7 research outputs found

    Associa√ß√£o entre interna√ß√Ķes por condi√ß√Ķes sens√≠veis e qualidade da aten√ß√£o prim√°ria

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    OBJECTIVE: To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019. METHOD: Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman‚Äôs test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years. RESULTS: A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations. CONCLUSIONS: The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators.OBJETIVO: Analisar a associa√ß√£o entre taxas municipais de interna√ß√Ķes por condi√ß√Ķes sens√≠veis √† aten√ß√£o prim√°ria (ICSAP), com a qualidade da aten√ß√£o prim√°ria √† sa√ļde (APS), vari√°veis socioecon√īmicas, demogr√°ficas e relacionadas a caracter√≠sticas locais do sistema de sa√ļde, de 2010 a 2019. M√ČTODOS: Estudo ecol√≥gico de s√©ries temporais nos munic√≠pios brasileiros analisando a correla√ß√£o das taxas de ICSAP, com a qualidade da APS medida pelos tr√™s ciclos do Programa de Melhoria do Acesso e da Qualidade da Aten√ß√£o B√°sica (PMAQ-AB). Foram inclu√≠dos munic√≠pios que participaram com 80% ou mais de suas equipes em, ao menos, dois ciclos do PMAQ-AB. Foi analisada a correla√ß√£o entre as taxas de ICSAP padronizadas com a qualidade da APS e demais vari√°veis. Empregou-se o teste de Spearman entre a vari√°vel resposta e as vari√°veis explicativas num√©ricas. Foi usado o generalized equations estimating como modelo multivariado associando as taxas de ICSAP e as demais vari√°veis ao longo dos anos. RESULTADOS: Foram inclu√≠dos 3.500 munic√≠pios nos modelos. A qualidade da APS (nota do PMAQ-AB) apresentou associa√ß√£o inversa com a varia√ß√£o das taxas de ICSAP. As taxas de interna√ß√£o tiveram queda de -2% ao ano a cada aumento de dez pontos na nota do PMAQAB, ajustado pelas demais vari√°veis. O aumento de uma unidade na vari√°vel leitos por mil habitantes impactou em uma eleva√ß√£o de aproximadamente +6,4% nas taxas de ICSAP. Quanto ao porte populacional, munic√≠pios maiores tiveram menores taxas de ICSAP. Tamb√©m se associaram √† redu√ß√£o das interna√ß√Ķes o aumento da cobertura da APS e a menor desigualdade socioecon√īmica. CONCLUS√ēES: A redu√ß√£o das taxas de ICSAP ao longo do tempo mostrou-se associada com o aumento da qualidade da APS. Al√©m disso, esteve associada com diminui√ß√£o do n√ļmero de leitos hospitalares e a munic√≠pios com melhores indicadores socioecon√īmicos

    Association between hospitalizations for sensitive conditions and quality of primary care

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    ABSTRACT OBJECTIVE To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019. METHOD Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman’s test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years. RESULTS A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations. CONCLUSIONS The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators

    Employment of artificial intelligence mechanisms for e-Health systems in order to obtain vital signs and detect diseases from medical images improving the processes of online consultations and diagnosis

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    Nowadays e-Health web applications allow doctors to access different types of features, such as knowing which medication the patient has consumed or performing online consultations. Internet systems for healthcare can be improved by using artificial intelligence mechanisms for the process of detecting diseases and obtaining biological data, allowing medical professionals to have important information that facilitates the diagnosis process and the choice of the correct treatment for each particular person. The proposed research work aims to present an innovative approach when compared to traditional platforms, by providing online vital signs in real time, access to a web stethoscope, to a medical image uploader that predicts if a certain disease is present, through deep learning methods, and also allows the visualization of all historical data of a patient. This dissertation has the objective of defending the concept of online consultations, providing complementary functionalities to the traditional methods for performing medical diagnoses through the use of software engineering practices. The process of obtaining vital signs was done via artificial intelligence using a computer camera as sensor. This methodology requires that the user is at a state of rest during the measurements. This investigation led to the conclusion that, in the future, many medical processes will most likely be done online, where this practice is considered extremely helpful for the analysis and treatment of contagious diseases, or cases that require constant monitoring.No quotidiano, as aplica√ß√Ķes Web e-Sa√ļde permitem aos m√©dicos acesso a diferentes tipos de funcionalidades, como saber qual a medica√ß√£o que o doente consumiu ou a realiza√ß√£o de consultas online. Os sistemas via internet para a sa√ļde podem ser melhorados, utilizando mecanismos de intelig√™ncia artificial para os processos de dete√ß√£o de doen√ßas e de obten√ß√£o de dados biol√≥gicos, permitindo que os m√©dicos tenham informa√ß√Ķes importantes que facilitam o processo de diagn√≥stico ou a escolha do tratamento correto para um determinado utente. O trabalho de investiga√ß√£o proposto pretende apresentar uma abordagem inovadora na compara√ß√£o com as plataformas tradicionais, ao disponibilizar sinais vitais online em tempo real, acesso a um estetosc√≥pio web, a um uploader de imagens m√©dicas que prev√™ se uma determinada doen√ßa est√° presente, atrav√©s de m√©todos de aprendizagem profunda, bem como permite visualizar todos os dados hist√≥ricos de um paciente. Esta disserta√ß√£o visa defender o conceito de consultas virtuais, providenciando funcionalidades complementares aos processos tradicionais de realiza√ß√£o de um diagn√≥stico m√©dico, atrav√©s da utiliza√ß√£o de pr√°ticas de engenharia de software. O processo de obten√ß√£o de sinais vitais foi feito atrav√©s de intelig√™ncia artificial para vis√£o computacional utilizando uma c√Ęmara de computador. Esta metodologia requer que o utilizador esteja em estado de repouso durante a obten√ß√£o dos dados medidos. Esta investiga√ß√£o permitiu concluir que, no futuro, muitos processos m√©dicos atuais provavelmente ser√£o feitos online, sendo esta pr√°tica considerada extremamente √ļtil na an√°lise e tratamento de doen√ßas contagiosas, ou de casos que requerem acompanhamento constante

    Volatile fingerprinting differentiates diverse-aged craft beers

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    Supplementary data to this article can be found online at https:// doi.org/10.1016/j.lwt.2019.03.044.Beer ageing on wood is a complex and difficult to control process involving several reactions and compounds. Difficulties in understanding the underlying phenomena often lead to empirical and unpredictable processes and heterogeneous products. This work resorts to volatile fingerprinting along with multivariate analysis as tools to differentiate and highlight differences in beers derived from diverse production processes. Volatile composition of beers originating from barrel ageing processes and unaged beer were analyzed by GC-MS. The collected data was processed by principal component analysis, which allowed the evaluation of relations between samples and volatile compounds. Beers were distinguished by clusters comprising different groups of volatiles. Beer with the longest period in barrel was in the cluster with the most volatiles. Beer produced by resident barrel microbiota fermentation was characterized by presence of Brettanomyces sp. metabolites. Beer aged in barrel by a shorter time period showed characteristic content of ethyl esters and oak extractives. Beer produced in inox vat and beer fermented in barrel with pitching of S. cerevisiae appeared in the same cluster, relating with fermentative esters. Volatile fingerprinting was a viable approach to characterize and distinguish the analyzed beers, providing relevant information regarding the impact of production methodologies in volatile composition.This work had funding support of the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2019 unit and COMPETE 2020 (POCI-01-0145 FEDER-006684) and BioTecNorte operation (NORTE-01-0145-FEDER000004) funded by the European Regional Development Fund under the scope of Norte2020 ‚Äď Programa Operacional Regional do Norte. Fermentum ‚ÄďEngenhariadasFermenta√ß√Ķes Lda.also participated incofunding and supplying materials for this work. Authors would like to thank Mr. Paulo Coutinho and Quinta do Portal for supplying the oak barrels used in this work.info:eu-repo/semantics/publishedVersio

    Formation of flavor-active compounds during continuous alcohol-free beer production : the influence of yeast strain, reactor configuration, and carrier type

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    The aim of this study is to demonstrate the influence of production strains (bottom-fermenting Saccharomyces pastorianus and S. cerevisiae with disruption in the KGD2 gene), carrier materials (spent grains and corncobs), reactor arrangements (packed-bed and gas-lift reactors), and mixing regimes (ideally mixed and plug flow) on the formation of flavor-active compounds during alcohol-free beer production. In addition, the composition of alcohol-free beer produced on a laboratory scale was compared with those of commercial products. The results confirmed the influence of each component of the production system (yeast strain, reactor, and carrier) on flavor formation, but their individual importance was case specific. The results indicate that the interplay between the appropriate production strain, carrier material, and bioreactor design is very important in continuous immobilized cell reactors and that suitable combinations could be used to improve both system performance and product quality.El objetivo de este trabajo es demostrar la influencia de las cepas de producci√≥n (fermentaci√≥n de fondo Saccharomyces pastorianus y S. cerevisiae con una interrupci√≥n en el gen KGD2), material de transportista (desperdicios de granos y mazorcas de ma√≠z), configuraciones del reactors (lecho empacado y elevaci√≥n de gas-reactor), y el sistema de mezclas (lo ideal es mixto y de flujo en pist√≥n) en la formaci√≥n de compuestos activos de sabor durante la producci√≥n de cerveza sin alcohol. Adem√°s, la composici√≥n de la cerveza sin alcohol producida en una escala de laboratorio se compararon con los de los productos comerciales. Los resultados confirmaron la influencia de cada componente del sistema de producci√≥n (cepa de levadura, de los reactores, y el transportista) en la formaci√≥n de sabor, pero su importancia individual era el caso espec√≠fico. Los resultados indican que la interacci√≥n entre la cepa de producci√≥n adecuados, material de soporte, y el dise√Īo de biorreactor es muy importante en los reactores de c√©lulas inmovilizadas continuas y que las combinaciones adecuadas se podr√≠an utilizar para mejorar tanto el rendimiento del sistema y la calidad del productoWe thank the Fundacao para a Ciencia e Tecnologia (SFRH/BD/37082/2007) and MSMT (MSM 6046137305, Czech Republic) for financial support

    Optimisation of lab-scale continuous alcohol-free beer production

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    In order to study the formation and conversion of the most important flavour compounds, the real wort used in alcohol-free beer fermentation was mimicked by a complex model medium containing glucose, yeast extract, and selected aldehydes. The fermentation experiments were carried out in a continuously operating gas-lift reactor with brewing yeast immobilised on spent grains (brewing by-product). During the continuous experiment, parameters such as oxygen supply, residence time (Rt), and temperature (T) were varied to find the optimal conditions for the alcohol-free beer production. The formation of ethanol, higher alcohols (HA), esters (ES), as well as the reduction of aldehydes and consumption of glucose were observed. The results suggest that the process parameters represent a powerful tool in controlling the degree of fermentation and flavour formation brought about by immobilised biocatalyst. Subsequently, the optimised process parameters were used to produce real alcohol-free beer during continuous fermentation. The final product was compared with batch fermented alcohol-free beers using the methods of instrumental and sensorial analysis.Ministry of Education, Youth and Sports of the Czech Republi
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