Análise dos custos assistenciais de uma operadora de plano de saúde no Brasil

The relevance of rising healthcare costs is a main topic in complementary health companies in Brazil. In 2011, these expenses consumed more than 80% of the monthly health insurance in Brazil. Considering the administrative costs, it is observed that the companies operating in this market work, on average, at the threshold between profit and loss. This paper presents results after an investigation of the welfare costs of a health plan company in Brazil. It was based on the KDD process and explorative Data Mining. A diversity of results is presented, such as data summarization, providing compact descriptions of the data, revealing common features and intrinsic observations. Among the key findings was observed that a small portion of the population is responsible for the most demanding of resources devoted to health care

Recuperação e purificação de proteínas do soro de queijo tipo coalho usando cromatografia de troca iônica e interação hidrofóbica em leito na forma expandida

Expanded Bed Adsorption plays an important role in the downstream processing mainly for reducing costs as well as steps besides could handling cells homogenates or fermentation broth. In this work Expanded Bed Adsorption was used to recover and purify whey proteins from coalho cheese manufacture using Streamline DEAE and Streamline SP both ionic resins as well as a hydrophobic resin Streamline Phenyl. A column of 2.6 cm inner diameter with 30 cm in height was coupled to a peristaltic pump. Hydrodynamics study was carried out with the three resins using Tris-HCl buffer in concentration of 30, 50 and 70 mM, with pH ranging from 7.0 to 8.0. In this case, assays of the expansion degree as well as Residence Time Distribution (RTD) were carried out. For the recovery and purification steps, a whey sample of 200 mL, was submitted to a column with 25mL of resin previously equilibrated with Tris/HCl (50 mM, pH 7.0) using a expanded bed. After washing, elution was carried out according the technique used. For ionic adsorption elution was carried out using 100 mL of Tris/HCl (50 mM, pH 7.0 in 1M NaCl). For Hydrophobyc interaction elution was carried out using Tris/HCl (50 mM, pH 7.0). Adsorption runs were carried out using the three resins as well as theirs combination. Results showed that for hydrodynamics studies a linear fit was observed for the three resins with a correlation coefficient (R2) about 0.9. In this case, Streamline Phenyl showed highest expansion degree reaching an expansion degree (H0/H) of 2.2. Bed porosity was of 0.7 when both resins Streamline DEAE and Streamline SP were used with StremLine Phenyl showing the highest bed porosity about 0.75. The number of theorical plates were 109, 41.5 and 17.8 and the axial dipersion coefficient (Daxial) were 0.5, 1.4 and 3.7 x 10-6 m2/s, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. Whey proteins were adsorved fastly for the three resins with equilibrium reached in 10 minutes. Breakthrough curves showed that most of proteins stays in flowthrough as well as washing steps with 84, 77 and 96%, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. It was observed protein peaks during elution for the three resins used. According to these peaks were identified 6 protein bands that could probably be albumin (69 KDa), lactoferrin (76 KDa), lactoperoxidase (89 KDa), β-lactoglobulin (18,3 KDa) e α-lactoalbumin (14 KDa), as well as the dimer of beta-lactoglobulin. The combined system compound for the elution of Streamline DEAE applied to the Streamline SP showed the best purification of whey proteins, mainly of the α-lactoalbumina

Recuperação e purificação do antígeno 503 de Leishmania i. chagasi expresso em E. coli e remoção de endotoxina utilizando adsorção em leito expandido

The growing interest and applications of biotechnology products have increased the development of new processes for recovery and purification of proteins. The expanded bed adsorption (EBA) has emerged as a promising technique for this purpose. It combines into one operation the steps of clarification, concentration and purification of the target molecule. Hence, the method reduces the time and the cost of operation. In this context, this thesis aim was to evaluate the recovery and purification of 503 antigen of Leishmania i. chagasi expressed in E. coli M15 and endotoxin removal by EBA. In the first step of this study, batch experiments were carried out using two experimental designs to define the optimal adsorption and elution conditions of 503 antigen onto Streamline chelating resin. For adsorption assays, using expanded bed, it was used a column of 2.6 cm in diameter by 30.0 cm in height coupled to a peristaltic pump. In the second step of study, the removal of endotoxin during antigen recovery process was evaluated employing the non-ionic surfactant Triton X-114 in the washing step ALE. In the third step, we sought developing a mathematical model able to predict the 503 antigen breakthrough curves in expanded mode. The experimental design results to adsorption showed the pH 8.0 and the NaCl concentration of 2.4 M as the optimum adsorption condition. In the second design, the only significant factor for elution was the concentration of imidazole, which was taken at 600 mM. The adsorption isotherm of the 503 antigen showed a good fit to the Langmuir model (R = 0.98) and values for qmax (maximum adsorption capacity) and Kd (equilibrium constant) estimated were 1.95 mg/g and 0.34 mg/mL, respectively. Purification tests directly from unclarified feedstock showed a recovery of 59.2% of the target protein and a purification factor of 6.0. The addition of the non-ionic surfactant Triton X-114 to the washing step of EBA led to high levels (> 99%) of LPS removal initially present in the samples for all conditions tested. The mathematical model obtained to describe the 503 antigen breakthrough curves in Streamline Chelanting resin in expanded mode showed a good fit for both parameter estimation and validation steps. The validated model was used to optimize the efficiencies, achieving maximum values of the process and of the column efficiencies of 89.2% and 75.9%, respectively. Therefore, EBA is an efficient alternative for the recovery of the target protein and removal of endotoxin from an E. coli unclarified feedstock in just one step.

Estudo de adsorvente obtido de terras diatomáceas para remoção de metais pesados em águas produzidas: processamento, caracterização e dinâmica em leito fixo

The acceleration of industrial growth in recent decades on all continents aroused the interest of the companies to counter the impacts produced on the environment, spurred primarily by major disasters in the petroleum industry. In this context, the water produced is responsible for the largest volume of effluent from the production and extraction of oil and natural gas. This effluent has in its composition some critical components such as inorganic salts, heavy metals (Fe, Cu, Zn, Pb, Cd, ), presence of oil and chemicals added in the various production processes. In response to impact, have been triggered by research alternative adsorbent materials for water treatment and water produced, in order to removing oils and acids and heavy metals. Many surveys of diatomaceous earth (diatomite) in Brazil involve studies on the physico-chemical, mineral deposits, extraction, processing and applications. The official estimated Jazi are around 2.5 million tonnes, the main located in the states of Bahia (44%) and Rio Grande do Norte (37,4%). Moreover, these two states appear as large offshore producers, earning a prominent role in research of adsorbents such as diatomite for treatment of water produced. Its main applications are as an agent of filtration, adsorption of oils and greases, industrial load and thermal insulator. The objective of this work was the processing and characterization of diatomite diatomaceous earth obtained from the municipality of Macaíba-RN (known locally as tabatinga) as a low cost regenerative adsorbent for removal of heavy metals in the application of water produced treatment. In this work we adopted a methodology for batch processing, practiced by small businesses located in producing regions of Brazil. The characterization was made by X-ray diffraction (XRD), scanning electron microscopy (SEM) and specific surface area (BET). Research conducted showed that the improvement process used was effective for small volume production of diatomite concentrated. The diatomite obtained was treated by calcination at temperature of 900 oC for 2 hours, with and without fluxing Na2CO3 (4%), according to optimal results in the literature. Column adsorption experiments were conducted to percolation of the in nature, calcined and calcined fluxing diatomites. Effluent was used as a saline solution containing ions of Cu, Zn, Na, Ca and Mg simulating the composition of produced waters in the state of Rio Grande do Norte, Brazil. The breakthrough curves for simultaneous removal of copper ions and zinc as a result, 84.3% for calcined diatomite and diatomite with 97.3 % for fluxing. The calcined fluxing diatomite was more efficient permeability through the bed and removal of copper and zinc ions. The fresh diatomite had trouble with the permeability through the bed under the conditions tested, compared with the other obtained diatomite. The results are presented as promising for application in the petroleum industry

Tecnologia para banho no leito de idosos e usuários acamados: uma contribuição para o cuidar humanizado

This study aimed to validate the technology at Bed Bath System, in view of bedridden elderly and their caregivers, with a view to transforming the conventional paradigm regarding the practice of bodily hygiene held in bath chairs adapted in long-stay institutions for the elderly. This is an experimental study involving 51 (fifty one) elderly and 17 (seventeen) caregivers of three long-stay institutions for the elderly of the city of João Pessoa. For data collection, applied initially to cognitive assessment scale Mini Mental State Examination, with the aim of tracking the subject group of elderly cognitively able to participate in the study. In the second phase, to measure the percentage of agreement and disagreement about the attributes of the subjects of the shower chair and adapted the system for bed bath, used a questionnaire with closed questions, Likert scale model of four (4) points, with a good reliability index (0.728), estimated by alpha conbrach, evidenced by the Wilcoxon test a significant difference (P<0.05) between the responses of seniors and caregivers about the attributes involving technology system in bath bed and bath chair adapted, confirming the perspective of the subjects that the two systems differ significantly. However, the system bed bath got greater degree of agreement for their use, characterizing this system is a technology that makes the differential bed bath pleasurable action, quality and humanized

À beira do leito : sentimentos de pacientes durante a passagem de plantão em Unidade de Terapia Intensiva

This study aims to understand the feelings of patients admitted to the Intensive Care Unit (ICU) that experienced a change of shift at the bedside. The change of shift is one of the routines used by nursing in their work process and of great significance for the patient; therefore, deserves careful analysis in seeking to perfect themselves for the improvement of nursing care. It is a descriptive research, with a qualitative approach. The collection of information was performed using semi-structured interview, in August and September of 2011, after authorization from the Ethics Committee of the Federal University of Rio Grande do Norte, as opinion 290/2011. The analysis, based on interviews of patients, took the humanization as the thread of investigation backed by authors who deal on the subject and the theory of the gift of Marcel Mauss that sits on drug give-receive-return. The results indicate that the change of shift at the bedside but has not configured, the content of the speech of patients interviewed, as a moment that has generated fear and anxiety, could be deduced by the expression of silence, tears and other signs during interviews, how hard it is to live this experience. Nevertheless, despite this apparent tranquility, revealed uncertainty and apprehension face the speech of professional, during the visit at the bedside, particularly when referring to their health and their neighbors. On the other hand, the indifference to the participation of the patient at the time of the visit, expressing an attitude of merely technical nature, dehumanizes the act of taking care, the essence of nursing. And, for all the patients that we understand, about the visit to the bedside, as well as the ICU, we can infer that there is suffering for them. However, we understand your feelings and revelations seeking support in the theory of Mauss's gift: the patient receives the gift (care), and imbued with a feeling of gratitude, the rewards in the form of compliments and courtesies. Precisely for this reason, we need to sharpen our sensitivity to deal about the human condition in all its vulnerability.

Classificação de distúrbios na rede elétrica usando redes neurais e wavelets

Post dispatch analysis of signals obtained from digital disturbances registers provide important information to identify and classify disturbances in systems, looking for a more efficient management of the supply. In order to enhance the task of identifying and classifying the disturbances - providing an automatic assessment - techniques of digital signal processing can be helpful. The Wavelet Transform has become a very efficient tool for the analysis of voltage or current signals, obtained immediately after disturbance s occurrences in the network. This work presents a methodology based on the Discrete Wavelet Transform to implement this process. It uses a comparison between distribution curves of signals energy, with and without disturbance. This is done for different resolution levels of its decomposition in order to obtain descriptors that permit its classification, using artificial neural networks

Estudo da hidrodinâmica de um novo separador líquido-líquido: aplicação ao sistema óleo-bruto/água produzida

This work aims to use a different hydrodynamic condition applied to a new design of mixer-settler on treating wastewater produced by petroleum industry, called MDIF (Misturador-Decantador à Inversão de Fases/ Mixer-Settler based on Phase Inversion MSPI). The use of this different hydrodynamic behaviour is possible due to vertical disposition of the device and the principle of Phase Inversion that controls the MDIF, providing the generation (creation) of a cascade of drops, into an organic layer, that works as micro-decanters, thus making possible the formation of a bed of non-coalesced drops, called Bed Formation . The use of this new hydrodynamics condition allows to increase the residence time of the oil carrier drops, into an organic layer, and the device can treat a greater volume of wastewater. In view of to get this condition it is necessary to operate at high throughput (58,6 m3.m-2.h-1). By results, the condition of Bed Formation is the best one to be used when MSPI operates with throughput up to 58,6 m3.m-2.h-1. The results using the condition of Bed Formation show that increasing the height of the bed of non-coalesced drops and/or decreasing the volumetric ratio (O/A) an increase of the separation efficiency is detected

Conversão do metano via oxicloração em reator de leito fixo utilizando catalisador do tipo CuCl2/SiO2

Supported catalysts of CuCl2 on sílica were used in the methane oxychlorination reaction. The materials were synthesized by the ion exchange technique in a basic solution, using a copper-ammonia complex with 3 and 6 % of nominal copper loading. The materials where characterized by thermogravimetry (TG), X-ray Fluorescence Spectroscopy (XRF), Temperature Programmed Reduction (TPR), Scanning Electron Microscopy with X-ray microanalysis (SEM/EDS), BET specific area and pore distribution. The characterization confirms the presence of copper on the support surface, concluding that the ion exchange technique was adequate in the catalyst synthesis. For the reaction test, an oxychlorination bench scale unit was employed. The tests were carried at 673 and 773 K. The results showed the influence of temperature and catalyst copper content on the oxychlorination of methane reaction

Implementação de um modelo computacional para estudo do processo Fischer-Tropsch em reator de leito de lama

This work aims at the implementation and adaptation of a computational model for the study of the Fischer-Tropsch reaction in a slurry bed reactor from synthesis gas (CO+H2) for the selective production of hydrocarbons (CnHm), with emphasis on evaluation of the influence of operating conditions on the distribution of products formed during the reaction.The present model takes into account effects of rigorous phase equilibrium in a reactive flash drum, a detailed kinetic model able of predicting the formation of each chemical species of the reaction system, as well as control loops of the process variables for pressure and level of slurry phase. As a result, a system of Differential Algebraic Equations was solved using the computational code DASSL (Petzold, 1982). The consistent initialization for the problem was based on phase equilibrium formed by the existing components in the reactor. In addition, the index of the system was reduced to 1 by the introduction of control laws that govern the output of the reactor products. The results were compared qualitatively with experimental data collected in the Fischer-Tropsch Synthesis plant installed at Laboratório de Processamento de Gás - CTGÁS-ER-Natal/RN

Estudo das características físico-químicas e funcionalidade de bagaços de frutas tropicais desidratados em leito de jorro

Fruits are rich sources of bioactive compounds, including phenolic compounds. Tropical fruit cultivation is an important productive segment in Brazilian Northeast. Its industrialization generates solid wastes as co-products, with potential environmental impact. Considering the recognized bioactive content of fruit and its derivatives, this research has the objective of investigating acerola (Malpighia glabra L.), cajá-umbu (Spondia ssp), jambolan (Syzygium cumini) and pitanga (Eugenia uniflora) dried wastes obtained by spouted bed drier. It was analyzed the physical-chemical composition, solubility and microphotographic aspect of these dried wastes. Besides this, it was also evaluated the bioactive content, antioxidant activity and inhibitory activity against aamylase and a-glycosidase enzymes of water and ethanol (70%, 80% e 100% v/v) extracts prepared from fruit dried wastes, as well as their possible correlations. The dried fruit wastes showed high phenolic (606.04 to 3074.6 mg GAE eq/100 g sample), anthocyanin (478.7 mg/100 g for jambolan) and ascorbic acid (2748.03 mg/100 g for acerola) contents, as well as high antioxidant DPPH activity (14.27 a 36.30 mg Trolox eq/g sample). The extracts exhibited moderate to high a-amylase inhibition (23.97% a 76.58%) and high α-glycosidase inhibition, which 99.32% peak was reached for ethanol 70% pitanga extracts. It was also observed great positive correlation between phenolic content and DPPH activity (0.97 for acerola), anthocyanin (0.95 for jambolan) and α- glycosidase inhibition (0.98 for acerola). The α-glycosidase inhibition also correlated well with the antioxidant activity for all fruit extracts. The results show that these dried fruit wastes are valuable material for further applications as functional ingredients

Secagem do resíduo industrial da acerola em leito de jorro: estudos fluidodinâmicos e análise do desempenho do secador

In this research, the drying process of acerola waste was investigated by using a spouted bed drier. The process was conducted using high density polyethylene inert particles with the objective of producing an ascorbic acid-rich final product. The fruit waste was ground and used to prepare different water-maltodextrin suspensions. Initially, fluidynamical experiments were conducted in order to evaluate the feeding effect on the spouted bed drier fluidynamics behavior. The experimental planning 23 + 3 was used to investigate the effect of the following variables: solids concentration, drying air temperature, intermittence time, production efficiency, solids retention and product losses by elutriation of fine particles on drier walls. The effect of selected independent variables on the drier stability was also evaluated based on a parameter defined as the ratio between the feed suspension volume and the total inert particles volume. Finally, the powder quality was verified in experiments with fixed feed flow and varying air drying temperature, drying air velocity and intermittence time. It was observed that the suspension interferes in the spouted bed drier fluidynamics behavior, and higher air flow is necessary to stabilize the drier. The suspension also promotes the expansion of the spouted bed diameter, decreases the solid circulation and favors the air distribution at the flush area. All variables interfere in the spouted bed performance, and the solids concentration has a major effect on the material retention and losses. The intermittence time also has great effect on the stability and material retention. When it comes to production efficiency, the main effect observed was the drying air temperature. First order models were well adjusted to retention and losses data. The acerola powder presented ascorbic acid levels around 600 to 700 mg/100g. Similar moisture and ascorbic acid levels were obtained for powders obtained by spouted bed and spray drier. However, the powder production efficiency of the spray drier was lower when compared to spouted bed drier. When it comes to energetic analysis, the spray drier process was superior. The results obtained for spouted bed drier are promising and highly dependent on the operational parameters chosen, but in general, it is inferred that this drying process is adequate for paste and suspension drying

Avaliacao de dados de secagem de suspensoes de polpas de frutas em leito de jorro com alimentacao intermitente

The objective of this work was the development and improvement of the mathematical models based on mass and heat balances, representing the drying transient process fruit pulp in spouted bed dryer with intermittent feeding. Mass and energy balance for drying, represented by a system of differential equations, were developed in Fortran language and adapted to the condition of intermittent feeding and mass accumulation. Were used the DASSL routine (Differential Algebraic System Solver) for solving the differential equation system and used a heuristic optimization algorithm in parameter estimation, the Particle Swarm algorithm. From the experimental data food drying, the differential models were used to determine the quantity of water and the drying air temperature at the exit of a spouted bed and accumulated mass of powder in the dryer. The models were validated using the experimental data of drying whose operating conditions, air temperature, flow rate and time intermittency, varied within the limits studied. In reviewing the results predicted, it was found that these models represent the experimental data of the kinetics of production and accumulation of powder and humidity and air temperature at the outlet of the dryer

Avaliação da aplicação de modelos para a secagem de pastas e suspensões em leito de jorro com alimentação contínua

This work studies the development, implementation and improvement of a macroscopic model to describe the behavior of the spouted bed dryer with continuous feeding for pastes and suspensions drying. This model is based on the CST model (Freire et al., 2009) and the model of Fernandes (2005), whose theoretical foundation is based on macroscopic mass and heat balances for the three phases involved in the process: gas, liquid and solid. Because this technique is quite relevant, the studies of modeling and simulation of spouted bed drying are essential in the analysis of the process as a whole, because through them it is possible to predict and understand the behavior of the process, which contributes significantly to more efficient project and operation. The development and understanding of the phenomena involved in the drying process can be obtained by comparing the experimental data with those from computer simulations. Such knowledge is critical for choosing properly the process conditions in order to obtain a good drying efficiency. Over the past few years, researches and development of works in the field of pastes and suspensions drying in spouted bed has been gaining ground in Brazil. The Particulate Systems Laboratory at Universidade Federal do Rio Grande do Norte, has been developing several researches and generating a huge collection of experimental data concerning the drying of fruit pulps, vegetables pastes, goat milk and suspensions of agro-industrial residues. From this collection, some data of goat milk and residue from acerola (Malpighia glabra L.) drying were collected. For the first time, these data were used for the development and validation of a model that can describe the behavior of spouted bed dryer. Thus, it was possible to model the dryer and to evaluate the influence of process variables (paste feeding, temperature and flow rate of the drying air) in the drying dynamics. We also performed water evaporation experiments in order to understand and to study the behavior of the dryer wall temperature and the evaporation rate. All these analysis will contribute to future works involving the implementation of control strategies in the pastes and suspensions drying. The results obtained in transient analysis were compared with experimental data indicating that this model well represents the process

Recuperação e purificação de quitosanases usando adsorção em leito expandido com streamline DEAE com modelagem e simulação usando redes neurais

Expanded Bed Adsorption (EBA) is an integrative process that combines concepts of chromatography and fluidization of solids. The many parameters involved and their synergistic effects complicate the optimization of the process. Fortunately, some mathematical tools have been developed in order to guide the investigation of the EBA system. In this work the application of experimental design, phenomenological modeling and artificial neural networks (ANN) in understanding chitosanases adsorption on ion exchange resin Streamline® DEAE have been investigated. The strain Paenibacillus ehimensis NRRL B-23118 was used for chitosanase production. EBA experiments were carried out using a column of 2.6 cm inner diameter with 30.0 cm in height that was coupled to a peristaltic pump. At the bottom of the column there was a distributor of glass beads having a height of 3.0 cm. Assays for residence time distribution (RTD) revelead a high degree of mixing, however, the Richardson-Zaki coefficients showed that the column was on the threshold of stability. Isotherm models fitted the adsorption equilibrium data in the presence of lyotropic salts. The results of experiment design indicated that the ionic strength and superficial velocity are important to the recovery and purity of chitosanases. The molecular mass of the two chitosanases were approximately 23 kDa and 52 kDa as estimated by SDS-PAGE. The phenomenological modeling was aimed to describe the operations in batch and column chromatography. The simulations were performed in Microsoft Visual Studio. The kinetic rate constant model set to kinetic curves efficiently under conditions of initial enzyme activity 0.232, 0.142 e 0.079 UA/mL. The simulated breakthrough curves showed some differences with experimental data, especially regarding the slope. Sensitivity tests of the model on the surface velocity, axial dispersion and initial concentration showed agreement with the literature. The neural network was constructed in MATLAB and Neural Network Toolbox. The cross-validation was used to improve the ability of generalization. The parameters of ANN were improved to obtain the settings 6-6 (enzyme activity) and 9-6 (total protein), as well as tansig transfer function and Levenberg-Marquardt training algorithm. The neural Carlos Eduardo de Araújo Padilha dezembro/2013 9 networks simulations, including all the steps of cycle, showed good agreement with experimental data, with a correlation coefficient of approximately 0.974. The effects of input variables on profiles of the stages of loading, washing and elution were consistent with the literature