992 resultados para Morbidity control
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Fractional Calculus (FC) goes back to the beginning of the theory of differential calculus. Nevertheless, the application of FC just emerged in the last two decades due to the progress in the area of nonlinear dynamics. This article discusses several applications of fractional calculus in science and engineering, namely: the control of heat systems, the tuning of PID controllers based on fractional calculus concepts and the dynamics in hexapod locomotion.
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RESUMO Nos países industrializados observam-se elevadas prevalências de pré- obesidade e obesidade em jovens e adolescentes, com consequências negativas para a saúde. A obesidade é apontada como o distúrbio nutricional mais frequente em crianças e adolescentes nos países desenvolvidos e é resultado da acumulação excessiva ou anormal de gordura no tecido adiposo. Segundo a I.O.T.F. considera- se que uma criança tem pré-obesidade quando o seu percentil de I.M.C. está entre o p88 e p99 para as raparigas e entre o p90 e o p99 para os rapazes. Considerase que tem obesidade quando o percentil de I.M.C. é superior ao p99, para ambos os sexos. A prevalência de pré-obesidade e obesidade em crianças e adolescentes tem vindo a aumentar a nível mundial a um ritmo alarmante, sobretudo nos países desenvolvidos e em alguns segmentos de países em desenvolvimento. Estudos demonstram que a obesidade em crianças e adolescentes se encontra fortemente correlacionada com o aumento da morbilidade e mortalidade, reflectindo-se numa variedade de situações patológicas com risco de persistência no adulto. Dada a sua extrema importância em termos de Saúde Pública, as tendências para a pré- obesidade e obesidade em crianças e adolescentes devem ser monitorizadas com especial atenção. Os hábitos alimentares e o gasto energético são factores que influenciam a obesidade e o seu controlo. Há estudos que concluem que existe uma associação directa entre estes factos e a presença de obesidade e outros apresentam conclusões contrárias. Pretendeu-se determinar a prevalência de excesso de peso (pré-obesidade e obesidade) infantojuvenil em Portugal e associá-la com os hábitos alimentares, actividade física e comportamentos sedentários dos adolescentes. A população em estudo é todos os adolescentes, de ambos os sexos, que frequentam o ensino básico (2º e 3º ciclos) e secundário oficial de Portugal Continental (n=5708). Todos os elementos em estudos foram avaliados antropometricamente (peso e altura) e responderam a um questionário de hábitos alimentares e frequência alimentar, actividade física e comportamentos sedentários. Como resultados do estudo verificou-se que a prevalência de pré- obesidade infanto-juvenil em Portugal é de 22,6% e a prevalência de obesidade de 7,8%. Quer a obesidade quer a pré-obesidade apresentam indicadores superiores nos rapazes (p=0,01) e nos adolescentes mais jovens (p=0,00). Em relação aos hábitos alimentares estudados é de referir que a frequência de consumo de refeições fora de casa é muito similar entre o grupo normoponderal e o grupo com excesso de peso sendo a refeição da ceia consumida por um número muito superior de adolescentes normoponderais comparativamente com os que apresentam excesso de peso (p=0,01). Em relação à ingestão de determinados alimentos ou grupos alimentícios, verificou-se que, regra geral, o consumo de alimentos de características nutricionais de baixa qualidade (gordura saturada, sal e açucares simples) era superior no grupo normoponderal comparativamente ao grupo com excesso de peso (refrigerantes, snacks, fast-food, cereais açucarados, sobremesas doces) (p<0,05). Em relação à actividade física, o número de horas semanais de actividade física diminui do grupo normoponderal para o grupo com excesso de peso. Dentro do grupo com excesso de peso, os obesos apresentam ainda uma média inferior em relação aos pré-obesos. Poderemos afirmar que quanto maior o índice de actividade física menor o percentil de I.M.C., mostrando-se assim a actividade física como um factor protector de um peso saudável (p<0,05). Quando solicitado que caracterizassem o estilo de vida e a habilidade desportiva, verificou-se que nos grupos com excesso de peso se caracterizavam em indicadores mais baixos do que os normoponderais (p<0,05). No que diz respeito aos comportamentos sedentários, verifica-se que são mais prevalentes nos grupos com excesso de peso do que no grupo normoponderal (p<0,05). Em conclusão, os resultados da prevalência de obesidade obtidos assemelham-se aos resultados obtidos noutros estudos, constituindo um dado revelador de uma situação bastante preocupante em termos de Saúde Pública. Em relação aos hábitos alimentares as diferenças não são significativas entre os diferentes grupos (normoponderal, pré-obesidade e obesidade). A actividade física apresentou-se como um factor protector do aumento de peso com uma associação directa com o estado nutricional (I.M.C.). Verificou-se que os adolescentes em Portugal que apresentavam indicadores mais elevados de actividade física eram aqueles que se encontravam com peso normal. Os comportamentos sedentários apresentaram-se como um factor propício ao desenvolvimento do excesso de peso estando directamente relacionados com o percentil de I.M.C. Os comportamentos sedentários mais frequentes são o visionamento televisivo e o computador/internet. Assim, poder-se-á fundamentar a necessidade de medidas interventivas a este nível com o intuito de controlar os indicadores encontrados. ABSTRACT In the industrialized countries high prevalences of pre-obesity and obesity are observed in youngsters and adolescents, with negative health consequences. Obesity is pointed as the most frequent nutritional disturbance in children and adolescents in developed countries and results from the excessive or abnormal accumulation of fat in the adipose tissue. According to the IOTF a child is pre-obese when the BMI percentile is between p88 and p99 for girls and between p90 and p99 for boys. Obesity is considered when the BMI percentile is above p99 for both sexes. The prevalence of pre-obesity and obesity in children and adolescents has been rising alarmingly worldwide, especially in developed countries and some segments of developing countries. Studies indicate that obesity in children and adolescents is strongly associated with increased morbidity and mortality resulting in a variety of pathological situations with risk of persistence in adulthood. Given its major Public Health importance, pre-obesity and obesity trends in children and adolescents should be monitored with special attention. Eating habits and energy expenditure are factors that influence obesity and its control. Some studies conclude that there is a direct association between these factors and the presence of obesity and others present opposite conclusions. It was intended to determine the prevalence of overweight (pre-obesity and obesity) in children and youth in Portugal and to associate it with eating habits, physical activity and sedentary behaviors of adolescents. The population in study is constituted by all adolescents of both sexes that attend basic (2nd and 3rd grade) and secondary official education of continental Portugal (n=5708). All participants in study were anthropometrically evaluated (weight and height) and answered a questionnaire of eating habits and food frequency, physical activity and sedentary behaviors. The study results indicate a prevalence of pre-obesity in children and youth in Portugal of 22.6% and a prevalence of obesity of 7.8%. Both obesity and pre-obesity present higher indicators in boys (p=0.01) and younger adolescents (p=0.00). In relation to the studied eating habits it should be noted that the frequency of consumption of meals away from home is very similar between the normal weight group and the overweight group. Moreover, the supper meal is consumed by a much larger number of normal weight adolescents as compared to the ones with overweight (p=0.01). Regarding the intake of certain foods or food groups, it was found that, in general, the consumption of foods with characteristics of low nutritional quality (saturated fat, salt and simple sugars) was higher in the normoponderal group compared with the overweight group (soft drinks, snacks, fast-food, sugary cereals, desserts) (p<0.05). In respect to physical activity, the number of weekly hours of physical activity decreases from the normoponderal group to the group with overweight. Within the group with overweight, obese subjects also present a lower average than pre-obese subjects. As we can affirm that the higher the physical activity index the lower the BMI percentile, physical activity appears as a protective factor for a healthy weight (p<0.05). When they were asked to characterize their lifestyle and sports ability, it was found that overweight groups characterized themselves with lower indicators than the normoponderal group (p<0.05). Regarding sedentary behaviors, it appears that they were more prevalent in groups with overweight than in the normoponderal group (p<0.05). In conclusion, the results of the obesity prevalence attained are similar to the results obtained in other studies, revealing a very worrying situation in terms of Public Health. In relation to the eating habits there were no significant differences between the groups (normoponderal, pre-obesity and obesity). Physical activity appears as a protective factor from weight gain with a direct association with nutritional status (BMI). It was found that young people in Portugal who had the highest indicators of physical activity were those who presented normal weight. The sedentary behaviors were presented as a factor conducive to the development of overweight being directly related to the BMI percentile. The most frequent sedentary behaviors were television viewing and computer/internet
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Fractional Calculus (FC) goes back to the beginning of the theory of differential calculus. Nevertheless, the application of FC just emerged in the last two decades, due to the progress in the area of chaos that revealed subtle relationships with the FC concepts. In the field of dynamical systems theory some work has been carried out but the proposed models and algorithms are still in a preliminary stage of establishment. Having these ideas in mind, the paper discusses a FC perspective in the study of the dynamics and control of some distributed parameter systems.
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A novel control technique is investigated in the adaptive control of a typical paradigm, an approximately and partially modeled cart plus double pendulum system. In contrast to the traditional approaches that try to build up ”complete” and ”permanent” system models it develops ”temporal” and ”partial” ones that are valid only in the actual dynamic environment of the system, that is only within some ”spatio-temporal vicinity” of the actual observations. This technique was investigated for various physical systems via ”preliminary” simulations integrating by the simplest 1st order finite element approach for the time domain. In 2004 INRIA issued its SCILAB 3.0 and its improved numerical simulation tool ”Scicos” making it possible to generate ”professional”, ”convenient”, and accurate simulations. The basic principles of the adaptive control, the typical tools available in Scicos, and others developed by the authors, as well as the improved simulation results and conclusions are presented in the contribution.
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This paper presents the most recent developments of the Simulator of Intelligent Transportation Systems (SITS). The SITS is based on a microscopic simulation approach to reproduce real traffic conditions in an urban or non-urban network. In order to analyse the quality of the microscopic traffic simulator SITS a benchmark test was performed. A dynamical analysis of several traffic phenomena, applying a new modelling formalism based on the embedding of statistics and Laplace transform, is then addressed. The paper presents also a new traffic control concept applied to a freeway traffic system.
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6th International Conference on Climbing and Walking Robots and the Support Technologies for Mobile Machines, Catania, Italy, 17-19 September
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The theory of fractional calculus goes back to the beginning of thr throry of differential calculus but its inherent complexity postponed the applications of the associated concepts. In the last decade the progress in the areas of chaos and fractals revealed subtle relationships with the fractional calculus leading to an increasing interest in the development of the new paradigm. In the area of automaticcontrol preliminary work has already been carried out but the proposed algorithms are restricted to the frequency domain. The paper discusses the design of fractional-order discrete-time controllers. The algorithms studied adopt the time domein, which makes them suited for z-transform analusis and discrete-time implementation. The performance of discrete-time fractional-order controllers with linear and non-linear systems is also investigated.
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Redundant manipulators have some advantages when compared with classical arms because they allow the trajectory optimization, both on the free space and on the presence of abstacles, and the resolution of singularities. For this type of manipulators, several kinetic algorithms adopt generalized inverse matrices. In this line of thought, the generalized inverse control scheme is tested through several experiments that reveal the difficulties that often arise. Motivated by theseproblems this paper presents a new method that ptimizes the manipulability through a least squre polynomialapproximation to determine the joints positions. Moreover, the article studies influence on the dynamics, when controlling redundant and hyper-redundant manipulators. The experiment confirm the superior performance of the proposed algorithm for redundant and hyper-redundant manipulators, revealing several fundamental properties of the chaotic phenomena, and gives a deeper insight towards the future development of superior trajectory control algorithms.
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Assessment of surgical performance is a must for every surgical practice nowadays and can be done by using scientific methods imported mostly from the Quality control tools that have been in use for long in industry. Surgical performance comprises several dimensions including clinical activity (mortality and morbidity as end points), academic activities, research and, more and more, efficiency. Stable long time results (efficacy), reducing error (safety) and meeting patient expectations (patient satisfaction) are among other performance components. This paper focus on the precise definitions of mortality and morbidity related to surgical activities and on the tools to evaluate patient complexity and assess pre operative risk. Some graphic representations are suggested to compare performance profiles of surgeons and to define individual performance profiles. Strong emphasis is put on pre operative risk assessment and its crucial role to interpret divergent surgical results. Where risk assessment is not possible or is unavailable, observed / expected ratios (O/E) for a given endpoint , be it mortality, length of stay or morbidity, must be established and routinely used to refer results and to identify performance outliers. Morbidity is being pointed out as a most valuable performance indicator in surgery because it is sensitive and comprises efficiency, safety and quality, at large.
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Tungiasis is a neglected parasitic skin disease caused by the permanent penetration of the female sand flea (also called jigger flea) Tunga penetrans into the skin of its host. After penetration, most commonly on the feet, the flea undergoes an impressing hypertrophy, and some days later the abdominal segments of the flea have enlarged up to the size of about 1 cm. The flea infestation is associated with poverty and occurs in many resource-poor communities in the Caribbean, South America and Africa. In this review, a historical overview on tungiasis is given. The natural history, pathology, epidemiology, diagnosis, therapy and control of the parasitic skin disease are discussed. It is concluded that tungiasis is an important parasitosis causing considerable morbidity in affected populations. Future studies are needed to increase the knowledge on the biology, pathophysiology, epidemiology, therapy and control of the ectoparasite.
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INTRODUCTION: Primary angioplasty is accepted as the preferred treatment for acute myocardial infarction in the first 12 hours. However, outcomes depend to a large extent on the volume of activity and experience of the center. Continuous monitoring of methods and results obtained is therefore crucial to quality control. OBJECTIVE: To describe the demographic, clinical and angiographic characteristics as well as in-hospital outcomes of patients undergoing primary PCI in a high-volume Portuguese center. We also aimed to identify variables associated with in-hospital mortality in this population. METHODS: This was a retrospective registry of consecutive primary PCIs performed at Santa Marta Hospital between January 2001 and August 2007. Demographic, clinical, and angiographic characteristics and in-hospital outcomes were analyzed. Independent predictors of in-hospital mortality were identified by multivariate logistic regression analysis. RESULTS: A total of 1157 patients were identified, mean age 61+/-12 years, 76% male. Mean pain-to-balloon time was 7.6 hours and primary angiographic success was 88%. Overall in-hospital mortality was 6.9%, or 5.5% if patients presenting in cardiogenic shock were excluded from the analysis. Previous history of heart failure, cardiogenic shock on admission, invasive ventilatory support, major hemorrhage, and age over 75 years were found to be associated with increased risk of in-hospital death. Conclusions: In this center primary PCI is effective and safe. Angiographic success rates and in-hospital mortality and morbidity are similar to other international registries. Patients at increased risk for adverse outcome can be identified by simple clinical characteristics such as advanced age, cardiogenic shock on admission, mechanical ventilation and major hemorrhage during hospitalization.
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This article aims to apply the concepts associated with artificial neural networks (ANN) in the control of an autonomous robot system that is intended to be used in competitions of robots. The robot was tested in several arbitrary paths in order to verify its effectiveness. The results show that the robot performed the tasks with success. Moreover, in the case of arbitrary paths the ANN control outperforms other methodologies, such as fuzzy logic control (FLC).
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In this paper we introduce a formation control loop that maximizes the performance of the cooperative perception of a tracked target by a team of mobile robots, while maintaining the team in formation, with a dynamically adjustable geometry which is a function of the quality of the target perception by the team. In the formation control loop, the controller module is a distributed non-linear model predictive controller and the estimator module fuses local estimates of the target state, obtained by a particle filter at each robot. The two modules and their integration are described in detail, including a real-time database associated to a wireless communication protocol that facilitates the exchange of state data while reducing collisions among team members. Simulation and real robot results for indoor and outdoor teams of different robots are presented. The results highlight how our method successfully enables a team of homogeneous robots to minimize the total uncertainty of the tracked target cooperative estimate while complying with performance criteria such as keeping a pre-set distance between the teammates and the target, avoiding collisions with teammates and/or surrounding obstacles.
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In the last 20 years, despite the known underestimation of cases, Brazil registered a marked increase in the incidence of visceral leishmaniasis. The main goal of this review is to reflect on some aspects of this zoonosis in Brazil and also to encourage the discussion in order to find more viable, effective and affordable strategies to be implemented by the Brazilian Leishmaniasis Control Program. The current situation of visceral leishmaniasis in Brazil might be seen as a paradox: the most important aspects of the disease are known, but so far the control of this disease has not yet been achieved. The current control strategies have not been able to prevent the geographical expansion, and even a rise in the incidence and lethality of visceral leishmaniasis. There is a need not only for a better definition of priority areas, but also for the implementation of a fieldwork monitoring system to the disease surveillance that could permit a further evaluation of the control program in areas where visceral leishmaniasis is endemic.
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The objective of the present study was to estimate the prevalence of soil-transmitted helminthiasis and evaluate the sanitary conditions and the role of a mass treatment campaign for control of these infections in Santa Isabel do Rio Negro. A cross-sectional survey was carried out in 2002, to obtain data related to the sanitary conditions of the population and fecal samples for parasitological examination in 308 individuals, followed by a mass treatment with albendazole or mebendazole with coverage of 83% of the city population in 2003. A new survey was carried out in 2004, involving 214 individuals, for comparison of the prevalences of intestinal parasitosis before and after the mass treatment. The prevalences of ascariasis, trichuriasis and hookworm infection were 48%; 27% and 21% respectively in 2002. There was a significant decrease for the frequency of infections by Ascaris lumbricoides (p < 0.05; OR / 95% CI = 0.44 / 0.30 - 0.65), Trichuris trichiura (p < 0.05; OR / 95% CI = 0.37 / 0.22 - 0.62), hookworm (p < 0.05; OR / 95% CI = 0.03 / 0.01 - 0.15) and helminth poliparasitism (p < 0.05; OR / 95% CI = 0.16 / 0.08 - 0.32). It was also noticed a decrease of prevalence of infection by Entamoeba histolytica / dispar (p < 0.05; OR / 95% CI = 0.30 / 0.19 - 0.49) and non-pathogenic amoebas. It was inferred that a mass treatment can contribute to the control of soil-transmitted helminthiasis as a practicable short-dated measure. However, governmental plans for public health, education and urban infrastructure are essential for the sustained reduction of prevalences of those infections.