953 resultados para Encuestas semi-estructuradas


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In the present study, in vitro techniques were used to investigate a range of biological activities of known natural quassinoids isobrucein B (1) and neosergeolide (2), known semi-synthetic derivative 1,12-diacetylisobrucein B (3), and a new semi-synthetic derivative, 12-acetylneosergeolide (4). These compounds were evaluated for general toxicity toward the brine shrimp species Artemia franciscana, cytotoxicity toward human tumour cells, larvicidal activity toward the dengue fever mosquito vector Aedes aegypti, haemolytic activity in mouse erythrocytes and antimalarial activity against the human malaria parasite Plasmodium falciparum. Compounds 1 and 2 exhibited the greatest cytotoxicity against all the tumor cells tested (IC50 = 5-27 µg/L) and against multidrug-resistant P. falciparum K1 strain (IC50 = 1.0-4.0 g/L) and 3 was only cytotoxic toward the leukaemia HL-60 strain (IC50 = 11.8 µg/L). Quassinoids 1 and 2 (LC50 = 3.2-4.4 mg/L) displayed greater lethality than derivative 4 (LC50 = 75.0 mg/L) toward A. aegypti larvae, while derivative 3 was inactive. These results suggest a novel application for these natural quassinoids as larvicides. The toxicity toward A. franciscana could be correlated with the activity in several biological models, a finding that is in agreement with the literature. Importantly, none of the studied compounds exhibited in vitro haemolytic activity, suggesting specificity of the observed cytotoxic effects. This study reveals the biological potential of quassinoids 1 and 2 and to a lesser extent their semi-synthetic derivatives for their in vitro antimalarial and cytotoxic activities.

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Reinforcement learning (RL) is a very suitable technique for robot learning, as it can learn in unknown environments and in real-time computation. The main difficulties in adapting classic RL algorithms to robotic systems are the generalization problem and the correct observation of the Markovian state. This paper attempts to solve the generalization problem by proposing the semi-online neural-Q_learning algorithm (SONQL). The algorithm uses the classic Q_learning technique with two modifications. First, a neural network (NN) approximates the Q_function allowing the use of continuous states and actions. Second, a database of the most representative learning samples accelerates and stabilizes the convergence. The term semi-online is referred to the fact that the algorithm uses the current but also past learning samples. However, the algorithm is able to learn in real-time while the robot is interacting with the environment. The paper shows simulated results with the "mountain-car" benchmark and, also, real results with an underwater robot in a target following behavior

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Introduction: Cette étude a pour but de déterminer la fréquence de survenue de l'arrêt cardio-respiratoire (ACR) au cabinet médical qui constitue un élément de décision quant à la justification de la présence d'un défibrillateur semi-automatique (DSA) au cabinet médical. Matériel et Méthode: Analyse rétrospective des fiches d'intervention pré-hospitalière des ambulances et des SMUR (Service Mobile d'Urgence et de Réanimation) du canton de Vaud (650'000 habitants) entre 2003 et 2006 qui relataient un ACR. Les variables suivantes ont été analysées: chronologie de l'intervention, mesures de réanimation cardio-pulmonaire (RCP) appliquées, diagnostic présumé, suivi à 48 heures. Résultats: 17 ACR (9 _, 8 _) ont eu lieu dans les 1655 cabinets médicaux du canton de Vaud en 4 ans sur un total de 1753 ACR extrahospitaliers, soit 1% de ces derniers. Tous ont motivés une intervention simultanée d'une ambulance et d'un SMUR. L'âge moyen était de 70 ans. Le délai entre l'ACR et l'arrivée sur site d'un DSA était en moyenne de plus de 10 minutes (min-max: 4-25 minutes). Dans 13 cas évaluables, une RCP était en cours à l'arrivée des renforts, mais seulement 7 étaient qualifiées d'efficaces. Le rythme initial était une fibrillation ventriculaire (FV) dans 8 cas et ont tous reçu un choc électrique externe (CEE), dont 1 avant l'arrivée des secours administré dans un cabinet équipé d'un DSA. Le diagnostic était disponible pour 9 cas: 6 cardiopathies, 1 embolie pulmonaire massive, 1 choc anaphylactique et 1 tentamen médicamenteux. Le devenir de ces patients a été marqué par 6 décès sur site, 4 décès à l'admission à l'hôpital et 7 vivants à 48 heures. Les données ne permettent pas d'avoir un suivi ni à la sortie de l'hôpital ni ultérieurement. Conclusions: Bien que la survenue d'un ACR soit très rare au cabinet médical, il mérite une anticipation particulière de la part du médecin. En effet, le délai d'arrivée des services d'urgences nécessite la mise en oeuvre immédiate de mesures par le médecin. En outre, comme professionnel de la santé, il se doit d'intégrer la chaîne de survie en procédant à une alarme précoce du 144 et initier des gestes de premier secours («Basic Life Support»). La présence d'un DSA pourrait être envisagée en fonction notamment de l'éloignement de secours professionnels équipés d'un DSA.

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OBJECTIVE: The principal aim of this study was to develop a Swiss Food Frequency Questionnaire (FFQ) for the elderly population for use in a study to investigate the influence of nutritional factors on bone health. The secondary aim was to assess its validity and both short-term and long-term reproducibility. DESIGN: A 4-day weighed record (4 d WR) was applied to 51 randomly selected women of a mean age of 80.3 years. Subsequently, a detailed FFQ was developed, cross-validated against a further 44 4-d WR, and the short- (1 month, n = 15) and long-term (12 months, n = 14) reproducibility examined. SETTING: French speaking part of Switzerland. SUBJECTS: The subjects were randomly selected women recruited from the Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture cohort study. RESULTS: Mean energy intakes by 4-d WR and FFQ showed no significant difference [1564.9 kcal (SD 351.1); 1641.3 kcal (SD 523.2) respectively]. Mean crude nutrient intakes were also similar (with nonsignifcant P-values examining the differences in intake) and ranged from 0.13 (potassium) to 0.48 (magnesium). Similar results were found in the reproducibility studies. CONCLUSION: These findings provide evidence that this FFQ adequately estimates nutrient intakes and can be used to rank individuals within distributions of intake in specific populations.

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Background: In patients with cervical spine injury, a cervical collar may prevent cervical spine movements but renders tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesized that despite the presence of a semi-rigid cervical collar and with the patient's head taped to the trolley, we would be able to intubate all patients with the GlideScopeR and its dedicated stylet. Methods: 50 adult patients (ASA 1 or 2, BMI ≤35 kg/m2) scheduled for elective surgical procedures requiring tracheal intubation were included. After standardized induction of general anesthesia and neuromuscular blockade, the neck was immobilized with an appropriately sized semi-rigid Philadelphia Patriot® cervical collar, the head was taped to the trolley. Laryngoscopy was attempted using a Macintosh laryngoscope blade 4 and the modified Cormack Lehane grade was noted. Subsequently, laryngoscopy with the GlideScopeR was graded and followed by oro-tracheal intubation. Results: All patients were successfully intubated with the GlideScopeR and its dedicated stylet. The median intubation time was 50 sec [43; 61]. The modified Cormack Lehane grade was 3 or 4 at direct laryngoscopy. It was significantly reduced with the GlideScopeR (p <0.0001), reaching 2a in most of patients. Maximal mouth opening was significantly reduced with the cervical collar applied, 4.5 cm [4.5; 5.0] vs. 2.0 cm [1.8; 2.0] (p <0.0001). Conclusions: The GlideScope® allows oro-tracheal intubation in patients having their cervical spine immobilized by a semi-rigid collar and their head taped to the trolley. It furthermore decreases significantly the modified Cormack Lehane grade.

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Uncertainty quantification of petroleum reservoir models is one of the present challenges, which is usually approached with a wide range of geostatistical tools linked with statistical optimisation or/and inference algorithms. Recent advances in machine learning offer a novel approach to model spatial distribution of petrophysical properties in complex reservoirs alternative to geostatistics. The approach is based of semisupervised learning, which handles both ?labelled? observed data and ?unlabelled? data, which have no measured value but describe prior knowledge and other relevant data in forms of manifolds in the input space where the modelled property is continuous. Proposed semi-supervised Support Vector Regression (SVR) model has demonstrated its capability to represent realistic geological features and describe stochastic variability and non-uniqueness of spatial properties. On the other hand, it is able to capture and preserve key spatial dependencies such as connectivity of high permeability geo-bodies, which is often difficult in contemporary petroleum reservoir studies. Semi-supervised SVR as a data driven algorithm is designed to integrate various kind of conditioning information and learn dependences from it. The semi-supervised SVR model is able to balance signal/noise levels and control the prior belief in available data. In this work, stochastic semi-supervised SVR geomodel is integrated into Bayesian framework to quantify uncertainty of reservoir production with multiple models fitted to past dynamic observations (production history). Multiple history matched models are obtained using stochastic sampling and/or MCMC-based inference algorithms, which evaluate posterior probability distribution. Uncertainty of the model is described by posterior probability of the model parameters that represent key geological properties: spatial correlation size, continuity strength, smoothness/variability of spatial property distribution. The developed approach is illustrated with a fluvial reservoir case. The resulting probabilistic production forecasts are described by uncertainty envelopes. The paper compares the performance of the models with different combinations of unknown parameters and discusses sensitivity issues.

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OBJECTIVE This study assesses the effectiveness of a structured telephone survey on cardiovascular prevention, in modifying lifestyle, on cardiovascular risk parameters, percentage of smoking cessation and overall cardiovascular risk (CVR). DESIGN Quasi-experimental study of preventive intervention. SETTING Ibermutuamur (Spanish Accident and Health Insurance Company). Centres established throughout Spain. PARTICIPANTS A total of 4,792 workers with moderate/high cardiovascular risk who had agreed to be contacted by phone. Subjects with a previous diagnosis of cardiovascular disease and those receiving treatment for hypertension, hypercholesterolemia or diabetes were excluded. INTERVENTION A final total of 3,085 workers were contacted and were followed up by telephone surveys on the first, fourth and eighth month after the initial check up (CU) in order to emphasise cardiovascular health advice (Group A); we failed to contact 1,707 workers, who only attended the baseline and one year CUs (Group B). PRINCIPAL OUTCOMES: CUs included medical records and physical examination, with two blood pressure measurements, Body Mass Index (BMI), and biochemical parameters. Cardiovascular risk was stratified following the European cardiovascular SCORE. Individuals with a relative risk higher than 4 were also considered as high-risk. All workers were informed about their cardiovascular risk profile (CVRF) and healthy cardiovascular lifestyle measures. They were also given a letter for their General Practitioner (GP) to inform them on the worker's cardiovascular risk level. RESULTS A total of 71.5% of the workers were over 45 years, 95.0% males, 76.6% manual workers ("Blue Collar") and 69.7% smokers. Both groups showed improvement in lipid parameters, blood pressure, smoking cessation and overall cardiovascular risk in the second CU. There were significant differences in favour of Group A as regards blood pressure, lipids (except HDL cholesterol), BMI, glycaemia, smoking cessation (A: 23.5%/B: 19.44%, P=0.001) and CVR stratum improvement (A: 46.6%/B: 37.7%, P=0.0001). The large majority (85%) of workers read preventive recommendations; 33% knew their risk level and 73% knew their CVRF. 52.9% gave the letter to the GP, which led them to start therapies on diet (47%), hypertension (19.5%), dyslipidaemia (16.7%), diabetes (4.4%) and smoking (2.9%) and no changes were made in 36.5% of cases. CONCLUSIONS The results of this study suggests that cardiovascular prevention strategy based on structured telephone surveys on high/moderate CVR subjects to promote lifestyle changes could be effective at reducing CVR. A clinical trial is required for confirmation. Sending information on CVRF following routine medial CUs and Primary Care involvement, could contribute to the positive changes observed.

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L’objectiu d’aquest PFC és desenvolupar una eina d’edició de façanes procedural apartir d’una imatge d’una façana real. L’aplicació generarà les regles procedurals de lafaçana a partir de dades adquirides del model que es vol representar, com unafotografia. L’usuari de l’aplicació generarà de forma semi-automàtica i interactiva lesregles de subdivisió i repetició, especificant també la inserció de elementsarquitectònics (portes, finestres), que podran ser instanciats a partir d’una llibreria. Uncop generades, les regles s’escriuran en el format del sistema BuildingEngine perintegrar-se completament dins el procés de modelatge urbà.Aquest projecte es desenvoluparà en Matlab

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Este trabalho tem como objetivos identificar a utilização, pelos profissionais de Enfermagem, do toque instrumental e/ou afetivo e suas características, na comunicação não-verbal com os pacientes da UTI e unidade semi-intensiva cirúrgica do HU-USP; e os sentimentos e percepções dos profissionais de Enfermagem e dos pacientes em relação aos toques experimentados. O estudo foi desenvolvido com 19 profissionais e 19 pacientes, no período de outubro a novembro de 2000, através de observação direta das interações e entrevista individual. Os sentimentos e percepções relatados foram categorizados e percebemos que a maioria dos toques é instrumental-afetivo.

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O estudo objetivou caracterizar erros de medicação e avaliar conseqüências na gravidade dos pacientes e carga de trabalho de enfermagem em duas Unidades de Terapia Intensiva (UTI) e duas Semi-Intensiva (USI) de duas instituições hospitalares do município de São Paulo. A amostra foi constituída por 50 pacientes e os dados obtidos por meio do registro de ocorrências e prontuários, retrospectivamente. A gravidade e carga de trabalho de enfermagem foram avaliadas antes e após o erro. Do total de 52 erros, 12 (23,08%) ocorreram por omissão de dose, 11 (21,15%) e 9 (17,31%) por medicamento e dose erradas, respectivamente. Não houve mudança na gravidade dos pacientes (p=0,316), porém houve aumento na carga de trabalho de enfermagem (p=0,009). Quanto ao grupo de medicamentos envolvidos, potencialmente perigosos e não potencialmente perigosos, não houve diferenças estatisticamente significantes na gravidade (p=0,456) e na carga de trabalho de enfermagem (p=0,264), após o erro de medicação.

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Estudos demonstram que a sobrevida após uma parada cardíaca diminui 10% para cada minuto de atraso na desfibrilação, e que a taxa de sobrevivência é de 98% quando ela é conseguida em 30 segundos. No atendimento de uma parada cardíaca, é primordial que seja incluído no treinamento a utilização dos desfibriladores externos semi-automáticos (DEA). O objetivo deste estudo foi comparar a Habilidade Psicomotora e o Conhecimento Teórico de leigos na técnica da ressuscitação cardiopulmonar (RCP) utilizando o DEA, antes e após treinamento. A amostra constituiu-se de 40 funcionários administrativos de uma instituição pública que receberam treinamento da técnica da RCP, utilizando o DEA, em laboratório. O aumento significativo de acertos nos itens do instrumento de avaliação da Habilidade Psicomotora e do Conhecimento Teórico, após o treinamento, indica que houve melhora no desempenho dos participantes.

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El presente proyecto ha sido pergeñado como una aplicación que pretende resolver las dos carencias principales detectadas en los sistemas clásicos de encuestas on-line gratuitos: por un lado, resultan estáticos (en el sentido de que las encuestas no son dinámicas en función de las respuestas acumuladas) y, por otro, no ofrecen al individuo encuestado el conocimiento que necesita (como máximo devolverán información agrupada de acuerdo a los resultados globales obtenidos sin retornar un análisis comparativo del grupo frente a la del usuario).

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El objetivo de estas recomendaciones es ayudar a incrementar la calidad y la eficiencia de las distintas encuestas que sobre condiciones de trabajo y salud se realizan en España, haciendo más comparable la información obtenida en los diferentes territorios y a lo largo del tiempo.