Optimization techniques to detect early ventilation extubation in intensive care units

The decision support models in intensive care units are developed to support medical staff in their decision making process. However, the optimization of these models is particularly difficult to apply due to dynamic, complex and multidisciplinary nature. Thus, there is a constant research and development of new algorithms capable of extracting knowledge from large volumes of data, in order to obtain better predictive results than the current algorithms. To test the optimization techniques a case study with real data provided by INTCare project was explored. This data is concerning to extubation cases. In this dataset, several models like Evolutionary Fuzzy Rule Learning, Lazy Learning, Decision Trees and many others were analysed in order to detect early extubation. The hydrids Decision Trees Genetic Algorithm, Supervised Classifier System and KNNAdaptive obtained the most accurate rate 93.2%, 93.1%, 92.97% respectively, thus showing their feasibility to work in a real environment.

Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure

OBJECTIVE: To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. METHODS: Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. RESULTS: We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. CONCLUSION: Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in imme-diate benefits for patients with severe heart failure.

Cross-sectional Study on Blood Pressure Control in the Department of Nephrology of the Escola Paulista de Medicina - UNIFESP

OBJECTIVE - To assess hypertension control rates in a specialized university-affiliated medical department, the influence of sex, diabetes, and obesity on that control, and the strategies for the treatment of hypertension. METHODS - We carried out a cross-sectional study with 1,210 patients followed up for at least 6 months. Information was gathered from medical and nursing records and comprised the following data: sex, age, weight, height, abdominal and hip circumferences, blood pressure, and class and number of the antihypertensive drugs prescribed. To assess obesity, we used body mass index and waist/hip ratio. Blood pressure was considered under control when its levels were below 140/90 mmHg. RESULTS - The study consisted of 73% females and 27% males. Most females (31.7%) were 50 to 59 years of age, and most males (28.3%) were 60 to 69 years. The blood pressure control rate found was 20.9% for the 1,210 patients and 23.4% for the hypertensive diabetic patients (n=290). Despite the low control rates found, 70% of the patients used 1 or 2 antihypertensive medications. A high prevalence of obesity (38%) was observed, and females had a greater abdominal obesity index than males did (90% vs 82%, p<0.05). Patients with a greater body mass index had less control of blood pressure. CONCLUSION - The percentage of hypertensive patients with controlled blood pressure levels was low and was associated with a high prevalence of obesity. These data indicate the need for reviewing the strategies of global treatment for hypertension.

The real economic effects of cross-delistingfrom the united states: evidence on post-operating performance, financial constraints and stock crash risk

Tese de Doutoramento em Ciências Empresariais.

Optimización en el cómputos de algoritmos de cuadratura para funciones especiales. Optimization of quadrature algorithms for special functions.

En nuestro proyecto anterior aproximamos el cálculo de una integral definida con integrandos de grandes variaciones funcionales. Nuestra aproximación paraleliza el algoritmo de cómputo de un método adaptivo de cuadratura, basado en reglas de Newton-Cote. Los primeros resultados obtenidos fueron comunicados en distintos congresos nacionales e internacionales; ellos nos permintieron comenzar con una tipificación de las reglas de cuadratura existentes y una clasificación de algunas funciones utilizadas como funciones de prueba. Estas tareas de clasificación y tipificación no las hemos finalizado, por lo que pretendemos darle continuidad a fin de poder informar sobre la conveniencia o no de utilizar nuestra técnica. Para llevar adelante esta tarea se buscará una base de funciones de prueba y se ampliará el espectro de reglas de cuadraturas a utilizar. Además, nos proponemos re-estructurar el cálculo de algunas rutinas que intervienen en el cómputo de la mínima energía de una molécula. Este programa ya existe en su versión secuencial y está modelizado utilizando la aproximación LCAO. El mismo obtiene resultados exitosos en cuanto a precisión, comparado con otras publicaciones internacionales similares, pero requiere de un tiempo de cálculo significativamente alto. Nuestra propuesta es paralelizar el algoritmo mencionado abordándolo al menos en dos niveles: 1- decidir si conviene distribuir el cálculo de una integral entre varios procesadores o si será mejor distribuir distintas integrales entre diferentes procesadores. Debemos recordar que en los entornos de arquitecturas paralelas basadas en redes (típicamente redes de área local, LAN) el tiempo que ocupa el envío de mensajes entre los procesadores es muy significativo medido en cantidad de operaciones de cálculo que un procesador puede completar. 2- de ser necesario, paralelizar el cálculo de integrales dobles y/o triples. Para el desarrollo de nuestra propuesta se desarrollarán heurísticas para verificar y construir modelos en los casos mencionados tendientes a mejorar las rutinas de cálculo ya conocidas. A la vez que se testearán los algoritmos con casos de prueba. La metodología a utilizar es la habitual en Cálculo Numérico. Con cada propuesta se requiere: a) Implementar un algoritmo de cálculo tratando de lograr versiones superadoras de las ya existentes. b) Realizar los ejercicios de comparación con las rutinas existentes para confirmar o desechar una mejor perfomance numérica. c) Realizar estudios teóricos de error vinculados al método y a la implementación. Se conformó un equipo interdisciplinario integrado por investigadores tanto de Ciencias de la Computación como de Matemática. Metas a alcanzar Se espera obtener una caracterización de las reglas de cuadratura según su efectividad, con funciones de comportamiento oscilatorio y con decaimiento exponencial, y desarrollar implementaciones computacionales adecuadas, optimizadas y basadas en arquitecturas paralelas.

Meaning refinement to improve cross-lingual information retrieval

Magdeburg, Univ., Fak. für Informatik, Diss., 2012

Synthesis of plantwide control strategies using mixed integer optimization

Magdeburg, Univ., Fak. für Elektrotechnik und Informationstechnik, Diss., 2012

Elevated Blood Pressure and Obesity in Childhood: A Cross-Sectional Evaluation of 4,609 Schoolchildren

Background: The incidence of obesity in children is increasing worldwide, primarily in urbanized, high-income countries, and hypertension development is a detrimental effect of this phenomenon. Objective: In this cross-sectional study, we evaluated the prevalence of excess weight and its association with high blood pressure (BP) in schoolchildren. Methods: Here 4,609 male and female children, aged 6 to 11 years, from 24 public and private schools in Maringa, Brazil, were evaluated. Nutritional status was assessed by body mass index (BMI) according to cutoff points adjusted for sex and age. Blood pressure (BP) levels above 90th percentile for gender, age and height percentile were considered elevated. Results: The prevalence of excess weight among the schoolchildren was 24.5%; 16.9% were overweight, and 7.6% were obese. Sex and socioeconomic characteristics were not associated with elevated BP. In all age groups, systolic and diastolic BP correlated with BMI and waist and hip measurements, but not with waist-hip ratio. The prevalence of elevated BP was 11.2% in eutrophic children, 20.6% in overweight children [odds ratio (OR), 1.99; 95% confidence interval (CI), 1.61-2.45], and 39.7% in obese children (OR, 5.4; 95% CI, 4.23-6.89). Conclusion: Obese and overweight children had a higher prevalence of elevated BP than normal-weight children. Our data confirm that the growing worldwide epidemic of excess weight and elevated BP in schoolchildren may also be ongoing in Brazil.

Modeling, design, and optimization of radiofrequency micromechanical structures

Coupled Electromechanical Analysis, MEMS Modeling, MEMS, RF MEMS Switches, Defected Ground Structures, Reconfigurable Resonator

Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

Introduction:Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce.Objective:To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use.Methods:Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012.Results:We included 407 patients (356 had atrial fibrillation and 51 had flutter). Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01) and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01). The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01). The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%.Conclusions:The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk, the use of anticoagulants was low, revealing difficulties for incorporating guideline recommendations. Public health strategies should be adopted in order to improve these rates.

Optimization of a procedure for emergency cooling and pressure relief for reactors with exothermal processes

Passive trip system, reactor trip, runaway reaction, batch reactor

Lexico-grammatical variation in the use of REQUEST strategies in Indian and British "letters to the editor" : a cross-cultural pragmatic study

Magdeburg, Univ., Fak. für Geistes-, Sozial- und Erziehungswiss., Diss., 2009

Analysis, design, optimization and realization of compact high performance printed RF filters

Magdeburg, Univ., Fak. für Elektrotechnik und Informationstechnik, Diss., 2010

Cross-talk of protein kinase B (PKB/Akt) with the transcription factor NFAT and the Src kinase Fyn in T lymphocytes

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2010