Tradução, adaptação cultural e validação do Nonarthritic Hip Score para o Brasil

A avaliação da qualidade de vida tem sido cada vez mais utilizada pelos profissionais da área de saúde para mensurar o impacto de doenças na vida dos pacientes, bem como para avaliar os resultados dos tratamentos realizados. O crescente interesse por protocolos de pesquisa clínica em doenças não degenerativas do quadril tem encontrado muitos obstáculos na avaliação objetiva de seus resultados, principalmente nos estudos de observação de novas intervenções terapêuticas, como a artroscopia. O Nonarthritic Hip Score (NAHS) é um instrumento de avaliação clínica, desenvolvido originalmente em inglês, cujo objetivo é avaliar a função da articulação do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir esse instrumento para a língua portuguesa, adaptá-lo para a cultura brasileira e validá-lo para que possa ser utilizado na avaliação de qualidade de vida de pacientes brasileiros com dor no quadril, sem doença degenerativa. A metodologia utilizada é a sugerida por Guillemin et al. (1993) e revisado por Beaton et al. (2000), que propuseram um conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida, incluindo cinco etapas: tradução, tradução de volta, revisão pelo comitê, pré-teste e teste, com reavaliação dos pesos dos escores, se relevante. A versão de consenso foi aplicada em 30 indivíduos. As questões sobre atividades esportivas e tarefas domésticas foram modificadas, para melhor adaptação à cultura brasileira. A versão brasileira do Nonarthritic Hip Score (NAHS-Brasil) foi respondida por 64 pacientes com dor no quadril, a fim de avaliar as propriedades de medida do instrumento: reprodutibilidade, consistência interna e validade. A reprodutibilidade foi 0,9, mostrando uma forte correlação; a consistência interna mostrou correlação entre 0,8 e 0,9, considerada boa e excelente; a validade foi considerada respectivamente boa e excelente; a correlação entre NAHS-Brasil e WOMAC foi 0,9; e a correlação entre o NAHS-Brasil e Questionário Algofuncional de Lequesne foi 0,79. O Nonarthritic Hip Score foi traduzido para a língua portuguesa e adaptado à cultura brasileira, de acordo com o conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida. Sua reprodutibilidade, consistência interna e validade foram também demonstradas.

La ética y el riesgo moral de las entidades financieras

[ES] Actualmente nos econtramos sumergidos en una de las mayores crisis económicas conocidas hasta el momento, la cual ha dado lugar a diversos debates sobre las posibles causas de la misma. Entre ellas, últimamente, han tomado cierta relevancia términos como la ética bancaria y el riesgo moral, los cuales permiten establecer una concordancia entre las actitudes de la banca en los años previos al año 2007 y el estallido de la crisis económica. Es necesario, por tanto, el análisis de casos concretos como Bankia, CAM y BBVA para conocer con exactitud las buenas y malas gestiones desarrolladas por las entidades financieras de nuestro entorno en los citados años. Asimismo, conviene mostrar las consecuencias de aquellas actitudes, como la pérdida de la confianza por parte de la clientela, para determinar las medidas adoptadas con objeto de reconducir el sistema financiero español, lo cual permite evaluar su grado de efectividad.

Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

Background: Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods: This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables 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. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results: In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better. Conclusions: Five clinical predictors easily available in the ED, and also in the primary care setting, can be used to create a simple and easily obtained score that allows clinicians to stratify patients with eCOPD upon ED arrival and guide the medical decision-making process.

El riesgo de crédito

El objetivo de este estudio es analizar el riesgo de crédito tanto desde el punto de vista de particulares como de los bancos y empresas. Se persigue hallar la forma de controlarlo y de buscar vías de reducirlo en la medida de lo posible, su estudio y seguimiento desde el momento de la concesión hasta el final de la operación. Una buena gestión del riesgo es la mejor herramienta para paliar sus efectos y anticiparse a los sucesos desfavorables. En este Trabajo me he propuesto analizar la situación económica y coyuntural en la que nos encontramos actualmente analizando la evolución que hemos vivido con el cambio de Basilea I hasta la actual directiva: Basilea III. El trabajo se ha estructurado en cuatro fases. La primera de ellas es una mera introducción, e incluye las definiciones - según varias fuentes - del riesgo de crédito, la legislación y las diferentes clasificaciones. La segunda, es un análisis de la situación actual del riesgo de crédito. La tercera, es un análisis de los rating y de los cambios que ha habido con cada directiva. Y por último, se realiza el análisis final junto con las conclusiones. Finalmente muestro posibles líneas de investigación futuras.

Aplicación de metodología estadística para predecir la mortalidad de pacientes con neumonía

[es]Con esta memoria se pretende crear una herramienta de trabajo que ayude a los médicos a clasificar a los pacientes que padecen neumonía en distintos grupos de riesgo dependiendo de su gravedad. Para ello, hemos estudiado la regresión logística, que relaciona la variable respuesta mortalidad con el resto de variables (datos demográficos, antecedentes médicos y datos clínicos y exploratorios del paciente). Una vez creado el score a partir del modelo de regresión, hemos querido validarlo y compararlo con otros dos que utilizan los neumólogos: el CURB-65 y el FINE.

El riesgo de orientación en la inversión en spin-offs universitarias. ¿Existe? ¿Es posible identificarlo en los primeros años de vida?

[ES] Diversos estudios han mostrado evidencias de que las empresas creadas desde las universidades (spin-offs) presentan unas tasas de crecimiento menores que otros tipos de start-ups. Esto puede deberse en parte a que un porcentaje de ellas pueden estar orientadas a dar continuidad a proyectos de investigación en base a ayudas públicas, en lugar de a valorizar resultados de investigación en el mercado. El principal objetivo de este trabajo es contrastar si es posible diferenciar dos tipos de spin-offs en función de si están orientadas al mercado o no. Además, en segundo lugar, hemos tratado de comprobar si es posible identificar esta orientación desde las primeras fases de vida de las spin-offs, lo que afectaría al perfil de riesgo desde el punto de vista de los inversores. Para ello hemos utilizado una muestra de 20 spin-offs y se ha procedido a analizar tanto sus estados contables como las ayudas y subvenciones públicas obtenidas durante sus primeros cinco años de actividad. La metodología empleada ha sido el análisis de conglomerados. Los resultados obtenidos sugieren que, si bien efectivamente un número significativo de spin-offs no parecen orientadas al mercado, esta diferenciación no puede inferirse de la información inicial económico financiera de la empresa. Este hecho puede dar lugar a un riesgo de orientación , definido como la imposibilidad por parte del inversor inicial de saber si existe una orientación o no al mercado de la spin-off.

Evaluation of quality of shark livers using bio-chemical properties and organoleptic score sheet

Shark livers are considered as an important raw material providing a quality fish oil. It has been reported to aid white — blood-cell production and act as an active ingredient in hemorrhoid treatments. It is also reported that liver oil as a good supplement of vitamin A and poly-unsaturated fatty acids which are important to the development of brain cells in human. Freshness of livers is very important to extract better quality oil. In Sri Lanka, the annual shark production amounts to 8000t, however the quality of livers collected from landing sites has not being measured yet. Present study was conducted to evaluate the quality of silky (Charcarninus fakiformis) shark livers available in Negombo and Beruwala landing sites in the West Coast of Sri Lanka and also to study the relationship between organoleptic and bio-chemical correlation on freshness of shark livers. Liver samples which were collected from landing sites in the West coast of Sri Lanka, were evaluated for external and internal colour, texture and odour. Total volatile nitrogen (TVN), pH value, free fatty acid (FFA%) and peroxide (PV) values of livers were also determined to assess quality. According to the organoleptic scoring system 4.3% of liver samples were categorized as best in quality while 30.4%, 56.5% and 8.7% rated as good, medium and poor in quality respectively at the Negombo and Beruwala landing sites. Bio-chemical analysis showed that the better quality livers had the highest score for sensory evaluation and low values for TVN, FFA and peroxide value while low quality livers gave low score for sensory evaluation and high TVN, FFA, peroxide values. Correlation coefficient of organoleptic scores against total volatile nitrogen value, pH value, free fatty acid % and peroxide value of shark livers were determined by statistical analysis. Organoleptic score of shark livers was found to be highly.

System combination and score normalization for spoken term detection

Spoken content in languages of emerging importance needs to be searchable to provide access to the underlying information. In this paper, we investigate the problem of extending data fusion methodologies from Information Retrieval for Spoken Term Detection on low-resource languages in the framework of the IARPA Babel program. We describe a number of alternative methods improving keyword search performance. We apply these methods to Cantonese, a language that presents some new issues in terms of reduced resources and shorter query lengths. First, we show score normalization methodology that improves in average by 20% keyword search performance. Second, we show that properly combining the outputs of diverse ASR systems performs 14% better than the best normalized ASR system. © 2013 IEEE.

Efficient decoding with generative score-spaces using the expectation semiring

State-of-the-art speech recognisers are usually based on hidden Markov models (HMMs). They model a hidden symbol sequence with a Markov process, with the observations independent given that sequence. These assumptions yield efficient algorithms, but limit the power of the model. An alternative model that allows a wide range of features, including word- and phone-level features, is a log-linear model. To handle, for example, word-level variable-length features, the original feature vectors must be segmented into words. Thus, decoding must find the optimal combination of segmentation of the utterance into words and word sequence. Features must therefore be extracted for each possible segment of audio. For many types of features, this becomes slow. In this paper, long-span features are derived from the likelihoods of word HMMs. Derivatives of the log-likelihoods, which break the Markov assumption, are appended. Previously, decoding with this model took cubic time in the length of the sequence, and longer for higher-order derivatives. This paper shows how to decode in quadratic time. © 2013 IEEE.

Desarrollo de una herramienta virtual educativa para la promoción de hábitos nutricionales saludables: evaluación de los hábitos alimentarios y conductas de riesgo de los TCA en la comunidad universitaria de la UEM

Sin índice de impacto (2012)

Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis

Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality.

Ictus: incidencia, factores de riesgo y repercusión

El término ictus fue definido por la Organización Mundial de la Salud (OMS) en 1978 como un "síndrome clínico de origen vascular, caracterizado por signos de alteración focal o global de las funciones cerebrales de rápida evolución, que perduran más de 24 horas o provocan la muerte". El término Ictus, supone una de las primeras causas de mortalidad en el mundo occidental y la primera causa de incapacidad y coste económico. Con este trabajo lo que se pretende es dar a conocer la tanto la incidencia y prevalencia como los factores predictores susceptibles que provocan la enfermedad. Así como la repercusión que lleva a cabo a nivel personal