Epidemiologia espacial e a detecção de aglomerados espaciais do dengue na Paraíba: uma comparação entre os métodos Scan flexível e Scan circular / Spatial epidemiology and the detection of spatial clusters of dengue in Paraíba: a comparison between the flexible Scan and circular Scan methods

Resumo Introdução Estatísticas espaciais são usadas para auxiliar gestores de saúde na tomada de decisão, informando a taxa de ocorrência de agravos na população e destacando quando estas alcançam valores além do esperado. Objetivo Compreender o funcionamento e aplicabilidade das Estatísticas Espaciais Scan flexível e Scan circular, comparando seus resultados na detecção de aglomerados espaciais usando dados epidemiológicos reais do dengue no estado da Paraíba - Brasil. Método Descreveu-se o processo detalhado da aplicação das estatísticas Scan flexível e Scan circular para a detecção de áreas significativas de risco (aglomerados) do dengue na Paraíba, nos anos de 2009 a 20013, por meio dos software FLeXScan e SaTScan. Resultados Ambos os métodos revelaram o oeste do estado como a região com maior frequência de aglomerados detectados com alto risco, em todos os anos analisados, levando-se em consideração os mapas de risco de incidência do dengue na Paraíba, nos anos de 2009 a 2013. Conclusão As estatísticas Scan flexível e Scan circular são praticamente similares quanto à eficiência na detecção de aglomerados do dengue. Entretanto, verificaram-se problemas de superestimação no método Scan circular e subestimação no método Scan flexível na detecção dos aglomerados. Destacou-se ainda o auxílio destas estatísticas espaciais aos gestores de saúde quanto à localização das regiões de agravo da doença, tornando mais efetivo o direcionamento das ações de combate de forma politicamente correta.

Abstract Background Spatial statistics are used to help health managers make decisions, informing the rate of occurrence of diseases in the population and highlighting when they reach values beyond expectations. Objective To understand the functioning and applicability of Spatial Statistics Flexible Scan and Circular Scan by comparing their results in the detection of spatial clusters using real epidemiological data of dengue in the state of Paraíba - Brazil. Method The detailed process for applying the flexible scan and circular scan statistics for detecting significant dengue risk areas (clusters) in Paraíba, between 2009 and 20013, was described using the software FLeXScan and SaTScan. Results Both methods showed the highest frequency of clusters detected at high risk in the western region of the state, in all the years analyzed, considering the risk maps of dengue incidence in Paraíba, between 2009 and 2013. Conclusion The flexible scan and circular scan statistics are practically similar in terms of efficiency in detecting clusters of dengue. However, there were problems of overestimation in the circular Scan method and underestimation in the flexible Scan method in the detection of clusters. It is also worth highlighting that these spatial statistics help health managers locate the regions of disease aggravation, making it more effective to direct combat actions in a politically correct manner.

COVID-19 y adultos mayores: comparación espaciotemporal entre mortalidad y vacunación en la provincia de Buenos Aires, Argentina / COVID-19 and older adults: spatiotemporal comparison between mortality and vaccination in the province of Buenos Aires, Argentina

RESUMEN El objetivo de este estudio fue analizar las variaciones espaciotemporales de la mortalidad por COVID-19 en adultos mayores y de la vacunación contra la COVID-19 en esta población. Se utilizaron datos de defunciones por COVID-19 y de personas de 70 a más años inmunizadas con la primera dosis de vacunas contra esta enfermedad, en partidos de la provincia de Buenos Aires, desde el 29 de diciembre del 2020 al 30 de junio de 2021. Se emplearon técnicas de escaneo espaciotemporal para detectar conglomerados. Los partidos del Gran Buenos Aires que tuvieron mayor vacunación con la primera dosis de la vacuna Sputnik V en población de 70 a más años, entre mediados de marzo y principios de abril de 2021, coincidieron mayormente en registrar una disminución de la mortalidad en esta población, entre finales de abril y finales de junio de 2021. Este estudio mostró algunos indicios del impacto positivo de la aplicación de la primera dosis de la vacuna Sputnik V en el Gran Buenos Aires.

ABSTRACT The aim of this study was to analyze the spatiotemporal variations of COVID-19 mortality and vaccination against COVID-19 in older adults. We used data from deaths due to COVID-19 and persons aged 70 years and older immunized with the first dose of vaccines against this disease, from districts of the province of Buenos Aires, between December 29, 2020, and June 30, 2021. Spatiotemporal scanning techniques were used to detect clusters. The parties of Greater Buenos Aires that had the highest vaccination rate with the first dose of the Sputnik V vaccine in population aged 70 years and older, between mid-March and early April 2021, also registered a decrease in mortality in this population, between the end of April and the end of June 2021. This study showed some signs of the positive impact associated with the application of the first dose of Sputnik V vaccine in Greater Buenos Aires.

Analysis on the distribution status and concentration degree of radiological diagnosis and treatment resources in Beijing / 中国辐射卫生

Objective To analyze the distribution status and agglomeration degree of radiological diagnosis and treatment resources in Beijing, and provide references for rationally coordinating the allocation of radiological diagnosis and treatment resources, formulating resource allocation policies, and promoting the stable development and efficient use of radiological diagnosis and treatment resources. Methods Based on the medical radiation protection monitoring data of Beijing medical and health institutions from 2019 to 2020, the current situation of radiological diagnosis and treatment resources is described by the number of radiological diagnosis and treatment resources, the average service volume, and the resource composition, and the distribution of radiological diagnosis and treatment resources in Beijing is evaluated with the aid of the agglomeration degree. Results The number of radiological diagnostic equipment, the number of service personnel, and the number of radiological workers engaged in third-level hospitals is the largest; for the number of service personnel for each type of single equipment, third-level hospitals account for a larger proportion, and radiotherapy and nuclear medicine services are concentrated in third-level hospitals. Human resource pressure and equipment service pressure are relatively high in third-level hospitals. First-level hospitals mainly undertake radiological diagnosis services. There is little difference in the amount of radiological diagnosis services per capita between second-level hospitals and third-level hospitals. Nuclear medicine and radiotherapy in third-level hospitals per capita service volume is significantly higher than that insecond-level hospitals. Radiological diagnosis and radiotherapy resources are concentrated in urban areas to a large extent. Conclusion There are obvious differences in the utilization of radiological diagnosis and treatment resources in different levels of hospitals. There is a significant concentration of radiological diagnosis and treatment resources in various districts. There is a certain degree of unbalanced distribution and inadequate utilization of radiological diagnosis and treatment resources in Beijing.

Distribution and suitable habitats of ticks in the Yangtze River Delta urban agglomeration / 中国血吸虫病防治杂志

Objective To investigate the current distribution of ticks and predict the suitable habitats of ticks in the Yangtze River Delta urban agglomeration in 2017, so as to provide insights into tick control and management of tick-borne diseases in these areas. Methods All publications pertaining to tick and pathogen distribution in the Yangtze River Delta urban agglomeration were retrieved, and the geographical location of tick distribution was extracted. The effects of 19 climatic factors on the distribution of ticks were examined using the jackknife method, including the mean temperature of the wettest quarter, precipitation of the coldest quarter, mean temperature of the driest quarter, maximum temperature of the warmest month, precipitation of the driest month, minimal temperature of the coldest month, annual precipitation, mean daily temperature range, precipitation seasonality, annual temperature range, temperature seasonality, annual mean temperature, mean temperature of the warmest quarter, precipitation of the wettest quarter, isothermality, mean temperature of the coldest quarter, precipitation of the wettest month, precipitation of the driest quarter and precipitation of the warmest quarter. The distribution of ticks was analyzed in 2020 using the maximum entropy (MaxEnt) model, and the potential suitable habitats of ticks were predicted in 2070 using the MaxEnt model based on climatic data. Results A total of 380 Chinese and English literatures were retrieved, and 148 tick distribution sites were extracted, with 135 sites included in the subsequent analysis. There were 7 genera (Haemaphysalis, Rhipicephalus, Ixodes, Dermacentor, Boophilus, Hyalomma and Amblyomma) and 27 species of ticks detected in the Yangtze River Delta urban agglomeration. The climatic factors affecting the distribution of ticks in the Yangtze River Delta urban agglomeration mainly included the mean temperature of the wettest quarter and the precipitation of the coldest quarter, with 26.1% and 23.6% contributions to tick distributions. The high-, medium- and low-suitable habitats of ticks were 20 337.08, 40 017.38 km2 and 74 931.43 km2 in the Yangtze River Delta urban agglomeration in 2020, respectively. The climate changes led to south expansion of the suitable habitats of ticks in the Yangtze River Delta urban agglomeration in 2070, and the total areas of suitable habitats of ticks was predicted to increase by 18 100 km2. In addition, the high-, medium- and low-suitable habitats of ticks were predicted to increase to 24 317.84, 45 283.02 km2 and 83 766.38 km2 in the Yangtze River Delta urban agglomeration in 2070, respectively. Conclusions Multiple tick species are widespread in the Yangtze River Delta urban agglomeration, and the future climate changes may lead to expansion of tick distribution in these areas.

Spatial Agglomeration of Health Industry and the Improvement of Residents'Health Level: Based on the Perspective of Threshold of Agglomeration and Spatial Spillovers / 中国卫生经济

Objective: To analyze the current non-linear and spatial dependence of health industry clustering and residents' health level in China. Methods: Using the panel data of China from 2002 t0 2017, the panel threshold model and the spatial Dubin model were constructed to conduct empirical tests. Results and Conclusion: Based on the internal perspective of the region, it was found that whether the health industry cluster would inevitably promote the improvement of residents' health level was bound by the threshold of agglomeration scale. Only when the agglomeration scale was in the median interval of [1.209, 1.763], the output effectiveness of the health industry cluster was more significant; based on the spatial spillover perspective, the positive health "spill effect" caused by the accumulation of health and health industries in the surrounding areas had made compensation on the “health short board” of the health and health industry in the region although the health and industrial clusters in the region had not made significant contributions to the improvement of the health of local residents.

Fatores associados às doenças transmitidas por alimentos em crianças durante o carnaval de Salvador / Factors associated with foodborne diseases in children during carnaval in Salvador / Los factores asociados a las enfermedades transmitidas por alimentos a los niños durante el carnaval de Salvador

Doenças transmitidas por alimentos (DTA) oferecem riscos à saúde. No Brasil em 2016 foram notificadas 9.935 pessoas com DTA, reforçando a importância de conhecer os fatores associados para prevenção e planejamento da redução de incidentes. Crianças estão expostas às DTA, principalmente no carnaval. O objetivo deste artigo é descrever as características clínicas e fatores associados às DTA em crianças durante o carnaval de Salvador. Este é um estudo transversal, com análise das fichas de atendimento de crianças de 0 a 12 anos, durante o carnaval de Salvador/2016. Para análise dos dados foi utilizada a estatística descritiva, aplicou-se o teste qui-quadrado de Pearson para medidas de associação (p < 0,05). A amostra foi constituída de 127 crianças, sendo que 37,8% foram diagnosticadas com DTA. Dentre as crianças com DTA, houve o predomínio da faixa etária de 1 a 9 anos (70,8%) e sexo masculino (54,2%), folião de rua (95,8%), atendidos no circuito Osmar (52,1%), no período da tarde (31,3%). Na análise bivariada identificou-se associação de DTA com: náuseas/vômitos (p < 0,001) e dor abdominal (p = 0,001). Prevaleceu o número de crianças de 1 a 9 anos, sexo masculino e a maioria sendo folião de rua, atendidos no turno da tarde. As DTA foram associadas com náuseas/vômitos e dor abdominal.

Foodborne diseases pose a health risk, regardless of age groups. In Brazil, in 2016, 9,935 people with foodborne diseases were notified, reinforcing the importance of knowing the associated factors to prevention and planning to reduce incidents. This paper describes the clinical characteristics and factors associated with foodborne diseases in children during Carnival in Salvador. This is a cross-sectional study with a retrospective analysis of the medical charts of children from 0 to 12 years old, during the Carnival in Salvador/2016. For data analysis, descriptive statistics was used, and Pearson's Chi-Square test was applied for association measures (p<0.05). The sample consisted of 127 children, and 37.8% were diagnosed with foodborne diseases. Among children with foodborne diseases, there was a predominance of: age group 1-9 years old (70.8%), male (54.2%), street carnival revelers (95.8%), having attended the Osmar circuit (52.1%), in the afternoon (31.3%). Bivariate analysis showed an association of foodborne diseases with: nausea/vomiting (p<0.001) and abdominal pain (p=0.001). Children from 1 to 9 years old, male, and most of them being street carnival revelers, having attended during the afternoon shift. Foodborne diseases were associated with nausea/vomiting and abdominal pain.

Las enfermedades transmitidas por alimentos (ETA) ofrecen riesgos a la salud humana. En Brasil en 2016 se notificaron 9.935 personas con ETA, lo que refuerza la importancia de conocer los factores asociados para la prevención y planificación de la reducción de incidentes. Los niños están expuestos a las ETA, principalmente durante el carnaval. El presente artículo objetivó describir las características clínicas y los factores asociados a las ETA en los niños durante el carnaval de Salvador. Es un estudio transversal, con análisis de las fichas de atención de los niños de 0 a 12 años, durante el carnaval de Salvador en 2016. Para el análisis de datos, se utilizó la estadística descriptiva, se aplicó el test chi-cuadrado de Pearson para medidas de asociación (p < 0,05). La muestra constó de 127 niños, de los cuales un 37,8% tuvieron diagnóstico de ETA. En el caso de los niños con ETA, hubo un predominio del grupo de edad de 1 a 9 años (70,8%), del sexo masculino (54,2%), rumberos del carnaval (95,8%), atendidos en el circuito Osmar (52,1%), en el turno de la tarde (31,3%). En el análisis bivariado se identificó asociación de ETA con: náuseas/vómitos (p < 0,001) y dolor abdominal (p = 0,001). Han prevalecido niños de 1 a 9 años, del sexo masculino y la mayoría rumberos del carnaval, atendidos en el período de la tarde. Las ETA se asociaron con náuseas/vómitos y dolor abdominal.

The Two Medical Prescriptions Treating Miscellaneous Diseases Written in Tangut Script Excavated from Heishui City / 浙江中医药大学学报

[Objective]To discuss the medical development situation of Tangut and the medicine cultural communication and fusion of the Central Plains, it decoded the medical prescriptions treating miscellaneous diseases in Heishui town. [Methods]It is done by arranging, decoding and translating the excavated Heishui town Tangut script which treats the people who can't swallow food and the pharyngitis and treats the constipation of men and women. Besides it can connect with the medical theory of Central Plains to discuss from the pathology dosage and eating aspects. [Results]The two medical prescriptions of Tangut which treating miscellaneous diseases are imbued with strong folk features. So it should be recorded by Tangut doctor. [Conslusion]Most of the Tangut medical pathology come from the traditional Chinese medicine theory. But it also has its own uniqe national features. So the medical culture of Central Plains has a deep influence on other peripheral ethnomedicine.

Analysis of the Equity of Health Resources Allocation of Traditional Chinese Medicine in China Based on the Agglomeration Degree / 中国医院管理

Objective To analyze the situation and change trend of health resources allocation of traditional Chinese medicine (TCM).Methods The agglomeration degree is used to analyze the situation and change trend of health resources allocation of TCM in different regionS.Results The regional disparity of health resource allocation of TCM is large,and the equity of health resources allocation according to geography and population needs to be further improved and optimized.Conclusion The availability of health resources of TCM should be improved,and the diversified needs of TCM in different regions be met.

Analysis of Trends on Spatial Agglomeration of Pharmaceutical Industry of China from 2011 to 2015 / 医药导报

Improving the spatial agglomeration level of regional pharmaceutical industry is an important measure to promote the competitive ability of national industry.We used three evaluation indicators,Spatial Gini Coefficient,Location Concentration Ratio and Agglomeration Index,was to calculate the degree and speed of regional agglomeration of pharmaceutical industry from 2011 to Oct 2015.At present,China's pharmaceutical industry has formed spatial concentration,particularly concentrates in Shandong,Jiangsu and Guangdong.And the chemical pharmaceutical industry mainly concentrates in Shandong, Jiangsu,Guangdong and Beijing;Chinese traditional medicine industry concentrates in Shandong,Sichuan,Jilin and Jiangxi;biopharmaceutical industry concentrates in Shandong,Jiangsu,Henan.From the point of view of development speed,the agglomeration speeds of bio-pharmaceutical and traditional medicine industry are accelerating compared with the shrink of chemical pharmaceutical industry.Three provinces of the greatest growing speed of agglomeration for chemical,traditional medicine and bio-pharmaceutical industry are Jilin,Tibet and Jiangxi, respectively.Agglomeration growth of biopharmaceutical industry in western region is prominent.This paper suggests that the national government should play a leading role in the development of regional cluster for pharmaceutical industry.Some effective measures should be taken which include formulating the supporting policies of enterprise cluster,establishing the incentive system of drug innovation and optimizing the industrial portfolio in order to promote the formation of regional sustainable competitive advantage through agglomeration effect.

Analysis of the agglomeration degree of health resources in Traditional Chinese Medicine / 中华医院管理杂志

Objective To evaluate the quantity,category and the distribution of health resources of Traditional Chinese Medicine(TCM)in order to advise on optimizing TCM service system.Methods Based on the concept of agglomeration degree,this paper compared and analyzed the agglomeration of TCM resources in terms of medical institutions,their beds and medical workers.Results Currently the agglomeration degree of TCM health resources is found to be low,as TCM medical institutions tend to be small,with most of them being TCM clinics.Conclusions To rationalize the distribution of TCM medical resources,we must increase financial input and provide supportive policies,actively encourage healthy development of TCM medical institutions,strength TCM medical service system development in areas of poor TCM resources.

The Application and evaluation of Nano-dispersion systems of nanomaterials in medical devices / 中国医学装备

Objective:To evaluate the methods of nano-dispersion systems and the stability of samples in medical devices.Methods: By analyzing the cause of agglomeration and comparing kinds of methods to orient the elements of nano-dispersion Systems and the evaluation means. Results: To obtain the repetitive results, the foundation methods of nano-dispersion systems should be recorded in detail and all the following tests should be based on it.Conclusion: The constitution and evaluation of a dispersion system in obtaining representative and reproducible results in biological evaluation is very important and should be studied case by case.

Engineering Spherical Beads as an Approach to Improve the Physico-Mechanical Properties of Poorly Soluble Drugs.

Improving oral bioavailability of drugs given as solid dosage forms remains a challenge for the formulation scientists due to solubility problems. To address this encumbrance, ionotropic gelation technique has attracted considerable interest of improving the dissolution rate of highly lipophilic drugs thereby improving their bioavailability by engineering spherical agglomerates. Spherical beads of poorly water soluble drug, piroxicam, were formulated by dispersing the drug in solutions of ionic polysaccharide sodium alginate and then dropping these dispersions into a solution of the counterion calcium chloride. The droplets rapidly created gelled spheres by ionotropic gelation. Strong spherical beads could be engineered with high yield and a drug content approaching 100%. The flow characteristics of micronized rods like crystals were significantly enhanced by this agglomeration technique when compared to the non-agglomerated drug crystals. Furthermore, scanning electron microscopy, size, image analysis, dissolution profiles and compression properties of piroxicam beads were evaluated. Beads engineered by using 1% sodium alginate and 3% calcium chloride gave the most desirable results as compared to other compositions.

Advance on crystallo-co-agglomeration based particle engineering technique / 中国药学杂志

OBJECTIVE: To introduce the crystallo-co-agglomeration (CCA) approach and its recent pharmaceutical progress.

Effect of Agglomeration on the Toxicity of Nano-sized Carbon Black in Sprague-Dawley Rats

OBJECTIVES: Recent studies have shown that nano-sized carbon black is more toxic than large respirable carbon black because of its higher surface area. However, it is not clear if carbon black made larger by agglomeration demonstrates decreased toxicity. The purpose of this study was to verify if agglomeration affects the toxicity of carbon black using three differently prepared nano-sized carbon black aerosols in nose-only inhalation chambers for 13 weeks. METHODS: Printex 90 was selected as a representative nano-sized carbon black. To generate aerosols of three different types of agglomerates, Printex 90 was dispersed in distilled water by three different methods: vortex, vortex+sonication, and vortex+sonication with dispersion in a stabilizer. Then, the three differently prepared solutions were aerosolized through venturi nozzles. Male Sprague-Dawley rats were exposed to Printex 90 aerosols in a nose-only exposure chamber for 6 h/d, 5 d/wk for 13 weeks at a concentration of approximately 9 mg/m3. RESULTS: Numbers of total cells in the bronchoalveolar lavage (BAL) fluid, macrophages, and polymorphonuclear leukocytes were increased and carbon black masses were clearly seen in BAL cells and lung tissues of rats exposed to Printex 90. However, few differences were found between the three differently agglomerated aerosols. In addition, there were no significant differences in other parameters, such as body weight, lung function or cytokine levels in BAL fluid following carbon black exposure. CONCLUSIONS: Only mild to moderate respiratory effects were found in rats exposed to nano-sized carbon black at 9 mg/m3 for 13 weeks. Agglomeration did not affect the toxicity of nano-sized carbon particles.

Discussion on the dispersion & agglomeration of aircraft industry / 药物分析学报

The aircraft industry is crucial to the economy and security of a nation. In this paper, the spatial characteristics and patterns of the aircraft industry are analyzed on different spatial scales. It is found that there is a 'Matthew effect' in the global aircraft industry and the spatial evolution of the industry is consistent with the industrialization process of the whole country. It is also revealed that the spatial evolution of the country is driven by both the centripetal forces including capital, talents, technology and agglomeration economies and the centrifugal forces including the comparative advantage, cost &risk sharing, emerging markets, development policy for less-developed regions and the military imperative. These forces have both market-stabilizing and market-disrupting effects on the spatial evolution of the aircraft industry. The study suggests that lessons drawn from the experiences in the United States and France are expected to be conducive to the rise of China's aircraft industry in the future.

Agglomeration Inhibition (tm) Changes in Absorptive Hypercalciuria Patients after Taking a New Slow-release Potassium Phosphate Preparation (Urophos-K) / 대한비뇨기과학회지

A new slow-release potassium phosphate preparation (Urophos-K), designed to minimize gastrointestinal side effects and avoid sodium-induced calciuria was tested in stone-formers with absorptive hypercalciuria(AH). In a prospective, randomized, double-blind tria1, 17 patients with AH received either Urophos-K (155mg P, 8 mEq K per tablet) 4 tablets twice daily or an identical placebo. Subjects were studied during a 4-day period in the hospital while consuming a constant metabolic diet containing 400mg Ca, 100meq Na, 800mg P/day before and after 3 months of treatment. The parameter of agglomeration inhibition ([h]) increased from 78.3+/-28.1 to 133.3+/-46.2 min4, consistent with the inhibitory action of citrate and pyrophosphate. Treatment with Urophos- K reduces urinary stone-forming potential.

The Experiment Study of Polyunsaturated Fatty Acids Affecting on Platelet Agglomeration and Anti-coagulation / 中国海洋药物

Polyunsaturated fatty acids (PUFA) was a functional component extracted from fish oil. The experiment results indicate that PUFA might inhibit platelet agglomeration induced by Adenosine diphosphate (ADP) in rabbit and rat. The results also suggested that PUFA has extent effect of anti-coagulation in mice. These effects are related with dosage of giving drug.