28 resultados para organizing purposes
em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.
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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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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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This paper presents the principal results of a detailed study about the use of the Meaningful Fractal Fuzzy Dimension measure in the problem in determining adequately the topological dimension of output space of a Self-Organizing Map. This fractal measure is conceived by combining the Fractals Theory and Fuzzy Approximate Reasoning. In this work this measure was applied on the dataset in order to obtain a priori knowledge, which is used to support the decision making about the SOM output space design. Several maps were designed with this approach and their evaluations are discussed here.
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This paper presents a technique for oriented texture classification which is based on the Hough transform and Kohonen's neural network model. In this technique, oriented texture features are extracted from the Hough space by means of two distinct strategies. While the first operates on a non-uniformly sampled Hough space, the second concentrates on the peaks produced in the Hough space. The described technique gives good results for the classification of oriented textures, a common phenomenon in nature underlying an important class of images. Experimental results are presented to demonstrate the performance of the new technique in comparison, with an implemented technique based on Gabor filters.
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The sugar cane crop according to several authors can generate, besides the industrialized stalks, an amount of crop residues from the order of 15 to 30% in weight of the aerial part of the plants, depending on the field conditions. The sugar cane area in Brazil is around 5.5×106 hectares, with an amount of 400.106 tons of stalks, with stalks yield of 72 tons.ha-1 (Unica, 2005). This study took place in a sugar cane plot (Latitude 22°46'S, Longitude 47°23'W and 600m of altitude) with 3% of slope, located in São Paulo State. The sugar cane variety was SP 80-1816, in its forth cut, 11 months old and with a planted row spacing of 1.40m. By other side, several sugar mills are bringing the crop residue to their patio to produce energy with the bagasse. One way for that is the baling operation to bring the crop residue at the sugar mill. Some fundamental variables were obtained to define the best set of machines to work with in sugar cane crop residue removal in the baling system among the studied ones, some of the variables were: Soil Index (T1 = 0.83%, T2 = 0.46%, T3 = 0.65%, T4 = 0.57%); Energy Efficiency (T1 = 82.48%, T2 = 83.88%, T3 = 82.83% and T4 = 82.97%) of the system and Effective Cost for Equivalent Energy in US$.EBP-1 (T1 = 11.10, T2= 10.46, T3 = 11.47 and T4 = 10.57) of the baled trash delivered at the sugar mill.