Mobile systems for monitoring Parkinson's disease

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device. One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data-driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time. Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.

Construção do teste de aptidão criativa - TAC: forma experimental

Este trabalho tem por finalidade a construção de um instrumento psicológico de medida de comportamentos criativos, o Teste de Aptidão Criativa - TAC. A construção do TAC é justificada de um lado, por sua utilidade; sobretudo para o orientador profissional e psicólogo escolar e de outro; pela inexistência no Brasil; em particular no Nordeste, de instrumentos de medida similar. A formulação do problema e seu contexto são descritos logo no início do trabalho, bem como, a fundamentação teórica. Neste particular, enfatizou-se o enfoque psicológico da criatividade v em suas abordagens personológica e cognitiva. Atenção especial foi dada ao estudo do "modelo da estrutura do intelecto" de J. P. Guilford, suporte teórico do TAC. O teste de Aptidão Criativa é apresentado em todas as etapas de sua construção , desde a forma pré-piloto ç à piloto e à experimental, salientando-se seus respectivos subtestes figural e verbal. Ilustrações dos itens, bem como, das formas do teste são também apresentadas para melhor compreensão do texto. Em prosseguimento descreve- se uma pesquisa empírica realizada com o TAC, cujas hipóteses operacionais visam comprovar sua validade de constrito sua fidedignidade. A população foi constituída de alunos, de ambos os sexos, que cursaram em 1977 a 8a. série do 1º grau, de escolas públicas ou particulares; do município do Recife. O trabalho descreve detalhadamente a determinação da amostra, os instrumentos utilizados bem como os critérios de avaliação dos dados. O tratamento estatístico consistiu em medidas de tendência ceutra e de variabilidade; análise fatorial (técnica dos componentes principais-solução Varimax) para verificação da validade de construto. Os resultados obtidos, pela análise fatorial, demonstraram a presença de três fatores: um denominado C e interpretado como Convergente e dois, mensuráveis pelo TAC (conforme mostram as cargas fatoriais) que foram chamados de F (Fluência e Flexibilidade) e 0 Originalidade. O índice de homogeneidade calculado pelo “ de Cronbach" da característica originalidade entendida como essencial para a criatividade foi de 0,72. Tal resultado permite afirmar que na amostra testada o TAC , neste aspecto, apresenta fidedignidade significativa. Uma análise de regressão múltipla por passos foi levada a efeito, visando a identificação dos itens que mais contribuíram para explicação do escore total. Os resultados permitiram apontar uma melhor forma para o TAC figural constituída pelos itens I , II, V, VI , VII e VIII, os quais comporão a forma definitiva do TAC. Calculou-se também o estatístico Z do "Teste de urna Amostra de Kolmogorou para verificação da normalidade da distribuição das três características que o de medir: Fluência, Flexibilidade e Originalidade. Explicita-se ainda uma crítica à técnica de computação das respostas do TAC em face do índice de flexibilidade e propõe-se a realização de estudos, que permitam a formulação de novos procedimentos para um tratamento mais adequado das respostas aos estímulos do teste. Sugere-se também um estudo teórico sistemático de maior profundidade sobre os pontos de convergência entre as teorias psicológicas que tratam o tema para uma melhor compreensão da natureza e dinâmica do comportamento criativa. Propõe-se ainda a continuidade da pesquisa empírica que deu origem a este trabalho, tendo por objetivo imediato a padronização do TAC, de modo a poder ser ele instrumento útil ao psicólogo, na prática da psicologia aplicada.

A confiança interorganizacional nas compras

This research is part of the field of organizational studies, focusing on organizational purchase behavior and, specifically, trust interorganizational at the purchases. This topic is current and relevant by addressing the development of good relations between buyer-supplier that increases the exchange of information, increases the length of relationship, reduces the hierarchical controls and improves performance. Furthermore, although there is a vast literature on trust, the scientific work that deal specifically at the trust interorganizational still need further research to synthesize and validate the variables that generate this phenomenon. In this sense, this investigation is to explain the antecedents of trust interorganizational by the relationship between the variable operational performance, organizational characteristics, shared values and interpersonal relationships on purchases by manufacturing industries, in order to develop a robust literature, most consensual, that includes the current sociological and economic, considering the effect of interpersonal relationships in this phenomenon. This proposal is configured in a new vision of the antecedents of interorganizational trust, described as significant quantitative from models Morgan and Hunt (1994), Doney and Cannon (1997), Zhao and Cavusgil (2006) and Nyaga, Whipple, Lynch (2011), as well as qualitative analysis of Tacconi et al. (2011). With regard to methodological aspects, the study assumes the form of a descriptive, survey type, and causal trace theoretical and empirical. As for his nature, the investigation, explicative character, has developed a quantitative approach with the use of exploratory factor analysis and structural equation modeling SEM, with the use of IBM software SPSS Amos 18.0, using the method of maximum verisimilitude, and supported by technical bootstraping. The unit of analysis was the buyer-supplier relationship, in which the object under investigation was the supplier organization in view of the purchasing company. 237 valid questionnaires were collected among key informants, using a simple random sampling developed in manufacturing industries (SIC 10-33), located in the city of Natal and in the region of Natal. The first results of descriptive analysis demonstrate the phenomenon of interorganizational trust, in which purchasing firms believe, feel secure about the supplier. This demonstration showed high levels of intensity, predominantly among the vendors that supply the company with materials that are used directly in the production process. The exploratory and confirmatory factor analysis, performed on each variable alone, generated a set of observable and unobservable variables more consistent, giving rise to a model, that needed to be further specified. This again specify model consists of trajectories was positive, with a good fit, with a composite reliability and variance extracted satisfactory, and demonstrates convergent and discriminant validity, in which the factor loadings are significant and strong explanatory power. Given the findings that reinforce the model again specify data, suggesting a high probability that this model may be more suited for the study population, the results support the explanation that interorganizational trust depends on purchases directly from interpersonal relationships, sharing value and operating performance and indirectly of personal relationships, social networks, organizational characteristics, physical and relational aspect of performance. It is concluded that this trust can be explained by a set of interactions between these three determinants, where the focus is on interpersonal relationships, with the largest path coefficient for the factor under study

Validação de conteúdo do instrumento para consulta de enfermagem na visita domiciliar às pessoas com lesão medular: um enfoque no autocuidado

This study aimed to validate the contents of an Instrument for Nursing Consultation in the Home Visit of people with Spinal Cord Injury (INCEVDOP-LM), based on the Self-Care Deficit Theory. The methodological development study was conducted with spinal cord injured (SCI) people ascribed in the Family Health Units the city of Natal/RN/Brazil, and with the nurses of these institutions. The study was conducted from Januray 2012 to January 2013 in two phases: the first aimed to identify the need for self-care of persons with SCI, and the second to develop and validate the INCEVDOP-LM. The first phase consisted of a census study of people with SCI living in Natal/RN. In the second phase, a non-probabilistic convencience sample of subjects was selected to form two groups: First stage - Group 1 of the first stage was comprised by 73 adults with SCI diagnosed with paraplegia or tetraplegia, with cognitive function preserved and that were registered to some family health unit; Group 2 of the Second phase was composed of six experts that were nurses with doctoral formation, scientific experience in the area of technology development or assistance to persons with SCI, and with publications in periodicals Qualis A2. Data collection of the first phase was conducted through home visits of people with SCI that responded three instruments: Questionnaire I (comprised of demographic and socioeconomic variables), The Competency Rating Scale for Self-care (ASA) and the Barthel Index (an instrument for evaluation of functional capacity). The research for the second phase was conducted in two stages: I-construction of the INCEVDOP LM; II-validation of the INCEVDOP-LM. The instrument and an evaluation form were forwarded to the experts for the validation. The correlations between the responses were analyzed by the Kappa test, with accepting values of>0.75. The evaluation criteria were: organization, clarity, simplicity, readability, appropriateness of vocabulary, objectivity, accuracy, reliability and suitability and the positive responses with frequency values of≥90% were considered excellent. The chi-square test was used to investigate the differences between proportions. The study attended to the principles of Human Rights CNS Resolution 196/96. Results were reported by means of four articles derived from the study. The findings indicate that the items that showed disagreement among experts (k=0.02) were diagnoses, interventions and evaluation of the nursing features pertaining to the domains of Nutrition, Hygiene, Elimination, Physical, Social and Psychological, and of the Ability to perform work activities feature. Agreement among the experts were reported for the other items, with kappa ranging from 0.72 to 1. After removing items with disagreement, all criteria achieved excellent rates and no significant differences were observed between the proportions of responses of evaluation of experts (p>0.05). We conclude that the instrument shows validity to serve as a guide for nurses to conduct a systematic consultation during the home visit to people with spinal cord injury, with emphasis on self-care. The instrument must go through other levels of validation when applied in the clinical setting

Optimised placement of control and protective devices in electric distribution systems through reactive tabu search algorithm

Optimised placement of control and protective devices in distribution networks allows for a better operation and improvement of the reliability indices of the system. Control devices (used to reconfigure the feeders) are placed in distribution networks to obtain an optimal operation strategy to facilitate power supply restoration in the case of a contingency. Protective devices (used to isolate faults) are placed in distribution systems to improve the reliability and continuity of the power supply, significantly reducing the impacts that a fault can have in terms of customer outages, and the time needed for fault location and system restoration. This paper presents a novel technique to optimally place both control and protective devices in the same optimisation process on radial distribution feeders. The problem is modelled through mixed integer non-linear programming (MINLP) with real and binary variables. The reactive tabu search algorithm (RTS) is proposed to solve this problem. Results and optimised strategies for placing control and protective devices considering a practical feeder are presented. (c) 2007 Elsevier B.V. All rights reserved.

Modeling and Experimental Aspects of Self-healing Bolted Joint through Shape Memory Alloy Actuators

Bolted joints are a form of mechanical coupling largely used in machinery due to their reliability and low cost. Failure of bolted joints can lead to catastrophic events, such as leaking, train derailments, aircraft crashes, etc. Most of these failures occur due to the reduction of the pre-load, induced by mechanical vibration or human errors in the assembly or maintenance process. This article investigates the application of shape memory alloy (SMA) washers as an actuator to increase the pre-load on loosened bolted joints. The application of SMA washer follows a structural health monitoring procedure to identify a damage (reduction in pre-load) occurrence. In this article, a thermo-mechanical model is presented to predict the final pre-load achieved using this kind of actuator, based on the heat input and SMA washer dimension. This model extends and improves on the previous model of Ghorashi and Inman [2004, "Shape Memory Alloy in Tension and Compression and its Application as Clamping Force Actuator in a Bolted Joint: Part 2 - Modeling," J. Intell. Mater. Syst. Struct., 15:589-600], by eliminating the pre-load term related to nut turning making the system more practical. This complete model is a powerful but complex tool to be used by designers. A novel modeling approach for self-healing bolted joints based on curve fitting of experimental data is presented. The article concludes with an experimental application that leads to a change in joint assembly to increase the system reliability, by removing the ceramic washer component. Further research topics are also suggested.

Biomechanical evaluation of internal and external hexagon platform switched implant-abutment connections: An in vitro laboratory and three-dimensional finite element analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of mechanical properties of dental feldsphatic porcelains for metal and zirconia core

Studies has been reported a significant incidence of chipping of the feldspathic porcelain veneer in zirconia-based restorations. The purpose of this study was to compare the three-point flexural strength (MPa), Weibull parameters, Vickers hardness (VHN) and Vickers indentation fracture toughness (MPa/mm(1/2)) in feldspatic porcelains for metal and for zirconia frameworks. Bar specimens were made with the porcelains e.MaxCeram (EM) and VitaVM9 (V9) for zirconia core, and Duceragold (DG) and VitaVMK95 (VK) for metal core (n = 15). Kruskal-Wallis and Dun test were used for statistical analysis. There was no significant difference (p=0.31) among the porcelains in the flexural strength (Median = 73.2; 74.6; 74.5; 74.4). Weibull calculation presented highest reliability for VK (10.8) followed by em (7.1), V9 (5.7) and DG (5.6). Vickers hardness test showed that em (536.3), V9 (579.9) and VK (522.1) had no difference and DG (489.6) had the lowest value (p<.001). The highest fracture toughness was to VK (1.77), DG (1.58) had an intermediate value while V9 (1.33) and em (1.18) had the lowest values (p<.001). Despite of the suitable flexural strength, reliability and high hardness, the porcelains used to zirconia-based fixed dental prostheses showed lower fracture toughness values.

The natural radioactivity in water by gross alpha and beta measurements

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Levantamentos epidemiológicos em saúde bucal: análise da metodologia proposta pela Organização Mundial da Saúde

Os levantamentos epidemiológicos são importantes para o conhecimento da prevalência e tipologia das doenças bucais, podendo-se a partir dos dados coletados, planejar, executar e avaliar ações de saúde. É necessário, no entanto, que haja rigor metodológico que garanta reprodutibilidade, validade e confiabilidade, e que haja uniformidade de procedimentos para permitir comparações nacionais e internacionais. A iniciativa da Organização Mundial da Saúde (OMS) na assessoria à realização de levantamentos tem se mostrado extremamente útil, estimulando o estabelecimento de padrões de procedimentos que podem ser utilizados em todos os países. em 1991 foi publicada a edição em português da terceira edição do Oral Health Surveys - basic methods, de 1987, um manual que objetiva fornecer instruções para a realização de levantamentos epidemiológicos e tal publicação passou a servir de base a estudos realizados em diversos locais do Brasil e do mundo. O objetivo deste trabalho, é analisar criticamente a metodologia para Levantamento Epidemiológico em Saúde Bucal da OMS, na tentativa de contribuir para o aperfeiçoamento da mesma. de acordo com a presente análise, foram encontrados pontos relevantes para consideração, referentes à amostragem, à calibração dos examinadores e aos critérios para a avaliação de saúde bucal e necessidades de tratamento. Concluiu-se, em nível de recomendação, que, devido ao caráter dinâmico do conhecimento científico e, levando-se em consideração as diferenças regionais com relação ao padrão de desenvolvimento das doenças bucais, as propostas de padronização de levantamentos devem ser periodicamente revisadas. É provável, ainda, que outros pontos importantes não tenham sido detectados nesta análise, tornando-se premente ampliar esta discussão para toda a comunidade odontológica.

Synthetic control chart for monitoring the pprocess mean and variance

In this article, we consider the synthetic control chart with two-stage sampling (SyTS chart) to control the process mean and variance. During the first stage, one item of the sample is inspected; if its value X, is close to the target value of the process mean, then the sampling is interrupted. Otherwise, the sampling goes on to the second stage, where the remaining items are inspected and the statistic T = Sigma [x(i) - mu(0) + xi sigma(0)](2) is computed taking into account all items of the sample. The design parameter is function of X-1. When the statistic T is larger than a specified value, the sample is classified as nonconforming. According to the synthetic procedure, the signal is based on Conforming Run Length (CRL). The CRL is the number of samples taken from the process since the previous nonconforming sample until the occurrence of the next nonconforming sample. If the CRL is sufficiently small, then a signal is generated. A comparative study shows that the SyTS chart and the joint X and S charts with double sampling are very similar in performance. However, from the practical viewpoint, the SyTS chart is more convenient to administer than the joint charts.

Joint control charts for monitoring location and dispersion

The T-2 and the generalized variance vertical bar S vertical bar charts are used for monitoring the mean vector and the covariance matrix of multivariate processes. In this article, we propose for bivariate processes the use of the T-2 and the VMAX charts. The points plotted on the VMAX chart correspond to the maximum of the sample variances of the two quality characteristics. The reason to consider the VMAX statistic instead of the generalized variance vertical bar S vertical bar is the user's familiarity with the computation of simple sample variances; we can't say the same with regard to the computation of the generalized variance vertical bar S vertical bar.

Optimized Allocation of Control and Protective Devices in Electric Distribution Systems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A comparison of nasopharyngeal endoscopy and lateral cephalometric radiography in the diagnosis of nasopharyngeal airway obstruction

Two auxiliary methods of diagnosing nasopharyngeal airway obstruction were compared. Cephalometric radiography and nasopharyngeal videoendoscopy were evaluated for efficacy in terms of reproducibility and validity. Thirty orthodontic patients (7 to 12 years of age) seeking otorhinolaryngologic treatment for mouth breathing, or mouth and nose breathing, had nasopharyngeal endoscopy and radiographic examinations performed on the same day. Two otorhinolaryngologists analyzed the results. Nasopharyngeal endoscopy was more reliable in identifying all the obstructive nasopharyngeal processes. Endoscopy obtained kappa index scores of almost perfect agreement for diagnosis of posterior nasal septum deviation, of substantial agreement for anterior nasal septum deviation and lower turbinate hypertrophy, and of moderate agreement for middle turbinate hypertrophy. Lateral cephalometric radiography obtained scores of perfect agreement for imaging hypertrophy of the middle turbinate, of almost perfect agreement for imaging hypertrophy of the posterior portion of the inferior turbinate, and of substantial agreement for imaging hypertrophy of the inferior turbinate. Radiographic diagnoses of hypertrophy of the middle and lower turbinates exhibited high sensitivity and low specificity when compared with diagnoses by nasopharyngeal endoscopy.

Specialized genetic algorithm for transmission network expansion planning considering reliability

This paper presents a methodology to solve the transmission network expansion planning problem (TNEP) considering reliability and uncertainty in the demand. The proposed methodology provides an optimal expansion plan that allows the power system to operate adequately with an acceptable level of reliability and in an enviroment with uncertainness. The reliability criterion limits the expected value of the reliability index (LOLE - Loss Of Load Expectation) of the expanded system. The reliability is evaluated for the transmission system using an analytical technique based in enumeration. The mathematical model is solved, in a efficient way, using a specialized genetic algorithm of Chu-Beasley modified. Detailed results from an illustrative example are presented and discussed. © 2009 IEEE.