Budget impact from the incorporation of positron emission tomography – computed tomography for staging lung cancers

OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.RESULTS The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively.CONCLUSIONS The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

On the relation between the fractional Brownian motion and the fractional derivatives

Physics Letters A, vol. 372; Issue 7

Production, purification and characterisation of polysaccharides from pleurotus ostreatus with antitumor activity

Background: Mushroom polysaccharides play an important role in functional foods because they exhibit biological modulator properties such as antitumour, antiviral and antibacterial activities. The present study involved the production, purification and characterisation of intracellular and extracellular free and protein-bound polysaccharides from Pleurotus ostreatus and the investigation of their growth-inhibitory effect on human carcinoma cell lines. Results: Several fermentation parameters were obtained: batch polysaccharide productivities of 0.013 +/- 8.12 x 10-5 and 0.037 +/- 0.0005 g L-1 day-1 for intracellular and extracellular polysaccharides respectively, a maximum biomass concentration of 9.35 +/- 0.18 g L-1, Pmax = 0.935 +/- 0.018 g L-1 day-1, µmax = 0.218 +/- 0.02 day-1, YEP/X = 0.040 +/- 0.0015 g g-1 and YIP/X = 0.014 +/- 0.0003 g g-1. Some polysaccharides exhibited superoxide dismutase (SOD)-like activity of 50-200 units. Fourier transform infrared analysis of the polysaccharides revealed absorption bands characteristic of such biological macromolecules. Cytotoxicity assays showed that both intracellular and extracellular polysaccharides exhibited antitumour activity towards several tested human carcinoma cell lines in a dose-dependent manner. Conclusion - The polysaccharides of P. ostreatus exhibited high SOD-like activity, which strongly supports their biological effect on tumour cell lines. The extracellular polysaccharides presented the highest antitumour activity towards the RL95 carcinoma cell line and should be further investigated as an antitumour agent.

Ir à terra - mobilidade transnacional e construção de sedentariedades imaginadas

Relações sociais de espaço, homenagem a Jean Remy, Lisboa, org. Casimiro Balsa p. 199-218.

Argumentation as Distributed Belief Revision: Conflict Resolution in Decentralised Multi-agent Systems

Decentralised co-operative multi-agent systems are computational systems where conflicts are frequent due to the nature of the represented knowledge. Negotiation methodologies, in this case argumentation based negotiation methodologies, were developed and applied to solve unforeseeable and, therefore, unavoidable conflicts. The supporting computational model is a distributed belief revision system where argumentation plays the decisive role of revision. The distributed belief revision system detects, isolates and solves, whenever possible, the identified conflicts. The detection and isolation of the conflicts is automatically performed by the distributed consistency mechanism and the resolution of the conflict, or belief revision, is achieved via argumentation. We propose and describe two argumentation protocols intended to solve different types of identified information conflicts: context dependent and context independent conflicts. While the protocol for context dependent conflicts generates new consensual alternatives, the latter chooses to adopt the soundest, strongest argument presented. The paper shows the suitability of using argumentation as a distributed decentralised belief revision protocol to solve unavoidable conflicts.

Distributed Generation and Demand Response Dispatch for a Virtual Power Player Energy and Reserve Provision

Recent changes in the operation and planning of power systems have been motivated by the introduction of Distributed Generation (DG) and Demand Response (DR) in the competitive electricity markets' environment, with deep concerns at the efficiency level. In this context, grid operators, market operators, utilities and consumers must adopt strategies and methods to take full advantage of demand response and distributed generation. This requires that all the involved players consider all the market opportunities, as the case of energy and reserve components of electricity markets. The present paper proposes a methodology which considers the joint dispatch of demand response and distributed generation in the context of a distribution network operated by a virtual power player. The resources' participation can be performed in both energy and reserve contexts. This methodology contemplates the probability of actually using the reserve and the distribution network constraints. Its application is illustrated in this paper using a 32-bus distribution network with 66 DG units and 218 consumers classified into 6 types of consumers.

Les Fables de La Fontaine au Monastère de S. Vicente de Fora - Etude d´in panneau d´azulejos

Congresso Internacional de História da Medicina (ISHM); 39º - p.217-218

Production of Shistosoma mansoni cercariae by Biomphalaria glabrata from a focus in Belo Horizonte, Minas Gerais

The snail density, levels of infection and the monthly production of Schistosoma mansoni cercariae by Biomphalaria glabrata were determined in a focus of Barreiro de Baixo (Belo Horizonte, MG, Brazil). During a period of 38 months (1984 to 1987) 5,366 snails were collected of which 324 (6.03%) were infected with S. mansoni. The total number of cercariae shed was 5,667,312. Each snail shed an average of 17,422 cercariae during the time that it was under study in the laboratory. The greatest longevity of infected snails was 218 days. Natural cure was observed in 42 (12.9%) of the infected specimens about 130 days after collection. The average snail density in the focus during the period of study was 16.3 snails per scoop. The shedding of cercariae by snails collected from the field was compared with laboratory bred specimens infected in mass with the LE strain of S. mansoni from Belo Horizonte. The laboratory infected snails shed an average of 6,061 cercariae each, a value 2.8 times less than the field specimens due to a shorter life span. The prevalence of schistosomiasis in the focus was 14.3%.

Chagas' infection in university students of Santa Cruz de la Sierra, Bolivia. A serologic-electrocardiographic study

In order to learn the prevalence of Chagas' infection among students from Santa Cruz de la Sierra's universities, a random sample of 372 new students was drawn. All participants have had electrocardiograms (EKG) and serologic analysis (IHAT). 64/372 (17.2%) had serologic evidence of Chagas' infection, and from those, 10/64 (15.6%) had some EKG alterations. Among students presenting negative serologic test, 31/308 (10.1%) had EKG alterations. There was no statistical association between Chagas' infection and EKG alterations (X2=1.67, p=0.2). There was a positive association between Chagas' infection and intraventricular conduction defects and this association was higher among the students of 19 years of age or less (O.R. 10.4, p<0.05).

Infection by Trypanosoma cruzi in mammals in Yucatan, Mexico: a serological and parasitological study

In order to determine Trypanosoma cruzi infection among mammals in Yucatan, Mexico, 372 animals, both wild and synanthropic including carnivores, marsupials and rodents were studied. Serological studies by indirect haemagglutination (IHA) were carried out to detect antibodies to T. cruzi and a parasitological study was also performed (blood smear and histopathology). Of all the animals tested 18.54% were serologically positive, with a significantly higher frequency among the wild ones (33.33%) compared to the synanthropic ones (17.79%). To determine T. cruzi in positive animals, blood was inoculated into a white mouse (webster type) to prove myocardium colonization. The serological and parasitological positivity of these animals, as well as their behavior in the environment, taken together with the socioeconomic and cultural characteristics of the population, suggest that in Yucatan, Mexico, Canis familiaris, Didelphis marsupialis and Rattus rattus act as a link with the wild cycle.

Constrained Consumption Shifting Management in the Distributed Energy Resources Scheduling Considering Demand Response

Demand response concept has been gaining increasing importance while the success of several recent implementations makes this resource benefits unquestionable. This happens in a power systems operation environment that also considers an intensive use of distributed generation. However, more adequate approaches and models are needed in order to address the small size consumers and producers aggregation, while taking into account these resources goals. The present paper focuses on the demand response programs and distributed generation resources management by a Virtual Power Player that optimally aims to minimize its operation costs taking the consumption shifting constraints into account. The impact of the consumption shifting in the distributed generation resources schedule is also considered. The methodology is applied to three scenarios based on 218 consumers and 4 types of distributed generation, in a time frame of 96 periods.

Demand Response Programs Definition Using Demand Price Elasticity to Define Consumers Aggregation for an Improved Remuneration Structure

The positioning of the consumers in the power systems operation has been changed in the recent years, namely due to the implementation of competitive electricity markets. Demand response is an opportunity for the consumers’ participation in electricity markets. Smart grids can give an important support for the integration of demand response. The methodology proposed in the present paper aims to create an improved demand response program definition and remuneration scheme for aggregated resources. The consumers are aggregated in a certain number of clusters, each one corresponding to a distinct demand response program, according to the economic impact of the resulting remuneration tariff. The knowledge about the consumers is obtained from its demand price elasticity values. The illustrative case study included in the paper is based on a 218 consumers’ scenario.

Remuneration Structure Definition for Distributed Generation Units and Demand Response Participants Aggregation

The implementation of competitive electricity markets has changed the consumers’ and distributed generation position power systems operation. The use of distributed generation and the participation in demand response programs, namely in smart grids, bring several advantages for consumers, aggregators, and system operators. The present paper proposes a remuneration structure for aggregated distributed generation and demand response resources. A virtual power player aggregates all the resources. The resources are aggregated in a certain number of clusters, each one corresponding to a distinct tariff group, according to the economic impact of the resulting remuneration tariff. The determined tariffs are intended to be used for several months. The aggregator can define the periodicity of the tariffs definition. The case study in this paper includes 218 consumers, and 66 distributed generation units.

Optimization of Generation and Aggregated Consumption Shifting for Demand Response Programs Definition

The concept of demand response has drawing attention to the active participation in the economic operation of power systems, namely in the context of recent electricity markets and smart grid models and implementations. In these competitive contexts, aggregators are necessary in order to make possible the participation of small size consumers and generation units. The methodology proposed in the present paper aims to address the demand shifting between periods, considering multi-period demand response events. The focus is given to the impact in the subsequent periods. A Virtual Power Player operates the network, aggregating the available resources, and minimizing the operation costs. The illustrative case study included is based on a scenario of 218 consumers including generation sources.

Gamma 60Co DL50/30 of Biomphalaria glabrata (Say, 1818)

The variation of resistance to 60Co gamma-rays of Biomphalaria glabrata was studied. A population of 480 mollusks was observed during 30 days - distributed in 8 groups of snails isolated and 8 groups of snails in colonies - after exposure (30 snails per group per dose) to increasing doses of gamma radiation. Doses of 10, 20, 40, 60, 80, 160, 320 and 640 Gy from a Gamma-cell 60Co irradiator, were applied to the test groups and two groups control (non-irradiated) of snails - isolated and colony - were kept apart. After have been exposed, the snails were drew back to the aquaria where they were maintained before. The survival was estimated on a daily score of the alive animals in each group-dose, starting after the irradiation exposure day. As a result, the survival self-fertilization forms (DL50/30 = 218.2 Gy) was found greater than in cross-fecundation forms. These data point to a low radio-resistance on the cross-fertilization forms - the sexual reproductive form - which is most found in nature. The lower radio-resistance of the cross-fertilization forms suggests the presence of some sex-linked hormonal factor related to this phenomenon.