Validity and reliability of 3-minute nutrition screening (3-MinNS)performed by nurses on oncology and surgical patients

Background Nutrition screening is usually administered by nurses. However, most studies on nutrition screening tools have not used nurses to validate the tools. The 3-Minute Nutrition Screening (3-MinNS) assesses weight loss, dietary intake and muscle wastage, with the composite score of each used to determine risk of malnutrition. The aim of the study was to determine the validity and reliability of 3-MinNS administered by nurses, who are the intended assessors. Methods In this cross sectional study, three ward-based nurses screened 121 patients aged 21 years and over using 3-MinNS in three wards within 24 hours of admission. A dietitian then assessed the patients’ nutritional status using Subjective Global Assessment within 48 hours of admission, whilst blinded to the results of the screening. To assess the reliability of 3-MinNS, 37 patients screened by the first nurse were re-screened by a second nurse within 24 hours, who was blinded to the results of the first nurse. The sensitivity, specificity and best cutoff score for 3-MinNS were determined using the Receiver Operator Characteristics Curve. Results The best cutoff score to identify all patients at risk of malnutrition using 3-MinNS was three, with sensitivity of 89% and specificity of 88%. This cutoff point also identified all (100%) severely malnourished patients. There was strong correlation between 3-MinNS and SGA (r=0.78, p<0.001). The agreement between two nurses conducting the 3-MinNS tool was 78.3%. Conclusion 3-Minute Nutrition Screening is a valid and reliable tool for nurses to identify patients at risk of malnutrition.

Role of CIP2A in carcinogenesis

Worldwide and notably in the developed countries, cancer is an increasing cause of morbidity and mortality, being the second most common cause of death after ischemic heart disease. Now and in the future new cancer cases need to be diagnosed earlier. Prognostic factors may be helpful in recognizing and handling those patients who need more aggressive therapy, and it is also desirable to predict treatment response accurately. Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an oncoprotein predominantly expressed in malignant tissues and inhibiting protein phosphatase 2A (PP2A) activity; it is a promising target for cancer therapy. The aim of this thesis was to evaluate the prognostic role of CIP2A in solid cancers, and for this purpose to explore expression of CIP2A, and investigating regulation of CIP2A in order to gain insight into signalling pathways leading to alteration in prognosis. Patients diagnosed with gastric, serous ovarian, tongue, or colorectal cancer at Helsinki University Central Hospital were included. Tumour tissue microarrays assembled from specimens from these patients were prepared and stained immunohistochemically for CIP2A protein expression. Associations with clinicopathologic parameters and other biomarkers were explored, and survival analyses were done according to the Kaplan-Meier method. Study of the role of CIP2A in intracellular signalling in vitro involved gastric, ovarian, and tongue cancer cell lines. We found CIP2A to be highly expressed in gastric, ovarian, tongue, and colorectal cancer specimens. CIP2A was associated with clinicopathologic parameters characterizing an aggressive disease, namely advanced stage, high grade, p53 immunopositivity, and high proliferation index. CIP2A led to recognition of gastric, ovarian, and tongue cancer patients with poor prognosis, however, with a cancer type-specific cut-off level for prognostic significance. In tongue cancer, it served as an independent prognostic marker. In contrast, in colorectal cancer, CIP2A provided no prognostic value. In cancer cell lines, CIP2A was highly expressed at both protein and mRNA levels, and promoted cell proliferation and anchorage-independent growth. In gastric cancer, we demonstrated with a MYCER construct in mouse embryo fibroblasts that activation of MYC led to increased CIP2A mRNA expression, and hence we suggested that a positive feedback mechanism between CIP2A and MYC may potentiate and prolong the oncogenic activity of these proteins. We demonstrated in ovarian cancer an association between CIP2A and EGFR protein overexpression and EGFR gene amplification. In ovarian and tongue cancer cells we showed that depletion of EGFR downregulates CIP2A expression. In conclusion, high CIP2A expression occurred frequently among patients with aggressive disease. CIP2A may serve as a prognostic marker in gastric, ovarian, and tongue cancer and thus may help in tailoring therapy for cancer patients. The positive feedback mechanism between CIP2A and MYC, as well as the positive regulation of CIP2A by EGFR, are a few signalling pathways regulating and regulated by CIP2A. These and other mechanisms need to be studied further, however. CIP2A is a potential target for therapy, and its potential role as predictive marker and as a tumour marker in serum requires exploration.

Geometric optimization methods for the analysis of gene expression data

DNA microarrays provide such a huge amount of data that unsupervised methods are required to reduce the dimension of the data set and to extract meaningful biological information. This work shows that Independent Component Analysis (ICA) is a promising approach for the analysis of genome-wide transcriptomic data. The paper first presents an overview of the most popular algorithms to perform ICA. These algorithms are then applied on a microarray breast-cancer data set. Some issues about the application of ICA and the evaluation of biological relevance of the results are discussed. This study indicates that ICA significantly outperforms Principal Component Analysis (PCA).

Mobilização do corpo-si na gestão da atividade de motoristas de ambulâncias

Esta tese busca explorar as possibilidades contidas do corpo na gestão da atividade de trabalho de motoristas de ambulâncias. Trata-se de uma concepção de corpo, não oponente a alma, que se notabiliza pelo pensamento, pela inteligência, pelo sistema nervoso, pela história: um corpo-si. O diálogo mantido com a perspectiva ergológica, aqui convocada, opera-se a partir da concepção de vida, saúde-doença em George Canguilhem, da contribuição ergonômica, dos referenciais da linguagem e trabalho e da etnografia. Para configuração do campo empírico, adotaram-se métodos e técnicas apropriados de pesquisa em situação concreta de trabalho, denominadas visitas, instrumentalizadas com técnicas de entrevistas dialógicas e observações da atividade, além de uma pesquisa bibliográfica e análise global do trabalho. A pesquisa contou com a participação de motoristas de UTI móvel de uma empresa de transportes de ambulâncias da cidade do Rio de Janeiro. A análise das situações de trabalho foi inspirada na ergonomia da atividade e nas contribuições da perspectiva dialógica. Dentre os resultados obtidos destacamos: problemas de comunicação na relação de trabalho entre motoristas e a Central de Atendimento (Call Center), estado de má conservação e de desconforto das ambulâncias, riscos de doenças no contato com o usuário, insuficiência salarial e atraso no pagamento, indeterminação de pausas durante a jornada, contraintes temporais decorrentes da pilotagem em casos de urgência e emergência, ameaças de multas por excesso de velocidade, além de obstáculos emanados do trânsito: engarrafamentos, barulhos, semáforos, etc. Enfim, um conjunto de variabilidades e infidelidades do meio de trabalho, que permite aos motoristas produzirem novos usos de si, porque mobilizam a integralidade do corpo para chegar a modos operatórios que deem conta dessas situações de trabalho, considerando, sobretudo, a gestão da dinâmica entre as exigências de produtividade e qualidade com saúde, segurança e fiabilidade.

Mulheres como eu, mulheres como as outras: desvelando o assédio moral e sexual no âmbito do trabalho das comerciárias do Estado do Rio Grande do Norte

As transformações no âmbito do trabalho e sua repercussão entre homens e mulheres no contexto da sociabilidade capitalista, bem como, as tendências atuais do trabalho feminino, que, dentre outros aspectos acentuam os processos de hierarquização têm sistematicamente se traduzido em violências no mundo do trabalho sob a forma de assédio moral e sexual que se caracterizam pela exposição dos (as) trabalhadores (as) a situações humilhantes e constrangedoras prolongadas durante a jornada de trabalho relativa ao exercício de suas funções, tendo, por sua vez, as mulheres como as mais vitimizadas, de modo que, tais aspectos intensificam a divisão sexual do trabalho e trazem sérios comprometimentos para a liberdade desses sujeitos. Vale ressaltar que esses tipos de assédio se dão tanto no âmbito das relações hierarquicamente superiores, como no âmbito das relações sem hierarquia superior, podendo ocorrer entre colegas do mesmo nível hierárquico. Contudo, a tendência é a prevalência nas relações a qual está presente alguma forma de hierarquia, seja ela de gênero ou de função no interior da empresa. A questão central que orientou este trabalho foi: como se objetivam o assédio moral e o assédio sexual em situações de precarização do trabalho das comerciárias no Estado do Rio Grande do Norte? Realizamos pesquisas bibliográfica, documental e de campo. Essa última foi desenvolvida por meio da realização de dezessete entrevistas semiestruturadas com trabalhadoras do comércio das cidades de Natal, Mossoró e Pau dos Ferros. Em nível dos aspectos conclusivos destacamos: 1. O assédio moral e o assédio sexual potencializam a intensificação da precarização do trabalho feminino se concretizando fundamentalmente a partir do medo nas mais variadas formas: (a) medo de perder o emprego; (b) medo de ser perseguida, caso denuncie as práticas de assédio (c) medo de ser agredida verbalmente (d) medo de ver expostos aspectos da sexualidade; 2. O assédio moral e o assédio sexual se constituem como expressões da violência sexista contra as mulheres no âmbito do trabalho na contemporaneidade; 3. As mulheres que vivenciam/vivenciaram situações de violência na esfera laboral não identificam os serviços púbicos para os quais recorrer, haja vista os governos seja nas esferas municipal ou estadual não disporem de serviços de prevenção e combate a este fenômeno agravando a precarização do trabalho feminino; 4. O enfrentamento a essas violações pressupõe, no meu entender, um movimento ampliado de contestação das condições de degradação humana impostas pelo capitalismo e ao mesmo tempo enfrentar as nefastas consequências do patriarcado, do racismo e da opressão sofridas pelas mulheres, construídos e legitimados historicamente, mas que são passíveis de serem desconstruídos e transformados, exigindo organização coletiva para tal. Qualquer esforço de prevenção/intervenção não pode deixar de levar em conta a natureza genrada do assédio sexual e moral, o qual se constituem numa das formas mais perniciosas de violência contra as mulheres.

银杉的分子谱系地理学研究

银杉（Cathaya argyrophylla）是中国特有的濒危裸子植物，孤立分布于我国亚热带山地。虽然以往等位酶和RAPD标记的研究表明，银杉群体的遗传多样性水平很低而群体间的遗传分化很高，但迄今对该种群体的动态变化以及物种的进化历史仍缺乏了解，包括影响群体遗传结构的因素以及物种可能的避难所等，对如何有效地保护和恢复银杉群体仍缺乏科学依据。本文根据8个核基因片段和2个线粒体片段的序列数据，运用群体遗传学和谱系地理学方法，探讨了银杉在DNA水平上的多样性和群体的动态历史，探讨了影响银杉特殊的群体遗传结构的各种因素，并推测了银杉第四纪冰期的避难所，对银杉花粉活力及其变异进行检测。在此基础上，提出了保护和恢复银杉群体的具体策略和措施。主要研究结果如下： 　　1. 核甘酸多态性和群体遗传结构 　　从101个核基因片段中筛选了8个适用于银杉的片段，对来自四个地区15个群体共86个个体的胚乳总DNA进行了扩增和测序。8个核基因座位的平均核苷酸多态性（θs＝0.0022，πs＝0.0027）显著低于其它松杉植物遗传多态性的多座位估计值。四个地区中，大瑶山（DY）的多态性最高（θs＝0.0026，πs＝0.0027），八面山（BM）最低（θs＝0.0014，πs＝0.0018），大娄山（DL）和越城岭（YC）介于二者之间。大多数座位内的多态位点间紧密连锁，座位间的连锁只在八面山地区检测到。AMOVA分析表明显著性的多态性比例存在于地区间（20.05％）和地区内群体间（9.37％）。FST分析也显示群体间（FST＝0.294）和地区间（FST =0.131-0.319）存在显著的遗传分化。推测伴随着瓶颈效应而出现的遗传漂变及其有限的基因流（Nm=1.2）是导致银杉群体低水平多态性和群体间强烈分化的主要原因。 　　2．谱系地理学分析 　　利用2个线粒体片段（nad1和nad4）序列以及高变异量的核2009片段序列对银杉的谱系地理进行了探讨。2个线粒体片段的多态位点组合成3种单倍型，将银杉分成大娄山（DL）、八面山（BM）以及越城岭（YC）和大瑶山（DY）3个地区，地区间的单倍型完全不同（GST=1.0），结合核基因呈现的群体遗传结构，推测现存银杉群体至少来源于4个冰期避难所，相当于银杉现存的4个相互隔离的地区。2009座位上12个变异位点组合成8种单倍型，位于单倍型谱系内部节点的4种祖先单倍型分布广泛、出现频率最高，其它7个核基因座位具有类似谱系结构。遗传距离和地理距离没有相关性，NST (0.138)与GST (0.134)没有显著性差异，说明现存的银杉群体是相对较近的时间内片断化的产物。2009片段分离位点的失配分布（mismatch distribution）呈双峰和多峰，表明银杉群体没有经历近期的扩张，与古生物学研究证据相吻合。 　　3. 银杉的基因杂合性和花粉生命力 　　利用2009和cad两个核基因片段，采用多胚乳序列法得到总的杂合体比率为64％（2009）和60％（cad），说明银杉群体中存在高比例的杂合体。大娄山地区的杂合体比率是八面山地区的2倍。银杉杂合体比率的高低可能与其遗传多态性有关，也可能是自然选择的结果。采用TTC染色法对银杉的花粉生命力进行了测定，在干燥低温条件下银杉花粉的活力很稳定，保存一年后有活力的花粉数仍高达80％以上。通过对来自两个地区（DY和YC）7个群体共16个银杉个体花粉活力的测定发现，银杉有活力花粉比例高达93.3％，与其它裸子植物相当。花粉活力在地区间和群体间存在显著差异，花坪地区（95.2%）的花粉活力高于大瑶山（91.3%）。花粉活力在群体内个体间差异不显著。 　　4．银杉的进化历史及其保护 　　银杉的低水平的遗传多样性和独特的群体遗传结构对我们推测其冰川期避难所提供了重要依据。本研究在银杉4个孤立分布区发现了彼此不重叠的线粒体单倍型，同时核基因表现出了4个地理群，说明随着第四纪冰期气候的波动和银杉分布范围的片段化，原来广布的群体逐步萎缩，最后被保留在位于西部大娄山（DL），东部八面山(BM)，中南部越城岭(YC)和南部大瑶山(DY) 4个相互隔离的避难所。银杉独特的群体结构和动态历史对进一步制定相应的保护措施具有重要参考价值。由于遗传多态性很低，群体又小，几乎所有现存的银杉群体都面临由于随机事件导致的物种灭绝。更严重的是，当前该物种的适生环境不断恶化和片段化，以及异常低的生殖和存活率导致银杉与其它物种竞争能力很低。因此，除目前采取的原地保护策略外，迁地保护应给予优先考虑。此外，采用传统的控制授粉策略（在遗传上有显著差异的群体间开展人工杂交）是丰富其遗传多态性、恢复衰退群体的可行措施之一。

Low-rank optimization on the cone of positive semidefinite matrices

We propose an algorithm for solving optimization problems defined on a subset of the cone of symmetric positive semidefinite matrices. This algorithm relies on the factorization X = Y Y T , where the number of columns of Y fixes an upper bound on the rank of the positive semidefinite matrix X. It is thus very effective for solving problems that have a low-rank solution. The factorization X = Y Y T leads to a reformulation of the original problem as an optimization on a particular quotient manifold. The present paper discusses the geometry of that manifold and derives a second-order optimization method with guaranteed quadratic convergence. It furthermore provides some conditions on the rank of the factorization to ensure equivalence with the original problem. In contrast to existing methods, the proposed algorithm converges monotonically to the sought solution. Its numerical efficiency is evaluated on two applications: the maximal cut of a graph and the problem of sparse principal component analysis. © 2010 Society for Industrial and Applied Mathematics.

Generalized power method for sparse principal component analysis

In this paper we develop a new approach to sparse principal component analysis (sparse PCA). We propose two single-unit and two block optimization formulations of the sparse PCA problem, aimed at extracting a single sparse dominant principal component of a data matrix, or more components at once, respectively. While the initial formulations involve nonconvex functions, and are therefore computationally intractable, we rewrite them into the form of an optimization program involving maximization of a convex function on a compact set. The dimension of the search space is decreased enormously if the data matrix has many more columns (variables) than rows. We then propose and analyze a simple gradient method suited for the task. It appears that our algorithm has best convergence properties in the case when either the objective function or the feasible set are strongly convex, which is the case with our single-unit formulations and can be enforced in the block case. Finally, we demonstrate numerically on a set of random and gene expression test problems that our approach outperforms existing algorithms both in quality of the obtained solution and in computational speed. © 2010 Michel Journée, Yurii Nesterov, Peter Richtárik and Rodolphe Sepulchre.

From subspace learning to distance learning: A geometrical optimization approach

In this paper, we adopt a differential-geometry viewpoint to tackle the problem of learning a distance online. As this problem can be cast into the estimation of a fixed-rank positive semidefinite (PSD) matrix, we develop algorithms that exploits the rich geometry structure of the set of fixed-rank PSD matrices. We propose a method which separately updates the subspace of the matrix and its projection onto that subspace. A proper weighting of the two iterations enables to continuously interpolate between the problem of learning a subspace and learning a distance when the subspace is fixed. © 2009 IEEE.

Optimization on the orthogonal group for independent component analysis

This paper derives a new algorithm that performs independent component analysis (ICA) by optimizing the contrast function of the RADICAL algorithm. The core idea of the proposed optimization method is to combine the global search of a good initial condition with a gradient-descent algorithm. This new ICA algorithm performs faster than the RADICAL algorithm (based on Jacobi rotations) while still preserving, and even enhancing, the strong robustness properties that result from its contrast. © Springer-Verlag Berlin Heidelberg 2007.

Geometric optimization methods for independent component analysis applied on gene expression data

DNA microarrays provide a huge amount of data and require therefore dimensionality reduction methods to extract meaningful biological information. Independent Component Analysis (ICA) was proposed by several authors as an interesting means. Unfortunately, experimental data are usually of poor quality- because of noise, outliers and lack of samples. Robustness to these hurdles will thus be a key feature for an ICA algorithm. This paper identifies a robust contrast function and proposes a new ICA algorithm. © 2007 IEEE.