Optimization and Applications of Large-Scale Biomedical Event Networks

The overwhelming amount and unprecedented speed of publication in the biomedical domain make it difficult for life science researchers to acquire and maintain a broad view of the field and gather all information that would be relevant for their research. As a response to this problem, the BioNLP (Biomedical Natural Language Processing) community of researches has emerged and strives to assist life science researchers by developing modern natural language processing (NLP), information extraction (IE) and information retrieval (IR) methods that can be applied at large-scale, to scan the whole publicly available biomedical literature and extract and aggregate the information found within, while automatically normalizing the variability of natural language statements. Among different tasks, biomedical event extraction has received much attention within BioNLP community recently. Biomedical event extraction constitutes the identification of biological processes and interactions described in biomedical literature, and their representation as a set of recursive event structures. The 2009–2013 series of BioNLP Shared Tasks on Event Extraction have given raise to a number of event extraction systems, several of which have been applied at a large scale (the full set of PubMed abstracts and PubMed Central Open Access full text articles), leading to creation of massive biomedical event databases, each of which containing millions of events. Sinece top-ranking event extraction systems are based on machine-learning approach and are trained on the narrow-domain, carefully selected Shared Task training data, their performance drops when being faced with the topically highly varied PubMed and PubMed Central documents. Specifically, false-positive predictions by these systems lead to generation of incorrect biomolecular events which are spotted by the end-users. This thesis proposes a novel post-processing approach, utilizing a combination of supervised and unsupervised learning techniques, that can automatically identify and filter out a considerable proportion of incorrect events from large-scale event databases, thus increasing the general credibility of those databases. The second part of this thesis is dedicated to a system we developed for hypothesis generation from large-scale event databases, which is able to discover novel biomolecular interactions among genes/gene-products. We cast the hypothesis generation problem as a supervised network topology prediction, i.e predicting new edges in the network, as well as types and directions for these edges, utilizing a set of features that can be extracted from large biomedical event networks. Routine machine learning evaluation results, as well as manual evaluation results suggest that the problem is indeed learnable. This work won the Best Paper Award in The 5th International Symposium on Languages in Biology and Medicine (LBM 2013).

The stochastic geometric machine model

This paper introduces the stochastic version of the Geometric Machine Model for the modelling of sequential, alternative, parallel (synchronous) and nondeterministic computations with stochastic numbers stored in a (possibly infinite) shared memory. The programming language L(D! 1), induced by the Coherence Space of Processes D! 1, can be applied to sequential and parallel products in order to provide recursive definitions for such processes, together with a domain-theoretic semantics of the Stochastic Arithmetic. We analyze both the spacial (ordinal) recursion, related to spacial modelling of the stochastic memory, and the temporal (structural) recursion, given by the inclusion relation modelling partial objects in the ordered structure of process construction.

Redes de conversação como possibilidade de formação do professor tutor virtual na mediação pedagógica da educação profissional a distância

A educação a distância apoiada pelos meios de comunicação digital ampliou as possibilidades de interação, flexibilizando o processo de mediação pedagógica no tempo e no espaço. Nessa perspectiva, a educação profissional democratizou seu acesso, na qual os conhecimentos de nível técnico são customizados em um Ambiente Virtual de Aprendizagem (AVA) para serem mediados a distância. Esta tese, apresentada na forma de artigos, problematiza o processo de mediação pedagógica realizado pelo professor tutor virtual na Rede e-Tec Brasil do Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense (IFSul) Campus Visconde da Graça (CAVG). Nesse modelo de ensino, o professor tutor virtual é contratado para atuar, pelo período de dois anos, em todas as disciplinas curriculares de um curso técnico. Se, por um lado, isso permite-lhe conhecer a realidade de seus alunos; por outro, exige-lhe um esforço pedagógico de apropriação e mediação dos conteúdos específicos nas diversas disciplinas que integram os currículos de cada curso. A pesquisa buscou conhecer como o professor tutor virtual apropria-se dos conhecimentos específicos nos cursos técnicos para mediá-los pedagogicamente com os alunos. Apresentamos, como hipótese explicativa neste estudo, que é na convivência com o professor pesquisador que o professor tutor virtual encontra a possibilidade de se apropriar dos conhecimentos curriculares para poder mediá-los pedagogicamente com os alunos. Para sustentar teoricamente nossas proposições na experiência vivida, estabelecemos uma rede de conversação com os autores Humberto Maturana, Pierre Lévy, Lee Shulman e Maurice Tardif, por meio dos conceitos: cultura em redes de conversação; inteligência coletiva; conhecimento pedagógico do conteúdo; e formação profissional docente. Como procedimento metodológico, encontramos na técnica do Discurso do Sujeito Coletivo (DSC), de Lefèvre e Lefèvre, uma estratégia de abordagem qualitativa para analisar as recorrências encontradas nos discursos dos professores tutores virtuais. O estudo aponta que uma rede de conversação recursiva entre o professor pesquisador e o professor tutor virtual possibilita a apropriação de conhecimentos técnicos e específicos necessários ao processo de mediação pedagógica com os estudantes. Essa convivência, no caminho da constituição de um coletivo inteligente, favorece o trabalho colaborativo no ambiente da tutoria, contribuindo para profissionalizar o processo de mediação pedagógica na educação profissional a distância do IFSul CAVG. Supported by digital media, distance learning has increased the possibilities of interaction, easing the process of pedagogical mediation in time and space. From this perspective, the access to professional education has been democratized: technical knowledge is customized in a Learning Managing System and later delivered by means of mediated distance education courses. Structured in a sequence of articles, this dissertation addresses the problem of the pedagogical mediation process performed by on-line tutor teachers at Rede e-Tec Brasil of the Instituto Federal Sul- rio-grandense (IF-Sul), Campus Visconde da Graça (CAVG). This model of education establishes that on-line tutor teachers are hired to work with all the curriculum courses of a technical program for two years. If, on the hand, it allows these teachers to know the reality of their students well, on the other hand it demands them a pedagogical effort of appropriation and mediation of the specific contents guiding the various courses that comprise the curriculum of each program. This research aimed to find out how on-line tutor teachers appropriate expertise from technical programs to mediate it with their students in a pedagogical way. The explanatory hypothesis given is that by working together and sharing experience with the teacher/researcher, on-line tutor teachers will be able to appropriate of curricular knowledge and pedagogically mediate it with their students afterwards. To support our theoretical propositions, a network of conversation was established with authors like Humberto Maturana, Pierre Lévy, Lee Shulman, and Maurice Tardif through the concepts of culture in networks of conversation, collective intelligence, pedagogical content knowledge, and teacher training. As a methodological procedure, the technique of the Collective Subject Discourse (CSD), by Lefèvre and Lefèvre, was found to offer a strategy of qualitative approach to analyze the recurrences seen in the speech of on-line tutor teachers. The study shows that a recursive network of conversation between the teacher/researcher and the on-line tutor teacher enables the appropriation of specific and technical knowledge required for the process of pedagogical mediation with students. The experience of sharing a consensual professional relationship, in which one respects and accepts the other as a way of establishing a collective intelligence, encourages collaborative work in the tutoring environment, helping professionalize the process of pedagogical mediation in distance professional education at IFSul CAVG.

O ser idoso estomizado sob o olhar complexo: uma proposta de gerontotecnologia educativa

Na presença da estomia, o idoso pode apresentar maior grau de complicações e dificuldades no processo de adaptação, talvez porque a estomia envolva significados que dizem respeito à auto-imagem e à presença/aumento de dependência. Resgatar a necessidade do autocuidado do idoso em relação à saúde é fundamental para que, no cuidado, se obtenha sua participação e mobilização diária quanto à formulação do processo educativo em saúde. Este estudo tem como objetivos identificar as características do idoso estomizado, atendido em um serviço de estomaterapia e propor uma gerontotecnologia educativa que venha a contribuir no cuidado de idosos estomizados, à luz da Complexidade, de Edgar Morin. Foi realizada uma pesquisa, com abordagem qualitativa, do tipo estudo de caso, tendo como local um serviço de estomaterapia, o qual possibilitou contato com fichas cadastrais e via telefone com os sujeitos e, depois, com o domicílio do idoso, no Rio Grande, Rio Grande do Sul, Brasil. Os sujeitos do estudo totalizaram 4 (quatro) idosos, sendo três mulheres e um homem. Foram utilizados, como instrumento, o formulário e o ecomapa, e como técnicas, a entrevista, a observação assistemática e a gravação. Foram respeitadas as normas éticas. A análise dos dados deu-se por: 1) leitura exaustiva dos dados; 2) apresentação dos casos e seus ecomapas tendo como suporte a Complexidade de Edgar Morin; 3) redescoberta de conceitos, a priori, que ilustraram a visão do idoso com estomia: ser humano idoso estomizado complexo, saúde complexa do idoso estomizado, cuidado complexo ao idoso estomizado e sua família. Por fim, elaborou-se uma cartilha educativa, junto ao idoso, como facilitadora para o autocuidado. Quanto aos resultados, verificou-se que cada idoso estomizado está permeado por situações pontuais e, a partir disso, percebeu-se diferentes concepções recursivas e formas de enfrentamento na adaptação. A aceitação da mudança corporal e psicológica mostrou-se mais fácil, quando se verificou apoio familiar, instrução técnica anterior ou presença de pessoas conhecidas. O enfrentamento da doença e a possibilidade da morte são aspectos presentes para os idosos e que limitam suas atividades de vida diária. Assim, surgiram conceitos que contemplaram o ser humano em sua totalidade, com incertezas e significados. A visão que transcende a complexidade da estomia engloba um cuidado que busca integrar a família do idoso com estomia, estimulando-o ao autocuidado e ao acolhimento diário, reforçando a auto-estima, como estratégia de recomeço em meio a desafios permanentes: ser idoso e ter uma estomia. Lançar um novo olhar sobre a temática idoso estomizado é complexo, exigindo abordagem multidimensional das características que o envolvem. Acreditase que mudanças favoráveis poderão advir após implementação de um programa de educação em saúde que contemple a singularidade das questões que envolvem o idoso estomizado e suas necessidades.

Evaluating functions using tail recursion and parameter substitution

This article shows a general way to implement recursive functions calculation by linear tail recursion. It emphasizes the use of tail recursion to perform computations efficiently.

Multirobot Tethering for Localization and Control

Particle filtering has proven to be an effective localization method for wheeled autonomous vehicles. For a given map, a sensor model, and observations, occasions arise where the vehicle could equally likely be in many locations of the map. Because particle filtering algorithms may generate low confidence pose estimates under these conditions, more robust localization strategies are required to produce reliable pose estimates. This becomes more critical if the state estimate is an integral part of system control. We investigate the use of particle filter estimation techniques on a hovercraft vehicle. The marginally stable dynamics of a hovercraft require reliable state estimates for proper stability and control. We use the Monte Carlo localization method, which implements a particle filter in a recursive state estimate algorithm. An H-infinity controller, designed to accommodate the latency inherent in our state estimation, provides stability and controllability to the hovercraft. In order to eliminate the low confidence estimates produced in certain environments, a multirobot system is designed to introduce mobile environment features. By tracking and controlling the secondary robot, we can position the mobile feature throughout the environment to ensure a high confidence estimate, thus maintaining stability in the system. A laser rangefinder is the sensor the hovercraft uses to track the secondary robot, observe the environment, and facilitate successful localization and stability in motion.

Monadic Parsing in Haskell

This paper is a tutorial on defining recursive descent parsers in Haskell. In the spirit of one-stop shopping, the paper combines material from three areas into a single source. The three areas are functional parsers, the use of monads to structure functional programs, and the use of special syntax for monadic programs in Haskell. More specifically, the paper shows how to define monadic parsers using do notation in Haskell. The paper is targeted at the level of a good undergraduate student who is familiar with Haskell, and has completed a grammars and parsing course. Some knowledge of functional parsers would be useful, but no experience with monads is assumed.

A Tutorial on the Universality and Expressiveness of Fold

In functional programming, fold is a standard operator that encapsulates a simple pattern of recursion for processing lists. This article is a tutorial on two key aspects of the fold operator for lists. First of all, we emphasize the use of the universal property of fold both as a proof principle that avoids the need for inductive proofs, and as a definition principle that guides the transformation of recursive functions into definitions using fold. Secondly, we show that even though the pattern of recursion encapsulated by fold is simple, in a language with tuples and functions as first-class values the fold operator has greater expressive power than might first be expected.

Proof methods for structured corecursive programs

Corecursive programs produce values of greatest fixpoint types, in contrast to recursive programs, which consume values of least fixpoint types. There are a number of widely used methods for proving properties of corecursive programs, including fixpoint induction, the take lemma, and coinduction. However, these methods are all rather low level, in that they do not exploit the common structure that is often present in corecursive definitions. We argue for a more structured approach to proving properties of corecursive programs. In particular, we show that by writing corecursive programs using a simple operator that encapsulates a common pattern of corecursive definition, we can then use high-level algebraic properties of this operator to conduct proofs in a purely calculational style that avoids the use of inductive or coinductive methods.

Jogos cooperativos: uma proposta de educação ambiental

O presente trabalho está vinculado ao Programa de Pós-Graduação em Educação Ambiental - PPGEA/FURG e tem como tema a Educação Ambiental, a Educação Física e os Jogos Cooperativos no contexto escolar, com o objetivo de repensar a prática de Educação Física na escola a partir do desenvolvimento dos jogos cooperativos. A Educação Física é uma disciplina inserida no espaço escolar caracterizada pela presença dos esportes competitivos como conteúdo dominante e a Educação Ambiental é uma prática social que considera outros modos de constituição de relações sociais que estejam para além da lógica perspectivada pelo capitalismo e tão presente na prática dos jogos competitivos realizada nas aulas de Educação Física. A pesquisa insere-se numa perspectiva qualitativa tendo como suporte metodológico a pesquisa-ação. Ocorreu na Escola Municipal de Ensino Fundamental Mate Amargo, onde a pesquisadora possui vínculo. Os sujeitos da pesquisa foram os alunos de uma turma da referida escola e a partir do questionamento ?quais os significados atribuídos aos jogos cooperativos pelos estudantes da turma 71 - sétima série (no ano de 2012 e oitava série em 2013) da Escola Municipal de Ensino Fundamental Mate Amargo, desenvolveu-se esta pesquisa. A produção dos dados ocorreu por meio da proposição de jogos cooperativos e semi-cooperativos com registros escritos dos sujeitos da pesquisa após as vivências, escrita no diário de campo da pesquisadora e a produção de uma história das aulas de Educação Física realizada pelos referidos alunos. Como instrumento de análise foi utilizado a análise textual discursiva (ATD) proposta por Moraes e Galliazzi (2007) o qual se constitui por diversas etapas num movimento recursivo de compreensão do fenômeno investigado. A partir dos dados analisados emergiram duas categorias de análise: a primeira intitula-se ?Jogos e suas múltiplas faces: o resgate do lúdico? onde foi possível analisar as percepções dos alunos diante de tais jogos, os sentimentos que surgiram, suas opiniões e aprendizados. Evidenciouse ainda o potencial lúdico existente nestes jogos propostos. A segunda denomina-se "Entre a competição e a cooperação", e são expressas suas percepções acerca destes dois elementos no jogo, demonstrando que em alguns momentos a competição se evidencia revelando talvez, as próprias vivências dos alunos em seu cotidiano, e por vezes a cooperação se anuncia confirmando a possibilidade desses jogos em impulsionar e desenvolver sentimentos de coletividade, cooperação e sentido de grupo nos sujeitos da pesquisa permitindo o encaminhamento do significado atribuído por eles aos jogos cooperativos como atividades que propiciaram momentos de diversão e prazer, acompanhados de situações em que possibilitou o exercício da cooperação, percepção do outro e da coletividade. Como aporte teórico, deu-se ênfase a autores como Loureiro (2006; 2009), Guimarães (1995;2007), Bracht (1992;2009), Orlick (1978) Brown (2002) Brotto (2001). A pesquisa mostrou que os jogos cooperativos propiciaram a emergência de atitudes cooperativas e a percepção do outro, como também foi possível apreender pelas análises um clima de diversão e prazer sentido e expressado por eles confirmando o potencial lúdico existente nestes jogos.

Análise de programas de educação ambiental no licenciamento ambiental de usinas hidrelétricas no Rio Grande do Sul : um estudo de caso

O trabalho intitulado - Análise de programas de Educação Ambiental no licenciamento ambiental de usinas hidrelétricas no Rio Grande do Sul: um estudo de caso - busca fazer uma análise compreensiva, reflexiva e problematizadora das ações de Educação Ambiental realizadas durante o processo de licenciamento ambiental, como medidas mitigadoras e/ou compensatórias de impactos ambientais causados pela instalação/operação de empreendimentos hidrelétricos. O objeto de análise foi o Programa de Educação Ambiental da UHE São José, instalada no rio Ijuí, interior do estado. Utilizou-se o movimento recursivo e reflexivo para elaboração da pesquisa, onde a primeira fase foi composta pelo levantamento bibliográfico que serviu de base para as discussões propostas, e a segunda fase foi composta pela investigação do referido programa, tendo como corpus da pesquisa documentos e entrevistas, e utilizando-se da Análise Textual Discursiva (ATD) como metodologia de análise. Os resultados obtidos fazem refletir sobre a ocupação dos espaços do licenciamento ambiental por uma Educação Ambiental que vá além do simples cumprimento das leis e normas, mas que seja de fato integradora e participativa, e envolva o compromisso dos empreendedores, das comunidades atingidas e dos órgãos fiscalizadores, contribuindo com a gestão ambiental e a sustentabilidade dos locais em transformação.

Análise e proposição de estratégias de estimação e controle de velocidade para motores de indução trifásicos

This study presents a proposal of speed servomechanisms without the use of mechanical sensors (sensorless) using induction motors. A comparison is performed and propose techniques for pet rotor speed, analyzing performance in different conditions of speed and load. For the determination of control technique, initially, is performed an analysis of the technical literature of the main control and speed estimation used, with their characteristics and limitations. The proposed technique for servo sensorless speed induction motor uses indirect field-oriented control (IFOC), composed of four controllers of the proportional-integral type (PI): rotor flux controller, speed controller and current controllers in the direct and quadrature shaft. As the main focus of the work is in the speed control loop was implemented in Matlab the recursive least squares algorithm (RLS) for identification of mechanical parameters, such as moment of inertia and friction coefficient. Thus, the speed of outer loop controller gains can be self adjusted to compensate for any changes in the mechanical parameters. For speed estimation techniques are analyzed: MRAS by rotóricos fluxes MRAS by counter EMF, MRAS by instantaneous reactive power, slip, locked loop phase (PLL) and sliding mode. A proposition of estimation in sliding mode based on speed, which is performed a change in rotor flux observer structure is displayed. To evaluate the techniques are performed theoretical analyzes in Matlab simulation environment and experimental platform in electrical machinery drives. The DSP TMS320F28069 was used for experimental implementation of speed estimation techniques and check the performance of the same in a wide speed range, including load insertion. From this analysis is carried out to implement closed-loop control of sensorless speed IFOC structure. The results demonstrated the real possibility of replacing mechanical sensors for estimation techniques proposed and analyzed. Among these, the estimator based on PLL demonstrated the best performance in various conditions, while the technique based on sliding mode has good capacity estimation in steady state and robustness to parametric variations.

On the Movements of the North Atlantic Subpolar Front in the Preinstrumental Past*

Three sediment records of sea surface temperature (SST) are analyzed that originate from distant locations in the North Atlantic, have centennial-to-multicentennial resolution, are based on the same reconstruction method and chronological assumptions, and span the past 15 000 yr. Using recursive least squares techniques, an estimate of the time-dependent North Atlantic SST field over the last 15 kyr is sought that is consistent with both the SST records and a surface ocean circulation model, given estimates of their respective error (co)variances. Under the authors' assumptions about data and model errors, it is found that the 10 degrees C mixed layer isotherm, which approximately traces the modern Subpolar Front, would have moved by ~15 degrees of latitude southward (northward) in the eastern North Atlantic at the onset (termination) of the Younger Dryas cold interval (YD), a result significant at the level of two standard deviations in the isotherm position. In contrast, meridional movements of the isotherm in the Newfoundland basin are estimated to be small and not significant. Thus, the isotherm would have pivoted twice around a region southeast of the Grand Banks, with a southwest-northeast orientation during the warm intervals of the Bolling-Allerod and the Holocene and a more zonal orientation and southerly position during the cold interval of the YD. This study provides an assessment of the significance of similar previous inferences and illustrates the potential of recursive least squares in paleoceanography.

Medizinische und gesundheitsökonomische Bewertung der Radiochirurgie zur Behandlung von Hirnmetastasen

Hintergrund: Für die Therapie maligner Neubildungen stellt die Strahlentherapie wichtige Behandlungsmöglichkeiten dar, die sich in den vergangenen Jahrzehnten deutlich weiterentwickelt haben. Hierzu gehört unter anderem die stereotaktische Radiochirurgie (SRS), die durch eine einmalige Applikation fokussierter hoher Strahlendosen in einem klar definierten Zeitraum gekennzeichnet ist. Von besonderer Bedeutung ist die SRS für die Behandlung von Hirnmetastasen. Fragestellung: Ziel dieses HTA-Berichts ist die Erstellung einer umfassenden Übersicht der aktuellen Literatur der Behandlung von Hirnmetastasen, um die Radiochirurgie als alleinige Therapie oder in Kombination mit Therapiealternativen bezüglich der medizinischen Wirksamkeit, Sicherheit und Wirtschaftlichkeit sowie ethischer, sozialer und juristischer Aspekte zu vergleichen. Methodik: Relevante Publikationen deutscher und englischer Sprache werden über eine strukturierte Datenbank- sowie mittels Handrecherche zwischen Januar 2002 und August 2007 identifiziert. Die Zielpopulation bilden Patienten mit einer oder mehreren Hirnmetastasen. Eine Beurteilung der methodischen Qualität wird unter Beachtung von Kriterien der evidenzbasierten Medizin (EbM) durchgeführt. Ergebnisse: Von insgesamt 1.495 Treffern erfüllen 15 Studien die medizinischen Einschlusskriterien. Insgesamt ist die Studienqualität stark eingeschränkt und mit Ausnahme von zwei randomisierte kontrollierte Studien (RCT) und zwei Metaanalysen werden ausschließlich historische Kohortenstudien identifiziert. Die Untersuchung relevanter Endpunkte ist uneinheitlich. Qualitativ hochwertige Studien zeigen, dass die Ergänzung der Ganzhirnbestrahlung (WBRT) zur SRS sowie der SRS zur WBRT mit einer verbesserten lokalen Tumorkontrolle und Funktionsfähigkeit einhergeht. Nur im Vergleich zur alleinigen WBRT resultiert die Kombination von SRS und WBRT jedoch bei Patienten mit singulären Hirnmetastasen, RPA-Klasse 1 (RPA = Rekursive Partitionierungsanalyse) und bestimmten Primärtumoren in verbesserter Überlebenszeit. Die Therapiesicherheit zeigt in beiden Fällen keine deutlichen Unterschiede zwischen den Interventionsgruppen. Methodisch weniger hochwertige Studien finden keine eindeutigen Unterschiede zwischen SRS und WBRT, SRS und Neurochirurgie (NC) sowie SRS und hypofraktionierter Strahlentherapie (HCSRT). Die Lebensqualität wird in keiner Studie untersucht. Durch die Datenbankrecherche werden 320 Publikationen für den ökonomischen Bereich identifiziert. Insgesamt werden fünf davon für den vorliegenden Health Technology Assessment (HTA)-Bericht verwendet. Die Qualität der Publikationen ist dabei unterschiedlich. Bezüglich der Wirtschaftlichkeit verschiedener Gerätealternativen ergibt sich, unter der Annahme gleicher Wirksamkeit, eine starke Abhängigkeit von der Anzahl der behandelten Patienten. Im Fall, dass die beiden Gerätealternativen nur für die SRS verwandt werden, liegen Hinweise vor, dass das Gamma Knife kostengünstiger sein kann. Andernfalls ist es sehr wahrscheinlich, dass der flexiblere modifizierte Linearbeschleuniger kostengünstiger ist. Nach einem HTA sind die Gesamtkosten für ein Gamma Knife und einen dedizierten Linearbeschleuniger ungefähr gleich, während ein modifizierter Linearbeschleuniger günstiger ist. Für ethische, juristische und soziale Fragestellungen werden keine relevanten Publikationen identifiziert. Diskussion: Insgesamt sind sowohl die Qualität als auch die Quantität identifizierter Studien stark reduziert. Es zeigt sich jedoch, dass die Prognose von Patienten mit Hirnmetastasen auch unter modernsten therapeutischen Möglichkeiten schlecht ist. Ausreichend starke Evidenz gibt es lediglich für die Untersuchung ergänzender WBRT zur SRS und der ergänzenden SRS zur WBRT. Ein direkter Vergleich von SRS und WBRT, SRS und NC sowie SRS und HCSRT ist hingegen nicht möglich. Die Wirtschaftlichkeit verschiedener Gerätealternativen hängt von der Patientenzahl und den behandelten Indikationen ab. Für ausgelastete dedizierte Systeme, liegen Hinweise vor, dass sie kostengünstiger sein können. Bei flexibler Nutzung scheinen modifizierte Systeme wirtschaftlich vorteilhafter. Diese Aussagen erfolgen unter der nicht gesicherten Annahme gleicher Wirksamkeit der Alternativen. Die Behandlungspräzision der Geräte kann Einfluss auf die Gerätewahl haben. Zu neueren Gerätealternativen wie z. B. dem CyberKnife liegen bisher keine Untersuchungen vor. Aus der wirtschaftlich vorteilhaften hohen Auslastung folgt aber eine begrenzte Geräteanzahl in einem vorgegebenen Gebiet, was evtl. einen gleichberechtigten, wohnortnahen Zugang zu dieser Technik erschwert. Schlussfolgerungen: Die Kombination SRS und WBRT geht mit einer verbesserten lokalen Tumorkontrolle und Funktionsfähigkeit gegenüber der jeweils alleinigen Therapie einher. Nur für Patienten mit singulärer Metastase resultiert dies in Vorteilen der Überlebenszeit. Qualitativ hochwertige Studien sind notwendig um die SRS direkt mit WBRT und NC zu vergleichen. Weiterhin sollte besonders die Lebensqualität in zukünftigen Studien mitberücksichtigt werden. Bei der Art des verwendeten Gerätes zeichnet sich eine deutliche Abhängigkeit der Wirtschaftlichkeit der Geräte von der erreichbaren Auslastung ab. Hohe Patientenzahlen bieten Vorteile für spezialisierte Systeme und bei geringeren Patientenzahlen ist die Flexibilität modifizierter System vorteilhaft. Weitere Studien z. B. zum CyberKnife sind wünschenswert. Insgesamt ist die Studienlage insbesondere für das deutsche Gesundheitssystem sehr mangelhaft.

A dinâmica do campo organizacional e a adoção de estratégias na carcinicultura do RN

This study aimed to understand the relations inside the organizational Structuring of the shrimp Field - the shrimp agribusiness placed in Rio Grande do Norte State and the strategies adopted by its players. In order to achieve that, semi-structured interviews were conducted with samples of various organizations that act in the field, like cooperatives, associations, enterprises of different links in the chain, universities and state agencies. The interviews built up a large collection of secondary data. As expected, it was found that Field and strategies are related in a recursive way: the configuration of the field, a result from his own biography, has decisively influenced the strategies adopted by its actors, who, as evolved, eventually caused further changes in the Field and outlines the plot of this area of interaction. It was found, for example, that after thirty-five years of its genesis, the Field of shrimp RN still has a low level of institutionalization, which helps to understand the difficulty of its actors in establish strategies based on partnerships and cooperation; Those actions are so necessary to alleviate the effects of the crisis that devastated the industry since 2004. It was noticed, however, that this level of institutionalization is a result, beside other factors, the very strategies that field actors are embracing along its trajectory. Thus, this study hopes to have contributed both to the necessary revival of the agency to institutional phenomenon, cited by Oliver (1991), and to meet the need for more contextualized approaches to organizational strategies (MINTZBERG, 1987; CLEGG, 2004; WHITTINGTON, 2004; 2006; SARAIVA and CARRIERI, 2007). It is an exploratory study that needs further investigation in order to get deep in this research. In this sense, others methodologies and theoretical perspectives need to be used, especially those relating to the seizure of the disputes and discursive aspects of power, as salient in the field investigated. Moreover, in terms of "practical actions", it is suggested that, as soon as possible, the main actors of the field (cooperatives, companies, and state entities in class) can be able of agglutinate efforts to support the shrimp field in RN State and make sustainable actions, which can promote the development of activity in a global view. On the apse of shrimp activities everybody wanted to be the "father of the child," Now, someone has to "stay in the goal."