Tecnologias da Informação: a gestão de processos através de aplicativos de mensagem

Introdução: A partir do desenvolvimento das tecnologias de informação e comunicação novas possibilidades de compartilhamento de dados e informações favoreceram mudanças significativas no comportamento da sociedade, contribuindo de forma acelerada para a globalização do conhecimento.  No âmbito da manutenção de aeronaves, o emprego de tais tecnologias na gestão de processos produtivos ganha novos contornos a partir do uso de tecnologias capazes de prover maior controle de recursos, garantindo a confiabilidade dos serviços prestados e o controle dos gastos operacionais. O objetivo central desse trabalho é analisar as potencialidades da utilização de um aplicativo de mensagens na gestão de atendimentos em uma empresa de manutenção de aeronaves. Método: o procedimento metodológico adotado caracteriza-se pela pesquisa-ação, tendo como foco a temática de tecnologias da informação e comunicação aplicadas na gestão de processos, favorecendo o desenvolvimento de um modelo de gestão eficiente na distribuição de recursos empregados nas atividades de atendimento de tarefas. Resultados: como resultados descreve-se a relevância do uso do aplicativo de mensagens, pelo Controle da Qualidade, ao estabelecer um padrão no atendimento das demandas no contexto da manutenção de aeronaves, proporcionando melhorias e contribuindo para uma melhor visibilidade no detalhamento das tarefas e, uma gestão mais eficiente dos recursos empregados nas solicitações realizadas pela manutenção. Conclusão: verifica-se que a aplicação de tais tecnologias proporciona uma maior sinergia entre os diversos setores envolvidos no processo, melhorando a comunicação e o direcionamento preciso dos recursos a serem empregados

A Mobile Health Intervention for Patients With Depressive Symptoms: Protocol for an Economic Evaluation Alongside Two Randomized Trials in Brazil and Peru

BACKGROUND: Mobile health interventions provide significant strategies for improving access to health services, offering a potential solution to reduce the mental health treatment gap. Economic evaluation of this intervention is needed to help inform local mental health policy and program development. OBJECTIVE: This paper presents the protocol for an economic evaluation conducted alongside 2 randomized controlled trials (RCTs) to evaluate the cost-effectiveness of a psychological intervention delivered through a technological platform (CONEMO) to treat depressive symptoms in people with diabetes, hypertension, or both. METHODS: The economic evaluation uses a within-trial analysis to evaluate the incremental costs and health outcomes of CONEMO plus enhanced usual care in comparison with enhanced usual care from public health care system and societal perspectives. Participants are patients of the public health care services for hypertension, diabetes, or both conditions in São Paulo, Brazil (n=880) and Lima, Peru (n=432). Clinical effectiveness will be measured by reduction in depressive symptoms and gains in health-related quality of life. We will conduct cost-effectiveness and cost-utility analyses, providing estimates of the cost per at least 50% reduction in 9-item Patient Health Questionnaire scores, and cost per quality-adjusted life year gained. The measurement of clinical effectiveness and resource use will take place over baseline, 3-month follow-up, and 6-month follow-up in the intervention and control groups. We will use a mixed costing methodology (ie, a combination of top-down and bottom-up approaches) considering 4 cost categories: intervention (CONEMO related) costs, health care costs, patient and family costs, and productivity costs. We will collect unit costs from the RCTs and national administrative databases. The multinational economic evaluations will be fully split analyses with a multicountry costing approach. We will calculate incremental cost-effectiveness ratios and present 95% CIs from nonparametric bootstrapping (1000 replicates). We will perform deterministic and probabilistic sensitivity analyses. Finally, we will present cost-effectiveness acceptability curves to compare a range of possible cost-effectiveness thresholds. RESULTS: The economic evaluation project had its project charter in June 2018 and is expected to be completed in September 2021. The final results will be available in the second half of 2021. CONCLUSIONS: We expect to assess whether CONEMO plus enhanced usual care is a cost-effective strategy to improve depressive symptoms in this population compared with enhanced usual care. This study will contribute to the evidence base for health managers and policy makers in allocating additional resources for mental health initiatives. It also will provide a basis for further research on how this emerging technology and enhanced usual care can improve mental health and well-being in low- and middle-income countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT12345678 (Brazil) and NCT03026426 (Peru); https://clinicaltrials.gov/ct2/show/NCT02846662 and https://clinicaltrials.gov/ct2/show/NCT03026426. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26164

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.Publisher PDFPeer reviewe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Evolución de las tecnologías de representación: de las lenguajes de marcado a los datos interconectados

The so-called Representation Languages have always been directly related to the instruments and professional practices identified in the field of Information Science. From the development of digital technologies, the bibliographic representation formats have evolved to meet emerging information demands. In this sense, the methods of representation have always been objects of investigation in the field of Information Science that since its creation, develops methods directed to the representation of the diverse types of informational resources. In view of this scenario, we ask: what are the relations between the representation languages conventionally used in the area of Information Science and the technologies of interconnected data publishing? The objective of the research is to analyze the evolution of representation languages and to identify the existing relationships between the representation tools used in the area of Information Science and the new trends of interconnected data publication. It is a theoretical research of qualitative approach, and applied nature, focused on the analytical observation of the documents that approach the thematic of information representation. Bibliographic and documentary analysis is used as methodological procedures, addressing the volume of data and information obtained through the technique of content analysis. The research is justified due to the need for studies that corroborate for a better understanding of the new models of representation based on the proposal of interconnected data and its applications for the area of Information Science. As a result, an overview of the evolution of representation languages is presented and the main relationships with the new interrelated data publishing trends are described, especially the BIBFRAME data model.Las denominadas Lenguajes de Representación siempre tuvieron relación directa con los instrumentos y prácticas profesionales identificados en el campo de la Ciencia de la Información. A partir del desarrollo de las tecnologías digitales los formatos bibliográficos de representación han evolucionado buscando atender a las demandas informales emergentes. En este sentido, los métodos de representación siempre fueron objetos de investigación en el campo de la Ciencia de la Información que desde su creación, desarrolla métodos dirigidos a la representación de los diversos tipos de recursos informacionales. Ante este escenario, se cuestiona: ¿cuáles son las relaciones existentes entre los lenguajes de representación convencionalmente utilizados en el área de Ciencia de la Información y las tecnologías de publicación de datos interconectados? El objetivo de la investigación es analizar la evolución de los lenguajes de representación e identificar las relaciones existentes entre los instrumentos de representación utilizados en el área de Ciencia de la Información y las nuevas tendencias de publicación de datos interconectados. Se trata de una investigación teórica de abordaje cualitativo, y naturaleza aplicada, enfocada en la observación analítica de los documentos que abordan la temática de representación de la información. Se utiliza como procedimientos metodológicos el análisis bibliográfico y documental, abordando el volumen de datos e informaciones obtenidos mediante la técnica de análisis de contenido. La investigación se justifica debido a la necesidad de estudios que corroboran para un mejor entendimiento de los nuevos modelos de representación fundamentados en la propuesta de datos interconectados y sus aplicaciones para el área de Ciencia de la Información. Como resultado, se presenta una visión general de la evolución de los lenguajes de representación y se describen las principales relaciones con las nuevas tendencias de publicación de datos interconectados, con destaque para el modelo de datos BIBFRAME.Não recebi financiamentoAs denominadas Linguagens de Representação sempre tiveram relação direta com os instrumentos e práticas profissionais identificados no campo da Ciência da Informação. A partir do desenvolvimento das tecnologias digitais os formatos bibliográficos de representação têm evoluído buscando atender às demandas informacionais emergentes. Nesse sentido, os métodos de representação sempre foram objetos de investigação no campo da Ciência da Informação que desde a sua criação, desenvolve métodos voltados para a representação dos diversos tipos de recursos informacionais. Diante deste cenário, questiona-se: quais as relações existentes entre as linguagens de representação convencionalmente utilizados na área de Ciência da Informação e as tecnologias de publicação de dados interligados? O objetivo da pesquisa é analisar a evolução das linguagens de representação e identificar as relações existentes entre os instrumentos de representação utilizados na área de Ciência da Informação e as novas tendências de publicação de dados interligados. Trata-se de uma pesquisa teórica de abordagem qualitativa, e natureza aplicada, focada na observação analítica dos documentos que abordam a temática de representação da informação. Utiliza-se como procedimentos metodológicos a análise bibliográfica e documental, abordando o volume de dados e informações obtidos mediante a técnica de análise de conteúdo. A pesquisa justifica-se devido à necessidade de estudos que corroborem para um melhor entendimento dos novos modelos de representação fundamentados na proposta de dados interligados e suas aplicações para a área de Ciência da Informação. Como resultado, é apresentada uma visão geral da evolução das linguagens de representação e descritas as principais relações com as novas tendências de publicação de dados interligados, com destaque para o modelo de dados BIBFRAME

Modelos de representação semântica na era do Big Data

The term Big Data refers to the large volume of data produced and made available in digital environments. Over the last few years, new models of representation have been proposed to improve the forms of representation of information in digital environments. The present work is linked to an ongoing research project, funded by FAPESP and CNPq agencies, and aims to analyze the principles underlying Big Data and its relationship with the new Resource Description Framework (RDF) representation patterns; Simple Knowledge Organization System (SKOS) and Onto-logy Web Language (OWL). The research has a theoretical char-acter and a qualitative approach, as it seeks to present characteristics aimed at describing, understanding and explaining the relationships between Big Data and the new models of representation. From the theoretical survey carried out, it was verified that the representation models analyzed contribute to the interconnection of large volumes of data without losing the context in which they originated, favoring a better understanding of Big Data and the new paradigms of representa-tion in digital environments.O termo Big Data se refere ao grande volume de dados produzidos e disponibilizados em ambientes digitais. Ao longo dos últimos anos novos modelos de representação têm sido propostos no intuito de aperfeiçoar as formas de representação de informações em ambientes digitais. O presente trabalho está vinculado a um projeto de pesquisa em andamento, financiado pelas agências FAPESP e CNPq, e possui como objetivo analisar os princípios que fundamentam o Big Data e sua relação com os novos padrões de representação Resource Description Framework (RDF); Simple Knowledge Organization System (SKOS) e Ontology Web Language (OWL). A pesquisa possui caráter teórico e abordagem qualitativa, pois busca apresentar características voltadas à descrição, com-preensão e explicação das relações do Big Data com os novos modelos de representação. A partir do levantamento teórico realizado, foi verificado que os modelos de representação analisados contribuem para interligar grandes volumes de dados sem perder o contexto no qual são originados, favorecendo um melhor entendimento do Big Data e os novos paradigmas de representação em ambientes digitais

Effect of a Digital Intervention on Depressive Symptoms in Patients with Comorbid Hypertension or Diabetes in Brazil and Peru:Two Randomized Clinical Trials

IMPORTANCE: Depression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low- and middle-income countries, but the effectiveness in these countries is unknown. OBJECTIVE: To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with diabetes and/or hypertension. DESIGN, SETTING, AND PARTICIPANTS: Participants with clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score ≥10) who were being treated for hypertension and/or diabetes were enrolled in a cluster randomized clinical trial (RCT) at 20 sites in São Paulo, Brazil (N=880; from September 2016 to September 2017; final follow-up, April 2018), and in an individual-level RCT at 7 sites in Lima, Peru (N=432; from January 2017 to September 2017; final follow-up, March 2018). INTERVENTIONS: An 18-session, low-intensity, digital intervention was delivered over 6 weeks via a provided smartphone, based on behavioral activation principles, and supported by nurse assistants (n = 440 participants in 10 clusters in São Paulo; n = 217 participants in Lima) vs enhanced usual care (n = 440 participants in 10 clusters in São Paulo; n = 215 participants in Lima). MAIN OUTCOMES AND MEASURES: The primary outcome was a reduction of at least 50% from baseline in PHQ-9 scores (range, 0-27; higher score indicates more severe depression) at 3 months. Secondary outcomes included a reduction of at least 50% from baseline PHQ-9 scores at 6 months. RESULTS: Among 880 patients cluster randomized in Brazil (mean age, 56.0 years; 761 [86.5%] women) and 432 patients individually randomized in Peru (mean age, 59.7 years; 352 [81.5%] women), 807 (91.7%) in Brazil and 426 (98.6%) in Peru completed at least 1 follow-up assessment. The proportion of participants in São Paulo with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 40.7% (159/391 participants) in the digital intervention group vs 28.6% (114/399 participants) in the enhanced usual care group (difference, 12.1 percentage points [95% CI, 5.5 to 18.7]; adjusted odds ratio [OR], 1.6 [95% CI, 1.2 to 2.2]; P = .001). In Lima, the proportion of participants with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 52.7% (108/205 participants) in the digital intervention group vs 34.1% (70/205 participants) in the enhanced usual care group (difference, 18.6 percentage points [95% CI, 9.1 to 28.0]; adjusted OR, 2.1 [95% CI, 1.4 to 3.2]; P < .001). At 6-month follow-up, differences across groups were no longer statistically significant. CONCLUSIONS AND RELEVANCE: In 2 RCTs of patients with hypertension or diabetes and depressive symptoms in Brazil and Peru, a digital intervention delivered over a 6-week period significantly improved depressive symptoms at 3 months when compared with enhanced usual care. However, the magnitude of the effect was small in the trial from Brazil and the effects were not sustained at 6 months. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02846662 (São Paulo) and NCT03026426 (Lima

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data