Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

Molecular phylogeny of advanced snakes (Serpentes, Caenophidia) with an emphasis on South American xenodontines: A revised classification and descriptions of new taxa

We present a molecular phylogenetic analysis of caenophidian (advanced) snakes using sequences from two mitochondrial genes (12S and 16S rRNA) and one nuclear (c-mos) gene (1681 total base pairs), and with 131 terminal taxa sampled from throughout all major caenophidian lineages but focussing on Neotropical xenodontines. Direct optimization parsimony analysis resulted in a well-resolved phylogenetic tree, which corroborates some clades identified in previous analyses and suggests new hypotheses for the composition and relationships of others. The major salient points of our analysis are: (1) placement of Acrochordus, Xenodermatids, and Pareatids as successive outgroups to all remaining caenophidians (including viperids, elapids, atractaspidids, and all other colubrid groups); (2) within the latter group, viperids and homalopsids are sucessive sister clades to all remaining snakes; (3) the following monophyletic clades within crown group caenophidians: Afro-Asian psammophiids (including Mimophis from Madagascar), Elapidae (including hydrophiines but excluding Homoroselaps), Pseudoxyrhophiinae, Colubrinae, Natricinae, Dipsadinae, and Xenodontinae. Homoroselaps is associated with atractaspidids. Our analysis suggests some taxonomic changes within xenodontines, including new taxonomy for Alsophis elegans, Liophis amarali, and further taxonomic changes within Xenodontini and the West Indian radiation of xenodontines. Based on our molecular analysis, we present a revised classification for caenophidians and provide morphological diagnoses for many of the included clades; we also highlight groups where much more work is needed. We name as new two higher taxonomic clades within Caenophidia, one new subfamily within Dipsadidae, and, within Xenodontinae five new tribes, six new genera and two resurrected genera. We synonymize Xenoxybelis and Pseudablabes with Philodryas; Erythrolamprus with Liophis; and Lystrophis and Waglerophis with Xenodon.

Lê cycles and Milnor classes

The purpose of this work is to establish a link between the theory of Chern classes for singular varieties and the geometry of the varieties in question. Namely, we show that if Z is a hypersurface in a compact complex manifold, defined by the complex analytic space of zeroes of a reduced non-zero holomorphic section of a very ample line bundle, then its Milnor classes, regarded as elements in the Chow group of Z, determine the global Lê cycles of Z; and vice versa: The Lê cycles determine the Milnor classes. Morally this implies, among other things, that the Milnor classes determine the topology of the local Milnor fibres at each point of Z, and the geometry of the local Milnor fibres determines the corresponding Milnor classes. © 2013 Springer-Verlag Berlin Heidelberg.

Archival Classification and Knowledge Organization: Theoretical Possibilities for the Archival Field

The main goal of this study is to outline a possible relation between archival classification and knowledge organization theory. In this sense, we seek to contribute to the conceptual classification in Archival Science, since there is a lack of systematization about archival classification; not just classification, but even the study of historical and conceptual aspects of the discipline. In the context of knowledge organization there is a considerable amount of research on how to build classification schemes and indexing systems that can help contribute to and expand archival classification theory. In order to comprehend this vast field of theories and methodologies we construct a parallel comparing the classification concepts in both areas and analyzing these concepts.

Lê Cycles and Milnor Classes of Compact Hypersurfaces

We determine the relation amongst the global Lê cycles and the Milnor classes of analytic hypersurfaces defined by a section of a very ample line bundle over a compact complex manifold. The key point is finding appropriate expressions for the global Lê cycles and for the Milnor classes in terms of polar varieties. Our starting points are an interpretation of the Lê cycles given by T. Gaffney and R. Gassler, a formula by A. Parusinski and P. Pragacz for the Milnor classes via McPherson’s functor, and a conjecture of J.-P. Brasselet, that we prove, stating that Milnor classes can be expressed in terms of polar varieties. We then use the work by R. Piegne for Mather classes, by J. Schürmann and M. Tibăr for MacPherson’s classes for constructible functions, and by D. Massey for an extension of the local Lê cycles for constructible sheaves.

Classification and regression tree (CART) model to predict pulmonary tuberculosis in hospitalized patients

Background: Tuberculosis (TB) remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods: Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART) model was generated and validated. The area under the ROC curve (AUC), sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results: We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear) and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions: The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with clinical suspicion of TB in tertiary health facilities in countries with limited resources.

"Evaluating the model of classification and valuation of disabilities used in Brazil and defining the elaboration and adoption of a unique model for all the country": Brazilian Interministerial Workgroup Task

The President of Brazil established an Interministerial Work Group in order to “evaluate the model of classification and valuation of disabilities used in Brazil and to define the elaboration and adoption of a unique model for all the country”. Eight Ministries and/or Secretaries participated in the discussion over a period of 10 months, concluding that a proposed model should be based on the United Nations Convention on the Rights of Person with Disabilities, the International Classification of Functioning, Disability and Health, and the ‘support theory’, and organizing a list of recommendations and necessary actions for a Classification, Evaluation and Certification Network with national coverage.

Implicit computational complexity and probabilistic classes

The thesis applies the ICC tecniques to the probabilistic polinomial complexity classes in order to get an implicit characterization of them. The main contribution lays on the implicit characterization of PP (which stands for Probabilistic Polynomial Time) class, showing a syntactical characterisation of PP and a static complexity analyser able to recognise if an imperative program computes in Probabilistic Polynomial Time. The thesis is divided in two parts. The first part focuses on solving the problem by creating a prototype of functional language (a probabilistic variation of lambda calculus with bounded recursion) that is sound and complete respect to Probabilistic Prolynomial Time. The second part, instead, reverses the problem and develops a feasible way to verify if a program, written with a prototype of imperative programming language, is running in Probabilistic polynomial time or not. This thesis would characterise itself as one of the first step for Implicit Computational Complexity over probabilistic classes. There are still open hard problem to investigate and try to solve. There are a lot of theoretical aspects strongly connected with these topics and I expect that in the future there will be wide attention to ICC and probabilistic classes.