MAPPING COVID-19 EPIDEMIC DATA USING FOSS

The recognition of spatial and temporal patterns in the distribution of a pandemic plays a pivotal role in guiding policy approaches to its management, containment and elimination. For this purpose, a database has been built for the COVID-19 pandemic in the Trentino Province, in the eastern Italian alps, near the border between Italy and Austria. The database management system and the WebGIS mapping these data is based on Free and Open Source Software. The Data Base Management System (DBMS) runs on MySQL, available under the GNU General Public License, storing and processing geographic data. A custom procedure has been created to update the dataset, with the capability to import data from suitably formatted spreadsheets by an authenticated administrator. To ensure flexibility and responsiveness on desktop and mobile devices, the WebGIS has been created with a client-side approach, using the Leaflet and Bootstrap JavaScript language libraries, available with Open Source Licenses. These libraries, with additional custom scripts, create the user interface and render geographic data into maps. The exchange of data between the DBMS server and the client is performed using geojson tables. To protect the privacy of the patients, WebGIS users cannot access the source data even though maps and graphs can be downloaded as pictures. Geo-statistical analysis aimed at the detection of spatial and temporal patters is underway

NEW SEISMIC SOURCE ZONE MODEL FOR PORTUGAL AND AZORES

The development of seismogenic source models is one of the first steps in seismic hazard assessment. In seismic hazard terminology, seismic source zones (SSZ) are polygons (or volumes) that delineate areas with homogeneous characteristics of seismicity. The importance of using knowledge on geology, seismicity and tectonics in the definition of source zones has been recognized for a long time [1]. However, the definition of SSZ tends to be subjective and controversial. Using SSZ based on broad geology, by spreading the seismicity clusters throughout the areal extent of a zone, provides a way to account for possible long-term non-stationary seismicity behavior [2,3]. This approach effectively increases seismicity rates in regions with no significant historical or instrumental seismicity, while decreasing seismicity rates in regions that display higher rates of seismicity. In contrast, the use of SSZ based on concentrations of seismicity or spatial smoothing results in stationary behavior [4]. In the FP7 Project SHARE (Seismic Hazard Harmonization in Europe), seismic hazard will be assessed with a logic tree approach that allows for three types of branches for seismicity models: a) smoothed seismicity, b) SSZ, c) SSZ and faults. In this context, a large-scale zonation model for use in the smoothed seismicity branch, and a new consensus SSZ model for Portugal and Azores have been developed. The new models were achieved with the participation of regional experts by combining and adapting existing models and incorporating new regional knowledge of the earthquake potential. The main criteria used for delineating the SSZ include distribution of seismicity, broad geological architecture, crustal characteristics (oceanic versus continental, tectonically active versus stable, etc.), historical catalogue completeness, and the characteristics of active or potentially-active faults. This model will be integrated into an Iberian model of SSZ to be used in the Project SHARE seismic hazard assessment

COMPILATION OF ACTIVE FAULT DATA IN PORTUGAL FOR USE IN SEISMIC HAZARD ANALYSIS

To estimate where future earthquakes are likely to occur, it is essential to combine information about past earthquakes with knowledge about the location and seismogenic properties of active faults. For this reason, robust probabilistic seismic hazard analysis (PSHA) integrates seismicity and active fault data. Existing seismic hazard assessments for Portugal rely exclusively on seismicity data and do not incorporate data on active faults. Project SHARE (Seismic Hazard Harmonization in Europe) is an EC-funded initiative (FP7) that aims to evaluate European seismic hazards using an integrated, standardized approach. In the context of SHARE, we are developing a fully-parameterized active fault database for Portugal that incorporates existing compilations, updated according to the most recent publications. The seismogenic source model derived for SHARE will be the first model for Portugal to include fault data and follow an internationally standardized approach. This model can be used to improve both seismic hazard and risk analyses and will be combined with the Spanish database for use in Iberian- and European-scale assessments

Ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP): outcomes on a large cohort

Purpose: To assess the effects of a new ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP) technique on sexual functions and micturition, in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) and to evaluate how the surgical technique of ES-ThuLEP can lead to ejaculation preservation. Methods: A prospective study was carried out between January 2015 and January 2018 on patients with surgical indication for BPH, who wished to preserve ejaculation. The patients were treated with ES-ThuLEP and were evaluated before and 3 and 6 months after surgery. Three validated questionnaires (ICIQ-MLUTSsex, IIEF-5 and IPSS) were used to assess changes in ejaculation, erectile function and urinary symptoms. Uroflowmetry (Qmax and Qavg), post-void residual volume and voided volume were also evaluated, to assess micturition improvement. Patients with moderate to severe erectile dysfunction were excluded. Statistical analysis was performed with the Student\u2019s t test, Chi-square test and logistic regression analysis. Results: Two hundred and eighty three patients were enrolled. Ejaculation was spared in 203 and 219 patients at 3 and 6 months after surgery. No significant differences were observed between erectile function before and after surgery: baseline IIEF-5 = 16.2 \ub1 4.47 vs 16.7 \ub1 2.9 (p = 0.419) and 17.7 \ub1 3.2 (p = 0.410) at 3 and 6 months. Significant improvement in urinary symptoms was achieved: baseline IPSS = 19.4 \ub1 7.24 vs 5.8 \ub1 4.3 (p = 0.032) and 3.9 \ub1 4.1 (p = 0.029) at 3 and 6 months. Conclusion: ES-ThuLEP effectively preserved ejaculation in over two thirds of the patients without compromising micturition improvement or erectile function. ES-ThuLEP could be a valid treatment option for BPH in young and sexually active men

Implementation of a distributed guideline-based decision support model within a patient-guidance framework

We report on new projection engine which was developed in order to implement a distributed guideline-based decision support system (DSS) within the European project MobiGuide.In this model, small portions of the guideline knowledge are projected, i.e. 'downloaded', from a central DSS server to a local DSS in the patient's mobile device, which then applies that knowledge using the mobile device’s local resources. Furthermore, the projection engine generates guideline projections which are adapted to the patient’s previously defined preferences and, implicitly, to the patient’s current context, which is embodied in the projected knowledge. We evaluated this distributed guideline application model for two complex guidelines: one for Gestational Diabetes Mellitus, and one for Atrial Fibrillation. We found that the initial specification of what we refer to as the customized guideline should be in the terms of the distributed DSS, i.e., include two levels: one for the central DSS, and one for the local DSS. In addition, we found significant differences between the customized, distributed versions of the two guidelines, indicating further research directions and possibly additional ways to analyze and characterize guidelines

Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

Background: To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods: This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results: No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions: HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred

A prospective multicenter randomized comparison between Holmium Laser Enucleation of the Prostate (HoLEP) and Thulium Laser Enucleation of the Prostate (ThuLEP)

Purpose: To compare intra and perioperative parameters between HoLEP and ThuLEP in the treatment of benign prostatic hyperplasia and to evaluate clinical and functional outcomes of the two procedures with a 12-month follow-up. Methods: A prospective randomized study was performed on 236 consecutive patients who underwent ThuLEP (n = 115), or HoLEP (n = 121) in three different centers. Intra and perioperative parameters were analyzed: operative time, enucleated tissue weight, irrigation volume, blood loss, catheterization time, hospital stay and complications. Patients were evaluated preoperatively and 3 and 12 months postoperatively with the international prostate symptom score (IPSS), the quality of life (QoL) score, post-void residual volume (PVR), PSA and maximum flow rate (Qmax). Results: Preoperative variables in each study arm did not show any significant difference. Compared to HoLEP, ThuLEP showed similar operative time (63.69 vs 71.66 min, p = 0.245), enucleated tissue weight (48.84 vs 51.13 g, p = 0.321), catheterization time (1.9 vs 2.0 days, p = 0.450) and hospital stay (2.2 vs 2.8 days, p = 0.216), but resulted in less haemoglobin decrease (0.45 vs 2.77 g/dL, p = 0.005). HoLEP presented a significantly higher number of patients with postoperative acute urinary retention and stress incontinence. No significant differences were found in PSA, Qmax, PVR, IPSS and QoL score during follow-up. Conclusion: ThuLEP and HoLEP both relieved lower urinary tract symptoms equally, with high efficacy and safety. ThuLEP detemined reduced blood loss and early postoperative complications. Catheterization time, enucleated tissue, hospital stay, operative time and follow-up parameters did not show any significant difference