Towards optimal clinical and epidemiological registration of haematological malignancies: Guidelines for recording progressions, transformations and multiple diagnoses

Haematological malignancies (HM) represent over 6% of the total cancer incidence in Europe and affect all ages, ranging between 45% of all cancers in children and 7% in the elderly. Thirty per cent of childhood cancer deaths are due to HM, 8% in the elderly. Their registration presents specific challenges, mainly because HM may transform or progress in the course of the disease into other types of HM. In the context of cancer registration decisions have to be made about classifying subsequent notifications on the same patient as the same tumour (progression), a transformation or a new tumour registration. Allocation of incidence date and method of diagnosis must also be standardised. We developed European Network of Cancer Registries (ENCR) recommendations providing specific advice for cancer registries to use haematology and molecular laboratories as data sources, conserve the original date of incidence in case of change of diagnosis, make provision for recording both the original as well as transformed tumour and to apply precise rules for recording and counting multiple diagnoses. A reference table advising on codes which reflect a potential transformation or a new tumour is included. This work will help to improve comparability of data produced by population-based cancer registries, which are indispensable for aetiological research, health care planning and clinical research, an increasing important area with the application of targeted therapies.

Principles and methods for automated palynology

Pollen grains are microscopic so their identification and quantification has, for decades, depended upon human observers using light microscopes: a labour-intensive approach. Modern improvements in computing and imaging hardware and software now bring automation of pollen analyses within reach. In this paper, we provide the first review in over 15 yr of progress towards automation of the part of palynology concerned with counting and classifying pollen, bringing together literature published from a wide spectrum of sources. We
consider which attempts offer the most potential for an automated palynology system for universal application across all fields of research concerned with pollen classification and counting. We discuss what is required to make the datasets of these automated systems as acceptable as those produced by human palynologists, and present suggestions for how automation will generate novel approaches to counting and classifying pollen that have hitherto been unthinkable.

Nanoflare Activity In the Solar Chromosphere

We use ground-based images of high spatial and temporal resolution to search for evidence of nanoflare activity in the solar chromosphere. Through close examination of more than 1 x 10(9) pixels in the immediate vicinity of an active region, we show that the distributions of observed intensity fluctuations have subtle asymmetries. A negative excess in the intensity fluctuations indicates that more pixels have fainter-than-average intensities compared with those that appear brighter than average. By employing Monte Carlo simulations, we reveal how the negative excess can be explained by a series of impulsive events, coupled with exponential decays, that are fractionally below the current resolving limits of low-noise equipment on high-resolution ground-based observatories. Importantly, our Monte Carlo simulations provide clear evidence that the intensity asymmetries cannot be explained by photon-counting statistics alone. A comparison to the coronal work of Terzo et al. suggests that nanoflare activity in the chromosphere is more readily occurring, with an impulsive event occurring every similar to 360 s in a 10,000 km(2) area of the chromosphere, some 50 times more events than a comparably sized region of the corona. As a result, nanoflare activity in the chromosphere is likely to play an important role in providing heat energy to this layer of the solar atmosphere.

Tools for Assessing Outcomes in Studies of Chronic Cough: CHEST Guideline and Expert Panel Report

BACKGROUND: Since the publication of the 2006 American College of Chest Physicians (CHEST) cough guidelines, a variety of tools has been developed or further refined for assessing cough. The purpose of the present committee was to evaluate instruments used by investigators performing clinical research on chronic cough. The specific aims were to (1) assess the performance of tools designed to measure cough frequency, severity, and impact in adults, adolescents, and children with chronic cough and (2) make recommendations or suggestions related to these findings.

METHODS: By following the CHEST methodologic guidelines, the CHEST Expert Cough Panel based its recommendations and suggestions on a recently published comparative effectiveness review commissioned by the US Agency for Healthcare Research and Quality, a corresponding summary published in CHEST, and an updated systematic review through November 2013. Recommendations or suggestions based on these data were discussed, graded, and voted on during a meeting of the Expert Cough Panel.

RESULTS: We recommend for adults, adolescents (≥ 14 years of age), and children complaining of chronic cough that validated and reliable health-related quality-of-life (QoL) questionnaires be used as the measurement of choice to assess the impact of cough, such as the Leicester Cough Questionnaire and the Cough-Specific Quality-of-Life Questionnaire in adult and adolescent patients and the Parent Cough-Specific Quality of Life Questionnaire in children. We recommend acoustic cough counting to assess cough frequency but not cough severity. Limited data exist regarding the performance of visual analog scales, numeric rating scales, and tussigenic challenges.

CONCLUSIONS: Validated and reliable cough-specific health-related QoL questionnaires are recommended as the measurement of choice to assess the impact of cough on patients. How they compare is yet to be determined. When used, the reporting of cough severity by visual analog or numeric rating scales should be standardized. Previously validated QoL questionnaires or other cough assessments should not be modified unless the new version has been shown to be reliable and valid. Finally, in research settings, tussigenic challenges play a role in understanding mechanisms of cough.

An integrated approach for real-time model-based state-of-charge estimation of lithium-ion batteries

Lithium-ion batteries have been widely adopted in electric vehicles (EVs), and accurate state of charge (SOC) estimation is of paramount importance for the EV battery management system. Though a number of methods have been proposed, the SOC estimation for Lithium-ion batteries, such as LiFePo4 battery, however, faces two key challenges: the flat open circuit voltage (OCV) vs SOC relationship for some SOC ranges and the hysteresis effect. To address these problems, an integrated approach for real-time model-based SOC estimation of Lithium-ion batteries is proposed in this paper. Firstly, an auto-regression model is adopted to reproduce the battery terminal behaviour, combined with a non-linear complementary model to capture the hysteresis effect. The model parameters, including linear parameters and non-linear parameters, are optimized off-line using a hybrid optimization method that combines a meta-heuristic method (i.e., the teaching learning based optimization method) and the least square method. Secondly, using the trained model, two real-time model-based SOC estimation methods are presented, one based on the real-time battery OCV regression model achieved through weighted recursive least square method, and the other based on the state estimation using the extended Kalman filter method (EKF). To tackle the problem caused by the flat OCV-vs-SOC segments when the OCV-based SOC estimation method is adopted, a method combining the coulombic counting and the OCV-based method is proposed. Finally, modelling results and SOC estimation results are presented and analysed using the data collected from LiFePo4 battery cell. The results confirmed the effectiveness of the proposed approach, in particular the joint-EKF method.

Thermodynamics of trajectories and local fluctuation theorems for harmonic quantum networks

We present a general method to undertake a thorough analysis of the thermodynamics of the quantum jump trajectories followed by an arbitrary quantum harmonic network undergoing linear and bilinear dynamics. The approach is based on the phase-space representation of the state of a harmonic network. The large deviation function associated with this system encodes the full counting statistics of exchange and also allows one to deduce for fluctuation theorems obeyed by the dynamics. We illustrate the method showing the validity of a local fluctuation theorem about the exchange of excitations between a restricted part of the environment (i.e., a local bath) and a harmonic network coupled with different schemes.

Fast Rule Mining over Multi-dimensional Windows

Association rule mining is an indispensable tool for discovering
insights from large databases and data warehouses.
The data in a warehouse being multi-dimensional, it is often
useful to mine rules over subsets of data defined by selections
over the dimensions. Such interactive rule mining
over multi-dimensional query windows is difficult since rule
mining is computationally expensive. Current methods using
pre-computation of frequent itemsets require counting
of some itemsets by revisiting the transaction database at
query time, which is very expensive. We develop a method
(RMW) that identifies the minimal set of itemsets to compute
and store for each cell, so that rule mining over any
query window may be performed without going back to the
transaction database. We give formal proofs that the set of
itemsets chosen by RMW is sufficient to answer any query
and also prove that it is the optimal set to be computed
for 1 dimensional queries. We demonstrate through an extensive
empirical evaluation that RMW achieves extremely
fast query response time compared to existing methods, with
only moderate overhead in pre-computation and storage

Smartphone and GPS technology for freeroaming dog population surveillance -a methodological study (Studio metodologico sull’applicazione di smartphone e tecnologia GPS alla sorveglianza delle popolazioni di cani vaganti)

Free-roaming dogs (FRD) represent a potential threat to the quality of life in cities from an ecological, social and public health point of view. One of the most urgent concerns is the role of uncontrolled dogs as reservoirs of infectious diseases transmittable to humans and, above all, rabies. An estimate of the FRD population size and characteristics in a given area is the first step for any relevant intervention programme. Direct count methods are still prominent because of their non-invasive approach, information technologies can support such methods facilitating data collection and allowing for a more efficient data handling. This paper presents a new framework for data collection using a topological algorithm implemented as ArcScript in ESRI® ArcGIS software, which allows for a random selection of the sampling areas. It also supplies a mobile phone application for Android® operating system devices which integrates Global Positioning System (GPS) and Google Maps™. The potential of such a framework was tested in 2 Italian regions. Coupling technological and innovative solutions associated with common counting methods facilitate data collection and transcription. It also paves the way to future applications, which could support dog population management systems.

Laser Surface Treatment of Polyamide and NiTi Alloy and the Effects on Mesenchymal Stem Cell Response

Mesenchymal stem cells (MSCs) are known to play important roles in development, post-natal growth, repair, and regeneration of mesenchymal tissues. What is more, surface treatments are widely reported to affect the biomimetic nature of materials. This paper will detail, discuss and compare laser surface treatment of polyamide (Polyamide 6,6), using a 60 W CO2 laser, and NiTi alloy, using a 100 W fiber laser, and the effects of these treatments on mesenchymal stem cell response. The surface morphology and composition of the polyamide and NiTi alloy were studied by scanning electron microscopy (SEM) and X-ray photoemission spectroscopy (XPS), respectively. MSC cell morphology cell counting and viability measurements were done by employing a haemocytometer and MTT colorimetric assay. The success of enhanced adhesion and spreading of the MSCs on each of the laser surface treated samples, when compared to as-received samples, is evidenced in this work. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Replicability of data collected for empirical estimation of relative pollen productivity

The effects of repeated survey and fieldwork timing on data derived from a recently proposed standard field methodology for empirical estimation of Relative Pollen Productivity have been tested. Seasonal variations in vegetation and associated pollen assemblages were studied in three contrasting cultural habitat types; semi-natural ancient woodlands, lowland heaths, and unimproved, traditionally managed hay meadows. Results show that in woodlands and heathlands the standard method generates vegetation data with a reasonable degree of similarity throughout the field season, though in some instances additional recording of woodland canopy cover should be undertaken, and differences were greater for woodland understorey taxa than for arboreal taxa. Large differences in vegetation cover were observed over the field season in the grassland community, and matching the phenological timing of surveys within and between studies is clearly important if RPP estimates from these sites are to be comparable. Pollen assemblages from closely co-located moss polsters collected on different visits are shown to be variable in all communities, to a greater degree than can be explained by the sampling error associated with pollen counting, and further study of moss polsters as pollen traps is recommended.

Infecção de mycobacterium bovis em células fagocíticas: estratégia aplicada ao diagnóstico da tuberculose bovina

Neste trabalho foram estudadas as interacções entre Mycobacterium bovis e células hospedeiras, na perspectiva de aplicar os conhecimentos resultantes desse estudo ao melhoramento do diagnóstico da tuberculose bovina. Foi estudada a dinâmica da infecção de células fagocíticas com estirpes de M. bovis, com ênfase para a invasão e multiplicação intracelular das micobactérias. Avaliações efectuadas por citometria de fluxo, microscopia de fluorescência e contagem de colónias demonstraram que as micobactérias invadiram e replicaram em todos os modelos celulares, sendo que as células epiteliais de pulmão de bovino foram as mais permissivas ao seu crescimento. Foi nas células macrofágicas J774 e THP-1 que se verificaram as maiores concentrações micobacterianas, pelo que foram utilizadas para a detecção e identificação de M. bovis por um método molecular. A optimização da extracção de DNA, por um processo mecânico, e o desenvolvimento do método de PCR-RFLP baseado no gene gyrB, com controlo interno, permitiram a identificação de M. bovis. A sensibilidade deste método foi de 100% quando aplicado a estirpes isoladas e apenas de 40% quando utilizado directamente em amostras de macerados de tecidos de bovinos com tuberculose. Uma pré-incubação (3 dias) das amostras nas culturas celulares contribuiu para melhorar significativamente a sensibilidade (77%) do PCR-RFLP gyrB. A cultura celular, como matriz a ser utilizada para aumentar a quantidade de M. bovis presente em amostras biológicas, revela-se um método promissor para o diagnóstico laboratorial rápido, específico e sensível da tuberculose bovina. ### - Summary - Interactions between Mycobacterium bovis and host cells were studied with the purpose to apply the outcome knowledge in the improvement of bovine tuberculosis diagnosis. The dynamic of infection of four cell models with three strains of M. bovis was evaluated, with emphasis given to the invasion and intracellular multiplication of mycobacteria. Assessments by flow cytometry, fluorescence microscopy and colony counting showed that every cell models permitted the replication of mycobacteria, although bovine lung epithelial cells had been the most permissive one. The highest mycobacteria) load was found, however, in J774 and THP-1 macrophages, and hence these cells were used for the optimization of a molecular method for detection and identification of M. bovis. The optimisation of a DNA extraction step, by a mechanical process, and the development of PCR-RFLP based on gyrB gene, with an internal control, allowed the identification of M. bovis. The sensitivity of this method was 100% when applied to isolated strains and only 40% when directly used on samples of macerated of tissues from cattle with tuberculosis. Assays in which a pre-incubation step (three days) of biological samples in cell cultures was introduced significantly improved the sensitivity (77%) of the gyrB PCR-RFLP. Cell cultures as a support for growth and rapid isolation of M. bovis is a promising method for the specific, sensitive and rapid laboratorial diagnosis of bovine tuberculosis.

A educação no processo de interação entre o enfermeiro e a pessoa idosa/família na comunidade

Objetivo: Compreender a educação no processo de interação entre o enfermeiro e a pessoa idosa e família no domicílio. Estudo de natureza qualitativa, enquadrado nos principais pressupostos do Interacionismo Simbólico e da Grounded Theory, em quatro freguesias do Agrupamento de Centros de Saúde do Ave III, com um total de inscritos de 80285 e destes 9,81% eram pessoas idosas com idades iguais ou superiores a 65 anos. Na colheita dos dados recorremos: (i) à observação não participante das práticas de enfermagem às pessoas idosas e família no domicílio;(ii) 12 entrevistas às enfermeiras observadas e 4 entrevistas em grupo (pessoa idosa e família). Emergiram as categorias: organização estrutural dos cuidados no domicílio; avaliação em contexto e intervenção terapêutica em contexto. A categoria central foi a “Construção da relação no contexto do domicílio” pelo facto da relação da enfermeira com o idoso e a família ser central em todo o processo de cuidados. Os conhecimentos fornecidos pela teoria substantiva “Cuidar no Domicílio – um Processo de Interação” fundamentada nos dados e na sua análise, fornecem contributos válidos para a prática de enfermagem nesta área específica do cuidar a pessoa idosa e família no domicílio e no contexto em que foi desenvolvido o estudo; ABSTRACT: Education in the Interaction Process between nurse and Elderly person/family in the community Objective: Understanding education in the interaction process between nurse and elderly and their relatives at home. Qualitative study, framed on Symbolic Interactionism and Grounded Theory main assumptions, counting with 802825 members of four parishes of Agrupamento de Centros de Saúde do Ave III, which 9, 81% were elderly and had 65 or more years old. Data collection instruments used: (i) non-participant observation of nursing practices with elderly and families at home, (ii) interviews of 12 nurses practices observed and 4 group interviews (family and elderly person). Categories emerged: structural organization of home care; assessment and therapeutic intervention in context. The core category emerged was "Construction of the relationship in the context of the household" once the relationship between nurse, elderly and family seem be central to the whole process of care. The knowledge provided by substantive theory "Caring at Home - An Interaction Process" founded on data analysis provided valuable contributions to nursing practice in this specific area of care, elderly care and their relatives at home, in which context study was developed.

Novos saberes básicos dos alunos, novas competências dos professores : um estudo no âmbito da supervisão da formação de professores do 1º ciclo do ensino básico na Universidade de Aveiro

As mudanças sociais que, na actualidade, pressionam e desafiam a Escola, nomeadamente quanto aos papéis, funções e desempenho dos professores, implicam a necessidade de repensar a sua formação para que possam responder mais adequadamente aos desafios emergentes. Estes têm particularmente a ver com os novos saberes que essas condições exigem a todos os cidadãos e que são entendidos, do ponto de vista epistemológico, como saberes para agir responsavelmente. Assim, o principal objectivo deste estudo consiste em aprofundar o conhecimento acerca das ambiências e culturas de formação inicial de professores do 1. º Ciclo do Ensino Básico na Universidade de Aveiro, nomeadamente dos processos de supervisão ao nível da disciplina de Prática Pedagógica, tendo em consideração que as características de monodocência dos profissionais deste ciclo de ensino pressupõem um perfil de competência específico. A investigação, de natureza qualitativa, desenvolveu-se de acordo com as abordagens próprias da complexidade e da sistémica, das quais relevamos os princípios da totalidade em que os fenómenos são percebidos como sistemas globais e dinâmicos e da recursividade ao admitirmos a possibilidade de uma relação dialéctica entre os diversos subsistemas considerados. Do ponto de vista metodológico, no sentido de construir uma visão integrada do objecto em estudo, foi utilizado um conjunto de procedimentos específicos (mixed-methods), nomeadamente análise documental, inquirição por questionário e por entrevista semi-estruturada. O questionário foi aplicado à totalidade de licenciados em Ensino do 1.º Ciclo do Ensino Básico pela Universidade de Aveiro, compreendendo o período de 1998 até 2005. A entrevista foi realizada junto de supervisores (cooperantes e institucionais) que vêm acompanhando os núcleos de Prática Pedagógica, no decurso e ao longo do 4.º ano da referida Licenciatura. Quanto aos resultados do estudo, estes podem ser lidos em função de três eixos. Relativamente ao primeiro, que genericamente se refere à evolução dos saberes básicos dos alunos, os contributos parecem sugerir a necessidade de alicerçar os processos de ensino/aprendizagem não apenas nas literacias ler, escrever e contar, como também no desenvolvimento de saberes básicos de natureza geral e transversal, percebidos como competências, tais como aprender a pensar, aprender a aprender, aprender a comunicar e a resolver problemas, numa perspectiva de aprender a ser. O segundo eixo de leitura tem a ver com as competências requeridas aos professores para o desenvolvimento desses saberes estruturantes. De acordo com os dados recolhidos na fase extensiva do estudo, estes parecem coerentes com a revisão de literatura realizada, bem como com os normativos legais que, em Portugal, enquadram o perfil de desempenho dos professores do 1.º Ciclo. Porém, sugerem a necessidade de interligar as dimensões saber, saber-fazer e saber ser, com ênfase nesta última. À semelhança dos resultados referidos no ponto anterior, também o referencial de competências proposto para os professores integra as dimensões saber, saber fazer e saber ser, no qual são valorizadas as competências de reflexão crítica, de aprender a aprender e, de igual forma, o conhecimento profissional nas suas múltiplas dimensões. O terceiro eixo relaciona-se com a qualidade das ambiências e culturas de formação e supervisão. De forma geral, os dados apontam que ambientes que possibilitem uma dimensão de prática curricular alargada em contextos diversificados, que valorizem os princípios da pessoalidade e respeito pelo Outro e que estimulem a reflexão crítica, a auto-implicação dos formandos, o desenvolvimento de competências pessoais e de desenvolvimento profissional (destacando-se as competências para aprender a aprender, a comunicar, a investigar e reflectir), parecem adequar se melhor ao desenvolvimento pessoal e profissional destes professores, no contexto das sociedades contemporâneas. Assim, é possível verificar que os eixos considerados remetem para um conjunto recursivo de saberes e competências que, em diferentes níveis, implicam um compromisso com a acção, numa visão de mundo comprometida com as ideias de bem comum, ou seja, de cidadania universal.

Contributos para a análise estatística de séries de contagem

A análise das séries temporais de valores inteiros tornou-se, nos últimos anos, uma área de investigação importante, não só devido à sua aplicação a dados de contagem provenientes de diversos campos da ciência, mas também pelo facto de ser uma área pouco explorada, em contraste com a análise séries temporais de valores contínuos. Uma classe que tem obtido especial relevo é a dos modelos baseados no operador binomial thinning, da qual se destaca o modelo auto-regressivo de valores inteiros de ordem p. Esta classe é muito vasta, pelo que este trabalho tem como objectivo dar um contributo para a análise estatística de processos de contagem que lhe pertencem. Esta análise é realizada do ponto de vista da predição de acontecimentos, aos quais estão associados mecanismos de alarme, e também da introdução de novos modelos que se baseiam no referido operador. Em muitos fenómenos descritos por processos estocásticos a implementação de um sistema de alarmes pode ser fundamental para prever a ocorrência de um acontecimento futuro. Neste trabalho abordam-se, nas perspectivas clássica e bayesiana, os sistemas de alarme óptimos para processos de contagem, cujos parâmetros dependem de covariáveis de interesse e que variam no tempo, mais concretamente para o modelo auto-regressivo de valores inteiros não negativos com coeficientes estocásticos, DSINAR(1). A introdução de novos modelos que pertencem à classe dos modelos baseados no operador binomial thinning é feita quando se propõem os modelos PINAR(1)T e o modelo SETINAR(2;1). O modelo PINAR(1)T tem estrutura periódica, cujas inovações são uma sucessão periódica de variáveis aleatórias independentes com distribuição de Poisson, o qual foi estudado com detalhe ao nível das suas propriedades probabilísticas, métodos de estimação e previsão. O modelo SETINAR(2;1) é um processo auto-regressivo de valores inteiros, definido por limiares auto-induzidos e cujas inovações formam uma sucessão de variáveis independentes e identicamente distribuídas com distribuição de Poisson. Para este modelo estudam-se as suas propriedades probabilísticas e métodos para estimar os seus parâmetros. Para cada modelo introduzido, foram realizados estudos de simulação para comparar os métodos de estimação que foram usados.

Politopo de Birkhoff acíclico

Neste trabalho estabelece-se uma interpreta c~ao geom etrica, em termos da teoria dos grafos, para v ertices, arestas e faces de uma qualquer dimens~ao do politopo de Birkho ac clico, Tn = n(T), onde T e uma arvore com n v ertices. Generaliza-se o resultado obtido por G. Dahl, [18], para o c alculo do di^ametro do grafo G( t n), onde t n e o politopo das matrizes tridiagonais duplamente estoc asticas. Adicionalmente, para q = 0; 1; 2; 3 s~ao obtidas f ormulas expl citas para a contagem do n umero de q faces do politopo de Birkho tridiagonal, t n, e e feito o estudo da natureza geom etrica dessas mesmas faces. S~ao, tamb em, apresentados algoritmos para efectuar contagens do n umero de faces de dimens~ao inferior a de uma dada face do politopo de Birkho ac clico.