An optimized lead system for long-term esophageal electrocardiography

Long-term electrocardiography (ECG) featuring adequate atrial and ventricular signal quality is highly desirable. Routinely used surface leads are limited in atrial signal sensitivity and recording capability impeding complete ECG delineation, i.e. in the presence of supraventricular arrhythmias. Long-term esophageal ECG might overcome these limitations but requires a dedicated lead system and recorder design. To this end, we analysed multiple-lead esophageal ECGs with respect to signal quality by describing the ECG waves as a function of the insertion level, interelectrode distance, electrode shape and amplifier's input range. The results derived from clinical data show that two bipolar esophageal leads, an atrial lead with short (15 mm) interelectrode distance and a ventricular lead with long (80 mm) interelectrode distance provide non-inferior ventricular signal strength and superior atrial signal strength compared to standard surface lead II. High atrial signal slope in particular is observed with the atrial esophageal lead. The proposed esophageal lead system in combination with an increased recorder input range of ±20 mV minimizes signal loss due to excessive electrode motion typically observed in esophageal ECGs. The design proposal might help to standardize long-term esophageal ECG registrations and facilitate novel ECG classification systems based on the independent detection of ventricular and atrial electrical activity.

LiLa-Klassifikation für Frakturen der langen Röhrenknochen im Wachstumsalter

Background. There are two child-specific fracture classification systems for long bone fractures: the AO classification of pediatric long-bone fractures (PCCF) and the LiLa classification of pediatric fractures of long bones (LiLa classification). Both are still not widely established in comparison to the adult AO classification for long bone fractures. Methods. During a period of 12 months all long bone fractures in children were documented and classified according to the LiLa classification by experts and non-experts. Intraobserver and interobserver reliability were calculated according to Cohen (kappa). Results. A total of 408 fractures were classified. The intraobserver reliability for location in the skeletal and bone segment showed an almost perfect agreement (K=0.91-0.95) and also the morphology (joint/shaft fracture) (K=0.87-0.93). Due to different judgment of the fracture displacement in the second classification round, the intraobserver reliability of the whole classification revealed moderate agreement (K=0.53-0.58). Interobserver reliability showed moderate agreement (K=0.55) often due to the low quality of the X-rays. Further differences occurred due to difficulties in assigning the precise transition from metaphysis to diaphysis. Conclusions. The LiLa classification is suitable and in most cases user-friendly for classifying long bone fractures in children. Reliability is higher than in established fracture specific classifications and comparable to the AO classification of pediatric long bone fractures. Some mistakes were due to a low quality of the X-rays and some due to difficulties to classify the fractures themselves. Improvements include a more precise definition of the metaphysis and the kind of displacement. Overall the LiLa classification should still be considered as an alternative for classifying pediatric long bone fractures.

Energy expenditure, body-part discomfort and mental work load among nurses

The purpose of this prospective observational field study was to present a model for measuring energy expenditure among nurses and to determine if there was a difference between the energy expenditure of nurses providing direct care to adult patients on general medical-surgical units in two major metropolitan hospitals and a recommended energy expenditure of 3.0 kcal/minute over 8 hours. One-third of the predicted cycle ergometer VO2max for the study population was used to calculate the recommended energy expenditure.^ Two methods were used to measure energy expenditure among participants during an 8 hour day shift. First, the Energy Expenditure Prediction Program (EEPP) developed by the University of Michigan Center for Ergonomics was used to calculate energy expenditure using activity recordings from observation (OEE; n = 39). The second method used ambulatory electrocardiography and the heart rate-oxygen consumption relationship (HREE; n = 20) to measure energy expenditure. It was concluded that energy expenditure among nurses can be estimated using the EEPP. Using classification systems from previous research, work load among the study population was categorized as "moderate" but was significantly less than (p = 0.021) 3.0 kcal/minute over 8 hours or 1/3 of the predicted VO2max.^ In addition, the relationships between OEE, body-part discomfort (BPCDS) and mental work load (MWI) were evaluated. The relationships between OEE/BPCDS and OEE/MWI were not significant (p = 0.062 and 0.091, respectively). Among the study population, body-part discomfort significantly increased for upper arms, mid-back, lower-back, legs and feet by mid-shift and by the end of the shift, the increase was also significant for neck and thighs.^ The study also provided documentation of a comprehensive list of nursing activities. Among the most important findings were the facts that the study population spent 23% of the workday in a bent posture, walked an average of 3.14 miles, and spent two-thirds of the shift doing activities other than direct patient care, such as paperwork and communicating with other departments. A discussion is provided regarding the ergonomic implications of these findings. ^

Impact of miR-21, miR-126 and miR-221 as prognostic factors of clear cell renal cell carcinoma with tumor thrombus of the inferior vena cava

Clear cell renal cell carcinoma (ccRCC) characterized by a tumor thrombus (TT) extending into the inferior vena cava (IVC) generally indicates poor prognosis. Nevertheless, the risk for tumor recurrence after nephrectomy and thrombectomy varies. An applicable and accurate prediction system to select ccRCC patients with TT of the IVC (ccRCC/TT) at high risk after nephrectomy is urgently needed, but has not been established up to now. To our knowledge, a possible role of microRNAs (miRs) for the development of ccRCC/TT or their impact as prognostic markers in ccRCC/TT has not been explored yet. Therefore, we analyzed the expression of the previously described onco-miRs miR-200c, miR-210, miR-126, miR-221, let-7b, miR-21, miR-143 and miR-141 in a study collective of 74 ccRCC patients. Using the expression profiles of these eight miRs we developed classification systems that accurately differentiate ccRCC from non-cancerous renal tissue and ccRCC/TT from tumors without TT. In the subgroup of 37 ccRCC/TT cases we found that miR-21, miR-126, and miR-221 predicted cancer related death (CRD) accurately and independently from other clinico-pathological features. Furthermore, a combined risk score based on the expression of miR-21, miR-126 and miR-221 was developed and showed high sensitivity and specificity to predict cancer specific survival (CSS) in ccRCC/TT. Using the combined risk score we were able to classify ccRCC/TT patients correctly into high and low risk cases. The risk stratification by the combined risk score (CRS) will benefit from further cohort validation and might have potential for clinical application as a molecular prediction system to identify high- risk ccRCC/TT patients.

Determining appropriate measurement methods for etiological research of computing-related musculoskeletal symptoms and disorders

Two studies among college students were conducted to evaluate appropriate measurement methods for etiological research on computing-related upper extremity musculoskeletal disorders (UEMSDs). ^ A cross-sectional study among 100 graduate students evaluated the utility of symptoms surveys (a VAS scale and 5-point Likert scale) compared with two UEMSD clinical classification systems (Gerr and Moore protocols). The two symptom measures were highly concordant (Lin's rho = 0.54; Spearman's r = 0.72); the two clinical protocols were moderately concordant (Cohen's kappa = 0.50). Sensitivity and specificity, endorsed by Youden's J statistic, did not reveal much agreement between the symptoms surveys and clinical examinations. It cannot be concluded self-report symptoms surveys can be used as surrogate for clinical examinations. ^ A pilot repeated measures study conducted among 30 undergraduate students evaluated computing exposure measurement methods. Key findings are: temporal variations in symptoms, the odds of experiencing symptoms increased with every hour of computer use (adjOR = 1.1, p < .10) and every stretch break taken (adjOR = 1.3, p < .10). When measuring posture using the Computer Use Checklist, a positive association with symptoms was observed (adjOR = 1.3, p < 0.10), while measuring posture using a modified Rapid Upper Limb Assessment produced unexpected and inconsistent associations. The findings were inconclusive in identifying an appropriate posture assessment or superior conceptualization of computer use exposure. ^ A cross-sectional study of 166 graduate students evaluated the comparability of graduate students to College Computing & Health surveys administered to undergraduate students. Fifty-five percent reported computing-related pain and functional limitations. Years of computer use in graduate school and number of years in school where weekly computer use was ≥ 10 hours were associated with pain within an hour of computing in logistic regression analyses. The findings are consistent with current literature on both undergraduate and graduate students. ^

Ser un trabajador estatal : Sentidos del trabajo, moralidades y acción colectiva de trabajadores de la salud pública

Los sistemas de auto-clasificación que enuncian los trabajadores del Hospital Castro Rendón de Neuquén son múltiples y se ponen en juego en diversos contextos, operando como categorías con las que se definen a sí mismos y a los otros. A partir de una estrategia metodológica cualitativa basada en la realización de observaciones participantes y entrevistas en profundidad, en este artículo se analiza cómo se pone en juego la categoría de 'trabajador estatal' en tanto forma de auto-adscripción en el trabajo cotidiano y durante los momentos de huelga. Los sentidos asociados al trabajo son centrales para comprender la lógica de acción de los actores, ya que sirven de sustento de una comunidad moral y profesional de trabajadores que se opone a los 'funcionarios' dentro de las estructuras del Estado provincial. A su vez ello permite mostrar la lógica en que se manifiestan las disputas en los procesos de gestión de las políticas de salud pública neuquina.

Ser un trabajador estatal : Sentidos del trabajo, moralidades y acción colectiva de trabajadores de la salud pública

Los sistemas de auto-clasificación que enuncian los trabajadores del Hospital Castro Rendón de Neuquén son múltiples y se ponen en juego en diversos contextos, operando como categorías con las que se definen a sí mismos y a los otros. A partir de una estrategia metodológica cualitativa basada en la realización de observaciones participantes y entrevistas en profundidad, en este artículo se analiza cómo se pone en juego la categoría de 'trabajador estatal' en tanto forma de auto-adscripción en el trabajo cotidiano y durante los momentos de huelga. Los sentidos asociados al trabajo son centrales para comprender la lógica de acción de los actores, ya que sirven de sustento de una comunidad moral y profesional de trabajadores que se opone a los 'funcionarios' dentro de las estructuras del Estado provincial. A su vez ello permite mostrar la lógica en que se manifiestan las disputas en los procesos de gestión de las políticas de salud pública neuquina.

Ser un trabajador estatal : Sentidos del trabajo, moralidades y acción colectiva de trabajadores de la salud pública

Los sistemas de auto-clasificación que enuncian los trabajadores del Hospital Castro Rendón de Neuquén son múltiples y se ponen en juego en diversos contextos, operando como categorías con las que se definen a sí mismos y a los otros. A partir de una estrategia metodológica cualitativa basada en la realización de observaciones participantes y entrevistas en profundidad, en este artículo se analiza cómo se pone en juego la categoría de 'trabajador estatal' en tanto forma de auto-adscripción en el trabajo cotidiano y durante los momentos de huelga. Los sentidos asociados al trabajo son centrales para comprender la lógica de acción de los actores, ya que sirven de sustento de una comunidad moral y profesional de trabajadores que se opone a los 'funcionarios' dentro de las estructuras del Estado provincial. A su vez ello permite mostrar la lógica en que se manifiestan las disputas en los procesos de gestión de las políticas de salud pública neuquina.

Ser un trabajador estatal : Sentidos del trabajo, moralidades y acción colectiva de trabajadores de la salud pública

Los sistemas de auto-clasificación que enuncian los trabajadores del Hospital Castro Rendón de Neuquén son múltiples y se ponen en juego en diversos contextos, operando como categorías con las que se definen a sí mismos y a los otros. A partir de una estrategia metodológica cualitativa basada en la realización de observaciones participantes y entrevistas en profundidad, en este artículo se analiza cómo se pone en juego la categoría de 'trabajador estatal' en tanto forma de auto-adscripción en el trabajo cotidiano y durante los momentos de huelga. Los sentidos asociados al trabajo son centrales para comprender la lógica de acción de los actores, ya que sirven de sustento de una comunidad moral y profesional de trabajadores que se opone a los 'funcionarios' dentro de las estructuras del Estado provincial. A su vez ello permite mostrar la lógica en que se manifiestan las disputas en los procesos de gestión de las políticas de salud pública neuquina.

Plant Functional Type (PFT) map over Siberia derived from GlobCover 2005 dataset, link to dataset in NetCDF format

High-latitude ecosystems play an important role in the global carbon cycle and in regulating the climate system and are presently undergoing rapid environmental change. Accurate land cover data sets are required to both document these changes as well as to provide land-surface information for benchmarking and initializing Earth system models. Earth system models also require specific land cover classification systems based on plant functional types (PFTs), rather than species or ecosystems, and so post-processing of existing land cover data is often required. This study compares over Siberia, multiple land cover data sets against one another and with auxiliary data to identify key uncertainties that contribute to variability in PFT classifications that would introduce errors in Earth system modeling. Land cover classification systems from GLC 2000, GlobCover 2005 and 2009, and MODIS collections 5 and 5.1 are first aggregated to a common legend, and then compared to high-resolution land cover classification systems, vegetation continuous fields (MODIS VCFs) and satellite-derived tree heights (to discriminate against sparse, shrub, and forest vegetation). The GlobCover data set, with a lower threshold for tree cover and taller tree heights and a better spatial resolution, tends to have better distributions of tree cover compared to high-resolution data. It has therefore been chosen to build new PFT maps for the ORCHIDEE land surface model at 1 km scale. Compared to the original PFT data set, the new PFT maps based on GlobCover 2005 and an updated cross-walking approach mainly differ in the characterization of forests and degree of tree cover. The partition of grasslands and bare soils now appears more realistic compared with ground truth data. This new vegetation map provides a framework for further development of new PFTs in the ORCHIDEE model like shrubs, lichens and mosses, to represent the water and carbon cycles in northern latitudes better. Updated land cover data sets are critical for improving and maintaining the relevance of Earth system models for assessing climate and human impacts on biogeochemistry and biophysics.

Analysis of the information about Doctoral Degrees presented in the Spanish universities websites.

Globalization has intensified competition, as evidenced by the growing number of international classification systems (rankings) and the attention paid to them. Doctoral education has an international character in itself. It should promote opportunities for graduate students lo participate in these international studies. The quality and competitiveness are two of the most important issues for universities. To promote the interest of graduates to continue their education after the graduate level, it would be necessary to improve the published information of ihe doctoral programs. It should increase the visibility and provide high-quality, easily accessible and comparable information which includes all the relevant aspects of these programs. The authors analysed the website contents of doctoral programs, it was observed a lack of quality of them and very poor information about the contents, so that it was decided that any of them could constitute a model for creating new websites. The recommendations on the format and contents in the web were made by a discussion group. They recommended an attractive design; a page with easy access to contents and easy to find on Ihe net and with the information in more than one language. It should include complete program and academic staff information. It should also be included the study's results which should be easily accessible and includes quantitative data, such as number of students who completed scholars, publications, research projects, average duration of the studies, etc. It will facilitate the choice of program

Classical vs. biometric features in the 2013 speaker recognition evaluation in mobile environments

MFCC coefficients extracted from the power spectral density of speech as a whole, seems to have become the de facto standard in the area of speaker recognition, as demonstrated by its use in almost all systems submitted to the 2013 Speaker Recognition Evaluation (SRE) in Mobile Environment [1], thus relegating to background this component of the recognition systems. However, in this article we will show that selecting the adequate speaker characterization system is as important as the selection of the classifier. To accomplish this we will compare the recognition rates achieved by different recognition systems that relies on the same classifier (GMM-UBM) but connected with different feature extraction systems (based on both classical and biometric parameters). As a result we will show that a gender dependent biometric parameterization with a simple recognition system based on GMM- UBM paradigm provides very competitive or even better recognition rates when compared to more complex classification systems based on classical features

Molecular tools to improve chestnut management: El Bierzo as a case study

The European chestnut (Castanea sativa Mill.) is a multipurpose species that has been widely cultivated around the Mediterranean basin since ancient times. New varieties were brought to the Iberian Peninsula during the Roman Empire, which coexist since then with native populations that survived the last glaciation. The relevance of chestnut cultivation has being steadily growing since the Middle Ages, until the rural decline of the past century put a stop to this trend. Forest fires and diseases were also major factors. Chestnut cultivation is gaining momentum again due to its economic (wood, fruits) and ecologic relevance, and represents currently an important asset in many rural areas of Europe. In this Thesis we apply different molecular tools to help improve current management strategies. For this study we have chosen El Bierzo (Castile and Leon, NW Spain), which has a centenary tradition of chestnut cultivation and management, and also presents several unique features from a genetic perspective (next paragraph). Moreover, its nuts are widely appreciated in Spain and abroad for their organoleptic properties. We have focused our experimental work on two major problems faced by breeders and the industry: the lack of a fine-grained genetic characterization and the need for new strategies to control blight disease. To characterize with sufficient detail the genetic diversity and structure of El Bierzo orchards, we analyzed DNA from 169 trees grafted for nut production covering the entire region. We also analyzed 62 nuts from all traditional varieties. El Bierzo constitutes an outstanding scenario to study chestnut genetics and the influence of human management because: (i) it is located at one extreme of the distribution area; (ii) it is a major glacial refuge for the native species; (iii) it has a long tradition of human management (since Roman times, at least); and (iv) its geographical setting ensures an unusual degree of genetic isolation. Thirteen microsatellite markers provided enough informativeness and discrimination power to genotype at the individual level. Together with an unexpected level of genetic variability, we found evidence of genetic structure, with three major gene pools giving rise to the current population. High levels of genetic differentiation between groups supported this organization. Interestingly, genetic structure does not match with spatial boundaries, suggesting that the exchange of material and cultivation practices have strongly influenced natural gene flow. The microsatellite markers selected for this study were also used to classify a set of 62 samples belonging to all traditional varieties. We identified several cases of synonymies and homonymies, evidencing the need to substitute traditional classification systems with new tools for genetic profiling. Management and conservation strategies should also benefit from these tools. The avenue of high-throughput sequencing technologies, combined with the development of bioinformatics tools, have paved the way to study transcriptomes without the need for a reference genome. We took advantage of RNA sequencing and de novo assembly tools to determine the transcriptional landscape of chestnut in response to blight disease. In addition, we have selected a set of candidate genes with high potential for developing resistant varieties via genetic engineering. Our results evidenced a deep transcriptional reprogramming upon fungal infection. The plant hormones ET and JA appear to orchestrate the defensive response. Interestingly, our results also suggest a role for auxins in modulating such response. Many transcription factors were identified in this work that interact with promoters of genes involved in disease resistance. Among these genes, we have conducted a functional characterization of a two major thaumatin-like proteins (TLP) that belongs to the PR5 family. Two genes encoding chestnut cotyledon TLPs have been previously characterized, termed CsTL1 and CsTL2. We substantiate here their protective role against blight disease for the first time, including in silico, in vitro and in vivo evidence. The synergy between TLPs and other antifungal proteins, particularly endo-p-1,3-glucanases, bolsters their interest for future control strategies based on biotechnological approaches.

O Teste de Apercepção Temática (TAT) em adultos: dados normativos para o sistema morvaliano

No contexto da pesquisa e utilização prática das técnicas de autoexpressão, o Teste de Apercepção Temática (TAT) apresenta reconhecidas vantagens. Apesar de linhas de pesquisa bastante desenvolvidas internacionalmente, não existem estudos atuais sobre as propriedades deste instrumento no Brasil, levantando a necessidade de conhecer seus alcances e limites nesse contexto cultural. Desse modo, o desenvolvimento de normas que descrevam o desempenho típico de uma população não clínica se mostra um importante passo inicial rumo à retomada da pesquisa com o TAT e sua adoção por profissionais. Tendo em vista que a validação das técnicas de autoexpressão se refere aos sistemas de classificação e não aos instrumentos em si, o presente estudo adotou, dentre a miríade de sistemas de categorização das histórias do TAT descritos na literatura, o sistema proposto por Monique Morval, que foi desenvolvido para estudantes e profissionais com pouca experiência com o TAT, utilizando pressupostos da Personologia de Henry Murray, Psicologia Cognitiva e Psicologia do Ego, possibilitando leituras objetivas e qualitativas do material. Considerando o potencial de utilização desse sistema por parte dos psicólogos brasileiros - visto sua semelhança com o atual sistema aprovado para uso pelo Sistema de Avaliação dos Testes Psicológicos (SATEPSI) do Conselho Federal de Psicologia - foram feitos aprimoramentos no assim chamado sistema morvaliano, possibilitando sua adoção no estudo normativo proposto pelo presente projeto. Tais aprimoramentos consistiram na revisão e adição de categorias e subcategorias, a partir de trabalhos brasileiros e internacionais sobre o instrumento. Desta forma, o presente estudo teve por objetivo desenvolver normas para o TAT (Sistema Morvaliano) em adultos, a partir de uma amostra não clínica, aleatória e estratificada por critérios de idade, sexo, escolaridade e nível socioeconômico (NSE) da cidade de Ribeirão Preto (SP). Os participantes foram 100 adultos (25 a 44 anos de idade), selecionados através de visita a domicílios sorteados em bairros de diferentes NSE. Foram realizadas entrevistas de avaliação psicológica individuais, utilizando um roteiro de entrevista semiestruturada, o Teste de Inteligência Geral Não-Verbal (TIG-NV) e 20 cartões do TAT, pré-selecionados de acordo com as recomendações do manual original do instrumento. As histórias do TAT foram categorizadas no sistema morvaliano revisado e seus dados passaram por análises estatísticas e sínteses qualitativas em busca de diferenças de desempenho relacionadas ao sexo, escolaridade e NSE. Os resultados mostram poucas diferenças entre os grupos que justifiquem a elaboração de normas específicas; apesar disso, foi identificada uma tendência (ainda que pequena) de o nível de escolaridade e o NSE favorecerem um melhor desempenho nas variáveis relativas à organização formal das histórias. São discutidas as implicações dos dados obtidos em termos do perfil normativo de desempenho nas variáveis do sistema morvaliano, suas evidências preliminares de validade e futuras direções para estudos sobre o TAT nesse sistema.

Characterization of rock slopes through slope mass rating using 3D point clouds

Rock mass classification systems are widely used tools for assessing the stability of rock slopes. Their calculation requires the prior quantification of several parameters during conventional fieldwork campaigns, such as the orientation of the discontinuity sets, the main properties of the existing discontinuities and the geo-mechanical characterization of the intact rock mass, which can be time-consuming and an often risky task. Conversely, the use of relatively new remote sensing data for modelling the rock mass surface by means of 3D point clouds is changing the current investigation strategies in different rock slope engineering applications. In this paper, the main practical issues affecting the application of Slope Mass Rating (SMR) for the characterization of rock slopes from 3D point clouds are reviewed, using three case studies from an end-user point of view. To this end, the SMR adjustment factors, which were calculated from different sources of information and processes, using the different softwares, are compared with those calculated using conventional fieldwork data. In the presented analysis, special attention is paid to the differences between the SMR indexes derived from the 3D point cloud and conventional field work approaches, the main factors that determine the quality of the data and some recognized practical issues. Finally, the reliability of Slope Mass Rating for the characterization of rocky slopes is highlighted.