Tuberculosis national registries and data on diagnosis delay - Is there room for improvement?

Introduction and objectives Excessive delay in the diagnosis of Tuberculosis may have a negative impact on the epidemiological control and elimination of this disease. An accurate determination and analysis of delay times may help identify where and how to improve Tuberculosis diagnosis according to local needs. The Portuguese Tuberculosis Surveillance System – SVIG-TB – is the main source of data regarding diagnosis delay. However, to our knowledge, there has been no recent evaluation of its data. This study's primary aim was to conduct a thorough quantitative and qualitative evaluation of data obtained from the SVIG-TB registry concerning the delay in Tuberculosis diagnosis in Matosinhos, a Portuguese municipality. Methods All patients living in the Matosinhos municipality diagnosed with Tuberculosis between January 1st 2012 and December 31st 2019 were identified and individual SVIG-TB records retrieved. Patient-related, Healthcare-related and Total delay in Tuberculosis diagnosis were determined based on data obtained from this source and compared to data recovered from patient record review. Missing data, registering errors and differences in diagnosis delay between these two sources were analysed and compared. Subsequently, diagnosis delay data from a recent Portuguese nationwide SVIG-TB paper, covering years 2010 to 2014, was compared to local SVIG-TB and patient record review data. Results This study identified a significantly greater percentage of cases with missing data on delay in SVIG-TB records when compared to Patient Record Review (57.2% versus 1.11%). The median patient-related, healthcare-related and Total delay in Tuberculosis diagnosis were of 17, 30 and 68 days, respectively, in the SVIG-TB based data. A significant underestimation of healthcare-related and total Tuberculosis diagnosis delay was identified in SVIG-TB data when compared to Patient Record Review. There was no significant difference between Patient-related delays determined from these two sources. Compared to the national study results, missing values were more common in this data set (57.2 vs 44.6%), mainly due to the absence of patient-related delay data. Median Total and Healthcare-related delays were significantly greater in Matosinhos Municipality, regardless of the data source (SVIG-TB or Patient Record Review). The patient-related delay was, conversely, shorter. Conclusions SVIG-TB has been crucial in guiding National Public Health policies on the path towards Tuberculosis elimination in Portugal. However, there is still room for improvement. These results provide a basis for further reflection on the shortcomings and potential of SVIG-TB in guiding the national Tuberculosis program.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

A Method to Tackle First Order Differential Equations with Liouvillian Functions in the Solution - II

We present a semi-decision procedure to tackle first order differential equations, with Liouvillian functions in the solution (LFOODEs). As in the case of the Prelle-Singer procedure, this method is based on the knowledge of the integrating factor structure.Comment: 11 pages, late

Thermodynamics of blackbody radiation in nonlinear electrodynamics

We study the blackbody properties and the thermodynamic equilibrium quantities of a photon gas in the framework of nonlinear electrodynamics. In this vein, we take into account the photon propagation in an uniform external magnetic field in the weak field approximation, where an angular anisotropic energy density distribution appears in the frequency spectrum. The special case when the photon propagates perpendicular to the background magnetic field is also discussed, which allows us to probe the strong field regime. We then derive a modified blackbody spectral distribution and the Stefan-Boltzmann law in this situation. Considerations about the Wien's displacement law and the Rayleigh-Jeans formula are contemplated as well. Deviations from the thermodynamic quantities at thermal equilibrium such as energy, pressure, entropy and heat capacity densities are obtained from the Helmholtz free energy. As an application, we study three nonlinear electrodynamics, namely, the Euler-Heisenberg, the generalized Born-Infeld and the Logarithmic electrodynamics. Possible implications on stellar systems with strong magnetic fields such as Magnetars are discussed.Comment: 11 pages, 1 figur

Improving the Knowledge on Seismogenic Sources in the Lower Tagus Valley for Seismic Hazard Purposes

The Lower Tagus Valley, that includes the metropolitan area of Lisbon, has been struck by several earthquakes which produced significant material damage and loss of lives. Their exact location remains unknown. Our goal is to shed some light into the seismogenic sources in the area using seismic reflection and geological data. In areas with no seismic coverage, potential-field data interpretation was carried out. Seismicity was overlaid to the potential seismogenic structures and high-resolution data was acquired in order to confirm which structures have been active into the Quaternary. Three major fault-zones affecting the Neogene were identified: V. F. Xira, Samora-Alcochete and Pinhal Novo. For the first fault, strong evidences suggest it is active. The other two fault-zones and other structures previously unknown can be correlated with several epicentres. Empirical relationships between maximum moment magnitude and fault area indicate that MW > 6.5 earthquakes can be expected for the larger structures

Methods of earth building in the Huila Province, Angola

In Angola, the construction made of raw earth is a cultural heritage widely used by low income households, representing over 80% of the population [1, 3]. In Huila province is evident construction in raw earth in a large scale, either in urban or in periurban and rural areas. The construction methods follow the ancestral standards, distributed throughout the region of Huila, being built by the several ethnic groups. Among the construction techniques in earth, stand out: the adobe, wattle-and-daub and more recently on CEB (Compressed Earth Block). The type of soil used to make the adobes is mainly silty-clayed sand [1]. The most applied materials are: rods, reeds, wood, grass, straw, soil and stone, almost with the same characteristics [2]. The manufacture of adobe, consists essentially in mixing clay and grass (plant fibers), then put the mixture inside a wooden mold, having a size of 42 cm long and 18 cm high and taking three to four days to dry and be applied in housing construction. The application of these materials makes the construction less expensive because they are collected, transformed and applied by the owner himself of housing without any project, based only on the result of the practice and experience acquired from their ancestors. They are simple constructions, presenting a typology of grouped and isolated single-family housing, ranging between 2 and 3 bedrooms [2]. The construction techniques used in such small housings have positive environmental aspects, both as regards the materials employed, such as the manner in which the constructions are raised, showing special concerns for the quality improvement of them, as regards the resistance, durability and comfort [4]

Models of inflammation: Carrageenan- or complete Freund's Adjuvant (CFA)-induced edema and hypersensitivity in the rat

Animal models of inflammation are used to assess the production of inflammatory mediators at sites of inflammation, the anti-inflammatory properties of agents such as nonsteroidal anti-inflammatory drugs (NSAIDs), and the efficacy of putative analgesic compounds in reversing cutaneous hypersensitivity. This unit details methods to elicit and measure carrageenan- and complete Freund's adjuvant (CFA)-induced cutaneous inflammation. Due to possible differences between the dorsal root sensory system and the trigeminal sensory system, injections of either the footpad or vibrissal pad are described. In this manner, cutaneous inflammation can be assessed in tissue innervated by the lumbar dorsal root ganglion neurons (footpad) and by the trigeminal ganglion neurons (vibrissal pad)