Fuzzy logic as a decision-making support system for the indication of bariatric surgery based on an index (OBESINDEX) generated by the association between body fat and body mass index

Background: A Fuzzy Obesity Index (OBESINDEX) for use as an alternative in bariatric surgery indication (BSI) is presented. The search for a more accurate method to evaluate obesity and to indicate a better treatment is important in the world health context. BMI (body mass index) is considered the main criteria for obesity treatment and BSI. Nevertheless, the fat excess related to the percentage of Body Fat (%BF) is actually the principal harmful factor in obesity disease that is usually neglected. This paper presents a new fuzzy mechanism for evaluating obesity by associating BMI with %BF that yields a fuzzy obesity index for obesity evaluation and treatment and allows building up a Fuzzy Decision Support System (FDSS) for BSI.

Methods: Seventy-two patients were evaluated for both BMI and %BF. These data are modified and treated as fuzzy sets. Afterwards, the BMI and %BF classes are aggregated yielding a new index (OBESINDEX) for input linguistic variable are considered the BMI and %BF, and as output linguistic variable is employed the OBESINDEX, an obesity classification with entirely new classes of obesity in the fuzzy context as well is used for BSI.

Results: There is a gradual, smooth obesity classification and BSI when using the proposed fuzzy obesity index when compared with other traditional methods for dealing with obesity.

Conclusion: The BMI is not adequate for surgical indication in all the conditions and fuzzy logic becomes an alternative for decision making in bariatric surgery indication based on the OBESINDEX

Relationship of arterial and exhaled CO2 during elevated artificial pneumoperitoneum pressure for introduction of the first trocar.

The present study evaluated the correlation between arterial CO2 and exhaled CO2 during brief high-pressure pneumoperitoneum. Patients were randomly distributed into two groups: P12 group (n=30) received a maximum intraperitoneal pressure of 12mmHg, and P20 group (n=37) received a maximum intraperitoneal pressure of 20mmHg. Arterial CO2 was evaluated by radial arterial catheter and exhaled CO2 was measured by capnometry at the following time points: before insufflation, once intraperitoneal pressure reached 12mmHg , 5 minutes after intraperitoneal pressure reached 12mmHg for the P12 group or 20mmHg for the P20 group, and 10 minutes after intraperitoneal pressure reached 12mmHg for the P12 group or when intraperitoneal pressure had decreased from 20mmHg to 12mmHg, for the P20 group. During brief durations of very high intraperitoneal pressure (20mmHg), there was a strong correlation between arterial CO2 and exhaled CO2. Capnometry can be effectively used to monitor patients during transient increases in artificial pneumoperitoneum pressure

O programa nacional de fortalecimento da agricultura familiar no Brasil: uma análise sobre a distribuição regional e setorial dos recursos.

No Brasil, as políticas públicas para o espaço rural sempre tenderam a priorizar a agricultura patronal, em detrimento dos agricultores familiares. Todavia, os estudos realizados pelos órgãos FAO - INCRA deram subsídio para a criação do Programa Nacional de Fortalecimento da Agricultura Familiar (PRONAF), resultando em um novo direcionamento dos investimentos públicos, os quais passaram a contemplar o segmento dos agricultores familiares. Entende-se o PRONAF como uma política não-compensatória, que, apesar de seus problemas, tem contribuído de fato para mudanças e melhorias no espaço agrário brasileiro. Desde sua criação no final da década de 1990, o PRONAF passou por várias mudanças em sua estrutura administrativa e operacional, a fim de alcançar seus objetivos e adequar-se face a complexa realidade social agrária brasileira. Sendo assim, o presente estudo visa discutir as ações do Estado por meio desse Programa, a partir de suas linhas de atuação, bem como analisar a distribuição de suas concessões de crédito regional e setorialmente. Assim, os procedimentos metodológicos utilizados para a realização deste trabalho compreendem pesquisa bibliográfica e documental, além de pesquisa em fontes secundárias, no intuito de obter dados e informações relevantes para a análise das relações sociais estabelecidas em meio a esse processo de concretização e espacialização desse Programa. Dentre as implicações do PRONAF pode-se notar em âmbito nacional, uma diminuição da disparidade regional brasileira, bem como a preocupação que o Programa tem demonstrado com os aspectos socioculturais locais e regionais, como forma de garantir que seus investimentos perpassem a dimensão econômica, mas valorize outras dimensões, a exemplo dos elementos culturais

Recovery of p-TBC from a butadiene washing stream in a pilot plant

Results obtained in a pilot-scale unit designed for COD removal and p-TBC (p-tert-butylcatechol) recovery from a butadiene washing stream (pH 14, 200,000 mg COD L-1, highly toxic) at a petrochemical industry are presented. By adding H3PO4, phase separation is achieved and p-TBC is successfully recovered (88 g L-1 of washing stream). Information (time for phase separation and organic phase characterization) was gathered for designing a future industrial unit. The estimated heat generation rate was 990 kJ min-1 and 15 min were enough to promote phase separation for a liquid column of approximately 1.15 m.PetroflexCNPqFUJ

Pressure effect in the X-ray intrinsic position resolution in noble gases and mixtures

A study of the gas pressure effect in the position resolution of an interacting X- or gamma-ray photon in a gas medium is performed. The intrinsic position resolution for pure noble gases (Argon and Xenon) and their mixtures with CO2 and CH4 were calculated for several gas pressures (1-10bar) and for photon energies between 5.4 and 60.0 keV, being possible to establish a linear match between the intrinsic position resolution and the inverse of the gas pressure in that energy range. In order to evaluate the quality of the method here described, a comparison between the available experimental data and the calculated one in this work, is done and discussed. In the majority of the cases, a strong agreement is observed

A dynamic method for charging-up calculations: the case of GEM

The simulation of Micro Pattern Gaseous Detectors (MPGDs) signal response is an important and powerful tool for the design and optimization of such detectors. However, several attempts to simulate exactly the effective charge gain have not been completely successful. Namely, the gain stability over time has not been fully understood. Charging-up of the insulator surfaces have been pointed as one of the responsible for the difference between experimental and Monte Carlo results. This work describes two iterative methods to simulate the charging-up in one MPGD device, the Gas Electron Multiplier (GEM). The first method uses a constant step for avalanches time evolution, very detailed, but slower to compute. The second method uses a dynamic step that improves the computing time. Good agreement between both methods was reached. Despite of comparison with experimental results shows that charging-up plays an important role in detectors operation, should not be the only responsible for the difference between simulated and measured effective gain, but explains the time evolution in the effective gain.Comment: Minor changes in grammatical statements and inclusion of some important information about experimental setup at section "Comparison with experimental results

Tracking persistence of Helicobacter pylori in potable water biofilms using novel 16S rRNA peptide nucleic acid probes

A two stage chemostat system was used to study the pathogenic bacteria H. pylori association to drinking water biofilms. After allowing one week old biofilms to be grown on stainless steel coupons the system was inoculated with the pathogen that was detected using the recently established technique of 16S rRNA peptide nucleic acid (PNA) fluorescence in situ hybridization (FISH). Results show that H. pylori can successfully incorporate within biofilms and its presence was detected for up to five days, either in the basal layer or inside typical biofilm structures such as stacks or fronds. The PNA FISH protocol appears to be a promising new technique for the in situ visualization of microorganisms in biofilms, especially because the hydrophobic nature of the PNA molecule allows a better diffusion through the constituents of the biofilm matrix allowing an improved discrimination of microorganisms inside these naturally occurring structures. A setback in the application of this methodology was the presence of autofluorescent microorganisms. This problem can be minimized by comparing the morphologic characteristics of these suspected false positives with typical H. pylori morphology. If questions subsist, the visualization of the biofilm under different filter blocks can also improve the degree of certainty in the identification, since the reporter probe has usually a very distinctive pattern of fluorescence when compared to the autofluorescent microorganisms

Simulation of gain stability of THGEM gas-avalanche particle detectors

Charging-up processes affecting gain stability in Thick Gas Electron Multipliers (THGEM) were studied with a dedicated simulation toolkit. Integrated with Garfield++, it provides an effective platform for systematic phenomenological studies of charging-up processes in MPGD detectors. We describe the simulation tool and the fine-tuning of the step-size required for the algorithm convergence, in relation to physical parameters. Simulation results of gain stability over time in THGEM detectors are presented, exploring the role of electrode-thickness and applied voltage on its evolution. The results show that the total amount of irradiated charge through electrode's hole needed for reaching gain stabilization is in the range of tens to hundreds of pC, depending on the detector geometry and operational voltage. These results are in agreement with experimental observations presented previously

Development of an optimized technique for the recovery of H. pylori from water and drinking water biofilms

At present, the route of transmission is perhaps one of the most controversialareas of Helicobacter pylori research. Drinking water and associated biofilms have been suggested as possible environmental reservoirs for the bacterium, however, successful and consistent detection of the bacterium in real systems has not yet been accomplished. A new protocol that offers improved recovery ratings of H. pylori from water and associated-biofilms has been developed and evaluated. This protocol includes optimized incubation atmospheres and a new recovery culture medium, as well as an assessmentof existing techniques for the detachment of H. pylori from surfaces. Even though obvious advantages in terms of cell counts are obtained using this method, certain problems, such as contamination by faster-growing species of the culture medium in heavily contaminated waters may still hinder a successful recovery of the pathogen.Future research will involve further improvement of the protocol and monitoring of real drinking water distribution systems.Unit of Helicobacter/Campylobacter of the Center of Bacteriology of INSA para a Ciência e a Tecnologia (FCT) ; European Commission Research Project SAFER