976 resultados para Multimorbidity coefficient
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Purpose: This exploratory research evaluates if there is a relationship between the number of years since an organization has achieved ISO 9001 certification and the highest level of recognition received by the same organization with the EFQM Business Excellence Model. Methodology/Approach: After state of the art review a detailed comparison between both models was made. Fifty two Portuguese organizations were considered and Correlation coefficient Spearman Rho was used to investigate the possible relationships. Findings: Conclusion is that there is indeed a moderate positive correlation between these two variables, the higher the number of years of ISO 9001 certification, the higher the results of the organization EFQM model evaluation and recognition. This supports the assumption that ISO 9001 International Standard by incorporating many of the principles present in the EFQM Business Excellence Model is consistent with this model and can be considered as a step towards that direction. Research Limitation/implication: Due to the dynamic nature of these models that might change over time and the possible time delays between implementation and results, more in-depth studies like experimental design or a longitudinal quasi-experimental design could be used to confirm the results of this investigation. Originality/Value of paper: This research gives additional insights on conjunct studies of both models. The use of external evaluation results carried out by the independent EFQM assessors minimizes the possible bias of previous studies accessing the value of ISO 9001 certification.
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Dissertation to Obtain the Degree of Master in Biomedical Engineering
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The determination of the rabies neutralizing antibody (VNA) response after immunization against rabies is an acceptable index of the efficacy of a vaccine and a successful treatment. Several tests have been developed in attempt to improve the assessment of VNA, from mice inoculation to cell-culture fluorescence inhibition tests. All of them, however, present special difficulties in terms of reading or accuracy. The present study describes a neutralization test performed in cell-culture appraised by flow cytometry (FC). Serial dilutions of the serum samples were mixed in vitro with rabies virus before the addition of BHK-21 cells. After 24h-incubation, cells were released by trypsin treatment, fixed and permeabilized with a p-formaldehyde solution and stained with a rabies virus nucleocapsid protein-specific antibody conjugate. The percentage of virus infection inhibition caused by specific antibodies present in the serum were evaluated in a Beckton & Dickinson FACSCalibur® flow cytometer. A correlation curve between the IU/ml content and the percentage of infective inhibition was built with a reference serum and the VNA titers of serum samples were obtained by extrapolation. Titers obtained by FC and standard test showed an effective pairing results (p < 0.01), with a correlation coefficient (r) = 0.7. These results permit to envisage the FC as a suitable technique to evaluate VNA in sera from immunized animals and likely in human serum samples. Nevertheless, new studies comparing FC to gold-standard techniques are required for determining the FC values of Sensibility and Specificity .
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Radio link quality estimation is essential for protocols and mechanisms such as routing, mobility management and localization, particularly for low-power wireless networks such as wireless sensor networks. Commodity Link Quality Estimators (LQEs), e.g. PRR, RNP, ETX, four-bit and RSSI, can only provide a partial characterization of links as they ignore several link properties such as channel quality and stability. In this paper, we propose F-LQE (Fuzzy Link Quality Estimator, a holistic metric that estimates link quality on the basis of four link quality properties—packet delivery, asymmetry, stability, and channel quality—that are expressed and combined using Fuzzy Logic. We demonstrate through an extensive experimental analysis that F-LQE is more reliable than existing estimators (e.g., PRR, WMEWMA, ETX, RNP, and four-bit) as it provides a finer grain link classification. It is also more stable as it has lower coefficient of variation of link estimates. Importantly, we evaluate the impact of F-LQE on the performance of tree routing, specifically the CTP (Collection Tree Protocol). For this purpose, we adapted F-LQE to build a new routing metric for CTP, which we dubbed as F-LQE/RM. Extensive experimental results obtained with state-of-the-art widely used test-beds show that F-LQE/RM improves significantly CTP routing performance over four-bit (the default LQE of CTP) and ETX (another popular LQE). F-LQE/RM improves the end-to-end packet delivery by up to 16%, reduces the number of packet retransmissions by up to 32%, reduces the Hop count by up to 4%, and improves the topology stability by up to 47%.
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The aim of this research was to evaluate the protein polymorphism degree among seventy-five C. albicans strains from healthy children oral cavities of five socioeconomic categories from eight schools (private and public) in Piracicaba city, São Paulo State, in order to identify C. albicans subspecies and their similarities in infantile population groups and to establish their possible dissemination route. Cell cultures were grown in YEPD medium, collected by centrifugation, and washed with cold saline solution. The whole-cell proteins were extracted by cell disruption, using glass beads and submitted to SDS-PAGE technique. After electrophoresis, the protein bands were stained with Coomassie-blue and analyzed by statistics package NTSYS-pc version 1.70 software. Similarity matrix and dendrogram were generated by using the Dice similarity coefficient and UPGMA algorithm, respectively, which made it possible to evaluate the similarity or intra-specific polymorphism degrees, based on whole-cell protein fingerprinting of C. albicans oral isolates. A total of 13 major phenons (clusters) were analyzed, according to their homogeneous (socioeconomic category and/or same school) and heterogeneous (distinct socioeconomic categories and/or schools) characteristics. Regarding to the social epidemiological aspect, the cluster composition showed higher similarities (0.788 < S D < 1.0) among C. albicans strains isolated from healthy children independent of their socioeconomic bases (high, medium, or low). Isolates of high similarity were not found in oral cavities from healthy children of social stratum A and D, B and D, or C and E. This may be explained by an absence of a dissemination route among these children. Geographically, some healthy children among identical and different schools (private and public) also are carriers of similar strains but such similarity was not found among other isolates from children from certain schools. These data may reflect a restricted dissemination route of these microorganisms in some groups of healthy scholars, which may be dependent of either socioeconomic categories or geographic site of each child. In contrast to the higher similarity, the lower similarity or higher polymorphism degree (0.499 < S D < 0.788) of protein profiles was shown in 23 (30.6%) C. albicans oral isolates. Considering the social epidemiological aspect, 42.1%, 41.7%, 26.6%, 23.5%, and 16.7% were isolates from children concerning to socioeconomic categories A, D, C, B, and E, respectively, and geographically, 63.6%, 50%, 33.3%, 33.3%, 30%, 25%, and 14.3% were isolates from children from schools LAE (Liceu Colégio Albert Einstein), MA (E.E.P.S.G. "Prof. Elias de Melo Ayres"), CS (E.E.P.G. "Prof. Carlos Sodero"), AV (Alphaville), HF (E.E.P.S.G. "Honorato Faustino), FMC (E.E.P.G. "Prof. Francisco Mariano da Costa"), and MEP (E.E.P.S.G. "Prof. Manasses Ephraim Pereira), respectively. Such results suggest a higher protein polymorphism degree among some strains isolated from healthy children independent of their socioeconomic strata or geographic sites. Complementary studies, involving healthy students and their families, teachers, servants, hygiene and nutritional habits must be done in order to establish the sources of such colonization patterns in population groups of healthy children. The whole-cell protein profile obtained by SDS-PAGE associated with computer-assisted numerical analysis may provide additional criteria for the taxonomic and epidemiological studies of C. albicans.
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Power law (PL) distributions have been largely reported in the modeling of distinct real phenomena and have been associated with fractal structures and self-similar systems. In this paper, we analyze real data that follows a PL and a double PL behavior and verify the relation between the PL coefficient and the capacity dimension of known fractals. It is to be proved a method that translates PLs coefficients into capacity dimension of fractals of any real data.
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OBJECTIVE: We set out to evaluate whether changes in N-terminal pro-brain natriuretic peptide (proBNP) can predict changes in functional capacity, as determined by cardiopulmonary exercise testing (CPET), in patients with chronic heart failure (CHF) due to dilated cardiomyopathy (DCM). METHODS: We studied 37 patients with CHF due to DCM, 81% non-ischemic, 28 male, who performed symptom-limited treadmill CPET, with the modified Bruce protocol, in two consecutive evaluations, with determination of proBNP after 10 minutes rest prior to CPET. The time between evaluations was 9.6+/-5.5 months, and age at first evaluation was 41.1+/-13.9 years (21 to 67). RESULTS IN THE FIRST AND SECOND EVALUATIONS RESPECTIVELY WERE: NYHA functional class >II 51% and 16% (p<0.001), sinus rhythm 89% and 86.5% (NS), left ventricular ejection fraction 24.9+/-8.9% and 26.6+/-8.6% (NS), creatinine 1.03+/-0.25 and 1.09+/-0.42 mg/dl (NS), taking ACE inhibitors or ARBs 94.5% and 100% (NS), beta-blockers 73% and 97.3% (p<0.001), and spironolactone 89% and 89% (NS). We analyzed the absolute and percentage variation (AV and PV) in peak oxygen uptake (pVO2--ml/kg/min) and proBNP (pg/ml) between the two evaluations. RESULTS: (1) pVO2 AV: -17.4 to 15.2 (1.9+/-5.7); pVO2 PV: -56.1 to 84% (11.0+/-25.2); proBNP AV: -12850 to 5983 (-778.4+/-3332.5); proBNP PV: -99.0 to 379.5% (-8.8+/-86.3); (2) The correlations obtained--r value and p value [r (p)]--are shown in the table below; (3) We considered that a coefficient of variation of pVO2 PV of >10% represented a significant change in functional capacity. On ROC curve analysis, a proBNP PV value of 28% showed 80% sensitivity and 79% specificity for pVO2 PV of >10% (AUC=0.876, p=0.01, 95% CI 0.75 to 0.99). CONCLUSIONS: In patients with CHF due to DCM, changes in proBNP values correlate with variations in pVO2, as assessed by CPET. However, our results suggest that only a proBNP PV of >28% predicts a significant change in functional capacity.
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Ten isolates of Paracoccidioides brasiliensis were examined for differences in virulence in outbred mice intravenously inoculated with the fungus, associated with mycelial morphology, and genetic patterns measured by random amplified polymorphic DNA (RAPD). Virulence was evaluated by viable yeast cell recovery from lungs and demonstration of histopathologic lesions in different organs. The results showed that the isolates presented four virulence degrees: high virulence, intermediate, low and non-virulence. RAPD clustered the isolates studied in two main groups with 56% of genetic similarity. Strains with low virulence, Pb265 or the non-virulent, Pb192, showed glabrous/cerebriform morphology and high genetic similarity (98.7%) when compared to the other isolates studied. The same was observed with Bt79 and Bt83 that shared 96% genetic similarity, cottony colonies and high virulence. The RAPD technique could only discriminate P. brasiliensis isolates according to glabrous/cerebriform or cottony colonies, and also high from low virulence strains. Isolates with intermediate virulence such as Pb18, Pb18B6, Bt32 and Bt56 showed variability in their similarity coefficient suggesting that RAPD was able to detect genetic variability in this fungal specie. Virulence profile of P. brasiliensis demonstrated that both mycelial morphologic extreme phenotypes may be associated with fungal virulence and their in vitro subculture time. Thus, RAPD technique analysis employed in association with virulence, morphologic and immunologic aspects might prove adequate to detect differences between P. brasiliensis isolates.
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Random amplified polymorphic DNA (RAPD) technique is a simple and reliable method to detect DNA polymorphism. Several factors can affect the amplification profiles, thereby causing false bands and non-reproducibility of assay. In this study, we analyzed the effect of changing the concentration of primer, magnesium chloride, template DNA and Taq DNA polymerase with the objective of determining their optimum concentration for the standardization of RAPD technique for genetic studies of Cuban Triatominae. Reproducible amplification patterns were obtained using 5 pmoL of primer, 2.5 mM of MgCl2, 25 ng of template DNA and 2 U of Taq DNA polymerase in 25 µL of the reaction. A panel of five random primers was used to evaluate the genetic variability of T. flavida. Three of these (OPA-1, OPA-2 and OPA-4) generated reproducible and distinguishable fingerprinting patterns of Triatominae. Numerical analysis of 52 RAPD amplified bands generated for all five primers was carried out with unweighted pair group method analysis (UPGMA). Jaccard's Similarity Coefficient data were used to construct a dendrogram. Two groups could be distinguished by RAPD data and these groups coincided with geographic origin, i.e. the populations captured in areas from east and west of Guanahacabibes, Pinar del Río. T. flavida present low interpopulation variability that could result in greater susceptibility to pesticides in control programs. The RAPD protocol and the selected primers are useful for molecular characterization of Cuban Triatominae.
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A dissertação foi realizada em ambiente industrial, mais precisamente na empresa Monteiro, Ribas – Embalagens Flexíveis, S.A.. Esta empresa dedica-se à impressão e laminagem de filmes, assim como à confeção de sacos. Os seus produtos são direcionados na sua maioria para a indústria alimentar, exportando mais de 50% da sua produção, e dizem respeito a complexos (dois ou mais filmes unidos pela presença de um adesivo) que podem possuir impressão ou não. Estes complexos podem ser enviados para o cliente em bobina ou já em saco. Os objetivos propostos pela empresa diziam respeito a estudos relacionados com a força de laminagem dos complexos, com o coeficiente de atrito dos mesmos e com a identificação dos espetros dos componentes dos adesivos, assim como o estudo do processo de reticulação dos mesmos por espetrofotometria de Infravermelho. Relativamente aos resultados obtidos verificou-se que tanto a tinta como os metalizados influenciam negativamente a força de laminagem. Por sua vez o coeficiente de atrito é afetado por vários fatores. Através dos ensaios experimentais verificou-se que o adesivo, a tinta e o verniz mate favorecem o aumento do valor do COF. Além disso, nos complexos em que se utilizaram filmes de polietileno de maior espessura obtiveram-se valores de COF mais baixos, e no que diz respeito à temperatura e à tensão de enrolamento, verificou-se que valores mais elevados e muito baixos da primeira traduzem-se num aumento do valor do COF e uma tensão de enrolamento maior também tem o mesmo efeito. Relativamente ao tipo de filme impresso, substratos com maior energia superficial atraem mais o agente de deslizamento (slip). Por último, não se conseguiu perceber qual o tipo de adesivo (com ou sem solvente) que tem maior impacto no COF uma vez que em 55% dos casos o valor do COF é superior nas amostras que foram complexadas com adesivo sem solvente e em 45% o COF era superior nas amostras complexadas com adesivo base solvente. No que diz respeito aos espetros obtidos verificou-se que a reticulação dos adesivos é identificada pela diminuição da extensão do pico correspondente à ligação N=C=O.
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The therapeutic approach to severe pulmonary arterial hypertension (PAH), whether primary or secondary to connective tissue disorders, thromboembolic phenomena or congenital heart disease with Eisenmenger syndrome, has evolved in recent years following the introduction of selective pulmonary vasodilators, including prostacyclin analogs and endothelin receptor antagonists. AIM: To correlate three different endpoints (6-minute walk test, Tei index and peak tricuspid regurgitation velocity by Doppler echocardiographic study) during follow-up of PAH patients under selective vasodilator therapy. METHODS: Eleven patients (9 female, age 42 +/- 18 years) with severe PAH (> or = 65 mmHg), 64% with Eisenmenger syndrome, in NYHA class > or = II, were assessed during a follow-up of 11 +/- 8 months. Eight patients were already under therapy with iloprost or bosentan. RESULTS: There was no correlation between the three endpoints before and after therapy as assessed by Pearson's correlation coefficient. There was, however, an improvement in all of them after selective vasodilatory therapy. CONCLUSION: Therapeutic response can be accurately measured by the traditional endpoint (6-minute walk test) or by echocardiographic endpoints. However, the lack of correlation between them excludes their use as alternatives in patient follow-up.
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Sorption is commonly agreed to be the major process underlying the transport and fate of polycyclic aromatic hydrocarbons (PAHs) in soils. However, there is still a scarcity of studies focusing on spatial variability at the field scale in particular. In order to investigate the variation in the field of phenanthrene sorption, bulk topsoil samples were taken in a 15 × 15-m grid from the plough layer in two sandy loam fields with different texture and organic carbon (OC) contents (140 samples in total). Batch experiments were performed using the adsorption method. Values for the partition coefficient K d (L kg−1) and the organic carbon partition coefficient K OC (L kg−1) agreed with the most frequently used models for PAH partitioning, as OC revealed a higher affinity for sorption. More complex models using different OC compartments, such as non-complexed organic carbon (NCOC) and complexed organic carbon (COC) separately, performed better than single K OC models, particularly for a subset including samples with Dexter n < 10 and OC <0.04 kg kg−1. The selected threshold revealed that K OC-based models proved to be applicable for more organic fields, while two-component models proved to be more accurate for the prediction of K d and retardation factor (R) for less organic soils. Moreover, OC did not fully reflect the changes in phenanthrene retardation in the field with lower OC content (Faardrup). Bulk density and available water content influenced the phenanthrene transport mechanism phenomenon.
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Purpose: The studies on links between sustainability, innovation, and competitiveness have been mainly focused at organizational and business level. The purpose of this research is to investigate if there is a correlation between these three variables at country level. Using international well recognized rankings of countries sustainability, innovation, and competitiveness, correlation analysis was performed allowing for the conclusion that there are indeed high correlations (and possible relationships) between the three variables at country level. Design/methodology/approach: Sustainability, innovation, and competitiveness literature were reviewed identifying a lack of studies examining these three variables at country level. Three major well recognized indexes were used to support the quantitative research: The World Economic Forum (2013) Sustainability-adjusted global competitiveness index, the Global Innovation Index (2014) issued by Cornell University, INSEAD, and WIPO and the IMD World Competitiveness Yearbook (2014). After confirming the distributions normality, Pearson correlation analysis was made with results showing high linear correlations between the three indexes. Findings: The results of the correlation analysis using Pearson correlation coefficient (all correlation coefficients are greater than 0.73) give a strong support to the conclusion that there is indeed a high correlation (and a possible relationship) between social sustainability, innovation and competitiveness at country level. Research limitations/implications: Further research is advisable to better understand the factors that contribute to the presented results and to establish a global paradigm linking these three main constructs (social sustainability, innovation, and competitiveness). Some authors consider that these measurements are not fully supported (e.g. due to different countries standards), however, it is assumed these differing underlying methodological approaches, by being used in conjunction, can be considered as a set of reliable and useful performance indicators. Practical implications: The results highlight the simultaneous relationship between social sustainability, innovation and competitiveness superior performance and the need to take that these considerations into business and operating models. Social implications: This research suggests that sustainability and innovation policies, strategies and practices are relevant for countries competitiveness and should be promoted particularly in countries ranked low on sustainability and innovation global scoring indexes. Originality/value: This is one of the few studies addressing the relationships between sustainability, innovation and competitiveness at country level.
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The Western blot technique was used to demonstrate the presence of antibodies in the blood of dogs that presented canine visceral leishmaniasis. This technique was used against some specific molecules present in the lysate of the promastigote form of Leshmania chagasi.Through the association of the results of the Western blot technique with the morphological alterations seen as a result of the serum neutralization technique performed in McCoy cells (which mimetizes the macrophage) it was possible to observe the role of some molecules of great relevance in determining the disease in symptomatic dogs as well as that of some other molecules associated with asymptomatic infected dogs that may become transmitters as well as differentiating them as asymptomatic resistant dogs. In the sera analyses carried out during the immunobloting a variation of 9 to 27 immunoreacting bands was observed, which were then compared using Dice's similarity coefficient. In the dendrogram constructed on the basis of the coefficient, 50% similarity was observed among the total number of reagent bands with the promastigote lysate, thus creating five groups. The main difference observed related to the clinical condition of the dogs: symptomatic and asymptomatic dogs were found in separate groups. The asymptomatic group of dogs was distributed in two different places in the dendrogram because they presented two different behavior patterns regarding the cellular morphology in the serum neutralization reaction: the presence or absence of cellular lysis. According to this analysis it is possible to evaluate the immune status and associate it with specific markers observed in the reaction found in the Western blot strips.
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This study aims to compare two methods of assessing the postural phase of gait initiation as to intrasession reliability, in healthy and post-stroke subjects. As a secondary aim, this study aims to analyse anticipatory postural adjustments during gait initiation based on the centre of pressure (CoP) displacements in post-stroke participants. The CoP signal was acquired during gait initiation in fifteen post-stroke subjects and twenty-three healthy controls. Postural phase was identified through a baseline-based method and a maximal displacement based method. In both healthy and post-stroke participants higher intra-class correlation coefficient and lower coefficient of variation values were obtained with the baseline-based method when compared to the maximal displacement based method. Post-stroke participants presented decreased CoP displacement backward and toward the first swing limb compared to controls when the baseline-based method was used. With the maximal displacement based method, there were differences between groups only regarding backward CoP displacement. Postural phase duration in medial-lateral direction was also increased in post-stroke participants when using the maximal displacement based method. The findings obtained indicate that the baseline-based method is more reliable detecting the onset of gait initiation in both groups, while the maximal displacement based method presents greater sensitivity for post-stroke participants.