885 resultados para Methods for Multi-criteria Evaluation
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O presente trabalho faz uma abordagem aos Sistemas de Informação Geográfica (SIG) e a análise multicritério (AMC) para o estudo da acessibilidade da rede escolar do municÃpio de Humpata, provÃncia da HuÃla, situada em Angola. Neste trabalho pretende-se demonstrar as dificuldades de acessibilidade e mobilidade tendo em conta aos principais factores que condicionam a rede escolar e também a acessibilidade em termos de oferta e recursos, analisando com algum pormenor as condições de ensino que as escolas oferecem. Por outro lado foram também elaborados modelos de velocidade com o objectivo de verificar a distância-tempo percorrida pelos usuários considerando o declive do terreno. Ficou demonstrado que, para o estudo da acessibilidade da rede escolar, o uso dos SIG e a AMC fornecem resultados com relevância na tomada de decisão. A AMC conjugada com a álgebra de mapas, permitiu registar as disparidades de acessibilidade entre diferentes povoações que compõem o municÃpio. Aconselha-se por isso a utilização de ferramentas de análise espacial como os SIG, em contextos como o do municÃpio de Humpata onde os recursos escassos devem ser bem geridos, de forma a levar os serviços públicos e privados à maior parte da população e à s povoações que mais necessitam através da localização óptima dos futuros serviços, que no caso das instituições escolares concorrera para garantia do sucesso escolar.
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Introduction Polymerase chain reaction (PCR) may offer an alternative diagnostic option when clinical signs and symptoms suggest visceral leishmaniasis (VL) but microscopic scanning and serological tests provide negative results. PCR using urine is sensitive enough to diagnose human visceral leishmaniasis (VL). However, DNA quality is a crucial factor for successful amplification. Methods A comparative performance evaluation of DNA extraction methods from the urine of patients with VL using two commercially available extraction kits and two phenol-chloroform protocols was conducted to determine which method produces the highest quality DNA suitable for PCR amplification, as well as the most sensitive, fast and inexpensive method. All commercially available kits were able to shorten the duration of DNA extraction. Results With regard to detection limits, both phenol: chloroform extraction and the QIAamp DNA Mini Kit provided good results (0.1 pg of DNA) for the extraction of DNA from a parasite smaller than Leishmania (Leishmania) infantum (< 100fg of DNA). However, among 11 urine samples from subjects with VL, better performance was achieved with the phenol:chloroform method (8/11) relative to the QIAamp DNA Mini Kit (4/11), with a greater number of positive samples detected at a lower cost using PCR. Conclusion Our results demonstrate that phenol:chloroform with an ethanol precipitation prior to extraction is the most efficient method in terms of yield and cost, using urine as a non-invasive source of DNA and providing an alternative diagnostic method at a low cost.
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Ecological economics is a recently developed field, which sees the economy as a subsystem of a larger finite global ecosystem. Ecological economists question the sustainability of the economy because of its environmental impacts and its material and energy requirements, and also because of the growth of population. Attempts at assigning money values to environmental services and losses, and attempts at correcting macroeconomic accounting, are part of ecological economics, but its main thrust is rather in developing physical indicators and indexes of sustainability. Ecological economists also work on the relations between property rights and resource management, they model the interactions between the economy and the environment, they study ecological distribution conflicts, they use management tools such as integrated environmental assessment and multi-criteria decision aids, and they propose new instruments of environmental policy.
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Els incendis forestals són una pertorbació amb un paper decisiu en l’estructura i dinà mica dels ecosistemes mediterranis. La majoria de les seves espècies vegetals presenten mecanismes de resposta al foc, com la germinació de llavors i la rebrotada d’individus cremats. Les masses forestals regenerades a partir de rebrots assoleixen densitats massa altes i una baixa producció, i, per tant, és fonamental dur a terme una gestió mitjançant tractaments silvÃcoles. El principal objectiu d’aquest projecte és quantificar l’efecte de la selecció de rebrots i la selecció de rebrots més la desbrossada sobre el creixement de l’Arbutus unedo. S’han estudiat 12 parcel—les en regeneració després dels incendis de 1985, 1986 i 1994 al terme municipal d’Esparreguera. Els resultats mostren que els dos tractaments afavoreixen de la mateixa manera el creixement dels peus d’Arbutus unedo, a causa de la disminució de la competència intraespecÃfica i interespecÃfica. La desbrossada (a nivell de parcel—la, no d’individu), no obstant, provoca un increment probablement perjudicial de l’alçada dels rebrots, per la major disponibilitat de llum. Per tal de proposar un model de gestió forestal, s’ha realitzat una anà lisi multicriterial dels diferents escenaris, on s’han considerat altres criteris, com són el model de combustible, la possibilitat de pastura i el cost econòmic. L’alternativa preferida en els boscos d’Arbutus unedo és la selecció de rebrots i la desbrossada.
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En aquesta tesis es presenten els resultats de la investigació duta a terme a les comunitats indÃgenes Tsimane’ de l’Amazònia boliviana. La investigació estudia la percepció dels indÃgenes sobre l’etnoclassificació del seu territori. S’estableix una clau de classificació i es determina la importà ncia dels elements paisatgÃstics del territori Tsimane’ segons la percepció local. Aquesta informació permetrà integrar el coneixement local dins dels programes de desenvolupament integral i de planificació territorial en l’Amazònia Boliviana. L’estudi conclou que la població Tsimane’ classifica els elements paisatgÃstics del seu entorn en 89 taques conformades per una espècies arbòria dominant i que estan incloses en un o més dels nou paisatges identificats: Därsi Därä, Sajras, Sinues Ojñi’, Mayes, Múcúya, Tsäquis Därä, Cum, Tajñi’ i Jaman. A partir d’un anà lisi multicriteri s’ha determinat una importà ncia total per cada paisatge segons els següents criteris d’importà ncia: diversitat de taques, activitats econòmiques realitzables, presència espiritual, percepció individual i importà ncia relativa segons els altres paisatges. Aixà doncs s’ha trobat que el paisatge més important és el Därsi Därä (bosc primari caracteritzat per un estrat arbori superior a 50 metres d’altura). També s’han analitzat les dades discernint segons el gènere de l’entrevistat i segons la proximitat de les comunitats estudiades a la ciutat més propera.
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The paper discusses the utilization of new techniques ot select processes for protein recovery, separation and purification. It describesa rational approach that uses fundamental databases of proteins molecules to simplify the complex problem of choosing high resolution separation methods for multi component mixtures. It examines the role of modern computer techniques to help solving these questions.
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BACKGROUND: Sunitinib (SU) is a multitargeted tyrosine kinase inhibitor with antitumor and antiangiogenic activity. The objective of this trial was to demonstrate antitumor activity of continuous SU treatment in patients with hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Key eligibility criteria included unresectable or metastatic HCC, no prior systemic anticancer treatment, measurable disease, and Child-Pugh class A or mild Child-Pugh class B liver dysfunction. Patients received 37.5 mg SU daily until progression or unacceptable toxicity. The primary endpoint was progression-free survival at 12 weeks (PFS12). RESULTS: Forty-five patients were enrolled. The median age was 63 years; 89% had Child-Pugh class A disease and 47% had distant metastases. PFS12 was rated successful in 15 patients (33%; 95% confidence interval, 20%-47%). Over the whole trial period, one complete response and a 40% rate of stable disease as the best response were achieved. The median PFS duration, disease stabilization duration, time to progression, and overall survival time were 1.5, 2.9, 1.5, and 9.3 months, respectively. Grade 3 and 4 adverse events were infrequent. None of the 33 deaths were considered drug related. CONCLUSION: Continuous SU treatment with 37.5 mg daily is feasible and has moderate activity in patients with advanced HCC and mild to moderately impaired liver dysfunction. Under this trial design (>13 PFS12 successes), the therapy is considered promising. This is the first trial describing the clinical effects of continuous dosing of SU in HCC patients on a schedule that is used in an ongoing, randomized, phase III trial in comparison with the current treatment standard, sorafenib (ClinicalTrials.gov identifier, NCT00699374).
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In this paper I review a series of theoretical concepts that are relevant for the integrated assessment of agricultural sustainability but that are not generally included in the curriculum of the various scientific disciplines dealing with quantitative analysis of agriculture. I first illustrate with plain narratives and concrete examples that sustainability is an extremely complex issue requiring the simultaneous consideration of several aspects, which cannot be reduced into a single indicator of performance. Following, I justify this obvious need for multi-criteria analysis with theoretical concepts dealing with the epistemological predicament of complexity, starting from classic philosophical lessons to arrive to recent developments in complex system theory, in particular Rosen´s theory of modelling relation which is essential to analyze the quality of any quantitative representation. The implications of these theoretical concepts are then illustrated with applications of multi-criteria analysis to the sustainability of agriculture. I wrap up by pointing out the crucial difference between "integrated assessment" and "integrated analysis". An integrated analysis is a set of indicators and analytical models generating an analytical output. An integrated assessment is much more than that. It is about finding an effective way to deal with three key issues: (i) legitimacy – how to handle the unavoidable existence of legitimate but contrasting points of view about different meanings given by social actors to the word "development"; (ii) pertinence – how to handle in a coherent way scientific analyses referring to different scales and dimensions; and (iii) credibility – how to handle the unavoidable existence of uncertainty and genuine ignorance, when dealing with the analysis of future scenarios.
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BACKGROUND: Incidence of perioperative in-stent thrombosis associated with myocardial infarction in patients undergoing major lung resection within 3 months of coronary stenting. METHODS: Retrospective multi-institutional trial including all patients undergoing major lung resection (lobectomy or pneumonectomy) within 3 months of coronary stenting with non-drug-eluting stents between 1999 and 2004. RESULTS: There were 32 patients (29 men and 3 women), with age ranging from 46 to 82 years. One, two or four coronary stents were deployed in 72%, 22% and 6% of the patients, respectively. The time intervals between stenting and lung surgery were <30 days, 30-60 days and 61-90 days in 22%, 53% and 25% of the patients, respectively. All patients had dual antiplatelet therapy after stenting. Perioperative medication consisted of heparin alone or heparin plus aspirin in 34% and 66% of the patients, respectively. Perioperative in-stent thrombosis with myocardial infarction occurred in three patients (9%) with fatal outcome in one (3%). Twenty patients underwent lung resection after 4 weeks of dual antiplatelet therapy as recommended by the ACC/AHA Guideline Update; however, two out of three perioperative in-stent thrombosis occurred in this group of patients. CONCLUSIONS: Major lung resection performed within 3 months of coronary stenting may be complicated by perioperative in-stent thrombosis despite 4 weeks of dual antiplatelet therapy after stenting as recommended by the ACC/AHA Guideline Update.
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Trimethyltin (TMT) is a neurotoxicant known to induce early microglial activation. The present study was undertaken to investigate the role played by these microglial cells in the TMT-induced neurotoxicity. The effects of TMT were investigated in monolayer cultures of isolated microglia or in neuron-enriched cultures and in neuron-microglia and astrocyte-microglia cocultures. The end points used were morphological criteria; evaluation of cell death and cell proliferation; and measurements of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and nitric oxide (NO) release in culture supernatant. The results showed that, in cultures of microglia, TMT (10(-6) M) caused, after a 5-day treatment, an increased release of TNF-alpha, without affecting microglial shape or cell viability. When microglia were cocultured with astrocytes, TNF-alpha release was decreased to undetectable levels. In contrast, in neuron-microglia cocultures, TNF-alpha levels were found to increase at lower concentrations of TMT (i.e., 10(-8) M). Moreover, at 10(-6) M of TMT, microglia displayed further morphological activation, as suggested by process retraction and by decrease in cell size. No morphological activation was observed in cultures of isolated microglial cells and in astrocyte-microglia cocultures. With regard to neurons, 10(-6) M of TMT induced about 30% of cell death, when applied to neuron-enriched cultures, whereas close to 100% of neuronal death was observed in neuron-microglia cocultures. In conclusion, whereas astrocytes may rather dampen the microglial activation by decreasing microglial TNF-alpha production, neuronal-microglial interactions lead to enhanced microglial activation. This microglial activation, in turn, exacerbates the neurotoxic effects of TMT. TNF-alpha may play a major role in such cell-cell communications.
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PURPOSE: To report the case of identical dichorionic diamniotic female twins with unilateral retinoblastoma in 13q deletion syndrome. METHODS: Clinical and ophthalmoscopic evaluation, combination of multiple ligation-dependent probe amplification, array-comparative genomic hybridization analyses, and magnetic resonance imaging were performed. RESULTS: Peculiar facial features, marked hypotonia, gastroesophageal reflux, interatrial septal defect with left to right shunt and light dilatation of right chambers, 5th finger hypoplasia, 3rd-5th toes clinodactyly, 2nd toe overlapped to 3rd toe, and cutis marmorata were found. Ophthalmoscopic evaluation revealed unilateral retinoblastoma in both girls. Magnetic resonance imaging detected corpus callosum hypoplasia in both twins. A 34.4-Mb deletion involving bands 13q13.2-q21.33 and including the RB1 gene was identified in both twins. The deletion was not present in the DNA of their parents and older brother. CONCLUSIONS: Dysmorphic features in children must be always suspicious of 13q deletion syndrome and a short ophthalmoscopic follow-up is necessary to detect the presence of a retinoblastoma.
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Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups. This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation. The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population. Trial Registration: (clinicaltrials.gov) NCT00674544.
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I study the impact of a universal child benefit on fertility and family well-being. I exploitthe unanticipated introduction of a new, sizeable, unconditional child benefit in Spain in2007, granted to all mothers giving birth on or after July 1, 2007. The regressiondiscontinuity-type design allows for a credible identification of the causal effects. I find thatthe benefit did lead to a significant increase in fertility, as intended, part of it coming froman immediate reduction in abortions. On the unintended side, I find that families whoreceived the benefit did not increase their overall expenditure or their consumption ofdirectly child-related goods and services. Instead, eligible mothers stayed out of the laborforce significantly longer after giving birth, which in turn led to their children spending lesstime in formal child care and more time with their mother during their first year of life. Ialso find that couples who received the benefit were less likely to break up the year afterhaving the child, although this effect was only short-term. Taken together, the resultssuggest that child benefits of this kind may successfully increase fertility, as well asaffecting family well-being through their impact on maternal time at home and familystability.
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PURPOSE: This study assessed whether a cycle of "routine" therapeutic drug monitoring (TDM) for imatinib dosage individualization, targeting an imatinib trough plasma concentration (C min) of 1,000Â ng/ml (tolerance: 750-1,500Â ng/ml), could improve clinical outcomes in chronic myelogenous leukemia (CML) patients, compared with TDM use only in case of problems ("rescue" TDM). METHODS: Imatinib concentration monitoring evaluation was a multicenter randomized controlled trial including adult patients in chronic or accelerated phase CML receiving imatinib since less than 5Â years. Patients were allocated 1:1 to "routine TDM" or "rescue TDM." The primary endpoint was a combined outcome (failure- and toxicity-free survival with continuation on imatinib) over 1-year follow-up, analyzed in intention-to-treat (ISRCTN31181395). RESULTS: Among 56 patients (55 evaluable), 14/27 (52Â %) receiving "routine TDM" remained event-free versus 16/28 (57Â %) "rescue TDM" controls (PÂ =Â 0.69). In the "routine TDM" arm, dosage recommendations were correctly adopted in 14 patients (median C min: 895Â ng/ml), who had fewer unfavorable events (28Â %) than the 13 not receiving the advised dosage (77Â %; PÂ =Â 0.03; median C min: 648Â ng/ml). CONCLUSIONS: This first target concentration intervention trial could not formally demonstrate a benefit of "routine TDM" because of small patient number and surprisingly limited prescriber's adherence to dosage recommendations. Favorable outcomes were, however, found in patients actually elected for target dosing. This study thus shows first prospective indication for TDM being a useful tool to guide drug dosage and shift decisions. The study design and analysis provide an interesting paradigm for future randomized TDM trials on targeted anticancer agents.
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The 2007 Iowa General Assembly, recognizing the increased demand for water to support the growth of industries and municipalities, approved funding for the first year of a multi-year evaluation and modeling of Iowa’s major aquifers by the Iowa Department of Natural Resources. The task of conducting this evaluation and modeling was assigned to the Iowa Geological and Water Survey (IGWS). The first aquifer to be studied was the Lower Dakota aquifer in a sixteen county area of northwest Iowa.