Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease

American visceral leishmaniasis is a main public health matter in Brazil. Since dogs have been incriminated as the main urban reservoir of AVL agent Leishmania chagasi, a cohort study aimed at understanding the dynamics of the canine infection was carried out in Jequié--an endemic community in the Northeast of Brazil. The inhabited urban and periurban areas of Jequié were divided into 140 clusters of 0.25 km2. All 1681 dogs domiciled in 34 randomly selected clusters were screened for Leishmania antibodies in an enzyme-linked immunosorbent assay. After the seropositive dogs were painlessly eliminated, a cohort of 1286 seronegative dogs was followed up for 18 months, yielding a total of 1739.7 dog-years. The overall incidence of Leishmania infection, as assessed by the detection of Leishmania antibodies in blood samples collected every six months, was 6.55 cases/100 dog-years (95% confidence interval; CI 6.04-7.26). Two subsets of clusters, with 0.70 and 1.35 relative risks of infection, were identified. The annual emigration rate was 2.26 cases/100 dog-years (95% CI 1.86-2.66). The implications of these findings for the control of American visceral leishmaniasis are discussed.     

Quality of ecologically produced foods of animal origin

The production of organic (ecological) food of animal origin is done in many ways and uses many different breeds. Therefore a real comparison with conventionally produced food is difficult. From the limited number of published data it appears, that the characteristics of quality of the products, the nutritional, hygienic, sensorial and technological factors, are not very different in both systems of production. In some factors organic food gets better marks, in others the conventionally produced food. The differences are in the production system (process quality) during lifetime of the animals.     

Sucrosemia in untreated celiac disease: a potential screening test

During studies to develop serum tests of small intestinal permeability, we detected an unidentified disaccharide in HPLC traces of sera from untreated celiacs. This present study aimed to identify the disaccharide and determine whether the presence of the disaccharide in the serum after an oral challenge had potential as a simple screening test for celiac disease. The disaccharide was identified as sucrose by incubation studies of sera with disaccharidases. Twenty untreated celiacs, 15 treated celiacs, and 20 normal or dyspeptic controls were studied for the presence of sucrose in their serum after an oral load (8 g). The results in celiacs were compared with the presence of serum IgA endomysial antibodies. The 10 normal controls were also given a larger sucrose challenge (50 g). Ten of the untreated celiacs and 10 controls had their brush border disaccharidase activities measured. Sucrose eluted in the same position as the unidentified disaccharide in the HPLC trace and the latter could be removed by incubation with sucrase. All untreated celiacs but none of the treated celiacs had sucrose in their serum after the 8-g oral challenge. None of the controls had sucrose in their serum after the 8-g or 50-g challenges. Three untreated celiacs were IgA endomysial antibody negative as were all the treated cases. Brush border sucrase activity was low in untreated celiac disease. The presence of sucrose in the serum after an oral load shows promise as a noninvasive test for celiac disease.     

Exploratory learning structures in artificial cognitive systems

The major goal of the COSPAL project is to develop an artificial cognitive system architecture, with the ability to autonomously extend its capabilities. Exploratory learning is one strategy that allows an extension of competences as provided by the environment of the system. Whereas classical learning methods aim at best for a parametric generalization, i.e., concluding from a number of samples of a problem class to the problem class itself, exploration aims at applying acquired competences to a new problem class, and to apply generalization on a conceptual level, resulting in new models. Incremental or online learning is a crucial requirement to perform exploratory learning.In the COSPAL project, we mainly investigate reinforcement-type learning methods for exploratory learning, and in this paper we focus on the organization of cognitive systems for efficient operation. Learning is used over the entire system. It is organized in the form of four nested loops, where the outermost loop reflects the user-reinforcement-feedback loop, the intermediate two loops switch between different solution modes at symbolic respectively sub-symbolic level, and the innermost loop performs the acquired competences in terms of perception–action cycles. We present a system diagram which explains this process in more detail.We discuss the learning strategy in terms of learning scenarios provided by the user. This interaction between user (’teacher’) and system is a major difference to classical robotics systems, where the system designer places his world model into the system. We believe that this is the key to extendable robust system behavior and successful interaction of humans and artificial cognitive systems.We furthermore address the issue of bootstrapping the system, and, in particular, the visual recognition module. We give some more in-depth details about our recognition method and how feedback from higher levels is implemented. The described system is however work in progress and no final results are available yet. The available preliminary results that we have achieved so far, clearly point towards a successful proof of the architecture concept.     

Development of clinical indicators for performance measurement and improvement: an HMO/purchaser collaborative effort

This article describes a collaborative effort between a major health care purchaser, three area health maintenance organizations, and a state Medicaid agency to develop clinical indicators as the basis for a comparison database. Some of the difficulties in developing a "common yardstick" of quality and value are candidly discussed.     

Investigating the tension load of rubber composites by impact dynamic testing

This work deals with establishing the tension load by impact dynamic testing of rubber composite conveyor belts. The value of tension load affects the shape of the used impactor and use of a support system as well as the weight of the ram and the impact height. An increase in the allowable stress when the belt is tensioned was examined during the test, to determine the effect of impact on the tension load. The obtained values of tension load are assessed using basic mathematical and statistical methods. Using the Design of Experiments method, factors that significantly affect the value of the tension load are identified.