796 research outputs found
Design and development of a speech synthesis software for colombian spanish applied to communication through mobile devices
In several scenarios of everyday life, there is a need to communicate orally with other people. However, various technological solutions such as mobile phones cannot be used in places such as meetings, classrooms, or conference rooms without disrupting the activities of people around the speaker. This research develops a tool that enables people to establish a conversation in a public place without disrupting the surrounding environment. To this end, a speech synthesizer is implemented on a personal computer connected to a cell phone, which allows one to establish a mobile call without using the human voice. The speech synthesizer uses the diphone concatenation technique and is developed specifically for the Spanish from Colombia. A mathematical description of the synthesizer shows the decomposition of the synthesizer into various mutually independent processes. Several user-acceptance and quality tests of the obtained signal were performed to evaluate the performance of the tool. The results show a high signal to noise ratio of generated signals and a high intelligibility of the tool
CONSENSO SOBRE EL USO DE PROTEÍNA EN EL PACIENTE CRÍTICO – ACNC
El paciente crítico tiene una pérdida de masa muscular significativa, observando frecuentemente sarcopenia en estos pacientes. Su presencia aumenta los desenlaces adversos, estancias hospitalarias, mayor riesgo de infecciones, aumento del tiempo de asistencia ventilatoria mecánica, mayor discapacidad al alta hospitalaria, menor posibilidad del retorno normal a la vida habitual de los pacientes, incremento en gastos en salud y mayor mortalidad. Objetivo: Indicar el uso oportuno y adecuado de la proteína en el paciente crítico. Métodos: la Asociación Colombiana De Nutrición Clínica (ACNC) y la Asociación Colombiana de Medicina Critica y Cuidados Intensivos (AMCI) mediante metodología de consenso realizaron unas recomendaciones con un grupo de expertos. Resultados: 46 recomendaciones fueron aprobadas con consenso superior al 80%. Conclusiones: La intervención óptima proteica temprana y progresiva en el paciente crítico, es importante para obtener los mejores desenlaces clínicos, disminuir complicaciones e impactar en costos de atención hospitalaria.
CONSENSO SOBRE O USO DE PROTEÍNA EM PACIENTES CRÍTICOS – ACNC
The critical patient has a significant loss of muscle mass, frequently observing sarcopenia in these patients. Its presence increases adverse outcomes, hospital stays, increased risk of infections, increased time on mechanical ventilatory assistance, greater disability at hospital discharge, less possibility of return to normal life for patients, increased health costs, and higher mortality. Objective: Indicate the opportune and adequate use of the protein in the critically ill patient. Methods: the Colombian Association of Clinical Nutrition (ACNC) and the Colombian Association of Critical Medicine and Intensive Care (AMCI), using a consensus methodology, made recommendations with a group of experts. Results: 46 recommendations were approved with a consensus greater than 80%. Conclusions: Optimal early and progressive protein intervention in critically ill patients is important to obtain the best clinical outcomes, reduce complications, and have an impact on hospital care costs.El paciente crítico tiene una pérdida de masa muscular significativa, observando frecuentemente sarcopenia en estos pacientes. Su presencia aumenta los desenlaces adversos, estancias hospitalarias, mayor riesgo de infecciones, aumento del tiempo de asistencia ventilatoria mecánica, mayor discapacidad al alta hospitalaria, menor posibilidad del retorno normal a la vida habitual de los pacientes, incremento en gastos en salud y mayor mortalidad. Objetivo: Indicar el uso oportuno y adecuado de la proteína en el paciente crítico. Métodos: la Asociación Colombiana De Nutrición Clínica (ACNC) y la Asociación Colombiana de Medicina Critica y Cuidados Intensivos (AMCI) mediante metodología de consenso realizaron unas recomendaciones con un grupo de expertos. Resultados: 46 recomendaciones fueron aprobadas con consenso superior al 80%. Conclusiones: La intervención óptima proteica temprana y progresiva en el paciente crítico, es importante para obtener los mejores desenlaces clínicos, disminuir complicaciones e impactar en costos de atención hospitalaria. O paciente crítico apresenta perda importante de massa muscular, observando-se frequentemente sarcopenia nesses pacientes. Sua presença aumenta os desfechos adversos, internações hospitalares, aumento do risco de infecções, aumento do tempo de assistência ventilatória mecânica, maior incapacidade na alta hospitalar, menor possibilidade de retorno à vida normal dos pacientes, aumento dos custos de saúde e maior mortalidade. Objetivo: Indicar o uso oportuno e adequado da proteína no paciente crítico. Métodos: a Associação Colombiana de Nutrição Clínica (ACNC) e a Associação Colombiana de Medicina Crítica e Terapia Intensiva (AMCI), utilizando uma metodologia de consenso, fizeram recomendações com um grupo de especialistas. Resultados: 46 recomendações foram aprovadas com consenso superior a 80%. Conclusões: A intervenção proteica precoce e progressiva ideal em pacientes críticos é importante para obter os melhores resultados clínicos, reduzir complicações e impactar nos custos hospitalares
A survey of the clinicopathological and molecular characteristics of patients with suspected Lynch syndrome in Latin America
Background: Genetic counselling and testing for Lynch syndrome (LS) have recently been introduced in several Latin America countries. We aimed to characterize the clinical, molecular and mismatch repair (MMR) variants spectrum of patients with suspected LS in Latin America.
Methods: Eleven LS hereditary cancer registries and 34 published LS databases were used to identify unrelated families that fulfilled the Amsterdam II (AMSII) criteria and/or the Bethesda guidelines or suggestive of a dominant colorectal (CRC) inheritance syndrome.
Results: We performed a thorough investigation of 15 countries and identified 6 countries where germline genetic testing for LS is available and 3 countries where tumor testing is used in the LS diagnosis. The spectrum of pathogenic MMR variants included MLH1 up to 54%, MSH2 up to 43%, MSH6 up to 10%, PMS2 up to 3% and EPCAM up to 0.8%. The Latin America MMR spectrum is broad with a total of 220 different variants which 80% were private and 20% were recurrent. Frequent regions included exons 11 of MLH1 (15%), exon 3 and 7 of MSH2 (17 and 15%, respectively), exon 4 of MSH6 (65%), exons 11 and 13 of PMS2 (31% and 23%, respectively). Sixteen international founder variants in MLH1, MSH2 and MSH6 were identified and 41 (19%) variants have not previously been reported, thus representing novel genetic variants in the MMR genes. The AMSII criteria was the most used clinical criteria to identify pathogenic MMR carriers although microsatellite instability, immunohistochemistry and family history are still the primary methods in several countries where no genetic testing for LS is available yet.
Conclusion: The Latin America LS pathogenic MMR variants spectrum included new variants, frequently altered genetic regions and potential founder effects, emphasizing the relevance implementing Lynch syndrome genetic testing and counseling in all of Latin America countries.Radium Hospital Foundation (Oslo, Norway) in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript, Helse Sør-Øst (Norway) in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript, the French Association Recherche contre le Cancer (ARC) in the analysis, and interpretation of data, the Groupement des Entreprises Françaises dans la Lutte contre le Cancer (Gefluc) in the analysis, and interpretation of data, the Association Nationale de la Recherche et de la Technologie (ANRT, CIFRE PhD fellowship to H.T.) in the analysis, and interpretation of data and by the OpenHealth Institute in the analysis, and interpretation of data. Barretos Cancer Hospital received financial support by FINEP-CT-INFRA (02/2010)info:eu-repo/semantics/publishedVersio
Alignment of the CMS tracker with LHC and cosmic ray data
© CERN 2014 for the benefit of the CMS collaboration, published under the terms of the Creative Commons Attribution 3.0 License by IOP Publishing Ltd and Sissa Medialab srl. Any further distribution of this work must maintain attribution to the author(s) and the published article's title, journal citation and DOI.The central component of the CMS detector is the largest silicon tracker ever built. The precise alignment of this complex device is a formidable challenge, and only achievable with a significant extension of the technologies routinely used for tracking detectors in the past. This article describes the full-scale alignment procedure as it is used during LHC operations. Among the specific features of the method are the simultaneous determination of up to 200 000 alignment parameters with tracks, the measurement of individual sensor curvature parameters, the control of systematic misalignment effects, and the implementation of the whole procedure in a multi-processor environment for high execution speed. Overall, the achieved statistical accuracy on the module alignment is found to be significantly better than 10μm
Study protocol for the multicentre cohorts of Zika virus infection in pregnant women, infants, and acute clinical cases in Latin America and the Caribbean: The ZIKAlliance consortium
Background: The European Commission (EC) Horizon 2020 (H2020)-funded ZIKAlliance Consortium designed a multicentre study including pregnant women (PW), children (CH) and natural history (NH) cohorts. Clinical sites were selected over a wide geographic range within Latin America and the Caribbean, taking into account the dynamic course of the ZIKV epidemic. Methods: Recruitment to the PW cohort will take place in antenatal care clinics. PW will be enrolled regardless of symptoms and followed over the course of pregnancy, approximately every 4 weeks. PW will be revisited at delivery (or after miscarriage/abortion) to assess birth outcomes, including microcephaly and other congenital abnormalities according to the evolving definition of congenital Zika syndrome (CZS). After birth, children will be followed for 2 years in the CH cohort. Follow-up visits are scheduled at ages 1-3, 4-6, 12, and 24 months to assess neurocognitive and developmental milestones. In addition, a NH cohort for the characterization of symptomatic rash/fever illness was designed, including follow-up to capture persisting health problems. Blood, urine, and other biological materials will be collected, and tested for ZIKV and other relevant arboviral diseases (dengue, chikungunya, yellow fever) using RT-PCR or serological methods. A virtual, decentralized biobank will be created. Reciprocal clinical monitoring has been established between partner sites. Substudies of ZIKV seroprevalence, transmissio
Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways
The QT interval is an electrocardiographic measure representing the sum of ventricular depolarization and repolarization, estimated by QRS duration and JT interval, respectively. QT interval abnormalities are associated with potentially fatal ventricular arrhythmia. Using genome-wide multi-ancestry analyses (>250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization
Violência sexual contra mulheres no Brasil: conquistas e desafios do setor saúde na década de 2000
O artigo traz uma revisão sobre as políticas públicas
para o enfrentamento da violência sexual contra
mulheres desenvolvidas ao longo da década de 2000.
Analisa o embate sobre os avanços, retrocessos e
desafios do tema à luz das proposições do setor
saúde. Foram analisados documentos institucionais
e artigos selecionados sobre o assunto, apontando
variadas estratégias para intervenções propostas
e realizadas pelo Sistema Único de Saúde. O texto
apresenta ainda questões emblemáticas que nos
fazem refletir sobre os desafios a serem superados
pelos gestores de saúde na década atual, tais como
a cobertura e continuidade dos serviços de atenção
e capacitação permanente dos profissionais, bem
como o atendimento para a interrupção da gravidez,
prevista em lei.The article brings a revision on the public politics
for the confronting of the sexual violence against
women developed along the decade of 2000s. It
analyzes the collision on the progress, retreats and
challenges of the theme to the light of the proposi-tions of the section health. Institutional documents
and articles were analyzed selected on the subject,
pointing varied strategies for intervention proposed
and accomplished by the Brazilian National Health
System. The text still presents emblematic ques-tions that send us to think on the challenges to be
overcome by the managers of health in the current
decade, such as the covering and continuity of the
services of attention, the professionals’ permanent
training, as well as the service to the legal abortion
The genetic architecture of type 2 diabetes
The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, these explain only a fraction of heritability. To test the hypothesis that lower-frequency variants explain much of the remainder, the GoT2D and T2D-GENES consortia performed whole genome sequencing in 2,657 Europeans with and without diabetes, and exome sequencing in a total of 12,940 subjects from five ancestral groups. To increase statistical power, we expanded sample size via genotyping and imputation in a further 111,548 subjects. Variants associated with type 2 diabetes after sequencing were overwhelmingly common and most fell within regions previously identified by genome-wide association studies. Comprehensive enumeration of sequence variation is necessary to identify functional alleles that provide important clues to disease pathophysiology, but large-scale sequencing does not support a major role for lower-frequency variants in predisposition to type 2 diabetes
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