Valor preditivo positivo das categorias 3, 4 e 5 do Breast Imaging Reporting and Data System (BI-RADS®)

OBJETIVO: O objetivo deste trabalho foi avaliar o BI-RADS® como fator preditivo de suspeição de malignidade em lesões mamárias não palpáveis nas categorias 3, 4 e 5, correlacionando as mamografias com os resultados histopatológicos através do cálculo do valor preditivo positivo do exame mamográfico. MATERIAIS E MÉTODOS: Trezentas e setenta e uma pacientes encaminhadas a um serviço de referência em tratamento de câncer em Teresina, PI, para realização de exames histopatológicos em mama no período de julho de 2005 a março de 2008, por terem mamografia de categorias 3, 4 ou 5, tiveram seus exames revisados. Das 371 pacientes, 265 foram submetidas a biópsia por agulha grossa e 106, a marcação pré-cirúrgica. RESULTADOS: Em relação às mamografias, 11,32% foram classificadas como categoria 3, 76,28% como categoria 4 e 12,4% como categoria 5. Os resultados histológicos demonstraram 24% de exames positivos para malignidade. Os valores preditivos positivos das categorias 3, 4 e 5 foram, respectivamente, de 7,14%, 16,96% e 82,61%. Foram calculados os valores preditivos positivos, separadamente, para as biópsias percutâneas (7,14%, 15,76%, 76,47%) e para as marcações pré-cirúrgicas (7,14%, 20%, 100%). CONCLUSÃO: Achados malignos foram subestimados pelo laudo radiológico e houve superestimação de achados benignos, o que resultou na realização desnecessária de alguns procedimentos invasivos.

Identification and ethnic diversity underlie support for multicultural rights : a multilevel analysis in Bulgaria

Bulgaria is historically a multicultural society, composed of the Bulgarian (ethnic) majority and a number of ethnic minorities among which Bulgarian Turks and Roma are the largest. Both minority communities are stigmatized in contemporary Bulgaria, though to different degrees and for different reasons. Ethnic minorities' rights to preserve their culture, customs, and language are a topic of contentious debate. The purpose of this study was to examine individual- and context-level antecedents of the ethnic Bulgarian majority's support for multicultural rights of ethnic minorities. Multilevel regression analyses were conducted with International Social Survey Programme ISSP 2003 data (N = 920 in 28 Bulgarian districts). At the individual-level, an ethnic conception of the nation and anti-Roma symbolic prejudice were negatively related to support for multicultural rights, whereas national identification was positively related to the support of these rights. Over and above individual-level effects, and in line with recent extensions of intergroup contact theory, thepercentage ofBulgarianTurks withindistricts was positively related to support for multicultural rights. Importantly, support for multicultural rights was particularly high in districts characterized by ethnic diversity, that is, in districts with high proportions of both Bulgarian Turks and Roma. The beneficial effects of ethnic diversity and theoretical implications of findings are discussed.

Positive predictive values of Breast Imaging Reporting and Data System (BI-RADS®) categories 3, 4 and 5 in breast lesions submitted to percutaneous biopsy

Objective To evaluate the BI-RADS as a predictive factor of suspicion for malignancy in breast lesions by correlating radiological with histological results and calculating the positive predictive value for categories 3, 4 and 5 in a breast cancer reference center in the city of São Paulo. Materials and Methods Retrospective, analytical and cross-sectional study including 725 patients with mammographic and/or sonographic findings classified as BI-RADS categories 3, 4 and 5 who were referred to the authors' institution to undergo percutaneous biopsy. The tests results were reviewed and the positive predictive value was calculated by means of a specific mathematical equation. Results Positive predictive values found for categories 3, 4 and 5 were respectively the following: 0.74%, 33.08% and 92.95%, for cases submitted to ultrasound-guided biopsy, and 0.00%, 14.90% and 100% for cases submitted to stereotactic biopsy. Conclusion The present study demonstrated high suspicion for malignancy in lesions classified as category 5 and low risk for category 3. As regards category 4, the need for systematic biopsies was observed.

The role of gadoxetic acid as a paramagnetic contrast medium in the characterization and detection of focal liver lesions: a review

Recent studies have demonstrated that the use of paramagnetic hepatobiliary contrast agents in the acquisition of magnetic resonance images remarkably improves the detection and differentiation of focal liver lesions, as compared with extracellular contrast agents. Paramagnetic hepatobiliary contrast agents initially show the perfusion of the lesions, as do extracellular agents, but delayed contrast-enhanced images can demonstrate contrast uptake by functional hepatocytes, providing further information for a better characterization of the lesions. Additionally, this intrinsic characteristic increases the accuracy in the detection of hepatocellular carcinomas and metastases, particularly the small-sized ones. Recently, a hepatobiliary contrast agent called gadolinium ethoxybenzyl dimeglumine, that is simply known as gadoxetic acid, was approved by the National Health Surveillance Agency for use in humans. The authors present a literature review and a practical approach of magnetic resonance imaging utilizing gadoxetic acid as contrast agent, based on patients' images acquired during their initial experiment.

Preparation of a blood culture pellet for rapid bacterial identification and antibiotic susceptibility testing.

Bloodstream infections and sepsis are a major cause of morbidity and mortality. The successful outcome of patients suffering from bacteremia depends on a rapid identification of the infectious agent to guide optimal antibiotic treatment. The analysis of Gram stains from positive blood culture can be rapidly conducted and already significantly impact the antibiotic regimen. However, the accurate identification of the infectious agent is still required to establish the optimal targeted treatment. We present here a simple and fast bacterial pellet preparation from a positive blood culture that can be used as a sample for several essential downstream applications such as identification by MALDI-TOF MS, antibiotic susceptibility testing (AST) by disc diffusion assay or automated AST systems and by automated PCR-based diagnostic testing. The performance of these different identification and AST systems applied directly on the blood culture bacterial pellets is very similar to the performance normally obtained from isolated colonies grown on agar plates. Compared to conventional approaches, the rapid acquisition of a bacterial pellet significantly reduces the time to report both identification and AST. Thus, following blood culture positivity, identification by MALDI-TOF can be reported within less than 1 hr whereas results of AST by automated AST systems or disc diffusion assays within 8 to 18 hr, respectively. Similarly, the results of a rapid PCR-based assay can be communicated to the clinicians less than 2 hr following the report of a bacteremia. Together, these results demonstrate that the rapid preparation of a blood culture bacterial pellet has a significant impact on the identification and AST turnaround time and thus on the successful outcome of patients suffering from bloodstream infections.

Identification and conservation of remnant genetic resources of brown trout in relict populations from Western Mediterranean streams

Brown trout is a cold-adapted freshwater species with restricted distribution to headwater streams in rivers of the South European peninsulas, where populations are highly vulnerable because Mediterranean regions are highly sensitive to the global climatic warming. Moreover, these populations are endangered due to the introgressive hybridization with cultured stocks. Individuals from six remnant populations in Western Mediterranean rivers were sequenced for the complete mitochondrial DNA control region and genotyped for 11 nuclear markers. Three different brown trout lineages were present in the studied region. Significant genetic divergence was observed among locations and a strong effect of genetic drift was suggested. An important stocking impact (close to 25%) was detected in the zone. Significant correlations between mitochondrial-based rates of hatchery introgression and water flow variation suggested a higher impact of stocked females in unstable habitats. In spite of hatchery introgression, all populations remained highly differentiated, suggesting that native genetic resources are still abundant. However, climatic predictions indicated that suitable habitats for the species in these rivers will be reduced and hence trout populations are highly endangered and vulnerable. Thus, management policies should take into account these predictions to design upstream refuge areas to protect remnant native trout in the region

Technology roadmap for new sales support and management system for crane manufacturing company

Sales configurators are essential tools for companies that offer complicated case specifically crafted products for customers. Most sophisticated of them are able to design an entire end product on the fly according to given constraints, calculate price for the offer and move the order into production. This thesis covers a sales configurator acquisition project in a large industrial company that offers cranes for its customers. The study spans the preliminary stages of a large-scale software purchase project starting from the specification of problem domain and ending up presenting the most viable software solution that fulfils the requirements for the new system. The project consists of mapping usage environment, use cases, and collecting requirements that are expected from the new system. The collected requirements involve fitting the new sales system into enterprise application infrastructure, mitigating the risks involved in the project and specifying new features to the application whilst preserving all of the admired features of the old sales system currently used in the company. The collected requirements were presented to a number of different sales software vendors who were asked to provide solution suggestions that would fulfil all the demands. All of the received solution proposals were exposed to an evaluation to determine the most feasible solutions, and the construction of evaluation criteria itself was a part of the study. The final outcome of this study is a short-list of the most feasible sales configurator solutions together with a description of how software purchase process in large enterprises work, and which aspects should be paid attention in large projects of similar kind.

Development of a Filter Aid Proportioning, Mixing, and Feeding System for a Polishing Filter

The purpose of this work was to study the characteristics of the most commonly used filter aid materials and their influences on the design of proportioning, mixing, and feeding system for polishing filter family. Based on the literature survey and hands-on experience a system was designed with defined equipment and capital and operating costs. The system was designed to serve precoating and bodyfeeding applications and is easily extended to be used in multiple filter processes. Also a test procedure was carried out where influences of flux and filter cloths to accumulated cake were studied. Filter aid is needed in challenging conditions to improve filtration efficiency and cleaning, and thus extend the operating life of the filter media. Filter aid preparation and feeding system was designed for the use of two different filter aids; precoat and bodyfeed. Precoating is used before the filtration step initiates. If the solids in the filterable solution have a tendency to clog the filter bag easily, precoat is used on the filter bag to obtain better filtration efficiency and quality. Diatomite or perlite is usually used as a precoating substance. The intention is to create a uniform cake to the overall surface of the filter cloth, with predetermined thickness, 2 – 5 mm. This ensures that the clogging of the filter cloth is reduced and the filtration efficiency is increased. Bodyfeed is used if the solids in the filterable solution have a tendency to form a sticky impermeable filter cake. The cake properties are enhanced by maintaining the permeability of the accumulating cake by using the filter aid substance as bodyfeed during the filtration process.

Improving the Potentials of Logistics Processes: Identification and Solutions

The importance of logistics for companies is a well known and justified issue. Today, enterprises are developing their logistics processes in order to match their products and services to the requirements of the most important customers. Therefore there is a need for developing analysing tools for logistics and especially for analysing the significance of various customer service elements. The aim of this paper is to propose analytic tools for supporting strategic level logistics decision making by emphasizing service level elements on two levels: (1) to introduce and propose approaches to categorize the developing efforts of logistics and (2) to introduce and/or propose approaches for solving some customer service related strategic level logistics problems. This study consists of two parts. In the first part an overview of the work is presented, and the second part comprises eight research papers on the topic of the study. The overview includes an introduction, where strategic and tactical level logistics problems are discussed and the relation of logistics to marketing and customer service issues is presented. In the first part of the study the objectives, the structure, the research strategy and the contribution of the research are described, and the challenges for future research are discussed. In the second part the three first papers deal with the identification of objectives for logistics while the remaining five papaers concentrate on solving customer service related strategic level logistics problems.

Combined dielectrophoretic and impedance system for on-chip controlled bacteria concentration: Application to Escherichia coli

The present paper reports a bacteria autonomous controlled concentrator prototype with a user-friendly interface for bench-top applications. It is based on a micro-fluidic lab-on-a-chip and its associated custom instrumentation, which consists in a dielectrophoretic actuator, to pre-concentrate the sample, and an impedance analyser, to measure concentrated bacteria levels. The system is composed by a single micro-fluidic chamber with interdigitated electrodes and a instrumentation with custom electronics. The prototype is supported by a real-time platform connected to a remote computer, which automatically controls the system and displays impedance data used to monitor the status of bacteria accumulation on-chip. The system automates the whole concentrating operation. Performance has been studied for controlled volumes of Escherichia coli (E. coli) samples injected into the micro-fluidic chip at constant flow rate of 10 μL/min. A media conductivity correcting protocol has been developed, as the preliminary results showed distortion of the impedance analyser measurement produced by bacterial media conductivity variations through time. With the correcting protocol, the measured impedance values were related to the quantity of bacteria concentrated with a correlation of 0.988 and a coefficient of variation of 3.1%. Feasibility of E. coli on-chip automated concentration, using the miniaturized system, has been demonstrated. Furthermore, the impedance monitoring protocol had been adjusted and optimized, to handle changes in the electrical properties of the bacteria media over time.

Identification and characterization of a Hydrangea ringspot virus isolate infecting hydrangea in São Paulo State

Hydrangea plants showing leaves with chlorotic and necrotic rings from Arujá Municipality, São Paulo State, were analyzed for the identification of the viral species. Elongated filamentous particles of 490 nm were visualized under transmission electron microscope. Oligonucleotides for Hydrangea ringspot virus (HdRSV), a potexvirus commonly found in Europe and in the United States, were tested using total RNA from hydrangea plants, amplifying two fragments, one around 550 and another one of 250 nucleotides. Nucleotide identity with HdRSV (accession number AJ 707100.1) was 96% and 88% for the longest and shortest fragment, respectively, indicating the presence of this virus. To evaluate its dissemination in the matrices of hydrangea used in the commercial production, 17 samples were collected in the region of Arujá, and eight were infected by HdRSV. For the analyzed viral replicase portion, the isolates from the varieties 'Azul LZR', 'Rosita', 'Renat Blue' and 'Vermelho Comum' did not differ in their amino acid sequences from isolates with sequences deposited in the GenBank (accession numbers AY 707100 and NC_006943). The isolates from 'Azul Rendado' and "Rosa Japonesa' showed few differences but were related to the remaining isolates. An antiserum was obtained for HdRSV and can be efficiently used to detect such virus in hydrangea and Primula malacoides, another ornamental plant also infected by HdRSV.

Researching Manufacturing Planning and Control system and Master Scheduling in a manufacturing firm.

The objective of this thesis is to research Manufacturing Planning and Control (MPC) system and Master Scheduling (MS) in a manufacturing firm. The study is conducted at Ensto Finland Corporation, which operates on a field of electrical systems and supplies. The paper consists of theoretical and empirical parts. The empirical part is based on weekly operating at Ensto and includes inter-firm material analysis, learning and meetings. Master Scheduling is an important module of an MPC system, since it is beneficial on transforming strategic production plans based on demand forecasting into operational schedules. Furthermore, capacity planning tools can remarkably contribute to production planning: by Rough-Cut Capacity Planning (RCCP) tool, a MS plan can be critically analyzed in terms of available key resources in real manufacturing environment. Currently, there are remarkable inefficiencies when it comes to Ensto’s practices: the system is not able to take into consideration seasonal demand and react on market changes on time; This can cause significant lost sales. However, these inefficiencies could be eliminated through the appropriate utilization of MS and RCCP tools. To utilize MS and RCCP tools in Ensto’s production environment, further testing in real production environment is required. Moreover, data accuracy, appropriate commitment to adapting and learning the new tools, and continuous developing of functions closely related to MS, such as sales forecasting, need to be ensured.