ABSTRACT
Gathering sufficient instance data to either train algorithm-selection models or understand algorithm footprints within an instance space can be challenging. We propose an approach to generating synthetic instances that are tailored to perform well with respect to a target algorithm belonging to a predefined portfolio but are also diverse with respect to their features. Our approach uses a novelty search algorithm with a linearly weighted fitness function that balances novelty and performance to generate a large set of diverse and discriminatory instances in a single run of the algorithm. We consider two definitions of novelty: (1) with respect to discriminatory performance within a portfolio of solvers; (2) with respect to the features of the evolved instances. We evaluate the proposed method with respect to its ability to generate diverse and discriminatory instances in two domains (knapsack and bin-packing), comparing to another well-known quality diversity method, Multi-dimensional Archive of Phenotypic Elites (MAP-Elites) and an evolutionary algorithm that only evolves for discriminatory behaviour. The results demonstrate that the novelty search method outperforms its competitors in terms of coverage of the space and its ability to generate instances that are diverse regarding the relative size of the "performance gap" between the target solver and the remaining solvers in the portfolio. Moreover, for the Knapsack domain, we also show that we are able to generate novel instances in regions of an instance space not covered by existing benchmarks using a portfolio of state-of-the-art solvers. Finally, we demonstrate that the method is robust to different portfolios of solvers (stochastic approaches, deterministic heuristics and state-of-the-art methods), thereby providing further evidence of its generality.
ABSTRACT
Objectives: We evaluated the prevalence of 25-hydroxyvitamin D (25-(OH)D) deficiency in our setting according to season, sex, and age. We also studied the association with parathyroid hormone (PTH) levels. Methods: The study population comprised all patients with requests for assessment of 25-(OH)D between January 1 and December 31, 2018, as registered in the database of the laboratory information system. Major exclusion criteria were pediatric samples (<18 years) and factors affecting 25-(OH)D and/or PTH levels (i.e., kidney injury, liver disease, PTH disorders). Results: Among 33,601 patients (24,028 women, 9,573 men), the prevalence of 25-(OH)D deficiency was 48%. Prevalence was greater in males than in females (53% vs. 46%). By age group, deficiency was more prevalent in quartile 1 (Q1, 74-87 years) and less prevalent in quartile 2 (Q2, 60-73 years). By season, deficiency was greater in spring (nonsignificant differences with respect to winter) and lower in summer. The association between 25-(OH)D and PTH was assessed in 9,368 persons. Linear regression analysis showed a weak association (coefficient - 0.303). Multiple logistic regression analysis revealed a significant association between 25-(OH)D deficiency and increased PTH (Odds ratio (OR), 1.63). Other risk factors for increased PTH include female sex (OR, 1.27), season (winter, OR 1.63, spring OR 1.16), and age (quartile 1, OR, 3). Conclusions: The prevalence of 25-(OH)D deficiency differed according to sex, age, and season of the year. Furthermore, elevation of PTH is mainly influenced by low 25-(OH)D, female sex, season, and age.
ABSTRACT
Introducción: La infección por el SARS-COV-2 afecta en su evolución a diferentes órganos, entre ellos, el riñón. Objetivo: Examinar el inusual caso de un paciente afectado por COVID-19, que exhibió un cuadro clínico y humoral compatible con síndrome nefrótico. Presentación del caso: Paciente de un año con antecedente de buena salud, sin enfermedad renal previa, remitido al Hospital Pediátrico Cerro por manifestaciones respiratorias, edema marcado y test de antígeno positivo al SARS-COV-S. Al ingreso se constató un peso 14 kg, anasarca, tensión arterial de 100/60 mm Hg. En los análisis complementarios se comprobó PCR positivo al SARS-COV-2, hipoproteinemia, proteinuria e hipercolesterolemia. Ultrasonido abdominal y torácico mostraron ascitis y derrame pleural. Conclusiones: Paciente preescolar, ingresado por síndrome respiratorio e hidropígeno y PCR positivo al SARS-COV-2. Muestra los indicadores clínicos y humorales compatibles con síndrome nefrótico, con óptima respuesta al tratamiento esteroideo. Este caso podría constituir una coincidencia o una inusual forma de presentación de COVID-19 y ayudar, por tanto, a un mejor conocimiento del síndrome y del cuadro clínico inicial que pudiera originar este nuevo morbo.
Introduction: SARS-COV-2 infection affects different organs in its evolution, including the kidney. Objective: To examine the unusual case of a patient affected by COVID-19, who showed a clinical and humoral picture compatible with nephrotic syndrome. Case presentation: One-year-old patient with a history of good health, without previous kidney disease, referred to Cerro Pediatric Hospital due to respiratory manifestations, marked edema and positive to SARS-COV-S antigen test. On admission, a weight of 14 kg, anasarca, blood pressure of 100/60 mmHg were observed. In the complementary tests, positive PCR to SARS-COV-2, hypoproteinemia, proteinuria and hypercholesterolemia were verified. Abdominal and thoracic ultrasound showed ascites and pleural effusion. Conclusions: Preschool patient, admitted due to respiratory and hydropygenic syndrome and positive PCR to SARS-COV-2. The patient showed the clinical and humoral indicators compatible with nephrotic syndrome, with optimal response to steroid treatment. This case could constitute a coincidence or an unusual form of presentation of COVID-19 and therefore help a better knowledge of the syndrome and the initial clinical picture that could cause this new morbidity.
ABSTRACT
A adolescência é um período desafiador no desenvolvimento do ser humano. Considerada especialmente vulnerável em termos psicológicos, sociais e biológicos. A gravidez na adolescência é um problema de saúde pública de carácter social, que demanda a inserção de políticas públicas que visem à redução desta situação de saúde. Constatou-se que a gravidez na adolescência, a partir da análise de dados é muito relevante na área de abrangência de nossa equipe pertencente ao ESF do Município Indiavaí, no estado de Mato Grosso. Por tanto este trabalho objetivou executar ações educativas na escola municipal, com a utilização de oficinas temáticas para discutir assuntos sobre a saúde integral do adolescente, envolvendo representantes escolares, professores e estudantes. Desta forma, contribuir com a redução da taxa de gravidez na adolescência do nosso município e sensibilizar a comunidade escolar e famílias para a importância da promoção á saúde e prevenção de agravos na adolescência. Após a intervenção obtivemos os seguintes resultados ou conclusões: A resolutividade da problemática gravidez na adolescência e sumamente difícil, devido à sua complexidade, dimensão e fatores de causalidades sociais e econômicos, nossos objetivos foram atingidos parcialmente, já que é muito difícil medir em tão pouco tempo os resultados deste projeto. Ficamos satisfeitos com os resultados alcançados nas oficinas, por isso decidimos programar este projeto com os outros grupos de adolescentes da escola e desempenha-lo durante todo o curso académico.
