Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain

OBJECTIVES: Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised. DESIGN: Cross-sectional study. SETTING: Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered). PARTICIPANTS: All insured polymedicated patients. Polymedicated patients were those with a consumption of ≥16 drugs/month. MAIN OUTCOMES MEASURES: The study variables were related to age, gender and medication intake obtained from the 2008 census and records of prescriptions dispensed in pharmacies and charged to the public health system. RESULTS: There were 36 880 polymedicated patients (women: 64.2%; average age: 74.5±10.9 years). The total number of prescriptions billed in 2008 was 2 266 830 (2 272 920 total package units). The most polymedicated group (up to 40% of the total prescriptions) was patients between 75 and 84 years old. The average number of prescriptions billed monthly per patient was 32±2, with an average cost of 452.7±27.5. The total cost of those prescriptions corresponded to 2% of the drug expenditure in Catalonia. The groups N, C, A, R and M represented 71.4% of the total number of drug package units dispensed to polymedicated patients. Great variability was found between the medication profiles of men and women, and between age groups; greater discrepancies were found in paediatric patients (5-14 years) and the elderly (≥65 years). CONCLUSIONS: This study provides essential information to take steps towards rational drug use and a structured approach in the polymedicated population in primary healthcare.

Framework for Traffic Pattern Identification: Required Step for Short-term Forecasting

In the world of transport management, the term ‘anticipation’ is gradually replacing ‘reaction’. Indeed, the ability to forecast traffic evolution in a network should ideally form the basis for many traffic management strategies and multiple ITS applications. Real-time prediction capabilities are therefore becoming a concrete need for the management of networks, both for urban and interurban environments, and today’s road operator has increasingly complex and exacting requirements. Recognising temporal patterns in traffic or the manner in which sequential traffic events evolve over time have been important considerations in short-term traffic forecasting. However, little work has been conducted in the area of identifying or associating traffic pattern occurrence with prevailing traffic conditions. This paper presents a framework for detection pattern identification based on finite mixture models using the EM algorithm for parameter estimation. The computation results have been conducted taking into account the traffic data available in an urban network.

Calculation of the critical crack size for cold form rectangular hollow section tube (CRHS) under bending load at -40º C temperature

To predict the capacity of the structure or the point which is followed by instability, calculation of the critical crack size is important. Structures usually contain several cracks but not necessarily all of these cracks lead to failure or reach the critical size. So, defining the harmful cracks or the crack size which is the most leading one to failure provides criteria for structure’s capacity at elevated temperature. The scope of this thesis was to calculate fracture parameters like stress intensity factor, the J integral and plastic and ultimate capacity of the structure to estimate critical crack size for this specific structure. Several three dimensional (3D) simulations using finite element method by Ansys program and boundary element method by Frank 3D program were carried out to calculate fracture parameters and results with the aid of laboratory tests (loaddisplacement curve, the J resistance curve and yield or ultimate stress) leaded to extract critical size of the crack. Two types of the fracture which is usually affected by temperature, Elastic and Elasti-Plastic fractures were simulated by performing several linear elastic and nonlinear elastic analyses. Geometry details of the weldment; flank angle and toe radius were also studied independently to estimate the location of crack initiation and simulate stress field in early stages of crack extension in structure. In this work also overview of the structure’s capacity in room temperature (20 ºC) was studied. Comparison of the results in different temperature (20 ºC and -40 ºC) provides a threshold of the structure’s behavior within the defined range.

Nontypable Haemophilus influenzae displays a prevalent surface structure molecular pattern in clinical isolates.

Non-typable Haemophilus influenzae (NTHi) is a Gram negative pathogen that causes acute respiratory infections and is associated with the progression of chronic respiratory diseases. Previous studies have established the existence of a remarkable genetic variability among NTHi strains. In this study we show that, in spite of a high level of genetic heterogeneity, NTHi clinical isolates display a prevalent molecular feature, which could confer fitness during infectious processes. A total of 111 non-isogenic NTHi strains from an identical number of patients, isolated in two distinct geographical locations in the same period of time, were used to analyse nine genes encoding bacterial surface molecules, and revealed the existence of one highly prevalent molecular pattern (lgtF+, lic2A+, lic1D+, lic3A+, lic3B+, siaA−, lic2C+, ompP5+, oapA+) displayed by 94.6% of isolates. Such a genetic profile was associated with a higher bacterial resistance to serum mediated killing and enhanced adherence to human respiratory epithelial cells.

Bowing the violin : a case study for auditory-motor pattern modelling in the context of music performance

This project addresses methodological and technological challenges in the development of multi-modal data acquisition and analysis methods for the representation of instrumental playing technique in music performance through auditory-motor patterning models. The case study is violin playing: a multi-modal database of violin performances has been constructed by recording different musicians while playing short exercises on different violins. The exercise set and recording protocol have been designed to sample the space defined by dynamics (from piano to forte) and tone (from sul tasto to sul ponticello), for each bow stroke type being played on each of the four strings (three different pitches per string) at two different tempi. The data, containing audio, video, and motion capture streams, has been processed and segmented to facilitate upcoming analyses. From the acquired motion data, the positions of the instrument string ends and the bow hair ribbon ends are tracked and processed to obtain a number of bowing descriptors suited for a detailed description and analysis of the bow motion patterns taking place during performance. Likewise, a number of sound perceptual attributes are computed from the audio streams. Besides the methodology and the implementation of a number of data acquisition tools, this project introduces preliminary results from analyzing bowing technique on a multi-modal violin performance database that is unique in its class. A further contribution of this project is the data itself, which will be made available to the scientific community through the repovizz platform.

Virulence pattern of Pyricularia grisea isolates from farmers' fields on newly released upland rice cultivars

The virulence pattern of the isolates of Pyricularia grisea from commercial fields of the upland rice (Oryza sativa) cultivars 'Primavera' and 'BRS Bonança' was analyzed. A hundred and seventy monoconidial isolates of the pathogen virulent to 'Primavera' and 139 to 'BRS Bonança' collected from eight fields, during two years (2001-2003) were tested, under greenhouse conditions, on six newly released rice cultivars. Differences in virulence pattern were observed in pathogenic populations of 'Primavera' and 'BRS Bonança'. Isolates with virulence to improved cultivars were common in samples from farmers' fields in the absence of aloinfection. The virulence frequency of P. grisea isolates collected from 'Primavera'' to cultivars 'BRS Vencedora', 'BRS Colosso', 'BRS Liderança', 'BRS Soberana', 'BRS Curinga' and 'BRS Talento', was high in descending order. On the other hand, in the fungus population of 'BRS BRS Bonança' virulence frequency was high in 'BRS Talento', followed by 'BRS Curinga', 'BRS Vencedora', 'BRS Liderança', 'BRS Colosso' and 'BRS Soberana'. While virulence to 'BRS Talento' was rare among isolates from 'Primavera', it was most frequent in isolates of 'BRS Bonança'. The six improved rice cultivars permitted to differentiating agriculturally important virulences in the pathogen population which can be utilized in selecting breeding lines for specific resistance, in rice blast improvement program.

Soil sampling intensity and spatial distribution pattern of soils attributes and corn yield in no-tillage system

Taking into account that the sampling intensity of soil attributes is a determining factor for applying of concepts of precision agriculture, this study aims to determine the spatial distribution pattern of soil attributes and corn yield at four soil sampling intensities and verify how sampling intensity affects cause-effect relationship between soil attributes and corn yield. A 100-referenced point sample grid was imposed on the experimental site. Thus, each sampling cell encompassed an area of 45 m² and was composed of five 10-m long crop rows, where referenced points were considered the center of the cell. Samples were taken from at 0 to 0.1 m and 0.1 to 0.2 m depths. Soil chemical attributes and clay content were evaluated. Sampling intensities were established by initial 100-point sampling, resulting data sets of 100; 75; 50 and 25 points. The data were submitted to descriptive statistical and geostatistics analyses. The best sampling intensity to know the spatial distribution pattern was dependent on the soil attribute being studied. The attributes P and K+ content showed higher spatial variability; while the clay content, Ca2+, Mg2+ and base saturation values (V) showed lesser spatial variability. The spatial distribution pattern of clay content and V at the 100-point sampling were the ones which best explained the spatial distribution pattern of corn yield.

Distribution pattern, surface tension and contact angle of herbicides associated to adjuvants on spraying and control of Ipomoea hederifolia under rainfall incidence

ABSTRACTScarlet Morning Glory is considered to be an infesting weed that affects several crops and causes serious damage. The application of chemical herbicides, which is the primary control method, requires a broad knowledge of the various characteristics of the solution and application technology for a more efficient phytosanitary treatment. Therefore this study aimed to characterize the effect of rainfall incidence on the control of Ipomoea hederifolia, considering droplet size, surface tension, contact angle of droplets formed by herbicides liquid on vegetal and artificial surfaces, associated to adjuvants and the volumetric distribution profile of the spray jet. The addition of the adjuvants to the herbicide spraying liquid improved the application quality, as it influenced the angle formed by the spray by broadening the deposition band of the spray nozzle and thus the possible distance between the nozzles on spray boom and due the changes at droplet size, which contribute to a safety application. The rainfall occurrence affected negatively the weed control with the different spraying liquids and also the dry matter weight, suggesting that the phytosanitary product applied was washed off.

Inguinal hernias in patients of 50 years and above. Pattern and outcome

OBJECTIVE: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. METHODS: a prospective descriptive study of patients (n=57) > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. RESULTS: the most representative age group was 61-70 years, and all patients were male. 52 (91.22%) patients had unilateral inguinal hernias, while five (8.77%) had bilateral hernias. In 50 (87.71%) patients, the hernia was uncomplicated, while seven (12.28%) patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71%) patients while seven (12.28%) patients were operated in emergency. Postoperatively, 50 (87.7%) patients had uneventful recovery, while seven (12.28%) patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. CONCLUSION: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate pre-operative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

Evaluation of Bubble Formation and Break Up in Suppression Pools by Using Pattern Recognition Methods

During a possible loss of coolant accident in BWRs, a large amount of steam will be released from the reactor pressure vessel to the suppression pool. Steam will be condensed into the suppression pool causing dynamic and structural loads to the pool. The formation and break up of bubbles can be measured by visual observation using a suitable pattern recognition algorithm. The aim of this study was to improve the preliminary pattern recognition algorithm, developed by Vesa Tanskanen in his doctoral dissertation, by using MATLAB. Video material from the PPOOLEX test facility, recorded during thermal stratification and mixing experiments, was used as a reference in the development of the algorithm. The developed algorithm consists of two parts: the pattern recognition of the bubbles and the analysis of recognized bubble images. The bubble recognition works well, but some errors will appear due to the complex structure of the pool. The results of the image analysis were reasonable. The volume and the surface area of the bubbles were not evaluated. Chugging frequencies calculated by using FFT fitted well into the results of oscillation frequencies measured in the experiments. The pattern recognition algorithm works in the conditions it is designed for. If the measurement configuration will be changed, some modifications have to be done. Numerous improvements are proposed for the future 3D equipment.

Model-View-Controller architectural pattern and its evolution in graphical user interface frameworks

Model-View-Controller (MVC) is an architectural pattern used in software development for graphical user interfaces. It was one of the first proposed solutions in the late 1970s to the Smart UI anti-pattern, which refers to the act of writing all domain logic into a user interface. The original MVC pattern has since evolved in multiple directions, with various names and may confuse many. The goal of this thesis is to present the origin of the MVC pattern and how it has changed over time. Software architecture in general and the MVC’s evolution within web applications are not the primary focus. Fundamen- tal designs are abstracted, and then used to examine the more recent versions. Prob- lems with the subject and its terminology are also presented.

NADPH-diaphorase activity in area 17 of the squirrel monkey visual cortex: neuropil pattern, cell morphology and laminar distribution

We studied the distribution of NADPH-diaphorase activity in the visual cortex of normal adult New World monkeys (Saimiri sciureus) using the malic enzyme "indirect" method. NADPH-diaphorase neuropil activity had a heterogeneous distribution. In coronal sections, it had a clear laminar pattern that was coincident with Nissl-stained layers. In tangential sections, we observed blobs in supragranular layers of V1 and stripes throughout the entire V2. We quantified and compared the tangential distribution of NADPH-diaphorase and cytochrome oxidase blobs in adjacent sections of the supragranular layers of V1. Although their spatial distributions were rather similar, the two enzymes did not always overlap. The histochemical reaction also revealed two different types of stained cells: a slightly stained subpopulation and a subgroup of deeply stained neurons resembling a Golgi impregnation. These neurons were sparsely spined non-pyramidal cells. Their dendritic arbors were very well stained but their axons were not always evident. In the gray matter, heavily stained neurons showed different dendritic arbor morphologies. However, most of the strongly reactive cells lay in the subjacent white matter, where they presented a more homogenous morphology. Our results demonstrate that the pattern of NADPH-diaphorase activity is similar to that previously described in Old World monkeys

Malnutrition during lactation as a metabolic imprinting factor inducing the feeding pattern of offspring rats when adults: The role of insulin and leptin

The aim of the present study was to determine the impact of malnutrition during early postnatal life and the feeding pattern of rat offspring when adults (2 months and 1 year old). In comparison with rats normally fed during lactation, we observed that adult offspring displayed a faster process of feeding reduction when a protein-free diet was offered. In addition, we studied the concentration of insulin and leptin in the lactating pups (10 days) and when these offspring became adult after the onset of a new feeding pattern induced by the protein-free diet. When the diet was changed at 60 days, the offspring malnourished during lactation displayed, after 3 days, a food intake reduction around 41.4 vs 14.2% of the control group. At 10 days of life, plasma leptin and insulin were higher in the malnourished pups when compared with normally fed rats (leptin: 4.6 ± 0.8 vs 2.25 ng/ml; insulin: 0.73 ± 0.12 vs 0.22 ± 0.03 ng/ml) while at 60 days they showed reduction of both hormones when compared with the control group (leptin: 1.03 ± 0.25 vs 1.43 ± 0.5 ng/ml; insulin: 0.54 ± 0.3 vs 0.61 ± 0.4 ng/ml). Despite the different food intake reductions, the malnourished and control rats displayed a similar reduction of insulin and leptin after 3 days of protein-free diet (from 60 to 63 days). The data suggest that the high concentration of insulin and leptin found at 10 days in the malnourished pups may elicit a sustained long-term and unique feeding pattern.