Análise da implantação de programa de triagem auditiva neonatal em um hospital universitário

Aperda auditiva é mais prevalente que outros distúrbios já rastreados ao nascimento. Esforços têm sido feitos para identificação e tratamento precoces de perdas auditivas por meio de programas de triagem auditiva neonatal. OBJETIVO: Estudo prospectivo com objetivo caracterizar o processo de implantação do Programa de Triagem Auditiva Neonatal (PTAN) num Hospital Universitário. Analisar a investigação diagnóstica de perda auditiva em recém-nascidos. Apresentar propostas para aprimoramento do PTAN. MATERIAIS E MÉTODOS: Foram estudados recém-nascidos (RNs) submetidos à TAN por emissões otoacústicas transientes (EOAT), reflexo cócleo-palpebral (RCP) e Potencial Evocado Auditivo de Tronco Encefálico (PEATE). RESULTADOS: Foram testadas 625 crianças. Na primeira etapa passaram 458 RNs e falharam 155. Retornaram na segunda etapa 122 RNs, sendo que 8 o fizeram por apresentar fator de alto risco para PA. Encaminhados para investigação diagnóstica 12 RNs (1,9%). Dos 5 que retornaram para PEATE, observou-se PA em dois RNs. CONCLUSÃO: O programa testou 81,7% dos candidatos. O índice de adesão ao programa foi 68,2%. Na primeira etapa falharam 26,7% dos RNs. A implantação do programa está em andamento e necessita constantemente de análise das dificuldades, visando solucioná-las a fim de tornar a Triagem Auditiva Neonatal Universal uma realidade.

Active Assistance for Senior Healthcare: A Wearable System for Fall Detection

Elders lose independence and wellbeing, accompanied by decreased functions in terms of hearing, vision, strength and coordination abilities. These factors contribute to balance difficulties that eventually lead to falls. The injuries due to falls, at this age, are risky, since most of the times may cause a significant – and permanent – decrease of quality of life or, in extreme cases, death. In this context, a fall detection system can bring an added value to assist elderly people.This paper describes a system consisting of a wearable sensor unit, a smartphone and a website. When the sensor detects a fall it sends an alert using the smartphone via Bluetooth 4.0, to notify the family members or stakeholders. The sensor device includes an inertial unit, a barometer, and a temperature and humidity sensor. The website displays the log of previous falls and enables the configuration of emergency contact numbers. The proposed fall detection system is one of multiple components within a larger project under development that offers a holistic perspective on falls; the complete wearable solution will also feature, among others, physical protection (minimizing the impact of falls that occur).

Automated traffic route identification through the shared nearest neighbour algorithm

Many organisations need to extract useful information from huge amounts of movement data. One example is found in maritime transportation, where the automated identification of a diverse range of traffic routes is a key management issue for improving the maintenance of ports and ocean routes, and accelerating ship traffic. This paper addresses, in a first stage, the research challenge of developing an approach for the automated identification of traffic routes based on clustering motion vectors rather than reconstructed trajectories. The immediate benefit of the proposed approach is to avoid the reconstruction of trajectories in terms of their geometric shape of the path, their position in space, their life span, and changes of speed, direction and other attributes over time. For clustering the moving objects, an adapted version of the Shared Nearest Neighbour algorithm is used. The motion vectors, with a position and a direction, are analysed in order to identify clusters of vectors that are moving towards the same direction. These clusters represent traffic routes and the preliminary results have shown to be promising for the automated identification of traffic routes with different shapes and densities, as well as for handling noise data.

People Detection and Tracking using Depth Camera

In this paper we present a method for real-time detection and tracking of people in video captured by a depth camera. For each object to be assessed, an ordered sequence of values that represents the distances between its center of mass to the boundary points is calculated. The recognition is based on the analysis of the total distance value between the above sequence and some pre-defined human poses, after apply the Dynamic Time Warping. This similarity approach showed robust results in people detection.

An approach for graphical user interface bad smells detection

In the context of an e ort to develop methodologies to support the evaluation of interactive system, this paper investigates an approach to detect graphical user interface bad smells. Our approach consists in detecting user interface bad smells through model-based reverse engineering from source code. Models are used to de ne which widgets are present in the interface, when can particular graphical user interface (GUI) events occur, under which conditions, which system actions are executed, and which GUI state is generated next.

Automated image analysis of lung branching morphogenesis from microscopic images of fetal rat explants

Background: Regulating mechanisms of branching morphogenesis of fetal lung rat explants have been an essential tool for molecular research. This work presents a new methodology to accurately quantify the epithelial, outer contour and peripheral airway buds of lung explants during cellular development from microscopic images. Methods: The outer contour was defined using an adaptive and multi-scale threshold algorithm whose level was automatically calculated based on an entropy maximization criterion. The inner lung epithelial was defined by a clustering procedure that groups small image regions according to the minimum description length principle and local statistical properties. Finally, the number of peripheral buds were counted as the skeleton branched ends from a skeletonized image of the lung inner epithelial. Results: The time for lung branching morphometric analysis was reduced in 98% in contrast to the manual method. Best results were obtained in the first two days of cellular development, with lesser standard deviations. Non-significant differences were found between the automatic and manual results in all culture days. Conclusions: The proposed method introduces a series of advantages related to its intuitive use and accuracy, making the technique suitable to images with different lightning characteristics and allowing a reliable comparison between different researchers.

Automated image analysis of lung branching morphogenesis

Regulating mechanisms of branchingmorphogenesis of fetal lung rat explants have been an essential tool formolecular research.This work presents a new methodology to accurately quantify the epithelial, outer contour, and peripheral airway buds of lung explants during cellular development frommicroscopic images. Methods.Theouter contour was defined using an adaptive and multiscale threshold algorithm whose level was automatically calculated based on an entropy maximization criterion. The inner lung epithelium was defined by a clustering procedure that groups small image regions according to the minimum description length principle and local statistical properties. Finally, the number of peripheral buds was counted as the skeleton branched ends from a skeletonized image of the lung inner epithelia. Results. The time for lung branching morphometric analysis was reduced in 98% in contrast to themanualmethod. Best results were obtained in the first two days of cellular development, with lesser standard deviations. Nonsignificant differences were found between the automatic and manual results in all culture days. Conclusions. The proposed method introduces a series of advantages related to its intuitive use and accuracy, making the technique suitable to images with different lighting characteristics and allowing a reliable comparison between different researchers.

Application of Gage R&R methodology for improving the training and evaluation of automatic optical inspection machine operators

The current level of demand by customers in the electronics industry requires the production of parts with an extremely high level of reliability and quality to ensure complete confidence on the end customer. Automatic Optical Inspection (AOI) machines have an important role in the monitoring and detection of errors during the manufacturing process for printed circuit boards. These machines present images of products with probable assembly mistakes to an operator and him decide whether the product has a real defect or if in turn this was an automated false detection. Operator training is an important aspect for obtaining a lower rate of evaluation failure by the operator and consequently a lower rate of actual defects that slip through to the following processes. The Gage R&R methodology for attributes is part of a Six Sigma strategy to examine the repeatability and reproducibility of an evaluation system, thus giving important feedback on the suitability of each operator in classifying defects. This methodology was already applied in several industry sectors and services at different processes, with excellent results in the evaluation of subjective parameters. An application for training operators of AOI machines was developed, in order to be able to check their fitness and improve future evaluation performance. This application will provide a better understanding of the specific training needs for each operator, and also to accompany the evolution of the training program for new components which in turn present additional new difficulties for the operator evaluation. The use of this application will contribute to reduce the number of defects misclassified by the operators that are passed on to the following steps in the productive process. This defect reduction will also contribute to the continuous improvement of the operator evaluation performance, which is seen as a quality management goal.

Access to information: assessment of the use of automated interaction technologies in call centers

With the purpose of at lowering costs and reendering the demanded information available to users with no access to the internet, service companies have adopted automated interaction technologies in their call centers, which may or may not meet the expectations of users. Based on different areas of knowledge (man-machine interaction, consumer behavior and use of IT) 13 propositions are raised and a research is carried out in three parts: focus group, field study with users and interviews with experts. Eleven automated service characteristics which support the explanation for user satisfaction are listed, a preferences model is proposed and evidence in favor or against each of the 13 propositions is brought in. With balance scorecard concepts, a managerial assessment model is proposed for the use of automated call center technology. In future works, the propositions may become verifiable hypotheses through conclusive empirical research.

O problema da mortalidade neonatal em S. Paulo, Brasil

São comentados alguns aspectos da mortalidade neonatal na cidade de São Paulo, a partir de 1950 e a sua participação na mortalidade infantil. A mortalidade neonatal, na área estudada, é bastante alta, comparada com outras de igual ou menor desenvolvimento. São analisados alguns resultados referentes ao primeiro ano da "Investigação Interamericana de Mortalidade na Infância" onde foi verificado que as causas perinatais e as doenças infecciosas são as grandes responsáveis pela alta mortalidade neonatal. São comentados alguns aspectos referentes à essas causas e alguns fatores que para elas estão contribuindo.

Detection of psychiatric morbidity in the primary medical care setting in Brazil

The aims of this study were a) to assess the ability of primary care doctors to make accurate ratings of psychiatric disturbance and b) to evaluate the use of a case-finding questionnaire in the detection of psychiatric morbidity. The estudy took place in three primary care clinics in the city of São Paulo, Brazil, during a six-month survey. A time sample of consecutive adult attenders were asked to complete a case-finding questionnaire for psychiatric disorders (the Self Report Questionnaire - SRQ) and a subsample were selected for a semi-structured psychiatric interview (the Clinical Interview Schedule - CIS). At the end of the consultation the primary care doctors were asked to assess, in a standardized way, the presence or absence of psychiatric disorder; these assessments were then compared with that ratings obtained in the psychiatric interview. A considerable proportion of minor psychiatric morbidity remained undetected by the three primary care doctors: the hidden morbidity ranged from 22% to 79%. When these were compared to those of the case-finding questionnaire, they were consistently lower, indicating that the use of these instruments can enhance the recognition of psychiatric disorders in primary care settings. Four strategies for adopting the questionnaire are described, and some of the clinical consequences of its use are discussed.

Metodological issues in measuring the detection of emotional disorders by primary care physicians: a review of the literature

A series of studies in the field of Epidemiological Psychiatry have been performed over the last two decades, and these have focused on the ability of primary care physicians to detect emotional disorders in the patients that attend their practices. The scientific methodology utilized in these studies is the subject of this review, which contains a discussion concerning: a) interviewer awareness bias; b) accuracy of the instruments and c) medical and psychological concepts involved in defining minor emotional disorders. Suggestions for change in the methodology are made in each of the sections of the review.

Wavelength Selective a-SiC:H p-i-n/p-i-n Heterostructure for Fluorescent Proteins Detection

In this paper we present results on the optimization of multilayered a-SiC:H heterostructures that can be used as optical transducers for fluorescent proteins detection using the Fluorescence Resonance Energy Transfer approach. Double structures composed by pin based aSiC:H cells are analyzed. The color discrimination is achieved by ac photocurrent measurement under different externally applied bias. Experimental data on spectral response analysis, current-voltage characteristics and color and transmission rate discrimination are reported. An electrical model, supported by a numerical simulation gives insight into the device operation. Results show that the optimized a-SiC:H heterostructures act as voltage controlled optical filters in the visible spectrum. When the applied voltages are chosen appropriately those optical transducers can detect not only the selective excitation of specimen fluorophores, but also the subsequent weak acceptor fluorescent channel emission.

Field effect and light-assisted a-Si:H sensors for detection of ions in solution

In this paper we present an amorphous silicon device that can be used in two operation modes to measure the concentration of ions in solution. While crystalline devices present a higher sensitivity, their amorphous counterpart present a much lower fabrication cost, thus enabling the production of cheap disposable sensors for use, for example, in the food industry. The devices were fabricated on glass substrates by the PECVD technique in the top gate configuration, where the metallic gate is replaced by an electrolytic solution with an immersed Ag/AgCl reference electrode. Silicon nitride is used as gate dielectric enhancing the sensitivity and passivation layer used to avoid leakage and electrochemical reactions. In this article we report on the semiconductor unit, showing that the device can be operated in a light-assisted mode, where changes in the pH produce changes on the measured ac photocurrent. In alternative the device can be operated as a conventional ion selective field effect device where changes in the pH induce changes in the transistor's threshold voltage.

Mortalidade neonatal de residentes em localidade urbana da região sul do Brasil

Caracterizou-se a mortalidade neonatal de residentes em Maringá -Paraná, no ano de 1990, segundo algumas variáveis. O material de estudo constituiu-se de 87 óbitos. Foram utilizadas informações retiradas das declarações de óbito, dos prontuários hospitalares, das entrevistas domiciliares, dos prontuários dos núcleos integrados de saúde e dos laudos de necrópsia. O coeficiente de mortalidade neonatal foi de 19,4 por 1.000 nascidos vivos. A maioria dos óbitos ocorreu na primeira semana de vida (92,0%), em recém-nascidos com menos de 37 semanas de gestação (79,8%), em crianças com baixo peso ao nascer (74,1%), em recém-nascidos do sexo masculino (56,3%) e em crianças nascidas através de cesariana (54,2%). As causas básicas de óbito foram codificadas de acordo com a Classificação Internacional das Doenças - 9ª revisão. As Causas perinatais juntamente com as Anomalias congênitas responderam por 94,0% dos óbitos neonatais. As Causas perinatais foram responsáveis por 83,2% dos óbitos neonatais, onde a prematuridade ocupou o primeiro lugar, causando 15,8% das mortes. Constatou-se, também, que a prematuridade foi a causa associada mais freqüente dos óbitos de recém-nascidos (59,0%).