52 resultados para Global Perception of Improvement


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Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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In this paper by using the Poincare compactification in R(3) make a global analysis of the Rabinovich system(x) over dot = hy - v(1)x + yz, (y) over dot = hx - v(2)y - xz, (z) over dot = -v(3)z + xy,with (x, y, z) is an element of R(3) and ( h, v(1), v(2), v(3)) is an element of R(4). We give the complete description of its dynamics on the sphere at infinity. For ten sets of the parameter values the system has either first integrals or invariants. For these ten sets we provide the global phase portrait of the Rabinovich system in the Poincare ball (i.e. in the compactification of R(3) with the sphere S(2) of the infinity). We prove that for convenient values of the parameters the system has two families of singularly degenerate heteroclinic cycles. Then changing slightly the parameters we numerically found a four wings butterfly shaped strange attractor.

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This article aims to analyze the impact of domestic politics and international changes that influence Brazilian positions regarding regional integration processes in South America, particularly the Southern Common Market, Mercosur. The dynamics of the international system and their impact on the evolution of the elite's perception of the role the country should play in the world are important variables for understanding these positions. The state's postures in relation to integration were and are based on a real interest, but this interest is also linked with the objective of ensuring better conditions for participation in other international arenas. Starting with the hypothesis that transformations in the international setting have strongly influenced Brazil's positioning, the elements of continuity and change in the country's behavior toward Mercosur are identified, with domestic politics as the main explanation.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coprological examination was used to estimate the prevalence of gastrointestinal parasites in stray and domiciled dogs from Botucatu, São Paulo State, Brazil. Risk factors for dog infection were assessed in relation to demographic, husbandry and management data. The dog owners completed a questionnaire survey on some aspects of dog parasitism such as parasite species, mechanisms of infection, awareness of zoonotic diseases and history of anthelmintic usage. Parasites were found in the faeces of 138 dogs, with an overall prevalence of 54.3%. Dogs harbouring one parasite were more common (31.4%) than those harbouring two (18.5%), three (3.2%) or four (1.2%). The following parasites and their respective frequencies were detected: Ancylostoma (37.8%), Giardia (16.9%), Toxocara canis (8.7%), Trichuris vulpis (7.1%), Dipylidium caninum (2.4%), Isospora (3.5%), Cryptosporidium (3.1%) and Sarcocystis (2.7%). Stray dogs were found more likely to be poliparasitized (P < 0.01) and presented higher prevalence of Ancylostoma, T. canis and Giardia (P < 0.01) than domiciled ones. Toxocara canis was detected more frequently in dogs with < 6 months of age (P < 0.05) and no effect of sex or breed could be observed (P > 0.05). Except for Ancylostoma, that showed a significantly higher prevalence in dogs living in a multi-dog household (P < 0.01), parasite prevalences were similar in single- and multi-dog household. The answers of dog owners to the questionnaire showed that the majority does not know the species of dog intestinal parasites, the mechanisms of transmission, the risk factors for zoonotic infections, and specific prophylactic measures. The predominance of zoonotic species in dogs in the studied region, associated with the elevated degree of misinformation of the owners, indicates that the risk of zoonotic infection by canine intestinal parasite may be high, even in one of the most developed regions of Brazil.

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The worldwide decline in amphibians has been attributed to several causes, especially habitat loss and disease. We identified a further factor, namely habitat split- defined as human- induced disconnection between habitats used by different life history stages of a species- which forces forest- associated amphibians with aquatic larvae to make risky breeding migrations between suitable aquatic and terrestrial habitats. In the Brazilian Atlantic Forest, we found that habitat split negatively affects the richness of species with aquatic larvae but not the richness of species with terrestrial development ( the latter can complete their life cycle inside forest remnants). This mechanism helps to explain why species with aquatic larvae have the highest incidence of population decline. These findings reinforce the need for the conservation and restoration of riparian vegetation.

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A novel common Tabu algorithm for global optimizations of engineering problems is presented. The robustness and efficiency of the presented method are evaluated by using standard mathematical functions and hy solving a practical engineering problem. The numerical results show that the proposed method is (i) superior to the conventional Tabu search algorithm in robustness, and (ii) superior to the simulated annealing algorithm in efficiency. (C) 2001 Elsevier B.V. B.V. All rights reserved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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What can we learn from solar neutrino observations? Is there any solution to the solar neutrino anomaly which is favored by the present experimental panorama? After SNO results, is it possible to affirm that neutrinos have mass? In order to answer such questions we analyze the current available data from the solar neutrino experiments, including the recent SNO result, in view of many acceptable solutions to the solar neutrino problem based on different conversion mechanisms, for the first time using the same statistical procedure. This allows us to do a direct comparison of the goodness of the fit among different solutions, from which we can discuss and conclude on the current status of each proposed dynamical mechanism. These solutions are based on different assumptions: (a) neutrino mass and mixing, (b) a nonvanishing neutrino magnetic moment, (c) the existence of nonstandard flavor-changing and nonuniversal neutrino interactions, and (d) a tiny violation of the equivalence principle. We investigate the quality of the fit provided by each one of these solutions not only to the total rate measured by all the solar neutrino experiments but also to the recoil electron energy spectrum measured at different zenith angles by the Super-Kamiokande Collaboration. We conclude that several nonstandard neutrino flavor conversion mechanisms provide a very good fit to the experimental data which is comparable with (or even slightly better than) the most famous solution to the solar neutrino anomaly based on the neutrino oscillation induced by mass.

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We review the work done by our group on cosmic topology. It ranges from early atempts to solve a famous controversy about quasars thought the multiplicity of images, to quantum cosmology in this context and an application to QED renormalization.