727 research outputs found

    Comparison and assessment of large-scale surface temperature in climate model simulations

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    We present a data-driven approach to assess and compare the behavior of large-scale spatial averages of surface temperature in climate model simulations and in observational products. We rely on univariate and multivariate dynamic linear model (DLM) techniques to estimate both long-term and seasonal changes in temperature. The residuals from the DLM analyses capture the internal variability of the climate system and exhibit complex temporal autocorrelation structure. To characterize this internal variability, we explore the structure of these residuals using univariate and multivariate autoregressive (AR) models. As a proof of concept that can easily be extended to other climate models, we apply our approach to one particular climate model (MIROC5). Our results illustrate model versus data differences in both long-term and seasonal changes in temperature. Despite differences in the underlying factors contributing to variability, the different types of simulation yield very similar spectral estimates of internal temperature variability. In general, we find that there is no evidence that the MIROC5 model systematically underestimates the amplitude of observed surface temperature variability on multi-decadal timescales – a finding that has considerable relevance regarding efforts to identify anthropogenic “fingerprints” in observational surface temperature data. Our methodology and results present a novel approach to obtaining data-driven estimates of climate variability for purposes of model evaluation.</p

    Geografia da saúde no cruzamento de saberes

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    Bridging the ICD11 and the DSM-5 personality disorders classification systems: The role of the PID5BF + M

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    Introduction: In both the ICD-11 Classification of Personality Disorders and the DSM-5 Alternative Model of Personality Disorders (AMPD) personality disorders (PD) are characterized by impairments in self- and interpersonal functioning which distinguish the various levels of dysfunction. Moreover, pathological traits are used by these classification systems to define the stylistic expression of personality dysfunction. Negative affectivity, detachment, antagonism/dissociality, and disinhibition feature as trait domains in each of these models. However, there are also differences between the two models, namely, in the psychoticism domain, which does not feature as a personality trait domain in the ICD-11, and in the anankastia domain, corresponding to compulsivity in the DSM-5, which was removed from the final AMPD model. Furthermore, facets are acknowledged by the DSM-5 within each trait domain, while this does not occur in the ICD-11. In view of the similarity between these classification systems, their harmonization would be beneficial for the clinical profession. With this goal in mind, the PID5BF + M, an algorithm that assesses the DSM-5 and ICD-11 six trait domains and 18 facets, was developed and has proven to adequately characterize the ICD-11 trait domains by means of DSM-5 trait facets. Methods: The current study compares a community sample (N = 280, Mage = 48.01, 53.2% females) with a PD sample (N = 131, Mage = 42.66, 45.0% females) along with the PID5BF + M, the LPFS-SR and the PID-5. Given that the PID5BF + M total can be seen as a measure of the level of personality dysfunction, strong relations between the PID5BF + M total and the LPFS-SR total are expected. Strong relations between the trait specifiers measured by the PID5BF + M and the PID-5 are also expected. Finally, the community and clinical samples are expected to differentiate by means of the dimensions assessed through the three afore-mentioned measures. The Spearman rank-order correlation coefficient was used to measure the strength and direction of associations between the PID5BF + M total and the LPFS-SR total and between the PID5BF + M and the PID-5 traits. Group differences were explored using the Mann–Whitney U test for independent samples. Results: As expected, there were strong, significant, and positive relations between the measures. Furthermore, higher scores were observed in all the variables for the PD group against the community group. Discussion: Although this study has limitations, its findings sustain that the PID5BF + M has potential to assess the severity of personality disfunction and to characterize the stylistic features of PD as they are conceived by both the ICD-11 and the DSM-5. Although more research is needed regarding the convergent validity of the PID5BF + M, this new test contributes to the harmonization of both systems and to parsimony in the assessment of PD, which is the main objective of clinical practice.info:eu-repo/semantics/publishedVersio

    Infeção gonocócica disseminada – Um quadro clínico a relembrar

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    Os autores apresentam um caso clínico de infeção gonocócica disseminada, numa mulher de 50 anos, cursando com febre, poliartalgias e exuberantes lesões cutâneas de tipo pápulo-pustuloso com componente hemorrágico. As hemoculturas e a cultura de exsudado vaginal foram negativas, sendo o diagnóstico confirmado por deteção do ADN bacteriano por PCR em amostra de urina. Pretende-se com este trabalho relembrar um quadro clínico pouco frequente e de identificação difícil por se confundir facilmente com outras entidades nosológicas,nomeadamente do foro autoimune

    Five-year follow-up of participants diagnosed with chronic airflow obstruction in a South African Burden of Obstructive Lung Disease (BOLD) survey

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    Background. A community-based prevalence survey performed in two suburbs in Cape Town, South Africa (SA), in 2005, using the international Burden of Obstructive Lung Disease (BOLD) method, confirmed a prevalence of chronic airflow obstruction (CAO) in 23.1% of adults aged >40 years. Objectives. To study the clinical course and prognosis over 5 years of patients with CAO identified in the 2005 survey. Methods. Patients with CAO in 2005 were invited to participate. Standard BOLD and modified questionnaires were completed. Spirometry was performed using spirometers of the same make as in 2005. Results. Of 196 eligible participants from BOLD 2005, 45 (23.0%) had died, 8 from respiratory causes, 10 from cardiovascular causes and 6 from other known causes, while in 21 cases the cause of death was not known. On multivariate analysis, only age and Global initiative for Obstructive Lung Disease (GOLD) stage 4 disease at baseline were significantly associated with death. Of the 151 survivors, 11 (5.6% of the original cohort) were unavailable and 33 (16.8%) declined or had medical exclusions. One hundred and seven survivors were enrolled in the follow-up study (54.6%, median age 63.1 years, 45.8% males). Post-bronchodilator spirometry performed in 106 participants failed to confirm CAO, defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio of <0.7, in 16 participants (15.1%), but CAO was present in 90. The median decline in FEV1 was 28.9 mL/year (interquartile range –54.8 - 0.0) and was similar between GOLD stages. The median total decline in FVC was 75 mL, and was significantly greater in GOLD stage 1 (–350 mL) than in stages 2 or 3 (–80 mL and +140 mL, respectively; p<0.01). Fifty-eight participants with CAO in 2005 (64.4%) remained in the same GOLD stage, while 21 (23.3%) deteriorated and 11 (12.2%) improved by ≥1 stage. Only one-third were receiving any treatment for chronic obstructive pulmonary disease (COPD). Conclusions. The prevalence, morbidity and mortality of CAO and COPD in SA are high and the level of appropriate treatment is very low, pointing to underdiagnosis and inadequate provision of and access to effective treatments and preventive strategies for this priority chronic non-communicable disease.info:eu-repo/semantics/publishedVersio

    The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer

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    Background: Using data from a large phase III study of previously treated advanced non-small-cell lung cancer (NSCLC) that showed similar efficacy for pemetrexed and docetaxel, this retrospective analysis evaluates the impact of first-line chemotherapy on the outcome of second-line chemotherapy. Patients and methods: In all, 571 patients with advanced NSCLC were randomly assigned to receive pemetrexed 500 mg/m2 or docetaxel 75 mg/m2 on day 1 of a 21-day cycle. Comparisons were made based on type of first-line therapy [gemcitabine + platinum (GP), taxane + platinum (TP), or other therapies (OT)], response to initial therapy, time since initial therapy, and clinical characteristics. The two second-line treatment groups were pooled for this analysis due to similar efficacy and were assumed to have no interaction with the first-line therapies. Results: Baseline characteristics were generally balanced. By multivariate analysis, gender, stage at diagnosis, performance status (PS), and best response to first-line therapy significantly influenced overall survival (OS). Additional factors by univariate analysis, histology, and time elapsed from first- to second-line therapy significantly influenced OS. Conclusions: Future trials in the second-line setting should stratify patients by gender, stage at diagnosis, PS, and best response to first-line therap

    Automatização de grade horária utilizando FET

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    Um dos problemas das instituições de ensino superior ao iniciar o seu período letivo é a programação dos horários das aulas (em inglês, timetabling problem). Este problema de otimização combinatória é de difícil resolução devido ao grande número de possibilidades a serem analisadas e a necessidade de verificação de uma série de requisitos de várias naturezas, muitos dos quais conflitantes entre si, como horários, disponibilidade dos professores, disciplinas, entre outras. É uma tarefa difícil que demanda tempo e nem sempre se consegue resolver o problema sem conflitos entre as partes envolvidas. Este problema pode ser resolvido por Programação Inteira ou via algoritmos Heurísticos e Metaheurísticos. Atualmente, no Curso de Ciência da Computação do Centro Universitário Serra dos Órgãos (UNIFESO), a grade horária é feita de forma manual, o que demanda tempo para a sua confecção e dificuldade caso seja necessária alguma modificação. O objetivo deste trabalho é automatizar a geração da grade horária do corpo docente do curso de Ciência da Computação do UNIFESO utilizando o software livre Free Timetabling Program (FET). O FET destina-se a resolver problemas de compromissos, tarefas, horários em escolas e universidades e possui como método de busca a Metaheurística Algoritmos Genéticos (AGs). A versão utilizada no projeto é a 5.92, que possibilita o cadastro dos professores, matérias, períodos, início e término de cada aula, número de aulas de cada professor e sua disponibilidade na Instituição. É possível ainda dividir o número de aulas por dia e por semana, colocar matérias como pré-requisitos de outras, além de outros recursos como o cadastro de salas e laboratórios. Durante o processo da geração da grade horária dos professores, caso algum requisito não esteja sendo obedecido, o FET identifica a inconsistência e para automaticamente o processo, exibindo mensagens de erros para correção de suas possíveis causas, evitando que somente no fim do processo os problemas sejam identificados. Além disso, o FET possibilita a exportação dos resultados em XML ou HTML
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