Fuzzy expert system in the prediction of neonatal resuscitation

In view of the importance of anticipating the occurrence of critical situations in medicine, we propose the use of a fuzzy expert system to predict the need for advanced neonatal resuscitation efforts in the delivery room. This system relates the maternal medical, obstetric and neonatal characteristics to the clinical conditions of the newborn, providing a risk measurement of need of advanced neonatal resuscitation measures. It is structured as a fuzzy composition developed on the basis of the subjective perception of danger of nine neonatologists facing 61 antenatal and intrapartum clinical situations which provide a degree of association with the risk of occurrence of perinatal asphyxia. The resulting relational matrix describes the association between clinical factors and risk of perinatal asphyxia. Analyzing the inputs of the presence or absence of all 61 clinical factors, the system returns the rate of risk of perinatal asphyxia as output. A prospectively collected series of 304 cases of perinatal care was analyzed to ascertain system performance. The fuzzy expert system presented a sensitivity of 76.5% and specificity of 94.8% in the identification of the need for advanced neonatal resuscitation measures, considering a cut-off value of 5 on a scale ranging from 0 to 10. The area under the receiver operating characteristic curve was 0.93. The identification of risk situations plays an important role in the planning of health care. These preliminary results encourage us to develop further studies and to refine this model, which is intended to implement an auxiliary system able to help health care staff to make decisions in perinatal care

Intensity-duration-frequency ratios obtained from annual records and partial duration records in the locality of Pelotas - RS, Brazil Relações intensidade-duração-frequência obtidas a partir de séries anual e de duração parcial para a localidade de Pelotas-RS

The intensity-duration-frequency occurrence ratio (IDF) is a tool commonly used for precipitation-runoff data transformation, which is established from observations of intense precipitations over a period sufficiently long as to allow the occurrence of extremes at the observation site. This study focused on verifying the existence or absence of new data, in terms of IDF ratio, by using partial duration records produced from data on maximum daily disaggregated rainfall for pre determined durations. The partial duration records considered a base value of 55 mm, totaling 279 values. After the rainfall series were established, their independence and seasonality were assessed. Using the Student's t-test statistics, it was established that no new data, as IDF ratio, emerged from the analysis of the partial duration series with the recommended base value of precipitation, as compared to the historical records.<br>A relação intensidade-duração-frequência de ocorrência (IDF) é uma ferramenta utilizada nos processos de transformação chuva-vazão, e sua determinação deve ser obtida a partir de observações de chuvas intensas, durante um período de tempo longo e representativo dos eventos extremos do local. O presente trabalho teve como objetivo verificar a existência ou não de ganho de informação, em termos de relação IDF, ao serem utilizadas séries de duração parcial, a partir dos dados de chuva máxima diária desagregada, em durações preestabelecidas. Quanto à série de duração parcial, foi utilizado o valor-base preestabelecido de 55 mm, constituindo então 279 valores. Posteriormente à constituição das séries de chuva, foi avaliada a independência e a estacionaridade dos valores contidos nas mesmas. Pela metodologia do teste "t" de Student, constatou-se que não há ganho de informação em termos de relação IDF quando utilizada a série de duração parcial, com o valor-base preestabelecido de precipitação, comparativamente à série de registros históricos