982 resultados para pre-symptomatic testing


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It has been demonstrated that rating trust and reputation of individual nodes is an effective approach in distributed environments in order to improve security, support decision-making and promote node collaboration. Nevertheless, these systems are vulnerable to deliberate false or unfair testimonies. In one scenario, the attackers collude to give negative feedback on the victim in order to lower or destroy its reputation. This attack is known as bad mouthing attack. In another scenario, a number of entities agree to give positive feedback on an entity (often with adversarial intentions). This attack is known as ballot stuffing. Both attack types can significantly deteriorate the performances of the network. The existing solutions for coping with these attacks are mainly concentrated on prevention techniques. In this work, we propose a solution that detects and isolates the abovementioned attackers, impeding them in this way to further spread their malicious activity. The approach is based on detecting outliers using clustering, in this case self-organizing maps. An important advantage of this approach is that we have no restrictions on training data, and thus there is no need for any data pre-processing. Testing results demonstrate the capability of the approach in detecting both bad mouthing and ballot stuffing attack in various scenarios.

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Sub-Saharan Africa faces an epidemic of diabetes. Visual loss from diabetic retinopathy (DR) is both preventable and treatable. This article reviews the epidemiology and clinical features of DR and current evidencebased interventions in three areas: primary prevention of retinopathy by optimum medical management, early detection of pre-symptomatic disease and management of established retinopathy to prevent or mitigate visual loss. There are significant challenges to DR care in resource poor environments. Appropriate provision of effective interventions by health services can reduce social and economic costs associated with patient care.

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BACKGROUND: Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. METHODS: Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA <50 copies/mL or ≥1.5 log reduction). RESULTS: Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15). CONCLUSIONS: In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

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Summary Background: The combination of the Pulmonary Embolism Severity Index (PESI) and troponin testing could help physicians identify appropriate patients with acute pulmonary embolism (PE) for early hospital discharge. Methods: This prospective cohort study included a total of 567 patients from a single center registry with objectively confirmed acute symptomatic PE. On the basis of the PESI, each patient was classified into 1 of 5 classes (I to V). At the time of hospital admission, patients had troponin I (cTnI) levels measured. The endpoint of the study was all-cause mortality within 30 days after diagnosis. We calculated the mortality rates in 4 patient groups: group 1: PESI class I-II plus cTnI <0.1 ng mL(-1); group 2: PESI classes III-V plus cTnI <0.1 ng mL(-1); group 3: PESI classes I-II plus cTnI >/= 0.1 ng mL(-1); and group 4: PESI classes III-V plus cTnI >/= 0.1 ng mL(-1). Results: The study cohort had a 30-day mortality of 10% (95% confidence interval [CI], 7.6 to 12.5%). Mortality rates in the 4 groups were 1.3%, 14.2%, 0% and 15.4%, respectively. Compared to non-elevated cTnl, the low-risk PESI had a higher negative predictive value (NPV) (98.9% vs 90.8%) and negative likelihood ratio (NLR) (0.1 vs 0.9) for predicting mortality. The addition of non-elevated cTnI to low-risk PESI did not improve the NPV or the NLR compared to either test alone. Conclusions: Compared to cTnl testing, PESI classification more accurately identified patients with PE who are at low risk of all-cause death within 30-days of presentation.

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Il lavoro di questa tesi riguarda principalmente la progettazione, simulazione e test di laboratorio di tre versioni successive di schede VME, chiamate Read Out Driver (ROD), che sono state fabbricate per l'upgrade del 2014 dell'esperimento ATLAS Insertable B-Layer (IBL) al CERN. IBL è un nuovo layer che diverrà parte del Pixel Detector di ATLAS. Questa tesi si compone di una panoramica descrittiva dell'esperimento ATLAS in generale per poi concentrarsi sulla descrizione del layer specifico IBL. Inoltre tratta in dettaglio aspetti fisici e tecnici: specifiche di progetto, percorso realizzativo delle schede e test conseguenti. Le schede sono state dapprima prodotte in due prototipi per testare le prestazioni del sistema. Queste sono state fabbricate al fine di valutare le caratteristiche e prestazioni complessive del sistema di readout. Un secondo lotto di produzione, composto di cinque schede, è stato orientato alla correzione fine delle criticità emerse dai test del primo lotto. Un'indagine fine e approfondita del sistema ha messo a punto le schede per la fabbricazione di un terzo lotto di altre cinque schede. Attualmente la produzione è finita e complessivamente sono state realizzate 20 schede definitive che sono in fase di test. La produzione sarà validata prossimamente e le 20 schede verranno consegnate al CERN per essere inserite nel sistema di acquisizione dati del rivelatore. Al momento, il Dipartimento di Fisica ed Astronomia dell'Università di Bologna è coinvolto in un esperimento a pixel solamente attravers IBL descritto in questa tesi. In conclusione, il lavoro di tesi è stato prevalentemente focalizzato sui test delle schede e sul progetto del firmware necessario per la calibrazione e per la presa dati del rivelatore.

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Background Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. Methods Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA <50 copies/mL or ≥1.5log reduction). Results Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15). Conclusions In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

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This paper analyzes data from a recently completed study of discrimination against African-American and Hispanic homebuyers when they visit mortgage lending institutions in two major metropolitan markets to make pre-application inquiries. It represents the first application of paired testing to rigorously measure discrimination in the mortgage lending process. The paired tests isolated significant levels of differential treatment on the basis of race and ethnicity in Chicago with African Americans and Hispanics receiving less information and assistance than comparable whites. Adverse treatment of African-Americans and Hispanics is also observed in Los Angeles for specific treatments, but the overall pattern of treatment observed did not differ statistically from equal treatment. Multivariate analyses for Chicago indicate that large lenders treat minorities more favorably than small lenders and that lenders with substantial numbers of applications from African-Americans treat African Americans more favorably than lenders with predominantly white application pools.

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This study is a retrospective longitudinal study at Texas Children's Hospital, a 350-bed tertiary level pediatric teaching hospital in Houston, Texas, for the period 1990 to 2006. It measured the incidence and trends of positive pre-employment drug tests among new job applicants At TCH. ^ Over the study period, 16,219 job applicants underwent pre-employment drug screening at TCH. Of these, 330 applicants (2%) tested positive on both the EMIT and GC/MS. After review by the medical review officer, the number of true drug test positive applicants decreased to 126 (0.78%). ^ According to the overall annual positive drug test incidence rates, the highest overall incidence was in 2002 (14.71 per 1000 tests) and the lowest in 2004 (3.17 per 1000 tests). Despite a marked increase in 2002, over the 15-year study period the overall incidence tended to decrease. Incidence rates and trends of other illegal drugs are further discussed in the study. And in general, these incidence rates also decline in the study period. In addition to that, we found the overall, positive drug tests were more common in females than in males (55.5% versus 44.4%). ^

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Employee substance abuse has long time been a topic of concern for the hospitality industry. Operating under the assumption that drug-users, and associated undesirable behavior, can be eliminated from the hiring process, many operations have adopted pre-employment drug-testing policies. Despite being represented across the industry as a major target of effort and resources, it is suggested that the perceived sensitive-nature of the subject has somewhat hindered access to qualitative information. The purpose of this research was to assess and explore the attitudes, beliefs and perceptions of both management and employees in the foodservice industry regarding pre-employment drug-testing and its impact on work performance. Through the use of a phenomenological survey, qualitative data was collected then used to identify themes in participants’ perceptions of such screening policies and their effects. Results and implications of these findings are discussed.

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In an attempt to reduce the heart failure epidemic,screening and prevention will become an increasing focus ofmanagement in the wider at-risk population. Refining riskprediction through the use of biomarkers in isolation or incombination is emerging as a critical step in this process.The utility of biomarkers to identify disease manifestationsbefore the onset of symptoms and detrimental myocardialdamage is proving to be valuable. In addition, biomarkers thatpredict the likelihood and rate of disease progression over timewill help streamline and focus clinical efforts and therapeuticstrategies. Importantly, several recent early intervention studiesusing biomarker strategies are promising and indicate thatnot only can new-onset heart failure be reduced but also thedevelopment of other cardiovascular conditions.

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Instrumented indentation has been used to investigate the mechanical properties of BETAMATE 1496 (R) Epoxy adhesive. The properties of the adhesive were analyzed by measuring its hardness and its Young`s modulus in samples extracted from six different positions of the front door of a commercial passenger vehicle in two phases of processing: after application of the adhesive in the door assembling (""pre-cured"" state) and after final cure in the painting oven (""cured"" state). Special attention was given to setting the optimal parameters (""creep"" time and unloading time step) for the instrumented indentation testing for the present application. Young`s modulus values around 1.1 +/- 0.2 GPa and hardness values around 0.15 +/- 0.05 GPa were obtained for all samples, irrespective of the variation of the indentation parameters in the testing procedure and of the relative position of the adhesive in the door frame in both states. (C) 2008 Elsevier Ltd. All rights reserved.