Targeting the uncertainty of predictions at patient-level using an ensemble of classifiers coupled with calibration methods, Venn-ABERS, and Conformal Predictors: A case study in AD.

Despite being able to make accurate predictions, most existing prognostic models lack a proper indication about the uncertainty of each prediction, that is, the risk of prediction error for individual patients. This hampers their translation to primary care settings through decision support systems. To address this problem, we studied different methods for transforming classifiers into probabilistic/confidence-based predictors (here called uncertainty methods), where predictions are complemented with probability estimates/confidence regions reflecting their uncertainty (uncertainty estimates). We tested several uncertainty methods: two well-known calibration methods (Platt Scaling and Isotonic Regression), Conformal Predictors, and Venn-ABERS predictors. We evaluated whether these methods produce valid predictions, where uncertainty estimates reflect the ground truth probabilities. Furthermore, we assessed the proportion of valid predictions made at high-certainty thresholds (predictions with uncertainty measures above a given threshold) since this impacts their usefulness in clinical decisions. Finally, we proposed an ensemble-based approach where predictions from multiple pairs of (classifier, uncertainty method) are combined to predict whether a given MCI patient will convert to AD. This ensemble should putatively provide predictions for a larger number of patients while releasing users from deciding which pair of (classifier, uncertainty method) is more appropriate for data under study. The analysis was performed with a Portuguese cohort (CCC) of around 400 patients and validated in the publicly available ADNI cohort. Despite our focus on MCI to AD prognosis, the proposed approach can be applied to other diseases and prognostic problems.

Karyotype diversity and 2C DNA content in species of the Caesalpinia group.

BACKGROUND: The Leguminosae family is the third-largest family of angiosperms, and Caesalpinioideae is its second-largest subfamily. A great number of species (approximately 205) are found in the Caesalpinia group within this subfamily; together with these species' phenotypic plasticity and the similarities in their morphological descriptors, make this a complex group for taxonomic and phylogenetic studies. The objective of the present work was to evaluate the karyotypic diversity and the 2C DNA content variation in 10 species of the Caesalpinia group, representing six genera: Paubrasilia, Caesalpinia, Cenostigma, Poincianella, Erythrostemon and Libidibia. The GC-rich heterochromatin and 45S rDNA sites (which are used as chromosome markers) were located to evaluate the karyotype diversity in the clade. The variation in the 2C DNA content was determined through flow cytometry. RESULTS: The fluorochrome banding indicated that the chromomycin A3+/4',6-diamidino-2-phenylindole- blocks were exclusively in the terminal regions of the chromosomes, coinciding with 45S rDNA sites in all analyzed species. Physical mapping of the species (through fluorescence in situ hybridization) revealed variation in the size of the hybridization signals and in the number and distribution of the 45S rDNA sites. All hybridization sites were in the terminal regions of the chromosomes. In addition, all species had a hybridization site in the fourth chromosome pair. The 2C DNA content ranged from 1.54 pg in Erythrostemon calycina to 2.82 pg in the Paubrasilia echinata large-leaf variant. The Pa. echinata small-leaf variant was isolated from the other leaf variants through Scoot-Knott clustering. CONCLUSIONS: The chromosome diversity and the variation in the 2C DNA content reinforce that the actual taxonomy and clustering of the analyzed taxa requires more genera that were previously proposed. This fact indicates that taxonomy, phylogeny and cytoevolutionary inference related to the complex Caesalpinia group have to be done through integrative evaluation.

Neuropsychological predictors of conversion from mild cognitive impairment to Alzheimer's disease: a feature selection ensemble combining stability and predictability.

BACKGROUND: Predicting progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) is an utmost open issue in AD-related research. Neuropsychological assessment has proven to be useful in identifying MCI patients who are likely to convert to dementia. However, the large battery of neuropsychological tests (NPTs) performed in clinical practice and the limited number of training examples are challenge to machine learning when learning prognostic models. In this context, it is paramount to pursue approaches that effectively seek for reduced sets of relevant features. Subsets of NPTs from which prognostic models can be learnt should not only be good predictors, but also stable, promoting generalizable and explainable models. METHODS: We propose a feature selection (FS) ensemble combining stability and predictability to choose the most relevant NPTs for prognostic prediction in AD. First, we combine the outcome of multiple (filter and embedded) FS methods. Then, we use a wrapper-based approach optimizing both stability and predictability to compute the number of selected features. We use two large prospective studies (ADNI and the Portuguese Cognitive Complaints Cohort, CCC) to evaluate the approach and assess the predictive value of a large number of NPTs. RESULTS: The best subsets of features include approximately 30 and 20 (from the original 79 and 40) features, for ADNI and CCC data, respectively, yielding stability above 0.89 and 0.95, and AUC above 0.87 and 0.82. Most NPTs learnt using the proposed feature selection ensemble have been identified in the literature as strong predictors of conversion from MCI to AD. CONCLUSIONS: The FS ensemble approach was able to 1) identify subsets of stable and relevant predictors from a consensus of multiple FS methods using baseline NPTs and 2) learn reliable prognostic models of conversion from MCI to AD using these subsets of features. The machine learning models learnt from these features outperformed the models trained without FS and achieved competitive results when compared to commonly used FS algorithms. Furthermore, the selected features are derived from a consensus of methods thus being more robust, while releasing users from choosing the most appropriate FS method to be used in their classification task.

Predicting progression of mild cognitive impairment to dementia using neuropsychological data: a supervised learning approach using time windows.

BACKGROUND: Predicting progression from a stage of Mild Cognitive Impairment to dementia is a major pursuit in current research. It is broadly accepted that cognition declines with a continuum between MCI and dementia. As such, cohorts of MCI patients are usually heterogeneous, containing patients at different stages of the neurodegenerative process. This hampers the prognostic task. Nevertheless, when learning prognostic models, most studies use the entire cohort of MCI patients regardless of their disease stages. In this paper, we propose a Time Windows approach to predict conversion to dementia, learning with patients stratified using time windows, thus fine-tuning the prognosis regarding the time to conversion. METHODS: In the proposed Time Windows approach, we grouped patients based on the clinical information of whether they converted (converter MCI) or remained MCI (stable MCI) within a specific time window. We tested time windows of 2, 3, 4 and 5 years. We developed a prognostic model for each time window using clinical and neuropsychological data and compared this approach with the commonly used in the literature, where all patients are used to learn the models, named as First Last approach. This enables to move from the traditional question "Will a MCI patient convert to dementia somewhere in the future" to the question "Will a MCI patient convert to dementia in a specific time window". RESULTS: The proposed Time Windows approach outperformed the First Last approach. The results showed that we can predict conversion to dementia as early as 5 years before the event with an AUC of 0.88 in the cross-validation set and 0.76 in an independent validation set. CONCLUSIONS: Prognostic models using time windows have higher performance when predicting progression from MCI to dementia, when compared to the prognostic approach commonly used in the literature. Furthermore, the proposed Time Windows approach is more relevant from a clinical point of view, predicting conversion within a temporal interval rather than sometime in the future and allowing clinicians to timely adjust treatments and clinical appointments.

Differential effects of salinity and osmotic stress on the plant growth-promoting bacterium Gluconacetobacter diazotrophicus PAL5.

Plant growth-promoting bacteria (PGPB) represent a promising alternative to the massive use of industrial fertilizers in agriculture. Gluconacetobacter diazotrophicus is a PGPB that colonizes several plant species. Although this bacterium is able to grow at high sucrose concentrations, its response to environmental stresses is poorly understood. The present study evaluated G. diazotrophicus PAL5 response to stresses caused by sucrose, PEG 400, NaCl, KCl, Na2SO4 and K2SO4. Morphological, ultrastructural and cell growth analysis revealed that G. diazotrophicus PAL5 is more sensitive to salt than osmotic stress. Growth inhibition and strong morphological changes were caused by salinity, in consequence of Cl ion-specific toxic effect. Interestingly, low osmotic stress levels were beneficial for bacterial multiplication, which was able to tolerate high sucrose concentrations, Na2SO4 and K2SO4. Our data show that G. diazotrophicus PAL5 has differential response to osmotic and salinity stress, which may influence its use as inoculant in saline environments.

Histological analysis of pollen-pistil interactions in sour passion fruit plants (Passiflora edulis Sims).

The success of sexual plant reproduction is directly influenced by specific interactions between the pollen and pistil. Light, fluorescence and scanning electron microscopy techniques were used to evaluate the steps of pollination in sour passion fruit plants (Passiflora edulis Sims). In the compatible interaction, pollen tubes grow through stigma projections towards the ovary. The pollen grain surface was found to be spheroidal and to consist of heteroreticulate exine with six colpi. Furthermore, analysis in vivo of pollen-pistil interactions indicated that stigmas of flowers 24 hours before anthesis are unable to discriminate compatible (genetically unrelated) and incompatible (genetically related) pollen grains. Taken together, these results provide insight into the cellular mechanisms underlying pollination in passion fruit plants.

Support policies for dependent older adults: Europe and Brazil. / Políticas de apoio aos idosos em situação de dependência: Europa e Brasil.

This theoretical essay discusses long-term care policies for dependent older adults. It aims to analyze the content and strategies that guided the formulation of the so-called "dependence policies" in some European states, seeking guidance to formulate actions related to the same issue in the Brazilian case. The knowledge bases are official documents and scientific papers analyzing the institutionalized proposals. The study shows that all the countries investigated included dependence policies within their social security system framework. Some offer total protection, while others only partial protection to older adults and family caregivers. However, older adults and their caregivers never fail to receive the care they need. In Brazil, some local experiences meet comprehensive care requirements. Initiatives of Belo Horizonte and São Paulo are narrated, and while important, they are not policies. They are successful cases that can evolve to increase social awareness or simply disappear as non-institutionalized experiences. The issue addressed in this paper is very relevant, due to the inexorable fact of the accelerated growth of the long-lived population, which requires care from others the most.

Neste ensaio teórico discutem-se políticas sobre cuidados de longa duração para pessoas idosas dependentes. O objetivo é analisar o conteúdo e as estratégias que guiaram a formulação das chamadas "políticas de dependência" em alguns estados europeus, buscando orientações para a realização de ações relativas à mesma questão no caso brasileiro. As bases de conhecimento são documentos oficiais e artigos científicos que descrevem e analisam a institucionalização das propostas. O estudo mostra que os países europeus aqui analisados incluíram as políticas sobre a dependência nos marcos de seu sistema de seguridade social; alguns oferecem proteção total, outros, apenas parcial ao idoso e ao cuidador familiar. Em nenhum deles, a pessoa idosa dependente deixa de receber os cuidados de que precisa. No Brasil, há algumas experiências locais que atendem aos requisitos de atenção integral. São narradas uma de Belo Horizonte e outra de São Paulo. Embora sejam importantes, tais iniciativas não constituem uma política, são casos exitosos que podem evoluir para o aumento da consciência social ou se esvaírem como experiências não institucionalizadas. A questão tratada neste artigo é de grande relevância, pelo fato inexorável do crescimento acelerado da população longeva, a que mais depende do cuidado de terceiros.

The collaborative process in the making of Ciência & Saúde Coletiva. / O processo colaborativo do fazer a Ciência & Saúde Coletiva.

This paper presents the different stages of the editorial process of Journal Ciência & Saúde Coletiva. Different processing work methods have been overcome over these 25 years, and others have been introduced. Each stage of this construction will be analyzed in-depth to discuss the "making" of an academic publication of such a large scale and complexity. The Journal Ciência & Saúde Coletiva delves into each issue a theme in the field, addressing its cross-sectionality and complexity. This thematization ranges from 10 to 35 papers. Thirty-five papers are published monthly (thematic and free subjects), mostly in Portuguese, English, and Spanish, fulfilling the most prestigious national and international open-access databases' deadline requirements. In this making, one of the significant issues is funding because the crucial development institutions' support is very scarce.

Este artigo apresenta as diversas etapas do processo editorial da Revista Ciência & Saúde Coletiva. Ao longo desses 25 anos diferentes modos de processar o trabalho foram sendo superados e outros foram sendo introduzidos. Cada etapa dessa construção será aprofundada com o objetivo de discutir "o fazer" cotidiano de uma publicação acadêmica de tamanha envergadura e complexidade. A Revista Ciência & Saúde Coletiva aprofunda em cada edição um tema da área, tratando-o em sua transversalidade e complexidade. Essa tematização vai de 10 a 35 artigos, pois 35 artigos são publicados mensalmente (temáticos e temas livres), em sua maioria em português e inglês e espanhol, cumprindo as exigências de prazos das mais conceituadas bases de dados nacionais e internacionais de livre acesso. Nesse a fazer, um dos grandes problemas é o financiamento, pois é muito escasso - embora fundamental - o apoio das instituições de fomento.

Perfectionism dimensions in pregnancy--a study in Portuguese women.

Pregnancy is essentially a physiological event, but neuroendocrinal and psychosocial changes are also important components of this experience. In this context, perceived stress may be enhanced by the activation of certain personality traits, like perfectionism, which in turn may be associated with more psychological distress (PD). The aim of this study was to investigate if perfectionism could be associated with more negative emotional outcomes (PD) in the transition to motherhood and to look at which of the perfectionism dimensions these consequences are specifically linked. The sample comprises 421 pregnant women (mean = 29.8, SD = 4.48 years) who completed measures of perfectionism and mood symptoms. A two-factor model with self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) dimensions and a three-factor model with SOP, SPP-others' high standards and SPP-conditional acceptance (CA) factors were explored. Correlations and linear regressions were calculated between perfectionism factors and mood variables. Results showed that higher levels of SPP factors were associated with increased anxiety, depression, anger, fatigue and confusion, with decreased vigour and with more severe depressive symptoms. Our results, in contrast with those from the study of Campbell and DiPaula (2002, In: Flett G, Hewitt P (eds) Perfectionism. Theory, research, and practice. American Psychological Association, Washington, pp 181-198), did not confirm a preferential association between SPP-CA and PD, revealing that both components of SPP were associated with PD.

Diagnostic and prognostic utility of molecular markers in synchronous bilateral breast carcinoma.

Histologic criteria have a limited role in determining whether the synchronous bilateral breast carcinomas represent two primaries or a metastasis to the contralateral breast. We studied the molecular analysis of synchronous bilateral breast carcinoma and whether they are originating from a single or different clone. We examined 17 patients with breast carcinoma, including 12 patients with synchronous bilateral carcinomas and control group of 5 infiltrating ductal carcinomas with regional lymph node metastases. Mutations were quantitatively determined to detect loss of heterozygosity (LOH) and microsatellite size alterations for a broad panel of 15 markers, involving 10 chromosomes using polymerase chain reaction. The carcinomas were classified as de novo or metastasis based on three levels of concordance: (1) marker-affected tumors were considered concordant if 50% or more of the same markers were mutated, (2) same gene copy affected, and (3) temporal sequence of mutation acquisition. In synchronous bilateral breast carcinoma patients, molecular analysis showed discordant mutations in all cases, supporting the diagnosis of de novo bilateral primary breast carcinomas. In patients with lymph node metastases, the primary breast carcinoma and metastases shared the same mutations, revealing a metastatic lesion. In conclusion, the application of molecular technology may play an important role for the differential diagnosis of dual primary carcinomas vs a metastatic breast cancer to contralateral breast. In this study, synchronous bilateral breast cancers represent two independent primaries rather than metastatic events.

Late-onset infections after LASIK.

PURPOSE: To report two cases of infectious keratitis that developed 2 and 6 years after LASIK. METHODS: Case 1 was a 56-year-old woman who presented with redness and decreased vision in the right eye 6 years after LASIK. Slit-lamp examination revealed inflammation of the flap interface, a partially detached flap, anterior chamber reaction, and hypopyon. Corneal scrapings were taken. Case 2 was a 23-year-old woman who presented with pain and a corneal infiltrate in the left eye 36 hours after eye trauma. She had undergone bilateral LASIK 2 years prior. The condition worsened despite treatment, and a flap amputation was performed. RESULTS: Cultures revealed Pseudomonas mesophilic and Fusarium solani, respectively. Keratitis in case 1 resolved after 21 days of fortified antibiotic therapy. Visual acuity of 20/40 was achieved after antibiotic treatment in case 2. CONCLUSIONS: These case reports demonstrate the risk of microbial keratitis occurring years after LASIK and emphasize the need for lifelong postoperative vigilance by patient and physician.

[Use of the family health record as a quality-of-care indicator in primary health care units]. / O uso do prontuário familiar como indicador de qualidade da atenção nas unidades básicas de saúde.

Expansion of the Family Health Program in Brazil requires indicators to evaluate the consistency of the approach actually adopted and the program's underlying principles. Together with the family health chart, the family health history (medical genealogy) allows improved follow-up of the clientele's health and the quality of care provided. This study used the family health chart based on external evaluation (accreditation) of family health teams and managers. The results showed variation in the health charts' conformity to the accreditation standard according to the nature of the function evaluated. The study showed the importance of external evaluation to signal the level of conformity to the required standards, suggesting the need to operate with a combined indicator, including internal and external evaluation of family health data as a management instrument.

The future of the Brazilian Health System: a short review of its pathways towards an uncertain and discouraging horizon. / Notas sobre o futuro do SUS: breve exame de caminhos e descaminhos trilhados em um horizonte de incertezas e desalentos.

This article reflects on the future of the Brazilian Unified Health System (SUS, acronym in Portuguese), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation. The text briefly reviews some paths followed by the SUS as referred to in the Federal Constitution of 1988. It highlights the movement towards the decentralization of care and the constraint of health financial resources that reduced policies of increasing public expenditures. It examines the public and private arrangements for financing and provision of services that have resulted in sectoral privatization, mainly from economic policies articulated with concession of fiscal benefits. It analyzes the changes in the public sector financing through successive constitutional amendments that resulted in the weakening of established social protection policies, particularly of the health sector. For the future, the text considers population aging and analyzes trends in the epidemiological profile, with consequent changes in the health care paradigm. The article concludes by pointing out the consequences of fiscal strangling in the organization of the healthcare system and the need to reverse legal provisions that hamper the fulfillment of the constitutional mandate for equity and universality.

Este artigo apresenta uma reflexão sobre o futuro do SUS, baseada em exercícios prospectivos desenvolvidos pela iniciativa Brasil Saúde Amanhã da Fundação Oswaldo Cruz. O texto faz uma breve revisão de caminhos e descaminhos percorridos pelo SUS, tendo como marco a Constituição Federal de 1988. Destaca os movimentos pela descentralização e a subtração de recursos da saúde que reduziu a política de incremento de gastos; e acentua os arranjos públicos e privados de financiamento e provisão de serviços que resultaram na privatização setorial decorrente, principalmente, de políticas econômicas articuladas com a concessão de benefícios e tributos. Analisa o financiamento do setor público através das sucessivas emendas constitucionais que resultaram na destruição da proteção social e no enfraquecimento do setor Saúde. Para o futuro, o texto considera o envelhecimento populacional e analisa tendências no perfil epidemiológico, com as consequentes mudanças no modelo de cuidados de atenção à saúde. O artigo conclui apontando os resultados do estrangulamento fiscal na organização do sistema de cuidados e a necessidade da reversão de dispositivos legais que obstaculizam o mandamento constitucional.

Palynology and meiotic behavior of Genipa americana L, a species native to the Amazon

Genipa americana L., commonly known as genipap, belongs to the Rubiaceae family. This study aimed to describe the pollen morphology of the species, evaluate its meiotic behavior and pollen viability, and provide information to help the maintenance and conservation of the species in its natural habitat. Flower buds were collected from 20 individuals in Alta Floresta and Matupá municipalities, Mato Grosso, Brazil. Pollen morphology was characterized using acetolysis and compared to existing literature. Meiotic and post-meiotic phases were analyzed using 2% acetocarmine stain, and pollen viability was estimated using Sudan IV, Alexander's stain, Lugol's solution (1%), and 2% acetocarmine stain. G. americana has medium-sized, 3-colporate pollen with reticulated exine and few meiotic irregularities. Acetocarmine stain showed the highest mean percentage of pollen viability (97.96%). Stain tests revealed significant differences, indicating high pollen viability and meiotic regularity. However, conservation and recovery of degraded areas are still necessary as there is no guarantee of successful reproduction due to factors associated with fragmentation, genetic drift, reduced gene flow, and inbreeding.

Flap-induced refraction change in LASIK after penetrating keratoplasty.

PURPOSE: To further analyze the refractive and topographic changes occurring with microkeratome lamellar keratotomy and to investigate possible factors associated in eyes with previous penetrating keratoplasty (PK). METHODS: The Hansatome microkeratome was used to create a lamellar corneal flap in 21 eyes of 19 patients after PK. The laser ablation was not performed in the first stage. Pre- and postoperative refractions and corneal topographies were compared to evaluate possible changes induced by the keratotomy. RESULTS: Twenty-one eyes were analyzed in this study. Mean time between PK and lamellar keratotomy was 36.63 +/- 28.23 months (range: 12 to 120 months). No microkeratome-related flap complications occurred. Previous to the keratotomy, the mean spherical equivalent refraction was -4.26 +/- 3.41 diopters (D), mean refractive astigmatism was -4.71 +/- 2.27 D, and mean topographic astigmatism was 5.28 +/- 2.94 D. After keratotomy, eyes showed statistically significant changes in spherical equivalent refraction from preoperative values (P = .025), with 3 eyes showing changes > 2.00 D. Average refractive and topographic astigmatism did not change significantly from before to after keratotomy. However, surgically induced astigmatism (SIA) calculated through vector analysis was > 1.01 in 11 (52.4%) eyes. A statistically significant correlation was found between the SIA values and preoperative refractive astigmatism (P = .025). CONCLUSIONS: Lamellar keratotomy as part of two-stage LASIK in eyes with prior PK led to refractive changes that justify the use of this technique, especially in eyes with high degrees of preoperative astigmatism.

Critical diagnoses (critical values) in anatomic pathology.

Similar to critical values in clinical pathology, occasional diagnoses in surgical pathology and cytology may require urgent contact of the physician to facilitate rapid intervention or treatment. However, there are no established critical value (critical diagnosis) guidelines in anatomic pathology. As discussed herein, the Association of Directors of Anatomic and Surgical Pathology (ADASP) believes that establishing anatomic pathology critical diagnosis guidelines represents a practice improvement and patient safety initiative. The ADASP also recognizes that a generic anatomic pathology critical diagnosis guideline such as this should only be used as a template because the list needs to be customized at each individual hospital after consultation with relevant clinical services. Based on surveys of the membership of the ADASP, this document provides examples of possible critical diagnoses in anatomic pathology.

Critical values in cytology.

The concept of critical values (CVs) is well established in clinical pathology, and has only recently been suggested in surgical pathology. To evaluate CVs in cytology, we reviewed 2,000 cytology reports at two large academic medical centers. Cases considered CV included unexpected malignancy, disagreement between immediate interpretation and final diagnosis in fine-needle aspirations (FNAs), and evidence of microorganisms in non-gynecology (non-GYN) and FNA specimens. We identified 52 CV cases (2.6%), including 0.25% (1/400) GYN, 1.88% (15/800) non-GYN, and 4.5% (36/800) FNA. Most of these (42 cases) were unexpected malignancies. Documentation of physician notification was present in 30 out of 52 cases. We also did a survey with 22 cytopathologists and 13 clinicians at large academic medical centers. The participants were asked to rate 18 different possible CVs from 1 to 3 as follows: (1) no phone call necessary, (2) phone call within 24 hr, (3) phone call as soon as possible (ASAP). Participants could also list additional diagnoses they believed constituted a CV. Most respondents agreed on the need for a phone call ASAP in many situations, and important additional CV cases were suggested. We suggest that a consensus conference of leaders in anatomic pathology and clinicians might prove useful to propose guidelines for CVs in cytology.

Solitary pulmonary metastasis presenting 20 years after primary resection of Wilms tumor.

Wilms tumor is the most common renal malignancy of childhood. Relapse occurs most often within 4 years of initial diagnosis, and the most common site of metastasis is the lung. We describe a 22-year-old man who presented with hemoptysis and a solitary pulmonary lesion 20 years after primary resection of Wilms tumor. Computed tomography of the chest showed an indeterminate pulmonary mass of heterogeneous attenuation with no other intrathoracic abnormalities. Surgical resection revealed a solitary pulmonary metastasis from Wilms tumor. Further evaluation yielded no evidence of extrathoracic metastases. This case shows that late relapse in the form of a solitary pulmonary mass can occur in patients with Wilms tumor.

Classification of primary progressive aphasia: Do unsupervised data mining methods support a logopenic variant?

Our objective was to test whether data mining techniques, through an unsupervised learning approach, support the three-group diagnostic model of primary progressive aphasia (PPA) versus the existence of two main/classic groups. A series of 155 PPA patients observed in a clinical setting and subjected to at least one neuropsychological/language assessment was studied. Several demographic, clinical and neuropsychological attributes, grouped in distinct sets, were introduced in unsupervised learning methods (Expectation Maximization, K-Means, X-Means, Hierarchical Clustering and Consensus Clustering). Results demonstrated that unsupervised learning methods revealed two main groups consistently obtained throughout all the analyses (with different algorithms and different set of attributes). One group included most of the agrammatic/non-fluent and some logopenic cases while the other was mainly composed of semantic and logopenic cases. Clustering the patients in a larger number of groups (k > 2) revealed some clusters composed mostly of non-fluent or of semantic cases. However, we could not evidence any group chiefly composed of logopenic cases. In conclusion, unsupervised data mining approaches do not support a clear distinction of logopenic PPA as a separate variant.

O processo colaborativo do fazer a Ciência & Saúde Coletiva / The collaborative process in the making of Ciência & Saúde Coletiva

Resumo Este artigo apresenta as diversas etapas do processo editorial da Revista Ciência & Saúde Coletiva. Ao longo desses 25 anos diferentes modos de processar o trabalho foram sendo superados e outros foram sendo introduzidos. Cada etapa dessa construção será aprofundada com o objetivo de discutir "o fazer" cotidiano de uma publicação acadêmica de tamanha envergadura e complexidade. A Revista Ciência & Saúde Coletiva aprofunda em cada edição um tema da área, tratando-o em sua transversalidade e complexidade. Essa tematização vai de 10 a 35 artigos, pois 35 artigos são publicados mensalmente (temáticos e temas livres), em sua maioria em português e inglês e espanhol, cumprindo as exigências de prazos das mais conceituadas bases de dados nacionais e internacionais de livre acesso. Nesse a fazer, um dos grandes problemas é o financiamento, pois é muito escasso - embora fundamental - o apoio das instituições de fomento.

Abstract This paper presents the different stages of the editorial process of Journal Ciência & Saúde Coletiva. Different processing work methods have been overcome over these 25 years, and others have been introduced. Each stage of this construction will be analyzed in-depth to discuss the "making" of an academic publication of such a large scale and complexity. The Journal Ciência & Saúde Coletiva delves into each issue a theme in the field, addressing its cross-sectionality and complexity. This thematization ranges from 10 to 35 papers. Thirty-five papers are published monthly (thematic and free subjects), mostly in Portuguese, English, and Spanish, fulfilling the most prestigious national and international open-access databases' deadline requirements. In this making, one of the significant issues is funding because the crucial development institutions' support is very scarce.