Paper 5: Surveillance of multiple congenital anomalies: implementation of a computer algorithm in European registers for classification of cases.

BACKGROUND: Surveillance of multiple congenital anomalies is considered to be more sensitive for the detection of new teratogens than surveillance of all or isolated congenital anomalies. Current literature proposes the manual review of all cases for classification into isolated or multiple congenital anomalies. METHODS: Multiple anomalies were defined as two or more major congenital anomalies, excluding sequences and syndromes. A computer algorithm for classification of major congenital anomaly cases in the EUROCAT database according to International Classification of Diseases (ICD)v10 codes was programmed, further developed, and implemented for 1 year's data (2004) from 25 registries. The group of cases classified with potential multiple congenital anomalies were manually reviewed by three geneticists to reach a final agreement of classification as "multiple congenital anomaly" cases. RESULTS: A total of 17,733 cases with major congenital anomalies were reported giving an overall prevalence of major congenital anomalies at 2.17%. The computer algorithm classified 10.5% of all cases as "potentially multiple congenital anomalies". After manual review of these cases, 7% were agreed to have true multiple congenital anomalies. Furthermore, the algorithm classified 15% of all cases as having chromosomal anomalies, 2% as monogenic syndromes, and 76% as isolated congenital anomalies. The proportion of multiple anomalies varies by congenital anomaly subgroup with up to 35% of cases with bilateral renal agenesis. CONCLUSIONS: The implementation of the EUROCAT computer algorithm is a feasible, efficient, and transparent way to improve classification of congenital anomalies for surveillance and research.

Computer algorithm to calculate longshore energy flux and wave direction from a two pressure sensor array /

"August 1982."

Dating the Siple Dome (Antarctica) Ice Core By Manual and Computer Interpretation of Annual Layering

The Holocene portion of the Siple Dome (Antarctica) ice core was dated by interpreting the electrical, visual and chemical properties of the core. The data were interpreted manually and with a computer algorithm. The algorithm interpretation was adjusted to be consistent with atmospheric methane stratigraphic ties to the GISP2 (Greenland Ice Sheet Project 2) ice core, (BE)-B-10 stratigraphic ties to the dendrochronology C-14 record and the dated volcanic stratigraphy. The algorithm interpretation is more consistent and better quantified than the tedious and subjective manual interpretation.

Design of the multicenter Australian study of epidural anesthesia and analgesia in major surgery: The MASTER Trial

The Multicenter Australian Study of Epidural Anesthesia and Analgesia in Major Surgery (The MASTER Trial) was designed to evaluate the possible benefit of epidural block in improving outcome in high-risk patients. The trial began in 1995 and is scheduled to reach the planned sample size of 900 during 2001. This paper describes the trial design and presents data comparing 455 patients randomized in 21 institutions in Australia, Hong Kong, and Malaysia, with 237 patients from the same hospitals who were eligible but not randomized. Nine categories of high-risk patients were defined as entry criteria for the trial. Protocols for ethical review, informed consent, randomization, clinical anesthesia and analgesia, and perioperative management were determined following extensive consultation with anesthesiologists throughout Australia. Clinical and research information was collected in participating hospitals by research staff who may not have been blind to allocation. Decisions about the presence or absence of endpoints were made primarily by a computer algorithm, supplemented by blinded clinical experts. Without unblinding the trial, comparison of eligibility criteria and incidence of endpoints between randomized and nonrandomized patients showed only small differences. We conclude that there is no strong evidence of important demographic or clinical differences between randomized and nonrandomized patients eligible for the MASTER Trial. Thus, the trial results are likely to be broadly generalizable. Control Clin Trials 2000;21:244-256 (C) Elsevier Science Inc. 2000.

Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome

Objective: To determine whether electromyographic (EMG) onsets of vastus medialis obliquus (VMO) and vastus lateralis (VL) are altered in the presence of patellofemoral pain syndrome (PFPS) during the functional task of stair stepping. Design: Cross-sectional. Setting: University laboratory. Patients: Thirty-three subjects with PFPS and 33 asymptomatic controls. Interventions: Subjects ascended and descended a set of stairs-2 steps, each 20-cm high-at usual stair-stepping pace. EMG readings of VMO and VL taken on middle stair during step up (concentric contraction) and step down (eccentric contraction). Main Outcome Measures: Relative difference in onset of surface EMG activity of VMO compared with VL during a stair-stepping task. EMG onsets were determined by using a computer algorithm and were verified visually. Results: In the PFPS population, the EMG onset of VL occurred before that of VMO in both the step up and step down phases of the stair-stepping task (p < .05). In contrast, no such differences occurred in the onsets of EMG activity of VMO and VL in either phase of the task for the control subjects. Conclusion: This finding supports the hypothesized relationship between changes in the timings of activity of the vastimuscles and PFPS. This finding provides theoretical rationale to support physiotherapy treatment commonly used in the management of PFPs.

Analysis of a circular patch antenna radiating in a parallel-plate radial guide

A field matching method is described to analyze a recessed circular cavity radiating into a radial waveguide. Using the wall impedance approach, the analysis is divided into two separate problems of the cavity and its external environment. Based on this analysis, a computer algorithm is developed for determining wall admittances as seen at the edge of the patch in the cavity, the radial admittance matrix for the two-probe feed arrangement, and the input impedance as observed from the coaxial line feeding the cavity. This algorithm is tested against the general-purpose Hewlett-Packard finite-element High Frequency Structure Simulator as well as against measured results. Good agreement in all considered cases is noted.

A unit cell waveguide model of a reflectarray formed by microstrip patches and slots

An equivalent unit cell waveguide approach (WGA) is described to obtain reflection coefficient phase curves for designing a microstrip patch reflectarray supported by a ground plane with periodic apertures or slots. Based on the presented theory, a computer algorithm for determining the reflection coefficient of a plane wave normally incident on a multi-layer structure of patches and apertures is developed. The validity of the developed algorithm is verified by comparing the obtained results with those published in the literature and the ones generated by Agilent High Frequency Structure Simulator (HFSS). A good agreement in all the presented examples is obtained, proving that the developed theory and computer algorithm can be an effective tool for designing multi-layer microstrip reflectarrays with a periodically perforated ground plane. (C) 2003 Wiley Periodicals, Inc.

Designing a 161-element Ku-band microstrip reflectarray of variable size patches using an equivalent unit cell waveguide approach

An equivalent unit cell waveguide approach (WGA) to designing 4 multilayer microstrip reflectarray of variable size patches is presented. In this approach, a normal incidence of a plane wave on an infinite periodic array of radiating elements is considered to obtain reflection coefficient phase curves for the reflectarray's elements. It is shown that this problem is equivalent to the problem of reflection of the dominant TEM mode in a waveguide with patches interleaved by layers of dielectric. This waveguide problem is solved using a field matching technique and a method of moments (MoM). Based on this solution, a fast computer algorithm is developed to generate reflection coefficient phase curves for a multilayer microstrip patch reflectarray. The validity of the developed algorithm is tested against alternative approaches and Agilent High Frequency Structure Simulator (HFSS). Having confirmed the validity of the WGA approach, a small offset feed two-layer microstrip patch array is designed and developed. This reflectarray is tested experimentally and shows good performance.

Proposta de abordagem para gestão de ocorrências em Serviços de Sangue

RESUMO: A gestão de ocorrências, sendo um requisito, quer legal, ao nível da regulação, quer normativo, tal como surge na ISO 9001, é um componente crítico para garantir a melhoria contínua um Serviço de Sangue, dado ter como objetivo a satisfação contínua dos requisitos dos dadores e recetores. A gestão eficaz, mas com eficiência, depende, também da eficácia da abordagem para gestão de ocorrência, nomeadamente, através da geração de correções, ações corretivas e ações preventiva eficazes. Esta dissertação discute a relevância, propondo um modelo de abordagem de gestão da qualidade conforme com os requisitos da lei fundamental da regulação de Serviços de Sangue, DL 267/2007, e com a norma global para sistemas de gestão da qualidade, ISO 9001. Esta abordagem usada descreve as várias etapas para a gestão eficaz de ocorrências, desde o seu relato, à sua classificação, tratamento com medição e análise risco associado e verificação da eficácia das ações tomadas. A eficácia do modelo teórico proposto foi verificado através da sua passagem para algoritmo informático num software comercial. Foi evidenciado neste software o cumprimento dos requisitos da abordagem teórica, pelo que a aplicação informática está conforme com os requisitos estabelecidos num procedimento documentado. Foi evidenciado, também, a rastreabilidade dos dados ao longo e toda a metodologia. A utilização de uma ferramenta informática também acrescentou valor ao modelo teórico, dado o acesso a toda a informação ser mais célere e de fácil acesso, quando comparado com o uso em suporte de papel.---------ABSTRACT: The issues management is a law requirement intended for regulation of “Blood Banks” and a quality management global requirement from ISO 9001. It is a critical activity, intended to to ensure continuous improvement on “Blood Bank”. Its goal is the continuous satisfaction of blood donors and transfusion recipients. Effective management and efficiency also depend on the effectiveness of the management of occurrence approach, namely in successful corrections, corrective actions and preventive actions. This paper discusses the relevance and it proposes a model approach to quality management according to the requirements of the fundamental law of regulation of “Blood Bank”, DL 267/2007, and according to the global standard for quality management systems, ISO 9001. This approach describes the various steps for effective management of incidents, such as his account, its classification, measurement and treatment using risk analysis and verification of the effectiveness of actions taken. The efficiency of the proposed theoretical model was verified through its transition to a computer algorithm trading software. It was demonstrated in this software that the requirements of the theoretical approach has been fulfilled by the computer application, which complies with the requirements established in a documented procedure. It was also evident that traceability of data across the methodology. The use of a software tool also added value to the theoretical model due to the access to all information to be faster and more easily accessible, when compared to paper.

Epidemiology of multiple congenital anomalies in Europe: a EUROCAT population-based registry study.

BACKGROUND: This study describes the prevalence, associated anomalies, and demographic characteristics of cases of multiple congenital anomalies (MCA) in 19 population-based European registries (EUROCAT) covering 959,446 births in 2004 and 2010. METHODS: EUROCAT implemented a computer algorithm for classification of congenital anomaly cases followed by manual review of potential MCA cases by geneticists. MCA cases are defined as cases with two or more major anomalies of different organ systems, excluding sequences, chromosomal and monogenic syndromes. RESULTS: The combination of an epidemiological and clinical approach for classification of cases has improved the quality and accuracy of the MCA data. Total prevalence of MCA cases was 15.8 per 10,000 births. Fetal deaths and termination of pregnancy were significantly more frequent in MCA cases compared with isolated cases (p < 0.001) and MCA cases were more frequently prenatally diagnosed (p < 0.001). Live born infants with MCA were more often born preterm (p < 0.01) and with birth weight < 2500 grams (p < 0.01). Respiratory and ear, face, and neck anomalies were the most likely to occur with other anomalies (34% and 32%) and congenital heart defects and limb anomalies were the least likely to occur with other anomalies (13%) (p < 0.01). However, due to their high prevalence, congenital heart defects were present in half of all MCA cases. Among males with MCA, the frequency of genital anomalies was significantly greater than the frequency of genital anomalies among females with MCA (p < 0.001). CONCLUSION: Although rare, MCA cases are an important public health issue, because of their severity. The EUROCAT database of MCA cases will allow future investigation on the epidemiology of these conditions and related clinical and diagnostic problems.

“Ombro-cabeça-ombro”: testando a lucratividade do padrão gráfico de análise técnica no mercado de ações brasileiro

A partir de uma adaptação da metodologia de Osler e Chang (1995), este trabalho avalia, empiricamente, a lucratividade de estratégias de investimento baseadas na identificação do padrão gráfico de Análise Técnica Ombro-Cabeça-Ombro no mercado de ações brasileiro. Para isso, foram definidas diversas estratégias de investimento condicionais à identificação de padrões Ombro-Cabeça- Ombro (em suas formas padrão e invertida), por um algoritmo computadorizado, em séries diárias de preços de 47 ações no período de janeiro de 1994 a agosto de 2006. Para testar o poder de previsão de cada estratégia, foram construídos intervalos de confiança, a partir da técnica Bootstrap de inferência amostral, consistentes com a hipótese nula de que, baseado apenas em dados históricos, não é possível criar estratégias com retornos positivos. Mais especificamente, os retornos médios obtidos por cada estratégia nas séries de preços das ações, foram comparados àqueles obtidos pelas mesmas estratégias aplicadas a 1.000 séries de preços artificiais - para cada ação - geradas segundo dois modelos de preços de ações largamente utilizados: Random Walk e E-GARCH. De forma geral, os resultados encontrados mostram que é possível criar estratégias condicionais à realização dos padrões Ombro- Cabeça-Ombro com retornos positivos, indicando que esses padrões conseguem capturar nas séries históricas de preços de ações sinais a respeito da sua movimentação futura de preços, que não são explicados nem por um Random Walk e nem por um E-GARCH. No entanto, se levados em consideração os efeitos das taxas e dos custos de transação, dependendo das suas magnitudes, essas conclusões somente se mantêm para o padrão na sua forma invertida

Implantação de um sistema de detecção de vazamentos em oleodutos com tratamento de alarmes falsos

The pumping of fluids in pipelines is the most economic and safe form of transporting fluids. That explains why in Europe there was in 1999 about 30.000 Km [7] of pipelines of several diameters, transporting millíons of cubic meters of crude oil end refined products, belonging to COCAWE (assaciation of companies of petroleum of Europe for health, environment and safety, that joint several petroleum companies). In Brazil they are about 18.000 Km of pipelines transporting millions of cubic meters of liquids and gases. In 1999, nine accidents were registered to COCAWE. Among those accidents one brought a fatal victim. The oil loss was of 171 m3, equivalent to O,2 parts per million of the total of the transported volume. Same considering the facts mentioned the costs involved in ao accident can be high. An accident of great proportions can bríng loss of human lives, severe environmental darnages, loss of drained product, loss . for dismissed profit and damages to the image of the company high recovery cost. In consonance with that and in some cases for legal demands, the companies are, more and more, investing in systems of Leak detection in pipelines based on computer algorithm that operate in real time, seeking wíth that to minimize still more the drained volumes. This decreases the impacts at the environment and the costs. In general way, all the systems based on softWare present some type of false alarm. In general a commitment exists betWeen the sensibílity of the system and the number of false alarms. This work has as objective make a review of thé existent methods and to concentrate in the analysis of a specific system, that is, the system based on hydraulic noise, Pressure Point Analyzis (PPA). We will show which are the most important aspects that must be considered in the implementation of a Leak Detection System (LDS), from the initial phase of the analysis of risks passing by the project bases, design, choice of the necessary field instrumentation to several LDS, implementation and tests. We Will make na analysis of events (noises) originating from the flow system that can be generator of false alarms and we will present a computer algorithm that restricts those noises automatically

Effects of mutations in acetate metabolism on high-cell-density growth of Escherichia coli

To study the role played by acetate metabolism during high-cell-density growth of Escherichia coli cells, we constructed isogenic null mutants of strain W3100 deficient for several genes involved either in acetate metabolism or the transition to stationary phase. We grew these strains under identical fed-batch conditions to the highest cell densities achievable in 8 h using a predictive-plus-feedback-controlled computer algorithm that maintained glucose at a set-point of 0.5 g/l, as previously described. Wild-type strains, as well as mutants lacking the sigma(s) subunit of RNA polymerase (rpoS), grew reproducibly to high cell densities (44-50 g/l dry cell weights, DCWs). In contrast, a strain lacking acetate kinase (ackA) failed to reach densities greater than 8 g/l. Strains lacking other acetate metabolism genes (pta, acs, poxB, iciR, and fadR) achieved only medium cell densities (15-21 g/l DCWs). Complementation of either the acs or the ackA mutant restored wild-type high-cell-density growth, on a dry weight basis, poxB and fadR strains produced approximately threefold more acetate than did the wild-type strain. In contrast, the pta, acs, or rpoS strains produced significantly less acetate per cell dry weight than did the wild-type strain. Our results show that acetate metabolism plays a critical role during growth of E. coli cultures to high cell densities. They also demonstrate that cells do not require the sigma(s) regulon to grow to high cell densities, at least not under the conditions tested.

Projeto e desenvolvimento de robô cartesiano de baixo custo para manipulação de produtos em linhas de média cadência

Pós-graduação em Engenharia Elétrica - FEB