Desempenho de índices de gravidade para estimar risco de morte em Unidades de Terapia Intensiva

O Simplified Acute Physiology Score II (SAPS II) e o Logistic Organ Dysfunction System (LODS) são instrumentos utilizados para classificar pacientes internados em Unidades de Terapia Intensiva (UTI) conforme a gravidade e o risco de morte, sendo um dos parâmetros da qualidade da assistência de enfermagem. Este estudo teve por objetivo avaliar e comparar as performances do SAPS II e do LODS para predizer mortalidade de pacientes admitidos em UTI. Participaram do estudo 600 pacientes de quatro diferentes UTIs de São Paulo, Brasil. A curva Receiver Operator Characteristic (ROC) foi utilizada para comparar o desempenho discriminatório dos índices. Os resultados foram: as áreas sob a curva do LODS (0.69) e do SAPS II (0.71) apresentaram moderada capacidade discriminatória para predizer mortalidade. Não foi encontrada diferença estatisticamente significativa entre as áreas (p=0,26). Concluiu-se que houve equivalência entre SAPS II e LODS para estimar risco de morte de pacientes em UTI.

[Archives de la Parole]. , Special text in santali / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

[Archives de la Parole]. , Special text in mundari / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

[Archives de la Parole]. , Special text in Ho [i.e. hō] : (poésie) / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

Técnicas de Data e Text Mining Para Anotação de Um Arquivo Digital

O presente trabalho cujo Título é técnicas de Data e Text Mining para a anotação dum Arquivo Digital, tem como objectivo testar a viabilidade da utilização de técnicas de processamento automático de texto para a anotação das sessões dos debates parlamentares da Assembleia da República de Portugal. Ao longo do trabalho abordaram-se conceitos como tecnologias de descoberta do conhecimento (KDD), o processo da descoberta do conhecimento em texto, a caracterização das várias etapas do processamento de texto e a descrição de algumas ferramentas open souce para a mineração de texto. A metodologia utilizada baseou-se na experimentação de várias técnicas de processamento textual utilizando a open source R/tm. Apresentam-se, como resultados, a influência do pré-processamento, tamanho dos documentos e tamanhos dos corpora no resultado do processamento utilizando o algoritmo knnflex.

Evaluation cardiologique préopératoire avant chirurgie non cardiaque: du choix cornélien a l'arbre décisionnel [Pre-operative cardiac assessment in non-cardiac surgery: a frequent dilemma simplified by a decision tree].

In patients undergoing non-cardiac surgery, cardiac events are the most common cause of perioperative morbidity and mortality. It is often difficult to choose adequate cardiologic examinations before surgery. This paper, inspired by the guidelines of the European and American societies of cardiology (ESC, AHA, ACC), discusses the place of standard ECG, echocardiography, treadmill or bicycle ergometer and pharmacological stress testing in preoperative evaluations. The role of coronary angiography and prophylactic revascularization will also be discussed. Finally, we provide a decision tree which will be helpful to both general practitioners and specialists.

An approach to costs and energy consumption in private urban Spanish Mediterranean landscapes from a simplified model in sprinkle irrigation

The number of private gardens has increased in recent years, creating a more pleasant urban model, but not without having an environmental impact, including increased energy consumption, which is the focus of this study. The estimation of costs and energy consumption for the generic typology of private urban gardens is based on two simplifying assumptions: square geometry with surface areas from 25 to 500 m2 and hydraulic design with a single pipe. In total, eight sprinkler models have been considered, along with their possible working pressures, and 31 pumping units grouped into 5 series that adequately cover the range of required flow rates and pressures, resultin in 495 hydraulic designs repeated for two climatically different locations in the Spanish Mediterranean area (Girona and Elche). Mean total irrigation costs for the locality with lower water needs (Girona) and greater needs (Elche) were € 2,974 ha-¹ yr-¹ and € 3,383 ha-¹ yr-¹, respectively. Energy costs accounted for 11.4% of the total cost for the first location, and 23.0% for the second. While a suitable choice of the hydraulic elements of the setup is essential, as it may provide average energy savings of 77%, due to the low energy cost in relation to the cost of installation, the potential energy savings do not constitute a significant incentive for the irrigation system design. The low efficiency of the pumping units used in this type of garden is the biggest obstacle and constraint to achieving a high quality energy solution

Handbook of Simplified Practice for Traffic Studies, November 2002

The Iowa Highway Research Board has identified the development of a simplified handbook of transportation studies as a high priority for the state of Iowa. The Center for Transportation Research and Education (CTRE) at Iowa State University was chosen to develop such a handbook. A well-executed, well-documented study is critical in the decision-making process for many transportation-related projects and in reporting to elected officials and members of the community. As more research is conducted in the area of transportation, study procedures in many cases have become more complex. It is often difficult for local jurisdictions with limited staff, training, experience, and time availability to perform these studies. The most commonly used publication for traffic studies is geared toward transportation professionals and professional engineers. That defining document, Manual of Transportation Studies (Institute of Transportation Engineers, 2000), is over 500 pages and includes several dozen types of transportation studies. Many of the transportation studies described in the manual are rarely (if ever) used by local jurisdictions. Further, those studies that are frequently used are at times very complex and possibly very costly to perform exactly as described. Local jurisdictions without the staff expertise to understand and apply the manual’s various studies have a need for a simplified handbook of procedures to perform common traffic studies themselves or properly define a scope of work to hire a consultant to perform the studies. This handbook describes simplified procedures that are easy to apply and are written for all potential users (civil engineers and traffic engineers, public works mangers, city managers and attorneys, and the general public).

Philo of Alexandria's De opificio mundi (LIII-LXI): discovering the essential features of Greek and Western Misogyny in a Platonising Jewish Text

The aim of this article is to show the Western centuries-old misogynist tradition from its origins in Greece by analysing a text by the allegorical interpreter of the Bible Philo of Alexandria, his De opifico mundi, which on many occasions is read by him from a Platonic point of view. The accurate analysis of the chapters devoted to the creation of the woman by God proves to what extent it is not possible to understand this text if one does not take into account a Greek philosophical tradition which was already centuries-old.

Filó d'Alexandria i el seu De opificio mundi (LIII-LXI): tot copsant les claus de la misogínia grega i occidental en un text jueu platonitzant.

L'objectiu d'aquest article és mostrar la secular tradició misògina occidental des dels seus orígens a Grècia tot analitzant un text de l'intèrpret al·legoric de la Bíblia Filó d'Alexandria, el De opificio mundi, al qual aplica una lectura fortament platonitzant. L'anàlisi acurada dels capítols dedicats a la creació divina de la dona i les seves conseqüències mostra fins a quin punt no és possible entendre aquest text sense tenir en compte una tradició filosòfica grega ja aleshores secular.

Pathological complete response after neoadjuvant chemotherapy is an independent predictive factor irrespective of simplified breast cancer intrinsic subtypes: a landmark and two-step approach analyses from the EORTC 10994/BIG 1-00 phase III trial.

BACKGROUND: Pathological complete response (pCR) following chemotherapy is strongly associated with both breast cancer subtype and long-term survival. Within a phase III neoadjuvant chemotherapy trial, we sought to determine whether the prognostic implications of pCR, TP53 status and treatment arm (taxane versus non-taxane) differed between intrinsic subtypes. PATIENTS AND METHODS: Patients were randomized to receive either six cycles of anthracycline-based chemotherapy or three cycles of docetaxel then three cycles of eprirubicin/docetaxel (T-ET). pCR was defined as no evidence of residual invasive cancer (or very few scattered tumour cells) in primary tumour and lymph nodes. We used a simplified intrinsic subtypes classification, as suggested by the 2011 St Gallen consensus. Interactions between pCR, TP53 status, treatment arm and intrinsic subtype on event-free survival (EFS), distant metastasis-free survival (DMFS) and overall survival (OS) were studied using a landmark and a two-step approach multivariate analyses. RESULTS: Sufficient data for pCR analyses were available in 1212 (65%) of 1856 patients randomized. pCR occurred in 222 of 1212 (18%) patients: 37 of 496 (7.5%) luminal A, 22 of 147 (15%) luminal B/HER2 negative, 51 of 230 (22%) luminal B/HER2 positive, 43 of 118 (36%) HER2 positive/non-luminal, 69 of 221(31%) triple negative (TN). The prognostic effect of pCR on EFS did not differ between subtypes and was an independent predictor for better EFS [hazard ratio (HR) = 0.40, P < 0.001 in favour of pCR], DMFS (HR = 0.32, P < 0.001) and OS (HR = 0.32, P < 0.001). Chemotherapy arm was an independent predictor only for EFS (HR = 0.73, P = 0.004 in favour of T-ET). The interaction between TP53, intrinsic subtypes and survival outcomes only approached statistical significance for EFS (P = 0.1). CONCLUSIONS: pCR is an independent predictor of favourable clinical outcomes in all molecular subtypes in a two-step multivariate analysis. CLINICALTRIALSGOV: EORTC 10994/BIG 1-00 Trial registration number NCT00017095.