Early multimodal outcome prediction after cardiac arrest in patients treated with hypothermia.

OBJECTIVES: Therapeutic hypothermia and pharmacological sedation may influence outcome prediction after cardiac arrest. The use of a multimodal approach, including clinical examination, electroencephalography, somatosensory-evoked potentials, and serum neuron-specific enolase, is recommended; however, no study examined the comparative performance of these predictors or addressed their optimal combination. DESIGN: Prospective cohort study. SETTING: Adult ICU of an academic hospital. PATIENTS: One hundred thirty-four consecutive adults treated with therapeutic hypothermia after cardiac arrest. MEASUREMENTS AND MAIN RESULTS: Variables related to the cardiac arrest (cardiac rhythm, time to return of spontaneous circulation), clinical examination (brainstem reflexes and myoclonus), electroencephalography reactivity during therapeutic hypothermia, somatosensory-evoked potentials, and serum neuron-specific enolase. Models to predict clinical outcome at 3 months (assessed using the Cerebral Performance Categories: 5 = death; 3-5 = poor recovery) were evaluated using ordinal logistic regressions and receiving operator characteristic curves. Seventy-two patients (54%) had a poor outcome (of whom, 62 died), and 62 had a good outcome. Multivariable ordinal logistic regression identified absence of electroencephalography reactivity (p < 0.001), incomplete recovery of brainstem reflexes in normothermia (p = 0.013), and neuron-specific enolase higher than 33 μg/L (p = 0.029), but not somatosensory-evoked potentials, as independent predictors of poor outcome. The combination of clinical examination, electroencephalography reactivity, and neuron-specific enolase yielded the best predictive performance (receiving operator characteristic areas: 0.89 for mortality and 0.88 for poor outcome), with 100% positive predictive value. Addition of somatosensory-evoked potentials to this model did not improve prognostic accuracy. CONCLUSIONS: Combination of clinical examination, electroencephalography reactivity, and serum neuron-specific enolase offers the best outcome predictive performance for prognostication of early postanoxic coma, whereas somatosensory-evoked potentials do not add any complementary information. Although prognostication of poor outcome seems excellent, future studies are needed to further improve prediction of good prognosis, which still remains inaccurate.

Suomen ja Viron tehtaiden välisen uistinliiketoiminnan suorituskyvyn ja kannattavuuden kasvattaminen

Tämän tutkimuksen tavoitteena oli selvittää Päijät-Hämeessä toimivan uistimia valmistavan tehdasyksikön sekä saman konsernin Virossa toimivan tehdasyksikön välisen uistinliiketoiminnan kannattavuuden ja suorituskyvyn mahdollinen kasvattaminen. Konsernilla on käytössään kannattavan kasvun strategia, johon tämäkin yksi liiketoiminnan kehittämishankekin omalta osaltaan myös tähtää. Kannattavuutta tarkasteltiin tehtaiden välisen päätoimialan ja sen tuottavuuden ja suorituskyvyn näkökulmasta. Työssä on lähdetty rakentamaan tehtaiden väliselle uistinliiketoiminnalle uudenlaista mittaristoa operationaalisen johdon käyttöön. Suorituskykymittaristossa otetaan huomioon suunnittelutiimin avulla määritellyt avainmittarien osa-alueet ja niiden kehittäminen tulevaisuudessa. Työ käsittelee myös hieman toimipisteissä tapahtuvan muutosten hallitsemista sekä kehittävän ilmapiirin kasvattamista. Tässä tutkimuksessa havaittiin, että suorituskyvyn mittaamisesta oli hyötyä niin operationaaliselle toimipaikkakohtaiselle johdolle kuin tuotannon työntekijällekin. Tehtaiden välisestä suorituskyvystä saatiin vertailevaa tietoa, jota voidaan käyttää hyödyksi tulevaisuudessa. Tulevaisuudessa tästä järjestelmästä saatava tieto helpottaa tuotantolaitoksissa tapahtuvaa työvaiheiden kokonaisvaltaista prosessointia josta kuitenkin pitkällä tähtäimellä suurimmat kustannussäästöt tulevat yritykselle.

Molecular modelling studies of binding of DACD derivatives into G-Quadruplex DNA: comparison of force field and quantum polarized ligand docking methods

The DNA G-qadruplexes are one of the targets being actively explored for anti-cancer therapy by inhibiting them through small molecules. This computational study was conducted to predict the binding strengths and orientations of a set of novel dimethyl-amino-ethyl-acridine (DACA) analogues that are designed and synthesized in our laboratory, but did not diffract in Synchrotron light.Thecrystal structure of DNA G-Quadruplex(TGGGGT)4(PDB: 1O0K) was used as target for their binding properties in our studies.We used both the force field (FF) and QM/MM derived atomic charge schemes simultaneously for comparing the predictions of drug binding modes and their energetics. This study evaluates the comparative performance of fixed point charge based Glide XP docking and the quantum polarized ligand docking schemes. These results will provide insights on the effects of including or ignoring the drug-receptor interfacial polarization events in molecular docking simulations, which in turn, will aid the rational selection of computational methods at different levels of theory in future drug design programs. Plenty of molecular modelling tools and methods currently exist for modelling drug-receptor or protein-protein, or DNA-protein interactionssat different levels of complexities.Yet, the capasity of such tools to describevarious physico-chemical propertiesmore accuratelyis the next step ahead in currentresearch.Especially, the usage of most accurate methods in quantum mechanics(QM) is severely restricted by theirtedious nature. Though the usage of massively parallel super computing environments resulted in a tremendous improvement in molecular mechanics (MM) calculations like molecular dynamics,they are still capable of dealing with only a couple of tens to hundreds of atoms for QM methods. One such efficient strategy that utilizes thepowers of both MM and QM are the QM/MM hybrid methods. Lately, attempts have been directed towards the goal of deploying several different QM methods for betterment of force field based simulations, but with practical restrictions in place. One of such methods utilizes the inclusion of charge polarization events at the drug-receptor interface, that is not explicitly present in the MM FF.

Epidemic K-Means clustering

The K-Means algorithm for cluster analysis is one of the most influential and popular data mining methods. Its straightforward parallel formulation is well suited for distributed memory systems with reliable interconnection networks. However, in large-scale geographically distributed systems the straightforward parallel algorithm can be rendered useless by a single communication failure or high latency in communication paths. This work proposes a fully decentralised algorithm (Epidemic K-Means) which does not require global communication and is intrinsically fault tolerant. The proposed distributed K-Means algorithm provides a clustering solution which can approximate the solution of an ideal centralised algorithm over the aggregated data as closely as desired. A comparative performance analysis is carried out against the state of the art distributed K-Means algorithms based on sampling methods. The experimental analysis confirms that the proposed algorithm is a practical and accurate distributed K-Means implementation for networked systems of very large and extreme scale.

Fault tolerant decentralised K-Means clustering for asynchronous large-scale networks

The K-Means algorithm for cluster analysis is one of the most influential and popular data mining methods. Its straightforward parallel formulation is well suited for distributed memory systems with reliable interconnection networks, such as massively parallel processors and clusters of workstations. However, in large-scale geographically distributed systems the straightforward parallel algorithm can be rendered useless by a single communication failure or high latency in communication paths. The lack of scalable and fault tolerant global communication and synchronisation methods in large-scale systems has hindered the adoption of the K-Means algorithm for applications in large networked systems such as wireless sensor networks, peer-to-peer systems and mobile ad hoc networks. This work proposes a fully distributed K-Means algorithm (EpidemicK-Means) which does not require global communication and is intrinsically fault tolerant. The proposed distributed K-Means algorithm provides a clustering solution which can approximate the solution of an ideal centralised algorithm over the aggregated data as closely as desired. A comparative performance analysis is carried out against the state of the art sampling methods and shows that the proposed method overcomes the limitations of the sampling-based approaches for skewed clusters distributions. The experimental analysis confirms that the proposed algorithm is very accurate and fault tolerant under unreliable network conditions (message loss and node failures) and is suitable for asynchronous networks of very large and extreme scale.

Design of associative memories using cellular neural networks

Cellular neural networks (CNNs) have locally connected neurons. This characteristic makes CNNs adequate for hardware implementation and, consequently, for their employment on a variety of applications as real-time image processing and construction of efficient associative memories. Adjustments of CNN parameters is a complex problem involved in the configuration of CNN for associative memories. This paper reviews methods of associative memory design based on CNNs, and provides comparative performance analysis of these approaches.

Structural matching of 2D electrophoresis gels using deformed graphs

2D electrophoresis is a well-known method for protein separation which is extremely useful in the field of proteomics. Each spot in the image represents a protein accumulation and the goal is to perform a differential analysis between pairs of images to study changes in protein content. It is thus necessary to register two images by finding spot correspondences. Although it may seem a simple task, generally, the manual processing of this kind of images is very cumbersome, especially when strong variations between corresponding sets of spots are expected (e.g. strong non-linear deformations and outliers). In order to solve this problem, this paper proposes a new quadratic assignment formulation together with a correspondence estimation algorithm based on graph matching which takes into account the structural information between the detected spots. Each image is represented by a graph and the task is to find a maximum common subgraph. Successful experimental results using real data are presented, including an extensive comparative performance evaluation with ground-truth data. (C) 2010 Elsevier B.V. All rights reserved.

Desenho de um sistema de metas sociais

Este trabalho discute a racionalidade econômica para o desenvolvimento de um sistema de metas sociais como forma de o governo federal aumentar a eficiência na utilização dos recursos sociais transferidos para os municípios. O trabalho desenvolve algumas extensões do modelo de agente-principal incluindo abordagens estáticas com e sem informação imperfeita e abordagens dinâmicas com contratos perfeitos e imperfeitos. Os resultados dos modelos estáticos indicam que o uso de critérios usuais de focalização onde localidades mais pobres recebem mais recursos pode levar a incentivos adversos para a erradicação da pobreza. Nós também mostramos que transferências incondicionais do governo federal deslocam gastos sociais locais. O trabalho argumenta em favor do uso de contratos onde quanto maior for a melhora no indicador social escolhido, mais recursos o município receberia. A introdução de informação imperfeita neste modelo basicamente gera uma penalidade aos segmentos pobres de áreas onde os governos demonstram ser menos avessos a pobreza. O trabalho também aborda o problema de favoritismo político onde determinados grupos sociais têm maior, ou menor, atenção por parte de governos locais. O resultado é que as políticas sociais acabam privilegiando determinados setores em detrimento de outros. Com o estabelecimento de metas sociais é possível, se não eliminar o problema, ao menos criar incentivos corretos para que os gastos sociais sejam distribuídos de forma mais equânime. Também desenvolvemos modelos dinâmicos com diferentes possibilidades de renegociação ao longo do tempo. Demonstramos que a melhor forma de aumentar a eficiência alocativa dos fundos seria criar mecanismos institucionais garantindo a impossibilidade de renegociações bilaterais. Esse contrato ótimo reproduz a seqüência de metas e transferências de vários períodos encontrada na solução do modelo estático. Entretanto, esse resultado- desaparece quando incorporamos contratos incompletos. Nesse caso, as ineficiências ex-ante criadas pela possibilidade de renegociação devem ser comparadas com as ineficiências ex-post criadas por não se usar a informação nova revelada ao longo do processo. Finalmente, introduzimos a possibilidade do resultado social observado depender não só do investimento realizado, mas também da presença de choques. Nesse caso, tanto o governo quanto o município aumentam as suas metas de investimento na área social. Contratos lineares na presença de choques negativos fazem com que os municípios recebem menos recursos justamente em situações adversas. Para contornar esse problema, mostramos a importância da utilização de contratos com comparação de performance.

O problema do caixeiro viajante alugador : um estudo algorítmico

The Car Rental Salesman Problem (CaRS) is a variant of the classical Traveling Salesman Problem which was not described in the literature where a tour of visits can be decomposed into contiguous paths that may be performed in different rental cars. The aim is to determine the Hamiltonian cycle that results in a final minimum cost, considering the cost of the route added to the cost of an expected penalty paid for each exchange of vehicles on the route. This penalty is due to the return of the car dropped to the base. This paper introduces the general problem and illustrates some examples, also featuring some of its associated variants. An overview of the complexity of this combinatorial problem is also outlined, to justify their classification in the NPhard class. A database of instances for the problem is presented, describing the methodology of its constitution. The presented problem is also the subject of a study based on experimental algorithmic implementation of six metaheuristic solutions, representing adaptations of the best of state-of-the-art heuristic programming. New neighborhoods, construction procedures, search operators, evolutionary agents, cooperation by multi-pheromone are created for this problem. Furtermore, computational experiments and comparative performance tests are conducted on a sample of 60 instances of the created database, aiming to offer a algorithm with an efficient solution for this problem. These results will illustrate the best performance reached by the transgenetic algorithm in all instances of the dataset

Measuring the efficiency of outsourcing: An illustrative case study from the aerospace industry

Outsourcing is related to the action which an organization deals with its suppliers through a kind of business contract where a specific activity or service has been hired to be made. The outsourcing of some activities has become a common practice in the industry, nowadays. It reduces costs, significantly, in the production process and, at the same time, adds some values to the business organization. However it is necessary to measure the performance of these activities. Data Envelopment Analysis (DEA) is a non-parametric method useful to measure comparative performance. It has a wide range of applications measuring comparative efficiency. The Analytic Hierarchy Process (AHP) is a multiple criteria decision-making method that uses hierarchic structures to represent a decision problem and then develops priorities for the alternatives based on the decision-maker's judgments. This paper presents an integrated application based on DEA and AHP to evaluate the efficiency of subcontracted companies in a Brazilian aerospace factory. © 2007 Springer-Verlag London Limited.

Modelagem de sistemas de detecção de descargas atmosféricas na Amazônia

As descargas atmosféricas representam um dos maiores fatores de riscos para o setor elétrico, especialmente na Amazônia, uma região do mundo identificada com altas densidades de ocorrências e picos de corrente de raios. Nesse contexto, a rede STARNET (Sferics Timing And Ranging NETwork), único sistema de detecção de descargas elétricas atmosféricas, terrestre, gratuito, e contínuo, cobrindo toda a região Amazônica, foi escolhido para a geração de padrões de descargas atmosféricas necessários a otimização dos sistemas de proteção das linhas de transmissão por meio de sistema de monitoramento de descargas atmosféricas. Contudo, o funcionamento intermitente, observado nos diagramas operacionais das várias estações da rede STARNET, afeta o desempenho global do sistema, em especial a eficiência de detecção. Por isso, foi desenvolvido um modelo de uniformização dos dados de descargas atmosféricas em função da configuração da rede (número e localização dos sensores em operação), no objetivo final de editar mapas de índice ceráunico e densidades de raios confiáveis. Existem regiões da Amazônia que sempre apresentam anomalias positivas de densidade de raios como as regiões de Belém e Manaus, bem como o estado do Tocantins que afeitam as linhas de transmissão. Depois, a incidência de raios nas linhas de transmissão na Amazônia foi estimada a partir da distribuição de pico de correntes registrada pela RDR-SIPAM e da densidade de raios corrigida da rede STARNET. A avaliação do desempenho da rede STARNET tendo como referencia à rede de detecção de raios do Sistema de Proteção da Amazônia (RDR-SIPAM) mostrou também uma forte dependência da eficiência de detecção da rede STARNET em função do pico de corrente das descargas atmosféricas.

Critérios para indicação de espécies prioritárias para a restauração da vegetação de cerrado

Knowing the attributes of the most suitable species to overcome the obstacles in different environmental conditions is an important tool for ecological restoration. To evaluate the comparative performance of native Cerrado species being cultivated at an arboretum (Assis State Forest, Assis, SP, Brazil), we categorized 106 species by the following attributes: average annual increment in height and crown diameter, survival rates, frequency of herbivory, frost susceptibility and seed dispersal syndrome. The score of each attribute may vary from 1 to 3, and the value of a species for restoration was generated from the sum of the scores for the different attributes converted to the scale of 0 to 100. Analyzing the species altogether, survival was 70%, the average annual increment was 30 cm in height and 21 cm in crown diameter. Only 8% of the species showed high susceptibility to frost and 17% high frequency of herbivory. Eighteen species had scores above 80, being the first Annona crassiflora, Cecropia pachystachya, Enterolobium gummiferum, Plathymenia reticulata e Protium heptaphyllum. In this group are the species that gather the highest number of favorable attributes for the restoration of Cerrado vegetation. We generated two separate lists of ten species of higher value, one for the cerrado sensu stricto and the other for cerradao the forest type of cerrado vegetation. We believe that using these species accelerates the recovery of vegetation structure and thus provide the restoration of ecological processes of ecosystems undergoing restoration. At the end of the list are species of low scores, which, if used, can lead to higher costs or delay in the recovery of structure and ecological processes of the ecosystem being restored.

Produção de forragem e composição estrutural de pastos de Brachiaria brizantha cv. Xaraés manejados em diferentes alturas de pastejo

The objective of this study was to analyze the production of dry mass, forage accumulation rate and the structural composition of Brachiaria brizantha cv. Xaraes pastures, managed under different grazing heights in continuous stocking. The experimental area was 12 hectares, divided in paddocks of one hectare each. The treatments were 15, 30, 45 and 60 cm of defoliation heights. Nellore steers were used to reach the desired heights. Every 28 days four cut samples and eight visual samples were collected for comparative performance in the experimental plots. Two grazing exclusion cages were used per treatment to estimate accumulation rates kg.ha(-1) DM. The cut material was taken to the laboratory for separation of the botanical components (green leaf, stem and senescent material), weighing and determination of dry matter. The experimental design was the completely randomized with three replicates. There were treatments effects at all seasons for the production of total mass, except in the spring. In summer and spring seasons it was observed the highest values for leaf blades (1.100 kg DM.ha(-1)). In the winter, the highest values of senescent material was observed, as expected. The average accumulation showed no significant difference among the treatments, except for stem and total mass in the summer and stem in the fall. The tillers were heavier and higher values for number of green leaves per tiller occurred in the fall, but for senescent leaves per tiller ocurred in the winter. Swards grazed at heights between 45 and 60 cm of defoliation, had good production of forage mass and leaf constituent.

A utilização de material didático impresso para o ensino de um modelo de classificação do esporte na educação física escolar

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Ranking of tests for pain hypersensitivity according to their discriminative ability in chronic neck pain

BACKGROUND AND OBJECTIVES Quantitative sensory testing (QST) is widely used to investigate peripheral and central sensitization. However, the comparative performance of different QST for diagnostic or prognostic purposes is unclear. We explored the discriminative ability of different quantitative sensory tests in distinguishing between patients with chronic neck pain and pain-free control subjects and ranked these tests according to the extent of their association with pain hypersensitivity. METHODS We performed a case-control study in 40 patients and 300 control subjects. Twenty-six tests, including different modalities of pressure, heat, cold, and electrical stimulation, were used. As measures of discrimination, we estimated receiver operating characteristic curves and likelihood ratios. RESULTS The following quantitative sensory tests displayed the best discriminative value: (1) pressure pain threshold at the site of the most severe neck pain (fitted area under the receiver operating characteristic curve, 0.92), (2) reflex threshold to single electrical stimulation (0.90), (3) pain threshold to single electrical stimulation (0.89), (4) pain threshold to repeated electrical stimulation (0.87), and (5) pressure pain tolerance threshold at the site of the most severe neck pain (0.86). Only the first 3 could be used for both ruling in and out pain hypersensitivity. CONCLUSIONS Pressure stimulation at the site of the most severe pain and parameters of electrical stimulation were the most appropriate QST to distinguish between patients with chronic neck pain and asymptomatic control subjects. These findings may be used to select the tests in future diagnostic and longitudinal prognostic studies on patients with neck pain and to optimize the assessment of localized and spreading sensitization in chronic pain patients.