Spatial distribution of the positivity of Schistosomiasis mansoni in Maranhao State, Northeastern Brazil, from 2007 to 2016

Schistosomiasis is considered one of the Neglected Tropical Diseases (NTDs), which affects around 240 million people worldwide. In Brazil, Schistosomiasis mansoni has been registered in 19 states, predominantly in rural areas. This study aimed to analyze the spatial distribution of Schistosomiasis mansoni cases in the Maranhao State from 2007 to 2016, as well as the temporal trend over this period. The data were obtained from secondary sources: Schistosomiasis Control Program of Maranhao (PCE-MA) and Information System for Notifiable Diseases (SINAN). The State Health Regions (HRs) were considered analysis units. Maranhao had a positivity rate of 3.8 for the period. The Regions that presented the highest percentages of positivity in the state were Pinheiro (7.92), Ze Doca (3.30), and Viana (3.10). Municipalities such as Bacuri, Serrano do Maranhao, and Bequimao, located in the Pinheiro HR, showed positivity rates of 16.56, 13.31, and 11.01 respectively. The spatial analysis of schistosomiasis cases showed that Maranhao has two main centers for the spread of the disease, both located in the northern portion of the state, namely the Baixada Maranhense and the east coast. This study concluded that the positivity of Schistosomiasis mansoni in Maranhao was stable over the analyzed period. The state still maintains the Baixada Maranhense micro-region as an important area for the spread of the disease reaching socially vulnerable population groups

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Indices of water quality for human consumption: modeling and influence of the use and occupation of land

Este trabalho teve como objetivo a modelagem de índices de qualidade da água pelo uso de análise de componentes principais e redes neurais artificiais para bacia do ribeirão São Bartolomeu no município de Viçosa, Minas Gerais, Brasil e avaliar a influência do uso e ocupação do solo nas variáveis de qualidade da água. Foram monitoradas, no período de outubro de 2009 a setembro de 2010, as variáveis oxigênio dissolvido, demanda bioquímica de oxigênio, fósforo, nitrogênio total, cor aparente, E. Coli, coliformes totais, turbidez, sólidos totais, temperatura, alumínio, cádmio, cromo, zinco, ferro, manganês, níquel e (oo) cistos de protozoários (Giardia e Cryptosporidium). Testes de adequacidade Kayser-Mayer-Olkim (KMO), de esfericidade de Bartlett e de normalidade pelo teste Kolmogorov-Smirnov indicaram que as análises poderiam ser realizadas. Os índices modelados pelo uso de análise de componentes principais (ACP) e de redes neurais artificiais (RNAs) apresentaram resultados semelhantes aos calculados pelo método desenvolvido pela Cetesb (Companhia Ambiental do Estado de São Paulo, Brasil). As variáveis oxigênio dissolvido, turbidez, nitrogênio total, cor e pH foram as que mais apareceram nos modelos, devendo ser mantidas, impreterivelmente, nos programas de monitoramentos da qualidade da água. Agricultura, café, pastagem degradada e piscicultura foram os usos do solo mais impactantes na degradação da qualidade da água. Áreas ocupadas com pastagem não degradada e formações florestais favoreceram uma melhor proteção dos solos e melhor qualidade da água. Os índices modelados selecionaram variáveis ajustadas às condições socioeconômicas da bacia, no entanto, novos estudos precisam ser desenvolvidos para avaliar a capacidade de generalização desses modelos em outras condições socioeconômicas e ambientais diferentes das encontradas na bacia do ribeirão São Bartolomeu.This study aimed the modeling of water quality indexes by using principal component analysis and artificial neural networks to São Bartolomeu watershed, in Viçosa, Minas Gerais, Brazil. It also concerned the evaluation of the influence of soil use and occupation on water quality variables. The following variables were monitored in the period from October 2009 to September 2010: dissolved oxygen, biochemical oxygen demand, phosphorus, total nitrogen, apparent color, E. coli, total coliform, turbidity, total solids, temperature, aluminum, cadmium, chromium, zinc, iron, manganese, nickel, and (oo) cysts, protozoan (Cryptosporidium and Giardia). Tests of adequacy (Kayser-Mayer-Olkim (KMO) and Bartlett's sphericity) and normality (Kolmogorov Smirnov) indicated the analyses could be performed. The indices modeled by using principal component analysis (PCA) and artificial neural networks (ANN) showed similar results to those calculated by the method developed by Cetesb (The Environmental Company of the State of São Paulo, Brazil). The variables dissolved oxygen, turbidity, total nitrogen, pH and color were the most apparent in the models and should necessarily be maintained in water quality monitoring programs. Agriculture, coffee, degraded pasture and fish-farming were the uses of soil that most strongly deteriorated water quality. Areas occupied by forest and non degraded grassland favored soil protection and a better water quality. The modeled indices selected variables which were adjusted to the socioeconomic conditions in the studied area, however, new studies are needed to evaluate the generalization of these models in other areas which hold distinct socioeconomic and environmental conditions than those from São Bartolomeu watershed.Conselho Nacional de Desenvolvimento Científico e Tecnológic

A logic synthesis approach to silicon compilation

Progress in digital technology has yielded continuing growth in the complexity of circuits that can be packed in a chip. As a consequence, reduced costs and miniaturization widen the range of application of custom-made or VLSI (Very Large Scale Integration) circuits. However, traditional design methodologies have failed to fulfil the requirements of VLSI design. An emerging approach, silicon compilation, proposes VLSI design by automated synthesis of hardware specification from an abstract circuit description. This thesis concerns the development of a low cost VLSI design tool which takes a high level description of a digital circuit and produces a mask layout specification. A circuit description languge, BELA, its compiler, and a functional simulator were designed and implemented. Also, an independent software package was developed to support the compiler in the process of synthesis. The tool is directed towards synchronous circuits; at present, the compiler produces a PLA (Programmable Logic Array) implementation although other implementations are possible. The two main applications envisaged are design of controllers based on finite state machines and design of arithmetic and logic circuit cells. Favourable experimental results concerning those applications were obtained. The distinguishing aspects in this work are the input language and the logic synthesis method developed. A BELA program is an algorithm describing a circuit behaviour; the compiler extracts a physical structure to implement this behaviour. The high level of the input demanded an emphasis on the logic synthesis process. This process integrates various design techniques, including extensive verification and minimization, whose automation benefits from the logic function formalism underlying the synthesis method. (D82642)</p

Un estudio sobre jardines históricos: manifestaciones del paisaje cultural en la ciudad de Natal/rn, Brasil

This article deals with the Historical Gardens in the city of Natal and ponders: Why do attempts to revitalize our historicalcenter not reach their goals? Why are public open areas abandoned by the population, so that they start deterioratingagain? The study tries to identify, to recognize and to alert for the necessity to preserve the Historical Gardens, tryingto be effective guaranteeing that the historical and cultural landscape remains and will be available for future generations.In order to give an account of history through its urban prints, our research stands between history of everydaylife and cultural geography, choosing culture – ways of life, habits, sense of identity and everyday life– as a componentof the relations between man and the space that surrounds him. Therefore, a historiographic reconstruction was carriedout, using photographic records and literary descriptions, to turn previous morphologic compositions into virtualreality. The procedure shall be adopted in eight parks, previously identified as Natal’s Historical Gardens. The caseof Augusto Severo Square, covered here, deals with a previous restoration during which a large esplanade was built,lacking vegetation and inappropriate given local climate and habits. Since the opportunity of cultural rescue has beenlost, at this moment, we expect that the area will recover its place in people’s memory and daily life.Este trabajo trata de los Jardines Históricos de Natal y cuestiona: ¿Por qué los intentos de revitalización de nuestroCentro Histórico no alcanzan sus objetivos y los espacios libres públicos son abandonados por la población, tornándosenuevamente decadentes? El estudio pretende identificar, reconocer y alertar sobre la necesidad de preservarlos Jardines Históricos, evitando desperdicios y garantizando la permanencia histórica del paisaje cultural para lasgeneraciones futuras. Buscando relatar la historia a partir de sus marcas urbanas, la investigación se coloca entre laHistoria cotidiana y la Geografía Cultural, eligiendo la cultura –modos de vida, costumbres, sentimientos de identidady usos cotidianos – como componente de las relaciones entre hombre y espacio. Para alcanzar tales objetivos, seaplicó una reconstitución historiográfica, partiendo de registros fotográficos y descripciones literarias, con objeto detransformar composiciones morfológicas anteriores en realidad virtual. El procedimiento será adoptado en ocho plazas,identificadas preliminarmente como Jardines Históricos de Natal. El caso de la Plaza Augusto Severo, aquí presentado,alude a una pretendida restauración que resultó en una gran explanada sin cobertura vegetal, inadecuada para elclima y los hábitos locales. Ya perdida, en este momento, la oportunidad de rescate cultural, se espera que el espacioreconquiste su lugar en la memoria y vida cotidiana de la población

Mulheres no cárcere: Uma revisão de literatura sobre a realidade das mulheres encarceradas

O aumento da quantidade de mulheres encarceradas nos sistemas prisionais, crescem exponecialmente nas últimas décadas. Embora com participação reduzida em relação aos homens na criminalidade, há violação e desigualdade de seus direitos, e invisibilidade das políticas públicas que deveriam garantir o seu regresso a sociedade em condições adequadas. Nesse contexto, objetiva-se compreender a realidade e as singularidades do sistema carcerário feminino no Brasil e no mundo. O presente estudo desenvolveu extensa revisão de literatura, com base em estudos científicos sobre as mulheres encarceradas. A pesquisa desenvolvida, identificou a necessidade da implementação de diferentes metodologias que visam avaliar a realidade das mulheres encarceradas, bem como o desenvolvimento e redirecionamento de políticas públicas ligadas as mulheres nos sistemas prisionais e setores da sociedade

Mulheres no cárcere: Uma revisão de literatura sobre a realidade das mulheres encarceradas

The increase in incarcerated women in prison systems has grown exponentially in recent decades. Although with reduced participation in relation to men in crime, there is a violation and inequality of their rights, and invisibility of public policies that should guarantee their return to society in adequate conditions. In this context, the objective is to understand the reality and the singularities of the female prison system in Brazil and in the world. The present study has developed an extensive literature review, based on scientific studies on incarcerated women. The research developed, identified the need to implement different methodologies that aim to assess the reality of incarcerated women, as well as the development and redirection of public policies related to women in prison systems and sectors of society.El aumento de la cantidad de mujeres encarceladas en los sistemas penitenciarios ha crecido exponencialmente en las últimas décadas. Aunque con una participación reducida en relación con los hombres en el crimen, existe una violación y desigualdad de sus derechos, y la invisibilidad de las políticas públicas que deberían garantizar su retorno a la sociedad en condiciones adecuadas. En este contexto, el objetivo es comprender la realidad y las singularidades del sistema penitenciario femenino en Brasil y en el mundo. El presente estudio ha desarrollado una extensa revisión de la literatura, basada en estudios científicos sobre mujeres encarceladas. La investigación desarrollada identificó la necesidad de implementar diferentes metodologías que tengan como objetivo evaluar la realidad de las mujeres encarceladas, así como el desarrollo y la redirección de políticas públicas relacionadas con las mujeres en los sistemas penitenciarios y sectores de la sociedad.O aumento da quantidade de mulheres encarceradas nos sistemas prisionais, crescem exponecialmente nas últimas décadas. Embora com participação reduzida em relação aos homens na criminalidade, há violação e desigualdade de seus direitos, e invisibilidade das políticas públicas que deveriam garantir o seu regresso a sociedade em condições adequadas. Nesse contexto, objetiva-se compreender a realidade e as singularidades do sistema carcerário feminino no Brasil e no mundo. O presente estudo desenvolveu extensa revisão de literatura, com base em estudos científicos sobre as mulheres encarceradas. A pesquisa desenvolvida, identificou a necessidade da implementação de diferentes metodologias que visam avaliar a realidade das mulheres encarceradas, bem como o desenvolvimento e redirecionamento de políticas públicas ligadas as mulheres nos sistemas prisionais e setores da sociedade

Un estudio sobre jardines históricos: manifestaciones del paisaje cultural en la ciudad de Natal/rn, Brasil

This article deals with the Historical Gardens in the city of Natal and ponders: Why do attempts to revitalize our historicalcenter not reach their goals? Why are public open areas abandoned by the population, so that they start deterioratingagain? The study tries to identify, to recognize and to alert for the necessity to preserve the Historical Gardens, tryingto be effective guaranteeing that the historical and cultural landscape remains and will be available for future generations.In order to give an account of history through its urban prints, our research stands between history of everydaylife and cultural geography, choosing culture – ways of life, habits, sense of identity and everyday life– as a componentof the relations between man and the space that surrounds him. Therefore, a historiographic reconstruction was carriedout, using photographic records and literary descriptions, to turn previous morphologic compositions into virtualreality. The procedure shall be adopted in eight parks, previously identified as Natal’s Historical Gardens. The caseof Augusto Severo Square, covered here, deals with a previous restoration during which a large esplanade was built,lacking vegetation and inappropriate given local climate and habits. Since the opportunity of cultural rescue has beenlost, at this moment, we expect that the area will recover its place in people’s memory and daily life.Este trabajo trata de los Jardines Históricos de Natal y cuestiona: ¿Por qué los intentos de revitalización de nuestroCentro Histórico no alcanzan sus objetivos y los espacios libres públicos son abandonados por la población, tornándosenuevamente decadentes? El estudio pretende identificar, reconocer y alertar sobre la necesidad de preservarlos Jardines Históricos, evitando desperdicios y garantizando la permanencia histórica del paisaje cultural para lasgeneraciones futuras. Buscando relatar la historia a partir de sus marcas urbanas, la investigación se coloca entre laHistoria cotidiana y la Geografía Cultural, eligiendo la cultura –modos de vida, costumbres, sentimientos de identidady usos cotidianos – como componente de las relaciones entre hombre y espacio. Para alcanzar tales objetivos, seaplicó una reconstitución historiográfica, partiendo de registros fotográficos y descripciones literarias, con objeto detransformar composiciones morfológicas anteriores en realidad virtual. El procedimiento será adoptado en ocho plazas,identificadas preliminarmente como Jardines Históricos de Natal. El caso de la Plaza Augusto Severo, aquí presentado,alude a una pretendida restauración que resultó en una gran explanada sin cobertura vegetal, inadecuada para elclima y los hábitos locales. Ya perdida, en este momento, la oportunidad de rescate cultural, se espera que el espacioreconquiste su lugar en la memoria y vida cotidiana de la población