Tendências do direito administrativo europeu

info:eu-repo/semantics/publishedVersio

3DBGrowth: volumetric vertebrae segmentation and reconstruction in magnetic resonance imaging

Segmentation of medical images is critical for making several processes of analysis and classification more reliable. With the growing number of people presenting back pain and related problems, the semi-automatic segmentation and 3D reconstruction of vertebral bodies became even more important to support decision making. A 3D reconstruction allows a fast and objective analysis of each vertebrae condition, which may play a major role in surgical planning and evaluation of suitable treatments. In this paper, we propose 3DBGrowth, which develops a 3D reconstruction over the efficient Balanced Growth method for 2D images. We also take advantage of the slope coefficient from the annotation time to reduce the total number of annotated slices, reducing the time spent on manual annotation. We show experimental results on a representative dataset with 17 MRI exams demonstrating that our approach significantly outperforms the competitors and, on average, only 37% of the total slices with vertebral body content must be annotated without losing performance/accuracy. Compared to the state-of-the-art methods, we have achieved a Dice Score gain of over 5% with comparable processing time. Moreover, 3DBGrowth works well with imprecise seed points, which reduces the time spent on manual annotation by the specialist.Comment: This is a pre-print of an article published in Computer-Based Medical Systems. The final authenticated version is available online at: https://doi.org/10.1109/CBMS.2019.0009

Química mineral do vulcano-plutonismo paleoproterozoico da região de São Félix do Xingu (PA), Cráton Amazônico

The Sobreiro and Santa Rosa formations are result of large paleoproterozoic volcanic activities in the São Félix do Xingu (PA) region, SE of Amazonian Craton. The Sobreiro Formation is composed of andesitic lava flow facies, with subordinate dacite and rhyodacite, and autoclastic volcaniclastic facies characterized by tuff, lapilli-tuff, and massive polymictic breccia. These rocks exhibit clinopyroxene, amphibole, and plagioclase phenocrysts in a microlytic or trachytic groundmass. The clinopyroxene is augite with subordinate diopside, and reveals chemical variations typical of minerals generated by arc-related magmatism. The amphibole is magnesiohastingsite, has oscillatory oxidizing conditions, and reveals breakdown rim textures linked to degassing during magma ascent. The Santa Rosa Formation has polyphase evolution controlled by large NE-SW crustal fissures, materialized by rhyolitic and dacitic lava flow facies. Volcaniclastic facies of ignimbrites, lapilli-tuffs, felsic crystal tuffs, and massive polymict breccias represents an explosive cycle in this unit. Metric dikes and stocks of granitic porphyries and equigranular granitoids complete this suite. K-feldspar, plagioclase, and quartz phenocrysts surrounded by quartz and K-feldspar integrowth occur in these rocks. Electron microprobe pressure and temperature estimates in clinopyroxene phenocrysts reveal formation depth between 58 and 17.5 km (17.5 - 4.5 kbar) at temperatures between 1,249 and 1,082 ºC; and between 28 and 15 km (7.8 - 4.1 kbar) for amphibole grains of the Sobreiro Formation, suggesting polybaric evolution. A model with generation of hydrated basaltic magma from partial melting of mantle wedge and accumulation in a hot zone of the lower crust, from which the andesitic and dacitic magmas are formed by the assimilation of continental crust and following fractional crystallization is proposed.As formações Sobreiro e Santa Rosa são resultado de intensas atividades vulcânicas paleoproterozoicas na região de São Félix do Xingu (PA), SE do Cráton Amazônico. A Formação Sobreiro é composta por rochas de fácies de fluxo de lava andesítica, com dacito e riodacito subordinados, além de rochas que compõem a fácies vulcanoclástica, caracterizadas por tufo, lapilli-tufo e brecha polimítica maciça. Essas rochas exibem fenocristais de clinopiroxênio, anfibólio e plagioclásio em uma matriz microlítica ou traquítica. O clinopiroxênio é classificado predominantemente como augita, com diopsídio subordinado, e apresenta caracterísiticas geoquímicas de minerais gerados em rochas de arco magmático. O anfibólio, representado pela magnesiohastingsita, foi formado sob condições oxidantes e apresenta texturas de desequilíbrio, como bordas de oxidação vinculadas à degaseificação por alívio de pressão. As rochas da Formação Santa Rosa foram extravasadas em grandes fissuras crustais de direção NE-SW, têm características de evolução polifásica e compõem uma fácies de fluxo de lava riolítica e riodacítica e uma fácies vulcanoclástica de ignimbritos, lapilli-tufos, tufos de cristais félsicos e brechas polimíticas maciças. Diques métricos e stocks de pórfiros graníticos e granitoides equigranulares completam essa suíte. Fenocristais de feldspato potássico, plagioclásio e quartzo dispersos em matriz de quartzo e feldspato potássico intercrescidos ocorrem nessas rochas. Por meio de análises químicas pontuais dos fenocristais em microssonda eletrônica, foram estimadas as condições de pressão e temperatura de sua formação, sendo que o clinopiroxênio das rochas intermediárias da Formação Sobreiro indica profundidade de formação variável entre 58 e 17,5 km (17,5 - 4,5 kbar), a temperaturas entre 1.294 e 1.082 ºC, enquanto o anfibólio cristalizou-se entre 28 e 15 km (7,8 - 4,1 kbar), o que sugere uma evolução polibárica. Assim, propõe-se um modelo de geração de magma basáltico hidratado com base na fusão parcial de cunha mantélica e no acúmulo na crosta inferior em uma zona quente, a partir da qual os magmas andesíticos e dacíticos são formados pela assimilação de crosta continental e cristalização fracionada

Fighting HIV/AIDS in a developing country: lessons from a small cohort from the largest Brazilian city

Not Applicabl

Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

Background Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown. Study Design Prospective multinational cohort. Setting & Participants 4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study). Predictors Dental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness; decayed, missing, and filled teeth index; teeth brushing and flossing; and dental health consultation. Outcomes All-cause and cardiovascular mortality at 12 months after dental assessment. Measurements Multivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries. Results During a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29; 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70; 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar. Limitations Convenience sample of clinics. Conclusions In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio

Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding: Bill & Melinda Gates Foundation