Analyses of cataract surgery performed by the Unified Health System in Brazil, 2006-2007

Objective. Estimate cataract surgical rates (CSR) for Brazil and each federal unit in 2006 and 2007 based on the number of surgeries performed by the Unified Health System to help plan a comprehensive ophthalmology network in order to eliminate cataract blindness in compliance with the target set by the World Health Organization (WHO) of 3 000 cataract surgeries per million inhabitants per year. Methods. This descriptive study calculates CSR by using the number of cataract surgeries carried out by the Brazilian Unified Health System for each federal unit and estimates the need for cataract surgery in Brazil for 2006-2007, with official population data provided by the Brazilian Institute of Geography and Statistics. The number of cataract surgeries was compared with the WHO target. Results. To reach the WHO goal for eliminating age-related cataract blindness in Brazil, 560 312 cataract surgeries in 2006 and 568 006 surgeries in 2007 needed to be done. In 2006, 179 121 cataract surgeries were done by the Unified Health System, corresponding to a CSR of 959 per million population; in 2007, 223 317 were performed, with a CSR of 1 179. With the Brazilian Council of Ophthalmology estimation of 165 000 surgeries each year by the non-public services, the CSR for Brazil would be 1 842 for 2006 and 2 051 for 2007. The proportions needed to achieve the proposed target were 38.6% in 2006 and 31.6% in 2007. Conclusions. Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.

Formulation of a tropical town energy budget (t-TEB) scheme

This work describes the tropical town energy budget (t-TEB) scheme addressed to simulate the diurnal occurrence of the urban heat island (UHI) as observed in the Metropolitan Area of Rio de Janeiro (MARJ; -22A degrees S; -44A degrees W) in Brazil. Reasoning about the tropical urban climate have guided the scheme implementation, starting from the original equations from Masson (Bound-Lay Meteorol 94:357-397, 2000). The modifications include (a) local scaling approaches for obtaining flux-gradient relationships in the roughness sub-layer, (b) the Monin-Obukhov similarity framework in the inertial sub-layer, (c) increasing aerodynamic conductance toward more unstable conditions, and (d) a modified urban subsurface drainage system to transfer the intercepted rainwater by roofs to the roads. Simulations along 2007 for the MARJ are obtained and compared with the climatology. The t-TEB simulation is consistent with the observations, suggesting that the timing and dynamics of the UHI in tropical cities could vary significantly from the familiar patterns observed in mid-latitude cities-with the peak heat island intensity occurring in the morning than at night. The simulations are suggesting that the thermal phase shift of this tropical diurnal UHI is a response of the surface energy budget to the large amount of solar radiation, intense evapotranspiration, and thermal response of the vegetated surfaces over a very humid soil layer.

Generalized external indexes for comparing data partitions with overlapping categories

There is a family of well-known external clustering validity indexes to measure the degree of compatibility or similarity between two hard partitions of a given data set, including partitions with different numbers of categories. A unified, fully equivalent set-theoretic formulation for an important class of such indexes was derived and extended to the fuzzy domain in a previous work by the author [Campello, R.J.G.B., 2007. A fuzzy extension of the Rand index and other related indexes for clustering and classification assessment. Pattern Recognition Lett., 28, 833-841]. However, the proposed fuzzy set-theoretic formulation is not valid as a general approach for comparing two fuzzy partitions of data. Instead, it is an approach for comparing a fuzzy partition against a hard referential partition of the data into mutually disjoint categories. In this paper, generalized external indexes for comparing two data partitions with overlapping categories are introduced. These indexes can be used as general measures for comparing two partitions of the same data set into overlapping categories. An important issue that is seldom touched in the literature is also addressed in the paper, namely, how to compare two partitions of different subsamples of data. A number of pedagogical examples and three simulation experiments are presented and analyzed in details. A review of recent related work compiled from the literature is also provided. (c) 2010 Elsevier B.V. All rights reserved.

A unified view on lifetime distributions arising from selection mechanisms

In this paper, we formulate a flexible density function from the selection mechanism viewpoint (see, for example, Bayarri and DeGroot (1992) and Arellano-Valle et al. (2006)) which possesses nice biological and physical interpretations. The new density function contains as special cases many models that have been proposed recently in the literature. In constructing this model, we assume that the number of competing causes of the event of interest has a general discrete distribution characterized by its probability generating function. This function has an important role in the selection procedure as well as in computing the conditional personal cure rate. Finally, we illustrate how various models can be deduced as special cases of the proposed model. (C) 2011 Elsevier B.V. All rights reserved.

On the unification of long-term survival models

In this paper we extend the long-term survival model proposed by Chen et al. [Chen, M.-H., Ibrahim, J.G., Sinha, D., 1999. A new Bayesian model for survival data with a surviving fraction. journal of the American Statistical Association 94, 909-919] via the generating function of a real sequence introduced by Feller [Feller, W., 1968. An Introduction to Probability Theory and its Applications, third ed., vol. 1, Wiley, New York]. A direct consequence of this new formulation is the unification of the long-term survival models proposed by Berkson and Gage [Berkson, J., Gage, R.P., 1952. Survival cure for cancer patients following treatment. journal of the American Statistical Association 47, 501-515] and Chen et al. (see citation above). Also, we show that the long-term survival function formulated in this paper satisfies the proportional hazards property if, and only if, the number of competing causes related to the occurrence of an event of interest follows a Poisson distribution. Furthermore, a more flexible model than the one proposed by Yin and Ibrahim [Yin, G., Ibrahim, J.G., 2005. Cure rate models: A unified approach. The Canadian journal of Statistics 33, 559-570] is introduced and, motivated by Feller`s results, a very useful competing index is defined. (c) 2008 Elsevier B.V. All rights reserved.

Formulation of the standard model in terms of spinor fields

We propose an alternative formulation of the Standard Model which reduces the number of free parameters. In our framework, fermionic fields are assigned to fundamental representations of the Lorentz and the internal symmetry groups, whereas bosonic field variables transform as direct products of fundamental representations of all symmetry groups. This allows us to reduce the number of fundamental symmetries. We formulate the Standard Model by considering the SU(3) and SU(2) symmetry groups as the underlying symmetries of the fundamental interactions. This allows us to suggest a model, for the description of the interactions of the intermediate bosons among themselves and interactions of fermions, that makes use of just two parameters. One parameter characterizes the symmetric phase, whereas the other parameter (the asymmetry parameter) gives the breakdown strength of the symmetries. All coupling strengths of the Standard Model are then derived in terms of these two parameters. In particular, we show that all fermionic electric charges result from symmetry breakdown.

A Precise Formulation of the Third Law of Thermodynamics

The third law of thermodynamics is formulated precisely: all points of the state space of zero temperature I""(0) are physically adiabatically inaccessible from the state space of a simple system. In addition to implying the unattainability of absolute zero in finite time (or ""by a finite number of operations""), it admits as corollary, under a continuity assumption, that all points of I""(0) are adiabatically equivalent. We argue that the third law is universally valid for all macroscopic systems which obey the laws of quantum mechanics and/or quantum field theory. We also briefly discuss why a precise formulation of the third law for black holes remains an open problem.

Design of a Modern Liposome and Bee Venom Formulation for the Traditional VIT-Venom Immunotherapy

Traditional venom immunotherapy uses injections of whole bee venom in buffer or adsorbed in Al (OH)(3) in an expensive, time-consuming way. New strategies to improve the safety and efficacy of this treatment with a reduction of injections would, therefore, be of general interest. It would improve patient compliance and provide socio-economic benefits. Liposomes have a long tradition in drug delivery because they increase the therapeutic index and avoid drug degradation and secondary effects. However, bee venom melittin (Mel) and phospholipase (PLA(2)) destroy the phospholipid membranes. Our central idea was to inhibit the PLA(2) and Mel activities through histidine alkylation and or tryptophan oxidation (with pbb, para-bromo-phenacyl bromide, and/or NBSN-bromosuccinimide, respectively) to make their encapsulations possible within stabilized liposomes. We strongly believe that this formulation will be nontoxic but immunogenic. In this paper, we present the whole bee venom conformation characterization during and after chemical modification and after interaction with liposome by ultraviolet, circular dichroism, and fluorescence spectroscopies. The PLA(2) and Mel activities were, measured indirectly by changes in turbidity at 400(nm), rhodamine leak-out, and hemolysis. The native whole bee venom (BV) presented 78.06% of alpha-helical content. The alkylation (A-BV) and succynilation (S-BV) of BV increased 0.44 and 0.20% of its alpha-helical content. The double-modified venom (S-A-BV) had a 0.74% increase of alpha-helical content. The BV chemical modification induced another change on protein conformations observed by Trp that became buried with respect to the native whole BV. It was demonstrated that the liposomal membranes must contain pbb (SPC:Cho:pbb, 26:7:1) as a component to protect them from aggregation and/or fusion. The membranes containing pbb maintained the same turbidity (100%) after incubation with modified venom, in contrast with pbb-free membranes that showed a 15% size decrease. This size decrease was interpreted as membrane degradation and was corroborated by a 50% rhodamine leak-out. Another fact that confirmed our interpretation was the observed 100% inhibition of the hemolytic activity after venom modification with pbb and NBS (S-A-BV). When S-A-BV interacted with liposomes, other protein conformational changes were observed and characterized by the increase of 1.93% on S-A-BV alpha-helical content and the presence of tryptophan residues in a more hydrophobic environment. In other words, the S-A-BV interacted with liposomal membranes, but this interaction was not effective to cause aggregation, leak-out, or fusion. A stable formulation composed by S-A-BV encapsulated within liposomes composed by SPC:Cho:pbb, at a ratio of 26:7:1, was devised. Large unilamellar vesicles of 202.5 nm with a negative surface charge (-24.29 mV) encapsulated 95% of S-A-BV. This formulation can, now, be assayed on VIT.

A new micro/nanoencapsulated porphyrin formulation for PDT treatment

The highly hydrophobic 5,10,15-triphenyl-20-(3-N-methylpyridinium-yl)porphyrin(3MMe)cationic species was synthesized, characterized and encapsulated in marine atelocollagen/xanthane gum microcapsules by the coacervation method. Further reduction in the capsule size, from several microns down to about 300-400 nm, was carried out successfully by ultrasonic processing in the presence of up to 1.6% Tween 20 surfactant, without affecting the distribution of 3MMe in the oily core. The resulting creamlike product exhibited enhanced photodynamic activity but negligible cytotoxicity towards HeLa cells. The polymeric micro/nanocapsule formulation was found to be about 4 times more phototoxic than the respective phosphatidylcholine lipidic emulsion, demonstrating high potentiality for photodynamic therapy applications. (C) 2009 Elsevier B.V. All rights reserved.