839 resultados para Real-world problem


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Objectives: We tested two novel drug-eluting stents (DES), covered with a biodegradable-polymer carrier and releasing paclitaxel or sirolimus, which were compared against a bare metal stent (primary objective). The DES differed by the drug, but were identical otherwise, allowing to compare the anti-restenosis effects of sirolimus versus paclitaxel (secondary objective). Background: The efficacy of novel DES with biodegradable polymers should be tested in the context of randomized trials, even when using drugs known to be effective, such as sirolimus and paclitaxel. Methods: Overall, 274 patients with de novo coronary lesions in native vessels scheduled for stent implantation were randomly assigned (2:21 ratio) for the paclitaxel (n = 111), sirolimus (n = 106), or bare metal stent (n = 57) groups. Angiographic follow-up was obtained at 9 months and major cardiac adverse events up to 12 months. Results: Both paclitaxel and sirolimus stents reduced the 9-month in-stent late loss (0.54-0.44 mm, 0.32-0.43 mm, vs. 0.90-0.45 mm respectively), and 1-year risk of target vessel revascularization and combined major adverse cardiac events (P < 0.05 for both, in all comparisons), compared with controls. Sirolimus stents had lower late loss than paclitaxel stents (P < 0.01), but similar 1-year clinical outcomes. There were no differences in the risk of death, infarction, or stent thrombosis among the study groups. Conclusion: Both novel DES were effective in reducing neointimal hyperplasia and 1-year re-intervention, compared to bare metal stents. Our findings also suggest that sirolimus is more effective than paclitaxel in reducing angiographic neointima, although this effect was not associated with better clinical outcomes. (C) 2009 Wiley-Liss, Inc.

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Objective: To evaluate the validity and applicability of the Mini International Neuropsychiatric Interview (MINI) used by family medicine residents in primary health care (PHC) in Brazil. Methods: Training for administrating the MINI was given as part of a broad psychiatry education program. Interviews were held with 120 PHC patients who were at least 15 years old. MINI was administered by 25 resident physicians, while the Structured Clinical Interview for Diagnosis (SCID) was administered by a psychiatrist blind to patients` results on the MINI, and the diagnoses on both interviews were compared. The resident physicians answered questions on the applicability of the MINI. Results: Concordance levels for any mental disorder, the broader current diagnostic categories and the most common specific diagnoses were analyzed. Kappa coefficients ranged between 0.65 and 0.85; sensitivity, between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV), between 0.60 and 0.86; negative predictive values (NPV), between 0.92 and 0.99; and accuracy, between 0.88 and 0.98. The resident physicians considered MINI comprehensibility and clinical relevance satisfactory. Conclusions: These good psychometric results in a real-world setting may be related to a special training program, which is more frequent, intensive and diversified. In these conditions, the MINI is a useful tool for general practitioners. (c) 2008 Elsevier Inc. All rights reserved.

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An important feature of some conceptual modelling grammars is the features they provide to allow database designers to show real-world things may or may not possess a particular attribute or relationship. In the entity-relationship model, for example, the fact that a thing may not possess an attribute can be represented by using a special symbol to indicate that the attribute is optional. Similarly, the fact that a thing may or may not be involved in a relationship can be represented by showing the minimum cardinality of the relationship as zero. Whether these practices should be followed, however, is a contentious issue. An alternative approach is to eliminate optional attributes and relationships from conceptual schema diagrams by using subtypes that have only mandatory attributes and relationships. In this paper, we first present a theory that led us to predict that optional attributes and relationships should be used in conceptual schema diagrams only when users of the diagrams require a surface-level understanding of the domain being represented by the diagrams. When users require a deep-level understanding, however, optional attributes and relationships should not be used because they undermine users' abilities to grasp important domain semantics. We describe three experiments which we then undertook to test our predictions. The results of the experiments support our predictions.

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A randomized controlled trial was carried out to measure the cost-effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas. One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit/s. Over two years, 274 patients required a hospital outpatient dermatology referral -126 patients (46%) were randomized to a telemedicine consultation and 148 (54%) to a conventional hospital outpatient consultation. Of those seen by telemedicine, 61% were registered with an urban practice, compared with 71% of those seen conventionally. The clinical outcomes of the two types of consultation were similar - almost half the patients were managed after a single consultation with the dermatologist. The observed marginal cost per patient of the initial realtime teledermatology consultation was f52.85 for those in urban areas and f59.93 per patient for those from rural areas. The observed marginal cost of the initial conventional consultation was f47.13 for urban patients and f48.77 for rural patients. The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas, mainly because of the fixed equipment costs. Sensitivity analysis using a real-world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal, while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation.

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Measures of eye activity, such as blink rate and scanning patterns, have been used extensively as psychophysiological indices of mental workload. In a review of measures derived from spontaneous eye activity it is shown that different measures are differentially sensitive to specific aspects of mental workload. A less well-known measure of non-spontaneous eye activity, the blink reflex, is also reviewed. Experiments using discrete punctuate stimuli and continuous tasks analogous to real-world systems show that blink reflexes are modulated by attention and that this modulation reflects modality-specific attentional engagement. Future research should examine the utility of the blink reflex according to the desirable properties of sensitivity, diagnosticity, validity, reliability, ease of use, unobtrusiveness, and operator acceptance.

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Conceptual modelling is an activity undertaken during information systems development work to build a representation of selected semantics about some real-world domain. Ontological theories have been developed to account for the structure and behavior of the real world in general. In this paper, I discuss why ontological theories can be used to inform conceptual modelling research, practice, and pedagogy. I provide examples from my research to illustrate how a particular ontological theory has enabled me to improve my understanding of certain conceptual modelling practices and grammars. I describe, also, how some colleagues and I have used this theory to generate several counter-intuitive, sometimes surprising predictions about widely advocated conceptual modelling practices - predictions that subsequently were supported in empirical research we undertook. Finally, I discuss several possibilities and pitfalls I perceived to be associated with our using ontological theories to underpin research on conceptual modelling.

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Like many states and territories, South Australia has a legacy of marine reserves considered to be inadequate to meet current conservation objectives. In this paper we configured exploratory marine reserve systems, using the software MARXAN, to examine how efficiently South Australia's existing marine reserves contribute to quantitative biodiversity conservation targets. Our aim was to compare marine reserve systems that retain South Australia's existing marine reserves with reserve systems that are free to either ignore or incorporate them. We devised a new interpretation of irreplaceability to identify planning units selected more than could be expected from chance alone. This is measured by comparing the observed selection frequency for an individual planning unit with a predicted selection frequency distribution. Knowing which sites make a valuable contribution to efficient marine reserve system design allows us to determine how well South Australia's existing reserves contribute to reservation goals when representation targets are set at 5, 10, 15, 20, 30 and 50% of conservation features. Existing marine reserves that tail to contribute to efficient marine reserve systems constitute 'opportunity costs'. We found that despite spanning less than 4% of South Australian state waters, locking in the existing ad hoc marine reserves presented considerable opportunity costs. Even with representation targets set at 50%, more than halt of South Australia's existing marine reserves were selected randomly or less in efficient marine reserve systems. Hence, ad hoc marine reserve systems are likely to be inefficient and may compromise effective conservation of marine biodiversity.

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The potential applications of macrocycles in chemistry and at its interfaces with biology and physics continue to emerge, one of which is as receptors for small molecules and ions. This review illustrates these applications with examples from the last ten years employing complexation as the binding mechanism; some of the systems presented have already found real-world sensor applications. In any case, the challenges remain to design more selective and sensitive receptors for guests.

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Arquitetura Corporativa promove o estabelecimento de uma visão holística da estrutura e forma de trabalho de uma organização. Um dos aspectos abordados em Arquitetura Corporativa está associada a "estrutura ativa" da organização, que diz respeito a “quem" realiza as atividades organizacionais. Várias abordagens têm sido propostas a fim de proporcionar um meio para a representação de Arquitetura Corporativa, entre as quais ARIS, RM-ODP, UPDM e ArchiMate. Apesar da aceitação por parte da comunidade, as abordagens existentes se concentram em propósitos diferentes, têm limitações de escopo e algumas não têm semântica de mundo real bem definida. Além das abordagens de modelagem, muitas abordagens de ontologias têm sido propostas, a fim de descrever o domínio de estrutura ativa, incluindo as ontologias de SUPER Project, TOVE, Enterprise Ontology e W3C Org Ontology. Embora especificadas para fundamentação semântica e negociação de significado, algumas das abordagens propostas têm fins específicos e cobertura limitada. Além disso, algumas das abordagens não são definidas usando linguagens formais e outras são especificadas usando linguagens sem semântica bem definida. Este trabalho apresenta uma ontologia de referência bem fundamentada para o domínio organizacional. A ontologia organizacional de referência apresentada abrange os aspectos básicos discutidos na literatura organizacional, tais como divisão do trabalho, relações sociais e classificação das unidades estruturais. Além disso, também abrange os aspectos organizacionais definidos em abordagens existentes, levando em consideração tanto abordagens de modelagem quanto abordagens ontológicas. A ontologia resultante é especificada em OntoUML e estende os conceitos sociais de UFO-C.

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This paper presents a study carried out in order to evaluate the students' perception in the development and use of remote Control and Automation education kits developed by two Universities. Three projects, based on real world environments, were implemented, being local and remotely operated. Students implemented the kits using the theoretical and practical knowledge, being the teachers a catalyst in the learning process. When kits were operational, end-user students got acquainted to the kits in the course curricula units. It is the author's believe that successful results were achieved not only in the learning progress on the Automation and Control fields (hard skills) but also on the development of the students soft skills, leading to encouraging and rewarding goals, motivating their future decisions and promoting synergies in their work. The design of learning experimental kits by students, under teacher supervision, for future use in course curricula by enduser students is an advantageous and rewarding experience.

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In this article we argue that digital simulations promote and explore complex relations between the player and the machines cybernetic system with which it relates through gameplay, that is, the real application of tactics and strategies used by participants as they play the game. We plan to show that the realism of simulation, together with the merger of artificial objects with the real world, can generate interactive empathy between players and their avatars. In this text, we intend to explore augmented reality as a means to visualise interactive communication projects. With ARToolkit, Virtools and 3ds Max applications, we aim to show how to create a portable interactive platform that resorts to the environment and markers for constructing the games scenario. Many of the conventional functions of the human eye are being replaced by techniques where images do not position themselves in the traditional manner that we observe them (Crary, 1998), or in the way we perceive the real world. The digitalization of the real world to a new informational layer over objects, people or environments, needs to be processed and mediated by tools that amplify the natural human senses.

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In this text, we intend to explore augmented reality as a means to visualise interactive communication projects. With ARToolkit, Virtools and 3ds Max applications, we aim to show how to create a portable interactive platform that resorts to the environment and markers for constructing the game’s scenario. We plan to show that the realism of simulation, together with the merger of artificial objects with the real world, can generate interactive empathy between players and their avatars.

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This paper presents an artificial neural network approach for short-term wind power forecasting in Portugal. The increased integration of wind power into the electric grid, as nowadays occurs in Portugal, poses new challenges due to its intermittency and volatility. Hence, good forecasting tools play a key role in tackling these challenges. The accuracy of the wind power forecasting attained with the proposed approach is evaluated against persistence and ARIMA approaches, reporting the numerical results from a real-world case study.

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The increased integration of wind power into the electric grid, as nowadays occurs in Portugal, poses new challenges due to its intermittency and volatility. Hence, good forecasting tools play a key role in tackling these challenges. In this paper, an adaptive neuro-fuzzy inference approach is proposed for short-term wind power forecasting. Results from a real-world case study are presented. A thorough comparison is carried out, taking into account the results obtained with other approaches. Numerical results are presented and conclusions are duly drawn. (C) 2011 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.

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This paper presents an algorithm to efficiently generate the state-space of systems specified using the IOPT Petri-net modeling formalism. IOPT nets are a non-autonomous Petri-net class, based on Place-Transition nets with an extended set of features designed to allow the rapid prototyping and synthesis of system controllers through an existing hardware-software co-design framework. To obtain coherent and deterministic operation, IOPT nets use a maximal-step execution semantics where, in a single execution step, all enabled transitions will fire simultaneously. This fact increases the resulting state-space complexity and can cause an arc "explosion" effect. Real-world applications, with several million states, will reach a higher order of magnitude number of arcs, leading to the need for high performance state-space generator algorithms. The proposed algorithm applies a compilation approach to read a PNML file containing one IOPT model and automatically generate an optimized C program to calculate the corresponding state-space.