Efficient Computation of Multiple Density-Based Clustering Hierarchies

HDBSCAN*, a state-of-the-art density-based hierarchical clustering method, produces a hierarchical organization of clusters in a dataset w.r.t. a parameter mpts. While the performance of HDBSCAN* is robust w.r.t. mpts in the sense that a small change in mpts typically leads to only a small or no change in the clustering structure, choosing a "good" mpts value can be challenging: depending on the data distribution, a high or low value for mpts may be more appropriate, and certain data clusters may reveal themselves at different values of mpts. To explore results for a range of mpts values, however, one has to run HDBSCAN* for each value in the range independently, which is computationally inefficient. In this paper, we propose an efficient approach to compute all HDBSCAN* hierarchies for a range of mpts values by replacing the graph used by HDBSCAN* with a much smaller graph that is guaranteed to contain the required information. An extensive experimental evaluation shows that with our approach one can obtain over one hundred hierarchies for the computational cost equivalent to running HDBSCAN* about 2 times.Comment: A short version of this paper appears at IEEE ICDM 2017. Corrected typos. Revised abstrac

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Biofertilizante bovino, cobertura morta e revestimento lateral dos sulcos na produção de pimentão

The adoption of management practices that reduce water losses is essential to conserve moisture and improve soil temperature, especially in arid and semiarid environments of the Brazilian Northeast, characterized by high evapotranspiration and the adoption of irrigation with saline water, which harms growth and yield of commercial crops. Given these factories, an experiment was conducted in Nova Floresta, Paraiba, from August 2010 to February 2011 in Oxisoil, in order to evaluate the production of bell pepper and soil moisture in grooves with side trim, and application of biofertilizer and mulch cattle. The experimental design was randomized blocks with four replications using a factorial 2 x 2 x 2 for the ground beef with and without biofertilizer, with and without residues of sisal fiber (Agave sisalana), with and without the side facing the grooves, to reduce lateral water losses by infiltration of water with polyethylene plastic film. From the results, the lining of the lateral grooves provided higher values of soil moisture, number of fruits, fruit mass, plant production and productivity, bell pepper plants. It was also found that the combination of biofertilizer and mulch the ground beef remained wetter in the first 15 cm depth.A adoção de práticas de manejo que reduzam as perdas hídricas é imprescindível para a conservação da umidade e melhoramento da temperatura do solo, principalmente em ambientes áridos e semiáridos do Nordeste brasileiro, caracterizado pela alta evapotranspiração e pela adoção da irrigação com água salina, que prejudica o crescimento e rendimento comercial das culturas. Diante desses fatos, foi desenvolvido um experimento no Sítio Estrondo, município de Nova Floresta- PB, no período de agosto de 2010 a fevereiro de 2011 em um LATOSSOLO AMARELO Eutrófico típico, objetivando avaliar a produção das plantas de pimentão, bem como a umidade do solo em sulcos com revestimento lateral, aplicação de biofertilizante bovino e cobertura morta. O delineamento experimental foi em blocos casualizados com quatro repetições, usando o esquema fatorial 2 x 2 x 2, com os fatores referentes ao solo sem e com biofertilizante bovino, sem e com cobertura morta com resíduo de sisal, sem e com revestimento lateral dos sulcos, para redução das perdas hídricas por infiltração lateral da água, com filme plástico de polietileno respectivamente. Pelos resultados, o revestimento lateral dos sulcos proporcionou maiores valores de umidade do solo, número de frutos por planta, massa de frutos, produção por planta e produtividade, em plantas de pimentão. Constatou-se também que a combinação da cobertura morta e biofertilizante bovino manteve o solo mais úmido nos primeiros 15 cm de profundidade

Update of the Brazilian consensus recommendations on Duchenne muscular dystrophy

In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Córdoba, 28 y 29 de junio de 2018

Actas del X Seminario Internacional de Investigación en UrbanismoEl seminario tiene como objetivo facilitar una instancia de reflexión compartida sobre las investigaciones en el campo del urbanismo y generar un intercambio entre investigadores sobre los fenómenos de la urbanización y la transformación urbana y territorial en distintos países iberoamericanos. Se propone analizar las características de los procesos de transformación del territorio y los factores que los explican, en relación con las estrategias de planificación, proyecto y renovación sostenible destinadas a ciudades y regiones. Se pretende integrar diferentes escalas y perspectivas de análisis, propias del planeamiento y la gestión urbana, metropolitana y regional, del diseño urbano y arquitectónico; de la geografía y la sociología urbanas, que habitualmente se examinan aisladamente en distintos foros. En el marco de este encuentro, y en conmemoración del primer centenario de la Reforma Universitaria iniciada en Córdoba –movimiento estudiantil que sienta las bases del actual sistema universitario nacional-se cree propicia la ocasión para reflexionar además sobre la relación entre ciudad y universidad, sobre ciudades universitarias, sobre la contribución desde la Universidad Nacional de Córdoba y del resto de las universidades latinoamericanas al urbanismo de nuestras ciudades