820 resultados para Risk assessment Mathematical models


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Experiments of continuous alcoholic fermentation of sugarcane juice with flocculating yeast recycle were conducted in a system of two 0.22-L tower bioreactors in series, operated at a range of dilution rates (D (1) = D (2) = 0.27-0.95 h(-1)), constant recycle ratio (alpha = F (R) /F = 4.0) and a sugar concentration in the feed stream (S (0)) around 150 g/L. The data obtained in these experimental conditions were used to adjust the parameters of a mathematical model previously developed for the single-stage process. This model considers each of the tower bioreactors as a perfectly mixed continuous reactor and the kinetics of cell growth and product formation takes into account the limitation by substrate and the inhibition by ethanol and biomass, as well as the substrate consumption for cellular maintenance. The model predictions agreed satisfactorily with the measurements taken in both stages of the cascade. The major differences with respect to the kinetic parameters previously estimated for a single-stage system were observed for the maximum specific growth rate, for the inhibition constants of cell growth and for the specific rate of substrate consumption for cell maintenance. Mathematical models were validated and used to simulate alternative operating conditions as well as to analyze the performance of the two-stage process against that of the single-stage process.

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Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.

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An overall theoretical approach to model phenomena of interest for forensic entomology is advanced. Efforts are concentrated in identifying biological attributes at the individual, population and community of the arthropod fauna associated with decomposing human corpses and then incorporating these attributes into mathematical models. In particular in this paper a diffusion model of dispersal of post feeding larvae is described for blowflies, which are the most common insects associated with corpses.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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As the juvenile justice system has evolved, there has been a need for clinicians to make judgments about risk posed by adolescents who have committed sexual offenses. There are inherent difficulties in attempting to assess risk for violence among adolescents due to the developmental changes taking place and the absence of well-validated instruments to guide risk prediction judgments. With minority groups increasing in numbers in the U.S., it is likely that professionals will encounter minority individuals when conducting risk assessments. Overall questions regarding race/ethnicity have been neglected and there are few if any published research that explores risk factors with minority juvenile sex offenders. The present study examined whether differences exist between Caucasian and racial/ethnic minority adolescent sexual offenders on four risk assessment measures (J-SORRAT-II, J-SOAP-II, SAVRY, and ERASOR). The sample of 207 male adolescent sexual offenders was drawn from treatment facilities in a Midwestern state. Overall results indicated that minority adolescent sex offenders had fewer risk factors endorsed than Caucasian youth across all risk assessment tools. Exploration of interactions between race and factors such as: family status, exposure to family violence, and family history of criminality upon the assessment tools risk ratings yielded non-significant findings. Limitations, suggestions for future directions, and clinical implications are discussed.

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The Vancouver International Airport (YVR) is the second busiest airport in Canada. YVR is located on Sea Island in the Fraser River Estuary - a world-class wintering and staging area for hundreds of thousands of migratory birds. The Fraser Delta supports Canada’s largest wintering populations of waterfowl, shorebirds, and raptors. The large number of aircraft movements and the presence of many birds near YVR pose a wide range of considerable aviation safety hazards. Until the late 1980s when a full-time Wildlife Control Program (WCP) was initiated, YVR had the highest number of bird strikes of any Canadian commercial airport. Although the risks of bird strikes associated with the operation of YVR are generally well known by airport managers, and a number of risk assessments have been conducted associated with the Sea Island Conservation Area, no quantitative assessment of risks of bird strikes has been conducted for airport operations at YVR. Because the goal of all airports is to operate safely, an airport wildlife management program strives to reduce the risk of bird strikes. A risk assessment establishes the current risk of strikes, which can be used as a benchmark to focus wildlife control activities and to assess the effectiveness of the program in reducing bird strike risks. A quantitative risk assessment also documents the process and information used in assessing risk and allows the assessment to be repeated in the future in order to measure the change in risk over time in an objective and comparative manner. This study was undertaken to comply with new Canadian legislation expected to take effect in 2006 requiring airports in Canada to conduct a risk assessment and develop a wildlife management plan. Although YVR has had a management plan for many years, it took this opportunity to update the plan and conduct a risk assessment.

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OBJECTIVE: Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4) as well as the risk ovarian malignancy algorithm (ROMA) and risk malignancy index (RMI) values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system. METHODS: Patients who had been diagnosed with ovarian masses through imaging analyses (n = 128) were assessed for their expression of the tumor markers CA125 and HE4. The ROMA and RMI values were also determined. The sensitivity and specificity of each parameter were calculated using receiver operating characteristic curves according to the area under the curve (AUC) for each method. RESULTS: The sensitivities associated with the ability of CA125, HE4, ROMA, or RMI to distinguish between malignant versus benign ovarian masses were 70.4%, 79.6%, 74.1%, and 63%, respectively. Among carcinomas, the sensitivities of CA125, HE4, ROMA (pre-and post-menopausal), and RMI were 93.5%, 87.1%, 80%, 95.2%, and 87.1%, respectively. The most accurate numerical values were obtained with RMI, although the four parameters were shown to be statistically equivalent. CONCLUSION: There were no differences in accuracy between CA125, HE4, ROMA, and RMI for differentiating between types of ovarian masses. RMI had the lowest sensitivity but was the most numerically accurate method. HE4 demonstrated the best overall sensitivity for the evaluation of malignant ovarian tumors and the differential diagnosis of endometriosis. All of the parameters demonstrated increased sensitivity when tumors with low malignancy potential were considered low-risk, which may be used as an acceptable assessment method for referring patients to reference centers.

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The growth parameters (growth rate, mu and lag time, lambda) of three different strains each of Salmonella enterica and Listeria monocytogenes in minimally processed lettuce (MPL) and their changes as a function of temperature were modeled. MPL were packed under modified atmosphere (5% O-2, 15% CO2 and 80% N-2), stored at 7-30 degrees C and samples collected at different time intervals were enumerated for S. enterica and L monocytogenes. Growth curves and equations describing the relationship between mu and lambda as a function of temperature were constructed using the DMFit Excel add-in and through linear regression, respectively. The predicted growth parameters for the pathogens observed in this study were compared to ComBase, Pathogen modeling program (PMP) and data from the literature. High R-2 values (0.97 and 0.93) were observed for average growth curves of different strains of pathogens grown on MPL Secondary models of mu and lambda for both pathogens followed a linear trend with high R2 values (>0.90). Root mean square error (RMSE) showed that the models obtained are accurate and suitable for modeling the growth of S. enterica and L monocytogenes in MP lettuce. The current study provides growth models for these foodborne pathogens that can be used in microbial risk assessment. (C) 2011 Elsevier Ltd. All rights reserved.

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The main goal of this article is to consider influence assessment in models with error-prone observations and variances of the measurement errors changing across observations. The techniques enable to identify potential influential elements and also to quantify the effects of perturbations in these elements on some results of interest. The approach is illustrated with data from the WHO MONICA Project on cardiovascular disease.

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OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 107 took part in this study. Their age was 77.9 +/- 6.4 years, and 62 were female. They were divided into two groups: a) no history of falls in the previous year and b) a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%). Among them, 27 (49.1%) presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that self-reported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

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Objective: To validate the 2000 Bernstein Parsonnet (2000BP) and additive EuroSCORE (ES) to predict mortality in patients who underwent coronary bypass surgery and/or heart valve surgery at the Heart Institute, University of Sao Paulo (InCor/HC-FMUSP). Methods:A prospective observational design. We analyzed 3000 consecutive patients who underwent coronary bypass surgery and/or heart valve surgery, between May 2007 and July 2009 at the InCor/HC-FMUSP. Mortality was calculated with the 2000BP and ES models. The correlation between estimated mortality and observed mortality was validated by calibration and discrimination tests. Results: There were significant differences in the prevalence of risk factors between the study population, 2000BP and ES. Patients were stratified into five groups for 2000BP and three for the ES. In the validation of models, the ES showed good calibration (P = 0396), however, the 2000BP (P = 0.047) proved inadequate. In discrimination, the area under the ROC curve proved to be good for models, ES (0.79) and 2000BP (0.80). Conclusion: In the validation, 2000BP proved questionable and ES appropriate to predict mortality in patients who underwent coronary bypass surgery and/or heart valve surgery at the InCor/HC-FMUSP.

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This work presents major results from a novel dynamic model intended to deterministically represent the complex relation between HIV-1 and the human immune system. The novel structure of the model extends previous work by representing different host anatomic compartments under a more in-depth cellular and molecular immunological phenomenology. Recently identified mechanisms related to HIV-1 infection as well as other well known relevant mechanisms typically ignored in mathematical models of HIV-1 pathogenesis and immunology, such as cell-cell transmission, are also addressed. (C) 2011 Elsevier Ltd. All rights reserved.

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The availability and uptake of Cd by lettuce (Lactuca sativa L.) in two common tropical soils (before and after liming) were studied in order to derive human health-based risk soil concentration. Cadmium concentrations ranging from 1 to 12 mg kg(-1) were added to samples from a clayey Oxisol and a sandy-loam Ultisol under glasshouse conditions. After incubation, a soil sample was taken from each pot, the concentration of Cd in the soil was determined, lettuce was grown during 36 d, and the edible parts were harvested and analyzed for Cd. A positive linear correlation was observed between total soil Cd and the Cd concentration in lettuce. The amount of Cd absorbed by lettuce grown in the Ultisol was about twice the amount absorbed in the Oxisol. Liming increased the soil pH and slightly reduced Cd availability and uptake. CaCl2 extraction was better than DTPA to reflect differences in binding strength of Cd between limed and unlimed soils. Risk Cd concentrations in the Ultisol were lower than in the Oxisol, reflecting the greater degree of uptake from the Ultisol. The derived risk Cd values were dependent on soil type and the exposure scenario.

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Le ricerche di carattere eustatico, mareografico, climatico, archeologico e geocronologico, sviluppatesi soprattutto nell’ultimo ventennio, hanno messo in evidenza che gran parte delle piane costiere italiane risulta soggetta al rischio di allagamento per ingressione marina dovuta alla risalita relativa del livello medio del mare. Tale rischio è la conseguenza dell’interazione tra la presenza di elementi antropici e fenomeni di diversa natura, spesso difficilmente discriminabili e quantificabili, caratterizzati da magnitudo e velocità molto diverse tra loro. Tra le cause preponderanti che determinano l’ingressione marina possono essere individuati alcuni fenomeni naturali, climatici e geologici, i quali risultano fortemente influenzati dalle attività umane soprattutto a partire dal XX secolo. Tra questi si individuano: - la risalita del livello del mare, principalmente come conseguenza del superamento dell’ultimo acme glaciale e dello scioglimento delle grandi calotte continentali; - la subsidenza. Vaste porzioni delle piane costiere italiane risultano soggette a fenomeni di subsidenza. In certe zone questa assume proporzioni notevoli: per la fascia costiera emiliano-romagnola si registrano ratei compresi tra 1 e 3 cm/anno. Tale subsidenza è spesso il risultato della sovrapposizione tra fenomeni naturali (neotettonica, costipamento di sedimenti, ecc.) e fenomeni indotti dall’uomo (emungimenti delle falde idriche, sfruttamento di giacimenti metaniferi, escavazione di materiali per l’edilizia, ecc.); - terreni ad elevato contenuto organico: la presenza di depositi fortemente costipabili può causare la depressione del piano di campagna come conseguenza di abbassamenti del livello della falda superficiale (per drenaggi, opere di bonifica, emungimenti), dello sviluppo dei processi di ossidazione e decomposizione nei terreni stessi, del costipamento di questi sotto il proprio peso, della carenza di nuovi apporti solidi conseguente alla diminuita frequenza delle esondazioni dei corsi d’acqua; - morfologia: tra i fattori di rischio rientra l’assetto morfologico della piana e, in particolare il tipo di costa (lidi, spiagge, cordoni dunari in smantellamento, ecc. ), la presenza di aree depresse o comunque vicine al livello del mare (fino a 1-2 m s.l.m.), le caratteristiche dei fondali antistanti (batimetria, profilo trasversale, granulometria dei sedimenti, barre sommerse, assenza di barriere biologiche, ecc.); - stato della linea di costa in termini di processi erosivi dovuti ad attività umane (urbanizzazione del litorale, prelievo inerti, costruzione di barriere, ecc.) o alle dinamiche idro-sedimentarie naturali cui risulta soggetta (correnti litoranee, apporti di materiale, ecc. ). Scopo del presente studio è quello di valutare la probabilità di ingressione del mare nel tratto costiero emiliano-romagnolo del Lido delle Nazioni, la velocità di propagazione del fronte d’onda, facendo riferimento allo schema idraulico del crollo di una diga su letto asciutto (problema di Riemann) basato sul metodo delle caratteristiche, e di modellare la propagazione dell’inondazione nell’entroterra, conseguente all’innalzamento del medio mare . Per simulare tale processo è stato utilizzato il complesso codice di calcolo bidimensionale Mike 21. La fase iniziale di tale lavoro ha comportato la raccolta ed elaborazione mediante sistema Arcgis dei dati LIDAR ed idrografici multibeam , grazie ai quali si è provveduto a ricostruire la topo-batimetria di dettaglio della zona esaminata. Nel primo capitolo è stato sviluppato il problema del cambiamento climatico globale in atto e della conseguente variazione del livello marino che, secondo quanto riportato dall’IPCC nel rapporto del 2007, dovrebbe aumentare al 2100 mediamente tra i 28 ed i 43 cm. Nel secondo e terzo capitolo è stata effettuata un’analisi bibliografica delle metodologie per la modellazione della propagazione delle onde a fronte ripido con particolare attenzione ai fenomeni di breaching delle difese rigide ed ambientali. Sono state studiate le fenomenologie che possono inficiare la stabilità dei rilevati arginali, realizzati sia in corrispondenza dei corsi d’acqua, sia in corrispondenza del mare, a discapito della protezione idraulica del territorio ovvero dell’incolumità fisica dell’uomo e dei territori in cui esso vive e produce. In un rilevato arginale, quale che sia la causa innescante la formazione di breccia, la generazione di un’onda di piena conseguente la rottura è sempre determinata da un’azione erosiva (seepage o overtopping) esercitata dall’acqua sui materiali sciolti costituenti il corpo del rilevato. Perciò gran parte dello studio in materia di brecce arginali è incentrato sulla ricostruzione di siffatti eventi di rottura. Nel quarto capitolo è stata calcolata la probabilità, in 5 anni, di avere un allagamento nella zona di interesse e la velocità di propagazione del fronte d’onda. Inoltre è stata effettuata un’analisi delle condizioni meteo marine attuali (clima ondoso, livelli del mare e correnti) al largo della costa emiliano-romagnola, le cui problematiche e linee di intervento per la difesa sono descritte nel quinto capitolo, con particolare riferimento alla costa ferrarese, oggetto negli ultimi anni di continui interventi antropici. Introdotto il sistema Gis e le sue caratteristiche, si è passati a descrivere le varie fasi che hanno permesso di avere in output il file delle coordinate x, y, z dei punti significativi della costa, indispensabili al fine della simulazione Mike 21, le cui proprietà sono sviluppate nel sesto capitolo.