874 resultados para Filmic approach methods
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BACKGROUND: Only few countries have cohorts enabling specific and up-to-date cardiovascular disease (CVD) risk estimation. Individual risk assessment based on study samples that differ too much from the target population could jeopardize the benefit of risk charts in general practice. Our aim was to provide up-to-date and valid CVD risk estimation for a Swiss population using a novel record linkage approach. METHODS: Anonymous record linkage was used to follow-up (for mortality, until 2008) 9,853 men and women aged 25-74 years who participated in the Swiss MONICA (MONItoring of trends and determinants in CVD) study of 1983-92. The linkage success was 97.8%, loss to follow-up 1990-2000 was 4.7%. Based on the ESC SCORE methodology (Weibull regression), we used age, sex, blood pressure, smoking, and cholesterol to generate three models. We compared the 1) original SCORE model with a 2) recalibrated and a 3) new model using the Brier score (BS) and cross-validation. RESULTS: Based on the cross-validated BS, the new model (BS = 14107×10(-6)) was somewhat more appropriate for risk estimation than the original (BS = 14190×10(-6)) and the recalibrated (BS = 14172×10(-6)) model. Particularly at younger age, derived absolute risks were consistently lower than those from the original and the recalibrated model which was mainly due to a smaller impact of total cholesterol. CONCLUSION: Using record linkage of observational and routine data is an efficient procedure to obtain valid and up-to-date CVD risk estimates for a specific population.
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There has been considerable research that investigates the outcomes, benefits, and perceptions of wilderness trip experiences. However, the transfer of learning from a wilderness trip to the everyday lives of youth trip participants, that has deliberately explored post-trip experience, is minimal. Using a qualitative multi-case study approach, methods of data collection included interviews with six youth program participants, six parents/legal guardians, and three program staff, as well as document solicitation. Reports from the participants suggested that the key content transferred to a post-wilderness trip context were interpersonal skills; life skills; and instances of personal growth. Participants applied their learning content from the wilderness trip to school; sports; community and international volunteering; work and career aspirations; family and home life; and social life contexts. Implications for adventure programming and curriculum design, instruction, and transfer are considered.
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Pour respecter les droits d’auteur, la version électronique de ce mémoire a été dépouillée de ses documents visuels et audio‐visuels. La version intégrale du mémoire a été déposée au Service de la gestion des documents et des archives de l'Université de Montréal.
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Introduction : Faute de tests diagnostiques précis, une étude histologique est souvent nécessaire pour diagnostiquer les tuméfactions latérales solides cervicales (TLSC) chez l’enfant. Nous étudierons les modalités diagnostiques pour les TLSC afin de créer une approche diagnostique standardisée intégrant de nouveaux outils diagnostics à ceux actuellement offerts. Méthodologie : Après révision des étiologies et des modalités diagnostiques, une revue de la littérature a été effectuée. Une étude rétrospective entre 2002 à 2012 est présentée suivie d’une étude de faisabilité de la cytoponction. Puis, un arbre décisionnel est créé basé sur nos résultats et sur l’avis d’un groupe d’experts de différentes disciplines médicales. Résultats : Le diagnostic différentiel des TLSC est varié, la littérature scientifique est désuète et la comparaison reste difficile. Pour nos 42 enfants avec un âge médian de sept ans, les tuméfactions inflammatoires représentent 59% (26/44 biopsies) des TLSC, surtout des lymphadénites à mycobactérie atypique (13/26) qui ont un dépistage ardu et multimodal. La biopsie fut peu contributive à la prise en charge dans 39% (17/44) des cas. La cytoponction sous échoguidance est une technique diagnostique faisable et moins invasive que la biopsie. L’arbre décisionnel offre aux cliniciens une approche diagnostique standardisée des TLSC appuyée sur des faits scientifiques que nous souhaitons valider par une étude prospective. Conclusion : Les TLSC chez l’enfant représentent un défi diagnostic et notre arbre décisionnel répond au manque de standardisation dans l’approche diagnostique. Une étude prospective sur notre arbre décisionnel est en voie d’acceptation au CHU Sainte-Justine.
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Inadequate links between researchers and farmers has resulted in low uptake of research advances recommended to improve food security in the central highlands of Kenya. Access to timely and accurate information by extension agents and farmers is paramount in dissemination of soil fertility management practices. Hence, the study sought to investigate the effect of education levels on communication channels used to disseminate soil fertility technologies in the Central highlands of Kenya. Questionnaires were used to elicit information from 105 extension agents and 240 farmers. About 50.5% of the extension officers were certificate holders while 29.5% were diploma holders from agricultural institutes. Majority of the farmers had attained primary education (59.6%) while 25.8% and 9.2% had attained secondary and post secondary education, respectively. Research institutions were the most accessible sources of information on soil fertility management practices by extension agents while internet and scientific conferences were the least scored as accessible sources of soil fertility management information by extension agents. Education levels significantly influenced preference of individual approach methods by farmers. There was a significant positive relationship between education and accessibility of internet as a source of information on green manure. The implication of the study was that education levels influenced the mode of communication used in the transfer of soil fertility research outputs to the end users. Consequently, it is extremely important to consider education levels in selection of dissemination pathways used in agriculture.
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Syfte: Syftet med studien var att beskriva distriktssköterskors upplevelser och erfarenheter av patientundervisning till patienter med diabetes samt att identifiera aspekter som kan relateras till ett personcentrerat förhållningssätt. Metod: Deskriptiv design med kvalitativ ansats med semistrukturerade intervjuer användes vid datainsamlingen. Vid urvalet användes strategiskt urval. Nio intervjuer utfördes med distriktssköterskor på sex olika vårdcentraler i Mellansverige. Vid analysen användes kvalitativ innehållsanalys. Resultat: Distriktssköterskorna önskade mer kunskap om invandrares kost- och motionsvanor. Distriktssköterskorna uttryckte att det var roligt och spännande med patientundervisning och att det var viktigt att de var engagerade. Distriktssköterskorna ville arbeta mer i team och de upplevde att de hade för lite tid avsatt för patientundervisning. De ansåg att de arbetade personcentrerat men det var svårare att arbeta personcentrerat vid gruppundervisning än vid enskild undervisning. Slutsats: Distriktssköterskor bör ha god kunskap om kulturella skillnader hos patienter med diabetes. Distriktssköterskorna upplever brist på tid- och resurser och önskar samarbeta mera i team. Det är viktigt med ett personcentrerat förhållningssätt där distriktssköterskorna utgår från den enskilda individen. En distriktssköterska som är engagerad och trivs med sitt arbete kan lättare klara av det ökade trycket och arbetsbelastningen.
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To mesure the human performance is a challenge, mainly due to the multidimensional factor movement. Instruments, mostly only assess one dimension of it. Objective: To develop a prototype capable of measuring the skills of human performance and check its validity using method comparison approach. Methods: The study was divided into two stages. The first Prototype was developed and tested simultaneously with an instrument to study the Rectilinear Uniform Motion and Uniformly Miscellaneous. In the second phase the sample consisted of Paralympic basketball athletes (n=09) and karate athletes (n=31) and all agreed to the terms of participation in the research. The evaluation of performance measures was performed with the prototype, the results obtained were compared with the data calculated by a statistical package is used as a reference. Results: All variables calculated by the prototype showed no significant differences when compared with the results calculated by the reference instrument and statistical package. Conclusion: The prototype has been developed and the results obtained in laboratory and field indicate that the prototype can be used for measuring human performance measures, with immediate results without the need for a conventional computer return, provided they fulfill the criteria described
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Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.
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Introduction: Intradural lumbar disc herniations are uncommon presentations of a relatively frequent pathology, representing less than 1% of all lumbar disc hernias. They show specific features concerning their clinical diagnosis, with a higher incidence of cauda equina syndrome, and their surgical treatment requires a transdural approach. Methods: In this article, we describe five cases of this pathology and review the literature as well as some considerations about the difficulties in the preoperative diagnostic issues and the surgical technique. Conclusion: We concluded that for intradural disc herniations the diagnosis is mainly intraoperative, and the surgical technique has some special aspects. © 2012 Springer-Verlag Berlin Heidelberg.
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Thermogravimetry, differential scanning calorimetry, and vibrational infrared spectroscopy were used to study nimesulide and its recrystallization products that were obtained from solutions of several alcohols. The thermoanalytical measurements were performed in both air and nitrogen atmospheres and the results suggest that, under the experimental conditions used in this paper, it was possible to obtain neither polymorphic nor pseudopolymorphic forms of this drug. In this investigation, quantum chemical approach methods were used to determine the molecular structures using the Becke three-parameter hybrid method and the Lee-Yang-Parr correlation functional. The performed molecular calculations were done with the Gaussian 09 routine and the theoretical calculation results were correlated with the experimental IR vibrational spectrum. © 2013 Akadémiai Kiadó, Budapest, Hungary.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background: Once multi-relational approach has emerged as an alternative for analyzing structured data such as relational databases, since they allow applying data mining in multiple tables directly, thus avoiding expensive joining operations and semantic losses, this work proposes an algorithm with multi-relational approach. Methods: Aiming to compare traditional approach performance and multi-relational for mining association rules, this paper discusses an empirical study between PatriciaMine - an traditional algorithm - and its corresponding multi-relational proposed, MR-Radix. Results: This work showed advantages of the multi-relational approach in performance over several tables, which avoids the high cost for joining operations from multiple tables and semantic losses. The performance provided by the algorithm MR-Radix shows faster than PatriciaMine, despite handling complex multi-relational patterns. The utilized memory indicates a more conservative growth curve for MR-Radix than PatriciaMine, which shows the increase in demand of frequent items in MR-Radix does not result in a significant growth of utilized memory like in PatriciaMine. Conclusion: The comparative study between PatriciaMine and MR-Radix confirmed efficacy of the multi-relational approach in data mining process both in terms of execution time and in relation to memory usage. Besides that, the multi-relational proposed algorithm, unlike other algorithms of this approach, is efficient for use in large relational databases.
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Object. Over the past few decades, various authors have performed open or stereotactic trigeminal nucleotractotomy for the treatment of neuropathic facial pain resistant to medical treatment. Stereotactic procedures can be performed percutaneously under local anesthesia, allowing intraoperative neurological examination as a method for target refinement. However, blind percutaneous procedures in the region of the atlantooccipital transition carry a considerably high risk of vascular injuries that may bring prohibitive neurological deficit or even death. To avoid such complications, the authors present the first clinical use of microendoscopy to assist percutaneous radiofrequency trigeminal nucleotractotomy. The aim of this article is to demonstrate intradural microendoscopic visualization of the medulla oblongata through an atlantooccipital percutaneous approach. Methods. The authors present a case of severe postherpetic facial neuralgia in a patient who underwent the procedure and had satisfactory results. Stereotactic computational image planning for targeting the spinal trigeminal tract and nucleus in the posterolateral medulla was performed, allowing for an accurate percutaneous approach. immediately before radiofrequency electrode insertion, a tine endoscope was introduced to visualize the structures in the cisterna magna. Results. Microendoscopic visualization offered clear identification of the pial surface of the medulla oblongata and its blood vessels, the arachnoid membrane, cranial nerve rootlets and their entry zone, and larger vessels such as the vertebral arteries and the branches of the posterior inferior cerebellar artery. Conclusions. The initial application of this technique suggests that percutaneous microendoscopy may be useful for particular manipulation of the medulla oblongata, increasing the safety of the procedure and likely improving its effectiveness. (DOI: 10.3171/2011.8.JNS11618)
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Abstract Background Once multi-relational approach has emerged as an alternative for analyzing structured data such as relational databases, since they allow applying data mining in multiple tables directly, thus avoiding expensive joining operations and semantic losses, this work proposes an algorithm with multi-relational approach. Methods Aiming to compare traditional approach performance and multi-relational for mining association rules, this paper discusses an empirical study between PatriciaMine - an traditional algorithm - and its corresponding multi-relational proposed, MR-Radix. Results This work showed advantages of the multi-relational approach in performance over several tables, which avoids the high cost for joining operations from multiple tables and semantic losses. The performance provided by the algorithm MR-Radix shows faster than PatriciaMine, despite handling complex multi-relational patterns. The utilized memory indicates a more conservative growth curve for MR-Radix than PatriciaMine, which shows the increase in demand of frequent items in MR-Radix does not result in a significant growth of utilized memory like in PatriciaMine. Conclusion The comparative study between PatriciaMine and MR-Radix confirmed efficacy of the multi-relational approach in data mining process both in terms of execution time and in relation to memory usage. Besides that, the multi-relational proposed algorithm, unlike other algorithms of this approach, is efficient for use in large relational databases.
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AIM: The aim of this study was to compare the clinical outcomes after 2 years with bone level implants placed to restore a single missing teeth that needed simultaneous augmentation and were treated with a transmucosal or submerged approach. METHODS: This study analyzed a subset of patients included in an ongoing prospective multicenter randomized clinical trial (RCT) involving12 centers where patients were to be followed-up to 5 years after loading. Of the 120 implants that were placed in the original study, and randomly assigned to submerged or non-submerged healing, 52 needed simultaneous augmentation (28 women patients and 24 men patients, between 23 and 78 years of age). Twenty-seven of them received implants with submerged healing (AuS), while in 25 patients the implants were inserted with a non-submerged protocol (AuNS). At the 2-year follow-up visit, radiographic crestal bone level changes were recorded as well as soft tissue parameters included Pocket probing depth (PPD), bleeding on probing (BoP) and clinical attachment level (CAL) at teeth adjacent to the implant site. RESULTS: After 2 years a small amount of bone resorption was found in both groups (0.37 ± 0.49 mm in the AuS group and 0.54 ± 0.76 in the AuNS group; P < 0.001). There was no statistically significant difference between AuS Group and AuNS group for PPD (2.5 vs. 2.4 mm), BOP (BOP + sites: 8.8% vs. 11.5%) and CAL (2.8 vs. 2.4 mm) at the 2-year follow-up visit. CONCLUSIONS: When a single implant is placed in the aesthetic zone in conjunction with bone augmentation for a moderate peri-implant defect, submerged and transmucosal healing determine similar outcome, hence there is no need to submerge an implant in this given clinical situation.