936 resultados para mean and variance ratio


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Objectives To examine the associations between economic and noneconomic factors and psychological distressin a group of 748 unemployed adults during economic recession. Methods Data were collected through a questionnaire. Bivariate and logistic regression analyses were used to test the associations between distress and the deprivation of income and latent benefits of employment (time structure, activity, status, collective purpose and social contact). Results The participants’ mean of distress was higher than the national population mean, and 46.5% of the participants scored above that. All economic and noneconomic factors emerged as strong predictors of distress; particularly financial deprivation (OR 1.06; CI 95 % 1.04–1.09) and lack of structured time (OR 1.07; CI 95 % 1.05–1.09). Women (OR 1.40; CI 95 % 1.04–1.86) and people with lower education levels (OR 0.45; CI 95 % 0.34–0.61) were more affected. Conclusions The unemployed individuals score high on distress, especially those facing financial strain and lack of structured time, and women and individuals with lower education in particular. Given the recessionary context and high unemployment rates, these insights raise awareness for policies and actions targeting the needs of unemployed people.

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The bubble crab Dotilla fenestrata forms very dense populations on the sand flats of the eastern coast of Inhaca Island, Mozambique, making it an interesting biological model to examine spatial distribution patterns and test the relative efficiency of common sampling methods. Due to its apparent ecological importance within the sandy intertidal community, understanding the factors ruling the dynamics of Dotilla populations is also a key issue. In this study, different techniques of estimating crab density are described, and the trends of spatial distribution of the different population categories are shown. The studied populations are arranged in discrete patches located at the well-drained crests of nearly parallel mega sand ripples. For a given sample size, there was an obvious gain in precision by using a stratified random sampling technique, considering discrete patches as strata, compared to the simple random design. Density average and variance differed considerably among patches since juveniles and ovigerous females were found clumped, with higher densities at the lower and upper shore levels, respectively. Burrow counting was found to be an adequate method for large-scale sampling, although consistently underestimating actual crab density by nearly half. Regression analyses suggested that crabs smaller than 2.9 mm carapace width tend to be undetected in visual burrow counts. A visual survey of sampling plots over several patches of a large Dotilla population showed that crab density varied in an interesting oscillating pattern, apparently following the topography of the sand flat. Patches extending to the lower shore contained higher densities than those mostly covering the higher shore. Within-patch density variability also pointed to the same trend, but the density increment towards the lowest shore level varied greatly among the patches compared.

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Statistical approaches to study extreme events require, by definition, long time series of data. In many scientific disciplines, these series are often subject to variations at different temporal scales that affect the frequency and intensity of their extremes. Therefore, the assumption of stationarity is violated and alternative methods to conventional stationary extreme value analysis (EVA) must be adopted. Using the example of environmental variables subject to climate change, in this study we introduce the transformed-stationary (TS) methodology for non-stationary EVA. This approach consists of (i) transforming a non-stationary time series into a stationary one, to which the stationary EVA theory can be applied, and (ii) reverse transforming the result into a non-stationary extreme value distribution. As a transformation, we propose and discuss a simple time-varying normalization of the signal and show that it enables a comprehensive formulation of non-stationary generalized extreme value (GEV) and generalized Pareto distribution (GPD) models with a constant shape parameter. A validation of the methodology is carried out on time series of significant wave height, residual water level, and river discharge, which show varying degrees of long-term and seasonal variability. The results from the proposed approach are comparable with the results from (a) a stationary EVA on quasi-stationary slices of non-stationary series and (b) the established method for non-stationary EVA. However, the proposed technique comes with advantages in both cases. For example, in contrast to (a), the proposed technique uses the whole time horizon of the series for the estimation of the extremes, allowing for a more accurate estimation of large return levels. Furthermore, with respect to (b), it decouples the detection of non-stationary patterns from the fitting of the extreme value distribution. As a result, the steps of the analysis are simplified and intermediate diagnostics are possible. In particular, the transformation can be carried out by means of simple statistical techniques such as low-pass filters based on the running mean and the standard deviation, and the fitting procedure is a stationary one with a few degrees of freedom and is easy to implement and control. An open-source MAT-LAB toolbox has been developed to cover this methodology, which is available at https://github.com/menta78/tsEva/(Mentaschi et al., 2016).

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The use of virtual social networks (VSNs) has been prevalent among consumers worldwide. Numerous studies have investigated various aspects of VSNs. However, these studies have mainly focused on students and young adults as they were early adopters of these innovative networks. A search of the literature revealed there has been a paucity of research on adult consumers’ use of VSNs. This research study addressed this gap in the literature by examining the determinants of engagement in VSNs among adult consumers in Singapore. The objectives of this study are to empirically investigate the determinants of engagement in VSNs and to offer theoretical insights into consumers’ preference and usage of VSNs. This study tapped upon several theories developed in the discipline of technology and innovation adoption. These were Roger’s Diffusion of Innovation, Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB), Technology Acceptance Model (TAM), Conceptual Framework of Individual Innovation Adoption by Frambach and Schillewaert (2002), Enhanced Model of Innovation Adoption by Talukder (2011), Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) and the Information Systems (IS) Success Model. The proposed research model, named the Media Usage Model (MUM), is a framework rooted in innovation diffusion and IS theories. The MUM distilled the essence of these established models and thus provides an updated, lucid explanation of engagement in VSNs. A cross-sectional, online social survey was conducted to collect quantitative data to examine the validity of the proposed research model. Multivariate data analysis was carried out on a data set comprising 806 usable responses by utilizing SPSS, and for structural equation modeling AMOS and SmartPLS. The results indicate that consumer attitude towards VSNs is significantly and positively influenced by: three individual factors – hedonic motivation, incentives and experience; two system characteristics – system quality and information quality; and one social factor – social bonding. Consumer demographics were found to influence people’s attitudes towards VSNs. In addition, consumer experience and attitude towards VSNs significantly and positively influence their usage of VSNs. The empirical data supported the proposed research model, explaining 80% of variance in attitude towards VSNs and 45% of variance in usage of VSNs. Therefore, the MUM achieves a definite contribution to theoretical knowledge of consumer engagement in VSNs by deepening and broadening our appreciation of the intricacies related to use of VSNs in Singapore. This study’s findings have implications for customer service management, services marketing and consumer behavior. These findings also have strategic implications for maximizing efficient utilization and effective management of VSNs by businesses and operators. The contributions of this research are: firstly, shifting the boundaries of technology or innovation adoption theories from research on employees to consumers as well as the boundaries of Internet usage or adoption research from students to adults, which is also known as empirical generalization; secondly, highlighting the issues associated with lack of significance of social factors in adoption research; and thirdly, augmenting information systems research by integrating important antecedents for success in information systems.

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Background: Passive smokers are involuntarily exposed to cigarette or tobacco smoke and as known, inhalation of environmental tobacco smoke is a serious threat. There is little information about the effect of passive smoking on salivary markers and periodontal indices. Objectives: This study investigated the effect of passive smoking on lactoferrin and AST in 12 - 15 years old children and adolescents. Patients and Methods: This case-control analytic correlation type study with no-convenience random sampling method was performed on 160 children aged 12 - 15 who had smokers in their families. The eligible children were divided into two equal groups; 80 cot+ children as case group and 80 cot– children as control group, matched according to age, sex and plaque index. Plaque index was obtained from all subjects. 2 cc unstimulated salivary samples were collected by spitting method. The collected specimens were tested by lactoferrin and AST kits in biochemistry were measured on the day of sampling laboratory. Gingival index Loe and Silness (GI) and Probing Pocket Depth (PPD). Results: Mean and Standard Deviation of PPD and GI was 2.01 ± 0.077 and 1.53 ± 0.055 in experimental group and 1.93 ± 0.073 and 1.49 ± 0.046 in control group respectively (P < 0.001). The Mean and Standard Deviation parameters of lactoferrin and AST, in the experimental group was 38.66 ± 25.15 and 13.45 ± 6.33 and in the control group 10.18 ± 6.82 and 6.53 ± 2.65 group, respectively (P < 0.001). Conclusions: Passive smoking can be effective on inflammatory process of periodontal and salivary biomarkers related to inflammation. Lactoferrin was 11 - 104 in case group and 0.5 - 38 in control group. Aspartat aminotransferase in case group was 2.64 - 30.43 and in control group it was 2.16 - 12.02.

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The purpose of this investigation was to evaluate body image dissatisfaction in relation to low self-esteem due to physical appearance in students of the Faculty of Medicine at the University of Los Andes in Mérida, Venezuela.  It was a non-experimental and correlational study.  The sample included 189 students (27% male and 73% female) with an average age of 19.58 ± 1.57 (men: 19.81 years of age ± 1.74 and women: 20.24 years of age ± 1.76).  Participants were intentionally selected from first-year courses of the Medicine, Nursing and Nutrition programs.  The Body Shape Questionnaire (BSQ) (Cooper and Taylor, 1987) was the instrument used to measure body image dissatisfaction and Graffar’s modified method (Méndez and De Méndez, 1994) was applied to determine the participants’ socioeconomic status.  A descriptive analysis (frequency, percentages, mean) and an inferential analysis (one-way ANOVA) were applied to the data using SPSS (Statistical Package for Social Sciences) version 9.0.  One of the most important findings in this study was the determination of a statistically significant relationship between dissatisfaction and body image and between low self-esteem and gender χ2 (2, N= 189) = 9.686, p=0.008.  Using ANOVA also helped determine that differences in the mean for dissatisfaction and low self-esteem levels with body image and gender are statistically significant, F= 11.236; p=0.008, F=10.23; p=0.002, respectively.  Conclusions: results obtained suggest a relationship between dissatisfaction and low self-esteem due to physical appearance. Consequently, subjects reject their body image because of a distorted or undistorted perception of their physical appearance, which can possibly affect self-esteem.  Moreover, it is observed that the students’ psychological health is more related to their satisfaction with their body-image than to the way their body image is perceived. Consequently, this group of participants must be analyzed regarding their self-esteem due to body image, as an expression in the institutional environment.  It is also important to emphasize that gender may be a risk factor concerning eating disorders.  We believe the foregoing because women showed higher dissatisfaction levels because of their physical appearance being conditioned by a higher dissatisfaction with their perceived body image, which is characterized by an overestimation of the physical dimension of their body image.

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Current procedures for flood risk estimation assume flood distributions are stationary over time, meaning annual maximum flood (AMF) series are not affected by climatic variation, land use/land cover (LULC) change, or management practices. Thus, changes in LULC and climate are generally not accounted for in policy and design related to flood risk/control, and historical flood events are deemed representative of future flood risk. These assumptions need to be re-evaluated, however, as climate change and anthropogenic activities have been observed to have large impacts on flood risk in many areas. In particular, understanding the effects of LULC change is essential to the study and understanding of global environmental change and the consequent hydrologic responses. The research presented herein provides possible causation for observed nonstationarity in AMF series with respect to changes in LULC, as well as a means to assess the degree to which future LULC change will impact flood risk. Four watersheds in the Midwest, Northeastern, and Central United States were studied to determine flood risk associated with historical and future projected LULC change. Historical single framed aerial images dating back to the mid-1950s were used along with Geographic Information Systems (GIS) and remote sensing models (SPRING and ERDAS) to create historical land use maps. The Forecasting Scenarios of Future Land Use Change (FORE-SCE) model was applied to generate future LULC maps annually from 2006 to 2100 for the conterminous U.S. based on the four IPCC-SRES future emission scenario conditions. These land use maps were input into previously calibrated Soil and Water Assessment Tool (SWAT) models for two case study watersheds. In order to isolate effects of LULC change, the only variable parameter was the Runoff Curve Number associated with the land use layer. All simulations were run with daily climate data from 1978-1999, consistent with the 'base' model which employed the 1992 NLCD to represent 'current' conditions. Output daily maximum flows were converted to instantaneous AMF series and were subsequently modeled using a Log-Pearson Type 3 (LP3) distribution to evaluate flood risk. Analysis of the progression of LULC change over the historic period and associated SWAT outputs revealed that AMF magnitudes tend to increase over time in response to increasing degrees of urbanization. This is consistent with positive trends in the AMF series identified in previous studies, although there are difficulties identifying correlations between LULC change and identified change points due to large time gaps in the generated historical LULC maps, mainly caused by unavailability of sufficient quality historic aerial imagery. Similarly, increases in the mean and median AMF magnitude were observed in response to future LULC change projections, with the tails of the distributions remaining reasonably constant. FORE-SCE scenario A2 was found to have the most dramatic impact on AMF series, consistent with more extreme projections of population growth, demands for growing energy sources, agricultural land, and urban expansion, while AMF outputs based on scenario B2 showed little changes for the future as the focus is on environmental conservation and regional solutions to environmental issues.

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Measurement and modeling techniques were developed to improve over-water gaseous air-water exchange measurements for persistent bioaccumulative and toxic chemicals (PBTs). Analytical methods were applied to atmospheric measurements of hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs). Additionally, the sampling and analytical methods are well suited to study semivolatile organic compounds (SOCs) in air with applications related to secondary organic aerosol formation, urban, and indoor air quality. A novel gas-phase cleanup method is described for use with thermal desorption methods for analysis of atmospheric SOCs using multicapillary denuders. The cleanup selectively removed hydrogen-bonding chemicals from samples, including much of the background matrix of oxidized organic compounds in ambient air, and thereby improved precision and method detection limits for nonpolar analytes. A model is presented that predicts gas collection efficiency and particle collection artifact for SOCs in multicapillary denuders using polydimethylsiloxane (PDMS) sorbent. An approach is presented to estimate the equilibrium PDMS-gas partition coefficient (Kpdms) from an Abraham solvation parameter model for any SOC. A high flow rate (300 L min-1) multicapillary denuder was designed for measurement of trace atmospheric SOCs. Overall method precision and detection limits were determined using field duplicates and compared to the conventional high-volume sampler method. The high-flow denuder is an alternative to high-volume or passive samplers when separation of gas and particle-associated SOCs upstream of a filter and short sample collection time are advantageous. A Lagrangian internal boundary layer transport exchange (IBLTE) Model is described. The model predicts the near-surface variation in several quantities with fetch in coastal, offshore flow: 1) modification in potential temperature and gas mixing ratio, 2) surface fluxes of sensible heat, water vapor, and trace gases using the NOAA COARE Bulk Algorithm and Gas Transfer Model, 3) vertical gradients in potential temperature and mixing ratio. The model was applied to interpret micrometeorological measurements of air-water exchange flux of HCB and several PCB congeners in Lake Superior. The IBLTE Model can be applied to any scalar, including water vapor, carbon dioxide, dimethyl sulfide, and other scalar quantities of interest with respect to hydrology, climate, and ecosystem science.

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To determine whether the heart rate (HR) response to exercise in 21 highly trained cyclists (mean (SD) age 25 (3) years) was related to their heart dimensions. Methods—Before performing an incremental exercise test involving a ramp protocol with workload increases of 25 W/min, each subject underwent echocardiographic evaluation of the following variables: left ventricular end diastolic internal diameter (LVIDd), left ventricular posterior wall thickness at end diastole (LVPWTd), interventricular septal wall thickness at end diastole (IVSTd), left ventricular mass index (LVMI), left atrial dimension (LAD), longitudinal left atrial (LLAD) and right atrial (LRAD) dimensions, and the ratio of early to late (E/A) diastolic flow velocity. Results—The HR response showed a de- flection point (HRd) at about 85% V~ O2MAX in 66.7% of subjects (D group; n = 14) and was linear in 33.3% (NoD group; n = 7). Several echocardiographic variables (LVMI, LAD, LLAD, LRAD) indicative of heart dimensions were similar in each group. However, mean LPWTd (p<0.01) and IVSTd (p<0.05) values were signifi- cantly higher in the D group. Finally, no significant diVerence between groups was found with respect to the E/A. The HR response is curvilinear during incremental exercise in a considerable number of highly trained endurance athletes—that is, top level cyclists. The departure of HR increase from linearity may predominantly occur in athletes with thicker heart walls.

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Introducción: Los trastornos musculoesqueléticos de origen laboral son la primera causa de baja en los trabajadores produciendo disminución de la capacidad productiva y reducción del salario y para las empresas suponen disfunciones de la actividad y pérdidas económicas. Objetivo: Identificar la prevalencia de síntomas musculoesqueléticos del personal tanto operativo como administrativo que laboran en la central eléctrica en Norte de Santander. Metodología: Estudio de corte transversal en una población de 184 trabajadores que laboran para la sección de gestión y control de pérdidas de energía en la Central eléctrica de Norte de Santander. Se utilizó como instrumento para la recolección de información el cuestionario Nórdico de Kuorinka en su versión en español, que permite realizar la detección y análisis de síntomas musculoesqueléticos de la población expuesta, el cual consta de dos partes, la primera que incluye datos socio demográficos tales como antecedentes personales y actividad laboral y la segunda que permite registrar síntomas músculo-esqueléticos en los segmentos corporales (cuello, hombros, codos, muñecas/manos, espalda superior, espalda inferior). El análisis descriptivo incluyó el cálculo de la media y los porcentajes y para estimar asociaciones se utilizó odds ratio (OR) Resultados: El 88% de los trabajadores eran hombres, con una media de edad de 36,1(±10,5) años. El 20,7% percibía molestias en el cuello y el 17,4 % en las muñecas. Tuvieron más riesgo de percibir molestias en la región del cuello las mujeres (OR 20,54), los trabajadores que pertenecen al sector administrativo (OR 15,9), los que no realizar actividad física (OR 2,33), los que tienen menos de 1 año en el cargo (OR 2,9) y los que tenían un Índice de masa corporal mayor de 25 (OR 1,31). Conclusiones: Ser mujer y trabajar en el sector administrativo influyen en la percepción de molestias y síntomas osteomusculares con mayor prevalencia en las zonas corporales de el cuello y las muñecas o manos. De acuerdo a lo encontrado en el estudio se sugiere la realización de actividades en salud laboral que prevengan el riesgo ergonómico.

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Introducción La ventilación mecánica es fundamental en el manejo de la falla respiratoria aguda, actualmente no existe consenso sobre el momento exacto de extubación. Este estudio describe el comportamiento de la escala OMAHA+ en nuestra institución. Objetivo Principal Describir los desenlaces clínicos relacionados con la escala OMAHA+ durante la extubación de los pacientes de las unidades de cuidado intensivo del hospital universitario. Métodos Estudio descriptivo, retrospectivo, basado en el registro de la escala OMAHA+ de 68 pacientes durante el proceso de extubación en las Unidades de cuidado intensivo adulto de la Fundación Santa Fe de Bogotá durante Agosto de 2014 a Mayo de 2015. Resultados Se encontraron valores gasométricos cercanos a la normalidad, con una PaO2/FiO2 media de 261 (DS 60,6), SaO2 media de 96% (DS 2%), media de lactato sérico de 1.5 mmol/L (DS 1,2 mmol/L), con signos vitales normales. La causa más común de ingreso a UCI fue Neumonía, seguida por cirugía cardiaca y abdominal. Las medias de parámetros ventilatorios al momento de extubación fueron; PEEP de 6 (DS 0,8), volumen corriente de 8ml/Kg (DS 1,4 ml/Kg), índice de Tobín de 34 (DS 11,9), test de fuga positivo 94%, y sólo una extubación fallida. Conclusiones La escala OMAHA+ puede ser una herramienta útil, aplicable y fácilmente reproducible en los pacientes con soporte ventilatorio mecánico invasivo previo al proceso de extubación, con baja proporción de fallo. Estos resultados deben ser evaluados en estudios prospectivos.

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OBJECTIVES: The aims of this study were to establish a Colombian smoothed centile charts and LMS tables for tríceps, subscapular and sum tríceps+subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic analysis based in a populationbased sample of schoolchildren in Bogota, Colombia and to compare them with international studies. METHODS: A total of 9 618 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9–17.9 years). Height, weight, body mass index (BMI), waist circumference, triceps and subscapular skinfold measurements were obtained using standardized methods. We have calculated tríceps+subscapular skinfold (T+SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived by the LMS method. Receiver operating characteristics curve (ROC) analyses were used to evaluate the optimal cut-off point of tríceps, subscapular and sum tríceps+subscapular skinfolds for overweight and obesity based on the International Obesity Task Force (IOTF) definitions. Data were compared with international studies. RESULTS: Subscapular, triceps skinfolds and T+SS were significantly higher in girls than in boys (P <0.001). The median values for triceps, subscapular as well as T+SS skinfold thickness increased in a sex-specific pattern with age. The ROC analysis showed that subscapular, triceps skinfolds and T+SS have a high discrimination power in the identification of overweight and obesity in the sample population in this study. Based on the raw non-adjusted data, we found that Colombian boys and girls had high triceps and subscapular skinfolds values than their counterparts from Spain, UK, German and US. CONCLUSIONS: Our results provide sex- and age-specific normative reference standards for the triceps and subscapular skinfold thickness values in a large, population-based sample of 3 schoolchildren and adolescents from an Latin-American population. By providing LMS tables for Latin-American people based on Colombian reference data, we hope to provide quantitative tools for the study of obesity and its complications.

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Remote sensing is a promising approach for above ground biomass estimation, as forest parameters can be obtained indirectly. The analysis in space and time is quite straight forward due to the flexibility of the method to determine forest crown parameters with remote sensing. It can be used to evaluate and monitoring for example the development of a forest area in time and the impact of disturbances, such as silvicultural practices or deforestation. The vegetation indices, which condense data in a quantitative numeric manner, have been used to estimate several forest parameters, such as the volume, basal area and above ground biomass. The objective of this study was the development of allometric functions to estimate above ground biomass using vegetation indices as independent variables. The vegetation indices used were the Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), Simple Ratio (SR) and Soil-Adjusted Vegetation Index (SAVI). QuickBird satellite data, with 0.70 m of spatial resolution, was orthorectified, geometrically and atmospheric corrected, and the digital number were converted to top of atmosphere reflectance (ToA). Forest inventory data and published allometric functions at tree level were used to estimate above ground biomass per plot. Linear functions were fitted for the monospecies and multispecies stands of two evergreen oaks (Quercus suber and Quercus rotundifolia) in multiple use systems, montados. The allometric above ground biomass functions were fitted considering the mean and the median of each vegetation index per grid as independent variable. Species composition as a dummy variable was also considered as an independent variable. The linear functions with better performance are those with mean NDVI or mean SR as independent variable. Noteworthy is that the two better functions for monospecies cork oak stands have median NDVI or median SR as independent variable. When species composition dummy variables are included in the function (with stepwise regression) the best model has median NDVI as independent variable. The vegetation indices with the worse model performance were EVI and SAVI.

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The near infrared (NIR) spectroscopy presents itself as an interesting non-destructive test tool as it enables a fast, simple and reliable way for characterizing large samplings of biological materials in a short period of time. This work aimed to establish multivariate models to estimate the crystallinity indices and tensile and burst strength of cellulosic and nanocellulosic films through NIR spectroscopy. NIR spectra were recorded from the films before tensile and bursting strength, and crystallinity tests. Spectral information were correlated with reference values obtained by laboratory procedures through partial least square regression (PLS-R). The PLS-R model for estimating the crystallinity index presented a coefficient of determination in cross-validation (R2cv) of 0,94 and the ratio of performance to deviation (RPD) was 3,77. The mechanical properties of the films presented a high correlation with the NIR spectra: R2p = 0,85 (RPD = 2,23) for tensile and R2p = 0,93 (RPD = 3,40) for burst strength. The statistics associated to the models presented have shown that the NIR spectroscopy has the potential to estimate the crystallinity index and resistance properties of cellulose and nanocellulose films on in-line monitoring systems.

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Introduzione Nel 2014 è stato proposto un protocollo di studio riguardante la sorveglianza delle lesioni cistiche del pancreas (intese come IPMN) e denominato PACYFIC Study. Obiettivi Obiettivo primario era di stabilire l’impatto di un programma di sorveglianza in termini di pazienti arruolati e pazienti con indicazione chirurgica. Obiettivi secondari erano: 1) stabilire l’impatto dei fattori demografici, clinici, radiologici e della strategia di sorveglianza sull’indicazione chirurgica, sulla capacità individuare le lesioni maligne, sulla sopravvivenza. Materiali e Metodi Lo studio su cui si è basata la raccolta dei dati è uno studio di tipo prospettico, di coorte, multicentrico, internazionale. Lo studio ha incluso gli individui con una IPMN, di nuova o pregressa diagnosi, che giustifichi una sorveglianza o il trattamento chirurgico. I dati clinici, demografici, radiologici e chirurgici sono stati raccolti in un database prospettico. Le variabili discrete sono state espresse come frequenza e percentuale. Le continue come medie e deviazioni standard o mediane e range interquartile (IQR). Per l’analisi statistica sono stati utilizzati il test di Fischer, il test del Chi quadro, il test di Spearman, il test di Student. L’analisi multivariata è stata eseguita utilizzando la regressione logistica espressa come Odds Ratio e intervallo di confidenza al 95 %. Per la sopravvivenza è stato utilizzato il metodo di Kaplan-Meier. L’analisi multivariata sulle sopravvivenze è stata eseguita mediante la regressione di Cox. Risultati Il protocollo di sorveglianza ha permesso l'arruolamento di 516 pazienti. 53 pazienti hanno raggiunto l'indicazione chirurgica. La sopravvivenza globale della coorte è stata di 326.8± 9.1 mesi. I fattori predittivi la sopravvivenza sono risultati età (OR 1.07, P-value<0.001), sesso (OR 1.82, P-value=0.006), ittero, noduli murali (OR 4.84, P-value=0.018 e OR 2.19, P-value=0.016), chirurgia (OR 0.46, P-value 0.038). Conclusioni L'introduzione del protocollo di sorveglianza ha portato ad un aumento di identificazione di lesioni e ha avuto impatto sulla sopravvivenza