comportamento de descarte pós-consumo de aparelhos e baterias de celulares, em um grupo de consumidores de telefonia móvel, que tem proximidade em seu cotidiano de trabalho e de estudo com informações sobre saúde pública e ambiental. Os resultados da pesquisa indicam que informação pode aproximar as pessoas do problema, porém não levam por si só à produção de alterações significativas sobre o que e como fazer com o descarte pós-consumo. Os participantes do estudo possibilitaram identificar, que além da informação e acesso a coletores específicos, outros aspectos e critérios pessoais ou coletivos interferem no procedimento de descarte: percepção sobre risco, valor econômico disponibilizado na compra do aparelho e vínculos afetivos, entre outros. Esses fatores podem produzir diferentes respostas dos usuários sobre como lidar com as inovações tecnológicas de uso pessoal.

PARALLAXES OF SOUTHERN EXTREMELY COOL OBJECTS. I. TARGETS, PROPER MOTIONS, AND FIRST RESULTS

We present results from the PARallaxes of Southern Extremely Cool objects ( PARSEC) program, an observational program begun in 2007 April to determine parallaxes for 122 L and 28 T southern hemisphere dwarfs using the Wide Field Imager on the ESO 2.2 m telescope. The results presented here include parallaxes of 10 targets from observations over 18 months and a first version proper motion catalog. The proper motions were obtained by combining PARSEC observations astrometrically reduced with respect to the Second US Naval Observatory CCD Astrograph Catalog, and the Two Micron All Sky Survey Point Source Catalog. The resulting median proper motion precision is 5 mas yr(-1) for 195,700 sources. The 140 0.3 deg(2) fields sample the southern hemisphere in an unbiased fashion with the exception of the galactic plane due to the small number of targets in that region. The proper motion distributions are shown to be statistically well behaved. External comparisons are also fully consistent. We will continue to update this catalog until the end of the program, and we plan to improve it including also observations from the GSC2.3 database. We present preliminary parallaxes with a 4.2 mas median precision for 10 brown dwarfs, two of which are within 10 pc. These increase the present number of L dwarfs by 20% with published parallaxes. Of the 10 targets, seven have been previously discussed in the literature: two were thought to be binary, but the PARSEC observations show them to be single; one has been confirmed as a binary companion and another has been found to be part of a binary system, both of which will make good benchmark systems. These results confirm that the foreseen precision of PARSEC can be achieved and that the large field of view will allow us to identify wide binary systems. Observations for the PARSEC program will end in early 2011 providing three to four years of coverage for all targets. The main expected outputs are: more than a 100% increase in the number of L dwarfs with parallaxes, increment in the number of objects per spectral subclass up to L9-in conjunction with published results-to at least 10, and to put sensible limits on the general binary fraction of brown dwarfs. We aim to contribute significantly to the understanding of the faint end of the H-R diagram and of the L/T transition region.

Search for Lorentz Invariance and CPT Violation with the MINOS Far Detector

We searched for a sidereal modulation in the MINOS far detector neutrino rate. Such a signal would be a consequence of Lorentz and CPT violation as described by the standard-model extension framework. It also would be the first detection of a perturbative effect to conventional neutrino mass oscillations. We found no evidence for this sidereal signature, and the upper limits placed on the magnitudes of the Lorentz and CPT violating coefficients describing the theory are an improvement by factors of 20-510 over the current best limits found by using the MINOS near detector.

New constraints on muon-neutrino to electron-neutrino transitions in MINOS

This paper reports results from a search for nu(mu) -> nu(e) transitions by the MINOS experiment based on a 7 x 10(20) protons-on-target exposure. Our observation of 54 candidate nu(e) events in the far detector with a background of 49.1 +/- 7.0(stat) +/- 2.7(syst) events predicted by the measurements in the near detector requires 2sin(2)(2 theta(13))sin(2)theta(23) < 0.12(0.20) at the 90% C.L. for the normal (inverted) mass hierarchy at delta(CP) = 0. The experiment sets the tightest limits to date on the value of theta(13) for nearly all values of delta(CP) for the normal neutrino mass hierarchy and maximal sin(2)(2 theta(23)).

Neutrino and antineutrino inclusive charged-current cross section measurements with the MINOS near detector

The energy dependence of the neutrino-iron and antineutrino-iron inclusive charged-current cross sections and their ratio have been measured using a high-statistics sample with the MINOS near detector exposed to the NuMI beam from the main injector at Fermilab. Neutrino and antineutrino fluxes were determined using a low hadronic energy subsample of charged-current events. We report measurements of nu-Fe ((nu) over bar - Fe) cross section in the energy range 3-50 GeV (5-50 GeV) with precision of 2%-8% (3%-9%) and their ratio which is measured with precision 2%-8%. The data set spans the region from low energy, where accurate measurements are sparse, up to the high-energy scaling region where the cross section is well understood.

Search for sterile neutrino mixing in the MINOS long-baseline experiment

A search for depletion of the combined flux of active neutrino species over a 735 km baseline is reported using neutral-current interaction data recorded by the MINOS detectors in the NuMI neutrino beam. Such a depletion is not expected according to conventional interpretations of neutrino oscillation data involving the three known neutrino flavors. A depletion would be a signature of oscillations or decay to postulated noninteracting sterile neutrinos, scenarios not ruled out by existing data. From an exposure of 3.18 x 10(20) protons on target in which neutrinos of energies between similar to 500 MeV and 120 GeV are produced predominantly as nu(mu), the visible energy spectrum of candidate neutral-current reactions in the MINOS far detector is reconstructed. Comparison of this spectrum to that inferred from a similarly selected near-detector sample shows that of the portion of the nu(mu) flux observed to disappear in charged-current interaction data, the fraction that could be converting to a sterile state is less than 52% at 90% confidence level (C. L.). The hypothesis that active neutrinos mix with a single sterile neutrino via oscillations is tested by fitting the data to various models. In the particular four-neutrino models considered, the mixing angles theta(24) and theta(34) are constrained to be less than 11 degrees and 56 degrees at 90% C. L., respectively. The possibility that active neutrinos may decay to sterile neutrinos is also investigated. Pure neutrino decay without oscillations is ruled out at 5.4 standard deviations. For the scenario in which active neutrinos decay into sterile states concurrently with neutrino oscillations, a lower limit is established for the neutrino decay lifetime tau(3)/m(3) > 2.1 x 10(-12) s/eV at 90% C.L.

Observation of muon intensity variations by season with the MINOS far detector

The temperature of the upper atmosphere affects the height of primary cosmic ray interactions and the production of high-energy cosmic ray muons which can be detected deep underground. The MINOS far detector at Soudan, MN, has collected over 67 X 10(6) cosmic ray induced muons. The underground muon rate measured over a period of five years exhibits a 4% peak-to-peak seasonal variation which is highly correlated with the temperature in the upper atmosphere. The coefficient, alpha(T), relating changes in the muon rate to changes in atmospheric temperature was found to be alpha(T) 0: 873 +/- 0: 009(stat) +/- 0.010(syst). Pions and kaons in the primary hadronic interactions of cosmic rays in the atmosphere contribute differently to alpha(T) due to the different masses and lifetimes. This allows the measured value of alpha(T) to be interpreted as a measurement of the K/pi ratio for E(p) greater than or similar to 7 TeV of 0.12(-0.05)(+0.07), consistent with the expectation from collider experiments.

Search for Muon-Neutrino to Electron-Neutrino Transitions in MINOS

This Letter reports on a search for nu(mu)->nu(e) transitions by the MINOS experiment based on a 3.14x10(20) protons-on-target exposure in the Fermilab NuMI beam. We observe 35 events in the Far Detector with a background of 27 +/- 5(stat)+/- 2(syst) events predicted by the measurements in the Near Detector. If interpreted in terms of nu(mu)->nu(e) oscillations, this 1.5 sigma excess of events is consistent with sin(2)(2 theta(13)) comparable to the CHOOZ limit when |Delta m(2)|=2.43x10(-3) eV(2) and sin(2)(2 theta(23))=1.0 are assumed.

Search for Active Neutrino Disappearance Using Neutral-Current Interactions in the MINOS Long-Baseline Experiment

We report the first detailed comparisons of the rates and spectra of neutral-current neutrino interactions at two widely separated locations. A depletion in the rate at the far site would indicate mixing between nu(mu) and a sterile particle. No anomalous depletion in the reconstructed energy spectrum is observed. Assuming oscillations occur at a single mass-squared splitting, a fit to the neutral- and charged-current energy spectra limits the fraction of nu(mu) oscillating to a sterile neutrino to be below 0.68 at 90% confidence level. A less stringent limit due to a possible contribution to the measured neutral-current event rate at the far site from nu(e) appearance at the current experimental limit is also presented.

Testing Lorentz Invariance and CPT Conservation with NuMI Neutrinos in the MINOS Near Detector

A search for a sidereal modulation in the MINOS near detector neutrino data was performed. If present, this signature could be a consequence of Lorentz and CPT violation as predicted by the effective field theory called the standard-model extension. No evidence for a sidereal signal in the data set was found, implying that there is no significant change in neutrino propagation that depends on the direction of the neutrino beam in a sun-centered inertial frame. Upper limits on the magnitudes of the Lorentz and CPT violating terms in the standard-model extension lie between 10(-4) and 10(-2) of the maximum expected, assuming a suppression of these signatures by a factor of 10(-17).

Measurement of neutrino oscillations with the MINOS detectors in the NuMI beam

This Letter reports new results from the MINOS experiment based on a two-year exposure to muon neutrinos from the Fermilab NuMI beam. Our data are consistent with quantum-mechanical oscillations of neutrino flavor with mass splitting vertical bar Delta m(2)vertical bar = (2.43 +/- 0.13) x 10(-3) eV(2) (68% C.L.) and mixing angle sin(2)(2 theta) > 0.90 (90% C.L.). Our data disfavor two alternative explanations for the disappearance of neutrinos in flight: namely, neutrino decays into lighter particles and quantum decoherence of neutrinos, at the 3.7 and 5.7 standard-deviation levels, respectively.