Qualificação da iluminação natural em interiores: aplicação das redes neurais artificiais e 3DSkyView

Environmental comfort in public school buildings is not often seen as a project requirement, due to the difficulty in considering all comfort-related architectural variables at once. This paper focuses on the level of illuminance in classrooms, by defining the importance and the relationship among visual comfort variables. The research method consisted of the observation of the users’ behaviour under different conditions of illuminance levels in the environment. Two methodological tools have been applied: the 3DSkyView extension, which was used for determining sky view factors, and artificial neural networks, which were applied for modelling the relationships between variables. The results indicate that students are used to develop tasks, either under too high, or under too low illuminance levels. The sky view factor (SVF) has presented the highest relevance for visual comfort among all variables investigated, assuming an importance level of 21% in May and 37,1% in November.O conforto ambiental em arquitetura de escolas públicas não é considerado sistematicamente requisito de projeto, sendo um dos obstáculos a impossibilidade de maximizar todas as variáveis do conforto simultaneamente. Este artigo analisa o nível de iluminância de sala de aula, definindo a importância e as relações entre as variáveis do conforto luminoso. O método de pesquisa consiste em uma análise através da observação comportamental e medições dos níveis de iluminância no ambiente. Faz-se uso de duas ferramentas metodológicas: a extensão 3DSkyView, como forma de obter a variável Fator de Visão do Céu (fator de forma), e as Redes Neurais Artificiais, como ferramenta de modelagem das relações entre as variáveis levantadas. Os resultados mostraram que os estudantes estão habituados a realizar tarefas com valores de iluminância baixos ou altos demais. A variável fator de visão do céu (FVC) apresentou os maiores valores de importância para o conforto visual, sendo 21% para o mês de maio e 37,1% para o mês de novembro

ANÁLISES DE MÉTODOS DE AVALIAÇÃO DE PROJETOS

Proposal: Studies on the State Foundation for the Development of Education (Fundação para o Desenvolvimento da Educação – FDE) design process show that professionals working for this foundation need support during the design process, especially to verify designs under development. This paper analyses design evaluation methods to verify the applicability for the construction of a specific method to evaluate school building designs in the State of São Paulo. Methods: A survey was held and three methods were selected for analysis: DQI for Schools (Design Quality Indicator), (DQI, 2010), the method called “Evaluation method for school building design with optimization of aspects of environmental comfort” (GRAÇA & KOWALTOWSKI, 2004) and Comparative floorplan analysis (VOORDT, VRIELINK & WEGEN, 1997). The sample is composed of school building designs documented by FDE (2006). Results: The results of the analysis of the three methods highlight the necessities for a school building design evaluation method that includes specific instruments to analyse both objective and subjective data within its structure. Design evaluation requires objectivity both in the application of the method and in result visualization, alongside a quick return of information to support the architectural design process. Essential also is the inclusion of specific design requirements for local conditions.Proposta: Estudos sobre o processo de projeto da Fundação para o Desenvolvimento da Educação (FDE) mostraram que os profissionais necessitam de apoio, especialmente para a verificação de projetos ainda em desenvolvimento. Este trabalho tem o objetivo de analisar métodos de avaliação de projetos a fim de verificar a aplicabilidade de seus elementos para a construção de um método que seja específico para projetos de edificações escolares do Estado de São Paulo. Método de pesquisa/Abordagens: Um levantamento foi realizado e três métodos foram selecionados para a análise: Design Quality Indicator (DQI for Schools), (DQI, 2010), o “Método de Avaliação de Conforto Ambiental de Projetos Escolares – otimização multi-critérios” (GRAÇA & KOWALTOWSKI, 2004) e Comparative floorplan analysis (VOORDT, VRIELINK & WEGEN, 1997). A amostra é composta dos projetos de edificações escolares documentados pela FDE (2006). Resultados: Os resultados confirmam a necessidade da criação de um método de avaliação de projetos escolares que inclua em sua estrutura instrumentos específicos para a análise de dados objetivos e subjetivos. A avaliação de projetos requer objetividade tanto no processo de aplicação do método quanto na visualização dos resultados, além de um retorno rápido das informações para apoiar o processo de projeto em arquitetura

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Estudo das variáveis do conforto térmico e luminoso em ambientes escolares

O desempenho do usuário em um ambiente está diretamente ligado às condições de conforto e estética oferecidas por aquele ambiente, inserindo-se no contexto dos estudos ergonômicos. Considerando-se espaços escolares, estas relações do usuário com o ambiente têm um caráter ainda mais importante, por refletir-se no próprio processo de aprendizado. É sob este aspecto que esta pesquisa se concentra, procurando estabelecer, qualificar e posteriormente quantificar variáveis que indiquem níveis de conforto ambiental para usuários de edificações escolares. É considerada a cidade de Bauru como área de estudo e dentro da linha ergonômica, visa estudar dois parâmetros de conforto ambiental especificamente: conforto térmico e conforto luminoso. Três escolas municipais são selecionadas e analisadas, definindo variáveis que abrangem três aspectos: pessoal, climático e constutivo. É feito um modelo de previsão de índice de satisfação térmica do usuário e de grau de iluminância de sala de aula. As importâncias relativas de cada variável são definidas através de testes de sensibilidade, valendo-se de redes neurais artificiais como ferramenta de modelação.The performance of users in an environment is directly related to the conditions of comfort and aesthetics offered by that environment, and it is part of the ergonomic studies field. Considering school environments, this relationship of the user with the environment is even more important, due to its influence in the learning process. This is the subject of this research, which establishes, qualifies and quantifies the variables that show the levels of environmental comfort for school users. The case study is the city of Bauru, and from the ergonomic point of view, two parameters of the environmental comfort are considered: thermal comfort and lighting comfort. Three public schools of the municipality are selected and analyzed for the determination of variables that incoude three aspects: personal, climatic and constructive. A prediction model is developed in order to simulate the level of user's satisfaction. The relative importance of each variable is determined by sensitivity tests using artificial neural network modeling tools.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

An analysis method based on precedents to support public school design in the State od São Paulo

Orientador: Doris Catharine Cornelie Knatz KowaltowskiTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e UrbanismoResumo: Os projetos de edificações escolares do Estado de São Paulo são gerenciados pela Fundação para o Desenvolvimento da Educação (FDE). Estudos sobre seu processo de projeto mostram que a Fundação apresenta um processo de projeto linear e com poucas fases de verificação. Os manuais e catálogos da FDE têm a vantagem de serem organizados e detalhados, mas apresentam um formato compatível com o processo de projeto rígido aplicado pela Fundação. Os arquitetos que projetam escolas para a FDE mostraram necessidade de apoio ao seu processo, principalmente sobre questões que tangem o estímulo e reflexão sobre o projeto e aumento do repertório. Este trabalho tem como objetivo principal criar um método que apóie o desenvolvimento dos projetos de edificações escolares da FDE. A hipótese é de que através do conhecimento adquirido sobre a morfologia de métodos de avaliação e análise de projetos propostos pela literatura é possível desenvolver um método que seja compatível com o contexto da FDE e também com as necessidades evidenciadas pelos arquitetos. Um levantamento foi realizado e três métodos foram selecionados para a análise: Design Quality Indicator (DQI) for Schools, a "Metodologia de avaliação de conforto ambiental de projetos escolares - otimização multicritério" e Comparative Floorplan-Analysis (CFA). Os resultados da análise desses três métodos evidenciaram aspectos que suportam o desenvolvimento do método para a FDE, como os requisitos específicos para a arquitetura escolar, a representação de resultados para atributos isolados e a decomposição do projeto em soluções; esse último suportado pela análise de precedentes destacada na literatura. O método elaborado para a FDE é composto de "grade conceitual", metodologia para definição da amostra, estrutura para análise dos projetos e procedimentos que analisam a ocorrência das relações entre soluções e requisitos funcionais. Foram analisados 34 projetos da FDE e projetos exemplares da arquitetura escolar, determinando quadros de evidências que suportam a consulta de soluções. Tem-se como resultado que o método é um instrumento favorável para sistematizar a tomada de decisão. Prevê-se a inserção do método em um sistema de banco de dados para projetos de edificações escolaresAbstract: School building designs in the State of São Paulo are managed by the Foundation for Educational Development (Fundação para o Desenvolvimento da Educação - FDE). Studies on the FDE design process show that this Foundation adopts a linear process with few evaluation phases. The process is based on catalogues and manuals which are detailed and well organized, but used within a rigid design process. Professionals working for this Foundation need support during the design process, especially to stimulate reflection on the various aspects of school design and its repertoire to verify design proposals still under development. The main goal of this study is to propose a method to support the design process of FDE's school buildings. The hypothesis states that through knowledge acquired on the morphology of evaluation methods and analysis of exemplary designs presented in the literature it is possible to develop a method that is compatible with the context of FDE and also to the specific needs highlighted by the architects working for FDE. A survey was conducted and three methods were selected: DQI for Schools (Design Quality Indicator), "Metodologia de avaliação de conforto ambiental de projetos escolares - otimização multicritério" and the method "Comparative Floorplan-Analyses" (CFA). The results of the analysis of these three methods indicated those aspects that should be the basis of a design evaluation method for FDE. These were: specific requirements for school architecture, the representation of results for isolated attributes and the decomposition of design solutions. The latter supported by the analysis of precedents found in the literature on school architecture. The method developed for FDE is composed of a structure of concepts to define the sample, a framework for the analysis of designs and procedures that examine the occurrence of relationships between functional requirements and solutions or proposals. 34 designs, both of FDE and exemplary school projects, were analyzed to determine the presence of these concepts for solutions. This analysis showed that the method is an efficient instrument for decision making during a school design process, which is seen as having a potential to be transformed, through future studies, into a database for school designDoutoradoArquitetura, Tecnologia e CidadeDoutora em Arquitetura, Tecnologia e Cidad