Influence of slow sand filter cleaning process type on filter media biomass: backwashing versus scraping

Biomass was assessed as a new approach for evaluating backwashed slow sand filters (BSF). Slow sand filtration (SSF) is a simple technology for water treatment, where biological mechanisms play a key role in filtration efficiency. Backwashed slow sand filters were previously recommended for small-scale filters (~1 m² of filtration area) as an alternative to conventional filters that are usually cleaned by scraping (ScSF). Biomass was never evaluated in BSF, which is a gap in the knowledge of this technology, considering the importance of its biological mechanisms. Therefore, for the first time, two filters operating under the same conditions were used to compare the influence of backwashing on biomass; one filter was cleaned by backwashing and the other by scraping. Biomass along the filter media depth (40 cm) was assessed by different techniques and compared in terms of cellular biomass (by chloroform fumigation), volatile solids, bacterial community (by 16S rRNA gene sequencing), and observations by scanning electron and fluorescence microscopy. Filters were also monitored and compared regarding filtered water quality and headloss; their differences were related to the different cleaning processes. Overall, filtered water quality was acceptable for slow sand filter standards (turbidity 1 log). However, headloss developed faster on scraped filters, and biomass was different between the two filters. Backwashing did not significantly disturb biomass while scraping changed its surface sand layers. Cell biomass was more abundant and spread across the filtration depth, related to lower headloss, turbidity, and cyanobacterial breakthrough. These results agreed with the water quality and microscopy observations. The bacterial community was also less stratified in the backwashed filter media. These results expand the knowledge of backwashing use in slow sand filters, demonstrating that this process preserves more biomass than scraping. In addition, biomass preservation can lead to bacterial selectivity and faster filter ripening. Considering the importance of biomass preservation on slow sand filtration and its biological filtration mechanisms, the results presented in this paper are promising. The novel insight that BSF can preserve biomass after backwashing may contribute to increasing its application in small communities

Frequency of Chlamydia trachomatis infection in cervical intraepithelial lesions and the status of cytological p16/Ki-67 dual-staining

Background: Chlamydia trachomatis (Ct) is not a disease subject to mandatory reporting in Brazil, and the prevalence rate of this genital infection varies according to the region in which studies are conducted, as well as by the detection technique employed. Ct has been associated with persistence of Human papillomavirus (HPV) infection and the facilitation of cervical carcinoma development. We evaluated the Chlamydia trachomatis infection and its association with cytology, p16/Ki-67 dual-stained cytology and cervical intraepithelial lesions status in a screening cohort in Brazil. Methods: This was a cross-sectional study of 1481 cervical samples from asymptomatic women aged 18 to 64. Samples were collected for liquid-based cytology and Ct detection by polymerase chain reaction. p16/Ki-67 double staining was performed on samples with abnormal cytology. Statistical analysis was by chi-square and likelihood-ratio tests. Odds ratio (OR) and 95% confidence intervals (95% CI) were determined. Results: The frequency of Ct was 15.6% and its presence was not associated with detection of p16/Ki-67 [OR = 1. 35 (0.5-3.4)]. There was also no association between abnormal cervical cytology and Ct-positivity [OR = 1.21 (0.46-3.2)]. Associations were observed between p16/Ki-67 and high-grade lesions detected by cytology and in biopsies [OR = 3.55 (1.50-8.42) and OR = 19.00 (0.6-7.2), respectively]. Conclusions: The asymptomatic women in our study had a high frequency of Ct infection but this was not associated with p16/Ki-67 detection in samples with abnormal cytology. The expression of p16/Ki-67 was highest in women with high-grade CIN (p = 0.003).info:eu-repo/semantics/publishedVersio

Depression among women living in the outskirts of São Paulo, Southeastern Brasil

OBJECTIVE: To assess the meaning of depression in women diagnosed with the disorder, and the context of care given by the psychiatrists who follow them up. METHODS: Qualitative study performed in Embu, outskirt of São Paulo, between August 2002 and January 2003. Etnographic observation and in-depth interview were carried out with 16 women diagnosed with depression in primary care, and four psychiatrists. After exhaustive reading, data were grouped into categories and assessed. The assessment of outcomes was based on the concept of culture. RESULTS: Women interviewed are well aware of the disorder, and accept treatment based on medication. For psychiatrists, depression is a term understood by the common sense. All women interviewed identified the onset of the disease from a past event such as: death of a son, violent episodes connected with drug traffic, unemployment, and partners' aggressiveness. Violence was common in the every day life of the interviewed women both inside and outside their homes. CONCLUSIONS: For these women, depression is a way to express their feelings, such as unhappiness in a context of poverty and violence. Psychiatrists go beyond their clinical functions and play an important role on reorganizing the daily life of these women.OBJETIVO: Analisar o significado da depressão para mulheres diagnosticadas com o transtorno e o contexto do atendimento realizado pelos psiquiatras que as acompanham. MÉTODOS: Estudo qualitativo realizado no município de Embu, na Grande São Paulo, entre agosto de 2002 e janeiro de 2003. Foram realizadas observação etnográfica e entrevistas em profundidade com 16 mulheres diagnosticadas com depressão, pacientes de uma Unidade Básica de Saúde, e quatro psiquiatras. Após a leitura exaustiva, os dados foram agrupados em categorias e analisados. A interpretação dos resultados baseou-se no conceito de cultura. RESULTADOS: As entrevistadas tinham ampla noção do transtorno, aceitando o tratamento com medicação. Para os psiquiatras, a depressão é um termo assimilado pelo senso-comum. Todas as entrevistadas identificaram a origem da doença em eventos passados, como: morte de filho, episódios violentos ligados ao tráfico de drogas, desemprego e agressividade do companheiro. A violência era comum no cotidiano das entrevistadas, tanto fora como dentro de casa. CONCLUSÕES: Para essas mulheres, a depressão era uma forma de expressar sentimentos, como a infelicidade num contexto de pobreza e violência. Os psiquiatras extrapolam as suas funções clínicas e têm um papel na reorganização do cotidiano dessas mulheres.Universidade Católica de Santos Programa de Mestrado em Saúde ColetivaUniversidade Federal de São Paulo (UNIFESP) Departamento de PsiquiatriaUNIFESP, Depto. de PsiquiatriaSciEL

The evolution of sex-specific virulence in infectious diseases

Fatality rates of infectious diseases are often higher in men than women. Although this difference is often attributed to a stronger immune response in women, we show that differences in the transmission routes that the sexes provide can result in evolution favouring pathogens with sex-specific virulence. Because women can transmit pathogens during pregnancy, birth or breast-feeding, pathogens adapt, evolving lower virulence in women. This can resolve the long-standing puzzle on progression from Human T-cell Lymphotropic Virus Type 1 (HTLV-1) infection to lethal Adult T-cell Leukaemia (ATL); a progression that is more likely in Japanese men than women, while it is equally likely in Caribbean women and men. We argue that breastfeeding, being more prolonged in Japan than in the Caribbean, may have driven the difference in virulence between the two populations. Our finding signifies the importance of investigating the differences in genetic expression profile of pathogens in males and females

Laboratory services contribution to supporting public health and health services in Portuguese-speaking countries

Objetivo: promover o debate sobre a importância do laboratório no apoio à saúde pública e aos serviços de saúde nos países de língua portuguesa, numa perspetiva global e de uma só saúde. Métodos: revisão de literatura, análise dos documentos preparatórios das comunicações do 5º Congresso Nacional de Medicina Tropical, apresentações realizadas pelos oradores de Cabo Verde, Angola e Portugal e o debate que se seguiu. Resultados: identificaram-se os desafios que deverão ser ultrapassados de forma a criar uma rede de laboratórios de diagnóstico que possa estimular o acesso universal das populações aos cuidados de saúde, tendo-se proposto medidas e estratégias com base na experiência dos sistemas de saúde dos diferentes países de língua portuguesa. Reviu-se o contributo dos Laboratórios do IHMT/NOVA para esta estratégia. Conclusão: não há acesso universal a cuidados de saúde de qualidade sem serviços de diagnóstico laboratorial de qualidade. Assim, deve-se promover uma correta, eficaz e sustentável inter-relação entre laboratórios de referência nacionais, hospitalares e privados e ainda laboratórios de investigação, todos cooperando em sintonia com os serviços de saúde de modo a garantir os melhores cuidados de saúde. Objective: To promote the debate on the importance of the laboratory services in supporting public health and health services in Portuguese-speaking countries, from a global and One Health perspective. Methods: literature review, analysis of the preparatory papers for the 5th Tropical Medicine National Congress, presentations by speakers from Cape Verde, Angola and Portugal and the ensuing debate. Results: we identified the challenges that must be overcome in order to create a network of diagnostic laboratories that can stimulate universal access to health care for the populations. Measures and strategies based on the experience of health systems in different Portuguese-speaking countries are proposed. The contribution of the IHMT/NOVA Laboratories to this strategy was reviewed. Conclusion: There is no universal access to quality health care with-out quality laboratory diagnostic services and without promoting a correct, effective and sustainable interrelationship between national reference laboratories, hospital and private, and research laboratories, all cooperating in line with health services to ensure the best quality health care.publishersversionpublishe

Identifying Variability in Process Performance Indicators

The performance perspective of business processes is concerned with the definition of performance requirements usually specified as a set of Process Performance Indicators (PPIs). Like other business process perspectives such as control-flow or data, there are cases in which PPIs are subject to variability. However, although the modelling of business process variability (BPV) has evolved significantly, there are very few contributions addressing the variability in the performance perspective of business processes. Modelling PPI variants with tools and techniques non-suitable for variability may generate redundant models, thus making it difficult its maintenance and future adaptations, also increasing possibility of errors in its managing. In this paper we present different cases of PPI variability detected as result of the analysis of several processes where BPV is present. Based on an existent metamodel used for defining PPIs over BPs, we propose its formal extension that allows the definition of PPI variability according to the cases identified.Ministerio de Economía y Competitividad TIN2015-70560-RJunta de Andalucía P12-TIC-1867Junta de Andalucía P10-TIC-590

Valor do EEG na caracterização e prognóstico de patologias neurológicas em recém-nascidos prematuros

A importância do EEG na investigação de patologias neurológicas no período neonatal tem sido discutido com frequência na atualidade, pois muitas vezes este é o único meio de avaliar a função cerebral em recém-nascidos (RN) com patologias graves ou sob efeito de medicações. O presente estudo foi realizado com 85 RN prematuros que apresentaram patologias neurológicas no período neonatal e foram submetidos a avaliação neurológica e eletrencefalográfica (EEG ou polissonografia -PS). Foram relacionadas alterações do EEG, patologias e prognóstico. Os EEGs foram classificados segundo as alterações da atividade de base, presença de atividade paroxística, organização dos estágios do sono e "maturidade". A patologia mais frequente foi asfixia perinatal (40%), seguida de hemorragia intra-ventricular (HIV, 16%). A queixa mais frequente na indicação do exame foi apnéia (71 %), seguida de convulsões (19%). Foram considerados normais 55% dos exames solicitados com queixa exclusiva de apnéia; dos exames solicitados por convulsões somente 31 % foram normais. A alteração do EEG mais frequentemente encontrada nos RN com asfixia, HIV e desnutrição intra-uterina foi a "imaturidade" da atividade elétrica cerebral. Nos RN com convulsões as alterações mais frequentes do EEG foram atividade paroxística anormal e "imaturidade". Os RN com infecção do sistema nervoso central apresentaram diversas alterações no EEG. Os achados de EEG mais correlacionados a mau prognóstico foram isoeletricidade e atividade paroxística anormal (100% dos casos com presença de ondas agudas positivas).The importance of the EEG for the investigation of neurological diseases in the neonatal period has been largely discussed, since it is often the only way to approach cerebral function in newborns with severe pathologies or under drug effect. The present study was carried out with 85 newborns (NB) who presented perinatal dysfuntions and were submitted to neurological and electroencephalogram (EEG) or polysomnography (PS) evaluation. EEG/PS alterations, pathologies and prognosis were reported. The EEG were classified according to basal activity alterations, presence of paroxysmal activity and sleep stages organization and maturity. The most frequent pathology was perinatal asphyxia (40%) followed by intraventricular hemorrhage (HIV, 16%). The most frequent complaint for exam indication was apnea (71%) followed by convulsion (19%). Fifty-five percent of the exams exclusively required because apnea complaint were considered normal and out of all exams required because seizures only 31 % were normal. The EEG alteration most frequently related to perinatal asphyxia, HIV and intrauterine growth delay was immaturity and in the NB with seizures immature EEG and abnormal paroxysms. Many different alterations were registered in the NB with nervous system infection. The EEG findings more correlated with unfavorable prognosis were isoelectricity and abnormal paroxysmal activity including positive sharp waves (100%)