O uso da dominância no problema da árvore geradora mínima com parâmetros fuzzy

O problema da árvore geradora mínima com parâmetros fuzzy é um dos principais problemas da programação matemática fuzzy, visto que possui aplicações nas mais diversas áreas, como, por exemplo, redes de distribuição de energia, armazenamento de informações e transportes. Neste trabalho é proposto um algoritmo exato para o problema da árvore geradora mínina com estrutura crisp e parâmetros fuzzy. Trata-se de uma adaptação do algoritmo clássico de Prim, utilizando a relação de dominância de alguns trabalhos da literatura que tratam do problema de caminho mínimo fuzzy. As incertezas nos pesos são abordadas por meio da teoria dos conjuntos fuzzy e as árvores geradoras do conjunto solução são armazenadas usando o conceito de rótulos. O algoritmo proposto foi testado em três diferentes redes, compatíveis `as instâncias dos principais trabalhos da literatura

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Produção de serapilheira em uma floresta de Araucaria angustifolia (Bertol.) Kuntze no município de Pinhal Grande-RS

O objetivo do trabalho foi avaliar a deposição anual de serapilheira, bem como a devolução de macronutrientes (N, P, K, Ca e Mg) em um povoamento de Araucaria angustifolia com 17 anos de idade, em Pinhal Grande-RS. O experimento foi instalado, de forma aleatória, em cinco parcelas de 10 x 20 m. Em cada uma destas foram distribuídos, de forma sistemática, quatro coletores de madeira de 1 m² de área. O material foi coletado mensalmente, durante um ano, e separado nas frações acículas e galhos, sendo, após seco em estufa e pesado em balança de precisão, moído e analisado quimicamente. A deposição de serapilheira foi de 6,96 Mg/ha, sendo composta por 74% de acículas e 26% de galhos. Ocorreu uma marcante sazonalidade de deposição, com picos entre a primavera e o verão, diminuindo nos meses de outono e inverno, de acordo com a variação da precipitação média mensal. Acículas e galhos foram responsáveis por devolver ao piso florestal 84 e 16% do total dos nutrientes, que foi de 254,3 kg/ha. O cálcio foi o nutriente de maior devolução (177,1 kg/ha). A quantidade expressiva de nutrientes devolvidos ao solo demonstra a importância da serapilheira na manutenção da capacidade produtiva do sítio

MARKETING CONTÁBIL: ESTUDO EXPLORATÓRIO EM ESCRITÓRIOS SITUADOS NA CIDADE DE SÃO PAULO

This research carried through an initial diagnosis on as the Accounting firms use the Marketing tools. It is a research carried through exploratory study in second half of 2003, that it combines the empirical research to identify important aspects of the current reality of the Accounting firms, bibliographical revision, field work using depth interview with five accounting firms of the city of Sao Paulo, and content analysis. It was verified that the use of the Marketing tools is embryonic in the sector and, as pointed for the analysis of international experiences, it can contribute for the Accounting firms to have better image before its customers, and for the development of its businesses. A challenge for the Accounting firms is the professionalization of its services, for the development of a personal mark, which can be mixed with the image of their partners, situation where the tools of Marketing can offer important contribution. The gotten results suggest the continuity of the studies, therefore the research allowed to identify assertive that will can be used for the construction of an attitudes scale, to be used in future research with a bigger amount of offices. The results to be gotten with the use of the scale could be used as subsidies so that the accounting entrepreneurs adopt the Marketing tools as an alternative for bigger valuation of their services for the market, and plus an element of support to its business.Esta pesquisa realizou um diagnóstico inicial sobre como os escritórios de contabilidade usam as ferramentas de marketing. Trata-se de um estudo exploratório realizado no segundo semestre de 2003, que combina pesquisa empírica, para identificar aspectos relevantes da realidade atual dos escritórios de contabilidade; revisão bibliográfica; trabalho de campo, tendo como base entrevistas de profundidade com cinco escritórios situados na cidade de São Paulo; e análise de conteúdo. Verificou-se que o uso das ferramentas de marketing é embrionário no setor e, conforme apontado pela análise de experiências internacionais, pode contribuir para a imagem dos escritórios de contabilidade perante seus clientes e para o desenvolvimento de seus negócios. Um desafio para os escritórios de contabilidade é a profissionalização de seus serviços, pelo desenvolvimento de uma marca pessoal que pode se mesclar com a imagem de seus sócios, situação em que as ferramentas de marketing podem oferecer relevante contribuição. Os resultados obtidos sugerem a continuidade dos estudos, uma vez que esta pesquisa permitiu identificar assertivas que poderão ser usadas para a construção de uma escala de atitudes visando à realização de pesquisas futuras em um maior número de escritórios. Os resultados a serem obtidos com a escala poderão ser usados como subsídios para que os empresários contábeis adotem as ferramentas de marketing como uma alternativa para maior valorização de seus serviços pelo mercado e como mais um elemento de apoio ao seu negócio