Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry.

BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients. METHODS COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)). RESULTS Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7). CONCLUSIONS COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.

Disease discovery, sistema de predicció de malalties

L'objectiu d'aquest projecte consisteix en crear una eina per servir de referència a metges, per tal d'ajudar-los en els diagnòstics, sobretot de malalties més estranyes que són més difícils de diagnostica, ja que no són tant conegudes. Estem interessats en realitzar una aplicació la qual donats uns símptomes ens doni les malalties mé probables. El personal sanitari doncs podrà disposar d'una eina que l'ajudi a diagnosticar malalties segons els símptomes dels pacients. L'eina que es presenta en aquest treball, Disease Discovery, disposa d'una base de dades omplerta des de fonts molt fiables i amb una quantitat elevada d'informació sobre malalties i símptomes. Aquesta base de dades s'entrena segons diferents classificadors. Les prediccions de les malalties es faran emprant un model generat per mitjà d'un entrenament realitzat amb un classificador sobre la base de dades. A més a més, s'ha realitzat una interfície web per ajudar als usuaris i fer que l'eina sigui més usable alhora que més còmoda de distribuir el programari entre el personal sanitari interessat.

Combined use of the GGSFT data base and on Board Marine Collected Data to Model the Moho Beneath the Powell Basin, Antarctica

The Powell Basin is a small oceanic basin located at the NE end of the Antarctic Peninsula developed during the Early Miocene and mostly surrounded by the continental crusts of the South Orkney Microcontinent, South Scotia Ridge and Antarctic Peninsula margins. Gravity data from the SCAN 97 cruise obtained with the R/V Hespérides and data from the Global Gravity Grid and Sea Floor Topography (GGSFT) database (Sandwell and Smith, 1997) are used to determine the 3D geometry of the crustal-mantle interface (CMI) by numerical inversion methods. Water layer contribution and sedimentary effects were eliminated from the Free Air anomaly to obtain the total anomaly. Sedimentary effects were obtained from the analysis of existing and new SCAN 97 multichannel seismic profiles (MCS). The regional anomaly was obtained after spectral and filtering processes. The smooth 3D geometry of the crustal mantle interface obtained after inversion of the regional anomaly shows an increase in the thickness of the crust towards the continental margins and a NW-SE oriented axis of symmetry coinciding with the position of an older oceanic spreading axis. This interface shows a moderate uplift towards the western part and depicts two main uplifts to the northern and eastern sectors.

Desenvolvimento e implantação de Data Base Marketing para apoiar estratégia de gestão de fidelização de clientes em empresa administradora de consórcios

o ambiente econômico atual tem exigido empenho das empresas em conhecer, interagir, diferenciar e personalizar cada vez mais produtos e serviços para os clientes. Este cenário requer ferramentas e modelos de gestão para gerenciar as relações com os clientes, com o objetivo de permitir que a empresa consiga perceber e responder rapidamente a exigências dos consumidores. Este trabalho revisa conceitos de CRM (Customer Relationschip Management ou Gerenciamento das Relações com os Clientes) e descreve a implementação de ferramenta de gestão de relacionamento com clientes em empresa de consórcio. O desenvolvimento do trabalho reflete uma necessidade apontada no planejamento estratégico da empresa, sendo que ferramentas de tecnologia de informação e software de banco de dados foram usadas como suporte aos propósitos da gestão empresarial. Como resultado do trabalho, a empresa está hoje atuando com um sistema de Data Base Marketing, o qual foi criado para auxiliar os profissionais envolvidos no processo de atendimento e gestão de relacionamento com clientes. O Data Base Marketing esta sendo utilizado para coletar dados de atendimento a clientes, tais como históricos de atendimento, dados cadastrais, perfil demográfico, perfil psicográfico e categoria de valor dos clientes. Durante o processo de interação com clientes, o sistema facilita o trabalho dos especialistas e permite melhorar a qualidade do atendimento aos clientes, contemplando necessidades dos diversos especialistas da empresa em assuntos como vendas, qualidade em serviços, finanças e gestão empresarial.O processo começou pela constituição de um grupo de trabalho interno para discutir estratégias e cronograma de implantação. A primeira decisão do grupo foi pelo desenvolvimento interno do software visando atender plenamente o "core business" da empresa. O processo começou pela constituição de um grupo de trabalho interno para discutir estratégias e cronograma de implantação. A primeira decisão do grupo foi pelo desenvolvimento interno do software visando atender plenamente o "core business" da empresa. O projeto contou com o conhecimento do negócio dos profissionais da empresa e auxilio de especialistas e consultores externos. O detalhamento do projeto, bem como os passos da pesquisa-ação, está descrito no corpo da dissertação.

Prognosis of Atrial Fibrillation in Patients with Symptomatic Peripheral Arterial Disease: Data from the REduction of Atherothrombosis for Continued Health (REACH) Registry

BACKGROUND: Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD). METHODS: The International Reduction of Atherothrombosis for Continued Health (REACH) Registry included 23,542 outpatients in Europe with established coronary artery disease, cerebrovascular disease (CVD), PAD and/or >/=3 risk factors. Of these, 3753 patients had symptomatic PAD. CV risk factors were determined at baseline. Study end point was a combination of cardiac death, non-fatal myocardial infarction (MI) and stroke (CV events) during 2 years of follow-up. Cox regression analysis adjusted for age, gender and other risk factors (i.e., congestive heart failure, coronary artery re-vascularisation, coronary artery bypass grafting (CABG), MI, hypertension, stroke, current smoking and diabetes) was used. RESULTS: Of 3753 PAD patients, 392 (10%) were known to have AF. Patients with AF were older and had a higher prevalence of CVD, diabetes and hypertension. Long-term CV mortality occurred in 5.6% of patients with AF and in 1.6% of those without AF (p<0.001). Multivariable analyses showed that AF was an independent predictor of late CV events (hazard ratio (HR): 1.5; 95% confidence interval (CI): 1.09-2.0). CONCLUSION: AF is common in European patients with symptomatic PAD and is independently associated with a worse 2-year CV outcome.

News of the European Resource Centre for Social Work Research Data base

The CERTS database is now online! Our efforts bear finally fruit! It is possible to visit our database on the web now in French, in English and in about ten European languages in the forthcoming months. Your turn! Connect you to the following address: www.certs-europe.com/database

Barents and Kara Seas oceanographic data base (BarKode)

Oceanographic data collected by ocean research organisations in Russia, the USA, the United Kingdom, Germany, Norway, and Poland for the Barents, Kara and White Seas region are presented in this atlas. Recently declassified naval data from Norway, the USA, and the UK are also included. More than 1,000,000 oceanographic stations containing temperature and/or sea-water salinity data were originally selected. After correcting errors and eliminating duplicates, data from 206,300 checked stations were placed on CD-ROM, together with many figures describing the characteristics of both the single-input and combined data set. In addition, temperature and salinity measurements were interpolated to the following standard horizons: 0, 25, 50, 100, 150, 200, 250, 300 m, and bottom. This atlas covers the 100-year period 1898 to 1998 and is, to date, the most complete oceanographic data collection for these Arctic shelf seas. This data set is complemented by more than 9,000 measurements of sea surface temperature, which were recently digitized from ships' logbooks. They cover the same geographical area within the time period 1867-1912.

Conservation Projects (ConPro) data base from The Nature Conservancy and others about the protected areas with analyzed Conservation Action Plans (CAP) before 2009 (Appendix 1) and after 2009 (Appendix 2)

It is widely recognized that climate change poses significant challenges to the conservation of biodiversity. The need of dealing with relatively rapid and uncertain environmental change calls for the enhancement of adaptive capacity of both biodiversity and conservation management systems. Under the hypothesis that most of the conventional biodiversity conservation tools do not sufficiently stimulate a dynamic protected area management, which takes rapid environmental change into account, we evaluated almost 900 of The Nature Conservancy's site-based conservation action plans. These were elaborated before a so-called climate clinic in 2009, an intensive revision of existing plans and a climate change training of the planning teams. We also compare these results with plans elaborated after the climate clinic. Before 2009, 20% of the CAPs employed the term "climate change" in their description of the site viability, and 45% identified key ecological attributes that are related to climate. 8% of the conservation strategies were directly or indirectly related to climate change adaptation. After 2009, a significantly higher percentage of plans took climate change into account. Our data show that many planning teams face difficulties in integrating climate change in their management and planning. However, technical guidance and concrete training can facilitate management teams learning processes. Arising new tools of adaptive conservation management that explicitly incorporate options for handling future scenarios, vulnerability analyses and risk management into the management process have the potential of further making protected area management more proactive and robust against change.

The CLIMATE data base of monthly normals for globally gridded climatic variables (version 2.1)

This database (Leemans & Cramer 1991) contains monthly averages of mean temperature, temperature range, precipitation, rain days and sunshine hours for the terrestrial surface of the globe, gridded at 0.5 degree longitude/latitude resolution. All grd-files contain the same 62483 pixels in the same order, with 30' latitude and longitude resolution. The coordinates are in degree-decimals and indicate the SW corner of each pixel. Topography is from ETOPO5 and indicates modal elevation. Data were generated from a large data base, using the partial thin-plate splining algorithm (Hutchinson & Bischof 1983). This version is widely used around the globe, notably by all groups participating in the IGBP NPP model intercomparison.