Infección con SARS-CoV2, antes y después de la vacunación, en funcionarios de un hospital de mediana y alta complejidad / Sars-CoV2 infection, before and after vaccination, in health care workers of a medium and high complexity hospital

Introducción: La pandemia de COVID-19 evidenció la importancia de los trabajadores esen-ciales de la salud. Objetivo: Estimar la ocurrencia de la infección por el virus Sars_CoV2 en funcionarios de un hospital, antes y después de implementación del programa de vacunación institucional y la fracción preventiva atribuible a la vacunación. Material y métodos: Estudio de cohorte histórica, teniendo como punto de inicio la fecha del primer funcionario diagnosticado con la Covid19 en el Hospital. Alrededor de mil traba-jadores fueron examinados, durante el periodo de estudio comprendido entre junio de 2020 y octubre 2021. Se utilizó el estadístico de Kaplan-Meier, para comparar la velocidad de infección y la fracción preventiva atribuible al programa de vacunación. Resultados. Hubo diferencias estadísticamente significativas en la reducción de casos según tipo de trabajo, los trabajadores asistenciales experimentaron una reducción del 58,1%, de 124 a 52 y la diferencia en la mediana de la velocidad de infección, antes y después, Log Rank = 127,4 gl = 1 p = 0,000; los administrativos 51,7% de 29 a 14, mediana log Rank = 34,4 gl = 1 p = 0,000, y los operativos 45,5% de 11 a 6, mediana Log Rank = 13,5 gl = 1 p = 0,000. La fracción atribuible preventiva entre los asistenciales fue 47,5% (37,4­54,9); 85,2% (77,7­88,9) en administrativos y una reducción no significativa de 43,6% (-20,7, 63,2) en operativos. Conclusiones: Los trabajadores asistenciales tienen un riesgo alto de contraer la infección por Sars_CoV2. Fue una acertada decisión vacunar a todos los trabajadores del hospital, el impacto es demostrable.

Introduction: The COVID-19 pandemic highlighted the importance of essential health care workers.Objective: To estimate the occurrence of Sars_CoV2 virus infection in hospital staff before and after implementation of the institutional vaccination program and the preventive fraction attributable to vaccination. Material and methods: Historical cohort study, having as starting point the date of the first employee diagnosed with Covid19 in the Hospital. About one thousand workers were exa-mined, during the study period from June 2020 to October 2021. The Kaplan-Meier statistic was used to compare the infection, rate and the preventive fraction attributable to the vac-cination program. Results: There were statistically significant differences in the reduction of cases according to type of work, with the assistential workers experiencing a reduction of 58.1%, from 124 to 52 and the difference in median infection rate, before and after, Log Rank = 127.4 gl = 1 p = 0.000; the administrative 51.7% from 29 to 14, median Log Rank = 34.4 gl = 1 p = 0.000, and the operatives 45.5% from 11 to 6, median Log Rank = 13.5 gl = 1 p = 0.000. The preventive attributable fraction among assistants was 47.5% (37.4-54.9); 85.2% (77.7-88.9) in adminis-trative and a non-significant reduction of 43.6% (-20.7, 63.2) in operatives.Conclusions: Healthcare workers are at high risk of contracting Sars_CoV2 infection. It was a wise decision to vaccinate all hospital workers, the impact is demonstrable.

Preliminary estimation of lung cancer risk of radon exposure in a uranium mine using different corrections / 中国职业医学

Objective: To explore the correction factors of lung cancer caused by radon exposure in a uranium mine, and estimate the excess relative risk (ERR) coefficient of lung cancer caused by radon in the uranium miners. Methods: Male miners who worked in a uranium mine more than one year in Hunan Province from 1958 to 2018 were selected. This study preliminarily estimated the ERR coefficient of lung cancer caused by radon in the miners with different corrections using the Possion regression model. Results: This study cohort included 4 851 uranium miners, with 187 miners died with lung cancer from 1958 to 2018, and cumulative follow-up of 207 251 person-year. The ERR coefficient of lung cancer caused by radon without correction factors was estimated to be 0.21%/WLM (95%CI: 0.04%/WLM-0.27%/WLM). In the final model, the exponential correction factors of radon-induced lung cancer were time since exposure and exposure rate. In this model, if time since exposure was 45 years and the average exposure rate was 0.14 WL, the estimated ERR coefficient was 1.73%/WLM (95%CI: 0.36%/WLM-3.11%/WLM). The ERR decreases by about 60.00% for every 10 years since exposure, and increases by about 30.00% for every one WL increase exposure rate. Conclusion: The correction factors of lung cancer caused by radon in uranium miners in this mine were the time since exposure and exposure rate. It was preliminarily estimated that the ERR coefficient of lung cancer caused by radon in the occupational radon exposed population in this uranium mine was 1.73%/WLM (95%CI: 0.36%/WLM-3.11%/WLM).

Association between time-weighted individual exposure to ambient pollutants and carotid intima-media thickness / 环境与职业医学

Background Evidence about the association between air pollution and carotid intima-media thickness (CIMT) is inconsistent, and limited studies have explored the relationship between gaseous pollutants and CIMT. Additionally, personal activity patterns and infiltrated ambient pollution are not comprehensively considered to estimate individual exposure to air pollutants. Objective To investigate the relationship between long-term time-weighted individual exposure to ambient pollutants [fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)] and the progression of CIMT. Methods This study was performed among 554 participants in the Beijing Health Management Cohort who were free of atherosclerotic lesions on carotid artery at baseline. Daily concentrations of pollutants were predicted at both residential and work addresses based on land-use regression model. With additional consideration of personal indoor and outdoor activity patterns at both addresses and exposure to ambient pollutants from traffic transportation, individual time-weighted concentration was calculated. Indoor exposure was estimated by infiltrated ambient pollutants (based on infiltration factors and land-use regression model). Personal activity patterns included type, time, location, and frequency. Exposure to ambient pollutants from different traffic transportations was estimated by the average outdoor pollutant concentrations at both residential and work addresses combined within filtration factors and time spent on commuting. Multiple linear regression was conducted to assess the association of time-weighted individual pollutant exposure and the central position of CIMT progression. Quantile regression was applied to explore the relationship between time-weighted individual pollutant exposure and the progression of CIMT on different percentiles. Results The median value of CIMT progression was 369.49 μm·year−1. PM2.5, PM10, SO2, and O3 were associated with CIMT progression in the multiple linear regression model. The largest effect sizes of PM2.5, PM10, and SO2 were obtained for one-year exposure (regression coefficient: 66.910, 64.077, and 191.070, respectively), and two-year exposure for O3 (regression coefficient: 62.197). The results of quantile regression demonstrated different effect sizes for pollutants among different percentiles on CIMT progression. Significant associations between CIMT progression and PM2.5 from P30 to P50, CO from P10 to P40, and PM10 from P30 to P60 were observed. Two-year and three-year exposures to NO2 (P10, P20 and P40) were also associated with CIMT progression. The association between SO2 and the progression of CIMT was proved on all percentiles, and larger effect sizes of one-year and two-year exposures to SO2 (except P90) were demonstrated with increasing percentiles. The upward trend for the coefficients was clearly presented from P50 to P80. Specifically, the coefficient of two-year exposure to SO2 ranged from 136.583 (P50) to 277.330 (P80). No statistically significant association was observed between O3 and CIMT progression on any percentile (P>0.05), and the results were inconsistent with those of the multiple linear regression. Conclusion Individual time-weighted exposures to PM2.5, PM10, SO2, NO2, and CO have the potential to promote the progression of CIMT, and the adverse effect of ambient pollution on atherosclerotic lesion is identified.

Estimativa de idade pela análise radiográfica de caninos permanentes ­ estudo piloto em uma população do interior da Bahia / Age estimation by radiographic analysis of permanent canines ­ pilot study in a population in the interior of Bahia

A estimativa de idade representa um tipo de perícia com a finalidade de auxiliar na estimativa do perfil biológico de indivíduos vivos e mortos. O presente trabalho teve como objetivo verificar a aplicabilidade do método Cameriere (2004) de estimativa de idade pelos dentes, em indivíduos adultos, a partir do emprego de radiografias panorâmicas, caracterizando a amostra segundo sexo e idade e verificando a relação entre idade real e idade estimada pelo método. Para isso, foram utilizados caninos hígidos para cálculo da área do dente e da polpa, com o Programa Adobe Photoshop, em 50 radiografias panorâmicas. Os valores em pixels foram inseridos em fórmulas propostas pelo método, obtendo-se, assim, a idade estimada. A concordância intraexaminador evidenciou um coeficiente de correlação intraclasse quase perfeito, com valor de p igual a 0,9998. Para a amostra estudada, quando comparadas às médias das idades estimadas e reais para cada indivíduo, observou-se uma tendência de subestimação da idade com o método de Cameriere (2004), em todas as formas de análises, apresentando resultados de médias mais discrepantes, quando utilizado os caninos inferiores. Conclui-se que o método de Cameriere (2004) não se mostrou aplicável considerando a amostra, a faixa etária e a população analisada, com tendência de subestimação das idades quando comparadas com as idades reais

Age estimation represents a type of expertise with the purpose of helping to estimate the biological profile of living and dead individuals. This study aimed to verify the applicability of the Cameriere (2004) method of age estimating by teeth, in adult individuals, from panoramic radiographs use, characterizing the sample according to sex and age and verifying the relationship between actual age and age estimated by the method. For this, we used healthy canine teeth to calculate the area of the tooth and the pulp, with the Adobe Photoshop Program, in 50 panoramic radiographs, using the healthy canine teeth as a reference for analysis. The pixel values were inserted into formulas proposed by the method, thus obtaining the estimated age. The intra-examiner agreement showed an almost perfect correlation coefficient, with p-value equal to 0.9998. For the sample studied, when comparing the averages of the estimated and actual ages for each individual, there was a tendency to underestimate age with the Cameriere (2004) method, in all forms of analysis, with more discrepant average results when using the lower canines It is concluded that the method of Cameriere (2004) was not applicable considering the sample, the age group and the population analyzed, with a tendency of underestimation of the ages when compared with the real ages

Preliminary study on calculating size-specific dose estimate values based on age in children′s head / 中华放射医学与防护杂志

Objective:To investigate the feasibility of size-specific dose estimate of head based on pediatric patients′ age.Methods:A retrospective study was conducted on plain head CT scans of 210 patients in Tianjin Children′s Hospital from January to March in 2022. The volume CT dose index (CTDI vol) values, age and sex of the patients were recorded. The anteroposterior diameter (AP) and lateral diameter(LAT), aera and CT value in the middle slice of the scan region were measured on the workspace. According to the AAPM reports 220 and 293, the water equivalent diameter ( DW) of head, size-specific conversion factors ( fmeasuredH16), and size-specific dose estimate (SSDE measured) were calculated. The effective diameter ( Deff; WHO) was calculated for male and female individuals using the ralationship between the standard head circumference and age of children provided by World Health Organization (WHO). The effective diameter ( Deff; WHO) was converted into a water equivalent diameter ( DW; WHO), using a correlation established from the Deff and DWwhich were measured in 210 image sets of male and female patients. Then the corresponding fWHOH16 and SSDE WHO of head can be calculated. The correlation between DW and DW; WHO, fmeasuredH16 and fWHOH16, the correlation and consistency between SSDE measured and SSDE WHO, and the conversion relationship between age and fWHOH16 were analyzed for male and female patients. Results:A significant correlation were found between the measured DW and DW; WHO(female: r=0.917, P<0.01; male: r=0.873, P<0.01), fmeasuredH16 and fWHOH16(female: r=0.916, P<0.01; male: r=0.883, P<0.01), SSDE measured and SSDE WHO( r=0.991, P<0.01; male: r=0.992, P<0.01). The Bland-Altman test indicated that there was good coherence between SSDE measured and SSDE WHO. Maximal mean root-mean-square errors of SSDE measured and SSDE WHO were 5.61% in female and 5.25% in male. The conversion relationship between fWHOH16 and patient age in different genders was obtained by curve fitting. Conclusion:The SSDE of head in pediatric patients can be estimated simply and accurately by directly using the patient′s age.

Direct measurement of urine tritium and estimation of internal doses to personnel at pressurized heavy water reactor nuclear power plants / 中华放射医学与防护杂志

Objective:To explore the optimization of tritium internal exposure monitoring and dose estimation for radiation workers at pressurized heavy water reactor nuclear power plants (PHWR NPPs).Methods:A total of 92 radiation workers at Candu-6 PHWR NPPs were observed to calculate the distribution of quenching index (tSIE). Ten samples with tSIE values ranging from 160 to 460 were selected to make the blank urine quenching curve. By comparing with the quenching curve accompined with the equipment, the optimization of correlationship of urine tritium measurement system was carried out. In estimating tritium internal radiation dose, the dose coefficient was optimized and adjusted by comparing the Canadian algorithm with the national standard algorithm. Dead time correction curve was drawn by means of heavy water simulation experiment diluting main heat transfer system.Results:Through the analysis and optimization of tritium internal dose estimation, the optimal dose coefficient was determined to be 4.8 and the quenching curve of blank urine sample was made. By comparison, it was found that the deviation was larger when tSIE<200, which confirmed the necessity of blank curve. When the tritium concentration in urine was higher than 2.4×10 4 Bq/ml, the urine sample needed to be diluted and then measured to correct the effect of death time. Conclusions:By optimizing both tritium internal exposure monitoring and dose estimation, not only the collective dose management can be improved, but also the unplanned tritium intake can be detected and treated in time, which plays an important role in ensuring the protection and safety of the radiation workers at PHWR NPPs.

The value of SSDE based on effective diameter and water equivalent diameter in pediatric head CT / 中华放射医学与防护杂志

Objective:To explore the value of size-specific dose estimate (SSDE) based on effective diameter and water equivalent diameter ( Dw) in pediatric head CT. Methods:A retrospective analysis of 187 children underwent unenhanced head CT scanning were reviewed and divided into 3 groups according to the age: Group 1 (<1 m), Group 2(≥1 m~6 y), Group 3 (≥6~14 y). All CTDI vol values were recorded. The central axial image in the scanning range was selected. The region of interest (ROI) containing all anatomical structures (including skin) was outlined and the area of ROI ( AROI), head circumference, average CT value (CT ROI) were measured. The Dw, conversion factor fH16 and SSDE were calculated. The CTDI vol, SSDE and the rate of change( Δvalue)were compared among groups. The regression model between CTDI vol and SSDE was established. Results:The Dw values of groups 1-3 were (11.24±0.51), (14.48±1.47), (16.69±0.90)mm, respectively. The CTDI vol values were(15.36±2.78), (18.83±4.60), (23.24±4.13)mGy, respectively. SSDE values were(27.92±4.91), (29.16±6.64), (32.38±5.35)mGy, respectively. The differences among Dw, CTDI vol and SSDE groups were all statistically significant ( F=207.69、38.48、8.15, P<0.001). The values of Dw, CTDI vol and SSDE were gradually increasing while the age was increasing. However, the Δ value gradually was decreasing with increasing age. The linear regression equation of CTDI vol and SSDE was established as SSDE=7.252 + 1.137×CTDI vol. Conclusions:The radiation dose of children′s head CT can be accurately assessed based on Dw combined with head conversion factor fH16 to estimate the body-specific dose SSDE. The radiation dose of children′s head CT was underestimated with the greater degree for smaller age.

The sum of kidney donor profile index and estimated post-transplant survival scale and their correlation with egfr decline in deceased donor kidney recipients

Background: The impact of donor quality on post-kidney transplant survival may vary by candidate condition. Objective: Analyzing the combined use of the Kidney Donor Profile Index (KDPI) and the estimated post-transplant survival (EPTS) scale and their correlation with the estimated glomerular filtration rate (eGFR) decline in deceased-donor kidney recipients (DDKR). Methods: This was a retrospective, observational cohort study. We included DDKRs between 2015 and 2017 at a national third-level hospital. Results: We analyzed 68 DDKR. The mean age at transplant was 41 ± 14 years, 47 (69%) had sensitization events, 18 (26%) had delayed graft function, and 16 (23%) acute rejection. The graft survival at 12 and 36 months was 98.1% (95% CI 94-100) and 83.7% (95% CI 65-100), respectively. The Pearson correlation coefficient between the percentage reduction in the annual eGFR and the sum of EPTS and KDPI scales was r = 0.61, p < 0.001. The correlation coefficient between the percentage reduction in the annual eGFR and the EPTS and KDPI scales separately was r = 0.55, p < 0.001, and r = 0.53, p < 0.001, respectively. Conclusions: The sum of EPTS and KDPI scales can provide a better donor-recipient relationship and has a moderately positive correlation with the decrease in eGFR in DDKR.

Size-specific dose estimations in children′s head CT scans / 中华放射医学与防护杂志

Objective:To investigate the value of the size-specific dose estimate (SSDE) on dose estimations of children's head CT scans.Methods:A retrospective study was conducted on plain head CT scans of 252 patients with the 64-row detector CT device of Discovery 750HD in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to September in 2019. The volume CT dose index (CTDI vol)values were recorded. The head circumference (HC), area, and CT value were measured using a self-developed computer program, and the water equivalent diameter (WED), size-specific conversion factors ( f293 and f220), and absorbed dose (SSDE 293 and SSDE 220) were calculated according to the AAPM reports 293 and 220.The patients were divided into three groups by the quartering meth odaccording to their HC(<47.8 cm, 47.8-52.7 cm, >52.7 cm)and four groups based on their ages(0-2, 3-6, 7-10 and 11-14 years old). The difference between parameters ( f220 and f293, SSDE 220 and SSDE 293、SSDE 293 and CTDI vol) were compared for different groups, and the correlation of HC with f293 and SSDE 293 was analyzed. Results:There was an overestimation of f220 by 11.11% ( t=252.61, P<0.05) compared with f293. SSDE 220 was overestimated by 10.31% ( t=228.21, P<0.05) compared with SSDE 293, and SSDE 293 was underestimated by 9.60% ( t=-31.34, P<0.05)compared with CTDI vol. For the three HC groups, SSDE 220 was overestimated by 8.54%, 10.37%, and 11.57% ( t=73.73, 438.58, 275.52, P<0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.30%, 9.79%, and 14.61% ( t=-1.91, -60.95, -47.64, P<0.05)compared with CTDI vol. For the four age groups SSDE 220 was overestimated by 8.45%, 10.00%, 10.57%, and 11.36% ( t=63.58, 232.29, 247.84, 302.95, P< 0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.49%, 8.27%, 10.63%, and 13.78% ( t=-1.83, -28.27, -37.30, -49.80, P< 0.05)compared with CTDI vol. Furthermore, HC was highly correlated with f293 and SSDE 293 ( r2=0.88 and 0.76, respectively, P< 0.05). Conclusions:The radiation dose in children′s head CT scanning can be more accurately estimated according to the AAPM Report 293, while it can be overestimated by CTDI vol. Meanwhile, the CT radiation dose can be patently overestimated with the AAPM Report 220 compared with Report 293.HC is closely correlated with f293 and SSDE 293 and it can be used to estimatee more accurately for SSDE and the radiation dose received by children during head CT scanning.

Treatment of sleep disorder in patients with acute cerebrovascular disease / 中国临床药理学与治疗学

The high incidence of cerebrovascular disease and the high rate of disability cause a huge burden on the patient, family and society. The incidence of sleep disorder in acute cerebrovascular disease is high, which has an important effect on the prognosis of patients with cerebrovascular disease. This paper reviews the treatment of sleep disorder in patients with acute cerebrovascular disease, mainly acute ischemic cerebrovascular disease.

Estimación de costos unitarios directos de atención curativa de dengue en Ecuador 2020 / Estimate of direct unit costs of curative Dengue care in Ecuador 2020

El dengue es una enfermedad viral aguda transmitida a través de la picadura del mosquito (artrópodo) Aedes aegypti infectado con cualquiera de los serotipos de virus dengue. Son virus envueltos, de 40 a 50 nm de diámetro, con cápside icosaédrica y genoma de ácido ribonucleico (ARN) monocatenario, no segmentado, de polaridad positiva perteneciente al género flavivirus de la familia Flaviviridae. El análisis filogenético de las distintas cepas del virus dengue indica que la diseminación global ha dado lugar a distintos genotipos dentro de cada serotipo. En el quinquenio 2015-2020, en Ecuador, se notificaron en toda la región 76.085 casos de dengue. La atención unitaria hospitalaria para el tratamiento del dengue de las unidades de atención sanitaria hospitalarias (A, B, C), generaron un costo total promedio de 498,04 $ con una desviación estándar de ± 40,36, en el Ecuador para el año 2020. Cabe considerar, por otra parte, que el costo unitario directo promedio en ($) de la atención sanitaria en las entidades hospitalarias estudiadas en la presente investigación, generanron un gasto total para el tratamiento hospitalario de 9.585.114,02. Al mismo tiempo en los 2.135 pacientes diagnosticados con dengue que presentaron signos de alarma y requirieron cuatro días de hospitalización, señalando un gasto total para el tratamiento de 1.471.385,06. Por su parte los 51 pacientes que fueron diagnosticados con dengue grave, generaron un costo unitario total en las unidades hospitalarias de 134.152,54. Los resultados son conservadores, porque algunos componentes importantes no se incluyeron en los costos relacionados con el dengue.En ausencia de vacunación, y siendo los programas de control del vector la estrategia básica para mitigar la propagación del dengue, esta enfermedad seguirá produciendo una carga económica y social considerable en el Ecuador, lo que se refleja en el costo total de la enfermedad(AU)

Dengue is an acute viral disease transmitted through the bite of the mosquito (arthropod) Aedes aegypti infected with any of the dengue virus serotypes. They are enveloped viruses, 40 to 50 nm in diameter, with an icosahedral capsid and a single-stranded, non-segmented ribonucleic acid (RNA) genome of positive polarity belonging to the genus Flavivirus of the Flaviviridae family. Phylogenetic analysis of the different dengue virus strains indicates that global spread has given rise to different genotypes within each serotype. In the five-year period 2015-2020, in Ecuador, 76,085 cases of dengue were reported throughout the region. The hospital unit care for the treatment of dengue in the hospital health care units (A, B, C), generated an average total cost of $ 498.04 with a standard deviation of ± 40.36, in Ecuador for the year 2020. It should be considered, on the other hand, that the average direct unit cost in ($) of health care in the hospital entities studied in the present investigation, generated a total cost for hospital treatment of 9,585,114.02. At the same time, in the 2,135 patients diagnosed with dengue who presented alarm signs and required four days of hospitalization, indicating a total cost for treatment of 1,471,385.06. On the other hand, the 51 patients who were diagnosed with severe dengue, generated a total unit cost in the hospital units of 134,152.54. The results are conservative, because some important components were not included in the costs related to dengue. In the absence of vaccination, and with vector control programs the basic strategy to mitigate the spread of dengue, this disease will continue to produce an economic burden and considerable social in Ecuador, which is reflected in the total cost of the disease(AU)

Potential of Alternative Sources for Electric Power Generation in the State of Paraná

Abstract The State of Paraná stands out in Brazil for its hydraulic potential for electricity generation. Furthermore, the State also shows potential for the use of other sources of energy, such as solar energy, biogas and biomass. The study traces the profile of electric energy consumption and compiles analysis of the alternative energy potentials of Paraná on the use of solar energy, the biomass of forest residues and agricultural crops, the generation of biogas through the residues of farmed animals and the urban solids residues. The work took account for the estimates, the logistical limitations for the biomass or biogas collection and the real availability of the wastes in terms of viability of exploration through distributed generation plants. The use of the business analytics software Tableau Desktop 2020.3.2® made possible the open data analysis at the municipal level. The paper provides realistic estimates about the feasibility of the use of alternative energy sources in the State of Paraná.

Predictive model for Covid-19 incidence in a medium-sized municipality in Brazil (Ponta Grossa, Paraná) / Modelo predictivo de la ocurrencia de Covid-19 en un municipio de tamaño medio en Brasil (Ponta Grossa-Paraná) / Modelo preditivo da ocorrência de Covid-19 em município de médio porte no Brasil (Ponta Grossa-Paraná)

ABSTRACT Objective: to produce a predictive model for the incidence of COVID-19 cases, severity and deaths in Ponta Grossa, state of Paraná. Methods: this is an ecological study with data from confirmed cases of COVID-19 reported between March 21, 2020 and May 3, 2020 in Ponta Grossa and proportion of severity, hospitalization and lethality in the literature. A susceptible-infected-recovered (SIR) epidemic model was developed, and reproduction rate (R0), duration of epidemic, peak period, number of cases, hospitalized patients and deaths were estimated. Deaths were calculated by age group and in three scenarios: at day 24, at day 34, and at day 44 of the epidemic. Results: in the three scenarios assessed in this study, the variation in the number of cases was explained by an exponential curve (r2=0.74, 0.79 and 0.89, respectively, p<0.0001 in all scenarios). The SIR model estimated that, in the best scenario, the peak period will be around 120 days after the first case (between July 11, 2020 and July 25, 2020), estimated R0 will be 1.07 and will infect 0.23% of the population. In the worst scenario, peak period will involve 4,375 (95% CI; 4156-4594) cases and 825 (95% CI; 700-950) cases in the best scenario. Most cases and hospital admissions will involve patients aged 20 to 39 years, the number of deaths will be higher among the elderly and more pronounced among patients aged ≥80 years. Conclusion: this is the first study that provides COVID-19 projections for a municipality that is not a large capital. It shows a peak period at a later moment; therefore, the municipality will have more time to prepare and adopt protective measures to reduce the number of simultaneous cases.

RESUMEN Objetivo: obtener un modelo predictivo para la ocurrencia de casos, severidad y muertes por COVID-19 en Ponta Grossa-Paraná. Métodos: estudio ecológico con datos de casos confirmados de COVID-19 notificados del 21/03/2020 al 3/3/2020 en Ponta Grossa y proporción de severidad, hospitalización y letalidad en la literatura. Se construyó un modelo epidemiológico (SIR) infectado-recuperado susceptible y tasa de reproducción estimada (R0), duración de la epidemia, fecha pico, número de casos, hospitalizaciones y muertes. Este último por grupo de edad y en tres escenarios: a los 24 días, a los 34 días y a los 44 días de epidemia. Resultados: en los tres escenarios evaluados, la variación en el número de casos se explicó por una curva exponencial (r2 = 0.74, 0.79 y 0.89, respectivamente y p <0.0001 en total). El modelo SIR estimó que, en el mejor escenario, el pico ocurrirá alrededor de 120 días después del primer caso (entre el 7/11/2020 y el 25/7/2020), el R0 estimado será de 1.07 y alcanzará 0.23 % de habitantes infectados. En el peor de los casos, el pico estimado será de 4375 (IC del 95%: 4156-4594) y 825 (IC del 95%: 700-950) en el mejor de los casos. El mayor número estimado de casos y hospitalizaciones estará en el rango entre 20 y 39 años, el número de muertes será mayor entre los ancianos y más pronunciado entre ≥ 80 años. Conclusión: este es el primer estudio con proyecciones para COVID-19 en un municipio fuera de las grandes capitales y demostró que el pico llegará tarde, por lo tanto, el municipio tendrá más tiempo de preparación y que las medidas de protección pueden reducir el número simultáneo de casos.

RESUMO Objetivo: obter um modelo preditivo da ocorrência de casos, gravidade e óbitos por COVID-19 em Ponta Grossa-Paraná. Métodos: estudo ecológico com dados de casos confirmados de COVID-19 notificados de 21/03/2020 a 03/05/2020 em Ponta Grossa e proporção de gravidade, hospitalização e letalidade da literatura. Um modelo epidemiológico suscetível-infectado-recuperado (SIR) foi construído e estimadas taxa de reprodução (R0), duração da epidemia, data do pico, número de casos, hospitalizações e óbitos. Estas últimas por faixa etária e em três cenários: aos 24 dias, aos 34 dias e aos 44 dias de epidemia. Resultados: nos três cenários avaliados, a variação no número de casos foi explicada por uma curva exponencial (r2=0,74, 0,79 e 0,89, respectivamente e p<0,0001 em todos). O modelo SIR estimou que, no melhor cenário, o pico ocorrerá em torno de 120 dias após o primeiro caso (entre 11/07/2020 e 25/07/2020), o R0 estimado será 1,07 e chegará a 0,23% dos habitantes infectados. No pior cenário, o pico estimado será de 4375 (IC 95% 4156-4594) casos e 825 (IC 95% 700-950) no melhor cenário. O maior número estimado de casos e hospitalizações será na faixa entre 20 e 39 anos, o número de óbitos será maior entre idosos e mais acentuado entre ≥ 80 anos. Conclusão: este é o primeiro estudo com projeções para a COVID-19 em um município fora das grandes capitais e mostrou que o pico será tardio, portanto, o município terá mais tempo de preparo e que medidas protetivas podem reduzir o número simultâneo de casos.

Distracted multinomial model for corona screening at entry ports

Background: On 24 January 2020, 1287 corona cases were noticed in Wuhan, China, causing 41 deaths. Its incubation period is at least 14 days. Now, this deadly virus has spread to other foreign countries. The prevalence of corona cases is changing daily. See www.who.org for daily reports. The corona cases are mystic and nightmare to the public, health professionals, and governing agencies globally.Methods: The Center for Disease Control (CDC) compiled in their webpage (www.cdc.org) the number of confirmed, number of healthy, and the number of pending cases at the port of entries in United States of America (USA). These numbers are perhaps under-estimates because of inappropriate diagnostics and imprecise incubation period. To resolve the under estimating, this article, introduces a distracted multinomial model to refine the imprecise corona screening process and interpret the probability of detecting a corona case in US entry gates.Results: An alternate expression (2) for the correlation between the corona ill and corona free cases at the USA ports of entry reveals that it was rising since 31st January 2020, reached its maximum on 5th February 2020, then declined to hit a bottom on 7th February 2020 only to rise again.Conclusions: Most desirable is an accurate predictability of a traveller with the corona virus at the portal entry to minimize its spread. To make such prediction, a regression is necessary with involvement of covariates like age, body’s immunity level, comorbidity, and precise understanding of its incubation period. The model in this article is the starting point for further future research work.

Risk assessment of cadmium contamination and dietary exposure in market aquatic products in one district of Shanghai / 上海预防医学

Objective To investigate the status of cadmium contamination in commercially sold aquatic products and to analyze the risk of dietary intake of cadmium among residents in one district of Shanghai. Methods Multistage sampling was used to collect 397 animal aquatic products from agricultural markets and supermarkets in 11 communities (townships), the District from 2018 to 2019.Cadmium content was tested according to national standard.The status of cadmium contamination was assessed by single factor pollution index(Pi)method.Risk of dietary intake of cadmium among residents was assessed by point evaluation method in combination with food consumption and dietary survey in 2013 and calculation of safe limits for cadmium in various aquatic diets(MOS). Results The detection rate of cadmium was 75.06% in the 397 animal aquatic products and the content of cadmium in 10 samples which crabs were totally exceeded the standard, accounting for 2.52%.The average contents of cadmium in crabs, bivalves which were higher than in shrimps(11.0 μg/kg), gastropods(7.6 μg/kg) and marine fish(3.8 μg/kg) were respectively 140.0 μg/kg and 90.0 μg/kg(χ2=186.41, P < 0.005), but no cadmium was detected in freshwater fish.The single factor pollution index(Pi) of crabs was 0.280 which meant light pollution and the Pi of other kinds of aquatic products was respectively under 0.100 that meant no cadmium contamination.The consumption of animal aquatic products was the highest in freshwater fish followed by shrimps, marine fish and crabs.The MOS of every kind of aquatic products is higher than 1 which meant cadmium intake from commercially sold animal products was an acceptable health risk for the population. Conclusion The risk level of cadmium intake by residents in the district through commercially sold animal aquatic products is relatively low, but the cadmium pollution status of commercially sold crustacean crabs should be vigilant, and the intake of crabs is advised to be reduced as far as possible.Relevant departments should also pay attention and strengthen monitoring and management in this regard.

Heart sound denoising by dynamic noise estimation / 生物医学工程学杂志

Denoising methods based on wavelet analysis and empirical mode decomposition cannot essentially track and eliminate noise, which usually cause distortion of heart sounds. Based on this problem, a heart sound denoising method based on improved minimum control recursive average and optimally modified log-spectral amplitude is proposed in this paper. The proposed method uses a short-time window to smoothly and dynamically track and estimate the minimum noise value. The noise estimation results are used to obtain the optimal spectrum gain function, and to minimize the noise by minimizing the difference between the clean heart sound and the estimated clean heart sound. In addition, combined with the subjective analysis of spectrum and the objective analysis of contribution to normal and abnormal heart sound classification system, we propose a more rigorous evaluation mechanism. The experimental results show that the proposed method effectively improves the time-frequency features, and obtains higher scores in the normal and abnormal heart sound classification systems. The proposed method can help medical workers to improve the accuracy of their diagnosis, and also has great reference value for the construction and application of computer-aided diagnosis system.

Aplicación de modelos paramétricos alternativos para el análisis de supervivencia de pacientes con cáncer / Application of alternative parametric models for the survival analysis of cancer patients

RESUMEN En el presente artículo se describe una metodología que permite tener un acercamiento a modelos probabilísticos alternativos para el análisis de supervivencia, con censura por la derecha, distintos a los que usualmente se estudian (distribución: exponencial, gamma, Weibull y log-normal), ya que es posible que los datos no se ajusten siempre con suficiente precisión por las distribuciones existentes. La metodología utilizada permite mayor flexibilidad de modelar observaciones extremas, ubicadas generalmente en la cola derecha de la distribución de los datos, lo cual admite que algunos eventos aún tengan la probabilidad de ocurrir, lo que no sucede con los modelos tradicionales y el estimador de Kaplan-Meier, el cual estima para los tiempos más prolongados, probabilidades de supervivencia aproximadamente iguales a cero. Para mostrar la utilidad de la propuesta metodológica, se consideró una aplicación con datos reales que relaciona tiempos de supervivencia de pacientes con cáncer de colon.

ABSTRACT This article describes a methodology that allows an approach to alternative right-censored probabilistic models for the analysis of survival, different to those usually studied (exponential, gamma, Weibull, and log-normal distribution) since it is possible that the data do not always fit with sufficient precision due to existing distributions. The methodology used allows for greater flexibility when modeling extreme observations, generally located in the right tail of data distribution, which admits that some events still have the probability of occurring, which is not the case with traditional models and the Kaplan-Meier estimator, which estimates for the longest times, survival probabilities approximately equal to zero. To show the usefulness of the methodological proposal, we considered an application with real data that relates survival times of patients with colon cancer (CC).

Estimativa do potencial de recuperação energética de resíduos sólidos urbanos usando modelos matemáticos de biodigestão anaeróbia e incineração / Estimation of municipal solid waste energy recovery potential using mathematical models of anaerobic biodigestion and incineration

RESUMO Atualmente, um dos grandes problemas enfrentados pelos gestores de resíduos sólidos urbanos (RSU) é a disposição final dos resíduos gerados por sua população. As disposições de resíduos devem ser feitas em espaços e sob condições adequados de modo a minimizar os impactos socioeconômicos e ambientais. Nesse contexto, este artigo teve por objetivo estimar o potencial de recuperação energética de RSU usando modelos de simulação matemática para a biodigestão anaeróbia e a incineração. Como objeto de estudo, foram considerados os resíduos dispostos no aterro sanitário de Caieiras, localizado no município de Caieiras (SP). Para avaliação da biodigestão anaeróbia, foram analisados modelos matemáticos que permitem estimar a produção de metano em função dos diversos fatores que interferem no processo (concentração de acetato e de micro-organismos, variação do pH, entre outros). No caso da incineração, foram considerados modelos matemáticos empíricos (baseados nas análises imediata, gravimétrica e elementar) para estimar o poder calorífico inferior dos RSU. De acordo com os resultados obtidos, para a biodigestão anaeróbia seria possível obter potência média de 38,8 MW. Caso a incineração fosse adotada como método de tratamento dos RSU, seria possível obter potência elétrica média de 214 MW (considerando a incineração de 100% dos resíduos). Com base nas simulações realizadas para a biodigestão anaeróbia e a incineração como possíveis métodos de destinação dos RSU, conclui-se que o processo de incineração apresenta potencial de geração de eletricidade aproximadamente cinco vezes maior do que a conversão energética da biodigestão anaeróbia.

ABSTRACT Currently, one of the major problems faced by managers of solid urban waste is the final disposal of the waste generated by their population. Waste disposals should be done in spaces and/or under appropriate conditions, in order to minimize socioeconomic and environmental impacts. In this context, this article aims at estimating the energy recovery potential of urban solid waste using mathematical simulation models for anaerobic biodigestion and incineration. As object of study, the waste disposed in Caieiras landfill, located in the city of Caieiras/SP, was considered. To evaluate the anaerobic digestion, mathematical models were used to estimate methane production as function of the various factors that influence the process (acetate and microorganisms concentration, pH variation among others). In the case of incineration, empirical mathematical models (based on immediate, gravimetric and elementary analysis) were used to estimate the lower heating value of urban solid waste. According to the results obtained, it would be possible to obtain an average power of 38.8 MW for anaerobic digestion. If the incineration method was adopted, it would be possible to obtain an average electrical power of 214 MW (considering the total incineration of the waste). Based on the simulations carried out for anaerobic biodigestion and incineration as possible methods of municipal solid waste disposal, it is concluded that the incineration process of municipal solid waste presents a greater potential of electricity generation, approximately five times higher than the energy conversion potential of anaerobic digestion.

Remote sensing extraction method of Codonopsis pilosula planting area in Weiyuan county / 中国中药杂志

Due to the large amount of Codonopsis pilosula planted in Weiyuan county,and the arable land area,the local medicinal materials office uses a large amount of manpower,financial resources and material resources to estimate its area every year. In order to extract the information of local Chinese medicinal materials more quickly and simply,we try to apply remote sensing technology to the extraction of Chinese medicinal materials. This paper will use Weiyuan county of Gansu province as the research area,and use the domestic ZY-3 Satellite multi-spectral remote sensing image as the data source to find out the spectral characteristics of the party's participation in other remote sensing images. The visual interpretation method was used to extract the planting area of the C. pilosula in Weiyuan county. The estimated value of the planting area of C. pilosula using satellite remote sensing technology was 75 965 mu( 1 mu≈667 m2),which was basically consistent with the field survey data of the local medicinal materials office. After the accuracy verification,it was found that the precision of C. pilosula planted by visual interpretation was more than 70%. It is concluded that the satellite remote sensing technology can be used to extract the information of C. pilosula and it can provide the relevant information of the planting area of Chinese medicinal materials quickly and accurately.

Application value of the two estimation methods in evaluating the radiation dose of adult chest CT / 中华放射医学与防护杂志

Objective To investigate the application value of CTDIvol and size-specific dose estimate( SSDE) in evaluating the radiation dose of adult chest CT. Methods A retrospective analysis was made on the CTDIvol and SSDE of 128 patients who underwent chest CT scanning in the First Affiliated Hospital of Zhejiang Chinese Medical University from March to April 2017 and all images are adequate for diagnosis. The subjects were divided into three groups according to body mass index ( BMI):Group A,38 cases with 16≤BMI<21. 1 kg/m2; Group B,53 cases with 21. 1≤BMI<23. 9 kg/m2; Group C,37 cases with 23. 9≤BMI<34. 1 kg/m2. The diameters of anterior-posterior (AP) and left-right (LAT) of each patient were measured in the slice of nipple level, and CTDIvol , effective diameter ( ED) , conversion factor ( fsize ) and SSDE of each patient were recorded and calculated. Meanwhile, the differences between CTDIvol and SSDE in different BMI groups were compared. Results SSDE of each group was higher than CTDIvol , and increased by 50. 13％, 42. 83％ and 33. 68％ in group A, B and C, respectively. There were significant differences in radiation dose between CTDIvol and SSDE in the three groups ( t=-48. 873,-57. 001, -32. 651, P<0. 05) . There were significant differences in ED, fsize , CTDIvol and SSDE among the three groups ( F=51. 456, 47. 749, 113. 916, 106. 449, P<0. 05) . Conclusions SSDE can evaluate the radiation dose absorbed by patients with different body types in chest CT, while CTDIvol underestimated the radiation dose. The lower BMI, the greater the underestimated dose value, the more radiation dose absorbed.