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.

Violência sexual como questão de saúde pública: importância da busca ao agressor

Apesar de predominar junto à população a idéia de que a violência sexual é praticada por pessoas desconhecidas, na realidade a maioria desses crimes é praticada por pessoa identificável pela vítima. Além de conseqüências físicas e psicológicas, também há risco em adquirir o vírus HIV. Para prevenção deste, em situação de risco, há orientação para uso da quimioprofilaxia anti-retroviral. Esse uso, por 28 dias, pode trazer efeitos adversos com intensidades variáveis. O conhecimento da sorologia anti-HIV do agressor torna-se fundamental para manter, ou suspender, com segurança, essa indicação. Este estudo descritivo, realizado no Conjunto Hospitalar de Sorocaba, teve como objetivo identificar os agressores e suas respectivas sorologias. Foi realizado a partir de fichas de notificação e os prontuários no período de julho de 2003 a dezembro de 2005. Encontraram-se 920 vítimas de violência sexual, com idades entre oito meses e 77 anos, havendo predomínio do sexo feminino (86,5 por cento). Dentre os agressores, 76 por cento foram referidos como identificáveis. Indicou-se profilaxia anti-retroviral para 24,9 por cento das vítimas. Para 80 (33,2 por cento) agressores localizados, a busca foi realizada através de contato telefônico. Encontrou-se 52,5 por cento em seus domicílios, 45 por cento em Presídio/Delegacia e 2,5 por cento no Pronto Socorro. Um agressor (1,3 por cento) apresentou sorologia positiva para HIV. As buscas encerraram-se, em sua maioria, em até seis dias (80 por cento), possibilitando a suspensão da quimioprofilaxia em 30,6 por cento dos casos. Concluiu-se que a busca ao denunciado permitiu conhecer sua sorologia anti-HIV e suspender, para um terço das vítimas, o uso da quimioprofilaxia anti-retroviral, diminuindo, com isso, a possibilidade de efeitos adversos

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.

Stimuli-responsive magnetic particles for biomedical applications

In recent years, magnetic nanoparticles have been studied due to their potential applications as magnetic carriers in biomedical area. These materials have been increasingly exploited as efficient delivery vectors, leading to opportunities of use as magnetic resonance imaging (MRI) agents, mediators of hyperthermia cancer treatment and in targeted therapies. Much attention has been also focused on ""smart"" polymers, which are able to respond to environmental changes, such as changes in the temperature and pH. In this context, this article reviews the state-of-the art in stimuli-responsive magnetic systems for biomedical applications. The paper describes different types of stimuli-sensitive systems, mainly temperature- and pH sensitive polymers, the combination of this characteristic with magnetic properties and, finally, it gives an account of their preparation methods. The article also discusses the main in vivo biomedical applications of such materials. A survey of the recent literature on various stimuli-responsive magnetic gels in biomedical applications is also included. (C) 2010 Elsevier B.V. All rights reserved.

Modeling and analysis of laminate composite plates with embedded active-passive piezoelectric networks

The objective of this work is to present the finite element modeling of laminate composite plates with embedded piezoelectric patches or layers that are then connected to active-passive resonant shunt circuits, composed of resistance, inductance and voltage source. Applications to passive vibration control and active control authority enhancement are also presented and discussed. The finite element model is based on an equivalent single layer theory combined with a third-order shear deformation theory. A stress-voltage electromechanical model is considered for the piezoelectric materials fully coupled to the electrical circuits. To this end, the electrical circuit equations are also included in the variational formulation. Hence, conservation of charge and full electromechanical coupling are guaranteed. The formulation results in a coupled finite element model with mechanical (displacements) and electrical (charges at electrodes) degrees of freedom. For a Graphite-Epoxy (Carbon-Fibre Reinforced) laminate composite plate, a parametric analysis is performed to evaluate optimal locations along the plate plane (xy) and thickness (z) that maximize the effective modal electromechanical coupling coefficient. Then, the passive vibration control performance is evaluated for a network of optimally located shunted piezoelectric patches embedded in the plate, through the design of resistance and inductance values of each circuit, to reduce the vibration amplitude of the first four vibration modes. A vibration amplitude reduction of at least 10 dB for all vibration modes was observed. Then, an analysis of the control authority enhancement due to the resonant shunt circuit, when the piezoelectric patches are used as actuators, is performed. It is shown that the control authority can indeed be improved near a selected resonance even with multiple pairs of piezoelectric patches and active-passive circuits acting simultaneously. (C) 2010 Elsevier Ltd. All rights reserved.

Optimization of modal filters based on arrays of piezoelectric sensors

Modal filters may be obtained by a properly designed weighted sum of the output signals of an array of sensors distributed on the host structure. Although several research groups have been interested in techniques for designing and implementing modal filters based on a given array of sensors, the effect of the array topology on the effectiveness of the modal filter has received much less attention. In particular, it is known that some parameters, such as size, shape and location of a sensor, are very important in determining the observability of a vibration mode. Hence, this paper presents a methodology for the topological optimization of an array of sensors in order to maximize the effectiveness of a set of selected modal filters. This is done using a genetic algorithm optimization technique for the selection of 12 piezoceramic sensors from an array of 36 piezoceramic sensors regularly distributed on an aluminum plate, which maximize the filtering performance, over a given frequency range, of a set of modal filters, each one aiming to isolate one of the first vibration modes. The vectors of the weighting coefficients for each modal filter are evaluated using QR decomposition of the complex frequency response function matrix. Results show that the array topology is not very important for lower frequencies but it greatly affects the filter effectiveness for higher frequencies. Therefore, it is possible to improve the effectiveness and frequency range of a set of modal filters by optimizing the topology of an array of sensors. Indeed, using 12 properly located piezoceramic sensors bonded on an aluminum plate it is shown that the frequency range of a set of modal filters may be enlarged by 25-50%.