Artificial neural network models for predicting 1-year mortality in elderly patients with intertrochanteric fractures in China

The mortality rate of older patients with intertrochanteric fractures has been increasing with the aging of populations in China. The purpose of this study was: 1) to develop an artificial neural network (ANN) using clinical information to predict the 1-year mortality of elderly patients with intertrochanteric fractures, and 2) to compare the ANN's predictive ability with that of logistic regression models. The ANN model was tested against actual outcomes of an intertrochanteric femoral fracture database in China. The ANN model was generated with eight clinical inputs and a single output. ANN's performance was compared with a logistic regression model created with the same inputs in terms of accuracy, sensitivity, specificity, and discriminability. The study population was composed of 2150 patients (679 males and 1471 females): 1432 in the training group and 718 new patients in the testing group. The ANN model that had eight neurons in the hidden layer had the highest accuracies among the four ANN models: 92.46 and 85.79% in both training and testing datasets, respectively. The areas under the receiver operating characteristic curves of the automatically selected ANN model for both datasets were 0.901 (95%CI=0.814-0.988) and 0.869 (95%CI=0.748-0.990), higher than the 0.745 (95%CI=0.612-0.879) and 0.728 (95%CI=0.595-0.862) of the logistic regression model. The ANN model can be used for predicting 1-year mortality in elderly patients with intertrochanteric fractures. It outperformed a logistic regression on multiple performance measures when given the same variables.

Desfolha artificial simulando danos de pragas na cultura do girassol (Helianthus annuus L., Asteraceae)

O girassol está sujeito às perdas de área foliar por diferentes fatores, dentre eles os insetos desfolhadores, contra aos quais geralmente são dirigidas aplicações de inseticidas na cultura. A desfolha artificial em plantas de importância econômica é uma metodologia útil na simulação de ataques dessas pragas em lavouras na determinação dos níveis de dano econômico. O objetivo deste estudo foi avaliar componentes de produção das plantas de girassol submetidas a níveis crescentes de desfolha de 0, 10, 25, 50, 75 e 100%, realizada em três distintos estádios fenológicos da cultura, a saber: V6 (seis folhas com no mínimo 4,0 cm de comprimento), R1 (quando a inflorescência circundada pela bráctea imatura torna-se visível) e R5.5 (50% das flores do disco estão fertilizadas ou em antese), perfazendo um total de 18 tratamentos, os quais foram dispostos em blocos ao acaso, com quatro repetições. Para todos os componentes de produção avaliados (diâmetro do capítulo, biomassa total de sementes da planta e biomassa de 100 aquênios) houve efeito significativo da interação dos tratamentos, evidenciando que o efeito da desfolha será dependente do estágio fenológico da planta. O estádio R5.5 foi mais sensível à desfolha, ocasionando perdas em todos os componentes de produção avaliados.

Dose inseminante utilizada na fertilização artificial de ovócito de piracanjuba (Brycon orbignyanus)

A piracanjuba (Brycon orbignyanus Valenciennes, 1849) é uma espécie de peixe migratória, ameaçada de extinção. O objetivo do presente estudo foi determinar a dose inseminante na fertilização artificial de ovócitos de piracanjuba. Para isso, utilizou-se delineamento em blocos casualizados, com quatro tratamentos e três repetições. Três casais de piracanjuba, selecionados dos tanques de reprodutores da Estação Ambiental de Itutinga (EAI - CEMIG), no período de piracema 2006/2007, receberam aplicação de hormônio extrato bruto de hipófise de carpa (EBHC) para obtenção dos gametas. Adotaram-se quatro tratamentos diferentes para a fertilização de 0,1 grama de ovócitos: 10µL, 20µL, 30µL e 40µL de sêmen. As amostras foram ativadas com 5 mL de água do próprio tanque e, em seguida, levadas para incubadoras, dotadas de renovação constante de água, à temperatura de 28ºC. Após 8 e 16 horas, analisaram-se as taxas de fertilização (ovos viáveis) e de eclosão dos ovos, respectivamente. Os resultados obtidos foram comparados pelo teste de Tukey a 5%. As relações sêmen-ovócitos testadas não alteraram as taxas de fertilização e eclosão (P>0,05). O número de espermatozoides-ovócitos, variando de 10,4 x10(5) a 41,6 x10(5), foi eficiente para obtenção de boas taxas de fertilidade.

Postharvest biological control of brown rot in peaches after cold storage preceded by preharvest chemical control 1

ABSTRACT Pathogenic fungi cause skin darkening and peach quality depreciation in post harvest. Therefore, alternative techniques to chemical treatment are necessary in order to reduce risks to human health. The aim of this study was to evaluate the effect of the application of Trichoderma harzianum in association with different fungicides applied before harvest to 'Eldorado' peaches for brown rot control and other quality parameters during storage. The treatments consisted of five preharvest fungicide applications (control, captan, iprodione, iminoctadine and tebuconazole) associated with postharvest application of T. harzianum, after cold storage (with and without application), in three evaluation times (zero, two and four days at 20 °C), resulting in a 5x2x3 factorial design. The application of T. harzianum only brought benefits to the control of brown rot when combined with the fungicide captan, at zero day shelf life. After two days, there was a greater skin darkening in peaches treated with T. harzianum compared with peaches without the treatment, except for peaches treated with the fungicide iprodione and T. harzianum The application of T. harzianum during postharvest showed no benefits for the control of brown rot, however, the association with fungicides reduced the incidence of Rhizopus stolonifer during the shelf life.

Applications of artificial intelligence to condition-based maintenance

In this paper we discuss interesting developments of expert systems for machine diagnosis and condition-based maintenance. We review some elements of condition-based maintenance and its applications, expert systems for machine diagnosis, and an example of machine diagnosis. In the last section we note some problems to be resolved so that expert systems for machine diagnosis may gain wider acceptance in the future.

Aspectos ecológicos da leishmaniose tegumentar americana: 2. ecótopo artificial como abrigo de Psychodopygus intermedius e observações sobre alimentação e reprodução sob influência de fatores físicos naturais

As observações levadas a cabo em um galinheiro experimental mostraram que Psychodopygus intermedius tem a capacidade de nele abrigar-se. Para se chegar a este resultado, a metodologia utilizada consistiu na coleta total diurna e exame do estado de alimentação e digestão sangüínea dos Ps. intermedius como parâmetro da sua maior ou menor permanência no ecótopo estudado. Além disso, observou-se paralelamente, os tempos para o repasto sangüíneo, digestão completa, oviposição, sobrevivência e cópula sob a influência direta dos fatores físicos naturais. A importância epidemiológica dos resultados reside em novas elucidações experimentais sobre a viabilidade da transmissão da leshmaniose tegumentar ocorrer em ambiente domiciliar.

Opinião de médicos brasileiros sobre fecundação artificial do ponto de vista ético

Foi realizado levantamento da opinião dos médicos que compareceram ao "XIV Congresso Brasileiro de Reprodução Humana", sob o ponto de vista ético, a respeito da fecundação artificial. Foram analisados os resultados, chegando-se a selecionar alguns itens comportamentais como preliminarmente aceitos. Propõe-se a realização de estudos mais profundos que objetivam abordar os vários aspectos aceitos ou não pela sociedade.

Duration of larval and pupal development stages of Aedes albopictus in natural and artificial containers

Aedes albopictus were reared in different containers: a tree hole, a bamboo stump and an auto tire. The total times from egg hatching to adult emergence were of 19.6,27.3 and 37.5 days, respectively, according to the container. The first, second and third-instar larvae presented growth periods with highly similar durations. The fourth-instar larvae was longer than the others stages. The pupation time was longer than the fourth-instar larvae growth period. The temperature of the breeding sites studied, which was of 18° C to 22° C on average, was also taken into consideration. The mortality of the immature stages was analysed and compared as between the experimental groups; it was lower in the natural containers than in the discarded tire. The average wing length of adult females emerging from tree hole was significantly larger (p < 0.05) than that of those emerging from the tire.

Encontro de Aedes scapularis (Diptera: Culicidae) em criadouro artificial em localidade da região Sul do Brasil

Duas larvas de Aedes scapularis foram encontradas em um criadouro artificial, no Município de Sertaneja, Norte do Estado do Paraná, Brasil, durante atividade de rotina para o controle de vetores da dengue.

Rede neural artificial para detecção de sobremortalidade atribuível à cólera no Ceará

OBJETIVO: Avaliar as redes neurais recorrentes enquanto técnica preditiva para séries temporais em saúde. MÉTODOS: O estudo foi realizado durante uma epidemia de cólera ocorrida no Estado do Ceará, em 1993 e 1994, a partir da sobremortalidade tendo como causa básica as infecções intestinais mal definidas (CID-9). O número mensal de óbitos por essa causa, referente ao período de 1979 a 1995 no Estado do Ceará, foram obtidos do Sistema de Informação de Mortalidade (SIM) do Ministério da Saúde. Estruturou-se uma rede com dois neurônios na camada de entrada, 12 na camada oculta, um neurônio na camada de saída e um na camada de memória. Todas as funções de ativação eram a função logística. O treinamento foi realizado pelo método de backpropagation, com taxa de aprendizado de 0,01 e momentum de 0,9, com dados de janeiro de 1979 a junho de 1991. O critério para fim do treinamento foi atingir 22.000 epochs. Compararam-se os resultados com os de um modelo de regressão binomial negativa. RESULTADOS: A predição da rede neural a médio prazo foi adequada, em dezembro de 1993 e novembro e dezembro de 1994. O número de óbitos registrados foi superior ao limite do intervalo de confiança. Já o modelo regressivo detectou sobremortalidade a partir de março de 1992. CONCLUSÕES: A rede neural se mostrou capaz de predição, principalmente no início do período, como também ao detectar uma alteração concomitante e posterior à ocorrência da epidemia de cólera. No entanto, foi menos precisa do que o modelo de regressão binomial, que se mostrou mais sensível para detectar aberrações concomitantes à circulação da cólera.

Diversity and equity: dealing with biological and social differences

In the context of the design of working hours inequities in health associated with biological, psychological, social, and socioeconomic diversities can be observed. The paper first tries to set up a frame of reference for a discussion of this topic, relating to the Universal Declaration of Human Rights and some recent discussions on equity in health and then goes into some factors that produce inequities in health in the context of the design of working hours, dealing with sex or gender, age and job age, personality traits, marital status, social support, diversities in values, and socio-economic differences; the discussion deals with approaches on how to deal with these differences and inequities.

Biological drugs for the treatment of psoriasis in a public health system

OBJECTIVE To analyze the access and utilization profile of biological medications for psoriasis provided by the judicial system in Brazil.METHODSThis is a cross-sectional study. We interviewed a total of 203 patients with psoriasis who were on biological medications obtained by the judicial system of the State of Sao Paulo, from 2004 to 2010. Sociodemographics, medical, and political-administrative characteristics were complemented with data obtained from dispensation orders that included biological medications to treat psoriasis and the legal actions involved. The data was analyzed using an electronic data base and shown as simple variable frequencies. The prescriptions contained in the lawsuits were analyzed according to legal provisions.RESULTS A total of 190 lawsuits requesting several biological drugs (adalimumab, efalizumab, etanercept, and infliximab) were analyzed. Patients obtained these medications as a result of injunctions (59.5%) or without having ever demanded biological medication from any health institution (86.2%), i.e., public or private health services. They used the prerogative of free legal aid (72.6%), even though they were represented by private lawyers (91.1%) and treated in private facilities (69.5%). Most of the patients used a biological medication for more than 13 months (66.0%), and some patients were undergoing treatment with this medication when interviewed (44.9%). Approximately one third of the patients discontinued treatment due to worsening of their illness (26.6%), adverse drug reactions (20.5%), lack of efficacy, or because the doctor discontinued this medication (13.8%). None of the analyzed medical prescriptions matched the legal prescribing requirements. Clinical monitoring results showed that 70.3% of the patients had not undergone laboratory examinations (blood work, liver and kidney function tests) for treatment control purposes.CONCLUSIONS The plaintiffs resorted to legal action to get access to biological medications because they were either unaware or had difficulty in accessing them through institutional public health system procedures. Access by means of legal action facilitated long-term use of this type of medication through irregular prescriptions and led to a high rate of adverse drug reactions as well as inappropriate clinical monitoring.

Gender in the allocation of organs in kidney transplants: meta-analysis

OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.RESULTS : Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

Biological and morphological characteristics of Schistosoma mansoni from Ribeira Valley, State of São Paulo, Brazil: I - susceptibility of Biomphalaria tenagophila snail to sympatric S. mansoni strain

In the São Paulo State, Brazil, where the Biomphalaria tenagophila is the intermediate host, the Ribeira Valley is an important endemic schistosomiasis mansoni area. During last eleven years there has been intense control measures focusing on schistosomiasis. The efforts have been concentrated in the municipalities of Pedro de Toledo and Itariri. We determined the susceptibility of B. tenagophila to sympatric strain of S. mansoni, both recently isolated from Itariri field. In 1988, this strain was isolated and maintained in the experimental model: Swiss mice - sympatric B. tenagophila. The second generation of the worm was evaluated. The snail were divided in the three groups of 60 snails each. One group was exposed to 1 miracidium and other to 10. The third group was the control. The mortality and the shedding of cercariae were checked during 78 days. After that, the positive snails were observed until they ceased to shed cercariae. The exposed molluscs showed mortality rates of 23% and 31% and infection indexes were of 8% and 60% to 1 and 10 miracidia respectively. The mortality was of 22% in the control group. The periods of shedding cercariae in the two groups were 82 and 104 days. We can conclude that B. tenagophila is an effective intermediate host to the sympatric strain of S. mansoni sympatric strain

Serological, electrophoretic and biological properties of Fasciola hepatica antigens

Fasciola hepatica somatic antigen, its partially purified fractions and excretion-secretion products were investigated as to serological, electrophoretic and biological properties. In a Sephadex G-100 column (SG-100), Fasciola hepatica total antigen (FhTA) gave 5 fractions, and SDS-PAGE analysis showed they were glycoproteins ranging from 14 to 94 kDa molecular weight (MW). When these fractions were analyzed by enzyme linked immunotransfer blot (EITB) and immunodiffusion in gel (ID) with serum from immunized rats with FhTA, the presence of different antigenic components was revealed. In the SDS-PAGE of excretor-secretor antigen (ESA), it was possible to observe peptides from 12 to 22 kDa, which were also present in FhTA. When the FhTA, its fractions and the ESA were analyzed by EITB with the immune rat serum (IRS), it was observed that only some fractions of the SG-100 shared antigens with the FhTA and ESA. Moreover, DTH and ITH responses were studied in FhTA immunized rats challenged with these different antigen components, revealing that the protein/carbohydrate ratio is important for inducing DTH response. The ESA was the most active component in the DTH and ITH response.