899 resultados para Expert System. Rule-based System. Inference Engine. Rules. Alarm Management. Alarm filtering
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Dissertação de Mestrado, Ciências da Linguagem, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2014
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Background: Complex chronic diseases are a challenge for the current configuration of Health services. Case management is a service frequently provided for people with chronic conditions and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures, and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers, and services used. Methods and design: The study was divided into three phases, covering the detection of information needs, the design and its implementation in the healthcare system, using literature review and expert consensus methods to select variables that would be included in the registry. Objective: To describe the essential characteristics of the provision of ca re lo people who receive case management (structure, process and outcomes), with special emphasis on those with complex chronic diseases. Study population: Patients from any District of Primary Care, who initiate the utilization of case management services, to avoid information bias that may occur when including subjects who have already been received the service, and whose outcomes and characteristics could not be properly collected. Results: A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. Total sample was composed of 427 patients, of which 211 (49.4%) were women and 216 (50.6%) were men. The average functional level (Barthel lndex) was 36.18 (SD 29.02), cognitive function (Pfeiffer) showed an average of 4.37 {SD 6.57), Chat1son Comorbidity lndex, obtained a mean of 3.03 (SD 2.7) and Social Support (Duke lndex) was 34.2 % (SD 17.57). More than half of patients include in the Registry, correspond lo immobilized or transitional care for patients discharged from hospital (66.5 %). The patient's educational level was low or very low (50.4%). Caregivers overstrain (Caregiver stress index), obtained an average value of 6.09% (SD 3.53). Only 1.2 % of patients had declared their advanced directives, 58.6 had not defined the tutelage and the vast majority lived at home 98.8 %. Regarding the major events recorded at RANGE Registry, 25.8 % of the selected patients died in the first three months, 8.2 % suffered a hospital admission at least once time, 2.3%, two times, and 1.2% three times, 7.5% suffered a fall, 8.7% had pressure ulcer, 4.7% had problems with medication, and 3.3 % were institutionalized. Stroke is the more prevalent health problem recorded (25.1%), followed by hypertension (11.1%) and COPD (11.1%). Patients registered by NCMs had as main processes diabetes (16.8%) and dementia (11.3 %). The most frequent nursing diagnoses referred to the self-care deficit in various activities of daily living. Regarding to nursing interventions, described by the Nursing Intervention Classification (NIC), dementia management is the most used intervention, followed by mutual goal setting, caregiver and emotional support. Conclusions: The patient profile who receive case management services is a chronic complex patient with severe dependence, cognitive impairment, normal social support, low educational level, health problems such as stroke, hypertension or COPD, diabetes or dementia, and has an informal caregiver. At the first follow up, mortality was 19.2%, and a discrete rate of readmissions and falls.
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Active regeneration experiments were carried out on a production 2007 Cummins 8.9L ISL engine and associated DOC and CPF aftertreatment system. The effects of SME biodiesel blends were investigated in this study in order to determine the PM oxidation kinetics associated with active regeneration, and to determine the effect of biodiesel on them. The experimental data from this study will also be used to calibrate the MTU-1D CPF model. Accurately predicting the PM mass retained in the CPF and the oxidation characteristics will provide the basis for computation in the ECU that will minimize the fuel penalty associated with active regeneration. An active regeneration test procedure was developed based on previous experimentation at MTU. During each experiment, the PM mass in the CPF is determined by weighing the filter at various phases. In addition, DOC and CPF pressure drop, particle size distribution, gaseous emissions, temperature, and PM concentration data are collected and recorded throughout each experiment. The experiments covered a range of CPF inlet temperatures using ULSD, B10, and B20 blends of biodiesel. The majority of the tests were performed at CPF PM loading of 2.2 g/L with in-cylinder dosing, although 4.1 g/L and a post-turbo dosing injector were also used. The PM oxidation characteristics at different test conditions were studied in order to determine the effects of biodiesel on PM oxidation during active regeneration. A PM reaction rate calculation method was developed to determine the global activation energy and the corresponding pre-exponential factor for all test fuels. The changing sum of the total flow resistance of the wall, cake, and channels was also determined as part of the data analysis process in order to check on the integrity of the data and to correct input data to be consistent with the expected trends of the resistance based on the engine conditions used in the test procedure. It was determined that increasing the percent biodiesel content in the test fuel tends to increase the PM reaction rate and the regeneration efficiency of fuel dosing, i.e., at a constant CPF inlet temperature, B20 test fuel resulted in the highest PM reaction rate and regeneration efficiency of fuel dosing. Increasing the CPF inlet temperature also increases PM reaction rate and regeneration efficiency of fuel dosing. Performing active regeneration with B20 as opposed to ULSD allows for a lower CPF temperature to be used to reach the same level of regeneration efficiency, or it allows for a shorter regeneration time at a constant CPF temperature, resulting in decreased fuel consumption for the engine during active regeneration in either scenario.
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In the medical field images obtained from high definition cameras and other medical imaging systems are an integral part of medical diagnosis. The analysis of these images are usually performed by the physicians who sometimes need to spend long hours reviewing the images before they are able to come up with a diagnosis and then decide on the course of action. In this dissertation we present a framework for a computer-aided analysis of medical imagery via the use of an expert system. While this problem has been discussed before, we will consider a system based on mobile devices. Since the release of the iPhone on April 2003, the popularity of mobile devices has increased rapidly and our lives have become more reliant on them. This popularity and the ease of development of mobile applications has now made it possible to perform on these devices many of the image analyses that previously required a personal computer. All of this has opened the door to a whole new set of possibilities and freed the physicians from their reliance on their desktop machines. The approach proposed in this dissertation aims to capitalize on these new found opportunities by providing a framework for analysis of medical images that physicians can utilize from their mobile devices thus remove their reliance on desktop computers. We also provide an expert system to aid in the analysis and advice on the selection of medical procedure. Finally, we also allow for other mobile applications to be developed by providing a generic mobile application development framework that allows for access of other applications into the mobile domain. In this dissertation we outline our work leading towards development of the proposed methodology and the remaining work needed to find a solution to the problem. In order to make this difficult problem tractable, we divide the problem into three parts: the development user interface modeling language and tooling, the creation of a game development modeling language and tooling, and the development of a generic mobile application framework. In order to make this problem more manageable, we will narrow down the initial scope to the hair transplant, and glaucoma domains.
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The present paper presents an application that composes formal poetry in Spanish in a semiautomatic interactive fashion. JASPER is a forward reasoning rule-based system that obtains from the user an intended message, the desired metric, a choice of vocabulary, and a corpus of verses; and, by intelligent adaptation of selected examples from this corpus using the given words, carries out a prose-to-poetry translation of the given message. In the composition process, JASPER combines natural language generation and a set of construction heuristics obtained from formal literature on Spanish poetry.
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Introducción: El dolor lumbar y los desórdenes músculo esqueléticos comprometen la salud y la calidad de vida de los trabajadores, pueden poner en riesgo el futuro laboral de las personas. bjetivo: Estimar la prevalencia de dolor lumbar y los posibles factores biomecánicos asociados en el personal operativo y administrativo en una empresa manufacturera de jabón en Bogotá, en el año 2016 Metodología: Estudio de corte transversal donde se evaluó el riesgo biomecánico y la prevalencia del dolor lumbar en personal administrativo (138) y operativo (165); se utilizó como instrumento el ERGOPAR validado en España. Se revisó la asociación utilizando la prueba Chi Cuadrado de Pearson, con un nivel de significación α 0.05 Resultados: 303 trabajadores de una empresa manufacturera de jabón en Bogotá, donde predominó el género masculino (51,82%) y la población adulta media entre 30-39 años (57,42%). La prevalencia del dolor lumbar en la población fue de 61,39% (186). La edad no se asoció estadísticamente al dolor lumbar. Se encontró asociación estadística entre el síntoma dolor lumbar y extensión de cuello (p=0,05 OR1.95 IC 1.33-2.88), así como con agarrar o sujetar objetos (p= 0,036. OR 2.3 IC 1.59-3.51) y con las exigencias físicas laborales (p= 0.001 OR 1.99 IC 1.31-3.02). Conclusiones: La población estudiada presentó una alta prevalencia de dolor lumbar, con predominio en personal que realiza labores operativas, y del género femenino. La adopción de posturas de extensión del cuello y la sujeción o agarre de objetos son factores asociados directamente con la aparición de lumbalgia.
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The present work proposes different approaches to extend the mathematical methods of supervisory energy management used in terrestrial environments to the maritime sector, that diverges in constraints, variables and disturbances. The aim is to find the optimal real-time solution that includes the minimization of a defined track time, while maintaining the classical energetic approach. Starting from analyzing and modelling the powertrain and boat dynamics, the energy economy problem formulation is done, following the mathematical principles behind the optimal control theory. Then, an adaptation aimed in finding a winning strategy for the Monaco Energy Boat Challenge endurance trial is performed via ECMS and A-ECMS control strategies, which lead to a more accurate knowledge of energy sources and boat’s behaviour. The simulations show that the algorithm accomplishes fuel economy and time optimization targets, but the latter adds huge tuning and calculation complexity. In order to assess a practical implementation on real hardware, the knowledge of the previous approaches has been translated into a rule-based algorithm, that let it be run on an embedded CPU. Finally, the algorithm has been tuned and tested in a real-world race scenario, showing promising results.
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INTRODUCTION: Subclinical hypothyroidism (SCH), defined as elevated concentrations of thyroid stimulating hormone (TSH) despite normal levels of thyroid hormones, is highly prevalent in Brazil, especially among women and the elderly. Although an increasing number of studies have related SCH to an increased risk of coronary artery disease and mortality, there have been no randomized clinical trials verifying the benefit of levothyroxine treatment in reducing these risks, and the treatment remains controversial. OBJECTIVE: This consensus, sponsored by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism and developed by Brazilian experts with extensive clinical experience with thyroid diseases, presents these recommendations based on evidence for the clinical management of SCH patients in Brazil. MATERIALS AND METHODS: After structuring the clinical questions, the search for evidence in the literature was initially performed in the MedLine-PubMed database and later in the Embase and SciELO - Lilacs databases. The strength of evidence was evaluated according to the Oxford classification system and established based on the experimental design used, considering the best available evidence for each question and the Brazilian experience. RESULTS: The topics covered included SCH definition and diagnosis, natural history, clinical significance, treatment and pregnancy, and the consensus issued 29 recommendations for the clinical management of adult patients with SCH. CONCLUSION: Treatment with levothyroxine was recommended for all patients with persistent SCH with serum TSH values > 10 mU/L and for certain patient subgroups.
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This article extends Defeasible Logic to deal with the contextual deliberation process of cognitive agents. First, we introduce meta-rules to reason with rules. Meta-rules are rules that have as a consequent rules for motivational components, such as obligations, intentions and desires. In other words, they include nested rules. Second, we introduce explicit preferences among rules. They deal with complex structures where nested rules can be involved.
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Data mining is the process to identify valid, implicit, previously unknown, potentially useful and understandable information from large databases. It is an important step in the process of knowledge discovery in databases, (Olaru & Wehenkel, 1999). In a data mining process, input data can be structured, seme-structured, or unstructured. Data can be in text, categorical or numerical values. One of the important characteristics of data mining is its ability to deal data with large volume, distributed, time variant, noisy, and high dimensionality. A large number of data mining algorithms have been developed for different applications. For example, association rules mining can be useful for market basket problems, clustering algorithms can be used to discover trends in unsupervised learning problems, classification algorithms can be applied in decision-making problems, and sequential and time series mining algorithms can be used in predicting events, fault detection, and other supervised learning problems (Vapnik, 1999). Classification is among the most important tasks in the data mining, particularly for data mining applications into engineering fields. Together with regression, classification is mainly for predictive modelling. So far, there have been a number of classification algorithms in practice. According to (Sebastiani, 2002), the main classification algorithms can be categorized as: decision tree and rule based approach such as C4.5 (Quinlan, 1996); probability methods such as Bayesian classifier (Lewis, 1998); on-line methods such as Winnow (Littlestone, 1988) and CVFDT (Hulten 2001), neural networks methods (Rumelhart, Hinton & Wiliams, 1986); example-based methods such as k-nearest neighbors (Duda & Hart, 1973), and SVM (Cortes & Vapnik, 1995). Other important techniques for classification tasks include Associative Classification (Liu et al, 1998) and Ensemble Classification (Tumer, 1996).
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Aim To assess the effectiveness of a program of computer-generated tailored advice for callers to a telephone helpline, and to assess whether it enhanced a series of callback telephone counselling sessions in aiding smoking cessation. Design Randomized controlled trial comparing: (1) untailored self-help materials; (2) computer-generated tailored advice only, and (3) computer-generated tailored advice plus callback telephone counselling. Assessment surveys were conducted at baseline, 3, 6 and 12 months. Setting Victoria, Australia. Participants A total of 1578 smokers who called the Quitline service and agreed to participate. Measurements Smoking status at follow-up; duration of cessation, if quit; use of nicotine replacement therapy; and extent of participation in the callback service. Findings At the 3-month follow-up, significantly more (chi(2)(2) = 16.9; P < 0.001) participants in the computer-generated tailored advice plus telephone counselling condition were not smoking (21%) than in either the computer-generated advice only (12%) or the control condition (12%). Proportions reporting not smoking at the 12-month follow-up were 26%, 23% and 22%, respectively (NS) for point prevalence, and for 9 months sustained abstinence; 8.2, 6.0, and 5.0 (NS). In the telephone counselling group, those receiving callbacks were more likely than those who did not to have sustained abstinence at 12 months (10.2 compared with 4.0, P < 0.05). Logistic regression on 3-month data showed significant independent effects on cessation of telephone counselling and use of NRT, but not of computer-generated tailored advice. Conclusion Computer-generated tailored advice did not enhance telephone counselling, nor have any independent effect on cessation. This may be due to poor timing of the computer-generated tailored advice and poor integration of the two modes of advice.
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O artigo apresenta uma an??lise das principais caracter??sticas da reforma administrativa empreendida no Reino Unido a partir da do primeiro governo Thatcher em 1979. Inicialmente, s??o descritos dois aspectos peculiares que, segundo os autores, explicam a intensidade das reformas administrativas a?? empreendidas: seu sistema pol??tico, no qual sobressai sobremaneira a alta capacidade decis??ria do Executivo, e as debilidades de seu sistema administrativo, alvo de cr??ticas reiteradas desde o Relat??rio do Comit?? Fulton, publicado em 1968. A partir disso, os autores descrevem tr??s fases recentes na reforma administrativa inglesa p??s-Thatcher. Nesta descri????o, s??o enfocadas as principais caracter??sticas e experi??ncias inovadoras adotadas, enfatizando, entre outros: 1) os chamados ???escrut??neos de Rayner???; 2) os sistemas de informa????es gerenciais adotados (Management Information System for Ministers e o Management Accounting System); 3) o programa Citizen???s Charter; 4) o processo de privatiza????o ingl??s; 5) a experi??ncia de contrata????o externa de servi??os (com a ado????o de instrumentos como a ???licita????o competitiva???, que permite aos pr??prios servidores p??blicos apresentarem propostas para presta????o de servi??os em competi????o com as empresas privadas, al??m dos sistemas Market Testing e Competing for Quality) e, por fim; 6) a pol??tica de gest??o de recursos humanos, com destaque para o forte processo de demiss??es no servi??o p??blico, o sistema de avalia????o de desempenho dos funcion??rios e de remunera????o por performance adotados no Reino Unido.
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Neste artigo se discute o conceito de subjetividade utilizado nas práticas de saúde. Parte-se da tese de que a concepção de subjetividade predominante no pensamento dos trabalhadores no campo da saúde não está em sintonia com valores e pressupostos de renovação de conceitos e práticas, neste âmbito, na atualidade. Defende-se o caráter processual e coletivo dos processos de produção de subjetividade, contra o caráter individualista, apriorístico e objetificado prevalente nas práticas em psicologia e campos afins. Desdobra-se desta reflexão a defesa das transformações dessas práticas tendo como norte as articulações entre gestão no trabalho e processos de subjetivação, com base nos pressupostos teórico-filosóficos da obra de M. Foucault e na ergologia de linhagem francesa. Nessa direção de análise, afirma-se a importância de se pesquisar as articulações entre organização do trabalho, produção de saúde-doença e processos de subjetivação em curso. O foco das análises é a escola pública.
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O estudo teve como objetivo compreender de forma crítica como se caracteriza a gestão participativa no campus Serra do Ifes, a partir do entendimento e do processo interativo dos servidores Técnico-administrativos (TAEs) das classes C, D e E, e das chefias imediatas. Para tanto, a Teoria da Ação Comunicativa (TAC) de Jürgen Habermas, bem como sua proposta de democracia deliberativa foram empreendidas como marco teórico para compreensão desse processo e os conceitos norteadores da TAC (atos de fala, mundo da vida, sistema, colonização do mundo da vida, esfera pública, ação comunicativa e instrumental ou estratégica) foram empregados como elementos de análise das estruturas relevantes identificadas na pesquisa. Esse trabalho caracteriza-se como uma pesquisa de abordagem qualitativa e possui um enfoque crítico com visão dialética da realidade social. A análise foi realizada considerando o duplo efeito que a prática da gestão participativa pode significar: como comprometimento com o desempenho e reforço do sistema capitalista; e como resistência dos trabalhadores organizados às formas de dominação e controle. Os dados empíricos foram produzidos por meio de pesquisa documental, observação participante e entrevista semiestruturada. Foram entrevistados oito TAEs subordinados e 13 chefias imediatas, selecionados conforme o critério da bola de neve. Utilizou-se a análise de conteúdo para o tratamento das informações obtidas nas entrevistas. Os resultados apontam para a construção de ações participativas de cunho instrumental, estabelecidas a partir dos interesses da gestão, de grupos específicos e individuais. Sendo assim, a prática da gestão participativa caracteriza-se como um espaço estratégico para alcance do êxito e não do entendimento, onde os TAEs são corresponsáveis no processo de manutenção e construção dos fenômenos que emperram o desenvolvimento de uma participação democrática.
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Mestrado em Contabilidade e Finanças Orientado por: Doutora Cláudia Lopes