Spatial analysis of avoidable hospitalizations due to tuberculosis in Ribeirao Preto, SP, Brazil (2006-2012)

ABSTRACT OBJECTIVE To describe the spatial distribution of avoidable hospitalizations due to tuberculosis in the municipality of Ribeirao Preto, SP, Brazil, and to identify spatial and space-time clusters for the risk of occurrence of these events. METHODS This is a descriptive, ecological study that considered the hospitalizations records of the Hospital Information System of residents of Ribeirao Preto, SP, Southeastern Brazil, from 2006 to 2012. Only the cases with recorded addresses were considered for the spatial analyses, and they were also geocoded. We resorted to Kernel density estimation to identify the densest areas, local empirical Bayes rate as the method for smoothing the incidence rates of hospital admissions, and scan statistic for identifying clusters of risk. Softwares ArcGis 10.2, TerraView 4.2.2, and SaTScanTM were used in the analysis. RESULTS We identified 169 hospitalizations due to tuberculosis. Most were of men (n = 134; 79.2%), averagely aged 48 years (SD = 16.2). The predominant clinical form was the pulmonary one, which was confirmed through a microscopic examination of expectorated sputum (n = 66; 39.0%). We geocoded 159 cases (94.0%). We observed a non-random spatial distribution of avoidable hospitalizations due to tuberculosis concentrated in the northern and western regions of the municipality. Through the scan statistic, three spatial clusters for risk of hospitalizations due to tuberculosis were identified, one of them in the northern region of the municipality (relative risk [RR] = 3.4; 95%CI 2.7–4,4); the second in the central region, where there is a prison unit (RR = 28.6; 95%CI 22.4–36.6); and the last one in the southern region, and area of protection for hospitalizations (RR = 0.2; 95%CI 0.2–0.3). We did not identify any space-time clusters. CONCLUSIONS The investigation showed priority areas for the control and surveillance of tuberculosis, as well as the profile of the affected population, which shows important aspects to be considered in terms of management and organization of health care services targeting effectiveness in primary health care.

Spatial dynamics of team sports exposed by Voronoi diagrams

Team sports represent complex systems: players interact continuously during a game, and exhibit intricate patterns of interaction, which can be identified and investigated at both individual and collective levels. We used Voronoi diagrams to identify and investigate the spatial dynamics of players' behavior in Futsal. Using this tool, we examined 19 plays of a sub-phase of a Futsal game played in a reduced area (20 m(2)) from which we extracted the trajectories of all players. Results obtained from a comparative analysis of player's Voronoi area (dominant region) and nearest teammate distance revealed different patterns of interaction between attackers and defenders, both at the level of individual players and teams. We found that, compared to defenders, larger dominant regions were associated with attackers. Furthermore, these regions were more variable in size among players from the same team but, at the player level, the attackers' dominant regions were more regular than those associated with each of the defenders. These findings support a formal description of the dynamic spatial interaction of the players, at least during the particular sub-phase of Futsal investigated. The adopted approach may be extended to other team behaviors where the actions taken at any instant in time by each of the involved agents are associated with the space they occupy at that particular time.

Economies of scale and scope in the provision of diagnostic techniques and therapeutic services in Portuguese hospitals

This paper analyses the provision of auxiliary clinical services that are typically carried out within the hospital. We estimate a exible cost function for the three most important (cost- wise) diagnostic techniques and therapeutic services in Portuguese hospitals: Clinical Pathology, Medical Imaging and Physical Medicine and Rehabilitation. Our objective in carrying out this estimation is the evaluation of economies of scale and scope in the provision of these services. For all services, we nd evidence of ray economies of scale and some evidence of economies of scope. These results have important policy implications and can be related to the ongoing discussion of where and how should hospitals provide these services.

Time-frequency and time-scale characterisation of the beat-by-beat high-resolution electrocardiogram

Proceedings of the Sixth Portuguese Conference on Bioemedical Engineering faro, Portugal

Fractional discrete-time signal processing: scale conversion and linear prediction

Nonlinear Dynamics, Vol. 29

Fractional signal processing: scale conversion

In Proceedings of the “ECCTD '01 - European Conference on Circuit Theory and Design, Espoo, Finland, August 2001

Adaption of the Creative Commons approach and the roaming concept to spatial data infrastructures (SDI)

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Estimation of vegetation carbon stock in Portugal using land use/ land cover data

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

SAKWeb – Spatial autocorrelation and kriging web, a W3 geocomputation perspective

A thesis submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy in Information Systems

Development and validation of a psychometric scale for assessing PA chest image quality

Purpose - To develop and validate a psychometric scale for assessing image quality for chest radiographs.

Adaptação para a população Portuguesa da escala de avaliação Trunk Impairment Scale (TIS)

Para uma melhor avaliação e definição do plano de intervenção do indivíduo, é cada vez mais importante a existência instrumentos de avaliação válidos e fiáveis para a população portuguesa. Objetivo: Traduzir e adaptar para a população Portuguesa a escala Trunk Impairment Scale (TIS) em pacientes pós-AVE, e avaliar as propriedades psicométricas da mesma. Metodologia: A TIS foi traduzida para o Português e adaptada culturalmente para a população portuguesa. As propriedades psicométricas da mesma, incluindo validade, fiabilidade, concordância inter-observadores, consistência interna, sensibilidade, especificidade, poder de resposta, foram avaliadas numa população diagnosticada com AVE e num grupo de controlo de participantes saudáveis. Participaram neste estudo 80 indivíduos, divididos em dois grupos, nomeadamente indivíduos pós-AVE (40) e um grupo sem patologia (40). Os participantes foram submetidos à aplicação das escalas de Berg, Medida de Independência Funcional e Escala de Desempenho Físico Fugl Meyer e a TIS de modo a avaliar as propriedades psicométricas desta. As avaliações foram realizadas por duas fisioterapeutas experientes e o re-teste foi realizado após 48 horas. Os dados foram registados e trabalhados com o programa informático SPSS 21.0. Resultados: Relativamente aos valores obtidos, verificou-se que, quanto à consistência interna da TIS estes apresentam-se de forma moderada a elevada (alfa Cronbach = 0,909). Quanto à fiabilidade inter-observadores, os itens com menor valor são os itens 1 e 4 (0,759 e 0,527, respetivamente) e os itens com valor de Kappa mais alto são os itens 5 e 6 (0,830 e 0,893, respetivamente). Relativamente à validade de critério, verificou-se que não houve correlação entre a escala de Desempenho Físico Fugl-Meyer, a escala de Equilibrio de Berg e a Medida de Independência Funcional, ou seja, os valores obtidos r=0,166; r=0,017; r= -0,002, respetivamente. Quanto à validade de construção, constatou-se que o valor da mediana é mais elevado nos itens 1 a 5, logo sugere que haja diferenças entre o grupo de indivíduos pós-AVE e o grupo de indivíduos saudáveis (p<0,001). Entre os outros dois itens (6 e 7) não foram encontradas diferenças nas respostas nos dois grupos, sendo o valor de p > 0,001. Conclusão: Os resultados obtidos neste estudo sugerem que a versão portuguesa da TIS apresenta bons níveis de fiabilidade, consistência interna e também apresenta bons resultados no que refere à concordância inter-observadores.

Scale-free networks and scalable interdomain routing

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial para obtenção do grau de Mestre em Engenharia Informática

An uncertainty and sensitivity analysis applied to the prioritisation of pharmaceuticals as surface water contaminants from wastewater treatment plant direct emissions

In this study, the concentration probability distributions of 82 pharmaceutical compounds detected in the effluents of 179 European wastewater treatment plants were computed and inserted into a multimedia fate model. The comparative ecotoxicological impact of the direct emission of these compounds from wastewater treatment plants on freshwater ecosystems, based on a potentially affected fraction (PAF) of species approach, was assessed to rank compounds based on priority. As many pharmaceuticals are acids or bases, the multimedia fate model accounts for regressions to estimate pH-dependent fate parameters. An uncertainty analysis was performed by means of Monte Carlo analysis, which included the uncertainty of fate and ecotoxicity model input variables, as well as the spatial variability of landscape characteristics on the European continental scale. Several pharmaceutical compounds were identified as being of greatest concern, including 7 analgesics/anti-inflammatories, 3 β-blockers, 3 psychiatric drugs, and 1 each of 6 other therapeutic classes. The fate and impact modelling relied extensively on estimated data, given that most of these compounds have little or no experimental fate or ecotoxicity data available, as well as a limited reported occurrence in effluents. The contribution of estimated model input variables to the variance of freshwater ecotoxicity impact, as well as the lack of experimental abiotic degradation data for most compounds, helped in establishing priorities for further testing. Generally, the effluent concentration and the ecotoxicity effect factor were the model input variables with the most significant effect on the uncertainty of output results.

Control of predators in industrial scale microalgae cultures with Pulsed Electric Fields.

This work describes the utilization of Pulsed Electric Fields to control the protozoan contamination of a microalgae culture, in an industrial 2.7m3 microalgae photobioreactor. The contaminated culture was treated with Pulsed Electric Fields, PEF, for 6h with an average of 900V/cm, 65μs pulses of 50Hz. Working with recirculation, all the culture was uniformly exposed to the PEF throughout the assay. The development of the microalgae and protozoan populations was followed and the results showed that PEF is effective on the selective elimination of protozoa from microalgae cultures, inflicting on the protozoa growth halt, death or cell rupture, without affecting microalgae productivity. Specifically, the results show a reduction of the active protozoan population of 87% after 6h treatment and 100% after few days of normal cultivation regime. At the same time, microalgae growth rate remained unaffected. © 2014 Elsevier B.V.