Elaboración de modelos espaciales predictivos de ocurrencia de incendios forestales asociada a la actividad humana

Los incendios forestales son un fenómeno de gran importancia a nivel global, con importantes consecuencias a todos los niveles (ecológico, económico, social, etc.). En los ambientes mediterráneos han estado ligados a lo largo de la historia al manejo del territorio, aunque el equilibrio se ha roto en las últimas décadas. En estas áreas, la mayor parte de los incendios obedecen a causas humanas. Para llevar a cabo unas buenas labores de prevención resulta de utilidad contar con sistemas de predicción de riesgo de incendio. Es necesario, para ello, contar con información adecuada acerca del fenómeno. El objetivo principal desarrollado en esta tesis ha sido la elaboración de modelos predictivos de ocurrencia de incendios asociada a la actividad humana, los cuales han formado parte de un índice integrado de riesgo de incendio forestal a disposición de gestores en materia de incendios, en el marco del proyecto Firemap. Las áreas de estudio han sido la C. de Madrid, Aragón, C. Valenciana y provincia de Huelva en España. Los modelos se han elaborado a partir de variables de tipo socioeconómico y de ocurrencia de incendios por causa humana, mediante el empleo de regresión logística y a una resolución de 1km2. Para la elaboración y manejo de la información espacial requerida se han empleado Sistemas de Información Geográfica. Estos modelos se han comparado con otros obtenidos a partir de otras técnicas estadísticas (Árboles de Clasificación y Redes Neuronales). A continuación, se ha procedido al empleo de información de ocurrencia de incendios espacialmente más precisa para la obtención de nuevos resultados en la C. de Madrid. Los nuevos modelos se ajustaban mejor a la realidad territorial del fenómeno. A continuación, en dicha área (en la que se contaba con más información disponible), se han elaborado modelos que incluyen la componente temporal y física para la predicción de incendios por causa humana. Para ello, se han empleado Generalized Additive Models, extensión de los modelos lineales generales a los que pertenece la regresión logística, y variables socioeconómicas y meteorológicas junto con la elevación del terreno. Los resultados obtenidos muestran un grado de ajuste satisfactorio a partir del empleo de una variable de ocurrencia de incendios más precisa espacialmente y la inclusión de variables de tipo dinámico. Finalmente, los modelos de ocurrencia por causa humana se han integrado con los de causa rayo, comparando dos áreas de estudio de diferente causalidad de incendio, C. de Madrid y Aragón. Los resultados obtenidos señalan la necesidad de contar con información precisa de la localización del origen de los incendios pero señalan la importancia en el desarrollo metodológico para integrar ambos modelos predictivos. La elaboración de modelos predictivos de incendios forestales resulta de gran interés debido a que es la causa principal de incendios, siendo difícil debido a que el comportamiento humano es difícil de predecir y modelizar. El empleo de Sistemas de Información Geográfica constituye una herramienta fundamental para el manejo de la información espacial

Elaboración de modelos espaciales predictivos de ocurrencia de incendios forestales asociada a la actividad humana

Los incendios forestales son un fenómeno de gran importancia a nivel global, con importantes consecuencias a todos los niveles (ecológico, económico, social, etc.). En los ambientes mediterráneos han estado ligados a lo largo de la historia al manejo del territorio, aunque el equilibrio se ha roto en las últimas décadas. En estas áreas, la mayor parte de los incendios obedecen a causas humanas. Para llevar a cabo unas buenas labores de prevención resulta de utilidad contar con sistemas de predicción de riesgo de incendio. Es necesario, para ello, contar con información adecuada acerca del fenómeno. El objetivo principal desarrollado en esta tesis ha sido la elaboración de modelos predictivos de ocurrencia de incendios asociada a la actividad humana, los cuales han formado parte de un índice integrado de riesgo de incendio forestal a disposición de gestores en materia de incendios, en el marco del proyecto Firemap. Las áreas de estudio han sido la C. de Madrid, Aragón, C. Valenciana y provincia de Huelva en España. Los modelos se han elaborado a partir de variables de tipo socioeconómico y de ocurrencia de incendios por causa humana, mediante el empleo de regresión logística y a una resolución de 1km2. Para la elaboración y manejo de la información espacial requerida se han empleado Sistemas de Información Geográfica. Estos modelos se han comparado con otros obtenidos a partir de otras técnicas estadísticas (Árboles de Clasificación y Redes Neuronales). A continuación, se ha procedido al empleo de información de ocurrencia de incendios espacialmente más precisa para la obtención de nuevos resultados en la C. de Madrid. Los nuevos modelos se ajustaban mejor a la realidad territorial del fenómeno. A continuación, en dicha área (en la que se contaba con más información disponible), se han elaborado modelos que incluyen la componente temporal y física para la predicción de incendios por causa humana. Para ello, se han empleado Generalized Additive Models, extensión de los modelos lineales generales a los que pertenece la regresión logística, y variables socioeconómicas y meteorológicas junto con la elevación del terreno. Los resultados obtenidos muestran un grado de ajuste satisfactorio a partir del empleo de una variable de ocurrencia de incendios más precisa espacialmente y la inclusión de variables de tipo dinámico. Finalmente, los modelos de ocurrencia por causa humana se han integrado con los de causa rayo, comparando dos áreas de estudio de diferente causalidad de incendio, C. de Madrid y Aragón. Los resultados obtenidos señalan la necesidad de contar con información precisa de la localización del origen de los incendios pero señalan la importancia en el desarrollo metodológico para integrar ambos modelos predictivos. La elaboración de modelos predictivos de incendios forestales resulta de gran interés debido a que es la causa principal de incendios, siendo difícil debido a que el comportamiento humano es difícil de predecir y modelizar. El empleo de Sistemas de Información Geográfica constituye una herramienta fundamental para el manejo de la información espacial

Infecção fúngica em doentes queimados

Mestrado em Biologia AplicadaA incidência das infecções fúngicas tem vindo a aumentar progressivamente nas duas últimas décadas. Na Unidade de Queimados o doente está mais susceptível ao desenvolvimento de processos infecciosos por perda da barreira de protecção cutânea, pela imunossupressão associada à queimadura, bem como pela necessidade de utilização de dispositivos invasivos e pela presença da microbiota local. As leveduras do género Candida, nomeadamente C. albicans, continuam a ser responsáveis pela maioria das infecções fúngicas em ambientes hospitalares, embora na última década se tenha assistido a um aumento da incidência de espécies não-albicans e de fungos filamentosos. O desenvolvimento de fármacos antifúngicos é complicado, uma vez que as células fúngicas, opostamente às células bacterianas, e à semelhança das humanas, são eucarióticas, o que pode levantar problemas relacionados com a sua toxicidade potencial. Este estudo teve como objectivo analisar a importância da infecção fúngica nos doentes queimados na Unidade de Queimados, dos Hospitais da Universidade de Coimbra. As leveduras do género Candida foram os fungos mais frequentemente isolados com a espécie Candida albicans, presente em 65% dos doentes infectados. Das espécies não-albicans, Candida parapsilosis e Candida tropicalis foram as mais frequentes (15% e 9%, respectivamente). Para além de Candida, o segundo fungo mais comum foi o género Trichosporon (4,4%) seguido do género Aspergillus (2%). Durante o período de estudo observou-se um aumento na frequência da infecção fúngica, que esteve associada a uma taxa de mortalidade de cerca de 38% nos doentes infectados. Queimaduras profundas, queimaduras causadas pelo fogo e internamento hospitalar prolongado contribuíram para um maior risco de infecção por fungos nos doentes queimados. A infecção fúngica ocorreu maioritariamente em doentes do sexo masculino (54,7%), afectando mais frequentemente a classe etária dos 71-90 anos. A incidência crescente de infecção fúngica nos doentes queimados e a presença relativamente frequente dos fungos emergentes, Trichosporon e Aspergillus, indicam que o controlo da infecção nos doentes queimados é fundamental.The incidence of fungal infections has increased steadily in the last two decades. In the Burn Unit, the patient is more susceptible to infectious processes due to the loss of the protective barrier of the skin, to the immunossuppression associated with burns, to the need for use of invasive devices and to the increased virulence of the local microbiota. The yeasts of Candida, namely C. albicans, remain responsible for the majority of fungal infections in hospitals, although in the last decade has witnessed an increased incidence of non-albicans species and filamentous fungi. The development of antifungal drugs is complex, since the fungal cells, unlike the bacteria and like the human cells, are eukaryotic, what may raise some concern related to its potential toxicity. The objective of this study was to evaluate the importance of fungal infection in the patients of the Burns Unit of Coimbra University Hospitals. Yeasts of the genus Candida were the most frequently isolated fungi, with the species Candida albicans, present in 65% of the infected patients. Of non-albicans species, Candida parapsilosis and Candida tropicalis were the most frequent ones (15 and 9%, respectively). The genus Trichosporon (4,4%) was the second most common fungus isolated in these patients followed by the genus Aspergillus (2%). During the study period there was an increased frequency of fungal infection that was associated with a mortality rate of 38%. The depth of the burn, burns caused by fire, and a prolonged stay in the hospital contributed to an increased risk of fungal infections in burned patients. The fungal infection occurred mostly in male patients (54,7%), affecting more frequently the age group of 71-90 years. The increasing incidence of fungal infection in burned patients and the relatively frequent presence of emerging Trichosporon and Aspergillus fungi, indicating that control of infection in burned patient is essential

"INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes"

Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21s

Projecting wildfire occurrence at regional scale from Land Use/Cover and climate change scenarios

LUC4FIRE: Project funded by the Spanish Ministry of Science, Innovation and Universities (CSO2015-73407-JIN)

Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma Are Not Explained by Differences in Comorbidities, Liver Disease Severity, or Tumor Burden

Black patients have higher mortality and are less likely to receive liver transplantation for hepatocellular carcinoma (HCC) than white patients. Reasons for these disparities have not been fully elucidated. Comorbid disease, liver disease severity, cirrhosis etiologies, and tumor characteristics were compared between black and white patients with HCC seen at the Indiana University Academic Medical Center from January 2000 to June 2014. Logistic regression was used to investigate the primary outcome, which was liver transplantation. Log-rank testing was used to compare survival between the two groups. Subgroup analysis explored reasons for failure to undergo liver transplantation in patients within Milan criteria. The cohort included 1,032 (86%) white and 164 (14%) black patients. Black and white patients had similar Model for End-Stage Liver Disease (MELD) and Child-Pugh scores (CPSs). There was a trend toward larger tumor size (5.3 cm versus 4.7 cm; P = 0.05) in black patients; however, Barcelona Clinic Liver Cancer (BCLC) staging and Milan criteria were similar. Black patients were less likely to undergo liver transplantation than white patients; this was a disparity that was not attenuated (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.21-0.90) on multivariable analysis. Substance abuse was more frequently cited as the reason black patients within Milan criteria failed to undergo transplantation compared to white patients. Survival was similar between the two groups. Conclusion: Racial differences in patient and tumor characteristics were small and did not explain the disparity in liver transplantation. Higher rates of substance abuse in black patients within Milan criteria who failed to undergo transplantation suggest social factors contribute to this disparity in this cohort

Older Age and Disease Duration Are Highly Associated with Hepatocellular Carcinoma in Patients with Autoimmune Hepatitis

Background: Hepatocellular carcinoma (HCC) is rare in patients with autoimmune hepatitis (AIH). However, the overall burden of AIH cirrhosis in causing HCC and patients' risk factors are not well understood. Aims: To characterize the proportion of HCC linked to AIH at a large academic health center, and to identify variables associated with HCC in patients with AIH in a case-control study design. Methods: Over a 14.5-year period, medical records of all patients with HCC were reviewed. Cases are AIH patients identified from the cohort, and controls are patients with AIH without HCC. Three controls were randomly chosen from the Genetic Repository of Autoimmune Liver Disease and Coexisting Exposures database for each eligible case. Results: Out of 1250 eligible patients, 20 were linked to AIH (1.6%). Their median age was 64 years, 40% men and 100% Caucasian. Ten percent of AIH patients did not have evidence of cirrhosis at HCC diagnosis. The proportion of HCCs due to AIH decreased during the time intervals of the study. Compared to controls, cases were more likely men (40.0% vs. 18%, p = 0.049), with longer AIH duration (median 16 years vs. 5 years, p = 0.004). Prolonged AIH duration (OR 1.68, p = 0.006) and older age (OR 1.15, p = 0.049) were risk factors for HCC. Conclusions: AIH is a rare cause (1.6%) for HCC in Midwestern USA with a decreasing trend over 14.5 years. Ten percent of AIH-HCC patients did not have cirrhosis at time of HCC diagnosis. Patients with prolonged duration of the disease and older age are at high risk to develop HCC

The Isolation of Typhoid or Paratyphoid Bacilll from Urines.

The socio-economic factors are of key importance during all phases of wildfire management that include prevention, suppression and restoration. However, modeling these factors, at the proper spatial and temporal scale to understand fire regimes is still challenging. This study analyses socio-economic drivers of wildfire occurrence in central Spain. This site represents a good example of how human activities play a key role over wildfires in the European Mediterranean basin. Generalized Linear Models (GLM) and machine learning Maximum Entropy models (Maxent) predicted wildfire occurrence in the 1980s and also in the 2000s to identify changes between each period in the socio-economic drivers affecting wildfire occurrence. GLM base their estimation on wildfire presence-absence observations whereas Maxent on wildfire presence-only. According to indicators like sensitivity or commission error Maxent outperformed GLM in both periods. It achieved a sensitivity of 38.9% and a commission error of 43.9% for the 1980s, and 67.3% and 17.9% for the 2000s. Instead, GLM obtained 23.33, 64.97, 9.41 and 18.34%, respectively. However GLM performed steadier than Maxent in terms of the overall fit. Both models explained wildfires from predictors such as population density and Wildland Urban Interface (WUI), but differed in their relative contribution. As a result of the urban sprawl and an abandonment of rural areas, predictors like WUI and distance to roads increased their contribution to both models in the 2000s, whereas Forest-Grassland Interface (FGI) influence decreased. This study demonstrates that human component can be modelled with a spatio-temporal dimension to integrate it into wildfire risk assessment

CLAREAMENTO DENTAL A LASER: MITOS E EVIDÊNCIAS CIÊNTÍFICAS

Introduction: The need to obtain a pleasant appearance has been accentuated over the years. In offices, a harmonious smile has become a requirement of patients who have intentions to adapt to current beauty standards (FONSECA, 2014). Whitening became part of the laser as an activating source of photosensitive components present in chemical agents. The literature reveals that in addition to the problems generated by chemical factors, the supposed activation of bleaching agents by heat, light or laser can cause side effects on the pulp tissue achieved (BISPO, 2006; RIEHL; NUNES, 2007). Objective: The present study aimed to address through a literature review, attributions and properties of laser tooth whitening. Material and methods: The study consists of a descriptive research through a literature review, using the electronic databases PubMed, Virtual Health Library (VHL), Scielo, Google Scholar. Results and Discussion: It is evidenced in this way that the results of bleaching using traditional methods can be achieved, as well as with the inclusion of the laser at low intensity (ADRIANO et al., 2022). Conclusion: Therefore, from the studies presented, there is evidence that laser tooth whitening presents satisfactory or unsatisfactory results depending on the purpose of its use.Introdução: A necessidade em obter-se uma aparência agradável vêm se acentuando com o decorrer dos anos. Nos consultórios, um sorriso harmonioso passou a ser uma exigência dos pacientes que apresentam intenções em adequar-se aos padrões de beleza atuais (FONSECA, 2014). O clareamento passou a integrar o laser como fonte ativadora de componentes fotossensíveis presentes nos agentes químicos. A literatura revela que além dos problemas gerados pelos fatores químicos, a suposta ativação de agentes clareadores por calor, luz ou laser pode causar efeitos colaterais sobre o tecido pulpar alcançados (BISPO, 2006; RIEHL; NUNES, 2007). Objetivo: O presente estudo teve como propósito abordar através de uma revisão de literatura, atribuições e propriedades do clareamento dental a laser. Material e métodos: O estudo consiste em uma pesquisa descritiva por meio de uma revisão de literatura, recorrendo aos bancos de dados eletrônicos PubMed, Biblioteca Virtual em Saúde (BVS), Scielo, Google Acadêmico. Resultados e Discussão : Evidencia-se dessa maneira que os resultados de branqueamento utilizando os métodos tradicionais podem ser alcançados, bem como com a inclusão do laser em baixa intensidade (ADRIANO et al., 2022). Conclusão: Portanto, a partir dos estudos apresentados, há evidências de que o clareamento dental a laser apresenta resultados satisfatórios ou insatisfatório a depender da finalidade da sua utilização

INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy

Background Hypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information. Objective The objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP. Method A comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index < 10(th) centile or a ponderal index < 10(th) centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden's index and probability ratios. Results The study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p < 0.01). Using body mass index (< 10(th) centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86-12.77) vs. 3.75 (95% CI: 1.49-9.43)) (DOR: 5.56 (95% CI: 1.82-16.98) vs. 4.84 (95% CI: 1.51-15.54)) Even when using Ponderal index (< 10(th) centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11-5.05) vs. 1.68 (95% CI: 0.70-4.03))(DOR 2.62 (95% CI: 1.00-6.87) vs. 1.90 (95% CI: 0.61-5.92)). Conclusion In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st