Spatial analysis of urban violence based on emergency room data

OBJETIVO: Estimar la intensidad espacial de eventos violentos utilizando metodología estadística basada en ondaletas (wavelets) y en datos de centros de urgencia. MÉTODOS: Fueron analizados datos referentes a víctimas de causas externas atendidas en centros de urgencias municipales localizados en zonas del sur de la ciudad de São Paulo (sudeste de Brasil) en el período de 1/1/2002 a 11/1/2003. Las informaciones fueron adquiridas a partir de registros hospitalarios. Las 3.540 ocurrencias fueron localizadas geográficamente en los casos con dirección incompleta fueron localizados en base en una elección aleatoria uniforme. Procesos puntuales y técnicas de ondaletas fueron utilizados para estimar la intensidad espacial, definida como el número esperado de eventos por unidad de área. RESULTADOS: Del total de ocurrencias georreferenciadas, 59% fueron accidentes y 40% agresiones. La intensidad estimada indica que la distribución espacial de los eventos no es homogénea, concentrándose en dos distritos y tres grandes avenidas localizadas en la zona sur de la ciudad de São Paulo. CONCLUSIONES: La utilización de ondaletas permite obtener el número esperado de eventos y respectiva banda de confianza para cualquier sub-región y, consecuentemente, calcular estimativas de los riesgos de ocurrencia de los eventos de interés, proporcionando subsidios para la definición de políticas para el enfrentamiento de la violencia urbana. Datos hospitalarios combinados con la metodología para estimar la intensidad de ocurrencia probaron ser útiles para estudiar la violencia urbana.OBJETIVO: Estimar a intensidade espacial de eventos violentos utilizando metodologia estatística baseada em ondaletas (wavelets) e em dados de pronto-socorro. MÉTODOS: Foram analisados dados referentes a vítimas de causas externas atendidas em pronto-socorro municipal localizado na zona Sul da cidade de São Paulo (SP) no período de 1/1/2002 a 11/1/2003. As informações foram obtidas a partir dos registros hospitalares. As 3.540 ocorrências foram localizadas geograficamente e os casos com endereço incompleto foram alocados com base numa escolha aleatória uniforme. Processos pontuais e técnicas de ondaletas foram utilizados para estimar a intensidade espacial, definida como o número esperado de eventos por unidade de área. RESULTADOS: Do total de ocorrências georreferenciadas, 59% foram acidentes e 40% agressões. A intensidade estimada indica que a distribuição espacial dos eventos não é homogênea, concentrando-se em dois distritos e três grandes avenidas localizados na zona Sul da cidade de São Paulo. CONCLUSÕES: A utilização de ondaletas permite obter o número esperado de eventos e respectiva banda de confiança para quaisquer sub-regiões e, conseqüentemente, calcular estimativas dos riscos de ocorrência dos eventos de interesse, fornecendo subsídios para a definição de políticas para o enfrentamento da violência urbana. Dados hospitalares combinados com a metodologia para estimação da intensidade de ocorrência provaram-se úteis para estudar a violência urbana.OBJECTIVE: To estimate the spatial intensity of urban violence events using wavelet-based methods and emergency room data. METHODS: Information on victims attended at the emergency room of a public hospital in the city of São Paulo, Southeastern Brazil, from January 1, 2002 to January 11, 2003 were obtained from hospital records. The spatial distribution of 3,540 events was recorded and a uniform random procedure was used to allocate records with incomplete addresses. Point processes and wavelet analysis technique were used to estimate the spatial intensity, defined as the expected number of events by unit area. RESULTS: Of all georeferenced points, 59% were accidents and 40% were assaults. There is a non-homogeneous spatial distribution of the events with high concentration in two districts and three large avenues in the southern area of the city of São Paulo. CONCLUSIONS: Hospital records combined with methodological tools to estimate intensity of events are useful to study urban violence. The wavelet analysis is useful in the computation of the expected number of events and their respective confidence bands for any sub-region and, consequently, in the specification of risk estimates that could be used in decision-making processes for public policies

Reliability of reflectance measures in passive filters

Measurements of optical reflectance in passive filters impregnated with a reactive chemical solution may be transformed to ozone concentrations via a calibration curve and constitute a low cost alternative for environmental monitoring, mainly to estimate human exposure. Given the possibility of errors caused by exposure bias, it is common to consider sets of m filters exposed during a certain period to estimate the latent reflectance on n different sample occasions at a certain location. Mixed models with sample occasions as random effects are useful to analyze data obtained under such setups. the intra-class correlation coefficient of the mean of the m measurements is an indicator of the reliability of the latent reflectance estimates. Our objective is to determine m in order to obtain a pre-specified reliability of the estimates, taking possible outliers into account. To illustrate the procedure, we consider an experiment conducted at the Laboratory of Experimental Air Pollution, University of São Paulo, Brazil (LPAE/FMUSP), where sets of m = 3 filters were exposed during 7 days on n = 9 different occasions at a certain location. the results show that the reliability of the latent reflectance estimates for each occasion obtained under homoskedasticity is k(m) = 0.74. A residual analysis suggests that the within-occasion variance for two of the occasions should be different from the others. A refined model with two within-occasion variance components was considered, yielding k(m) = 0.56 for these occasions and k(m) = 0.87 for the remaining ones. To guarantee that all estimates have a reliability of at least 80% we require measurements on m = 10 filters on each occasion. (C) 2014 the Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).INAIRA - Instituto Nacional de Avaliacao Integrada de Risco AmbientalConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Inst Math & Stat, BR-05508 São Paulo, BrazilUniv São Paulo, Sch Med, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilCNPq: 15/2008FAPESP: 2008/57717-6CNPq: 308613/2011-2Web of Scienc

Serviço Escola Interdisciplinar: perfil epidemiológico dos pacientes assistidos

Objective: To describe the epidemiological profile of the patients who attended the Interdisciplinary Service School. Methods: It is a retrospective study with descriptive analyzes of the sociodemographics, clinical, physical therapy, and pharmacy variables obtained from the medical records of the patients attended between 2016 and 2019. Results: Most of the patients were female (57,65%), adults (58,98%), brown-skinned (16,41%), married (33,70%), employed (38,14%), and the comorbidities most frequent were systemic arterial hypertension (58,70%) and diabetes mellitus (21,30%). The physical therapy attendance was mostly for chronic conditions (58,29%) and in traumatic-orthopedic (67,09%) and neurofunctional areas (23,37%). The problems related to medications most identified were the presence of adverse effects (26,85%) and misprescribed doses (20,00%). Conclusions: The analysis of the panorama regarding the prevalence of conditions and population characteristics allows the planning and direction of strategies to adapt the service, in order to offer more integrated care, aiming patient health as a whole and offering improved quality services to the population attended.Objetivo: Descrever o perfil epidemiológico dos pacientes atendidos no Serviço Escola Interdisciplinar, desde o início de seu funcionamento. Métodos: Trata-se de estudo retrospectivo que analisou de forma descritiva as variáveis sociodemográficas, clínicas, de atendimentos fisioterapêuticos e farmacêuticos dos prontuários dos pacientes atendidos entre 2016 e 2019. Resultados: A maioria dos pacientes atendidos foi do sexo feminino (57,65%), adultos (58,98%), pardos (16,41%), casados (33,70%) e empregados (38,14%) e as comorbidades mais frequentes foram hipertensão arterial sistêmica (58,70%) e diabetes mellitus (21,30%). Os atendimentos da fisioterapia foram, sobretudo, de condições crônicas (58,29%) e nas áreas traumato-ortopédica (67,09%) e neurofuncional (23,37%). Os problemas relacionados aos medicamentos mais identificados durante os atendimentos farmacêuticos foram presença de efeitos adversos (26,85%) e doses muito baixas (20,00%). Conclusões: A análise do panorama relativo à prevalência de condições e de características da população permite o planejamento e o direcionamento de estratégias para adequação do serviço, a fim de oferecer atendimentos mais integrados, voltados à saúde do indivíduo como um todo, e de melhor qualidade

Painel: a dívida externa dos países em desenvolvimento e o caso brasileiro

A publicação deste painel foge à tradição editorial desta revista, mas a leitura da transcrição da fita gravado nos levou a esta decisão

The Multifunctional LigB Adhesin Binds Homeostatic Proteins with Potential Roles in Cutaneous Infection by Pathogenic Leptospira interrogans

Leptospirosis is a potentially fatal zoonotic disease in humans and animals caused by pathogenic spirochetes, such as Leptospira interrogans. The mode of transmission is commonly limited to the exposure of mucous membrane or damaged skin to water contaminated by leptospires shed in the urine of carriers, such as rats. Infection occurs during seasonal flooding of impoverished tropical urban habitats with large rat populations, but also during recreational activity in open water, suggesting it is very efficient. LigA and LigB are surface localized proteins in pathogenic Leptospira strains with properties that could facilitate the infection of damaged skin. Their expression is rapidly induced by the increase in osmolarity encountered by leptospires upon transition from water to host. In addition, the immunoglobulin-like repeats of the Lig proteins bind proteins that mediate attachment to host tissue, such as fibronectin, fibrinogen, collagens, laminin, and elastin, some of which are important in cutaneous wound healing and repair. Hemostasis is critical in a fresh injury, where fibrinogen from damaged vasculature mediates coagulation. We show that fibrinogen binding by recombinant LigB inhibits fibrin formation, which could aid leptospiral entry into the circulation, dissemination, and further infection by impairing healing. LigB also binds fibroblast fibronectin and type III collagen, two proteins prevalent in wound repair, thus potentially enhancing leptospiral adhesion to skin openings. LigA or LigB expression by transformation of a nonpathogenic saprophyte, L. biflexa, enhances bacterial adhesion to fibrinogen. Our results suggest that by binding homeostatic proteins found in cutaneous wounds, LigB could facilitate leptospirosis transmission. Both fibronectin and fibrinogen binding have been mapped to an overlapping domain in LigB comprising repeats 9–11, with repeat 11 possibly enhancing binding by a conformational effect. Leptospirosis patient antibodies react with the LigB domain, suggesting applications in diagnosis and vaccines that are currently limited by the strain-specific leptospiral lipopolysaccharide coats

Influence of the interaction between nodal fibroblast and breast cancer cells on gene expression

Our aim was to evaluate the interaction between breast cancer cells and nodal fibroblasts, by means of their gene expression profile. Fibroblast primary cultures were established from negative and positive lymph nodes from breast cancer patients and a similar gene expression pattern was identified, following cell culture. Fibroblasts and breast cancer cells (MDA-MB231, MDA-MB435, and MCF7) were cultured alone or co-cultured separated by a porous membrane (which allows passage of soluble factors) for comparison. Each breast cancer lineage exerted a particular effect on fibroblasts viability and transcriptional profile. However, fibroblasts from positive and negative nodes had a parallel transcriptional behavior when co-cultured with a specific breast cancer cell line. The effects of nodal fibroblasts on breast cancer cells were also investigated. MDA MB-231 cells viability and migration were enhanced by the presence of fibroblasts and accordingly, MDA-MB435 and MCF7 cells viability followed a similar pattern. MDA-MB231 gene expression profile, as evaluated by cDNA microarray, was influenced by the fibroblasts presence, and HNMT, COMT, FN3K, and SOD2 were confirmed downregulated in MDA-MB231 co-cultured cells with fibroblasts from both negative and positive nodes, in a new series of RT-PCR assays. In summary, transcriptional changes induced in breast cancer cells by fibroblasts from positive as well as negative nodes are very much alike in a specific lineage. However, fibroblasts effects are distinct in each one of the breast cancer lineages, suggesting that the inter-relationships between stromal and malignant cells are dependent on the intrinsic subtype of the tumor