Desenvolvimento de aplicativos de apoio clínico para médicos de família

Telemedicin

IPSAL: Implementação do módulo para geração da sequência e índices de Sobol

Sensitivity and uncertainty analysis hold significant importance across a range of applications, spanning from industrial problems to climate change, financial risk assessment, as well as mathematical and computational models. These analyses involve identifying influential input parameters in models to comprehend their impact on the output. Sensitivity analysis can be performed locally, examining parameter effects at a fixed value, or globally, evaluating the model across a range of parameter values. The Sobol method stands as a robust approach for global sensitivity analysis, employing a Sobol sequence to create samples more uniformly within the input parameter space, thus enabling efficient exploration of model inputs. This paper aims to introduce a computational implementation in Scilab to generate the Sobol sequence for utilization in sensitivity analysis through the Sobol method. A test case was applied to generate Sobol sequences and discuss the obtained results.A análise de sensibilidade e da incerteza tem uma importância significativa numa série de aplicações, abrangendo desde problemas industriais até alterações climáticas, avaliação de riscos financeiros, bem como modelos matemáticos e computacionais. Essas análises envolvem a identificação de parâmetros de entrada influentes nos modelos para compreender seu impacto na saída. A análise de sensibilidade pode ser realizada localmente, examinando os efeitos dos parâmetros em um valor fixo, ou globalmente, avaliando o modelo em uma faixa de valores de parâmetros. O método de Sobol apresenta uma abordagem robusta para análise de sensibilidade global, empregando uma sequência de Sobol para criar amostras de forma mais uniforme dentro do espaço de parâmetros de entrada, permitindo assim a exploração eficiente das entradas do modelo. Este artigo tem como objetivo apresentar uma implementação computacional no Scilab para gerar a sequência e os índices de Sobol para utilização em análise de sensibilidade através do método Sobol. Um caso de teste foi aplicado para gerar sequências de Sobol e discutir os resultados obtidos

Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders

Objetivo: estimar la prevalencia de hipoalbuminemia en ancianos hospitalizados, considerando las variables sociodemográficas, estado nutricional y tiempo de internación. Método: estudio transversal, en 200 pacientes internados en hospital de gran porte del sur de Brasil, durante un período de tres meses. Fueron realizadas evaluaciones, análisis de exámenes de laboratorio y se realizó una entrevista usando un cuestionario. Resultados: el promedio de albuminemia fue 2,9 ± 0,5g/dL. El diagnóstico de hipoalbuminemia, fue encontrado en 173 sujetos (87%), y no revelado en 27 (13%), que presentaron albuminemia normal (p=0,000). Se constató que después de seis días de internación la prevalencia de niveles bajos aumentó significativamente para 90% (p=0,002), con promedio de 2,7 ± 0,5g/dL. Utilizando la Mini Evaluación Nutricional, se observó que 41 pacientes estaban desnutridos, y que de estos, 40 presentaban hipoalbuminemia. Conclusión: la prevalencia de hipoalbuminemia se mostró elevada, afectando aproximadamente nueve entre diez ancianos, siendo que el estado nutricional, de la misma manera que el tiempo de internación, está relacionado a la disminución de los niveles de albúmina sérica. Así, se sugiere monitorizar los niveles de albuminemia para evaluar el riesgo que el paciente tiene de desarrollar desnutrición y demás complicaciones durante la internación hospitalaria.Objetivo: estimar a prevalência de hipoalbuminemia em idosos hospitalizados, em relação às variáveis sociodemográficas, estado nutricional e tempo de internação. Método: estudo transversal, com 200 pacientes internados em hospital de grande porte do sul do Brasil, durante o período de três meses. Foram realizadas avaliações, análise de exames laboratoriais e entrevista através de questionário. Resultados: a média de albuminemia foi 2,9 ± 0,5g/dL. O diagnóstico de hipoalbuminemia, foi encontrado em 173 sujeitos (87%), e não revelado em 27 (13%), que apresentaram albuminemia normal (p=0,000). Constatou-se que após seis dias de internação a prevalência de níveis baixos aumentou significativamente para 90% (p=0,002), com média de 2,7 ± 0,5g/dL. Utilizando-se a Mini Avaliação Nutricional, observou-se que 41 pacientes estavam desnutridos, e que destes, 40 apresentavam hipoalbuminemia. Conclusão: a prevalência de hipoalbuminemia mostrou-se elevada, acometendo aproximadamente nove entre dez idosos, sendo que o estado nutricional, da mesma maneira que o tempo de internação , está relacionado à diminuição dos níveis de albumina sérica. Assim, sugere-se monitorar os níveis de albuminemia para avaliar o risco que o paciente tem de desenvolver desnutrição e demais complicações durante a internação hospitalar.Objective: to estimate the prevalence of hypoalbuminemia in hospitalized elders, related to socio-demographic variables, nutritional status and length of stay. Methods: crosscutting study with 200 patients hospitalized in a large hospital in the South of Brazil during three months. Evaluations, lab tests and interviews through questionnaires were performed. Results: the average albuminemia was 2,9 ± 0,5g/dL. Hypoalbuminemia was diagnosed in 173 subjects (87%) and was absent in 27 (13%) that have normal albuminemia (p=0,000). After six days of hospitalization, the prevalence of low levels grew significantly to 90% (p=0,002), average 2,7 ± 0,5g/dL. Using the Mini Nutritional Assessment, it was observed that 41 patients were malnourished and from those, 40 had hypoalbuminemia. Conclusion: the prevalence of hypoalbuminemia proved to be high, in approx. nine in ten elders, and the nutritional status and the length of stay proved to be related to the decrease of serum albumin levels. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays

Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders

Objective: to estimate the prevalence of hypoalbuminemia in hospitalized elders, related to socio-demographic variables, nutritional status and length of stay. Methods: crosscutting study with 200 patients hospitalized in a large hospital in the South of Brazil during three months. Evaluations, lab tests and interviews through questionnaires were performed. Results: the average albuminemia was 2,9 ± 0,5g/dL. Hypoalbuminemia was diagnosed in 173 subjects (87%) and was absent in 27 (13%) that have normal albuminemia (p=0,000). After six days of hospitalization, the prevalence of low levels grew significantly to 90% (p=0,002), average 2,7 ± 0,5g/dL. Using the Mini Nutritional Assessment, it was observed that 41 patients were malnourished and from those, 40 had hypoalbuminemia. Conclusion: the prevalence of hypoalbuminemia proved to be high, in approx. nine in ten elders, and the nutritional status and the length of stay proved to be related to the decrease of serum albumin levels. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays

Acute changes in serum and skeletal muscle steroids in resistance-trained men

IntroductionResistance exercise can significantly increase serum steroid concentrations after an exercise bout. Steroid hormones are involved in the regulation of several important bodily functions (e.g., muscle growth) through both systemic delivery and local production. Thus, we aimed to determine whether resistance exercise-induced increases in serum steroid hormone concentrations are accompanied by enhanced skeletal muscle steroid concentrations, or whether muscle contractions per se induced by resistance exercise can increase intramuscular steroid concentrations.MethodsA counterbalanced, within-subject, crossover design was applied. Six resistance-trained men (26 ± 5 years; 79 ± 8 kg; 179 ± 10 cm) performed a single-arm lateral raise exercise (10 sets of 8 to 12 RM - 3 min rest between sets) targeting the deltoid muscle followed by either squat exercise (10 sets of 8 to 12 RM - 1 min rest) to induce a hormonal response (high hormone [HH] condition) or rest (low hormone [LH] condition). Blood samples were obtained pre-exercise and 15 min and 30 min post-exercise; muscle specimens were harvested pre-exercise and 45 min post-exercise. Immunoassays were used to measure serum and muscle steroids (total and free testosterone, dehydroepiandrosterone sulfate, dihydrotestosterone, and cortisol; free testosterone measured only in serum and dehydroepiandrosterone only in muscle) at these time points.ResultsIn the serum, only cortisol significantly increased after the HH protocol. There were no significant changes in muscle steroid concentrations after the protocols.DiscussionOur study provides evidence that serum steroid concentration increases (cortisol only) seem not to be aligned with muscle steroid concentrations. The lack of change in muscle steroid after protocols suggests that resistance-trained individuals were desensitized to the exercise stimuli. It is also possible that the single postexercise timepoint investigated in this study might be too early or too late to observe changes. Thus, additional timepoints should be examined to determine if RE can indeed change muscle steroid concentrations either by skeletal muscle uptake of these hormones or the intramuscular steroidogenesis process

Calendário ilustrativo: uma abordagem no combate à doença de chagas e seus vetores / Illustrative calendar: an approach to combating chagas disease and its vectors

Atualmente, no Brasil, as atividades de controle da transmissão vetorial da doença de Chagas (DCH) são calcadas na vigilância dos vetores com participação comunitária, a partir nas notificações de insetos suspeitos de serem “barbeiros”, pela população. Diversos métodos didáticos podem ser empregados no avanço do conhecimento e sensibilização do público alvo para que haja maior adesão ao Programa de Controle da doença de Chagas (PCDCh). Sendo assim, esse trabalho teve como objetivo a elaboração e distribuição de um calendário ilustrado sobre a DCH, que abordasse como devem ser conduzidas as capturas dos vetores e os modos de prevenção da doença. Como resultado, produziram-se nove mil cópias de um calendário ilustrativo intitulado “Calendário Doença de Chagas”, distribuído para a população rural do Rio Grande do Sul, Brasil, com frases, figuras e ilustrações no que concerne, sobretudo, o combate, captura e a notificação correta dos vetores da doença, além de citações que auxiliam na prevenção de acidentes com animais peçonhentos e dicas de promoção da saúde. Assim, concebeu-se uma nova ferramenta educativa para o fortalecimento da vigilância entomológica da afecção, tendo a possibilidade de replicação em diversas localidades endêmicas

Ações federais para apoio e fortalecimento local no combate ao COVID-19: a atenção primária à saúde (APS) no assento do condutor

The Ministry of Health, through the Secretariat of Primary Health Care and in partnership with the Secretariat of Health Surveillance, built and implemented strategies of Primary Health Care (PHC) within the scope of support to local managers and in partnership with the Council National Secretary of State (CONASS) and Municipal Health (CONASEMS) to combat COVID-19. These actions have PHC as the main responsible for several areas and physical, human and financial resources, as well as allowing to boost national progress towards the use of information and communication technologies and new partnerships for conducting research.El Ministerio de Salud, a través de la Secretaría de Atención Primaria de Salud y en asociación con la Secretaría de Vigilancia Sanitaria, elaboró ​​e implementó estrategias de Atención Primaria de Salud (APS) dentro del alcance del apoyo a los gerentes locales y en asociación con la Secretaría Consejo Nacional de Salud Estado (CONASS) y Salud Municipal (CONASEMS) para combatir COVID-19. Estas acciones tienen a PHC como el principal responsable de varias áreas y recursos físicos, humanos y financieros, además de promover el progreso nacional en el uso de tecnologías de información y comunicación y nuevas alianzas para realizar investigaciones.O Ministério da Saúde, por intermédio da Secretaria de Atenção Primária à Saúde e em parceria com a Secretaria de Vigilância em Saúde construiu e implementou estratégias da Atenção Primária à Saúde (APS) no âmbito do apoio aos gestores locais e em articulação com o Conselho Nacional de Secretários Estaduais (CONASS) e Municipais de Saúde (CONASEMS) para o combate ao COVID-19. Essas ações têm a APS como a grande responsável por diversas áreas e recursos físicos, humanos e financeiros, assim como permite impulsionar o avanço nacional para o uso de tecnologias de informação e comunicação e novas parcerias para realização de pesquisas

Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders

ABSTRACT Objective: to estimate the prevalence of hypoalbuminemia in hospitalized elders, related to socio-demographic variables, nutritional status and length of stay. Methods: crosscutting study with 200 patients hospitalized in a large hospital in the South of Brazil during three months. Evaluations, lab tests and interviews through questionnaires were performed. Results: the average albuminemia was 2,9 ± 0,5g/dL. Hypoalbuminemia was diagnosed in 173 subjects (87%) and was absent in 27 (13%) that have normal albuminemia (p=0,000). After six days of hospitalization, the prevalence of low levels grew significantly to 90% (p=0,002), average 2,7 ± 0,5g/dL. Using the Mini Nutritional Assessment, it was observed that 41 patients were malnourished and from those, 40 had hypoalbuminemia. Conclusion: the prevalence of hypoalbuminemia proved to be high, in approx. nine in ten elders, and the nutritional status and the length of stay proved to be related to the decrease of serum albumin levels. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays

The Seventeenth Data Release of the Sloan Digital Sky Surveys: Complete Release of MaNGA, MaStar and APOGEE-2 Data

This paper documents the seventeenth data release (DR17) from the Sloan Digital Sky Surveys; the fifth and final release from the fourth phase (SDSS-IV). DR17 contains the complete release of the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey, which reached its goal of surveying over 10,000 nearby galaxies. The complete release of the MaNGA Stellar Library (MaStar) accompanies this data, providing observations of almost 30,000 stars through the MaNGA instrument during bright time. DR17 also contains the complete release of the Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) survey which publicly releases infra-red spectra of over 650,000 stars. The main sample from the Extended Baryon Oscillation Spectroscopic Survey (eBOSS), as well as the sub-survey Time Domain Spectroscopic Survey (TDSS) data were fully released in DR16. New single-fiber optical spectroscopy released in DR17 is from the SPectroscipic IDentification of ERosita Survey (SPIDERS) sub-survey and the eBOSS-RM program. Along with the primary data sets, DR17 includes 25 new or updated Value Added Catalogs (VACs). This paper concludes the release of SDSS-IV survey data. SDSS continues into its fifth phase with observations already underway for the Milky Way Mapper (MWM), Local Volume Mapper (LVM) and Black Hole Mapper (BHM) surveys