ABSTRACT
Genomic selection is revolutionizing plant breeding. However, its practical implementation is still very challenging, since predicted values do not necessarily have high correspondence to the observed phenotypic values. When the goal is to predict within-family, it is not always possible to obtain reasonable accuracies, which is of paramount importance to improve the selection process. For this reason, in this research, we propose the Adversaria-Boruta (AB) method, which combines the virtues of the adversarial validation (AV) method and the Boruta feature selection method. The AB method operates primarily by minimizing the disparity between training and testing distributions. This is accomplished by reducing the weight assigned to markers that display the most significant differences between the training and testing sets. Therefore, the AB method built a weighted genomic relationship matrix that is implemented with the genomic best linear unbiased predictor (GBLUP) model. The proposed AB method is compared using 12 real data sets with the GBLUP model that uses a nonweighted genomic relationship matrix. Our results show that the proposed AB method outperforms the GBLUP by 8.6, 19.7, and 9.8% in terms of Pearson's correlation, mean square error, and normalized root mean square error, respectively. Our results support that the proposed AB method is a useful tool to improve the prediction accuracy of a complete family, however, we encourage other investigators to evaluate the AB method to increase the empirical evidence of its potential.
Subject(s)
Models, Genetic , Polymorphism, Single Nucleotide , Genome , Genomics/methods , Linear Models , Phenotype , GenotypeABSTRACT
Structural racism is a root cause of poor health in the United States and underlies COVID-19-related disparities for Black and Latinx populations. We describe how one community-based organization responded to structural racism and COVID-19 in Florida. Informed by the literature on how public health practice changed from emphasizing prevention (Public Health 1.0) to collaboration between governmental and public health agencies (Public Health 2.0) and examining social determinants of health (Public Health 3.0), we call for a politically engaged Public Health 4.0. (Am J Public Health. 2021;111(S3):S201-S203. https://doi.org/10.2105/AJPH.2021.306408).
Subject(s)
Black or African American/ethnology , COVID-19/economics , Healthcare Disparities/ethnology , Public Health , Racism/ethnology , Florida , Humans , Sexual and Gender Minorities/psychology , Social Determinants of Health , United StatesABSTRACT
Objective To analyze 78 cases of brachial plexus injury submitted to the Oberlin technique between 2003 and 2012. The potential complications of this technique were analyzed, especially motor damage or hypoesthesia of the hand. Method Medical records from patients with brachial plexus injuries at the levels of the C5-C6 and C5-C6-C7 vertebrae were retrospectively analyzed. Cases submitted to the Oberlin procedure with or without concomitant brachial plexus procedures between 2003 and 2012 were evaluated. The minimum follow-up period was of 1 year. In addition to the clinical examination, electromyography and magnetic resonance imaging (MRI) of the brachial plexus were used to diagnose and locate the nerve damage. Results A total of 78 surgical patients met the inclusion criteria. Postoperative neurological changes, mostly transient, were observed in 18 patients. Hypoesthesia in the ulnar side of the handwas observed in seven cases; neuropathic pain in five cases; allodynia in four cases, and hand motor loss in two cases. Conclusion Based on the results of the present case series, we conclude that there are few sequelae in the donor nerve territory compared with the benefit of the Oberlin technique on the recovery of elbow flexion after brachial plexus injuries.
Subject(s)
Postoperative Complications , Brachial Plexus/surgery , Brachial Plexus/injuries , Musculocutaneous Nerve/surgery , Medical Records , Retrospective Studies , Nerve Transfer/methods , Hypesthesia/complicationsABSTRACT
Idiopathic spinal cord herniation is a rare cause of progressivemyelopathy, especially in the absence of a history of spinal or surgical trauma. The radiological diagnosis ismade through a myelography or an MRI exam. The spinal cord is pushed anteriorly, buffering the dural defect and leading inmost cases to Brown-Séquard syndrome. The present study describes the case of a male patient with a clinical picture of progressive thoracicmyelopathy. In the clinical and radiological investigation, an idiopathic spinal cord herniation on the chest level was identified. During the surgery, the spinal cord was reduced to the natural site, taking its usual elliptical shape, and the dural defect was repaired with a dural substitute. The numbness of the patient improved, and the shocks in the lower limbs disappeared. A postoperative MRI confirmed the surgical reduction of the herniation and the restoration of the anterior cerebrospinal fluid (CSF) column to the spinal cord. The authors describe the clinical, radiological, intraoperative, and postoperative evolution.
Subject(s)
Humans , Male , Adult , Spinal Cord Diseases/surgery , Spinal Cord Diseases/diagnostic imaging , Herniorrhaphy , Hernia/diagnostic imaging , Spinal Cord Diseases/complications , Magnetic Resonance Imaging , Myelography , Diagnosis, DifferentialABSTRACT
A derivação ventriculoperitoneal (DVP) representa uma forma importante e comum de tratamento da hidrocefalia. Entretanto, pode ocorrer uma série de complicações durante a sua instalação ou por causa de seu mau funcionamento, como infecção, obstrução e hiperdrenagem liquórica. Nesse trabalho, descrevemos uma rara complicação em que um paciente submetido à DVP evoluiu com tetraparesia progressiva. Investigação posterior evidenciou hiperdrenagem da válvula, levando a diminuição do retorno venoso intracraniano, dilatação do plexo venoso epidural e consequente compressão medular no nível da junção bulbomedular. Após o diagnóstico, fizemos o ajuste no nível de desempenho da válvula, e o paciente evoluiu com melhora clínica. Concluímos que o conhecimento desse tipo de complicação associada à disfunção de DVP pode levar a um diagnóstico mais precoce e melhor resposta ao tratamento. O tratamento envolve a correção do fator causal, ou seja, a hiperdrenagem...
The ventriculoperitoneal shunt represents an important and common treatment of hydrocephalus. However, there may be a number of complications during installation or due to a malfunction, such as infection, obstruction and overdrainage. In this paper, we described a rare complication in a patient submitted to a shunt who evolved to progressive tetraparesis. Further investigation showed valve overdrainage, leading to a decrease in venous return, intracranial epidural venous plexus dilatation and consequent cord compression at cervicomedullary junction. After the diagnosis, we adjusted the level of performance of the valve and the patient clinically improved. We concluded that the knowledge of this kind of complication related to shunt dysfunction may take to an early diagnosis and a better treatment response. The treatment involves correcting the causative factor which is the overdrainage...
Subject(s)
Humans , Male , Adult , Ventriculoperitoneal Shunt/adverse effects , Hydrocephalus/complications , Spinal Cord CompressionABSTRACT
PURPOSE: Kyphosis is a major complication of spina bifida, causing skin ulcers and osteomyelitis. This study examined the clinical and surgical characteristics of eight patients who underwent surgery, as well as improvement of their postoperative kyphosis angulations. METHOD: The authors reviewed eight cases submitted to surgery between 2006 and 2010. Surgical intervention was indicated for osteomyelitis and recurrent ulcers at the curvature apex. Osteotomies and spine stabilization were performed. The patients' clinical characteristics were analyzed, as were the surgical techniques employed, variables of surgical complications, and angle range of the kyphosis deformity postcorrection. RESULTS: There were no deaths. The average age at the time of surgery was 11 years old. The level of neurological injury was T10 in four patients and T12 in four. Average amount of bleeding during surgery was 1,442 ml, (range, 340 to 3,200 ml). Improvement of kyphosis angle was evident in all patients. The average difference between preoperative and postoperative kyphosis angle was 63.2. CONCLUSIONS: Surgery performed by a multidisciplinary team minimizes risks. Despite the high number of complications published in the literature, the results found in this study were excellent with regards to improving kyphosis angle, as well as facilitating rehabilitation and daily care of children.
Subject(s)
Kyphosis/surgery , Meningomyelocele/rehabilitation , Osteomyelitis/surgery , Postoperative Complications , Skin Ulcer/surgery , Spinal Fusion/methods , Adolescent , Child , Female , Humans , Kyphosis/complications , Male , Meningomyelocele/complications , Neurosurgical Procedures , Osteomyelitis/etiology , Patient Care Team , Retrospective Studies , Skin Ulcer/etiology , Treatment OutcomeABSTRACT
UNLABELLED: Spinal cord tumors are a rare neoplasm of the central nervous system (CNS). The occurrence of metastases is related to poor prognosis. The authors analyzed one series of metastasis cases and their associated mortality. METHODS: Clinical characteristics were studied in six patients with intramedullary tumors with metastases in a series of 71 surgical cases. RESULTS: Five patients had ependymomas of which two were WHO grade III. The patient with astrocytoma had a grade II histopathological classification. Two patients required shunts for hydrocephalus. The survival curve showed a higher mortality than the general group of patients with no metastases in the CNS (p<0.0001). CONCLUSION: Mortality is elevated in patients with metastasis and greater than in patients with only primary lesions. The ependymomas, regardless of their degree of anaplasia, are more likely to cause metastasis than spinal cord astrocytomas.
Subject(s)
Astrocytoma , Brain Neoplasms , Ependymoma , Meningeal Neoplasms , Spinal Cord Neoplasms , Adult , Astrocytoma/mortality , Astrocytoma/secondary , Brain Neoplasms/mortality , Brain Neoplasms/secondary , Ependymoma/mortality , Ependymoma/secondary , Female , Humans , Magnetic Resonance Imaging , Male , Meningeal Neoplasms/mortality , Meningeal Neoplasms/secondary , Middle Aged , Neoplasm Staging , Prognosis , Spinal Cord Neoplasms/mortality , Spinal Cord Neoplasms/pathology , Survival RateABSTRACT
Spinal cord tumors are a rare neoplasm of the central nervous system (CNS). The occurrence of metastases is related to poor prognosis. The authors analyzed one series of metastasis cases and their associated mortality. METHODS: Clinical characteristics were studied in six patients with intramedullary tumors with metastases in a series of 71 surgical cases. RESULTS: Five patients had ependymomas of which two were WHO grade III. The patient with astrocytoma had a grade II histopathological classification. Two patients required shunts for hydrocephalus. The survival curve showed a higher mortality than the general group of patients with no metastases in the CNS (p<0.0001). CONCLUSION: Mortality is elevated in patients with metastasis and greater than in patients with only primary lesions. The ependymomas, regardless of their degree of anaplasia, are more likely to cause metastasis than spinal cord astrocytomas.
Tumores da medula espinhal são neoplasias raras do sistema nervoso central (SNC). A ocorrência de metástases é relacionada a pior prognóstico. Os autores analisaram uma série de casos de metástases e a mortalidade relacionada. MÉTODO: Foram estudadas as características clínicas em seis pacientes com metástases tumorais numa série de 71 casos operados. RESULTADOS: Cinco pacientes tinham ependimomas e dois dos quais foram grau III pela classificação da OMS. O paciente portador de astrocitoma tinha classificação histopatológica de grau II. Dois pacientes necessitaram de derivação devido à hidrocefalia. A curva de sobrevivência mostrou mortalidade mais elevada no grupo de pacientes com disseminação pelo SNC (p<0,0001). CONCLUSÃO: A mortalidade, além de elevada em pacientes com metástases, é maior do que em pacientes apenas com lesão primária. Os ependimomas, independentemente do seu grau de anaplasia, costumam causar mais metástases do que os astrocitomas medulares.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Astrocytoma , Brain Neoplasms , Ependymoma , Meningeal Neoplasms , Spinal Cord Neoplasms , Astrocytoma/mortality , Astrocytoma/secondary , Brain Neoplasms/mortality , Brain Neoplasms/secondary , Ependymoma/mortality , Ependymoma/secondary , Magnetic Resonance Imaging , Meningeal Neoplasms/mortality , Meningeal Neoplasms/secondary , Neoplasm Staging , Prognosis , Survival Rate , Spinal Cord Neoplasms/mortality , Spinal Cord Neoplasms/pathologyABSTRACT
El objetivo general es conocer y determinar el nivel de calidad de servicio y grado de satisfacción de los trabajadores en las áreas de limpieza, lavandería, cocina y portería en la IMPB en gestión 1999
Subject(s)
Catchment Area, Health , Health Services Research , Household Work , Total Quality Management , Bolivia , Job Satisfaction , Personal SatisfactionABSTRACT
El Proyecto YACUPAC, Proyecto de Saneamiento Básico para las Poblaciones Dispersas del Departamento de Potosí, surgío por iniciativa del Programa PNUD/Banco Mundial de Agua y Saneamiento en base a su experiencia en 35 países en vías de desarrollo. El Programa tiene el objetivo de incrementar la capacidad de los países para abastecer agua y saneamiento de bajo costo y en base a enfoques comunitarios a los grupos de bajos ingresos principalmente. El objetivo del presente informe es documentar las experiencias de campo de los proyectos demostrativos del Proyecto después de dos años de ejecución. Este documento contiene una descripción general de los cinco objetivos del Proyecto con un enfoque más específico en la explicación y análisis de la estrategia de los proyectos demostrativos, así como en las lecciones aprendidas hasta la fecha