The influence of middle-aged male driver profile on driving performance and the effects of three perceptual countermeasures: A simulator study.

The human-environment-vehicle triad and how it relates to crashes has long been a topic of discussion, in which the human factor is consistently seen as the leading cause. Recently, more sophisticated approaches to Road Safety have advocated for a road-driver interaction view, in which human characteristics influence road perception and road environment affects driver behavior. This study focuses on road-driver interaction by using a driving simulator. The objective is to investigate how the driver profile influences driving performance and the effects of three countermeasures (peripheral transverse lines before and after the beginning of the curves and roadside poles in the curves). Fifty-six middle-aged male participants drove a non-challenging rural highway simulated scenario based on a real road where many single-vehicle crashes occurred. The drivers' profiles were assessed through their behavioral history measured by a validated version of the Driver Behavior Questionnaire (DBQ) comprising three dimensions: Errors (E), Ordinary Violations (OV), and Aggressive Violations (AV). The relationship between speed and trajectory measures and drivers' profiles was investigated using random-parameter models with heterogeneity in the means. The models' results showed that the DBQ subscale scores in OV explained a considerable part of the heterogeneity found in drivers' performance. Furthermore, the heterogeneity in the means caused by the DBQ subscale scores in OV and E in the presence of peripheral transverse lines indicates a difference in how drivers react to the countermeasures. The peripheral lines were more efficient than roadside poles to moderate speed but did not positively influence all drivers' trajectories. Although the peripheral lines could be seen as an alternative to change driver behavior in a non-challenging or monotonous road environment, the design used in this study should be reviewed.

Prevalence, distribution and environmental effects on faecal indicator bacteria and pathogens of concern in commercial shellfish production areas in a subtropical region of a developing country (Santa Catarina, Brazil).

This paper reviews recent literature on the abundance and distribution of faecal indicator bacteria and pathogens in shellfish production areas in the state of Santa Catarina, on the subtropical coast of Brazil. This state supplies > 95% of the national production of shellfish. Microbiological monitoring data were mapped using GIS and the results compared with those from other countries. Coastal human population is the main predictive parameter for faecal bacteria in the production areas. Temporal variations of the bacteria can also be predicted by solar radiation and rainfall. The prevalence of pathogens such as hepatitis A virus, human norovirus, Salmonella spp. and Vibrio spp. does not differ substantially from that in developed countries. The information reported here can be used to inform development of microbiological risk profiles for shellfish production areas.

Baseline health risk assessment of trace metals in bivalve shellfish from commercial growing areas in the estuaries of Ashtamudi and Vembanad (Kerala, India).

Trace metal concentrations were monitored in the yellow clam (Paphia malabarica), green mussel (Perna viridis) and edible oyster (Crassostrea madrasensis) from growing areas in the Ashtamudi and Vembanad estuaries, Kerala. Samples of shellfish (clams n=26, mussels n=18, oysters n=36) and environmental parameters (salinity, temperature, pH and rainfall) were measured in these growing areas from July 2012 to December 2014. Ranges of mean annual concentrations (mg/kg) were Ni (0.46-0.65); Co (2.87-3.49); Fe (80.0-119.4); Mn (3.88-9.38); Zn (40.8-76.2); Pb (1.28-2.00); and Cu (1.59-4.38). In Ashtamudi, clams had higher mean concentrations of Ni, Co, Fe, Mn and Pb than oysters. Mean concentrations of Ni, Pb (in all species), Zn (in clams and mussels) and Cu (in mussels) did not exceed maximum permissible limits mandated by the Food Safety and Standards Authority of India. Mean Mn concentrations exceeded the World Health Organization guideline (1 mg/kg) in the three species while mean Fe concentrations in clams and oysters did not exceed the guideline (100 mg/kg). Target hazard quotients were generally ≤ 1, except for a few Pb results in clams and mussels. Although results suggest no health risk to consumers for the reference doses, daily intakes and elements considered, regular monitoring of trace metals is recommended to maintain consumer protection given increasing anthropogenic and climatic pressures on the shellfish growing areas.

Optimising statistical models to predict faecal pollution in coastal areas based on geographic and meteorological parameters.

This article describes a methodology for optimising predictive models for concentrations of faecal indicator organisms (FIOs) in coastal areas based on geographic and meteorological characteristics of upstream catchments. Concentrations of FIOs in mussels and water sampled from 50 sites in the south of Brazil from 2012 to 2013 were used to develop models to separately predict the spatial and temporal variations of FIOs. The geographical parameters used in predictive models for the spatial variation of FIOs were human population, urban area, percentage of impervious cover and total catchment area. The R2 of models representing catchments located within 3.1 km from the monitoring points was up to 150% higher than that for the nearest catchment. The temporal variation of FIOs was modelled considering the combined effect of meteorological parameters and different time windows. The explained variance in models based on rainfall and solar radiation increased up to 155% and 160%, respectively.

Compliance of brown mussel (Perna perna) production areas in the South of Brazil with the bacteriological criteria of the shellfish hygiene systems in the European Union and United States of America: assessing the impacts on consumer safety.

Levels of faecal indicator organisms (FIOs) monitored in surface water and brown mussels collected at 28 production areas in Brazil from August 2012 to October 2013 were used to assess compliance with the bacteriological standards of the shellfish hygiene classification systems used in the European Union (EU) and USA. This classification determines the level of post-harvesting purification needed to reduce the risk of illness in consumers. The results indicate that 36% of production areas would be class A under the EU system and 75% would be 'Approved' under the US system. Mathematical models showed that a 90th percentile of FIO levels in water of 43 MPN (most probable number) 100 mL-1 (standard for 'Approved' areas under the US system) would correspond to an 80th percentile of FIO levels in mussels of 572 MPN 100 g-1. This concentration is more than double that in the class A standard in the EU system. These results have important implications for public health since no post-harvesting purification is required for any of these classification categories. Areas compliant with the US 'Restricted' and EU class B standards, however, provide similar levels of consumer safety.

Redescription of Licnophora chattoni Villeneuve-Brachon, 1939 (Ciliophora, Spirotrichea), associated with Zyzzyzus warreni Calder, 1988 (Cnidaria, Hydrozoa).

Licnophora chattoni, found in association with Zyzzyzus warreni, a tubulariid hydroid epizoic in sponges from São Sebastião (SP, Brazil), is redescribed and illustrated using light and electron microscopy. The ciliate has a flexible, transparent body formed by an oval anterior region linked to the posterior basal disc via a flexible neck region. Numerous cortical granules are observed scattered throughout the body and densely packed along the neck. The adoral zone is formed by about 81 external and 24 infundibular paramembranelles. The paroral membrane, formed by a row of long cilia arranged in monokinetids, extends through a groove in the body to the adhesive disc. Two dorsal kinetids are present along the right body margin and around the neck. The adhesive disc (18µm in diameter) lacks cilia in the area above the velum. The velum covers a row of dikinetids bearing long cilia and four dikineties, two or three of which are interrupted on the ventral surface. Nine to twelve macronuclear nodules connected by isthmuses are distributed in the cytoplasm, plus two nodules located in the adhesive disc and between those there is an ovate micronucleus.

Computerized analysis of snoring in sleep apnea syndrome.

UNLABELLED: The International Classification of Sleep Disorders lists 90 disorders. Manifestations, such as snoring, are important signs in the diagnosis of the Obstructive Sleep Apnea Syndrome; they are also socially undesirable. OBJECTIVE: The aim of this paper was to present and evaluate a computerized tool that automatically identifies snoring and highlights the importance of establishing the duration of each snoring event in OSA patients. MATERIAL AND METHODS: The low-sampling (200 Hz) electrical signal that indicates snoring was measured during polysomnography. The snoring sound of 31 patients was automatically classified by the software. The Kappa approach was applied to measure agreement between the automatic detection software and a trained observer. Student's T test was applied to evaluate differences in the duration of snoring episodes among simple snorers and OSA snorers. RESULTS: Of a total 43,976 snoring episodes, the software sensitivity was 99. 26%, the specificity was 97. 35%, and Kappa was 0. 96. We found a statistically significant difference (p <0. 0001) in the duration of snoring episodes (simple snoring x OSA snorers). CONCLUSIONS: This computer software makes it easier to generate quantitative reports of snoring, thereby reducing manual labor.

Computerized analysis of snoring in sleep apnea syndrome / Análise computadorizada do ronco na síndrome da apneia do sono

The International Classification of Sleep Disorders lists 90 disorders. Manifestations, such as snoring, are important signs in the diagnosis of the Obstructive Sleep Apnea Syndrome; they are also socially undesirable. OBJECTIVE: The aim of this paper was to present and evaluate a computerized tool that automatically identifies snoring and highlights the importance of establishing the duration of each snoring event in OSA patients. MATERIAL AND METHODS: The low-sampling (200 Hz) electrical signal that indicates snoring was measured during polysomnography. The snoring sound of 31 patients was automatically classified by the software. The Kappa approach was applied to measure agreement between the automatic detection software and a trained observer. Student's T test was applied to evaluate differences in the duration of snoring episodes among simple snorers and OSA snorers. RESULTS: Of a total 43,976 snoring episodes, the software sensitivity was 99. 26 percent, the specificity was 97. 35 percent, and Kappa was 0. 96. We found a statistically significant difference (p <0. 0001) in the duration of snoring episodes (simple snoring x OSA snorers). CONCLUSIONS: This computer software makes it easier to generate quantitative reports of snoring, thereby reducing manual labor.

A classificação internacional de distúrbios do sono enumera aproximadamente 90 distúrbios. Manifestações, como o ronco, são um sinal no diagnóstico da Síndrome da Apneia Obstrutiva, além de ser um incômodo social. OBJETIVO: O objetivo deste artigo é apresentar e avaliar a ferramenta computacional que identifica o ronco automaticamente e destacar a importância da quantificação da duração de cada evento do ronco em pacientes com SAHOS. MATERIAL E MÉTODOS: O sinal elétrico que representa o ronco de baixa amostragem (200 hz) foi captado enquanto os pacientes eram submetidos à polissonografia. O sinal do ronco dos 31 pacientes foi classificado pelo programa computacional automaticamente. Utilizamos o valor de Kappa para avaliar a concordância entre o programa de detecção automática e o observador treinado (teste t-student). Avaliamos a diferença da duração dos episódios de ronco entre simples roncadores e roncadores com SAOS. RESULTADOS: De um total de 43,976 roncos, o programa computacional obteve uma sensibilidade de 99,26 por cento, especificidade de 97,35 por cento e Kappa de 0,96. Foi observada diferença estatística significante (p<0,0001) na duração de episódios de ronco (simples roncadores x roncadores com SAOS). CONCLUSÃO: Este programa computacional facilita a criação de relatórios quantitativos do ronco, oferecendo redução do trabalho manual.

Recuperação de informações em campos de texto livres de prontuários eletrônicos do paciente baseada em semelhança semântica e ortográfica / Information retrieval from free text s of electronic patient records, based on semantic and orthographic portuguese similarity

A maior parte da informação médica em forma digital se encontra na forma de textos livres como nos sites de medicina e saúde, artigos científicos em banco de dados da literatura biomédica e em prontuários eletrônicos do paciente (PEP). Muitos problemas podem ocorrer em sistemas de recuperação de informações médicas como o uso de sinonímia, erros de digitação e variações semânticas na linguagem médica. Para analisar a quantidade de informações que são perdidas em sistemas de busca tradicionais, que fazem um busca do termo exato, foram selecionados 34 termos médicos de duas bases de dados de PEPs e pesquisados com um algoritmo tradicional de busca direta embutido em um PEP chamado Clinic ManagerÒ e um sistema desenvolvido batizado SIRIMED que embutiu algoritmos de semelhança semântica (incorporação de sinônimos) e semelhança ortográfica (edit distance+stemming).Os resultados mostram que a recuperação dos termos aumenta em cerca de 30% em relação à busca tradicional, com uma quantidade de falsos positivos baixa (menos de 1%), o que mostra que muitas informações são perdidas normalmente.

Most medical information in digital form occurs in internet health sites, biomedical literature databases and electronic patient record (EPR). Many problems can be found in medical information retrieval systems like problems of synonyms, mistakes on typing and semantic variations in medical language. To analyse the amount of lost infomation in traditional information retrieval systems which use exact string matching, 34 medical terms were selected from two databases of EPRs and they were analysed with traditional search found in EPR System called Clinic Manager and a new system called Sirimed developed by autor which was added algorithms to semantic approximate (synonymous) and approximate string matching (edit distance + stemming). The results show that information retrieval was improved in 30% in compare with the traditional search, with little amopunt of false positives (less 1%), that show a lot of lost informations.

Os sites de medicina e saúde frente aos princípios éticos da Health on the Net Foundation (HON) / Medicine and health websites in face of the Health on the Net Foundation (HON) ethical principles

Este estudo analisa uma amostra de 80 sites nacionais e internacionais que trazem informações sobre as doenças cerebrovasculares e infarto do miocárdio, classificando-os quanto à obediência a cada um dos oito princípios do código de conduta para sites de saúde delineados pela Health on the Net Foundation-HON: 1. Da autoridade; 2. Da complementaridade; 3. Da confidencialidade; 4. Das atribuições; 5. Das justificativas; 6. Da transparência na propriedade; 7. Da transparência no patrocínio; 8. Da honestidade editorial da publicidade e da política editorial.O estudo conclui que os sites analisados não atendem a esses oito princípios, considerando ainda que confrontar sites de saúde com os princípios éticos estimula o convívio respeitoso entre a tecnologia da informação e a área da saúde.

[Computing in medical practice]. / A informática no consultório médico.

OBJECTIVES: Currently, information technology is part of several aspects of our daily life. The objective of this paper is to analyze and discuss the use of information technology in both medical education and/or medical practice. SOURCES: Information was gathered through non-systematic bibliographic review, including articles, official regulations, book chapters and annals. Direct search and search of electronic databanks in Medline and Lilacs databases were also performed. SUMMARY OF THE FINDINGS: This paper was structured in topics. First, there is a discussion on the electronic medical record. The following aspects are presented: history, functions, costs, benefits, ethical and legal issues, and positive and negative characteristics. Medical decision-support systems are also evaluated in view of the huge amount of information produced every year regarding healthcare. The impact of the Internet on the production and diffusion of knowledge is also analyzed. Telemedicine is assessed, since it presents new challenges to medical practice, and raises important ethical issues such as "virtual medical consultation." Finally, a practical experience of modernization of a pediatric outpatient center by the introduction of computers and telecommunication tools is described. CONCLUSIONS: Medical computing offers tools and instruments that support the administrative organization of medical visits, gather, store and process patient's data, generate diagnoses, provide therapeutical advice and access to information in order to improve medical knowledge and to make it available whenever and wherever adequate decision-making is required.

Monitorizaçäo eletroencefalográfica ambulatorial na epilepsia de difícil controle da infância / Eletroencephalographic monitoring in refractory epilepsies in childhood

O objetivo deste estudo foi analisar através da monitorizaçäo eletroencefalográfica ambulatorial contínua e prolongada a distribuiçäo temporal de descargas paroxísticas em sono e em vigília de crianças e adolescentes com epilepsia de difícil controle medicamentoso. Foram selecionadas 21 pacientes na faixa etária de 4 a 17 anos de idade com epilepsia de difícil controle medicamentoso, sendo 52,3 por cento (n=11) do sexo masculino e 47,7 por cento (n=10) do feminino, provenientes da Disciplina de Neurologia da Universidade Federal de Säo Paulo. Os exames foram realizados com o equipamento Bioware EEG-2008 de monitorizaçäo eletroencefalográfica ambulatorial prolongada (Holter cerebral). Observamos maior frequência das descargas epilépticas isoladas e agrupadas no sono diurno e noturno em relaçäo a vigília; o sono, diurno e noturno, levou a ativaçäo de descargas epilépticas, tanto isoladas como agrupadas. O Holter cerebral foi mais eficaz em detectar descargas epileptiformes do que o EEG de rotina em 33,33 por cento dos pacientes. O Holter cerebral se mostrou método útil e preciso na detecçäo de descargas epilépticas, auxiliando na avaliaçäo das flutuaçöes da frequência da atividade paroxística em crianças com epilepsia de difícil controle medicamentoso, tanto em relaçäo as atividades da vida cotidiana, quanto em relaçäo ao ciclo biológico de sono e vigília

Effect of lateralized epileptic discharges on the thought flow

PURPOSE: Pauses in verbal expression of thought flow in patients with partial epilepsy was studied in order to achieve a best comprehension of brain interhemispheric influences. METHOD: We studied thirty nine patients with partial epileptic seizures and twenty four volunteers (control group). Free association of ideas was used as a method to stablish the thought flow, starting with a stimulus word (subject name) that must be followed by spontaneous and consecutive word-phrase. Patients were instructed to say any thought that came to their minds without any kind of censoring. Subject responses were recorded through a PC keyboard and time intervals (pauses) between each word-phrase were processed by a software developed for this purpose. RESULTS: Time intervals reduction among associations in right lesional group were compared to left lesional, right non-lesional and control groups. An increase of associative time intervals was observed in the right non-lesional group compared to left non-lesional group. CONCLUSIONS: We suggest a possible inhibitory inter-hemispheric function of the right hemisphere modulating verbal expression of the thought flow. Considering the hypothesis of the inter-hemispheric inhibition by the right hemisphere on left hemisphere, we admit that in epileptic patients with right hemispheric lesion there is an attenuation of the inter-hemispheric inhibition and an increase in thought flow, whereas in patients without a lesion but a paroxysmal epileptic activity in right temporal lobe there is an exacerbation of this inhibitory function and consequent reduction in the thought flow

Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos / Surgical treatment of cerebral vascular pathologies in epileptic patients

A cirurgia das malformaçöes arteriovenosas (MAV) e dos cavernomas (angioma cavernoso) na maioria das vezes é indicada após episódios de sangramento. Como o desenvolvimento das técnicas de diagnóstico e cirúrgicas na epilepsia de difícil controle, passou a ser cada vez maior a indicaçäo cirúrgica destas lesöes vasculares. Apresentamos nove pacientes com lesöes vasculares cerebrais e crises muito frequentes, apesar do tratamento clínico adequado. A faixa etária variou de 12 a 42 anos de idade, com média de 25 anos; houve prevalência no sexo masculino (2:1). A cirurgia constitui na exérese da lesäo em todos os casos. Em quatro casos houve também ressecçäo da área irritativa perilesional, que foi demostrada pela eletrocorticografia. O estudo anatomopatológico das lesöes mostrou cinco casos de cavernoma, três de MAV e um angioma venoso. Quanto à localizaçäo, observamos três lesöes no lobo temporal, quatro no frontal e duas na regiäo parietal. O acompanhamento ambulatorial mostrou reduçäo das crises em todos os pacientes, sendo que sete evoluíram sem crises após a cirurgia.

Especializaçäo funcional hemisférica na afasia motora: achados neurofisiológicos ao mapeamento eletrencefalográfico computadorizado sob estimulaçä sonora musical e verbal: estudo de dois casos / Hemispheric functional specialization in motor aphasia: neurophysiologic findings with electroencephalographic brain mapping during musical and oral sonours stimulation: study of 2 cases

Este estudo diz respeito à atividade elétrica cerebral durante estimulaçäo auditiva em dois pacientes afásicos, um com afasia clássica (lesäo no hemisfério esquerdo) e outro com afasia cruzada (lesäo no hemisfério direito). Ambos foram submetidos ao teste de estimulaçäo auditiva dicótica (consoante-vogal-consoante) e de audiçäo musical (canto gregoriano) durante mapeamento eletrencefalográfico cerebral. Encontramos, em ambos, grande proporçäo da frequência delta e potência no hemisfério näo lesado, durante a estimulaçäo dicótica e musical. Alé disso, foi observado aumento na frequência de atividade alfa somente no hemisfério näo lesado, restrito à regiäo do lobo temporal. Esses achados sugerem um interessante campo de pesquisa acerca da medida de correlatos neurofisiológicos de estimulaçäo auditiva e de atividade elétrica cerebral na afasia

Diferenças sexuais da atençäo visual na epilepsia parcial criptogênica / Sex differences of visual attention in cryptogenic partial epilepsy

Estudamos o rendimento em testes de atençäo visual e verbal e näo-verbal de 14 homens e 18 mulheres controles normais e 33 pacientes com epilepsia parcial criptogênica. O grupo epilépico foi constituido de 17 homens e 16 mulheres sem evidência de lesöes à tomografia computadorizada de crânio. As descargas epilépticas interictais localizavam-se unilateralmente, no lobo temporal direito (8 homens, 8 mulheres) ou no esquerdo (9 homens, 8 mulheres). O desempenho dos homens epilépticos foi semelhante ao dos homens controles. Estes resultados parecem de acordo com a literatura que sugere a atençäo visual nas mulheres dependa da integridade funcional dos dois hemisférios cerebrais. Os homens processariam basicamente os estímulos visuais verbais no hemisfério cerebral esquerdo e os näo verbais no hemisfério cerebral direito. Säo necessários estudos posteriores para o melhor entendimento dessas diferenças sexuais da assimetria funcional hemisférica

Epilepsias: aspectos sociais / Epilepsy: social aspects

O autor aborda fatores sociais da epilepsia, tais como aspectos profissionais, preconceitos sociais, o sistema de saúde, a inexistência de serviços multiprofissionais especializados, e as más condições sanitárias. Ao enfatizar que a epilepsia não é apenas uma condição biológica, mas também uma condição médica e social, aponta caminhos para a resolução desses problemas

Epilepsy and anxiety

Foram avaliados os níveis de ansiedade em 155 indivíduos pelo IDATE (Inventário de Ansiedade Traço-Estado). O grupo de estudo constou de 75 pacientes epilépticos matriculados no Setor de Investigaçäo e Tratamento das Epilepsias da Disciplina de Neurologia da Escola Paulista de Medicina. O grupo controle foi constituído de 80 indivíduos normais. Foram observados maiores níveis de ansiedade crônica (Ansiedade-Traço) em epilépticos que em controles näo epilépticos. Esses níveis foram tanto maiores quanto menor a duraçäo das epilepsias. Em toda a populaçäo epiléptica estudada, os níveis mais altos de ansiedade crônica ocorreram em pacientes com anormalidades do EEG de localizaçäo temporal esquerda. A perda ou näo da consciência näo interferiu nos níveis de ansiedade aguda (Ansiedade-Estado) ou crônica