A simplified method of stabilization and hemostasis for minimally invasive coronary artery bypass.

We describe a simple method to achieve both hemostasis and stabilization of the left anterior descending coronary artery during minimally invasive coronary artery bypass grafting. This technique allows the surgeon to perform a precise anastomosis of the left internal mammary artery to the target vessel on a beating heart.

Three-dimensional morphological analysis of intracranial aneurysms: a fully automated method for aneurysm sac isolation and quantification

Morphological descriptors are practical and essential biomarkers for diagnosis andtreatment selection for intracranial aneurysm management according to the current guidelinesin use. Nevertheless, relatively little work has been dedicated to improve the three-dimensionalquanti cation of aneurysmal morphology, automate the analysis, and hence reduce the inherentintra- and inter-observer variability of manual analysis. In this paper we propose a methodologyfor the automated isolation and morphological quanti cation of saccular intracranial aneurysmsbased on a 3D representation of the vascular anatomy.

A method for extracting semantic information from on-line art music discussion forums

In this paper a method for extracting semantic informationfrom online music discussion forums is proposed. The semantic relations are inferred from the co-occurrence of musical concepts in forum posts, using network analysis. The method starts by defining a dictionary of common music terms in an art music tradition. Then, it creates a complex network representation of the online forum by matchingsuch dictionary against the forum posts. Once the complex network is built we can study different network measures, including node relevance, node co-occurrence andterm relations via semantically connecting words. Moreover, we can detect communities of concepts inside the forum posts. The rationale is that some music terms are more related to each other than to other terms. All in all, this methodology allows us to obtain meaningful and relevantinformation from forum discussions.

A Method Towards the Fully Automatic Merging of Lexical Resources

Lexical Resources are a critical component for Natural Language Processing applications. However, the high cost of comparing and merging different resources has been a bottleneck to obtain richer resources and a broader range of potential uses for a significant number of languages. With the objective of reducing cost by eliminating human intervention, we present a new method towards the automatic merging of resources. This method includes both, the automatic mapping of resources involved to a common format and merging them, once in this format. This paper presents how we have addressed the merging of two verb subcategorization frame lexica for Spanish, but our method will be extended to cover other types of Lexical Resources. The achieved results, that almost replicate human work, demonstrate the feasibility of the approach.

Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

Comparing deep sclerectomy with collagen implant to the new method of very deep sclerectomy with collagen implant: a single-masked randomized controlled trial.

AIM: To prospectively study the intraocular pressure (IOP) lowering effect and safety of the new method of very deep sclerectomy with collagen implant (VDSCI) compared with standard deep sclerectomy with collagen implant (DSCI). METHODS: The trial involved 50 eyes of 48 patients with medically uncontrolled primary and secondary open-angle glaucoma, randomized to undergo either VDSCI procedure (25 eyes) or DSCI procedure (25 eyes). Follow-up examinations were performed before surgery and after surgery at day 1, at week 1, at months 1, 2, 3, 6, 9, 12, 18, and 24 months. Ultrasound biomicroscopy was performed at 3 and 12 months. RESULTS: Mean follow-up period was 18.6+/-5.9 (VDSCI) and 18.9+/-3.6 (DSCI) months (P=NS). Mean preoperative IOP was 22.4+/-7.4 mm Hg for VDSCI and 20.4+/-4.4 mm Hg for DSCI eyes (P=NS). Mean postoperative IOP was 3.9+/-2.3 (VDSCI) and 6.3+/-4.3 (DSCI) (P<0.05) at day 1, and 12.2+/-3.9 (VDSCI) and 13.3+/-3.4 (DSCI) (P=NS) at month 24. At the last visit, the complete success rate (defined as an IOP of < or =18 mm Hg and a percentage drop of at least 20%, achieved without medication) was 57% in VDSCI and 62% in DSCI eyes (P=NS) ultrasound biomicroscopy at 12 months showed a mean volume of the subconjunctival filtering bleb of 3.9+/-4.2 mm3 (VDSCI) and 6.8+/-7.5 mm3 (DSCI) (P=0.426) and 5.2+/-3.6 mm3 (VDSCI) and 5.4+/-2.9 mm3 (DSCI) (P=0.902) for the intrascleral space. CONCLUSIONS: Very deep sclerectomy seems to provide stable and good control of IOP at 2 years of follow-up with few postoperative complications similar to standard deep sclerectomy with the collagen implant.

Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality--preliminary findings.

BACKGROUND: Radiation dose exposure is of particular concern in children due to the possible harmful effects of ionizing radiation. The adaptive statistical iterative reconstruction (ASIR) method is a promising new technique that reduces image noise and produces better overall image quality compared with routine-dose contrast-enhanced methods. OBJECTIVE: To assess the benefits of ASIR on the diagnostic image quality in paediatric cardiac CT examinations. MATERIALS AND METHODS: Four paediatric radiologists based at two major hospitals evaluated ten low-dose paediatric cardiac examinations (80 kVp, CTDI(vol) 4.8-7.9 mGy, DLP 37.1-178.9 mGy·cm). The average age of the cohort studied was 2.6 years (range 1 day to 7 years). Acquisitions were performed on a 64-MDCT scanner. All images were reconstructed at various ASIR percentages (0-100%). For each examination, radiologists scored 19 anatomical structures using the relative visual grading analysis method. To estimate the potential for dose reduction, acquisitions were also performed on a Catphan phantom and a paediatric phantom. RESULTS: The best image quality for all clinical images was obtained with 20% and 40% ASIR (p < 0.001) whereas with ASIR above 50%, image quality significantly decreased (p < 0.001). With 100% ASIR, a strong noise-free appearance of the structures reduced image conspicuity. A potential for dose reduction of about 36% is predicted for a 2- to 3-year-old child when using 40% ASIR rather than the standard filtered back-projection method. CONCLUSION: Reconstruction including 20% to 40% ASIR slightly improved the conspicuity of various paediatric cardiac structures in newborns and children with respect to conventional reconstruction (filtered back-projection) alone.

O empreendedorismo. O perfil do empreendedor da Ilha de Santiago Cabo Verde

Este trabalho apresenta um estudo qualitativo, desenvolvido através de pesquisa exploratória, bibliográfica e de campo, feito a trezentos e noventa e nove empreendedores e empresários da Ilha de Santiago, tendo em consideração o cenário económico actual e a preocupação à volta do sector privado. Procurou-se através de pesquisa junto às empresas activas, e cujo número de pessoas ao seu serviço não ultrapassa vinte, identificar três pontos fundamentais relacionados com os empreendedores: investigar os factores que levaram as pessoas a tornarem-se empreendedores; investigar as características principais do empreendedor de sucesso; identificar as características imprescindíveis para se atingir o sucesso empresarial relacionadas com o conhecimento, competências, atitude e talento, sequenciadas por ordem de importância. Para um melhor entendimento destas questões foi utilizado um referencial teórico que aborda o empreendedorismo. A pesquisa de campo foi realizada através de utilização de questionários – entrevistas às empresas estabelecidas nesta ilha, e o método de recolha de dados foi o de entrevista directa. Os resultados obtidos mostraram que os empreendedores enfatizam a importância dos factores comportamentais no sucesso das pequenas e médias empresas e evidenciaram que os factores mais significativos e limitativos do sucesso dos empreendedores no Município da Praia, ilha de Santiago, se referem ao ambiente interno do negócio. Considerando todos estes factores e de acordo com as pesquisas desenvolvidas e analisadas, este trabalho recolheu informações específicas dos empreendedores de sucesso da ilha de Santiago e que podem ser úteis para os que almejam o sucesso empresarial e para eventuais programas de capacitação e formação empreendedora na ilha. This work presents a qualitative study developed through exploratory, bibliographic and field research to three hundred and ninety nine managers and entrepreneurs from Santiago Island, taking into consideration the present economical scenario and main concerns linked to private sector. Through a research in active enterprises and whose staff number doesn’t exceed twenty, the goal was to identify three main issues related to entrepreneurs: look into the factors that encouraged people to become entrepreneurs; examine the main characteristics of a successful entrepreneur and identify, sequenced by order of importance, the most critical characteristics related to knowledge, skills, attitude and talent, that allow entrepreneurial success achievement. For a better understanding of these questions, a theoretical approach to entrepreneurship was exploited. Field research was carried on through the use of questionnaires in enterprises located in Praia, and the data collection method was direct interviews. Results obtained showed that entrepreneurs emphasize the importance of behavioral factors in the success of small and medium enterprises and they evidenced that the most significant and restrictive factors of entrepreneurs’ success in Santiago Island are related to internal business environment. Considering these factors, and according to research developed and analyzed, the work has collected specific information of successful entrepreneurs in Santiago that can be useful for those, in the island, who seek entrepreneurial success and for eventual capacity building and entrepreneurial training programs.

Desafios da gestão e liderança feminina em Cabo Verde: como exercer a liderança em espaços de identidade masculina

O objectivo do presente estudo é identificar, caracterizar e entender os factores que contribuem para a eficácia da gestão e liderança da mulher cabo-verdiana num cenário de chefia de topo, em espaços caracterizados pela predominância masculina, transformando-se assim num desafio constante para as mulheres a nível mundial e em particular, para as mulheres cabo-verdianas. Foi realizada uma pesquisa bibliográfica sobre liderança e sobre género, mais especificamente, sobre o papel da mulher no contexto do trabalho. Trata-se de uma pesquisa de natureza exploratória, utilizando uma abordagem qualitativa e quantitativa. Neste sentido, foi analisado o processo da liderança feminina no contexto mundial e nacional, a evolução da sua participação nas chefias de topo, os factores que contribuem para o seu desempenho, e o que fazer para vencer os desafios e atingir a eficácia. O método de pesquisa utilizado foi a pesquisa quantitativa e qualitativa, através de aplicação de um questionário a trinta gestores de primeira linha, com o objectivo de avaliar a forma como o líder se auto percepciona, bem assim como ele é percepcionado pelo seu superior hierárquico, pelos colegas e pelos subordinados directos. As conclusões do estudo apontam para a existência de divergências entre as percepções dos líderes e dos outros membros da organização em relação à liderança exercida. Por outro lado, a questão do género parece ter pouca influência na eficácia da liderança. The aim of this paper is to identify, characterize and understand the factors that contribute to effective management and leadership of the Cape Verdean women in male dominated areas characterized by a background of top management. This scenario is characterized by a high male predominance, which represents a constant challenge for women worldwide and in particular for the Cape Verdean women. A literature search on the topics of leadership and on gender, specifically on the role of women in the work context was carried out. It is an exploratory research, using a qualitative and quantitative approach. In this sense the process of women's leadership in global and national context, the evolution of their participation in top leadership, the factors that contribute to their performance as well as how to overcome challenges and achieve efficiency were considered. The research method used was a qualitative and quantitative research through application of a questionnaire to 30 first line managers, in order to assess how the leader perceives itself, as well as, how he is perceived by his superior, colleagues and direct reports. The conclusions indicate that there are important differences between the perception of the leaders and other members of the organization in relation to the leadership exercise. On the other hand, gender seems to have little influence on leadership effectiveness.

O empreendedorismo. O perfil do empreendedor da Ilha de Santiago Cabo Verde

Este trabalho apresenta um estudo qualitativo, desenvolvido através de pesquisa exploratória, bibliográfica e de campo, feito a trezentos e noventa e nove empreendedores e empresários da Ilha de Santiago, tendo em consideração o cenário económico actual e a preocupação à volta do sector privado. Procurou-se através de pesquisa junto às empresas activas, e cujo número de pessoas ao seu serviço não ultrapassa vinte, identificar três pontos fundamentais relacionados com os empreendedores: investigar os factores que levaram as pessoas a tornarem-se empreendedores; investigar as características principais do empreendedor de sucesso; identificar as características imprescindíveis para se atingir o sucesso empresarial relacionadas com o conhecimento, competências, atitude e talento, sequenciadas por ordem de importância. Para um melhor entendimento destas questões foi utilizado um referencial teórico que aborda o empreendedorismo. A pesquisa de campo foi realizada através de utilização de questionários – entrevistas às empresas estabelecidas nesta ilha, e o método de recolha de dados foi o de entrevista directa. Os resultados obtidos mostraram que os empreendedores enfatizam a importância dos factores comportamentais no sucesso das pequenas e médias empresas e evidenciaram que os factores mais significativos e limitativos do sucesso dos empreendedores no Município da Praia, ilha de Santiago, se referem ao ambiente interno do negócio. Considerando todos estes factores e de acordo com as pesquisas desenvolvidas e analisadas, este trabalho recolheu informações específicas dos empreendedores de sucesso da ilha de Santiago e que podem ser úteis para os que almejam o sucesso empresarial e para eventuais programas de capacitação e formação empreendedora na ilha. This work presents a qualitative study developed through exploratory, bibliographic and field research to three hundred and ninety nine managers and entrepreneurs from Santiago Island, taking into consideration the present economical scenario and main concerns linked to private sector. Through a research in active enterprises and whose staff number doesn’t exceed twenty, the goal was to identify three main issues related to entrepreneurs: look into the factors that encouraged people to become entrepreneurs; examine the main characteristics of a successful entrepreneur and identify, sequenced by order of importance, the most critical characteristics related to knowledge, skills, attitude and talent, that allow entrepreneurial success achievement. For a better understanding of these questions, a theoretical approach to entrepreneurship was exploited. Field research was carried on through the use of questionnaires in enterprises located in Praia, and the data collection method was direct interviews. Results obtained showed that entrepreneurs emphasize the importance of behavioral factors in the success of small and medium enterprises and they evidenced that the most significant and restrictive factors of entrepreneurs’ success in Santiago Island are related to internal business environment. Considering these factors, and according to research developed and analyzed, the work has collected specific information of successful entrepreneurs in Santiago that can be useful for those, in the island, who seek entrepreneurial success and for eventual capacity building and entrepreneurial training programs.

Development of appropriateness criteria for the surgical treatment of symptomatic lumbar degenerative spondylolisthesis (LDS).

PURPOSE: Spine surgery rates are increasing worldwide. Treatment failures are often attributed to poor patient selection and inappropriate treatment, but for many spinal disorders there is little consensus on the precise indications for surgery. With an aging population, more patients with lumbar degenerative spondylolisthesis (LDS) will present for surgery. The aim of this study was to develop criteria for the appropriateness of surgery in symptomatic LDS. METHODS: A systematic review was carried out to summarize the current level of evidence for the treatment of LDS. Clinical scenarios were generated comprising combinations of signs and symptoms in LDS and other relevant variables. Based on the systematic review and their own clinical experience, twelve multidisciplinary international experts rated each scenario on a 9-point scale (1 highly inappropriate, 9 highly appropriate) with respect to performing decompression only, fusion, and instrumented fusion. Surgery for each theoretical scenario was classified as appropriate, inappropriate, or uncertain based on the median ratings and disagreement in the ratings. RESULTS: 744 hypothetical scenarios were generated; overall, surgery (of some type) was rated appropriate in 27 %, uncertain in 41 % and inappropriate in 31 %. Frank panel disagreement was low (7 % scenarios). Face validity was shown by the logical relationship between each variable's subcategories and the appropriateness ratings, e.g., no/mild disability had a mean appropriateness rating of 2.3 ± 1.5, whereas the rating for moderate disability was 5.0 ± 1.6 and for severe disability, 6.6 ± 1.6. Similarly, the average rating for no/minimal neurological abnormality was 2.3 ± 1.5, increasing to 4.3 ± 2.4 for moderate and 5.9 ± 1.7 for severe abnormality. The three variables most likely (p < 0.0001) to be components of scenarios rated "appropriate" were: severe disability, no yellow flags, and severe neurological deficit. CONCLUSION: This is the first study to report criteria for determining candidacy for surgery in LDS developed by a multidisciplinary international panel using a validated method (RAM). The panel ratings followed logical clinical rationale, indicating good face validity. The work refines clinical classification and the phenotype of degenerative spondylolisthesis. The predictive validity of the criteria should be evaluated prospectively to examine whether patients treated "appropriately" have better clinical outcomes.

Trabecular bone score: a noninvasive analytical method based upon the DXA image.

The trabecular bone score (TBS) is a gray-level textural metric that can be extracted from the two-dimensional lumbar spine dual-energy X-ray absorptiometry (DXA) image. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Based on experimental variograms of the projected DXA image, TBS has the potential to discern differences between DXA scans that show similar BMD measurements. An elevated TBS value correlates with better skeletal microstructure; a low TBS value correlates with weaker skeletal microstructure. Lumbar spine TBS has been evaluated in cross-sectional and longitudinal studies. The following conclusions are based upon publications reviewed in this article: 1) TBS gives lower values in postmenopausal women and in men with previous fragility fractures than their nonfractured counterparts; 2) TBS is complementary to data available by lumbar spine DXA measurements; 3) TBS results are lower in women who have sustained a fragility fracture but in whom DXA does not indicate osteoporosis or even osteopenia; 4) TBS predicts fracture risk as well as lumbar spine BMD measurements in postmenopausal women; 5) efficacious therapies for osteoporosis differ in the extent to which they influence the TBS; 6) TBS is associated with fracture risk in individuals with conditions related to reduced bone mass or bone quality. Based on these data, lumbar spine TBS holds promise as an emerging technology that could well become a valuable clinical tool in the diagnosis of osteoporosis and in fracture risk assessment.

Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses

Abstract OBJECTIVE To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. METHOD A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. RESULTS The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. CONCLUSION The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.