Study of a Context Quality Model for UbiPri Middleware

With the growth of ubiquitous computing, context-aware computing-based applications are increasingly emerging, and these applications demonstrate the impact that context has on the adaptation process. From the context, it will be possible to adapt the application according to the requirements and needs of its users. Therefore, the quality of the context information must be guaranteed so that the application does not have an incorrect or unexpected adaptation process. But like any given data, there is the possibility of inaccuracy and/or uncertainty and so Quality of Context (QoC) plays a key role in ensuring the quality of context information and optimizing the adaptation process. To guarantee the Quality of Context it is necessary to study a quality model to be created, which will have the important function of evaluating the context information. Thus, it is necessary to ensure that the parameters and quality indicators to be used and evaluated are the most appropriate for a given type of application. This paper aims to study a context quality model for the UbiPri middleware, defining its quality indicators to ensure its proper functioning in the process of adaptation in granting access to ubiquitous environments. Keywords: QoC, Model, Context-Aware, Data, Privac

PRISEC: Comparison of Symmetric Key Algorithms for IoT Devices

With the growing number of heterogeneous resource-constrained devices connected to the Internet, it becomes increasingly challenging to secure the privacy and protection of data. Strong but efficient cryptography solutions must be employed to deal with this problem, along with methods to standardize secure communications between these devices. The PRISEC module of the UbiPri middleware has this goal. In this work, we present the performance of the AES (Advanced Encryption Standard), RC6 (Rivest Cipher 6), Twofish, SPECK128, LEA, and ChaCha20-Poly1305 algorithms in Internet of Things (IoT) devices, measuring their execution times, throughput, and power consumption, with the main goal of determining which symmetric key ciphers are best to be applied in PRISEC. We verify that ChaCha20-Poly1305 is a very good option for resource constrained devices, along with the lightweight block ciphers SPECK128 and LEA.info:eu-repo/semantics/publishedVersio

Primary health care and the coordination of care in health regions: managers’ and users’ perspective

This paper aims to analyze the healthcare coordination by Primary Health Care (PHC), with the backdrop of building a Health Care Network (RAS) in a region in the state of São Paulo, Brazil. We conducted a case study with qualitative and quantitative approaches, proceeding to the triangulation of data between the perception of managers and experience of users. We drew analysis realms and variables from the three pillars of healthcare coordination – informational, clinical and administrative/organizational. Stroke was the tracer event chosen and therapeutic itineraries were conducted with users and questionnaires applied to the managers. The central feature of the construction of the Health Care Network in the studied area is the prominence of a philanthropic organization. The results suggest fragility of PHC in healthcare coordination in all analyzed realms. Furthermore, we identified a public-private mix, in addition to services contracted from the Unified Health System (SUS), with out-of-pocket payments for specialist consultation, tests and rehabilitation. Much in the same way that there is no RAS without a robust PHC capable of coordinating care, PHC is unable to play its role without a solid regional arrangement and a virtuous articulation between the three federative levels.O objetivo deste artigo é analisar a coordenação do cuidado pela Atenção Primária à Saúde (APS), tendo como pano de fundo o processo de construção da Rede de Atenção à Saúde (RAS) em região do estado de São Paulo. Foi realizado estudo de caso com abordagens quantitativa e qualitativa, procedendo-se à triangulação dos dados, entre a percepção dos gestores e as experiências dos usuários. As dimensões e as variáveis de análise partiram dos três pilares da coordenação do cuidado – informacional, clínico, administrativo/organizacional. Tendo como evento traçador o Acidente Vascular Encefálico, itinerários terapêuticos foram conduzidos com usuários e questionários aplicados a gestores. A construção da Rede de Atenção à Saúde na região estudada tem como traço central o protagonismo de entidade filantrópica. Os resultados sugerem fragilidades da APS em assumir papel de coordenação do cuidado em todas as dimensões analisadas. Ademais, foi identificado mix público-privado para além dos serviços contratados pelo SUS, com desembolso direto para consultas especializadas, exames e reabilitação. Da mesma forma que não existe RAS sem APS robusta capaz de coordenar o cuidado, a APS não consegue exercer seu papel sem um sólido arranjo regional e uma articulação virtuosa entre os três entes federados

DAS CAPIVARAS E CARRAPATOS A UMA PROPOSTA DE COMUNICAÇÃO E MANEJO NO PARQUE NACIONAL DA SERRA DO CIPÓ PARA REDUÇÃO DE RISCOS À SAÚDE.

We report a study first designed to deal with a collective condemnation of the capybaras, in a protected area. The emphasis shifted from the capybaras to the high risks associated to exposure to ticks, a diversified group of complex ecological relations, both with hosts and pathogens. A management program associating communication tools and varied strategies to reduce exposition to ticks was collectively proposed considering local perception about the capybaras and their ecological relations, the risk of occurrence of spotted fever, the spatial distribution of ticks, and resistance of local community to explicitly deal with transmissible health problems, due to high social magnificence and economic losses after a wrong report about Schistosomiasis in the region in a previous year. Key-words:  Environmental management; protected areas; risk management; tick bite fever.Traemos un caso de investigación enfocada en el manejo de un área protegida en lo cual el centro de las atenciones ha cambiado desde la preocupación con la condena colectiva de una especie silvestre, la capibara, hacia la proposición de una estrategia de manejo del paisaje y de comunicación dirigidas a la reducción del riesgo de contacto con garrapatas, considerando las enfermedades y la incomodidad asociadas a este vector. El caso se pasó en la región de Serra do Cipó,  donde la economía está fuertemente basada en el turismo,  y la consideración de temas relativos a enfermedades transmisibles es dificultado por lo trauma con la divulgación de noticias incorrectas acerca de un caso de esquistosomiasis en la región, hace más de 10 años.  Palabras claves:  Areas naturales protegidas;  ecologia de paisaje; manejo de riesgo; uso público.Apresentamos um estudo de caso em que o foco das preocupações de manejo em uma área protegida se deslocou de uma evidente condenação pública a uma espécie silvestre, a capivara, para a construção de uma proposta coletiva de manejo da paisagem e de comunicação visando à redução da exposição das pessoas a carrapatos de modo a diminuir o risco de doenças a eles associadas. O caso aconteceu na região da Serra do Cipó, Minas Gerais, com forte apelo turístico, onde a abordagem de questões relativas a doenças transmissíveis é dificultada pelo trauma da quebra da economia local, baseada no turismo, em função da divulgação equivocada, há mais de 10 anos, de um caso de esquistossomose pela imprensa, com ampla repercussão. Investigou-se a presença de agentes causadores da Febre Maculosa Brasileira (FMB) por meio de exames sorológicos em cavalos, cães e capivaras e teste de hemolinfa seguido de exame de PCR dos carrapatos casos positivos. As formas de Rickettsia encontradas não pertencem ao grupo das relacionadas à FMB, mas esta informação não reduz a preocupação com a vigilância sanitária e cuidados com exposição a carrapatos

A cirurgia plástica no contexto estético: aspectos sociais por uma revisão de literatura

The objective of this study is to disassemble, through scientific articles, the aspects related to aesthetic plastic surgery and the body satisfaction resulting from these procedures by the individuals who undergo them. A deep search of articles was carried out in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and PubMed, with the following Health Sciences Descriptors (DeCS): Body; Body image; Surgical procedures. Articles were selected between the periods of 1998 to 2023, in French, Spanish, English and Portuguese, to increase the level of relevance and quality of the review, given the scarcity of scientific studies on the subject. This review study made it possible to expose the current moment of aesthetic plastic surgeries, in addition to understanding the profile of the individuals who undergo it. Body dissatisfaction becomes an image disorder, correlated with feelings and emotions, are reasons that lead to the search for “correction” through aesthetic procedures. However, plastic surgery can alleviate dissatisfaction and is a tool against different body contexts.El objetivo de este estudio es desmontar, a través de artículos científicos, los aspectos relacionados con la cirugía plástica estética y la satisfacción corporal resultante de estos procedimientos por parte de los individuos que se someten a ellos. Se realizó una búsqueda profunda de artículos en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) y PubMed, con los siguientes Health Sciences Descriptors (DeCS): Body; Imagen corporal; Procedimientos quirúrgicos. Se seleccionaron artículos entre los períodos de 1998 a 2023, en francés, español, inglés y portugués, para aumentar el nivel de relevancia y calidad de la revisión, dada la escasez de estudios científicos sobre el tema. Este estudio de revisión permitió exponer el momento actual de las cirugías plásticas estéticas, además de comprender el perfil de los individuos que se someten a ella. La insatisfacción corporal se convierte en un trastorno de la imagen, correlacionado con los sentimientos y emociones, son motivos que llevan a la búsqueda de “corrección” a través de procedimientos estéticos. Sin embargo, la cirugía plástica puede aliviar la insatisfacción y es una herramienta frente a diferentes contextos corporales.Objetivo desse estudo é desmontar, por meio de artigos científicos, os aspectos que tange a cirurgia plástica estética e a satisfação corporal advinda desses procedimentos pelos indivíduos submetidos. Foi realizada uma profunda pesquisa de artigos nas bases de dados Medical Literature Analysis and Retrievel System Online (MEDLINE), Scientific Electronic Library Online (SciELO) e PubMed, com os seguintes Descritores em Ciências da Saúde (DeCS): Body; Body image; Surgical procedures. Foram selecionados artigos entre os períodos de 1998 a 2023, nos idiomas Frances, Espanhol, Inglês e Português, para ampliar o nível de relevância e a qualidade da revisão, visto a escassez de estudos científicos sobre a temática. Este estudo de revisão possibilitou expor o momento atual das cirurgias plásticas estéticas, além da compreensão do perfil dos indivíduos que são submetidos. A insatisfação do corpo se torna um distúrbio de imagem, correlacionados a sentimentos e emoções, são motivos que levam a busca de “correção” através de procedimentos estéticos. Todavia, a cirurgia plástica pode amenizar quadros de insatisfação e é uma ferramenta contra diversos contextos corporais

Determinants of HIV late presentation among men who have sex with men in Portugal (2014–2019): who’s being left behind?

Introduction: HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods: We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results: The median age was 31 years, 51% had a current income between 501-1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion: Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.info:eu-repo/semantics/publishedVersio

HIV-1-Transmitted Drug Resistance and Transmission Clusters in Newly Diagnosed Patients in Portugal Between 2014 and 2019

Objective: To describe and analyze transmitted drug resistance (TDR) between 2014 and 2019 in newly infected patients with HIV-1 in Portugal and to characterize its transmission networks. Methods: Clinical, socioepidemiological, and risk behavior data were collected from 820 newly diagnosed patients in Portugal between September 2014 and December 2019. The sequences obtained from drug resistance testing were used for subtyping, TDR determination, and transmission cluster (TC) analyses. Results: In Portugal, the overall prevalence of TDR between 2014 and 2019 was 11.0%. TDR presented a decreasing trend from 16.7% in 2014 to 9.2% in 2016 (p for-trend = 0.114). Multivariate analysis indicated that TDR was significantly associated with transmission route (MSM presented a lower probability of presenting TDR when compared to heterosexual contact) and with subtype (subtype C presented significantly more TDR when compared to subtype B). TC analysis corroborated that the heterosexual risk group presented a higher proportion of TDR in TCs when compared to MSMs. Among subtype A1, TDR reached 16.6% in heterosexuals, followed by 14.2% in patients infected with subtype B and 9.4% in patients infected with subtype G. Conclusion: Our molecular epidemiology approach indicates that the HIV-1 epidemic in Portugal is changing among risk group populations, with heterosexuals showing increasing levels of HIV-1 transmission and TDR. Prevention measures for this subpopulation should be reinforced.info:eu-repo/semantics/publishedVersio

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701