Limiar do Índice Homeostasis Model Assessment (HOMA) para Resistência à Insulina numa População de Doentes Admitidos Electivamente numa Enfermaria Portuguesa de Cardiologia

INTRODUCTION: Insulin resistance is the pathophysiological key to explain metabolic syndrome. Although clearly useful, the Homeostasis Model Assessment index (an insulin resistance measurement) hasn't been systematically applied in clinical practice. One of the main reasons is the discrepancy in cut-off values reported in different populations. We sought to evaluate in a Portuguese population the ideal cut-off for Homeostasis Model Assessment index and assess its relationship with metabolic syndrome. MATERIAL AND METHODS: We selected a cohort of individuals admitted electively in a Cardiology ward with a BMI < 25 Kg/m2 and no abnormalities in glucose metabolism (fasting plasma glucose < 100 mg/dL and no diabetes). The 90th percentile of the Homeostasis Model Assessment index distribution was used to obtain the ideal cut-off for insulin resistance. We also selected a validation cohort of 300 individuals (no exclusion criteria applied). RESULTS: From 7 000 individuals, and after the exclusion criteria, there were left 1 784 individuals. The 90th percentile for Homeostasis Model Assessment index was 2.33. In the validation cohort, applying that cut-off, we have 49.3% of individuals with insulin resistance. However, only 69.9% of the metabolic syndrome patients had insulin resistance according to that cut-off. By ROC curve analysis, the ideal cut-off for metabolic syndrome is 2.41. Homeostasis Model Assessment index correlated with BMI (r = 0.371, p < 0.001) and is an independent predictor of the presence of metabolic syndrome (OR 19.4, 95% CI 6.6 - 57.2, p < 0.001). DISCUSSION: Our study showed that in a Portuguese population of patients admitted electively in a Cardiology ward, 2.33 is the Homeostasis Model Assessment index cut-off for insulin resistance and 2.41 for metabolic syndrome. CONCLUSION: Homeostasis Model Assessment index is directly correlated with BMI and is an independent predictor of metabolic syndrome

Dynamic Limit Growth Indices in Discrete Time

We propose a new class of mappings, called Dynamic Limit Growth Indices, that are designed to measure the long-run performance of a financial portfolio in discrete time setup. We study various important properties for this new class of measures, and in particular, we provide necessary and sufficient condition for a Dynamic Limit Growth Index to be a dynamic assessment index. We also establish their connection with classical dynamic acceptability indices, and we show how to construct examples of Dynamic Limit Growth Indices using dynamic risk measures and dynamic certainty equivalents. Finally, we propose a new definition of time consistency, suitable for these indices, and we study time consistency for the most notable representative of this class -- the dynamic analog of risk sensitive criterion

Crowd sourcing challenges assessment index for disaster management

Emergency agencies (EA) rely on inter-agency approaches to information management during disasters. EA have shown a significant interest in the use of cloud-based social media such as Twitter and Facebook for crowd-sourcing and distribution of disaster information. While the intentions are clear, the question of what are its major challenges are not. EA have a need to recognise the challenges in the use of social media under their local circumstances. This paper analysed the recent literature, 2010 Haiti earthquake and 2010-11 Queensland flood cases and developed a crowd sourcing challenges assessment index construct specific to EA areas of interest. We argue that, this assessment index, as a part of our large conceptual framework of context aware cloud adaptation (CACA), can be useful for the facilitation of citizens, NGOs and government agencies in a strategy for use of social media for crowd sourcing, in preventing, preparing for, responding to and recovering from disasters. © (2012) by the AIS/ICIS Administrative Office All rights reserved

MvSSIM: A quality assessment index for hyperspectral images

Quality assessment indexes play a fundamental role in the analysis of hyperspectral image (HSI) cubes. To assess the quality of an HSI cube, the structural similarity (SSIM) index has been widely applied in a band-by-band manner, as SSIM was originally designed for 2D images, and then the mean SSIM (MeanSSIM) index over all bands is adopted. MeanSSIM fails to accommodate the spectral structure which is a unique characteristic of HSI. Hence in this paper, we propose a new and simple multivariate SSIM (MvSSIM) index for HSI, by treating the pixel spectrum as a multivariate random vector. MvSSIM maintains SSIM’s ability to assess the spatial structural similarity via correlation between two images of the same band; and adds an ability to assess the spectral structural similarity via covariance among different bands. MvSSIM is well founded on multivariate statistics and can be easily implemented through simple sample statistics involving mean vectors, covariance matrices and cross-covariance matrices. Experiments show that MvSSIM is a proper quality assessment index for distorted HSIs with different kinds of degradations

Staff Nurse Ratings of Implementation Self-Efficacy for EBP (ISE4EBP) and Organizational EBP Readiness

There is limited research about nurses' confidence in implementing evidence into clinical practice. The purpose of this study was to further test, refine and strengthen the Implementation Self-Efficacy for EBP (ISE4EBP) scale and gain knowledge about staff nurses' perspectives of their confidence in EBP implementation in relation to the work environment as measured by the Context Assessment Index (CAI). We proposed, higher nurses confident in implementing evidence into practice would result in higher levels of implementing evidence-based practices (EBP). Bandura's theory of self-efficacy, which postulates that task-specific self-efficacy predicts performance guided the study. In a sample of 75 registered nurses, the overall average score for the ISE4EBP scale was 63%, indicating moderate confidence in implementation strategies. This study furthered the construct validity of the ISE4EBP scale by demonstrating associations between the ISE4EBP scores with the CAI.No embargoAcademic Major: Nursin

PROSES PEMBELAJARAN STUDENT CENTERED PADA MATA KULIAH STATISTIK NONPARAMETRIK (PENERAPAN STRATEGI INSTANT ASSESSMENT, INDEX CARD MATCH, PRACTICE REHEARSAL PAIRS, DAN CASE STUDY)

Mata kuliah Statistik Nonparametrik merupakan salah satu mata kuliah pilihan bidang statistika yang diberikan pada semester IV. Standar kompetensi mata kuliah Statistik Nonparametrik adalah menerapkan teknik nonparametrik untuk menganalisis data baik secara manual maupun dengan paket program Minitab dan SPSS, dan membuat interpretasi dari hasil analisis data. Aspek yang dikembangkan adalah pembelajaran student centered dengan menggunakan strategi instant assessment, index card match, practice-rehearsal pairs, dan case study. Instant assessment adalah strategi menarik yang dapat digunakan untuk memotivasi mahasiswa untuk aktif sejak awal perkuliahan, index card match digunakan untuk mereview materi yang telah dibahas, practice-rehearsal pairs merupakan strategi sederhana untuk mempraktekkan dan melatih suatu ketrampilan atau prosedur dengan teman atau kelompok lain, dan case study adalah strategi yang banyak digunakan di berbagai bidang dan merupakan salah satu metode pembelajaran terbaik. Berdasarkan evaluasi penerapan metode pembelajaran diperoleh kesimpulan bahwa metode student centered dengan strategi instant assessment, index card match, practice-rehearsal pairs, dan case study dapat meningkatkan hasil belajar mahasiswa. Selain itu, strategi-strategi yang diterapkan juga dapat meningkatkan keaktifan mahasiswa dalam perkuliahan, meningkatkan kemampuan mengemukakan pendapat, serta merangsang daya pikir dan sifat kritis mahasiswa. Kata kunci: instant assessment, index card, practice-rehearsal pairs, case stud

The Development of an Stream Water Quality Assessment Index to Evaluate Stream Health Conesus Lake Tributaries Spring 2011

The major goal was to develop an assessment tool for watershed health utilizing the USDA data base. Such a tool would allow the county to evaluate the status of watersheds; that is, are they improving, getting worse, or not changing. An evaluation tool of this type would allow further development and direction of the Conesus Lake Watershed Management Plan. Monitoring of two of the USDA streams (Cottonwood Gully and North McMillan Creek) was changed to the spring rather than the summer. This was done as a result of last year’s work which suggested that spring monitoring may provide a better Stream Water Quality Assessment Index watershed status than a summer index. A Stream Water Quality Assessment Index was developed based on spring data that has promise for evaluating trends in the impact of land use on Conesus Lake subwatersheds

Association between serum Mg2+ concentrations and cardiovascular organ damage in a cohort of adult subjects

Magnesium (Mg2+) levels are associated with insulin resistance, hypertension, atherosclerosis, and type 2 diabetes (T2DM). We evaluated the clinical utility of physiological Mg2+ in assessing subclinical cardiovascular organ damage including increased carotid artery intima-media thickness (c-IMT) and left ventricular mass index (LVMI) in a cohort of well-characterized adult non-diabetic individuals. Age-and gender-adjusted correlations between Mg2+ and metabolic parameters showed that Mg2+ circulating levels were correlated negatively with body mass index (BMI), fasting glucose, and 2h-oral glucose tolerance test (OGTT) glucose. Similarly, Mg2+ levels were significantly and negatively related to c-IMT and LVMI. A multivariate regression analysis revealed that age (β = 0.440; p &lt; 0.0001), BMI (β = 0.225; p &lt; 0.0001), and Mg2+ concentration (β = −0.122; p &lt; 0.01) were independently associated with c-IMT. Age (β = 0.244; p = 0.012), Mg2+ (β = −0.177; p = 0.019), and diastolic blood pressure (β = 0.184; p = 0.038) were significantly associated with LVMI in women, while age (β = 0.211; p = 0.019), Mg2+ (β = −0.171; p = 0.038) and the homeostasis model assessment index of insulin resistance (HOMA-IR) (β = −0.211; p = 0.041) were the sole variables associated with LVMI in men. In conclusion, our data support the hypothesis that the assessment of Mg2+ as part of the initial work-up might help unravel the presence of subclinical organ damage in subjects at increased risk of cardiovascular complications