Implementation of ROSA radio occultation data handling into EUMETSAT and GRAS SAF processing

Within this contribution, outcomes from a GRAS - SAF Visiting Scientist activity focused on the analysis of ROSA data quality for their use in operational weather forecasting will be described and main results will be shown. The ROSA Radio Occultation instrument has been developed by Thales-Alenia-Space, Italy and was funded by the Italian Space Agency (ASI). Such instrument is actually flying on-board three opportunity missions: the Indian OCEANSAT-2, the Argentinean SAC-D and the Indian-French MEGATROPIQUES. Focus of this Visiting Scientist activity has primarily been the analysis of ROSA data from OCEANSAT-2.This activity was divided into two parts. In the first one, performed at EUMETSAT, ROSA data processing was implemented into the EUMETSAT YAROS processor. The required updates into such processing package were implemented in order to make it able to properly manage also ROSA raw observations. It has to be noted that this processor is the baseline for the operational next generation EUMETSAT Radio Occultation ground segment: any changes performed in the framework of YAROS can easily be transferred to the operational ground segment. The YAROS - EUMETSAT processor was then updated and adapted to work with the ROSA raw data, tracking frequencies and instrument database. Adaptation to open loop data, navigation bits acquisition and potentially ionospheric measurement will be performed in the next future. NetCDF-4 YAROS output files are phases, amplitudes, bending angles over impact parameter, along with all other required data. Robust bias and standard deviation of bending angles to ECMWF collocated data were the statistical indicators generated to evaluate the quality of the ROSA observations. The second part of the activity was the adaptation of the GRAS-SAF ROPP (Radio Occultation Processing Package) processor for ROSA data processing. This second part was performed at Danish Meteorological Institute and has been focused on bending angles, refractivity and higher level product generation and validation against ECMWF and co-located occultation profiles. For the first time, one month of ROSA data have been deeply analyzed by a state-of-the-art Radio Occultation processing software and results will be described in the framework of this contributio

O profissional de educação física em hospital de alta complexidade

O presente trabalho tem como objetivo analisar as competências e atuação requeridas do Profissional de Educação Física na área da promoção da saúde, bem como sua importância na equipe multidisciplinar, mais especificadamente como profissional atuante dessa equipe na Unidade de Internação Pediátrica (UIP) de um hospital de alta complexidade, o Hospital de Clínicas de Porto Alegre, no Rio Grande do Sul. Desta forma, compreendo que o presente trabalho pode contribuir com a formação do Bacharelado no curso de Educação Física, por apresentar informações e reflexões pertinentes do atual cenário de inserção do Profissional de Educação Física (PEF) no Sistema Único de Saúde (SUS), oferecendo ao bacharelando, um olhar mais próximo da nova realidade do aumento das políticas públicas voltadas para a promoção de saúde, aonde o PEF é cada vez mais requisitado, sendo o profissional capaz e habilitado para mostrar aos pacientes, com base científica, os benefícios e a execução correta dos exercícios físicos. As reflexões e conclusões deste trabalho levam a crer que o PEF em um hospital de alta complexidade da rede pública de saúde é capacitado para trabalhar junto às equipes multidisciplinares de saúde, atuando na prevenção de diversas enfermidades, reduzindo os danos e agravos de doenças através das práticas corporais.The objective of this study is to analyze the competencies and performance required of the Physical Education Professional in the area of health promotion, as well as its importance in the multidisciplinary team, more specifically as a working professional of this team in the Pediatric Internment Unit (UIP) of a hospital of high complexity, the Clinical Hospital of Porto Alegre, in Rio Grande do Sul. In this way, I understand that the present work can contribute to the formation of the Bachelor in Physical Education, for presenting relevant information and reflections of the current scenario of insertion of the Physical Education Professional (PEP) into the Unified Health System (SUS), offering a closer look at the new reality of the increase of public policies aimed at health promotion, where PEF is increasingly required, and the professional is capable and able to show patients, on a scientific basis, the benefits and correct execution of physical exercises. The reflections and conclusions of this work lead to believe that the PEF in a hospital of high complexity of the public health network is able to work with the multidisciplinary health teams, acting in the prevention of various diseases, reducing the damages and diseases through practices

ZIKV Diagnostics: Current Scenario and Future Directions

Since the discovery of the Zika virus in Uganda in 1947, diagnostic challenges remain, especially when we take into account the epidemiological context of the surveyed population. Genetic similarities with other flavivirus are responsible for cross-reactivity during serological evaluation that would often be the only resources to confirm the infection in asymptomatic cases or samples collected after the short window of viral RNA detection. The importance of Zika virus infection diagnosis is undoubtedly useful for pregnant women. This statement became evident after 2015 Brazil’s Zika outbreak when a significant increase in cases of newborn with microcephaly was observed. Reverse transcriptase real-time PCR is the most reliable tool for Zika virus infection diagnosis. It detects viral RNA in both biological fluids and tissues and contributes to clinical case classification for initial description of developmental changes observed in neonates exposed congenitally to Zika virus. In conclusion, advances in serological diagnostic are urgent. The safest pathway for these studies requires laborious, subjective, and low throughput PRNT evaluations. Consequently, critical public health questions remain unanswered: how serum prevalent is the general population and pregnant women; can we define risk for congenital Zika syndrome (CZS) and Guillain-Barré syndrome; and how to assess vaccine efficacy and long-term protection

Retinopathy of prematurity prevention, screening and treatment programmes: Progress in South America.

Retinopathy of prematurity (ROP) is the main cause of blindness and visual impairment in Latin America and prevention, detection and treatment have been a priority in the Region in the last two decades. There is progress in the number of eligible babies screened and treated in at least half of the countries with strong regulations on ROP, but screening is not yet available in all provinces in most. More effort is needed to increase national protocols and legislation, strengthening of services and human resources to cover all national provinces; telemedicine might be a promising strategy

Prevalence of retinopathy of prematurity in Latin America

The purpose of this work was to review the studies published over the last 10 years concerning the prevalence of retinopathy of prematurity (ROP) in Latin American countries, to determine if there was an improvement in ROP prevalence rates in that period, and to identify the inclusion criteria for patients at risk of developing ROP in the screening programs. A total of 33 studies from ten countries published between 2000 and 2010 were reviewed. Prevalence of any ROP stage in the regions considered ranged from 6.6% to 82%; ROP severe enough to require treatment ranged from 1.2% to 23.8%. There was no routine screening for ROP, and there was a lack of services for treatment of the disease in many countries. Inclusion criteria for patients in the studies ranged between birth weight ≤1500 g and ≤2000 g and gestational age ≤32 and <37 weeks. Use of different inclusion criteria regarding birth weight and gestational age in several Latin American studies hindered comparative analysis of the published data. Highly restrictive selection criteria for ROP screening in relation to birth weight and gestational age should not be used throughout most Latin American countries because of their different social characteristics and variable neonatal care procedures. The studies included in this review failed to provide adequate information to determine if the prevalence of ROP has decreased in Latin America

Brazilian guidelines proposal for screening and treatment of retinopathy of prematurity (ROP)

Retinopathy of prematurity is one of the main causes of childhood blindness. Worldwide, there are more than 50,000 children blind due to retinopathy of prematurity. Visual impairment is a consequence of retinal detachment. It can be detected by serial ophthalmologic examination of infants at risk, and those identified with the severe form of the disease can be treated by laser or cryotherapy, which can decrease significantly the blindness due to ROP. The Brazilian Society of Pediatrics, Brazilian Council of Ophthalmology and Brazilian Society of Pediatric Ophthalmology suggest a guideline for the detection and treatment of retinopathy of prematurity in Brazil. This document was based on the results of the I Workshop of Retinopathy of Prematurity and presents the attributes for the implementation of an efficient diagnostic and treatment program.A retinopatia da prematuridade é uma das principais causas de cegueira na infância, havendo cerca de 50.000 crianças cegas pela doença em todo o mundo. A deficiência visual causada pela retinopatia dá-se em função de descolamento de retina tracional. O exame de rotina de prematuros possibilita a identificação de formas graves da doença, cujo tratamento por fotocoagulação ou crioterapia pode reduzir significativamente a cegueira por retinopatia da prematuridade (ROP). A seguir serão apresentadas as diretrizes brasileiras para exame de prematuros e tratamento daqueles com a forma grave da retinopatia da prematuridade (ROP), recomendadas pela Sociedade Brasileira de Pediatria, Conselho Brasileiro de Oftalmologia e Sociedade Brasileira de Oftalmologia Pediátrica. Essas diretrizes foram baseadas nos resultados do I Workshop de Retinopatia da Prematuridade e apresentam os atributos para a implementação de um programa eficiente de diagnóstico e tratamento.Instituto Fernandes Figueira Programa de Saúde da Criança e da MulherInstituto Fernandes Figueira Departamento de NeonatologiaFundação Altino Ventura Departamento de Retina ClínicaProjeto de Prevenção a Cegueira por ROPUniversidade Federal do Rio Grande do Sul Faculdade de MedicinaUniversidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Instituto da Visão Departamento de OftalmologiaSecretaria Municipal de Saúde do Rio de Janeiro Câmara Técnica de NeonatologiaCETRINSociedade Brasileira de Pediatria Grupo de Trabalho de Prevenção da Cegueira InfantilUniversidade de São Paulo Departamento de Oftalmologia e Berçário Anexo à MaternidadeSociedade de Pediatria de São Paulo Departamento de OftalmologiaSecretaria da Sociedade Brasileira de Oftalmologia Conselho Brasileiro de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Instituto da Visão Setor de Retina e VítreoUNIFESP, Instituto da Visão Depto. de OftalmologiaUNIFESP, Instituto da Visão Setor de Retina e VítreoSciEL

Should Patients on Metformin Be Screened for Vit B12 Deficiency, and if so When?

Background: Metformin and its ability to cause vitamin B12 deficiency has been thoroughly studied and documented. Despite this, there is no formal screening recommendation. Our study investigates: whether there is a benefit to a formal screening guideline and, if so, when is it appropriate to screen for vitamin B12 deficiency in patients on Metformin. We additionally investigated quantifying if vitamin B12 testing is completed.Methods:We conducted a retrospective cohort study on a population of HAP patients who were ever tested for Vitamin B12 deficiency. Our exposed group was comprised of patients who had filled at least two prescriptions of Metformin between 1/1/2010 to 10/1/2016. Our unexposed group was not exposed to Metformin. Patients were followed through 12/31/2018 for vitamin B12 testing and deficiency. Results:Amongst our exposed population of 13489 patients, 44.86% of patients were tested for Vitamin B12 deficiency. Average time to test was 990 days, the average time to test positive was 1831 days. Factors associated with testing for B12 deficiency were male gender (41.5%), older age (62.79% in patients over 80 years old), Caucasian race (48.98%), and malabsorption syndromes (71.7%) including bariatric surgery, celiac disease, small bowel disease, and PPI use. Amongst tested patients in the exposed population, it was found that 3.34% had vitamin B12 deficiency. The only factor associated with deficiency in a multivariable analysis was older age. African American ethnicity approached significance as a protective factor. Discussion: While we found testing to be suboptimal, vitamin B12 deficiency incidence was lower than expected. On chart review it was found that reasons for testing for B12 level included anemia, cognitive decline, and neuropathy. This implies that patients were having symptoms of deficiency leading to testing. Our study found that 3.34% of patients exposed to Metformin had vitamin B12 deficiency. Of patients not exposed to Metformin, 2.14% were found to have deficiency.https://scholarlycommons.henryford.com/merf2019basicsci/1000/thumbnail.jp

Undifferentiated round cell sarcoma with BCOR internal tandem duplications (ITD) or YWHAE fusions:a clinicopathologic and molecular study

Until recently, undifferentiated round cell sarcomas (URCS) in infants have been considered a wastebasket diagnosis, composed of various pathologic entities and lacking consistent genetic alterations. The recent identification of recurrent BCOR internal tandem duplications (ITD) and less common alternative YWHAE\u2013NUTM2B/E fusions in half of infantile URCS and the majority of so-called primitive myxoid mesenchymal tumors of infancy (PMMTI) suggests a common pathogenesis with clear cell sarcoma of the kidney which also harbors the same genetic alterations. These tumors also share a similar morphology and immunoprofile, including positivity for BCOR, cyclin D1, and SATB2. In this study, we investigate the largest cohort to date of genetically confirmed URCS and PMMTI with BCOR ITD or YWHAE fusions to better define their morphologic spectrum and clinical behavior. Twenty-eight cases harbored BCOR ITD and five YWHAE fusions, occurring in 29 infants and 4 children, 19 males and 14 females. Microscopically, 20 were classified as URCS and 13 as PMMTI. Follow-up was available in 25 patients, with 14 (56%) succumbing to their diseases at a mean duration of 18-months follow-up (range: 2\u201362). Six patients remained with no evidence of disease at a mean follow-up of 63 months (range: 4\u2013192), four patients were still alive with disease (mean follow-up: 46 months, range: 4\u2013120), and one died of other causes. Local recurrence and distant metastasis were each observed in 11/25 (44%) of the patients. The overall survival was 42% at 3 years and 34% at 5 years (median survival: 26 months). There was no statistically significant survival difference between cases diagnosed as URCS and PMMTI and between those with BCOR ITD and YWHAE fusions