Purchasing management in a tertiary teaching hospital: a case study

Modelo do Estudo: Estudo de Caso. Objetivo do Estudo: O presente trabalho visou estudar o processo de compras e programação de materiais de um hospital público de ensino de nível terciário e analisar os perfis de itens de materiais de consumo faltantes em determinado período, com a finalidade de identificar como ferramentas de gestão de materiais podem ajudar na definição de políticas de compras e estoque. Metodologia: O estudo foi elaborado com base em análises qualitativas e quantitativas. As primeiras foram feitas por meio de coleta de dados relativos ao entendimento dos processos e estrutura interna da Divisão de Materiais do Hospital através de observação e entrevistas semiestruturadas entre o período de setembro a novembro de 2013. A relação dos itens faltantes em 2012 e 2013 foi obtida através do sistema de informação da instituição e a partir destes dados foram feitas as análises quantitativas dos perfis destes itens segundo as classificações ABC e VEN (ou XYZ). Resultado: Os resultados apontam que dos 8.595 itens de materiais de consumo do Hospital apenas 5% em quantidade são classificados como A na curva ABC, no entanto tais itens correspondem a 42% em valores. Já os itens vitais representam 49% do valor e 46% em termos de quantidade. Quando analisadas em conjunto, as duas curvas apontam que a maioria das quantidades de materiais de consumo do Hospital são classificados como vitais da curva C (36,35%) e os itens não essenciais da curva A representam tanto em valor como em quantidade a menor parcela de materiais. O perfil dos itens faltantes em 2012 e 2013 são semelhantes, o maior índice de faltas está nos itens vitais da curva C e a menor nos itens não essenciais da curva A. Conclusão: Por meio do estudo foi possível concluir que a definição de políticas de compras e estoques que analisem não somente recursos econômicos, mas também a criticidade dos itens para o funcionamento dos processos é fundamental, principalmente levando em consideração o atual contexto das organizações de saúde públicas, a fim de melhor otimizar recursos e minimizar faltas.Model Study: Case Study. Purpose of the Study: This study aims to explore the purchasing materials process in a tertiary teaching hospital and analyze the missing items profiles in a given period in order to identify how materials management tools can help optimizing purchasing and inventory policies. Methodology: The study was based on qualitative and quantitative analyses. The first was made by means of collecting data to understand both processes and internal structure of the Materials Division through observation and semi-structured interviews between September-November 2013. A list of missing items in 2012 and 2013 was obtained from system information in order to analyze the profiles of these items according to the ABC and VEN (or XYZ) ratings. Results: The results show that out of 8,595 items of consumable materials, only 5 % in volume are classified as A in ABC curve, however such items correspond to 42 % in value. On the other hand, vital items represent 49 % on value and 46 % in terms of quantity. When analyzed together, the two curves show that most quantities of consumables materials are classified as vital from the C curve (36.35%) whereas non-essential items from the A curve represent both in value and in volume the smallest amount portion of materials. The missing items profile in 2012 and 2013 were similar, the highest rate of faults is from vital and C curve materials and the smaller, of nonessentials of the A curve. Conclusion: Through the study, it can be concluded that the definition of procurement policies inventories from the analyses of not only economic resources, but also item’s criticality to processes is essential, especially considering the current context of public health organizations, in order to optimize resources and minimize materials faults

Ferromagnetic Levan Composite: An Affinity Matrix to Purify Lectin

A simple and inexpensive procedure used magnetite and levan to synthesize a composite recovered by a magnetic field. Lectins from Canavalia ensiformis (Con A) and Cratylia mollis (Cramoll 1 and Cramoll 1, 4) did bind specifically to composite. The magnetic property of derivative favored washing out contaminating proteins and recovery of pure lectins with glucose elution. Cramoll 1 was purified by this affinity binding procedure in two steps instead of a previous three-step protocol with ammonium sulfate fractionation, affinity chromatography on Sephadex G-75, and ion exchange chromatography through a CM-cellulose column

Brazilian Maternal and Child Nutrition Consortium: establishment, data harmonization and basic characteristics.

Pooled data analysis in the field of maternal and child nutrition rarely incorporates data from low- and middle-income countries and existing studies lack a description of the methods used to harmonize the data and to assess heterogeneity. We describe the creation of the Brazilian Maternal and Child Nutrition Consortium dataset, from multiple pooled longitudinal studies, having gestational weight gain (GWG) as an example. Investigators of the eligible studies published from 1990 to 2018 were invited to participate. We conducted consistency analysis, identified outliers, and assessed heterogeneity for GWG. Outliers identification considered the longitudinal nature of the data. Heterogeneity was performed adjusting multilevel models. We identified 68 studies and invited 59 for this initiative. Data from 29 studies were received, 21 were retained for analysis, resulting in a final sample of 17,344 women with 72,616 weight measurements. Fewer than 1% of all weight measurements were flagged as outliers. Women with pre-pregnancy obesity had lower values for GWG throughout pregnancy. GWG, birth length and weight were similar across the studies and remarkably similar to a Brazilian nationwide study. Pooled data analyses can increase the potential of addressing important questions regarding maternal and child health, especially in countries where research investment is limited

Whole-genome sequencing of 1,171 elderly admixed individuals from Brazil

As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics and medical applications, data on diverse non-European and admixed individuals are still scarce. Here, we present a high-coverage WGS dataset of 1,171 highly admixed elderly Brazilians from a census-based cohort, providing over 76 million variants, of which ~2 million are absent from large public databases. WGS enables identification of ~2,000 previously undescribed mobile element insertions without previous description, nearly 5 Mb of genomic segments absent from the human genome reference, and over 140 alleles from HLA genes absent from public resources. We reclassify and curate pathogenicity assertions for nearly four hundred variants in genes associated with dominantly-inherited Mendelian disorders and calculate the incidence for selected recessive disorders, demonstrating the clinical usefulness of the present study. Finally, we observe that whole-genome and HLA imputation could be significantly improved compared to available datasets since rare variation represents the largest proportion of input from WGS. These results demonstrate that even smaller sample sizes of underrepresented populations bring relevant data for genomic studies, especially when exploring analyses allowed only by WGS

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio