Agreement and accuracy using the FIGO, ACOG and NICE cardiotocography interpretation guidelines.

INTRODUCTION: One of the limitations reported with cardiotocography (CTG) is the modest interobserver agreement observed in tracing interpretation. This study compared agreement, reliability and accuracy of CTG interpretation using the FIGO, ACOG and NICE guidelines. MATERIAL AND METHODS: A total of 151 tracings was evaluated by 27 clinicians from three centers where FIGO, ACOG and NICE guidelines were routinely used. Interobserver agreement was evaluated using the proportions of agreement (PA) and reliability with the kappa (k) statistic. The accuracy of tracings classified as "pathological/category III" was assessed for prediction of newborn acidemia. For all measures, 95% confidence intervals (95%CI) were calculated RESULTS: CTG classifications were more distributed with FIGO (9%, 52%, 39%) and NICE (30%, 33%, 37%) than with ACOG (13%, 81%, 6%). The category with the highest agreement was ACOG category II (PA=0.73 95%CI 0.70-76), and the ones with the lowest agreement were ACOG categories I and III. Reliability was significantly higher with FIGO (k=0.37, 95%CI 0.31-0.43), and NICE (k=0.33, 95%CI 0.28-0.39) than with ACOG (k= 0.15, 95%CI 0.10-0.21), however all represent only slight/fair reliability. FIGO and NICE showed a trend towards higher sensitivities in prediction of newborn acidemia (89% and 97% respectively) than ACOG (32%,), but the latter achieved a significantly higher specificity (95%) CONCLUSIONS: With ACOG guidelines there is high agreement in category II, low reliability, low sensitivity and high specificity in prediction of acidemia. With FIGO and NICE guidelines there is higher reliability, a trend towards higher sensitivity, and lower specificity in prediction of acidemia. This article is protected by copyright. All rights reserved

Wide spectrum of NR5A1-related phenotypes in 46,XY and 46,XX individuals

Steroidogenic factor 1 (NR5A1, SF-1, Ad4BP) is a transcriptional regulator of genes involved in adrenal and gonadal development and function. Mutations in NR5A1 have been among the most frequently identified genetic causes of gonadal development disorders and are associated with a wide phenotypic spectrum. In 46,XY individuals, NR5A1-related phenotypes may range from disorders of sex development (DSD) to oligo/azoospermia, and in 46,XX individuals, from 46,XX ovotesticular and testicular DSD to primary ovarian insufficiency (POI). The most common 46,XY phenotype is atypical or female external genitalia with clitoromegaly, palpable gonads, and absence of Müllerian derivatives. Notably, an undervirilized external genitalia is frequently seen at birth, while spontaneous virilization may occur later, at puberty. In 46,XX individuals, NR5A1 mutations are a rare genetic cause of POI, manifesting as primary or secondary amenorrhea, infertility, hypoestrogenism, and elevated gonadotropin levels. Mothers and sisters of 46,XY DSD patients carrying heterozygous NR5A1 mutations may develop POI, and therefore require appropriate counseling. Moreover, the recurrent heterozygous p.Arg92Trp NR5A1 mutation is associated with variable degrees of testis development in 46,XX patients. A clear genotype-phenotype correlation is not seen in patients bearing NR5A1 mutations, suggesting that genetic modifiers, such as pathogenic variants in other testis/ovarian-determining genes, may contribute to the phenotypic expression. Here, we review the published literature on NR5A1-related disease, and discuss our findings at a single tertiary center in Brazil, including ten novel NR5A1 mutations identified in 46,XY DSD patients. The ever-expanding phenotypic range associated with NR5A1 variants in XY and XX individuals confirms its pivotal role in reproductive biology, and should alert clinicians to the possibility of NR5A1 defects in a variety of phenotypes presenting with gonadal dysfunction

Insight into aquaculture's potential of marine annelid worms and ecological concerns: a review

Polychaetes are marine annelid worms that can contribute to aquaculture diversification. Its culture has been viable, and commercially attempted, but intensive production has progressed only in few countries around the world. In the countries with no production, marine polychaetes are imported or harvested. A strong and sustained research investment provided to a better understanding of the nutritional requirements and reproduction of some species. Recent studies showed new technical improvements, which can lead to an important progress in productivity and give a new impetus to the polychaete production. Some marine worm species were identified as good candidates for integrated multitrophic aquaculture. The development of cost-effective aquaculture techniques for marine annelid worms is essential to ensure a balance between commercial interests and the preservation of ecosystems. The influence of polychaete aquaculture on the environment and vice versa raise important concerns related to ecological security and sustainability of this activity. This review focus on the main technical improvements and advances that have been made in areas as diverse as: aquaculture potential of polychaetes, reared species, main species used worldwide, and highlights biological and ecological concerns, important challenges and recommendations.This study was supported by the FCT (Portuguese National Board of Scientific Research), through the MARE (Marine and Environmental Sciences Centre) (UID/MAR/04292/2013) strategic programme and through strategic project PEst-OE/MAR/UI0199/2014, granted to MARE. This study has also the financial support of PROMAR Program through the project 31-03-05-FEP42: LIVE BAIT – Annelid polychaetes as live bait in Portugal: harvesting, import and rearing management.info:eu-repo/semantics/publishedVersio

On the formal foundations of cash management systems

[EN] Cash management aims to find a balance between what is held in cash and what is allocated in other investments in exchange for a given return. Dealing with cash management systems with multiple accounts and different links between them is a complex task. Current cash management models provide analytic solutions without exploring the underlying structure of accounts and its main properties. There is a need for a formal definition of cash management systems. In this work, we introduce a formal approach to manage cash with multiple accounts based on graph theory. Our approach allows a formal reasoning on the relation between accounts in cash management systems. A critical part of this formal reasoning is the characterization of desirable and non-desirable cash management policies. Novel theoretical results guide cash managers in the analysis of complex cash management systems.This work is partially funded by projects Logistar (H2020-769142), AI4EU (H2020-825619) and 2017 SGR 172.Salas-Molina, F.; Rodriguez-Aguilar, JA.; Pla Santamaría, D.; Garcia-Bernabeu, A. (2021). On the formal foundations of cash management systems. Operational Research. 21(2):1081-1095. https://doi.org/10.1007/s12351-019-00464-6S10811095212Baccarin S (2009) Optimal impulse control for a multidimensional cash management system with generalized cost functions. Eur J Oper Res 196(1):198–206Bollobás B (2013) Modern graph theory, vol 184. Springer, BerlinBondy JA, Murty USR (1976) Graph theory with applications, vol 290. Macmillan, LondonChartrand G, Oellermann OR (1993) Applied and algorithmic graph theory, vol 993. McGraw-Hill, New YorkConstantinides GM, Richard SF (1978) Existence of optimal simple policies for discounted-cost inventory and cash management in continuous time. Oper Res 26(4):620–636da Costa Moraes MB, Nagano MS, Sobreiro VA (2015) Stochastic cash flow management models: a literature review since the 1980s. In: Guarnieri P (ed) Decision models in engineering and management. Springer, Berlin, pp 11–28de Avila Pacheco JV, Morabito R (2011) Application of network flow models for the cash management of an agribusiness company. Comput Ind Eng 61(3):848–857Golden B, Liberatore M, Lieberman C (1979) Models and solution techniques for cash flow management. Comput Oper Res 6(1):13–20Gormley FM, Meade N (2007) The utility of cash flow forecasts in the management of corporate cash balances. Eur J Oper Res 182(2):923–935Gregory G (1976) Cash flow models: a review. Omega 4(6):643–656Makridakis S, Wheelwright SC, Hyndman RJ (2008) Forecasting methods and applications. Wiley, New YorkRighetto GM, Morabito R, Alem D (2016) A robust optimization approach for cash flow management in stationery companies. Comput Ind Eng 99:137–152Salas-Molina F (2017) Risk-sensitive control of cash management systems. Oper Res. https://doi.org/10.1007/s12351-017-0371-0Salas-Molina F, Pla-Santamaria D, Rodriguez-Aguilar JA (2018) A multi-objective approach to the cash management problem. Ann Oper Res 267(1):515–529Srinivasan V, Kim YH (1986) Deterministic cash flow management: state of the art and research directions. Omega 14(2):145–166Valiente G (2013) Algorithms on trees and graphs. Springer, Berli

Prognosis of chronic low back pain: design of an inception cohort study

BACKGROUND: Although clinical guidelines generally portray chronic low back pain as a condition with a poor prognosis this portrayal is based on studies of potentially unrepresentative survival cohorts. The aim of this study is to describe the prognosis of an inception cohort of people with chronic low back pain presenting for primary care. METHODS/DESIGN: The study will be an inception cohort study with one year follow-up. Participants are drawn from a cohort of consecutive patients presenting with acute low back pain (less than 2 weeks duration) to primary care clinics in Sydney, Australia. Those patients who continue to experience pain at three months, and are therefore classified as having chronic back pain, are invited to participate in the current study. The cohort will be followed up by telephone at baseline, 9 months and 12 months after being diagnosed with chronic low back pain. Recovery from low back pain will be measured by sampling three different outcomes: pain intensity, interference with function due to pain, and work status. Life tables will be generated to determine the one year prognosis of chronic low back pain. Prognostic factors will be assessed using Cox regression. DISCUSSION: This study will determine the prognosis of chronic non-specific low back pain in a representative cohort of patients sourced from primary care. The results of this study will improve understanding of chronic low back pain, allowing clinicians to provide more accurate prognostic information to their patients

Allelic frequencies and statistical data obtained from 12 codis STR loci in an admixed population of the Brazilian Amazon

The allelic frequencies of 12 short tandem repeat loci were obtained from a sample of 307 unrelated individuals living in Macapá, a city in the northern Amazon region, Brazil. These loci are the most commonly used in forensics and paternity testing. Based on the allele frequency obtained for the population of Macapá, we estimated an interethnic admixture for the three parental groups (European, Native American and African) of, respectively, 46%, 35% and 19%. Comparing these allele frequencies with those of other Brazilian populations and of the Iberian Peninsula population, no significant distances were observed. The interpopulation genetic distances (FST coefficients) to the present database ranged from FST = 0.0016 between Macapá and Belém to FST = 0.0036 between Macapá and the Iberian Peninsula

Are ant assemblages of Brazilian veredas characterised by location or habitat type?

Wetland areas in the Brazilian Cerrado, known as “veredas”, represent ecosystems formed on sandy soils with high concentrations of peat, and are responsible for the recharge of aquiferous reservoirs. They are currently under threat by various human activities, most notably the clearing of vegetation for Eucalyptus plantations. Despite their ecological importance and high conservation value, little is known about the actual effects of human disturbance on the animal community. To assess how habitat within different veredas, and plantations surrounding them affect ant assemblages, we selected four independent vereda locations, two being impacted by Eucalyptus monoculture (one younger and one mature plantation) and two controls, where the wetland was surrounded by cerrado vegetation. Ant sampling was conducted in May 2010 (dry season) using three complementary methods, namely baits, pitfall traps, and hand collection, in the wetland and in the surrounding habitats. A total of 7,575 ants were sampled, belonging to seven subfamilies, 32 genera and 124 species.Ant species richness and abundance did not differ between vereda locations, but did between the habitats. When impacted by the monoculture, ant species richness and abundance decreased in wetlands, but were less affected in the cerrado habitat. Ant species composition differed between the three habitats and between vereda locations. Eucalyptus plantations had an ant species composition defined by high dominance of Pheidole sp. and Solenopsis invicta, while natural habitats were defined by Camponotus and Crematogaster species. Atta sexdens was strictly confined to native habitats of non-impacted “veredas”. Eucalyptus monocultures require high quantities of water in the early stages, which may have caused a decrease in groundwater level in the wetland, allowing hypogeic ants such as Labidus praedator to colonise this habitat