Artificial neural network models for predicting 1-year mortality in elderly patients with intertrochanteric fractures in China

The mortality rate of older patients with intertrochanteric fractures has been increasing with the aging of populations in China. The purpose of this study was: 1) to develop an artificial neural network (ANN) using clinical information to predict the 1-year mortality of elderly patients with intertrochanteric fractures, and 2) to compare the ANN's predictive ability with that of logistic regression models. The ANN model was tested against actual outcomes of an intertrochanteric femoral fracture database in China. The ANN model was generated with eight clinical inputs and a single output. ANN's performance was compared with a logistic regression model created with the same inputs in terms of accuracy, sensitivity, specificity, and discriminability. The study population was composed of 2150 patients (679 males and 1471 females): 1432 in the training group and 718 new patients in the testing group. The ANN model that had eight neurons in the hidden layer had the highest accuracies among the four ANN models: 92.46 and 85.79% in both training and testing datasets, respectively. The areas under the receiver operating characteristic curves of the automatically selected ANN model for both datasets were 0.901 (95%CI=0.814-0.988) and 0.869 (95%CI=0.748-0.990), higher than the 0.745 (95%CI=0.612-0.879) and 0.728 (95%CI=0.595-0.862) of the logistic regression model. The ANN model can be used for predicting 1-year mortality in elderly patients with intertrochanteric fractures. It outperformed a logistic regression on multiple performance measures when given the same variables.

Expression of beclin 1 in primary salivary adenoid cystic carcinoma and its relation to Bcl-2 and p53 and prognosis

Beclin 1 plays a critical role in autophagy and functions as a haploinsufficient tumor suppressor. The expression and prognostic significance of beclin 1 in head and neck adenoid cystic carcinoma (ACC) are largely unexplored. Therefore, we investigated the expression of beclin 1, Bcl-2, and p53 in head and neck ACC tissue. Tissue samples from 35 cases (15 females, 20 males) of head and neck ACC were utilized for immunohistochemistry. Beclin 1 expression was observed in 32 cases (91.4%) and considered to be high in 15 cases (42.9%) and low in 20 cases (57.1%). Beclin 1 expression was significantly correlated with a histological growth pattern (P=0.046) and histological grade (P=0.037). Beclin 1 expression was inversely correlated with Bcl-2 expression (P=0.013) and significantly associated with overall survival (P=0.006). Bcl-2 and p53 expression were observed in 21 cases (60.0%) and 16 cases (45.7%). Bcl-2 expression was significantly correlated with perineural invasion (P=0.041) and not associated with overall survival (P=0.053). p53 expression was directly correlated with beclin 1 expression (P=0.044). Our results indicated that beclin 1 may be a novel, promising prognostic factor for clinical outcome in head and neck ACC patients and may play a part in the development of head and neck ACC by interacting with Bcl-2 and p53.

Expression of β-catenin and c-myc during human common bile duct development: a possible role in the morphogenesis of the common bile duct

β-catenin and c-myc play important roles in the development of tissues and organs. However, little is known about their expression patterns during the development of the human common bile duct. Immunohistochemistry was used to detect β-catenin and c-myc expression in common bile duct samples from postmortem tissues of 14 premature infants and 6 spontaneously aborted fetuses. The expression of β-catenin and c-myc was also analyzed by Western blot. The samples were divided into four groups based on the stage of human fetal development: 12, 13-27, 28-37, and >37 weeks. The Image-Pro Plus v. 6.0 image analysis software was used to calculate the mean qualifying score (MQS). At fetal stages 12, 13-27, 28-37, and >37 weeks, MQS of β-catenin were 612.52±262.13, 818.38±311.73, 706.33±157.19, and 350.69±110.19, respectively. There was a significant difference in MQS among the four groups (ANOVA, P=0.0155) and between the scores at >37 and 13-27 weeks (Student-Newman-Keuls, P<0.05). At fetal stages 12, 13-27, 28-37, and >37 weeks, the MQS of c-myc were 1376.64±330.04, 1224.18±171.66, 1270.24±320.75, and 741.04±219.19, respectively. There was a significant difference in MQS among the four groups (ANOVA, P=0.0087) and between the scores at >37 and 12 weeks, >37 and 13-27 weeks, and >37 and 28-37 weeks (all P<0.05, Student-Newman-Keuls). Western blots showed that β-catenin and c-myc expression were significantly higher in fetal than in postnatal control duct tissue (P<0.05). c-myc and β-catenin are involved in the normal development of the human common bile duct.

Determinação de minerais em café cru

Dois métodos de preparo de amostra foram avaliados: via seca e via úmida, para a determinação e quantificação dos minerais Al, Ba, Ca, Co, Cu, Fe, K, Mg, Mn, Ni, P e Zn em café cru, empregando-se a técnica de Espectrometria de Emissão Ótica em Plasma Indutivamente Acoplado (ICP-OES). As concentrações dos minerais não diferiram significativamente ao nível de 5% (Teste F) entre os dois métodos empregados. Para avaliar a exatidão dos métodos testados foi realizada a recuperação dos minerais em uma amostra de café. Os resultados obtidos pelos métodos empregando via seca e via úmida foram, respectivamente: Al = 93% e 104%; Ba = 85% e 54%; Ca = 99% e 108%; Co = 98% e 96%; Cu = 78% e 96%; Fe = 96% e 96%; K = 91% e 82%; Mg = 100% e 95%; Mn = 104% e 101%; Ni = 95% e 107%; P = 101% e 104%; Zn = 89% e 96%. O método por via seca foi empregado para a determinação dos teores de minerais em 45 amostras de café provenientes de diferentes regiões de cultivo dos Estados de São Paulo, Minas Gerais e Bahia. Os teores de minerais (em mg kg-1) encontrados nas diferentes amostras variaram entre: Al (0,612 a 32,2), Ba (1,11 a 17,6), Ca (925 a 1889), Co (0 a 1,16), Cu (6,21 a 369), Fe (23,3 a 367), K (12252 a 17205), Mg (1526 a 2059), Mn (14,2 a 60,4), Ni (0 a 44,2), P (1172 a 1826) e Zn (3,71 a 57,0). O emprego da técnica instrumental de ICP-OES e digestão da amostra por via seca mostraram-se adequados para a determinação simultânea de elementos minerais em café, uma vez que os níveis de precisão e exatidão obtidos foram satisfatórios.

Validação de métodos para determinação dos ácidos fítico e oxálico em multimistura

Considerando a composição da multimistura distribuída em Belo Horizonte/MG (trigo, fubá, casca de ovo e folha de mandioca), as metodologias de detecção e/ou quantificação dos fitatos e oxalatos foram validadas. A purificação em coluna de troca aniônica forte do ácido fítico e seus derivados desfosforilados extraídos da multimistura apresentou baixos valores de recuperação (49%) nas concentrações menores do fitato adicionado, em relação às mais elevadas (101%), sugerindo a interferência de minerais presentes em altas concentrações, principalmente cálcio. Dos métodos avaliados para a determinação do ácido oxálico, a cromatografia de exclusão iônica foi a que apresentou os melhores resultados, com boas recuperações nos níveis mais altos de adição (88%), apresentando, contudo, recuperação mais baixa nos níveis inferiores de adição (61%). Os teores de ácido fítico nas amostras variaram de 1,61 g/100 g a 2,25 g/100 g e, para o ácido oxálico, de 0,044 g/100 g a 0,057 g/100 g. Os critérios de validação dos métodos analíticos por cromatografia líquida de alta eficiência foram considerados satisfatórios quanto a seletividade e especificidade, linearidade, repetitividade e limites de detecção e quantificação. Contudo, o de recuperação não foi atendido satisfatoriamente, visto que as porcentagens obtidas foram inferiores ao esperado, levando-se em conta a concentração adicionada nas amostras.

Censo Brasileiro de Diálise, 2009

INTRODUÇÃO: Dados nacionais sobre diálise crônica são fundamentais para o planejamento do tratamento. OBJETIVO: Apresentar dados do censo anual da SBN sobre os pacientes com doença renal crônica em diálise de manutenção a 1º de janeiro de 2009. MÉTODOS: Levantamento de dados de unidades de diálise de todo o país. A coleta de dados foi feita utilizando questionário preenchido pelas unidades de diálise do Brasil cadastradas na SBN. RESULTADOS: Das unidades consultadas, 437 (69,8%) responderam ao censo. Em janeiro de 2009, o número estimado de pacientes em diálise foi de 77.589. As estimativas das taxas de prevalência e de incidência de insuficiência renal crônica em tratamento dialítico foram de 405 e 144 pacientes por milhão da população, respectivamente. O número estimado de pacientes que iniciaram tratamento em 2009 foi de 27.612. A taxa anual de mortalidade bruta foi de 17,1%. Dos pacientes prevalentes, 39,9% tinham idade > 60 anos, 89,6% estavam em hemodiálise e 10,4% em diálise peritoneal, 30.419 (39,2%) estavam em fila de espera para transplante, 27% eram diabéticos, 37,9% tinham fósforo sérico > 5,5 mg/dL e 42,8% hemoglobina < 11 g/dL. Cateter venoso foi usado como acesso vascular em 12,4% dos pacientes em hemodiálise. CONCLUSÕES: A prevalência de pacientes em diálise tem apresentado aumento progressivo embora em 2009 as estimativas sejam inferiores às de 2008. Os dados chamam atenção para indicadores da qualidade diálise de manutenção que necessitam ser melhorados. E destacam a importância do censo anual para o planejamento da assistência dialítica.

Central auditory processing and the acquisition of phonology in 2-year-old children with recurrent acute otitis media

Middle ear infections (acute otitis media, AOM) are among the most common infectious diseases in childhood, their incidence being greatest at the age of 6–12 months. Approximately 10–30% of children undergo repetitive periods of AOM, referred to as recurrent acute otitis media (RAOM). Middle ear fluid during an AOM episode causes, on average, 20–30 dB of hearing loss lasting from a few days to as much as a couple of months. It is well known that even a mild permanent hearing loss has an effect on language development but so far there is no consensus regarding the consequences of RAOM on childhood language acquisition. The results of studies on middle ear infections and language development have been partly discrepant and the exact effects of RAOM on the developing central auditory nervous system are as yet unknown. This thesis aims to examine central auditory processing and speech production among 2-year-old children with RAOM. Event-related potentials (ERPs) extracted from electroencephalography can be used to objectively investigate the functioning of the central auditory nervous system. For the first time this thesis has utilized auditory ERPs to study sound encoding and preattentive auditory discrimination of speech stimuli, and neural mechanisms of involuntary auditory attention in children with RAOM. Furthermore, the level of phonological development was studied by investigating the number and the quality of consonants produced by these children. Acquisition of consonant phonemes, which are harder to hear than vowels, is a good indicator of the ability to form accurate memory representations of ambient language and has not been studied previously in Finnish-speaking children with RAOM. The results showed that the cortical sound encoding was intact but the preattentive auditory discrimination of multiple speech sound features was atypical in those children with RAOM. Furthermore, their neural mechanisms of auditory attention differed from those of their peers, thus indicating that children with RAOM are atypically sensitive to novel but meaningless sounds. The children with RAOM also produced fewer consonants than their controls. Noticeably, they had a delay in the acquisition of word-medial consonants and the Finnish phoneme /s/, which is acoustically challenging to perceive compared to the other Finnish phonemes. The findings indicate the immaturity of central auditory processing in the children with RAOM, and this might also emerge in speech production. This thesis also showed that the effects of RAOM on central auditory processing are long-lasting because the children had healthy ears at the time of the study. An effective neural network for speech sound processing is a basic requisite of language acquisition, and RAOM in early childhood should be considered as a risk factor for language development.

Le Petit journal. Supplément du dimanche

1902/08/10 (Numéro 612).

L'Écho de Paris

1885/11/13 (Numéro 612).