Covid-19 vaccination priorities defined on machine learning

OBJECTIVE: Defining priority vaccination groups is a critical factor to reduce mortality rates. METHODS: We sought to identify priority population groups for covid-19 vaccination, based on in-hospital risk of death, by using Extreme Gradient Boosting Machine Learning (ML) algorithm. We performed a retrospective cohort study comprising 49,197 patients (18 years or older), with RT-PCR-confirmed for covid-19, who were hospitalized in any of the 336 Brazilian hospitals considered in this study, from March 19th, 2020, to March 22nd, 2021. Independent variables encompassed age, sex, and chronic health conditions grouped into 179 large categories. Primary outcome was hospital discharge or in-hospital death. Priority population groups for vaccination were formed based on the different levels of in-hospital risk of death due to covid-19, from the ML model developed by taking into consideration the independent variables. All analysis were carried out in Python programming language (version 3.7) and R programming language (version 4.05). RESULTS: Patients’ mean age was of 60.5 ± 16.8 years (mean ± SD), mean in-hospital mortality rate was 17.9%, and the mean number of comorbidities per patient was 1.97 ± 1.85 (mean ± SD). The predictive model of in-hospital death presented area under the Receiver Operating Characteristic Curve (AUC - ROC) equal to 0.80. The investigated population was grouped into eleven (11) different risk categories, based on the variables chosen by the ML model developed in this study. CONCLUSIONS: The use of ML for defining population priorities groups for vaccination, based on risk of in-hospital death, can be easily applied by health system managers

Factores de influência na prescrição em Clínica Geral no Norte de Portugal

Dissertação de Doutoramento em Medicina apresentada à Faculdade de Medicina da Universidade do PortoIntrodução A relação médico /doente tem sido objecto de extensa literatura procurando proporcionar uma visão interna aprofundada das perspectivas psicodinâmicas, comportamentais e sociológicas. A escolha de um medicamento apoia-se numa decisão probabilística, tendo em consideração numerosos factores, e em particular a referência benefício /risco do medicamento e / ou das associações terapêuticas utilizadas. Têem sido evidenciados em diversos estudos vários factores, que influenciam a decisão de prescrição, alguns inerentes ao doente, como por exemplo a idade, o sexo, as condições socio-económicas, outras dependentes do médico, como por exemplo a sua formação contínua, a organização da consulta, bem como factores externos como a formação pré e pós graduada, a indústria farmacêutica, a influência dos meios de comunicação social, entre outros.Métodos Foram efectuados dois estudos do tipo analítico transversal. No primeiro estudo foi realizado um inquérito postal em três fases consecutivas: elaboração de questionário de auto-preenchimento, sua aplicação à população em estudo, e estudo dos não respondentes. O questionário era constituído por perguntas sobre dados sócio-demográficos, diferentes meios de actualização médica contínua utilizados e estudo das opções terapêuticas em três situações clínicas - amigdalite eritemato-pultácea, hipertensão arterial ligeira, e stress profissional. Após a análise de dados no programa SPSS para o Windows 95, classificação e análise das variáveis, elaborou-se um questionário semi-estruturado, a ser aplicado por entrevista, sobre as principais áreas, identificadas no questionário, como podendo ser factores de influência na prescrição. Procedeu-se à análise global dos dados, com análise por tabelas de frequência e feitos os agrupamentos necessários e analisadas as correlações. Foi utilizado o teste t de student e o valor de Qui Quadrado de Pearson, com nível de significância de valor < ou = 0,05.Resultados Responder ..

Students Knowledge level of sustainability dynamics

The paper examines the knowledge level of sustainability dynamics in a Federal Education University in Brazil. A survey with 360 respondents was conducted online with undergraduate and graduate students; the data was analyzed by quantitative research. The results show that students have few knowledge about world affairs but present higher levels of knowledge about local sustainable issues

Exercise training improves relaxation response and SOD-1 expression in aortic and mesenteric rings from high caloric diet-fed rats

<p>Abstract</p> <p>Background</p> <p>Obesity has been associated with a variety of disease such as type II diabetes mellitus, arterial hypertension and atherosclerosis. Evidences have shown that exercise training promotes beneficial effects on these disorders, but the underlying mechanisms are not fully understood. The aim of this study was to investigate whether physical preconditioning prevents the deleterious effect of high caloric diet in vascular reactivity of rat aortic and mesenteric rings.</p> <p>Methods</p> <p>Male Wistar rats were divided into sedentary (SD); trained (TR); sedentary diet (SDD) and trained diet (TRD) groups. Run training (RT) was performed in sessions of 60 min, 5 days/week for 12 weeks (70–80% VO_2max). Triglycerides, glucose, insulin and nitrite/nitrate concentrations (NO_x^-) were measured. Concentration-response curves to acetylcholine (ACh) and sodium nitroprusside (SNP) were obtained. Expression of Cu/Zn superoxide dismutase (SOD-1) was assessed by Western blotting.</p> <p>Results</p> <p>High caloric diet increased triglycerides concentration (SDD: 216 ± 25 mg/dl) and exercise training restored to the baseline value (TRD: 89 ± 9 mg/dl). Physical preconditioning significantly reduced insulin levels in both groups (TR: 0.54 ± 0.1 and TRD: 1.24 ± 0.3 ng/ml) as compared to sedentary animals (SD: 0.87 ± 0.1 and SDD: 2.57 ± 0.3 ng/ml). On the other hand, glucose concentration was slightly increased by high caloric diet, and RT did not modify this parameter (SD: 126 ± 6; TR: 140 ± 8; SDD: 156 ± 8 and TRD 153 ± 9 mg/dl). Neither high caloric diet nor RT modified NO_x^-levels (SD: 27 ± 4; TR: 28 ± 6; SDD: 27 ± 3 and TRD: 30 ± 2 μM). Functional assays showed that high caloric diet impaired the relaxing response to ACh in mesenteric (about 13%), but not in aortic rings. RT improved the relaxing responses to ACh either in aortic (28%, for TR and 16%, to TRD groups) or mesenteric rings (10%, for TR and 17%, to TRD groups) that was accompanied by up-regulation of SOD-1 expression and reduction in triglycerides levels.</p> <p>Conclusion</p> <p>The improvement in endothelial function by physical preconditioning in mesenteric and aortic arteries from high caloric fed-rats was directly related to an increase in NO bioavailability to the smooth muscle mostly due to SOD-1 up regulation.</p

Adaptando A Cor Púrpura : narrativa epistolar e voz-over

Transforming a book’s text into an audiovisual media foresees a series of proceedings, being indispensable, among others, the choices concerning the characters’interpreters, the location used for the fictional space, besides a very specific work concerning language, in order to transposition and dialogues’creation. This study’s focus, The Color Purple (Alice Walker, 1982) presents an additional level of difficulty as being structured as an epistolary novel. The movie’s fidelity (Steven Spielberg, 1985) towards the book will not be discussed. Differently within this process, both the aesthetics and ideological confluences with be examined in this essay, taking into account their natures (novel and movie) as independent fictional pieces.Transformar texto literário em mídia audiovisual pressupõe uma série de procedimentos, sendo imprescindíveis, dentre outros, a escolha de intérpretes para os personagens, de locação para os espaços ficcionais, além de um trabalho específico com a linguagem para a transposição e criação de diálogos. O objeto desse estudo, A cor púrpura (Alice Walker, 1982) apresenta dificuldade adicional por se tratar de uma narrativa epistolar. Não se discute a questão da fidelidade do filme (Steven Spielberg, 1985) em relação ao livro. Diferentemente desse processo, examinam-se confluências estética e ideológica entre ambos, levando-se em conta a natureza de cada um deles como obra ficcional autônoma