ELF (Enhanced Liver Fibrosis) como marcador não invasivo de fibrose hepáticana hepatite C crônica

A fibrose hepática é o aspecto mais relevante e o mais importante determinante de morbimortalidade na hepatite C crônica (HCC). Historicamente, a biópsia hepática é o método de referência para avaliação da fibrose causada pela HCC, apesar de apresentar limitações. O estudo de marcadores não invasivos, que possam obviar a necessidade da biópsia, é uma área de constante interesse na hepatologia. Idealmente, a avaliação da fibrose hepática deveria ser acurada, simples, prontamente disponível, de baixo custo e informar sobre o prognóstico da patologia. Os marcadores não invasivos mais estudados são a elastografia hepática transitória (EHT) e os laboratoriais. A EHT já foi extensamente validada na HCC e está inserida na rotina de avaliação destes pacientes. Dentre os laboratoriais, existem diversos testes em continua experimentação e, até o momento, nenhum foi integrado à prática clínica no Brasil, embora já aplicados rotineiramente em outros países. O Enhanced Liver Fibrosis (ELF), um teste que dosa no soro ácido hialurônico, pró-peptídeo amino-terminal do colágeno tipo III e inibidor tissular da metaloproteinase 1, tem se mostrado bastante eficaz na detecção de fibrose hepática significativa e de cirrose na HCC. Neste estudo o ELF teve o seu desempenho avaliado em relação a biópsia hepática e demonstrou apresentar boa acurácia na detecção tanto de fibrose significativa quanto de cirrose. Na comparação com a EHT apresentou acurácia semelhante para estes mesmos desfechos, com significância estatística. No entanto, foi observada uma superestimação da fibrose com a utilização dos pontos de corte propostos pelo fabricante. Este achado está em acordo com a literatura, onde não há consenso sobre o melhor ponto de corte a ser empregado na prática clínica. Com a ampliação da casuística foi possível propor novos pontos de corte, através da análise clássica, com a biópsia hepática como padrão ouro. O resultado obtido vai ao encontro do observado por outros autores. Em seguida, os novos pontos de corte do ELF foram reavaliados sem que a biópsia hepática fosse a referência, através da análise de classes latentes. Mais uma vez o ELF apresentou bom desempenho, inclusive com melhora de suas sensibilidade e especificidade em comparação com a análise clássica, onde a biópsia hepática é a referência. Assim sendo, é possível concluir que o ELF é um bom marcador não invasivo de fibrose hepática. No entanto, para detecção de fibrose significativa e cirrose, deve ser considerada a aplicação na prática clínica dos novos pontos de corte aqui propostos.

Comments on the nature of persistence in dendrochronologic records with implications for hydrology and climatology [abstract]

EXTRACT (SEE PDF FOR FULL ABSTRACT): Jurate Landwehr discussed the use of surrogate hydrologic records, specifically dendrochronologic records, to study the nature of persistence which is characteristic of hydrologic phenomenon. These proxy records are generally considered to correspond to such hydrologic measures as mean annual discharge but are much longer in length than directly measured hydrologic records. Consequently, they allow one to explore questions pertaining to the structure of candidate stochastic processes with greater validity than permitted by the latter.

Impact of the invasive colonial tunicate Didemnum vexillum on the recruitment of the bay scallop (Argopecten irradians irradians) and implications for recruitment of the sea scallop (Placopecten magellanicus) on Georges Bank

The invasive colonial tunicate Didemnum vexillum has become widespread in New England waters, colonizing large areas of shell-gravel bottom on Georges Bank including commercial sea scallop (Placopecten magellanicus) grounds. Didemnum vexillum colonies are also fouling coastal shellfish aquaculture gear which increases maintenance costs and may affect shellfish growth rates. We hypothesized that D. vexillum will continue to spread and may affect shellfish larval settlement and survival. We conducted a laboratory experiment to assess interactions between larval bay scallops (Argopectin irradians irradians) and D. vexillum. We found that larval bay scallops avoid settling on D. vexillum colonies, possibly deterred by the low pH of the tunicate’s surface tissue. The results of this study suggest that widespread colonization of substrata by D. vexillum could affect scallop recruitment by reducing the area of quality habitats available for settlement. We propose that the bay scallop can serve as a surrogate for the sea scallop in estimating the negative impact D. vexillum could have on the recruitment of sea scallops on Georges Bank.

Vibration-assisted bone-graft compaction in impaction bone grafting of the femur

The complications of impaction bone grafting in revision hip replacement includes fracture of he femur and subsidence of the prosthesis. In this in vitro study we aimed to investigate whether the use of vibration, combined with a perforated tamp during the compaction of morsellised allograft would reduce peak loads and hoop strains in the femur as a surrogate marker of the risk of fracture and whether it would also improve graft compaction and prosthetic stability. We found that the peak loads and hoop strains transmitted to the femoral cortex during graft compaction and subsidence of the stem in subsequent mechanical testing were reduced. This innovative technique has the potential to reduce the risk of intra-operative fracture and to improve graft compaction and therefore prosthetic stability. © 2007 British Editorial Society of Bone and Joint Surgery.

A probabilistic energy model for non-domestic building sectors applied to analysis of school buildings in greater London

The diversity of non-domestic buildings at urban scale poses a number of difficulties to develop models for large scale analysis of the stock. This research proposes a probabilistic, engineering-based, bottom-up model to address these issues. In a recent study we classified London's non-domestic buildings based on the service they provide, such as offices, retail premise, and schools, and proposed the creation of one probabilistic representational model per building type. This paper investigates techniques for the development of such models. The representational model is a statistical surrogate of a dynamic energy simulation (ES) model. We first identify the main parameters affecting energy consumption in a particular building sector/type by using sampling-based global sensitivity analysis methods, and then generate statistical surrogate models of the dynamic ES model within the dominant model parameters. Given a sample of actual energy consumption for that sector, we use the surrogate model to infer the distribution of model parameters by inverse analysis. The inferred distributions of input parameters are able to quantify the relative benefits of alternative energy saving measures on an entire building sector with requisite quantification of uncertainties. Secondary school buildings are used for illustrating the application of this probabilistic method. © 2012 Elsevier B.V. All rights reserved.

Multiply conditioned analyses of stratification in highly swirling methane/air flames

The effects of stratification on a series of highly swirling turbulent flames under globally lean conditions (φg=0.75) are investigated using a new high-spatial resolution multi-scalar dataset. This dataset features two key properties: high spatial resolution which approaches the 60 micron optical limit of the measurement system, and a wavelet oversampling methodology which significantly reduces the influence of noise. Furthermore, the very large number of realizations (30,000) acquired in the stratified cases permits statistically significant results to be obtained even after aggressive conditioning is applied. Data are doubly conditioned on equivalence ratio and the degree of stratification across the flame in each instantaneous realization. The influence of stoichiometry is limited by conditioning on the equivalence ratio at the location of peak CO mass fraction, which is shown to be a good surrogate for the location of peak heat release rate, while the stratification is quantified using a linear gradient in equivalence ratio across the instantaneous flame front. This advanced conditioning enables robust comparisons with the baseline lean premixed flame. Species mass fractions of both carbon monoxide and hydrogen are increased in temperature space under stratified conditions. Stratification is also shown to significantly increase thermal gradients, yet the derived three-dimensional flame surface density is shown to be relatively insensitive to stratification. Whilst the presence of instantaneous stratification broadens the curvature distribution relative to the premixed case, the degree of broadening is not significantly influenced by the range of global stratification ratios examined in this study. © 2012 The Combustion Institute.

Cortical thickness estimation of the proximal femur from multi-view Dual-Energy X-ray Absorptiometry (DXA)

Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 ± 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 ± 0:79 mm. © 2013 SPIE.

Discrete multicomponent model for biodiesel spray combustion simulation

An important first step in spray combustion simulation is an accurate determination of the fuel properties which affects the modelling of spray formation and reaction. In a practical combustion simulation, the implementation of a multicomponent model is important in capturing the relative volatility of different fuel components. A Discrete Multicomponent (DM) model is deemed to be an appropriate candidate to model a composite fuel like biodiesel which consists of four components of fatty acid methyl esters (FAME). In this paper, the DM model is compared with the traditional Continuous Thermodynamics (CTM) model for both diesel and biodiesel. The CTM model is formulated based on mixing rules that incorporate the physical and thermophysical properties of pure components into a single continuous surrogate for the composite fuel. The models are implemented within the open-source CFD code OpenFOAM, and a semi-quantitative comparison is made between the predicted spray-combustion characteristics and optical measurements of a swirl-stabilised flame of diesel and biodiesel. The DM model performs better than the CTM model in predicting a higher magnitude of heat release rate in the top flame brush region of the biodiesel flame compared to that of the diesel flame. Using both the DM and CTM models, the simulation successfully reproduces the droplet size, volume flux, and droplet density profiles of diesel and biodiesel. The DM model predicts a longer spray penetration length for biodiesel compared to that of diesel, as seen in the experimental data. Also, the DM model reproduces a segregated biodiesel fuel vapour field and spray in which the most abundant FAME component has the longest vapour penetration. In the biodiesel flame, the relative abundance of each fuel component is found to dominate over the relative volatility in terms of the vapour species distribution and vice versa in the liquid species distribution. © 2014 Elsevier Ltd. All rights reserved.

OpenOffice.org对非BMP平面字符支持的实现

Unicode标准中的非BMP平面字符多用于古籍研究或者少数民族语言文字,由于这些字符的使用面特别窄,多数软件系统包括办公软件都不支持对这些字符的处理。本文以开源办公套件OpenOffice.org为基础,分析了它对非BMP平面支持的现状,然后着重探讨了实现对非BMP平面字符的全面支持所需要解决的一系列问题,并分别给出了合理的改进方案,最后以CJK和藏文为例展示了改进后的效果。

Study of turbulent heat transfer of aviation kerosene flows in a curved pipe at supercritical pressure

The now and heat transfer characteristics of China No. 3 aviation kerosene in a heated curved tube under supercritical pressure are numerically investigated by a finite volume method. A two-layer turbulence model, consisting of the RNG k-epsilon two-equation model and the Wolfstein one-equation model, is used for the simulation of turbulence. A 10-species kerosene surrogate model and the NIST Supertrapp software are applied to obtain the thermophysical and transport properties of the kerosene at various temperature under a supercritical pressure of 4 MPa. The large variation of thermophysical properties of the kerosene at the supercritical pressure make the flow and heat transfer more complicated, especially under the effects of buoyancy and centrifugal force. The centrifugal force enhances the heat transfer, but also increases the friction factors. The rise of the velocity caused by the variation of the density does not enhance the effects of the centrifugal force when the curvature ratios are less than 0.05. On the contrary, the variation of the density increases the effects of the buoyancy. (C) 2010 Elsevier Ltd. All rights reserved.

基于代理模型的水下滑翔机机翼设计优化方法

在复杂工程系统的概念设计优化中,高精度数值分析方法得到广泛应用,将高精度数值分析与优化方法有机结合,对设计空间展开全面搜索与寻优,已经成为现代设计优化方法的重要发展方向。以水下滑翔机的概念设计为研究对象,引入代理模型,控制高精度分析试验的数量,有效地化解精度与效率之间的矛盾。将参数化几何建模、网格划分以及流体数值模拟分析集成为自动分析流程,并以此为基础采用试验设计理论,构建代理模型,解决水下滑翔机机翼的多目标设计优化问题。给出基于代理模型的设计优化过程,并系统地比较几种试验设计方法的适应性,重点讨论多项式响应面和径向基函数代理模型,所得代理模型相对误差小于2%。采用梯度寻优方法与遗传算法在给定设计空间内进行全面搜索,获得机翼的最佳平面构形,水下滑翔机的升阻比提高6.76%,俯仰力矩的绝对值由0.2760N•m降低为0.0015N•m,提高水下滑翔机的运动性能。

Relaxação Lagsur como alternativa para obtenção de soluções viáveis de boa qualidade para os problemas da otimização combinatória.

Relaxação Lagrangeana surrogate (Lagsur). Problema de atribuição generalizado. Problema do caxeiro viajante simétrico (PCV).

Stereoselektywna addycja pochodnych orto-toluiloamidów do imin jako metoda syntezy alkaloidów protoberberynowych

Wydział Chemii: Pracownia Spektrochemii Organicznej

Using ground reaction force to predict knee kinetic asymmetry following anterior cruciate ligament reconstruction.

Asymmetries in sagittal plane knee kinetics have been identified as a risk factor for anterior cruciate ligament (ACL) re-injury. Clinical tools are needed to identify the asymmetries. This study examined the relationships between knee kinetic asymmetries and ground reaction force (GRF) asymmetries during athletic tasks in adolescent patients following ACL reconstruction (ACL-R). Kinematic and GRF data were collected during a stop-jump task and a side-cutting task for 23 patients. Asymmetry indices between the surgical and non-surgical limbs were calculated for GRF and knee kinetic variables. For the stop-jump task, knee kinetics asymmetry indices were correlated with all GRF asymmetry indices (P < 0.05), except for loading rate. Vertical GRF impulse asymmetry index predicted peak knee moment, average knee moment, and knee work (R(2)  ≥ 0.78, P < 0.01) asymmetry indices. For the side-cutting tasks, knee kinetic asymmetry indices were correlated with the peak propulsion vertical GRF and vertical GRF impulse asymmetry indices (P < 0.05). Vertical GRF impulse asymmetry index predicted peak knee moment, average knee moment, and knee work (R(2)  ≥ 0.55, P < 0.01) asymmetry indices. The vertical GRF asymmetries may be a viable surrogate for knee kinetic asymmetries and therefore may assist in optimizing rehabilitation outcomes and minimizing re-injury rates.

Development and usability testing of a Web-based decision aid for families of patients receiving prolonged mechanical ventilation.

BACKGROUND: Web-based decision aids are increasingly important in medical research and clinical care. However, few have been studied in an intensive care unit setting. The objectives of this study were to develop a Web-based decision aid for family members of patients receiving prolonged mechanical ventilation and to evaluate its usability and acceptability. METHODS: Using an iterative process involving 48 critical illness survivors, family surrogate decision makers, and intensivists, we developed a Web-based decision aid addressing goals of care preferences for surrogate decision makers of patients with prolonged mechanical ventilation that could be either administered by study staff or completed independently by family members (Development Phase). After piloting the decision aid among 13 surrogate decision makers and seven intensivists, we assessed the decision aid's usability in the Evaluation Phase among a cohort of 30 surrogate decision makers using the Systems Usability Scale (SUS). Acceptability was assessed using measures of satisfaction and preference for electronic Collaborative Decision Support (eCODES) versus the original printed decision aid. RESULTS: The final decision aid, termed 'electronic Collaborative Decision Support', provides a framework for shared decision making, elicits relevant values and preferences, incorporates clinical data to personalize prognostic estimates generated from the ProVent prediction model, generates a printable document summarizing the user's interaction with the decision aid, and can digitally archive each user session. Usability was excellent (mean SUS, 80 ± 10) overall, but lower among those 56 years and older (73 ± 7) versus those who were younger (84 ± 9); p = 0.03. A total of 93% of users reported a preference for electronic versus printed versions. CONCLUSIONS: The Web-based decision aid for ICU surrogate decision makers can facilitate highly individualized information sharing with excellent usability and acceptability. Decision aids that employ an electronic format such as eCODES represent a strategy that could enhance patient-clinician collaboration and decision making quality in intensive care.