COVID-19, SDGs and public health systems: Linkages in Brazil.

Background: The global 2030 Agenda covers a range of interconnected issues which need interdisciplinary and holistic approaches to improve human well-being and protect the natural environment. The COVID-19 pandemic has brought to light critical inequities in society and policy gaps in health services. As highlighted through analyses of the interlinkages among the Sustainable Development Goals (SDGs), connections between human health and well-being and the environment, can help support new policy needs in addressing systemic health crises, including widespread pandemics. Method: We identify links between the COVID-19 crisis and multiple SDGs in the context of Brazil based on a review of the current literature in the health sector.Findings: We identify synergistic connections between 88 out of 169 SDG targets and COVID-19, notably around themes such as City Environment, Contextual Policies and the value created by improved Information and Technology. Using the context of the Brazilian National Health Service (SUS) highlights recurrent interconnections from the focal point of target 3.8. This includes topics such as challenges for universal healthcare coverage, budget allocation, and universalisation. Conclusions: The framework developed for supporting policy-making decisions and the design of toolkits for dealing with future health-related emergency scenarios offers a practical solution in the health sector. It is worth noting that progress and action on public health systems and policies must go hand in hand with addressing existing socio-economic vulnerabilities in society. This is vital for tackling future pandemics and simultaneously addressing the SDGs.

Case management intervention of high users of the emergency department of a Portuguese hospital: a before-after design analysis.

BACKGROUND: Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group (GRHU) identifies and provides care to HU to improve their health conditions and reduce the frequency of ED visits by delivering patient-centered case management integrated care. The main objective of this study was to measure the impact of the GRHU intervention in reducing ED visits, outpatient appointments, and hospitalizations. As secondary objectives, we aimed to compare the GRHU intervention costs against its potential savings or additional costs. Finally, we intend to study the impact of this intervention across different groups of patients. METHODS: We studied the changes triggered by the GRHU program in a retrospective, non-controlled before-after analysis of patients' hospital utilization data on 6 and 12-month windows from the first appointment. RESULTS: A total of 238 ED HU were intervened. A sample of 152 and 88 patients was analyzed during the 6 and 12-month window, respectively. On the 12-month window, GRHU intervention was associated with a statistically significant reduction of 51% in ED visits and hospitalizations and a non-statistically significant increase in the total number of outpatient appointments. Overall costs were reduced by 43.56%. We estimated the intervention costs to be €79,935.34. The net cost saving was €104,305.25. The program's Return on Investment (ROI) was estimated to be €2.3. CONCLUSION: Patient-centered case management for ED HU seems to effectively reduce ED visits and hospitalizations, leading to better use of resources.

Fungi on irrigated rice seeds produced in the pre-germinated system in the Alto Vale do Itajaí region, Santa Catarina state, Brazil / Fungos em sementes de arroz irrigado produzidas no sistema pré-germinado na região do Alto Vale do Itajaí, estado de Santa Catarina, Brasil

ABSTRACT: The aim of this research was to identify and quantify fungi infecting irrigated rice seeds produced in the 2015/16, 2016/17 and 2017/18 harvests in the pre-germinated system in the Alto Vale do Itajaí Region, Santa Catarina State, Brazil. A total of 479 lots of eight cultivars were analyzed. Seeds were disinfected and sown in potato-sucrose-agar culture medium with incubation for seven days at 25ºC ± 2ºC and photoperiod of 12 hours. The main fungus detected in the three crops season was Microdochium albescens with 54.9% of average incidence, followed by Alternaria padwikii (7.7%) and Bipolaris oryzae (3.3%).

RESUMO: O objetivo deste trabalho foi identificar e quantificar fungos infectando sementes de arroz irrigado, produzidas nas safras 2015/16, 2016/17 e 2017/18, no sistema pré-germinado na região do Alto Vale do Itajaí, estado de Santa Catarina. Foram analisados 479 lotes de oito cultivares, sendo as sementes desinfestadas e semeadas em meio de cultura de batata-sacarose-ágar com incubação por sete dias a 25ºC ± 2 ºC e fotoperíodo de 12 horas. O principal fungo detectado nas três safras foi Microdochium albescens com 54,9% de incidência média, seguido de Alternaria padwikii (7,7%) e Bipolaris oryzae (3,3%).

Hydrodynamic modelling of a polluted tropical bay: Assessment of anthropogenic impacts on freshwater runoff and estuarine water renewal.

A bay's capacity to buffer fluvial fluxes between the land and sea is sensitive to hydrological changes that can affect its water renewal rates. In Cartagena Bay, Colombia, pollution issues have been associated with freshwater fluxes which are projected to increase in future years. This has led to plans to reduce freshwater flows by constructing upstream hydraulic doors. Given the influence of freshwater discharge on coastal water renewal, it is important to assess how these upstream changes will affect the bay's hydrodynamic processes. This study calibrated the 3D MOHID Water model, configured with a high-resolution mixed vertical discretization to capture the bay's characteristic processes of vertical stratification and mixing. A Lagrangian transport model was used to analyze the flow of passive particle tracers and calculate water renewal time scales. Mean residence times of 3-6 days and flushing times of 10-20 days for canal water were found, while mean residence times of 23-33 days and flushing times of 70-99 days were calculated for the bay's complete water volume. An assessment of future scenarios showed that increases in freshwater runoff would result in faster water renewal in the bay, while plans to decrease freshwater discharge would result in slower water renewal in the bay. It is therefore imperative that any plans for reducing fluvial fluxes into the bay be accompanied by the control of local pollution sources, which are abundant and could worsen the bay's water quality issues should water renewal times become longer.

Faster and Slower Posttraining Recovery in Futsal: Multifactorial Classification of Recovery Profiles.

PURPOSE: To investigate the existence of faster vs slower recovery profiles in futsal and factors distinguishing them. METHODS: 22 male futsal players were evaluated in countermovement jump, 10-m sprint, creatine kinase, total quality of recovery (TQR), and Brunel Mood Scale (fatigue and vigor) before and immediately and 3, 24, and 48 h posttraining. Hierarchical cluster analysis allocated players to different recovery profiles using the area under the curve (AUC) of the percentage differences from baseline. One-way ANOVA compared the time course of each variable and players' characteristics between clusters. RESULTS: Three clusters were identified and labeled faster recovery (FR), slower physiological recovery (SLphy), and slower perceptual recovery (SLperc). FR presented better AUC in 10-m sprint than SLphy (P = .001) and SLperc (P = .008), as well as better TQR SLphy (P = .018) and SLperc (P = .026). SLperc showed better AUC in countermovement jump than SLphy (P = .014) but presented worse fatigue AUC than SLphy (P = .014) and FR (P = .008). AUC of creatine kinase was worse in SLphy than in FR (P = .001) and SLperc (P < .001). The SLphy players were younger than SLperc players (P = .027), whereas FR were slower 10-m sprinters than SLphy players (P = .003) and SLperc (P = .013) and tended to have higher maximal oxygen consumption than SLphy (effect size =1.13). CONCLUSION: Different posttraining recovery profiles exist in futsal players, possibly influenced by their physical abilities and age/experience.

CardNutri: Um software de planejamento de cardápios nutricionais semanais para alimentação escolar aplicando inteligência artificial / CardNutri: software of weekly menus nutritional planning for scholarfeeding applying artificial intelligence / CardNutri: una desarrollo de menús de software nutricional semanal para la alimentación escolar aplicación de la inteligencia artificia

O objetivo deste artigo é apresentar e avaliar um software que utiliza técnicas de Inteligência Artificial para elaborar, automaticamente e de forma rápida, cardápios nutricionais semanais para a Alimentação Escolar,atendendo às necessidades nutricionais diárias dos alunos e, simultaneamente, minimizando o custo total do cardápio. Esses cardápios satisfazem as referências nutricionais do Programa Nacional de Alimentação Escolar (PNAE) de acordo com a faixa etária, variedade, harmonia das preparações e um valor máximo a ser pago por refeição. O tempo de resposta para essa elaboração não ultrapassa cinco minutos. Contudo, o nutricionista precisa escolher o cardápio que melhor lhe atende, pois a ferramenta fornece um conjunto de cardápios eficientes. Assim, o sistema contribui para a elaboração de cardápios nutritivos e baratos, além de facilitar o trabalho do nutricionista que despende de muito tempo para essa tarefa, uma vez que ele necessita de exercer outras funções de sua responsabilidade.(AU)

The aim of this paper is to present and evaluate a software that uses Artificial Intelligence techniques to design, automatically and quickly, weekly nutritional menus for School Feeding, meeting the daily nutritional needs of students and simultaneously minimizing the total cost of the menu. These menus meet the nutritional references the National School Feeding Programme (PNAE) according to age, variety,the harmony of preparations and a maximum amount to be paid per meal. The response time for this preparation does not exceed five minutes. However, the nutritionist must choose the menu that suits youbest, because the tool provides a set of efficient menus. Thus, the system contributes to the development of nutritious and cheap menus, in addition to facilitating nutritionist work spends much time for this task, since it needs to perform other duties of responsibility

El objetivo de este trabajo es presentar y evaluar un software que utiliza técnicas de Inteligencia Artificial para elaborar, de forma automática y rápida, menús nutricionales semanales para alimentación escolar, con el objetivo de satisfacer las necesidades nutricionales diarias de los alumnos y al mismo tiempo reducir al mínimo el costo total del menú. Estos menús siguen las recomendaciones nutricionales del Programa Nacional de Alimentación Escolar (PNAE) de acuerdo al grupo de edad, variedad y armonía delas preparaciones, y costo máximo por comida. El tiempo de respuesta para esta preparación no debe ser superior a cinco minutos. No obstante, el especialista en nutrición debe elegir el menú que más le convenga, ya que la herramienta proporciona un conjunto de menús eficientes. De este modo, el sistema contribuye a la confección de menús nutritivos y baratos, además de facilitar el trabajo del nutricionista, que invierte mucho tiempo en esa tarea, y que tiene que llevar a cabo otras funciones de su responsabilidad

The density-driven circulation of the coastal hypersaline system of the Great Barrier Reef, Australia.

The coastal hypersaline system of the Great Barrier Reef (GBR) in the dry season, was investigated for the first time using a 3D baroclinic model. In the shallow coastal embayments, salinity increases to c.a. 1‰ above typical offshore salinity (~35.4‰). This salinity increase is due to high evaporation rates and negligible freshwater input. The hypersalinity drifts longshore north-westward due to south-easterly trade winds and may eventually pass capes or headlands, e.g. Cape Cleveland, where the water is considerably deeper (c.a. 15m). Here, a pronounced thermohaline circulation is predicted to occur which flushes the hypersalinity offshore at velocities of up to 0.08m/s. Flushing time of the coastal embayments is around 2-3weeks. During the dry season early summer, the thermohaline circulation reduces and therefore, flushing times are predicted to be slight longer due to the reduced onshore-offshore density gradient compared to that in the dry season winter period.

Early stages of bipolar disorder: characterization and strategies for early intervention.

OBJECTIVE: To characterize the early stages of bipolar disorder (BD), defined as the clinical prodrome/subsyndromal stage and first-episode phase, and strategies for their respective treatment. METHODS: A selective literature search of the PubMed, Embase, PsycINFO, and ISI databases from inception until March 2014 was performed. Included in this review were articles that a) characterized prodromal and first-episode stages of BD or b) detailed efficacy and safety/tolerability of interventions in patients considered prodromal for BD or those with only one episode of mania/hypomania. RESULTS: As research has only recently focused on characterization of the early phase of BD, there is little evidence for the effectiveness of any treatment option in the early phase of BD. Case management; individual, group, and family therapy; supportive therapy; and group psychoeducation programs have been proposed. Most evidence-based treatment guidelines for BD do not address treatment specifically in the context of the early stages of illness. Evidence for pharmacotherapy is usually presented in relation to illness polarity (i.e., manic/mixed or depressed) or treatment phase. CONCLUSIONS: Although early recognition and treatment are critical to preventing unfavorable outcomes, there is currently little evidence for interventions in these stages of BD.

Towards a common oil spill risk assessment framework ­ Adapting ISO 31000 and addressing uncertainties.

Oil spills are a transnational problem, and establishing a common standard methodology for Oil Spill Risk Assessments (OSRAs) is thus paramount in order to protect marine environments and coastal communities. In this study we firstly identified the strengths and weaknesses of the OSRAs carried out in various parts of the globe. We then searched for a generic and recognized standard, i.e. ISO 31000, in order to design a method to perform OSRAs in a scientific and standard way. The new framework was tested for the Lebanon oil spill that occurred in 2006 employing ensemble oil spill modeling to quantify the risks and uncertainties due to unknown spill characteristics. The application of the framework generated valuable visual instruments for the transparent communication of the risks, replacing the use of risk tolerance levels, and thus highlighting the priority areas to protect in case of an oil spill.

Multimodal medical information retrieval with unsupervised rank fusion.

Modern medical information retrieval systems are paramount to manage the insurmountable quantities of clinical data. These systems empower health care experts in the diagnosis of patients and play an important role in the clinical decision process. However, the ever-growing heterogeneous information generated in medical environments poses several challenges for retrieval systems. We propose a medical information retrieval system with support for multimodal medical case-based retrieval. The system supports medical information discovery by providing multimodal search, through a novel data fusion algorithm, and term suggestions from a medical thesaurus. Our search system compared favorably to other systems in 2013 ImageCLEFMedical.

Enhancing the management response to oil spills in the Tuscany Archipelago through operational modelling.

A new approach towards the management of oil pollution accidents in marine sensitive areas is presented in this work. A set of nested models in a downscaling philosophy was implemented, externally forced by existing regional operational products. The 3D hydrodynamics, turbulence and the oil transport/weathering models are all linked in the same system, sharing the same code, exchanging information in real time and improving its ability to correctly reproduce the spill. A wind-generated wave model is also implemented using the same downscaling philosophy. Observations from several sources validated the numerical components of the system. The results obtained highlight the good performance of the system and its ability to be applied for oil spill forecasts in the region. The success of the methodology described in this paper was underline during the Costa Concordia accident, where a high resolution domain was rapidly created and deployed inside the system covering the accident site.

Wind and freshwater influence over hydrocarbon dispersal on Patos Lagoon, Brazil.

The two-dimensional barotropic, hydrodynamic and transport model MOHID is applied to the Patos Lagoon system using a nested modelling approach to reproduce both the lagoon and estuary hydrodynamics. A new Lagrangian oil spill model is presented and used to simulate a hypothetical oil spill in the estuary. Hydrodynamic fields are validated and used to force the oil model. Results show that the hydrodynamics of this system is mainly controlled by the wind and freshwater discharge. The dispersion, concentration and thickness evolution of the oil in the first day after the spill is determined by the equilibrium between these two factors. The freshwater discharge is the major factor controlling the oil dispersion for discharges greater than 5000 m3 while the wind assumes control for lower discharge amounts. The results presented are a first step toward a coastal management tool for the Patos Lagoon.

Eletrocauterização de hemangioma bucal: caso clínico / Eletrocaurerization of buccal hemangioma: case report

Os autores apresentam o caso clínico de uma lesão localizada na comissura labial direita, em uma mulher de 38 anos, com quatro anos de duração. As características clínicas consistiam em um nódulo exofítico arroxeado, medindo cerca de 1,5 centímetros de diâmetro, isquêmica após compressão, confirmando o diagnóstico clínico de hemangioma. A remoção cirúrgica através da eletrocauterização demonstrou ser uma excelente técnica para pequenas lesões de hemangioma oral, como esta relatada, promovendo cicatrização normal e sendo bem tolerada pelo paciente

Comparaçäo entre ventilaçäo de alta frequência em fatos e ventilaçäo com pressäo positiva contínua em modelo experimental de insuficiência respiratória aguda

Considerando as dificuldades na terapêutica da insuficiência respiratória aguda, as repercussöes adversas verificadas com as técnicas clássicas de suporte ventilatório e o surgimento dos sistemas de ventilaçäo de alta freqüência, os autores propuseram-se a avaliar comparativamente as repercussöes sobre parâmetros respiratórios e hemodinâmicos da ventilaçäo com pressäo positiva intermitente (VPPI) ou contínua contra a ventilaçäo de alta freqüência em jatos (VAFJ), sem e com platô expiratório. Para tanto foram estudados 14 cäes nos quais foi provocada insuficiência respiratória aguda através de injeçäo endovenosa de 0,07 ml/Kg de peso corpóreo de ácido oleico. Os cäes foram subdivididos em dois grupos de 7 cada. Grupo T - ventilaçäo de alta freqüência em jatos (aparelho Takaoka, modelo 995) e grupo B - ventilaçäo com pressäo positiva intermitente (Bird Mark-7). Em ambos os grupos, após amostragem de gases arteriais e parâmetros ventilatórios e hemodinâmicos na fase basal (fase I), fazia-se a injeçäo endovenosa de ácido oleico e aguardava-se estabilizaçäo de PaO2, quando eram analisados os mesmos parâmetros anteriores (fase II). A seguir, ao grupo I acrescentava-se platô expiratório de 5 cm H2O e ao grupo B, pressäo positiva expiratória (PEEP) de 5 cm H2O. Aguaravam-se 60 minutos e determinavam-se os parâmetros em estudo (fase III). Ao final da experiência os animais eram sacrificados, seus pulmöes retirados, fazendo-se estudo macroscópico e relaçäo peso úmido/peso seco para avaliar o grau de e