884 resultados para Inmaculada Concepción-Culto
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Background: Gene expression technologies have opened up new ways to diagnose and treat cancer and other diseases. Clustering algorithms are a useful approach with which to analyze genome expression data. They attempt to partition the genes into groups exhibiting similar patterns of variation in expression level. An important problem associated with gene classification is to discern whether the clustering process can find a relevant partition as well as the identification of new genes classes. There are two key aspects to classification: the estimation of the number of clusters, and the decision as to whether a new unit (gene, tumor sample ... ) belongs to one of these previously identified clusters or to a new group. Results: ICGE is a user-friendly R package which provides many functions related to this problem: identify the number of clusters using mixed variables, usually found by applied biomedical researchers; detect whether the data have a cluster structure; identify whether a new unit belongs to one of the pre-identified clusters or to a novel group, and classify new units into the corresponding cluster. The functions in the ICGE package are accompanied by help files and easy examples to facilitate its use. Conclusions: We demonstrate the utility of ICGE by analyzing simulated and real data sets. The results show that ICGE could be very useful to a broad research community.
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Plenário vota o direito adquirido, liberdade de expressão, liberdade de culto e racismo. Emenda para tirar o Direito Adquirido do texto constitucional é rejeitada. Foi aprovada a emenda que resguarda o sigilo da fonte, quando este sigilo for necessário ao exercício profissional. Foi aprovado também o parágrafo sexto, que trata da liberdade de culto. Foi também aprovada a emenda que diz que o racismo é crime inafiançável. Para parlamentares, os acordos além de acelerar a conclusão da Constituinte, vão possibilitar uma Carta que represente toda a sociedade brasileira. Os representantes dos partidos já buscam o acordo em torno do Capítulo 2, que é um dos mais polêmicos do projeto. Ele trata do direito de greve, jornada de trabalho, horas extras, organização sindical e estabilidade no emprego. A previsão é que haja entendimento em alguns pontos, outros devem ser definidos pelo voto, como a estabilidade no emprego.
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Saber se tortura e terrorismo são crimes iguais provoca a divisão de opinião dos parlamentares. A Comissão de Sistematização coloca apenas a tortura como crime inafiançável, imprescritível e sem direito à anistia. O substituto do Centrão inclui neste parágrafo também o terrorismo. Este parágrafo deve ser resolvido pelo voto. A emenda que define o racismo como crime inafiançável e sem direito de anistia foi aprovada por 518 e 3 contra. O livre exercício de crença deverá ser votado ainda hoje. Enquanto se discute o primeiro capítulo, os constituintes buscam o acordo no capítulo seguinte, que trata dos direitos sociais dos brasileiros.
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Background: Patients with chronic obstructive pulmonary disease (COPD) often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these important gaps in clinical care, we created the IRYSS-COPD Appropriateness Study. Methods/Design: The RAND/UCLA Appropriateness Methodology was used to identify appropriate and inappropriate scenarios for hospital admission for patients experiencing COPD exacerbations. These scenarios were then applied to a prospective cohort of patients attending the emergency departments (ED) of 16 participating hospitals. Information was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up after admission or discharge home. While complete data were generally available at the time of ED admission, data were often missing at the time of decision making. Predefined assumptions were used to impute much of the missing data. Discussion: The IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients.
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693 p.
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Background: Consensus development techniques were used in the late 1980s to create explicit criteria for the appropriateness of cataract extraction. We developed a new appropriateness of indications tool for cataract following the RAND method. We tested the validity of our panel results. Methods: Criteria were developed using a modified Delphi panel judgment process. A panel of 12 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the influence of all variables on the final panel score using linear and logistic regression models. The explicit criteria developed were summarized by classification and regression tree analysis. Results: Of the 765 indications evaluated by the main panel in the second round, 32.9% were found appropriate, 30.1% uncertain, and 37% inappropriate. Agreement was found in 53% of the indications and disagreement in 0.9%. Seven variables were considered to create the indications and divided into three groups: simple cataract, with diabetic retinopathy, or with other ocular pathologies. The preoperative visual acuity in the cataractous eye and visual function were the variables that best explained the panel scoring. The panel results were synthesized and presented in three decision trees. Misclassification error in the decision trees, as compared with the panel original criteria, was 5.3%. Conclusion: The parameters tested showed acceptable validity for an evaluation tool. These results support the use of this indication algorithm as a screening tool for assessing the appropriateness of cataract extraction in field studies and for the development of practice guidelines.
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616 p.
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521 p.
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572 p.
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340 p.