A Platform-Based Software Design Methodology for Embedded Control Systems: An Agile Toolkit

A discrete control system, with stringent hardware constraints, is effectively an embedded real-time system and hence requires a rigorous methodology to develop the software involved. The development methodology proposed in this paper adapts agile principles and patterns to support the building of embedded control systems, focusing on the issues relating to a system's constraints and safety. Strong unit testing, to ensure correctness, including the satisfaction of timing constraints, is the foundation of the proposed methodology. A platform-based design approach is used to balance costs and time-to-market in relation to performance and functionality constraints. It is concluded that the proposed methodology significantly reduces design time and costs, as well as leading to better software modularity and reliability

Tranquilização rápida para pacientes agitados nos serviços de emergência psiquiátrica: um ensaio clínico randomisado de olanzapina, ziprasidona, haloperidol mais prometazina, haloperidol mais midazolam e haloperidol em monoterapia

OBJECTIVE: To compare the effectiveness of intramuscular olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone as the first medication(s) used to treat patients with agitation and aggressive behavior. METHOD: One hundred fifty patients with agitation caused by psychotic or bipolar disorder were randomly assigned under double-blind conditions to receive olanzapine, ziprasidone, haloperidol plus midazolam, haloperidol plus promethazine or haloperidol alone. The Overt Agitation Severity Scale, Overt Aggression Scale and Ramsay Sedation Scale were applied within 12 hours after the first dosage. RESULTS: All medications produced a calming effect within one hour of administration, but only olanzapine and haloperidol reduced agitation by less than 10 points, and only olanzapine reduced aggression by less than four points in the first hour. After twelve hours, only patients treated with haloperidol plus midazolam had high levels of agitation and aggression and also more side effects. Ziprasidone, olanzapine and haloperidol alone had more stable results for agitation control, while ziprasidone, haloperidol plus promethazine and olanzapine had stable results for aggression control. CONCLUSION: Olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol were effective in controlling agitation and aggression caused by mental illness over 12 hours. Although all the drugs had advantages and disadvantages, haloperidol plus midazolam was associated with the worst results in all the observed parameters.OBJETIVO: Comparar a eficácia da olanzapina, ziprasidona, haloperidol associado ao midazolam, haloperidol associado à prometazina e haloperidol isoladamente por via intramuscular como primeira escolha no tratamento de pacientes em agitação e agressividade. MÉTODO: Cento e cinquenta pacientes com agitação psicomotora por transtorno psicótico ou transtorno bipolar foram recrutados para estudo duplo-cego e receberam olanzapina, ziprasidona, haloperidol associado a midazolam, haloperidol associado a prometazina ou haloperidol isoladamente. Foram aplicadas as escalas Overt Agitation Severity Scale, Overt Aggression Scale e Ramsay Sedation Scale no período de 12 horas após a primeira aplicação. RESULTADOS: Todas as medicações foram capazes de acalmar os pacientes após uma hora da administração. Apenas a olanzapina e o haloperidol reduziram a agitação para menos de 10 pontos e apenas a olanzapina reduziu a agressividade para menos de quatro pontos nesse período. Doze horas depois, apenas o haloperidol com midazolam apresentou valores altos para a agitação e agressividade, e também esteve relacionado com maior proporção de efeitos colaterais. A ziprasidona, a olanzapina e o haloperidol apresentaram resultados mais estáveis para o controle da agitação e a ziprasidona, haloperidol associado a prometazina e olanzapina para o controle da agressividade. CONCLUSÃO: A olanzapina, a ziprasidona, o haloperidol associado a prometazina, o haloperidol associado ao midazolam e o haloperidol isoladamente foram efetivos no controle da agitação e da agressividade secundária a transtornos mentais dentro de 12 horas. Todas as drogas apresentaram vantagens e desvantagens, exceto pela associação haloperidol e midazolam que demonstrou os piores resultados em todos os parâmetros.Universidade Federal do TocantinsUniversidade Federal de São Paulo (UNIFESP)Irmandade da Santa Casa de Misericórdia de São PauloUniversity of TexasUNIFESPSciEL

Invasive Species in the Amazon

One of the main reasons for environmental disturbances such as declination in pasture productivity and biodiversity losses is the high infestation of herbaceous weeds, generally referred to as “Juquira” in the Amazon region. If they are not adequately controlled, such infestation might lead to degradation of pasture, resulting in complete loss of productivity and subsequent abandonment of the area. In this sense, this chapter aims to describe the main invasive species present in the Amazon region, as well as to characterize both the old and innovative techniques of use in agriculture, in large and small scale, for the control of agricultural pests

Portuguese recommendations for the use of methotrexate in rheumatic diseases – 2016 update

info:eu-repo/semantics/publishedVersio

FIBRILAÇÃO ATRIAL COMO FATOR DE RISCO PARA AVC: ABORDAGENS CLÍNICAS E TRATAMENTO

Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke due to the formation of clots that can obstruct cerebral vessels. This literature review analyzed five references obtained from databases such as PubMed and Scielo, focusing on the relationship between AF and stroke. The methodology involved critical reading of studies on epidemiology, risk factors, and preventive interventions. The results showed that AF, prevalent in up to 2% of the population, increases the risk of ischemic stroke up to fivefold, especially in the elderly and individuals with comorbidities such as hypertension and diabetes. Oral anticoagulation, particularly with new non-vitamin K antagonist oral anticoagulants (NOACs), is effective in preventing strokes in patients with AF. The final considerations highlight the importance of a multifaceted approach to managing AF and preventing strokes, emphasizing the need for public health policies to improve access to appropriate treatments and raise awareness about the importance of anticoagulation, especially in regions like Latin America.A fibrilação atrial (FA) é uma arritmia cardíaca comum que aumenta o risco de acidente vascular cerebral (AVC) devido à formação de coágulos que podem obstruir vasos cerebrais. Esta revisão bibliográfica analisou cinco referências obtidas de bases de dados como PubMed e Scielo, focando na relação entre FA e AVC. A metodologia envolveu a leitura crítica de estudos sobre epidemiologia, fatores de risco e intervenções preventivas. Os resultados mostraram que a FA, prevalente em até 2% da população, aumenta o risco de AVC isquêmico em até cinco vezes, especialmente em idosos e indivíduos com comorbidades como hipertensão e diabetes. A anticoagulação oral, especialmente com novos anticoagulantes orais não antagonistas da vitamina K (NOACs), é eficaz na prevenção de AVCs em pacientes com FA. As considerações finais destacam a importância de uma abordagem multifacetada para gerenciar a FA e prevenir AVCs, enfatizando a necessidade de políticas de saúde pública para melhorar o acesso a tratamentos adequados e aumentar a conscientização sobre a importância da anticoagulação, especialmente em regiões como a América Latina

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.Peer reviewe

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC = 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.Peer reviewe