Objective characterization of the course of the parasellar internal carotid artery using mathematical tools

Background Along the internal carotid artery (ICA), atherosclerotic plaques are often located in its cavernous sinus (parasellar) segments (pICA). Studies indicate that the incidence of pre-atherosclerotic lesions is linked with the complexity of the pICA; however, the pICA shape was never objectively characterized. Our study aims at providing objective mathematical characterizations of the pICA shape. Methods and results Three-dimensional (3D) computer models, reconstructed from contrast enhanced computed tomography (CT) data of 30 randomly selected patients (60 pICAs) were analyzed with modern visualization software and new mathematical algorithms. As objective measures for the pICA shape complexity, we provide calculations of curvature energy, torsion energy, and total complexity of 3D skeletons of the pICA lumen. We further measured the posterior knee of the so-called ""carotid siphon"" with a virtual goniometer and performed correlations between the objective mathematical calculations and the subjective angle measurements. Conclusions Firstly, our study provides mathematical characterizations of the pICA shape, which can serve as objective reference data for analyzing connections between pICA shape complexity and vascular diseases. Secondly, we provide an objective method for creating Such data. Thirdly, we evaluate the usefulness of subjective goniometric measurements of the angle of the posterior knee of the carotid siphon.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

An objective reconstruction of the chain of contagion

North's clustering method, which is based on a much used ecological model, the nearest neighbor distance, was applied to the objective reconstruction of the chain of household-to-household transmission of variola minor (the mild form of smallpox). The discrete within-household outbreaks were considered as points which were ordered in a time sequence using a 10-40 day interval between introduction of the disease into a source household and a receptor household. The closer points in the plane were assumed to have a larger probability of being links of a chain of household-to-household spread of the disease. The five defining distances (Manhattan or city-block distance between presumptive source and receptor dwellings) were 100, 200, 300, 400 and 500 m. The subchain sets obtained with the five defining distances were compared with the subchains empirically reconstructed during the field study of the epidemic through direct investigation of personal contacts of the introductory cases with either introductory or subsequent cases from previously affected households. The criteria of fit of theoretical to empirical clusters were: (a) the number of clustered dwellings and subchains, (b) number of dwellings in a subchain and (c) position of dwellings in a subchain. The defining distance closet to the empirical findings was 200 m, which fully agrees with the travelling habits of the study population. Less close but acceptable approximations were obtained with 100, 300, 400 and 500 m. The latter two distances gave identical results, as if a clustering ceiling had been reached. It seems that North's clustering model may be used for an objective reconstruction of the chain of contagious whose links are discrete within-household outbreaks. © 1984.

A multi-objective evaluation of the impact of the penetration of Distributed Generation

This paper proposes a methodology to consider the effects of the integration of DG on planning. Since DG has potential to defer investments in networks, the impact of DG on grid capacity is evaluated. A multi-objective optimization tool based on the meta-heuristic MEPSO is used, supporting an alternative approach to exploiting the Pareto front features. Tests were performed in distinct conditions with two well-known distribution networks: IEEE-34 and IEEE-123. The results combined minimization and maximization in order to produce different Pareto fronts and determine the extent of the impact caused by DG. The analysis provides useful information, such as the identification of futures that should be considered in planning. A future means a set of realizations of all uncertainties. MEPSO also presented a satisfactory performance in obtaining the Pareto fronts. © 2011 IEEE.

Medicinal plants in pregnancy and lactation: perception of the health risk and practical educational group in Araraquara, São Paulo State, Brazil

The use of medicinal plants among pregnant women and lactating is a common practice in diverse countries. However, many medicinal plants are contraindicated during pregnancy and lactating, due to various adverse effects, such as teratogenic, embryotoxic and abortive effects, exposing these women, their fetus and babies to health unknown risks. Thus, the purpose of this commentary, was to analyze the perception about the use of medicinal plants by pregnant women and lactating registered in the "baby on board" NGO, Araraquara, São Paulo state, Brazil, between 2010 at 2013. The group was constituted by 48 women, between the first and last trimester of pregnancy or whilst breastfeeding. Information was collected during group meetings by oral interview, using a questionnaire, as script. The nature of the study was a qualitative analysis. The results were based on reports about the use of medicinal plants by pregnant women during group meetings: use, indication of use, knowledge about risks. All participants received written and oral information about the study and they gave a written informed consent. The use of medicinal plants is a reality among pregnant and lactating women of the "baby on board" NGO. They reported that they feel that "natural" products are not harmful for their health. The primary information sources for the majority of women about medicinal plants during pregnancy are family, neighbors and herbalists. The plants most cited (in popular name in Brazil) were: senna, chamomile, boldo, lemon balm, lemon grass. They were used mainly for: nausea, heartburn, indigestion, flatulence, intestinal and abdominal pain, anxiety, intestinal constipation and low milk production. The pregnant and lactating women lacked knowledge about the health risks of the use of medicinal plants and herbal medicines in pregnancy and lactation. They also reported difficulties in clarifying some questions about the use of medicinal plants with their doctors. The results of the present study showed that educative actions about the rational use of medicinal plants in pregnancy and breastfeeding could be part of the operating protocols to promote the maternal and child health programs in Araraquara. Thus, our results also suggest the importance of creating institutionalized places, to the implementation of continued education programs about rational use of medicinal plants in pregnancy and lactation. These targeted programs are not only for health professionals, but also for community members, pregnant women and breastfeeding. Our results pointed out the importance of guidance of doctors and healthcare professionals on the scientific studies about medicinal plants and herbal medicines and the risk/benefit of using herbs during pregnancy. Finally, it is noted the importance of the health professionals to inform women of childbearing on risks to their health, as well as on possibilities of utilization of herbs during fertile period, giving special attention to the potential risk of self-medication.

A numerical methodology for the multi-objective optimization of the DI Diesel engine combustion

DI Diesel engine are widely used both for industrial and automotive applications due to their durability and fuel economy. Nonetheless, increasing environmental concerns force that type of engine to comply with increasingly demanding emission limits, so that, it has become mandatory to develop a robust design methodology of the DI Diesel combustion system focused on reduction of soot and NOx simultaneously while maintaining a reasonable fuel economy. In recent years, genetic algorithms and CFD three-dimensional combustion simulations have been successfully applied to that kind of problem. However, combining GAs optimization with actual CFD three-dimensional combustion simulations can be too onerous since a large number of calculations is usually needed for the genetic algorithm to converge, resulting in a high computational cost and, thus, limiting the suitability of this method for industrial processes. In order to make the optimization process less time-consuming, CFD simulations can be more conveniently used to generate a training set for the learning process of an artificial neural network which, once correctly trained, can be used to forecast the engine outputs as a function of the design parameters during a GA optimization performing a so-called virtual optimization. In the current work, a numerical methodology for the multi-objective virtual optimization of the combustion of an automotive DI Diesel engine, which relies on artificial neural networks and genetic algorithms, was developed.

Reduced perception of the motion-induced blindness illusion in schizophrenia

Motion-induced blindness (MIB) occurs when target stimuli are presented together with a moving distractor pattern. Most observers experience the targets disappearing and reappearing repeatedly for periods of up to several seconds. MIB can be viewed as a striking marker for the organization of cognitive functioning. In the present study, MIB rates and durations were assessed in 34 schizophrenia-spectrum disorder patients and matched controls. The results showed that positive symptoms and excitement enhanced MIB, whereas depression and negative symptoms attenuated the illusion. MIB was more frequently found in normal subjects. The results remained consistent after adjusting for reaction time and error rates. Hence, MIB may provide a valid and reliable measure of cognitive organization in schizophrenia.

Objective assessment of the built environment and its relationship to physical activity and obesity

The role of physical activity in the promotion of individual and population health has been well documented in research and policy publications. Significant research activities have produced compelling evidence for the support of the positive association between physical activity and improved health. Despite the knowledge about these public health benefits of physical activity, over half of US adults do not engage in physical activity at levels consistent with public health recommendations. Just as physical inactivity is of significant public health concern in the US, the prevalence of obesity (and its attendant co-morbidities) is also increasing among US adults.^ Research suggests racial and ethnic disparities relevant to physical inactivity and obesity in the US. Various studies have shown more favorable outcomes among non-Hispanic whites when compared to other minority groups as far as physical activity and obesity are concerned. The health disparity issue is especially important because Mexican-Americans who are the fastest growing segment of the US population are disproportionately affected by physical inactivity and obesity by a significant margin (when compared to non-Hispanic whites), so addressing the physical inactivity and obesity issues in this group is of significant public health concern. ^ Although the evidence for health benefits of physical activity is substantial, various research questions remain on the potential motivators for engaging in physical activity. One area of emerging interest is the potential role that the built environment may play in facilitating or inhibiting physical activity.^ In this study, based on an ongoing research project of the Department of Epidemiology at the University of Texas M. D. Anderson Cancer Center, we examined the built environment, measured objectively through the use of geographical information systems (GIS), and its association with physical activity and obesity among a cohort of Mexican- Americans living in Harris County, Texas. The overall study hypothesis was that residing in dense and highly connected neighborhoods with mixed land-use is associated with residents’ increased participation in physical activity and lowered prevalence of obesity. We completed the following specific aims: (1) to generate a land-use profile of the study area and create a “walkability index” measure for each block group within the study area; (2) to compare the level of engagement in physical activity between study participants that reside in high walkability index block groups and those from low walkability block groups; (3) to compare the prevalence of obesity between study participants that reside in high walkability index block groups and those from low walkability block groups. ^ We successfully created the walkability index as a form of objective measure of the built environment for portions of Harris County, Texas. We used a variety of spatial and non-spatial dataset to generate the so called walkability index. We are not aware of previous scholastic work of this kind (construction of walkability index) in the Houston area. Our findings from the assessment of relationships among walkability index, physical activity and obesity suggest the following, that: (1) that attempts to convert people to being walkers through health promotion activities may be much easier in high-walkability neighborhoods, and very hard in low-walkability neighborhoods. Therefore, health promotion activities to get people to be active may require supportive environment, walkable in this case, and may not succeed otherwise; and (2) Overall, among individuals with less education, those in the high walkability index areas may be less obese (extreme) than those in the low walkability area. To the extent that this association can be substantiated, we – public health practitioners, urban designers, and policy experts – we may need to start thinking about ways to “retrofit” existing urban forms to conform to more walkable neighborhoods. Also, in this population especially, there may be the need to focus special attention on those with lower educational attainment.^

Perception of the sport events held in a permanent facility: the case of the Madrid Sports Palace

The aims of this study were to analyse perceptions regarding the sporting events held in the Madrid Sports Palace and to analyse whether those perceptions vary by age or gender. One hundred and ninetyfive residents answered the Ntloko and Swart (2008) questionnaire. The dimensions most highly rated were economic benefits (3.9±0.8), the event as a regional showcase (3.6±0.7), and the event as entertainment (3.4±0.6). However, the respondents did not agree with the negative environmental impact (2.0±0.8). Men rated the use of public money (z=2.4; pmenor que.05) and the regional showcase (z=2.0 pmenor que.05) more positively than women. Finally, women rated the increase in prices (z=2.0; pmenor que.05) more highly than men. The age groups differed significantly only regarding the promotion of community pride. Seniors and middle-aged adults rated it more positively than young adults (?2(2)=9.9; pmenor que.01). The fact that in an urban sports facility regular sporting events take place on a regular basis means that there are diverse perceptions, though mainly positive, and those perceptions differ from the perceptions about mega events that take place once in a life time at temporary sports facilities.

Student's cross-perception of the economic crises in the European Union and in Southeast Asia. EU Centre in Singapore Working Paper No. 11, December 2012

The financial crisis of 1997-1998 in Southeast Asia and the European Union’s financial crisis of 2008 followed by the sovereign debt crisis represented major policy events in the regions and beyond. The crises triggered policy adjustments with implications on economic and other policies. This paper aims at evaluating the perception of university students in the European Union (EU) and Southeast Asia on the management of these crises. It strives to confirm several ex ante assumptions about the relationship between students’ background, their policy orientation and their knowledge of the European Union and ASEAN policies. It also provides an analysis of the students’ evaluation of the geopolitical importance of the global regions and the EU and ASEAN policies. The paper is based on opinion surveys conducted during the first part of 2012 at four universities, two in the EU and two in ASEAN countries. In the eyes of EU and ASEAN students, the EU crisis is not being managed appropriately. The citizens of the EU surveyed were even significantly more critical of the EU’s anti-crisis measures than any other surveyed group. Their ASEAN counterparts were generally more positive in their evaluations.