Rendimiento del score PIM 2 en una Unidad de Cuidados Intensivos Pediátricos

Objetivo: evaluar el rendimiento del score de predicción de mortalidad PIM 2 en una población de pacientes pediátricos críticos. Materiales y métodos: se realizó un estudio prospectivo, entre el 01 de enero y el 31 de diciembre de 2013. Se incluyeron todos los pacientes con una edad comprendida entre 29 días y 14 años que ingresaron a la Unidad de Cuidados Intensivos Pediátricos (CIP) de la Asociación Española. Fueron excluidos aquellos pacientes que fallecieron antes de las 12 horas, los que ingresaron para monitorización u observación luego de procedimientos endoscópicos o quirúrgicos menores o para realización de vías y los neonatos. Para evaluar el rendimiento del score PIM 2 se analizó tanto su calibración, como su discriminación, mediante la aplicación del test de bondad de ajuste de Hosmer-Lemeshow y la construcción de la curva ROC y el cálculo del área bajo la curva. Resultados: se incluyeron 184 pacientes para el análisis. La tasa de mortalidad de esta población fue de 5,4% (IC95% 1,88-8,98). La media de internación fue de 8,3 días (rango 12 horas a 27 días) y en el caso de los fallecidos fue de 11.3 días (rango 1-20). La aplicación del test de Hosmer-Lemeshow arrojó un valor de Chi cuadrado de 5,37 (p=0,71). El área bajo la curva ROC fue de 0,90. Para un punto de corte de 0,5 el rendimiento de la prueba evidenció una validez global del 96,7% (IC 95% entre 93,77-99,57), un valor predictivo positivo del 100% (87,50-100) y un valor predictivo negativo de 96,67% (93,77-99,57). La sensibilidad para este corte fue del 40% (4,64-75,36) y una especificidad del 100% (99,71-100). Conclusiones: el score PIM 2 ha presentado en la población estudiada una adecuada calibración y discriminación global. Por tanto, su utilidad como instrumento para medición y evaluación de la calidad asistencial permanece vigente. Pese a ello, su aplicabilidad práctica fue limitada en pacientes asignados a deciles de riesgo “bajo” en donde el score presentó problemas de discriminación y una alta tasa de falsos negativos.

Evaluation of Information Entropy from Acoustic Emission Waveforms as a Fatigue Damage Metric for Al7075-T6

Information entropy measured from acoustic emission (AE) waveforms is shown to be an indicator of fatigue damage in a high-strength aluminum alloy. Several tension-tension fatigue experiments were performed with dogbone samples of aluminum alloy, Al7075-T6, a commonly used material in aerospace structures. Unlike previous studies in which fatigue damage is simply measured based on visible crack growth, this work investigated fatigue damage prior to crack initiation through the use of instantaneous elastic modulus degradation. Three methods of measuring the AE information entropy, regarded as a direct measure of microstructural disorder, are proposed and compared with traditional damage-related AE features. Results show that one of the three entropy measurement methods appears to better assess damage than the traditional AE features, while the other two entropies have unique trends that can differentiate between small and large cracks.

Relação entre o score de adesão à dieta mediterrânica e a hemoglobina glicosilada em pessoas com diabetes mellitus tipo 2

Poster apresentado no XIV Congresso de Nutrição e Alimentação. Centro de Congressos de Lisboa, 21-22 Maio de 2015

From the traditional verification approach to the spatial methods: a study of applicability of the SAL metric in the framework of the WMO project MesoVICT

Increasing in resolution of numerical weather prediction models has allowed more and more realistic forecasts of atmospheric parameters. Due to the growing variability into predicted fields the traditional verification methods are not always able to describe the model ability because they are based on a grid-point-by-grid-point matching between observation and prediction. Recently, new spatial verification methods have been developed with the aim of show the benefit associated to the high resolution forecast. Nested in among of the MesoVICT international project, the initially aim of this work is to compare the newly tecniques remarking advantages and disadvantages. First of all, the MesoVICT basic examples, represented by synthetic precipitation fields, have been examined. Giving an error evaluation in terms of structure, amplitude and localization of the precipitation fields, the SAL method has been studied more thoroughly respect to the others approaches with its implementation in the core cases of the project. The verification procedure has concerned precipitation fields over central Europe: comparisons between the forecasts performed by the 00z COSMO-2 model and the VERA (Vienna Enhanced Resolution Analysis) have been done. The study of these cases has shown some weaknesses of the methodology examined; in particular has been highlighted the presence of a correlation between the optimal domain size and the extention of the precipitation systems. In order to increase ability of SAL, a subdivision of the original domain in three subdomains has been done and the method has been applied again. Some limits have been found in cases in which at least one of the two domains does not show precipitation. The overall results for the subdomains have been summarized on scatter plots. With the aim to identify systematic errors of the model the variability of the three parameters has been studied for each subdomain.

Development of an activity disease score in patients with uveitis (UVEDAI)

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct “uveitis inflammatory activity” was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases.

Measured Time: Imposing a Temporal Metric toClassificatory Structures

Describes three units of time helpful for understanding and evaluating classificatory structures: long time (versions and states of classification schemes), short time (the act of indexing as repeated ritual or form), and micro-time (where stages of the interpretation process of indexing are separated out and inventoried). Concludes with a short discussion of how time and the impermanence of classification also conjures up an artistic conceptualization of indexing, and briefly uses that to question the seemingly dominant understanding of classification practice as outcome of scientific management and assembly line thought.

Collocative Integrity and Our Many Varied Subjects: What the Metric of Alignment between Classification Scheme and Indexer Tells Us About Langridge’s Theory of Indexing

As the universe of knowledge and subjects change over time, indexing languages like classification schemes, accommodate that change by restructuring. Restructuring indexing languages affects indexer and cataloguer work. Subjects may split or lump together. They may disappear only to reappear later. And new subjects may emerge that were assumed to be already present, but not clearly articulated (Miksa, 1998). In this context we have the complex relationship between the indexing language, the text being described, and the already described collection (Tennis, 2007). It is possible to imagine indexers placing a document into an outdated class, because it is the one they have already used for their collection. However, doing this erases the semantics in the present indexing language. Given this range of choice in the context of indexing language change, the question arises, what does this look like in practice? How often does this occur? Further, what does this phenomenon tell us about subjects in indexing languages? Does the practice we observe in the reaction to indexing language change provide us evidence of conceptual models of subjects and subject creation? If it is incomplete, but gets us close, what evidence do we still require?

Correlacion entre hemoglobina glicosilada con hallazgos sintax score ii en pacientes con sospecha clínica de enfermedad coronaria, hospitalizados en la unidad coronaria del hospital San José centro en enero a septiembre del año 2015

Se realiza un estudio de corte transversal en el periodo de enero a septiembre del año 2016 en la unidad coronaria del Hospital San José Centro de la Ciudad de Bogotá; en pacientes con sospecha de enfermedad coronaria (Síndrome coronario agudo y angina estable) y antecedente de Diabetes Mellitus Tipo 2, se recolectaron 42 pacientes con los criterios de inclusión a quienes se realizó angiografía coronaria como parte del protocolo de estudio y manejo de la unidad, el objetivo primario fue demostrar la posible correlación entre niveles de hemoglobina glicosilada y la escala de severidad SYNTAX Score I y II de enfermedad coronaria, como objetivos secundarios; caracterizar las variables sociodemográficas, comorbilidades y posible relación con el tipo de presentación de enfermedad coronaria. Como hallazgos relevantes no se encontró correlación importante ni significativa entre niveles de hemoglobina glicosilada y la escala Syntax score II ni Syntax score I, a pesar de que la mayoría de pacientes mostraban mal control crónico de su diabetes mellitus tipo 2, con niveles mayores > 7%, como hallazgo positivo se encontro asociación estadísticamente significativa con niveles de LDL y las diferentes formas de presentación de enfermedad coronaria, a mayor niveles de LDL mayor probabilidad de IAM e IAM con elevación del segmento ST. Se considera que con estudios multicentricos en diferentes ciudades y unidades de cuidado cardiovascular con diferentes niveles de riesgo, se podría demostrar la posible correlación entre niveles de hemoglobina glicosilada y los grados de severidad de enfermedad coronaria representados por las escalas Syntax score I y II.

Proposal and Validation of a Scale of Composite Measure Reactivity Score to Characterize the Reactivity in Horses During Handling

This study aimed to identify the parameters related to the expression of the reactivity in horses during handling and based on that proposed and validated a scale of composite measure reactivity score to characterize horse's reactivity. To this end, the first stage (S1) proposed the scale and the second (S2) validated it. In S1, 364 Lusitano horses were evaluated, 188 were adult breeding mares (4–12 years old), and 176 were foals (males/females, aged from 2 months to 2 years). During hooves trimming, vermifuge application, palpation scores were assigned to behaviors of movement, ears and eyes position, breathing, vocalization, and urination. A response parameter called reactivity was attributed to each animal, ranging from score 1 (nonreactive/calm) to score 4 (very reactive/aggressive). The verification of the possible parameters (age, behavior), which explains the response parameter (reactivity), was taken using ordinal proportional odds model. Movement, breathing, ears and eyes position, vocalization, and age appear to explain the reactivity of horses during handling (P < .01). Therefore, based on these parameters, it was possible to propose two scales of composite measure reactivity score: one to characterize the mares and another the foals. On S2, the proposed scale was validated by the simultaneous application of Forced Human Approach Test, another commonly used test to evaluate the reactivity in horses, with a correlation of 0.97 (P < .05). The assessment of the reactivity of horses during handling by a composite measure reactivity score scale is valid, and easy to apply, without disrupting daily routine and override the impact of individual differences.

Portuguese Version of the Suicidal Behaviors Questionnaire-Revised: Validation Data and the Establishment of a Cut-Score for Screening Purposes

The aim of the present study is to provide validation data regarding the Portuguese version of the Suicidal Behaviors Questionnaire Revised in nonclinical individuals. Two studies were undertaken with two different nonclinical samples in order to demonstrate reliability, concurrent, predictive, and construct validity, and in order to establish an appropriate cut-score for nonclinical individuals. A sample of 810 community adults participated in Study 1. Results from this study provided information regarding scale internal consistency, exploratory and confirmatory factor analysis, and concurrent validity. Receiver operating characteristic curve analysis established a cut-off score to be used for screening purposes with nonclinical individuals. A sample of 440 young adults participated in Study 2, which demonstrated scale score internal consistency and 5-month predictive validity. Further, 5-month test-retest reliability was also evaluated and the correlations of SBQ-R scale scores with two other measures that assess constructs related to suicidality, depression and psychache, were also performed. In addition, confirmatory factor analysis was undertaken to demonstrate the robustness of the result obtained in Study 1. Overall, findings supported the psychometric appropriateness of the Portuguese Suicidal Behaviors Questionnaire-Revise

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

Tracking people in 3D using position, size and shape

This paper presents a prototype tracking system for tracking people in enclosed indoor environments where there is a high rate of occlusions. The system uses a stereo camera for acquisition, and is capable of disambiguating occlusions using a combination of depth map analysis, a two step ellipse fitting people detection process, the use of motion models and Kalman filters and a novel fit metric, based on computationally simple object statistics. Testing shows that our fit metric outperforms commonly used position based metrics and histogram based metrics, resulting in more accurate tracking of people.

Search engine content analysis

Search engines have forever changed the way people access and discover knowledge, allowing information about almost any subject to be quickly and easily retrieved within seconds. As increasingly more material becomes available electronically the influence of search engines on our lives will continue to grow. This presents the problem of how to find what information is contained in each search engine, what bias a search engine may have, and how to select the best search engine for a particular information need. This research introduces a new method, search engine content analysis, in order to solve the above problem. Search engine content analysis is a new development of traditional information retrieval field called collection selection, which deals with general information repositories. Current research in collection selection relies on full access to the collection or estimations of the size of the collections. Also collection descriptions are often represented as term occurrence statistics. An automatic ontology learning method is developed for the search engine content analysis, which trains an ontology with world knowledge of hundreds of different subjects in a multilevel taxonomy. This ontology is then mined to find important classification rules, and these rules are used to perform an extensive analysis of the content of the largest general purpose Internet search engines in use today. Instead of representing collections as a set of terms, which commonly occurs in collection selection, they are represented as a set of subjects, leading to a more robust representation of information and a decrease of synonymy. The ontology based method was compared with ReDDE (Relevant Document Distribution Estimation method for resource selection) using the standard R-value metric, with encouraging results. ReDDE is the current state of the art collection selection method which relies on collection size estimation. The method was also used to analyse the content of the most popular search engines in use today, including Google and Yahoo. In addition several specialist search engines such as Pubmed and the U.S. Department of Agriculture were analysed. In conclusion, this research shows that the ontology based method mitigates the need for collection size estimation.

A framework for analyzing system intelligence of the building control system : a study of the integrated building management system

The lack of satisfactory consensus for characterizing the system intelligence and structured analytical decision models has inhibited the developers and practitioners to understand and configure optimum intelligent building systems in a fully informed manner. So far, little research has been conducted in this aspect. This research is designed to identify the key intelligent indicators, and develop analytical models for computing the system intelligence score of smart building system in the intelligent building. The integrated building management system (IBMS) was used as an illustrative example to present a framework. The models presented in this study applied the system intelligence theory, and the conceptual analytical framework. A total of 16 key intelligent indicators were first identified from a general survey. Then, two multi-criteria decision making (MCDM) approaches, the analytic hierarchy process (AHP) and analytic network process (ANP), were employed to develop the system intelligence analytical models. Top intelligence indicators of IBMS include: self-diagnostic of operation deviations; adaptive limiting control algorithm; and, year-round time schedule performance. The developed conceptual framework was then transformed to the practical model. The effectiveness of the practical model was evaluated by means of expert validation. The main contribution of this research is to promote understanding of the intelligent indicators, and to set the foundation for a systemic framework that provide developers and building stakeholders a consolidated inclusive tool for the system intelligence evaluation of the proposed components design configurations.

Airwaves: 100 years of radio

Music composition using prominent broadcast speeches across the whole twentieth century in commemoration of the centenary of Marconi's first transatlantic radio transmission. The work is based on creating music from the found objects of melody derived from spoken intonation. Recordings of the speeches are accompanied throughout by live instrumental music.