961 resultados para Clinical-prediction Rules


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In order to select superior hybrids for the concentration of favorable alleles for resistance to papaya black spot, powdery mildew and phoma spot, 67 hybrids were evaluated in two seasons, in 2007, in a randomized block design with two replications. Genetic gains were estimated from the selection indices of Smith & Hazel, Pesek & Baker, Williams, Mulamba & Mock, with selection intensity of 22.39%, corresponding to 15 hybrids. The index of Mulamba & Mock showed gains more suitable for the five traits assessed when it was used the criterion of economic weight tentatively assigned. Together, severity of black spot on leaves and on fruits, characteristics considered most relevant to the selection of resistant materials, expressed percentage gain of -44.15%. In addition, there were gains for other characteristics, with negative predicted selective percentage gain. The results showed that the index of Mulamba & Mock is the most efficient procedure for simultaneous selection of papaya hybrid resistant to black spot, powdery mildew and phoma spot.

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Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

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A growing number of predicting corporate failure models has emerged since 60s. Economic and social consequences of business failure can be dramatic, thus it is not surprise that the issue has been of growing interest in academic research as well as in business context. The main purpose of this study is to compare the predictive ability of five developed models based on three statistical techniques (Discriminant Analysis, Logit and Probit) and two models based on Artificial Intelligence (Neural Networks and Rough Sets). The five models were employed to a dataset of 420 non-bankrupt firms and 125 bankrupt firms belonging to the textile and clothing industry, over the period 2003–09. Results show that all the models performed well, with an overall correct classification level higher than 90%, and a type II error always less than 2%. The type I error increases as we move away from the year prior to failure. Our models contribute to the discussion of corporate financial distress causes. Moreover it can be used to assist decisions of creditors, investors and auditors. Additionally, this research can be of great contribution to devisers of national economic policies that aim to reduce industrial unemployment.

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A growing number of predicting corporate failure models has emerged since 60s. Economic and social consequences of business failure can be dramatic, thus it is not surprise that the issue has been of growing interest in academic research as well as in business context. The main purpose of this study is to compare the predictive ability of five developed models based on three statistical techniques (Discriminant Analysis, Logit and Probit) and two models based on Artificial Intelligence (Neural Networks and Rough Sets). The five models were employed to a dataset of 420 non-bankrupt firms and 125 bankrupt firms belonging to the textile and clothing industry, over the period 2003–09. Results show that all the models performed well, with an overall correct classification level higher than 90%, and a type II error always less than 2%. The type I error increases as we move away from the year prior to failure. Our models contribute to the discussion of corporate financial distress causes. Moreover it can be used to assist decisions of creditors, investors and auditors. Additionally, this research can be of great contribution to devisers of national economic policies that aim to reduce industrial unemployment.

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One of the current frontiers in the clinical management of Pectus Excavatum (PE) patients is the prediction of the surgical outcome prior to the intervention. This can be done through computerized simulation of the Nuss procedure, which requires an anatomically correct representation of the costal cartilage. To this end, we take advantage of the costal cartilage tubular structure to detect it through multi-scale vesselness filtering. This information is then used in an interactive 2D initialization procedure which uses anatomical maximum intensity projections of 3D vesselness feature images to efficiently initialize the 3D segmentation process. We identify the cartilage tissue centerlines in these projected 2D images using a livewire approach. We finally refine the 3D cartilage surface through region-based sparse field level-sets. We have tested the proposed algorithm in 6 noncontrast CT datasets from PE patients. A good segmentation performance was found against reference manual contouring, with an average Dice coefficient of 0.75±0.04 and an average mean surface distance of 1.69±0.30mm. The proposed method requires roughly 1 minute for the interactive initialization step, which can positively contribute to an extended use of this tool in clinical practice, since current manual delineation of the costal cartilage can take up to an hour.

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RESUMO: Esta dissertação teve como objetivo central replicar o estudo realizado por Piaget sobre aquisição do conceito de regras em crianças, a fim de procurarmos saber se passados 78 anos da obra “O Juízo Moral na Criança”, os dados que o mesmo encontrou sobre a aquisição do princípio da moral se mantêm em nossa atualidade. Para atingir esse objetivo realizamos uma breve revisão bibliográfica, abrangendo alguns autores, teóricos e pesquisadores que enfatizaram estudos sobre o princípio da ética e a fundamentação da moral, entre os quais constam: Platão, Aristóteles, Nietzsche, Kant, Durkheim. Baseamo-nos igualmente em alguns autores mais recentes como Vázquez, Lourenço, Cortina e Martinez, Biaggio, dentre outros. Ao analisarmos a origem psicológica do desenvolvimento moral da criança, buscamos suporte na teoria de Kolhberg e principalmente de Jean Piaget, autor principal para esta pesquisa. A pesquisa guiou-se por uma dimensão descritiva e qualitativa, centrada na observação direta e indireta, baseada no modelo clínico introduzido por Piaget. Os resultados da pesquisa demonstraram que os dados obtidos por Piaget há 78 anos, são compatíveis com os dias de hoje, pois as crianças apresentaram dados equivalentes em média com as idades estipuladas para a aquisição da moral heterônoma e da moral autônoma. Constatámos que a aquisição do princípio da reversibilidade leva as crianças a adquirirem capacidades cognitivas para uma moral autônoma. A concepção de regras transmitidas pelas crianças, emergiram em uma concepção de respeito a uma norma pré estabelecida, e que, gradualmente se transforma em consciência da importância das mesmas para o princípio da boa convivência. ABSTRACT: This dissertation aimed to replicate the study worked out by Piaget on acquisition of concept rules in children, in order to know if, 78 years passed from "The Moral Judgment in Child", data about acquisition of morality principle remain current. To achieve this goal we conducted a brief bibliographic review, covering some authors, theorists and researchers who emphasized studies on ethics principle and moral fundamentation, such as: Plato, Aristotle, Nietzsche, Kant, Durkheim. We were also based on some latest authors as Vázquez, Lourenço, Cortina and Martinez, Biaggio, and others. Considering the psychological origin of moral development of children, we sought support in Kolhberg´s theory and, especially, Jean Piaget, the main author for this search. The research was led by a descriptive and qualitative dimension, focused on direct and indirect observation, based on clinical model introduced by Piaget. The survey results showed that data obtained by Piaget 78 years ago are still compatible with the present day, because children have, on average, equivalent data through all ages stipulated for the acquisition of heteronomic and autonomous moral. We found that the acquisition of the reversibility principle leads children to acquire cognitive skills for an autonomous moral. The conception of rules provided by children, emerged to a conception of respect to a pre-established standard, that gradually becomes aware of its importance to the principle of coexistence.

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The increased integration of wind power into the electric grid, as nowadays occurs in Portugal, poses new challenges due to its intermittency and volatility. Wind power prediction plays a key role in tackling these challenges. The contribution of this paper is to propose a new hybrid approach, combining particle swarm optimization and adaptive-network-based fuzzy inference system, for short-term wind power prediction in Portugal. Significant improvements regarding forecasting accuracy are attainable using the proposed approach, in comparison with the results obtained with five other approaches.

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Demand for power is growing every day, mainly due to emerging economies in countries such as China, Russia, India, and Brazil. During the last 50 years steam pressure and temperature in power plants have been continuously raised to improve thermal efficiency. Recent efforts to improve efficiency leads to the development of a new generation of heat recovery steam generator, where the Benson once-through technology is applied to improve the thermal efficiency. The main purpose of this paper is to analyze the mechanical behavior of a high pressure superheater manifold by applying finite element modeling and a finite element analysis with the objective of analyzing stress propagation, leading to the study of damage mechanism, e.g., uniaxial fatigue, uniaxial creep for life prediction. The objective of this paper is also to analyze the mechanical properties of the new high temperature resistant materials in the market such as 2Cr Bainitic steels (T/P23 and T/P24) and also the 9-12Cr Martensitic steels (T/P91, T/P92, E911, and P/T122). For this study the design rules for construction of power boilers to define the geometry of the HPSH manifold were applied.

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OBJETIVO: Comparar o valor preditivo do CRIB (Clinical Risk Index for Babies) para o risco de mortalidade neonatal ao peso de nascimento (PN) e idade gestacional (IG). MÉTODO: Numa coorte prospectiva foram estudados, durante o ano de 1996, 71 recém-nascidos admitidos na unidade de terapia intensiva, com PN < 1.500 g e/ou IG < 31 semanas. RESULTADOS: A taxa de mortalidade foi de 29,6%; para PN < 1.000 g ou IG < 29 semanas foi de 60%, enquanto que para o escore de CRIB > 10 foi de 100%. CONCLUSÕES: O escore de CRIB > 10 correspondeu a maiores especificidade e valor preditivo positivo em relação aos demais parâmetros. A área determinada pela "receiver operating characteristic" relativa ao CRIB também foi superior. O CRIB mostrou-se um marcador mais acurado na previsão de risco de mortalidade quando comparado ao PN ou IG isoladamente.

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Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização: Intervenção Cardiovascular.

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OBJECTIVE: To determine the severity of dapsone (DDS) acute intoxication – an uncommon medical event – using clinical and laboratory parameters. METHODS: Two hundred and seventy four patients with acute DDS intoxication, aged 1 month to 50 years old, were studied and classified into four age groups. Clinical evaluation was assessed through a protocol and correlated with laboratory parameters. Spectrophotometric methods were used to analyze methemoglobinemia (MHbp) and dapsonemia (DDSp). RESULTS: The most prevalent clinical sign of intoxication was cyanosis, seen in 65.7% of the patients and in 100% of children less than 5 years of age. According to laboratory criteria, MHbp-related severe clinical intoxication was seen in 56.2% and DDSp-related occurred in 58% of the patients. Regarding DDSp, intoxication was considered severe when 20 tablets (100 mg each) were ingested, a median of 29 mug/ml. Regarding MHbp, intoxication was severe when 7.5 tablets were ingested, a median of 38% of the total Hb. The correlation between MHbp and DDSp was statistically significant (n=144, r=0.32, p<0.05). Negative correlation was observed between MHbp and the time elapsed since DDS intake (n=124, r=-0.34, p<0.001). There was also a negative correlation between DDSp and the time elapsed since DDS intake (n=63, r=-0.35, p<0.0001). CONCLUSIONS: Longitudinal analysis showed a significant association between methemoglobinemia and the time elapsed after the intake (t), according to the equation: Dapsonemia = 12.9256 - 0.0682t + 0.234 methemoglobinemia

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Solubility measurements of quinizarin. (1,4-dihydroxyanthraquinone), disperse red 9 (1-(methylamino) anthraquinone), and disperse blue 14 (1,4-bis(methylamino)anthraquinone) in supercritical carbon dioxide (SC CO2) were carried out in a flow type apparatus, at a temperature range from (333.2 to 393.2) K and at pressures from (12.0 to 40.0) MPa. Mole fraction solubility of the three dyes decreases in the order quinizarin (2.9 x 10(-6) to 2.9.10(-4)), red 9 (1.4 x 10(-6) to 3.2 x 10(-4)), and blue 14 (7.8 x 10(-8) to 2.2 x 10(-5)). Four semiempirical density based models were used to correlatethe solubility of the dyes in the SC CO2. From the correlation results, the total heat of reaction, heat of vaporization plus the heat of solvation of the solute, were calculated and compared with the results presented in the literature. The solubilities of the three dyes were correlated also applying the Soave-Redlich-Kwong cubic equation of state (SRK CEoS) with classical mixing rules, and the physical properties required for the modeling were estimated and reported.

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The prevalence and clinical forms of Trypanosoma cruzi were evaluated among blood donor candidates attended at a general hospital in Rio de Janeiro, Brazil, from January 1997 to April 1999. The investigation was done by means of the indirect hemagglutination test and was confirmed via ELISA. Data were collected from clinical examinations, conventional electrocardiogram, chest radiography and echocar-diography. The results showed that despite Trypanosoma cruzi prevalence of 1.17% (128 patients), mainly in males aged 40 years or over, 70.8% of these patients, mainly males aged 19 to 39 years, demonstrated abnormalities that allowed the diagnosis of cardiopathy and/or esophagopathy. This once again corroborates the importance of Trypanosoma cruzi infection in urban centers.

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Neonatal anthropometry is an inexpensive, noninvasive and convenient tool for bedside evaluation, especially in sick and fragile neonates. Anthropometry can be used in neonates as a tool for several purposes: diagnosis of foetal malnutrition and prediction of early postnatal complications; postnatal assessment of growth, body composition and nutritional status; prediction of long-term complications including metabolic syndrome; assessment of dysmorphology; and estimation of body surface. However, in this age group anthropometry has been notorious for its inaccuracy and the main concern is to make validated indices available. Direct measurements, such as body weight, length and body circumferences are the most commonly used measurements for nutritional assessment in clinical practice and in field studies. Body weight is the most reliable anthropometric measurement and therefore is often used alone in the assessment of the nutritional status, despite not reflecting body composition. Derived indices from direct measurements have been proposed to improve the accuracy of anthropometry. Equations based on body weight and length, mid-arm circumference/head circumference ratio, and upper-arm cross-sectional areas are among the most used derived indices to assess nutritional status and body proportionality, even though these indices require further validation for the estimation of body composition in neonates.

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Clinical education is recognized as being crucial for the training of health professionals. This subject is debated amongst teachers, students and professionals. Besides the clinical and research skills, we look for other competencies such as oratory, creative thinking or leadership. We present the results of a study with 4th graders. It’s a exploratory study; the main purpose was to evaluate the outcomes of a unit of clinical education prepared according a new set of competencies and methodologies. The competencies were seen as valuable. Organization, leading or supporting a colleague, rethinking a program to serve client and family are equally important.