934 resultados para Computer Knowledge Bank on Medical Diagnostics
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This study aims to develop a computer program based on VBA programming language, using Microsoft Excel, for designing pumping systems of water. The program allows the user to determine the economical diameter, using the equation of Bresse, for a given installation, since the geometric elevation, the material of the tube, the accessories along the line and the volumetric flow are known. In addition, the program estimates the total annual cost of the installation for three different diameters, in order to compare which diameter is more advantageous from an economical perspective. The program interface is designed to be simple and intuitive with the intention of being didactic and offering to engineering students an advantageous tool to analyze this type of project. Microsoft Excel was chosen for this work because is present in virtually all personal computer, and is an indispensable tool for educational purposes
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In this work, we discuss the procedures adopted for the design of built-up columns (laced and battened columns). Built-up columns are widely used in steel construction generally when the compression forces are relatively low and the column buckling lengths are large. They are commonly used in industrial buildings, for example, as posts for cladding, or as columns supporting a crane girder. Unlike columns with full section, in the case of built-up columns, it is necessary to evaluate the shear stiffness. In fact, the shear strength leads to a significant reduction of the critical load. In the context of this work, the components of the columns (chords, diagonals, posts, etc.) are formed by cold-formed members. In order to systematize and rationalize the verification of the built-up columns, this work aim to develop a computer program based on the standards NBR 14762, NBR 6355 and Eurocode 3, basically the considerations of the part EN 1993-1-1
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Objective: Major Depressive Disorder (MDD) is a debilitating condition with a marked social impact. The impact of MDD and Treatment-Resistant Depression (TRD+) within the Brazilian health system is largely unknown. The goal of this study was to compare resource utilization and costs of care for treatment-resistant MDD relative to non-treatment-resistant depression (TRD-). Methods: We retrospectively analyzed the records of 212 patients who had been diagnosed with MDD according to the ICD-10 criteria. Specific criteria were used to identify patients with TRD+. Resource utilization was estimated, and the consumption of medication was annualized. We obtained information on medical visits, procedures, hospitalizations, emergency department visits and medication use related or not to MDD. Results: The sample consisted of 90 TRD+ and 122 TRD-patients. TRD+ patients used significantly more resources from the psychiatric service, but not from non-psychiatric clinics, compared to TRD-patients. Furthermore, TRD+ patients were significantly more likely to require hospitalizations. Overall, TRD+ patients imposed significantly higher (81.5%) annual costs compared to TRD-patients (R$ 5,520.85; US$ 3,075.34 vs. R$ 3,042.14; US$ 1,694.60). These findings demonstrate the burden of MDD, and especially of TRD+ patients, to the tertiary public health system. Our study should raise awareness of the impact of TRD+ and should be considered by policy makers when implementing public mental health initiatives.
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Aim Estimates of geographic range size derived from natural history museum specimens are probably biased for many species. We aim to determine how bias in these estimates relates to range size. Location We conducted computer simulations based on herbarium specimen records from localities ranging from the southern United States to northern Argentina. Methods We used theory on the sampling distribution of the mean and variance to develop working hypotheses about how range size, defined as area of occupancy (AOO), was related to the inter-specific distribution of: (1) mean collection effort per area across the range of a species (MC); (2) variance in collection effort per area across the range of a species (VC); and (3) proportional bias in AOO estimates (PBias: the difference between the expected value of the estimate of AOO and true AOO, divided by true AOO). We tested predictions from these hypotheses using computer simulations based on a dataset of more than 29,000 herbarium specimen records documenting occurrences of 377 plant species in the tribe Bignonieae (Bignoniaceae). Results The working hypotheses predicted that the mean of the inter-specific distribution of MC, VC and PBias were independent of AOO, but that the respective variance and skewness decreased with increasing AOO. Computer simulations supported all but one prediction: the variance of the inter-specific distribution of VC did not decrease with increasing AOO. Main conclusions Our results suggest that, despite an invariant mean, the dispersion and symmetry of the inter-specific distribution of PBias decreases as AOO increases. As AOO increased, range size was less severely underestimated for a large proportion of simulated species. However, as AOO increased, range size estimates having extremely low bias were less common.
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Semisupervised learning is a machine learning approach that is able to employ both labeled and unlabeled samples in the training process. In this paper, we propose a semisupervised data classification model based on a combined random-preferential walk of particles in a network (graph) constructed from the input dataset. The particles of the same class cooperate among themselves, while the particles of different classes compete with each other to propagate class labels to the whole network. A rigorous model definition is provided via a nonlinear stochastic dynamical system and a mathematical analysis of its behavior is carried out. A numerical validation presented in this paper confirms the theoretical predictions. An interesting feature brought by the competitive-cooperative mechanism is that the proposed model can achieve good classification rates while exhibiting low computational complexity order in comparison to other network-based semisupervised algorithms. Computer simulations conducted on synthetic and real-world datasets reveal the effectiveness of the model.
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Public health strategies to reduce cardiovascular morbidity and mortality should focus on global cardiometabolic risk reduction. The efficacy of lifestyle changes to prevent type 2 diabetes have been demonstrated, but low-cost interventions to reduce cardiometabolic risk in Latin-America have been rarely reported. Our group developed 2 programs to promote health of high-risk individuals attending a primary care center in Brazil. This study compared the effects of two 9-month lifestyle interventions, one based on medical consultations (traditional) and another with 13 multi-professional group sessions in addition to the medical consultations (intensive) on cardiometabolic parameters. Adults were eligible if they had pre-diabetes (according to the American Diabetes Association) and/or metabolic syndrome (International Diabetes Federation criteria for Latin-America). Data were expressed as means and standard deviations or percentages and compared between groups or testing visits. A p-value < 0.05 was considered significant. Results: 180 individuals agreed to participate (35.0% men, mean age 54.7 ± 12.3 years, 86.1% overweight or obese). 83 were allocated to the traditional and 97 to the intensive program. Both interventions reduced body mass index, waist circumference and tumor necrosis factor-α. Only intensive program reduced 2-hour plasma glucose and blood pressure and increased adiponectin values, but HDL-cholesterol increased only in the traditional. Also, responses to programs were better in intensive compared to traditional program in terms of blood pressure and adiponectin improvements. No new case of diabetes in intensive but 3 cases and one myocardial infarction in traditional program were detected. Both programs induced metabolic improvement in the short-term, but if better results in the intensive are due to higher awareness about risk and self-motivation deserves further investigation. In conclusion, these low-cost interventions are able to minimize cardiometabolic risk factors involved in the progression to type 2 diabetes and/or cardiovascular disease.
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Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.
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La prova informatica richiede l’adozione di precauzioni come in un qualsiasi altro accertamento scientifico. Si fornisce una panoramica sugli aspetti metodologici e applicativi dell’informatica forense alla luce del recente standard ISO/IEC 27037:2012 in tema di trattamento del reperto informatico nelle fasi di identificazione, raccolta, acquisizione e conservazione del dato digitale. Tali metodologie si attengono scrupolosamente alle esigenze di integrità e autenticità richieste dalle norme in materia di informatica forense, in particolare della Legge 48/2008 di ratifica della Convenzione di Budapest sul Cybercrime. In merito al reato di pedopornografia si offre una rassegna della normativa comunitaria e nazionale, ponendo l’enfasi sugli aspetti rilevanti ai fini dell’analisi forense. Rilevato che il file sharing su reti peer-to-peer è il canale sul quale maggiormente si concentra lo scambio di materiale illecito, si fornisce una panoramica dei protocolli e dei sistemi maggiormente diffusi, ponendo enfasi sulla rete eDonkey e il software eMule che trovano ampia diffusione tra gli utenti italiani. Si accenna alle problematiche che si incontrano nelle attività di indagine e di repressione del fenomeno, di competenza delle forze di polizia, per poi concentrarsi e fornire il contributo rilevante in tema di analisi forensi di sistemi informatici sequestrati a soggetti indagati (o imputati) di reato di pedopornografia: la progettazione e l’implementazione di eMuleForensic consente di svolgere in maniera estremamente precisa e rapida le operazioni di analisi degli eventi che si verificano utilizzando il software di file sharing eMule; il software è disponibile sia in rete all’url http://www.emuleforensic.com, sia come tool all’interno della distribuzione forense DEFT. Infine si fornisce una proposta di protocollo operativo per l’analisi forense di sistemi informatici coinvolti in indagini forensi di pedopornografia.
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Negli ultimi anni si è assistito ad un miglioramento della qualità di vita dei piccoli animali che, oltre ad aumentarne l'aspettativa di vita, ha determinato un aumento della frequenza di patologie associate all'età medio-avanzata, quali le patologie renali croniche. Il presente studio si fonda sulla necessità, sempre più sentita nella pratica clinica veterinaria, di poter fornire al proprietario del paziente affetto da CKD, una serie di parametri che, oltre a fungere da target terapeutico, possano aiutare a comprenderne la prognosi. Lo studio ha valutato una popolazione di cani affetti da CKD e ne ha seguito o ricostruito il follow-up, per tutto il periodo di sopravvivenza fino al momento dell’exitus. Di tali soggetti sono stati raccolti dati relativi ad anamnesi, esame clinico, misurazione della pressione arteriosa, diagnostica per immagini, esami ematochimici, analisi delle urine ed eventuale esame istologico renale. È stato possibile individuare alcuni importanti fattori prognostici per la sopravvivenza in pazienti con CKD. Oltre a fattori ben noti in letteratura, come ad esempio elevati valori di creatinina e fosforo, o la presenza di proteinuria, è stato possibile anche evidenziare il ruolo prognostico negativo di alcuni parametri meno noti, ed in particolare delle proteine di fase acuta positive e negative, e del rapporto albumina/globuline. Una possibile spiegazione del valore prognostico di tali parametri risiede nel ruolo prognostico negativo dell’infiammazione nel paziente con CKD: tale ruolo è stato suggerito e dimostrato nell’uomo e avrebbe alla base numerosi possibili meccanismi (sviluppo di anemia, complicazioni gastroenteriche, neoplasie, etc.), ma dati analoghi sono mancanti in medicina veterinaria. Una seconda possibile spiegazione risiede nel fatto che potenzialmente i livelli delle proteine di fase acuta possono essere influenzati dalla presenza di proteinuria nel paziente con CKD e di conseguenza potrebbero essere una conferma di come la proteinuria influenzi negativamente l'outcome.
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Die vorliegende Dissertation dient dazu, das Verständnis des Exzitonentransports in organischen Halbleitern, wie sie in Leuchtdioden oder Solarzellen eingesetzt werden, zu vertiefen. Mithilfe von Computersimulationen wurde der Transport von Exzitonen in amorphen und kristallinen organischen Materialien beschrieben, angefangen auf mikroskopischer Ebene, auf der quantenmechanische Prozesse ablaufen, bis hin zur makroskopischen Ebene, auf welcher physikalisch bestimmbare Größen wie der Diffusionskoeffizient extrahierbar werden. Die Modellbildung basiert auf dem inkohärenten elektronischen Energietransfer. In diesem Rahmen wird der Transport des Exzitons als Hüpfprozess aufgefasst, welcher mit kinetischen Monte-Carlo Methoden simuliert wurde. Die notwendigen quantenmechanischen Übergangsraten zwischen den Molekülen wurden anhand der molekularen Struktur fester Phasen berechnet. Die Übergangsraten lassen sich in ein elektronisches Kopplungselement und die Franck-Condon-gewichtete Zustandsdichte aufteilen. Der Fokus dieser Arbeit lag einerseits darauf die Methoden zu evaluieren, die zur Berechnung der Übergangsraten in Frage kommen und andererseits den Hüpftransport zu simulieren und eine atomistische Interpretation der makroskopischen Transporteigenschaften der Exzitonen zu liefern. rnrnVon den drei untersuchten organischen Systemen, diente Aluminium-tris-(8-hydroxychinolin) der umfassenden Prüfung des Verfahrens. Es wurde gezeigt, dass stark vereinfachte Modelle wie die Marcus-Theorie die Übergangsraten und damit das Transportverhalten der Exzitonen oftmals qualitativ korrekt wiedergeben. Die meist deutlich größeren Diffusionskonstanten von Singulett- im Vergleich zu Triplett-Exzitonen haben ihren Ursprung in der längeren Reichweite der Kopplungselemente der Singulett-Exzitonen, wodurch ein stärker verzweigtes Netzwerk gebildet wird. Der Verlauf des zeitabhängigen Diffusionskoeffizienten zeigt subdiffusives Verhalten für kurze Beobachtungszeiten. Für Singulett-Exzitonen wechselt dieses Verhalten meist innerhalb der Lebensdauer des Exzitons in ein normales Diffusionsregime, während Triplett-Exzitonen das normale Regime deutlich langsamer erreichen. Das stärker anomale Verhalten der Triplett-Exzitonen wird auf eine ungleichmäßige Verteilung der Übergangsraten zurückgeführt. Beim Vergleich mit experimentell bestimmten Diffusionskonstanten muss das anomale Verhalten der Exzitonen berücksichtigt werden. Insgesamt stimmten simulierte und experimentelle Diffusionskonstanten für das Testsystem gut überein. Das Modellierungsverfahren sollte sich somit zur Charakterisierung des Exzitonentransports in neuen organischen Halbleitermaterialien eignen.
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Nowadays communication is switching from a centralized scenario, where communication media like newspapers, radio, TV programs produce information and people are just consumers, to a completely different decentralized scenario, where everyone is potentially an information producer through the use of social networks, blogs, forums that allow a real-time worldwide information exchange. These new instruments, as a result of their widespread diffusion, have started playing an important socio-economic role. They are the most used communication media and, as a consequence, they constitute the main source of information enterprises, political parties and other organizations can rely on. Analyzing data stored in servers all over the world is feasible by means of Text Mining techniques like Sentiment Analysis, which aims to extract opinions from huge amount of unstructured texts. This could lead to determine, for instance, the user satisfaction degree about products, services, politicians and so on. In this context, this dissertation presents new Document Sentiment Classification methods based on the mathematical theory of Markov Chains. All these approaches bank on a Markov Chain based model, which is language independent and whose killing features are simplicity and generality, which make it interesting with respect to previous sophisticated techniques. Every discussed technique has been tested in both Single-Domain and Cross-Domain Sentiment Classification areas, comparing performance with those of other two previous works. The performed analysis shows that some of the examined algorithms produce results comparable with the best methods in literature, with reference to both single-domain and cross-domain tasks, in $2$-classes (i.e. positive and negative) Document Sentiment Classification. However, there is still room for improvement, because this work also shows the way to walk in order to enhance performance, that is, a good novel feature selection process would be enough to outperform the state of the art. Furthermore, since some of the proposed approaches show promising results in $2$-classes Single-Domain Sentiment Classification, another future work will regard validating these results also in tasks with more than $2$ classes.
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It is well known that the early initiation of a specific antiinfective therapy is crucial to reduce the mortality in severe infection. Procedures culturing pathogens are the diagnostic gold standard in such diseases. However, these methods yield results earliest between 24 to 48 hours. Therefore, severe infections such as sepsis need to be treated with an empirical antimicrobial therapy, which is ineffective in an unknown fraction of these patients. Today's microbiological point of care tests are pathogen specific and therefore not appropriate for an infection with a variety of possible pathogens. Molecular nucleic acid diagnostics such as polymerase chain reaction (PCR) allow the identification of pathogens and resistances. These methods are used routinely to speed up the analysis of positive blood cultures. The newest PCR based system allows the identification of the 25 most frequent sepsis pathogens by PCR in parallel without previous culture in less than 6 hours. Thereby, these systems might shorten the time of possibly insufficient antiinfective therapy. However, these extensive tools are not suitable as point of care diagnostics. Miniaturization and automating of the nucleic acid based method is pending, as well as an increase of detectable pathogens and resistance genes by these methods. It is assumed that molecular PCR techniques will have an increasing impact on microbiological diagnostics in the future.
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Delays in adequate antimicrobial treatment contribute to high cost and mortality in sepsis. Polymerase chain reaction (PCR) assays are used alongside conventional cultures to accelerate the identification of microorganisms. We analyze the impact on medical outcomes and healthcare costs if improved adequacy of antimicrobial therapy is achieved by providing immediate coverage after positive PCR reports.
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Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.