Intervención comunitaria en el escenario de un brote de la COVID-19

Introducción: Existen experiencias positivas en Cuba relativas a la COVID-19, que incluyen la participación comunitaria en las estrategias de salud, para enfrentar esta epidemia en la atención primaria. Objetivo: Evaluar la efectividad de una intervención comunitaria para disminuir los casos de la COVID-19. Métodos: Se implementó una intervención comunitaria en la población del Policlínico Docente "Dr. Gustavo Aldereguía Lima", de Las Tunas (53 392 habitantes), en el período del 11 de julio al 24 de octubre de 2021. Las variables estudiadas fueron; casos sospechosos en cuerpo de guardia, casos confirmados, casos sospechosos ingresados en el domicilio, casos confirmados ingresados en el domicilio, estratificación del área de salud, complejidad de las semanas estadísticas, tendencia, fallecidos, letalidad, cobertura de vacunación y efectividad. Se realizó un análisis descriptivo de los datos de las variables. Resultados: Ingresaron en el domicilio 8314 (15,60 %) sospechosos de la COVID-19. Los meses de mayor y menor complejidad, fueron agosto y octubre. En la semana 1 se confirmaron entre 401 y 500 casos, con reducción sostenida de la tasa de incidencia y letalidad, desde la semana estadística 35; a partir de la cual inician los reportes de pacientes inmunizados (26 422 en total) con las vacunas cubanas Abdala y Soberana Plus. Conclusiones: La intervención comunitaria, junto a la inmunización anti-COVID-19, fue efectiva para disminuir los casos de la COVID-19 en la población estudiada.

Introduction: There are positive experiences in Cuba related to COVID-19, which include community participation in health strategies to confront this epidemic in primary care. Objective: Evaluate the effectiveness of a community intervention to reduce COVID-19 cases. Methods: A community intervention was implemented in the population of the "Dr. Gustavo Aldereguía Lima", from Las Tunas (53,392 inhabitants), in the period from July 11 to October 24, 2021. The variables studied were; suspected cases in the guard unit, confirmed cases, suspected cases admitted to the home, confirmed cases admitted to the home, stratification of the health area, complexity of statistical weeks, trend, deaths, fatality, vaccination coverage and effectiveness. A descriptive analysis of the variable data was carried out. Results: 8,314 (15.60%) COVID-19 suspects were admitted to the home. The months of greatest and least complexity were August and October. In week 1, between 401 and 500 cases were confirmed, with a sustained reduction in the incidence and fatality rate, since statistical week 35; from which the reports of immunized patients (26,422 in total) with the Cuban Abdala and Soberana Plus vaccines begin. Conclusions: Community intervention, together with anti-COVID-19 immunization, was effective in reducing COVID-19 cases in the studied population.

Control of a COVID-19 outbreak in a health area of ​​Las Tunas / Control de un brote de COVID-19 en un área de salud de Las Tunas / Controle de um surto de COVID-19 em uma área de saúde de Las Tunas

Introduction: Cuba adopted measures against COVID-19 with multisectoral implications that forced it to live in a new normality. At the beginning of 2021, a rise in cases occurred in the presence of other virus variants, including the SARS-CoV-2 Delta.Objective: To assess the community intervention designed to control an outbreak of COVID-19 in a health area of ​​Las Tunas.Material and method: A community intervention was carried out, implemented in the population that attends the health area of ​​the Dr Gustavo Aldereguía Lima Teaching Polyclinic in Las Tunas, made up of 53 thousand 392 dispensary inhabitants in the period from July 11, 2021 to October 24, 2021. 2021.Results: 7,000 ARI medical attentions were provided, 8,314 suspects and 1,695 confirmed COVID-19 entered the home. The months of August and October were the most and least complex by constituency, respectively. 210.6 ± 136,396 confirmed patients were reported per week with sustained reduction from statistical week 35; after statistical week 36 there were no new deaths. From statistical week 35, immunized patients (26,422) with the Cuban ABDALA or Soberana Plus vaccines were reported.Conclusions: The community intervention contributed to better control of the COVID-19 outbreak in the health area, given the decrease in cases and deaths from the disease and the levels of complexity by constituencies.

Introducción: Cuba adoptó medidas contra la COVID-19 con implicaciones multisectoriales que obligaron a convivir en una nueva normalidad. A principios de 2021 ocurrió un alza de casos  en presencia de otras variantes del virus, entre ellas, la Delta del SARS-CoV-2. Objetivo: Valorar la intervención comunitaria diseñada para controlar un brote de COVID-19 en un área de salud de Las Tunas. Material y método: Se realizó una intervención comunitaria implementada en la población que asiste el área de salud del Policlínico Docente Dr Gustavo Aldereguía Lima de Las Tunas compuesta por 53 mil 392 habitantes dispensarizados en el período del 11 de julio de 2021 al 24 de octubre de 2021. Resultados: Se realizaron 7 mil atenciones médicas por IRA, ingresaron en el domicilio 8 mil 314 sospechosos y mil 695 confirmados de COVID-19. Los meses de agosto y octubre fueron los de mayor y menor complejidad por circunscripciones respectivamente. Se notificaron 210,6±136,396 pacientes confirmados por semana con reducción sostenida a partir de la semana estadística 35; posterior a la semana estadística 36 no hubo nuevos fallecidos. Desde la semana estadística 35 se reportaron pacientes inmunizados (26 mil 422) con las vacunas cubanas ABDALA o Soberana Plus. Conclusiones: La intervención comunitaria contribuyó al mejor control del brote por COVID-19 en el área de salud,  dado en la disminución de casos y fallecidos por la enfermedad y los niveles de complejidad por circunscripciones.

Introdução: Cuba adotou medidas contra a COVID-19 com implicações multissetoriais que a obrigaram a viver em uma nova normalidade. No início de 2021, ocorreu um aumento de casos na presença de outras variantes do vírus, incluindo o SARS-CoV-2 Delta.Objetivo: Avaliar a intervenção comunitária destinada a controlar um surto de COVID-19 em uma área de saúde de Las Tunas.Material e método: Foi realizada uma intervenção comunitária, implementada na população que frequenta a área de saúde da Policlínica Docente Dr. Gustavo Aldereguía Lima em Las Tunas, composta por 53 mil 392 habitantes do dispensário no período de 11 de julho de 2021 a 24 de outubro de 2021. 2021. See MoreResultados: Foram prestados 7.000 atendimentos de IRA, 8.314 suspeitos e 1.695 confirmados de COVID-19 entraram em casa. Os meses de agosto e outubro foram os mais e menos complexos por círculo eleitoral, respectivamente. 210,6 ± 136.396 pacientes confirmados foram relatados por semana com redução sustentada da semana estatística 35; após a semana estatística 36 não houve novas mortes. A partir da semana estatística 35, foram relatados pacientes imunizados (26.422) com as vacinas cubanas ABDALA ou Soberana Plus.Conclusões: A intervenção comunitária contribuiu para um melhor controlo do surto de COVID-19 na área da saúde, dada a diminuição dos casos e óbitos pela doença e dos níveis de complexidade por circunscrições.

Expected annual probability of infection: A flood-risk approach to waterborne infectious diseases.

This study introduces a new approach for the investigation of infections after an accidental ingestion of contaminated floodwater. The concept of Expected Annual Probability of Infection (EAPI) is introduced and implemented in an infection risk-model approach, by combining a Quantitative Microbial Risk Assessment (QMRA) with the four steps in flood risk assessment. Two groups and exposure paths are considered: adults wading in floodwater and small children swimming/playing in floodwater. The study area is located in Ghana, West Africa. Even though Ghana is one of the most urbanized countries in Africa it has significant problems with water resources management and public health. While cholera is classified as endemic in Accra, the natural and human-made characteristics of the capital makes it prone to flooding. The results of the EAPI approach show that on one hand the concentration of pathogens in floodwater, and thus the risk of infection, decreases with the increase of the flood magnitude. On the other hand, larger floods can spread the pathogens further from the point source, threatening populations previously not identified as at risk by small-scale floods. The concept of EAPI is demonstrated for cholera but it can be extended to other waterborne diseases and also different pathways of exposure, requiring minimal adaptations. For future applications, better estimation of EAPI key components and improvement points are discussed and recommendations given for all the assessment steps.

An Inverse Problem Approach for Parameter Estimation of Cardiovascular System Models.

Left ventricular assist devices (LVADs) are mechanical pumps that help patients with chronic heart failure waiting for a heart transplant. Mathematical models of these devices can be used along cardiovascular system (CVS) models to evaluate the assistance performance under different operating modes. The estimation of the CVS model parameters for a particular patient and numerical simulations allow the implementation of adequate LVAD operation mode. This work presents a method to estimate the parameters of a CVS model using only one hemodynamic variable: the systemic arterial pressure (Ps). Synthetic signals of Ps are used to solve this ill-posed inverse problem partially, and the results show the high accuracy of the proposed method, which achieves 0.5%.Clinical relevance- The measurements of hemodynamic variables using noninvasive techniques avoid many clinical problems arising from invasive measures such as infections.

Sugarloaf Land in south-eastern Brazil: a tropical hotspot of lowland inselberg plant diversity.

BACKGROUND: Isolated monoliths of granitic and/or gneissic rock rising abruptly from the surrounding landscape are known as inselbergs. Dome-shaped inselbergs are common throughout the Atlantic Forest in south-eastern Brazil, a region known as Sugarloaf Land (SLL). This study aimed to create the first checklist of vascular plant species occurring on lowland inselbergs in SLL, with a focus on vegetation islands. We used information from online databases, our own field sampling and data from previously-published studies. We found 548 vascular plant species (505 angiosperms; 43 ferns and lycophytes) belonging to 69 families and 212 genera. Of all identified species, 536 are native and 12 are naturalised. NEW INFORMATION: We updated the information currently available in Flora do Brasil 2020, as 59% of the angiosperms and 63% of the ferns and lycophytes on our checklist were not previously characterised as occurring on rock outcrops. As a first step towards generating a Virtual Herbarium of lowland inselberg vascular plants, we added barcode vouchers with images available online for 75% of the total number of vascular species. In the official lists of endangered species, 115 angiosperms and five ferns and lycophytes are mentioned. However, the conservation status of many species have not yet been evaluated (77% angiosperms; 88% ferns and lycophytes), thus this list is an important step towards their conservation. The information provided herein is essential for management programmes related to rock outcrops in Brazil as they are facing serious threats to conservation.

Violência, funções executivas e rendimento acadêmico em estudantes universitários / Violence, executive functions and academic achievement in university students / Violencia, funciones ejecutivas y rendimiento académico en estudiantes universitarios

O presente artigo teve como objetivo avaliar impactos da vitimização, no último ano e ao longo da vida, no desempenho acadêmico no ensino superior a partir da análise das funções executivas. Participaram do estudo 90 estudantes com idade de 19 a 24 anos. Os instrumentos utilizados foram o Five Digit Test (FDT) e o questionário Juvenile Victimization Questionnaire (JVQ). Foram avaliados a violência ocorrida no último ano e ao longo da vida, as funções executivas (FE) e o rendimento acadêmico (CR). Os resultados apontaram que indivíduos que sofreram violência por maus-tratos e sexual no último ano apresentaram CR mais baixo em relação ao grupo que não sofreu violência. Violência por maus-tratos e violência sexual também correlacionaram positivamente com funções executivas, tanto nos processos automáticos quanto nos controlados. Os dados apontam que sofrer violências têm repercussão nas funções executivas e desempenho acadêmico na vida adulta.

This study aimed to evaluate the impact of victimization in the previous year and throughout life on academic performance in higher education from the analysis of executive functions. The study included 90 students aged 19 to 24 years. The instruments used were the Five Digit Test (FDT) and the Juvenile Victimization Questionnaire (JVQ). Violence suffered in the previous year and throughout the lifetime, executive functions (EFs) and academic achievement (AC) were assessed. The results showed that individuals that had suffered abuse and sexual violence in the previous year had lower AC compared to the group that had not suffered violence. Violence through ill-treatment and sexual violence also positively correlated with executive functions in both automatic and controlled processes. The data indicate that suffering violence has repercussions on the executive functions and academic performance in adulthood.

Este artículo tuvo como objetivo evaluar el impacto de la victimización en el rendimiento académico en la educación superior, en el último año y a lo largo de la vida, a partir del análisis de las funciones ejecutivas. El estudio se realizó con 90 estudiantes con edades entre 19 y 24 años. Los instrumentos utilizados fueron el Five Digit Test (FDT) y el cuestionario Juvenile Victimization Questionnaire (JVQ). Se evaluó la violencia vivida en el último año y a lo largo de la vida, las funciones ejecutivas (FE) y el rendimiento académico (CR). Los resultados mostraron que las personas que sufrieron abuso y violencia sexual en el último año tuvieron un CR más bajo en comparación con el grupo que no sufrió violencia. La violencia por maltrato y violencia sexual también se correlacionaron positivamente con las funciones ejecutivas tanto en procesos automáticos como en los controlados. Los datos indican que sufrir violencia genera repercusiones en las funciones ejecutivas y el rendimiento académico en la edad adulta.

Fungemia following Saccharomyces cerevisiae var. boulardii probiotic treatment in an elderly patient / Fungemia posterior al tratamiento con Saccharomyces cerevisiae var. boulardii como probiótico en una paciente anosa

Abstract The yeast Saccharomyces cerevisiae var. boulardii is a biotherapeutic agent used for the prevention and treatment of several gastrointestinal diseases. We report a case of fungemia in a patient suffering from Clostridium difficile-associated diarrhea and treated with metronidazole and a probiotic containing S. cerevisiae var. boulardii. The yeasts isolated from the blood culture and capsules were identified by MALDI-TOF MS and API ID 32 C as S. cerevisiae, and showed the same appearance and color on CHROMAgar Candida. Treatment with fluconazole 400mg/day was initiated and the probiotic was stopped. The patient was discharged from hospital in good condition and was referred to a rehabilitation center. We suggest that the potential benefit of S. cerevisiae var. boulardii should be accurately evaluated, especially in elderly patients. Moreover, all physicians should be trained in the use of probiotic agents and enquire whether the use probiotics was included in the patients'medical histories. © 2019 Asociación Argentina de Microbiología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Resumen Saccharomyces cerevisiae var. boulardii es un agente bioterapéutico usado en la prevención y el tratamiento de varias enfermedades gastrointestinales. Informamos de un caso de fungemia en una paciente con diarrea asociada a Clostridium difficile, y tratada con metron-idazol y un probiótico que contenía S. cerevisiae var. boulardii. Las levaduras aisladas a partir del hemocultivo y del contenido de las cápsulas tomadas por la paciente se identificaron como S. cerevisiae mediante MALDI-TOF MS y API® ID 32C, las colonias mostraron el mismo color y aspecto en el medio CHROMAgar™ Candida. Se instauró un tratamiento con fluconazol 400mg/día y se suspendió el probiótico. La paciente fue dada de alta del hospital en buenas condiciones, y remitida a un centro de rehabilitación. Sugerimos que el beneficio potencial del uso de S. cerevisiae var. boulardii debe ser evaluado en cada paciente, especialmente en personas añosas. El uso de probióticos debería incluirse en los interrogatorios orientados al diagnóstico y formar parte de la historia clínica. © 2019 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Consideraciones diagnósticas y terapéuticas de la tuberculosis intestinal / Diagnostic and Therapeutic Considerations about Abdominal Tuberculosis

Introducción: La tuberculosis es una enfermedad reemergente, importante como causa mayor de incapacidad y muerte en muchas zonas del mundo. La tuberculosis intestinal representa 11 por ciento de todas las formas extrapulmonares; 0,5 por ciento de todos los casos nuevos de y el 10 al 15 por ciento en los no infectados por el VIH. En el municipio Tunas se notificó el caso de un adolescente de 17 años, masculino, al que se le diagnostica esta enfermedad luego de haber presentado síntomas de dolor abdominal recurrente durante de varios meses antes del diagnóstico. Objetivo: Actualizar la información sobre el diagnóstico y tratamiento de la tuberculosis intestinal. Métodos: Se realizó una revisión bibliográfica sobre tuberculosis intestinal con la literatura encontrada en bases de datos disponibles en la red Infomed: PubMed, Hinari, The Cochrane Library, SciELO, MEDLINE y MedicLatina; con un enfoque histórico-lógico y de análisis-síntesis. Conclusiones: El diagnóstico precoz de la tuberculosis intestinal sin tuberculosis pulmonar activa continúa siendo un problema de salud, ya que los parámetros clínicos, bioquímicos, imagenológicos y endoscópicos aún carecen de especificidad, y en algunos casos se ha mostrado resistencia al tratamiento habitual(AU)

Introduction: Tuberculosis is a reemerging disease, also important as a major cause of disability and death in many regions of the world. Abdominal tuberculosis represents 11 percent of all extrapulmonary forms; 0.5 percent of all new cases of HIV infection and 10-15 percent of those not infected with HIV. In Las Tunas Municipality, the case of a 17-year-old male adolescent who was diagnosed with this disease was reported after the patient presented symptoms of recurrent abdominal pain for several months before diagnosis. Objective: To update information on the diagnosis and treatment of abdominal tuberculosis. Methods: A literature review on intestinal tuberculosis was carried out with the literature found in databases available on the Infomed network, such as PubMed, Hinari, The Cochrane Library, SciELO, MEDLINE, and MedicLatina, with a historical-logical and analysis-synthesis approach. Conclusions: The early diagnosis of intestinal tuberculosis without active pulmonary tuberculosis continues to be a health concern, since clinical, biochemical, imaging, and endoscopic parameters still lack specificity, and, in some cases, resistance to usual treatment has been shown(AU)

A scalable flood-resilience-index for measuring climate change adaptation: Munich city.

Climate change is affecting the frequency and intensity of rainfall extreme events worldwide. Despite the growing global awareness, developing flood resilient cities has proven to be a major challenge. This paper investigates the application of an event-based scalable Flood Resilience Index (FRI) for assessing climate change adaptation. Flood resilience is represented by three dimensions: physical, social and economic. A household climate adaptation is adopted consisting of a combination of a flood-proof gate with an indoor tank and a submersible pump system implemented in all houses. The climate related impact under a high-emission scenario (RCP8.5) is analysed for Munich with the CRCM5 Large-Ensemble. Results show that for Munich extreme heavy rainfall events are increasing. The FRI can successfully identify households and districts which: a) are mostly affected by heavy rainfall, b) benefit the most from the climate adaptation, and c) are the most resilient. For the most severe future scenario investigated the climate adaptation measure was able to improve 57% of all affected buildings within Maxvorstadt to an FRI equal to 1.0 during the event and recovery phase.

Fungemia following Saccharomyces cerevisiae var. boulardii probiotic treatment in an elderly patient.

The yeast Saccharomyces cerevisiae var. boulardii is a biotherapeutic agent used for the prevention and treatment of several gastrointestinal diseases. We report a case of fungemia in a patient suffering from Clostridiumdifficile-associated diarrhea and treated with metronidazole and a probiotic containing S. cerevisiae var. boulardii. The yeasts isolated from the blood culture and capsules were identified by MALDI-TOF MS and API ID 32 C as S. cerevisiae, and showed the same appearance and color on CHROMAgar Candida. Treatment with fluconazole 400mg/day was initiated and the probiotic was stopped. The patient was discharged from hospital in good condition and was referred to a rehabilitation center. We suggest that the potential benefit of S. cerevisiae var. boulardii should be accurately evaluated, especially in elderly patients. Moreover, all physicians should be trained in the use of probiotic agents and enquire whether the use probiotics was included in the patients'medical histories.

Burst ranking for blind multi-image deblurring.

We propose a new incremental aggregation algorithm for multi-image deblurring with automatic image selection. The primary motivation is that current burst deblurring methods do not handle well situations in which misalignment or out-of-context frames are present in the burst. These real-life situations result in poor reconstructions or manual selection of the images that are used to deblur. Automatically selecting the best frames within the burst to improve the base reconstruction is challenging because the number of possible images fusions is equal to the power set cardinal. Here, we approach the multi-image deblurring problem as a two steps process. First, we successfully learn a comparison function to rank a burst of images using a deep convolutional neural network. Then, an incremental Fourier burst accumulation with a reconstruction degradation mechanism is applied fusing only less blurred images that are sufficient to maximize the reconstruction quality. Experiments with the proposed algorithm have shown superior results when compared to other similar approaches, outperforming other methods described in the literature in previously described situations. We validate our findings on several synthetic and real datasets.

Automated Spatial Pattern Analysis for Identification of Foot Arch Height From 2D Foot Prints.

Arch height is an important determinant for the risk of foot pathology, especially in an aging population. Current methods for analyzing footprints require substantial manual processing time. The current research investigated automated determination of foot type based on features derived from the Gabor wavelet utilizing digitized footprints to allow timely assessment of foot type and focused intervention. Two hundred and eighty footprints were collected, and area, perimeter, curvature, circularity, 2nd wavelet moment, mean bending energy (MBE), and entropy were determined using in house developed MATLAB codes. The results were compared to the gold standard using Spearman's Correlation coefficient and multiple linear regression models with significance set at 0.05. The proposed approach found MBE combined with foot perimeter to give the best results as shown by ANOVA (F(2,211) = 10.18, p < 0.0001) with the mean ±SD of low, normal, and high arch being, respectively, 0.26 ± 0.025,.24 ± 0.021, and 0.23 ± 0.024. A clinical review of the new cut off values, as set by the first and the third quartiles of our sample, lead to reliability up to 87%. Our results suggest that automated wavelet-based foot type classification of 2D binary images of the plantar surface of the foot is comparable to current state-of-the-art methods providing a cost and time effective tool suitable for clinical diagnostics.

Numerical and experimental study of the fundamental flow characteristics of a 3D gully box under drainage.

Numerical studies regarding the influence of entrapped air on the hydraulic performance of gullies are nonexistent. This is due to the lack of a model that simulates the air-entrainment phenomena and consequently the entrapped air. In this work, we used experimental data to validate an air-entrainment model that uses a Volume-of-Fluid based method to detect the interface and the Shear-stress transport k-ω turbulence model. The air is detected in a sub-grid scale, generated by a source term and transported using a slip velocity formulation. Results are shown in terms of free-surface elevation, velocity profiles, turbulent kinetic energy and discharge coefficients. The air-entrainment model allied to the turbulence model showed a good accuracy in the prediction of the zones of the gully where the air is more concentrated.

A comparative study of manhole hydraulics using stereoscopic PIV and different RANS models.

Flows in manholes are complex and may include swirling and recirculation flow with significant turbulence and vorticity. However, how these complex 3D flow patterns could generate different energy losses and so affect flow quantity in the wider sewer network is unknown. In this work, 2D3C stereo Particle Image Velocimetry measurements are made in a surcharged scaled circular manhole. A computational fluid dynamics (CFD) model in OpenFOAM® with four different Reynolds Averaged Navier Stokes (RANS) turbulence model is constructed using a volume of fluid model, to represent flows in this manhole. Velocity profiles and pressure distributions from the models are compared with the experimental data in view of finding the best modelling approach. It was found among four different RANS models that the re-normalization group (RNG) k-ɛ and k-ω shear stress transport (SST) gave a better approximation for velocity and pressure.

Qualidade da água de abastecimento público do município de Jaboticabal, SP / Quality of public-supply water in Jaboticabal city, Brazil

RESUMO A água de abastecimento público pode ser um veículo de doenças e agravos à saúde humana, portanto, é necessário um tratamento eficiente e constantes avaliações da sua qualidade. O presente estudo objetivou avaliar a dinâmica populacional de indicadores microbiológicos e parâmetros físico-químicos da qualidade da água em diferentes pontos de uma estação de tratamento de água do tipo convencional, do sistema de distribuição e dos mananciais de abastecimento do município de Jaboticabal, São Paulo, nas estações chuvosa e de seca. Os resultados demonstraram que, apesar do manancial superficial apresentar qualidade microbiológica inferior (comparado aos demais mananciais estudados), após tratamento convencional foi obtida a potabilidade do mesmo. A estação chuvosa foi crítica para amostras coletadas nas etapas logo após adição de cloro, principalmente no sistema de distribuição do manancial subsuperficial. Dentre os pontos avaliados na rede de distribuição, os reservatórios domiciliares apresentaram o maior número de amostras fora do padrão de potabilidade, principalmente na rede abastecida pelo manancial subsuperficial. São necessárias estratégias para a melhoria do processo de tratamento da água do dreno - voltado para a redução da turbidez - principalmente na estação chuvosa; assim como programas de educação em saúde para a população, a fim de melhorar a qualidade da água no ponto de consumo, a partir da limpeza periódica dos reservatórios domiciliares.

ABSTRACT The public-supply water can be a vehicle of disease and harm to human health, therefore, efficient treatment and constant evaluation of its quality is required. The present study aimed to evaluate the population dynamics of microbiological and physico-chemical indicators of water quality parameters at different points of a water treatment plant of the conventional type, in the distribution system and sources of supply in Jaboticabal city, São Paulo state, Brazil, in the rainy and dry seasons. The results showed that although the present fountain surface presents worse microbiological quality (compared to other sources studied) after the conventional treatment, it became potable. The rainy season was critical for samples collected in steps after adding chlorine, especially in the distribution of sub-surface source system. Among the evaluated points in the distribution network, domestic containers had the highest number of samples outside the potability standards, mainly those fueled by the sub-surface source network. Strategies to improve the treatment process of the drain water (turbidity reduction) are needed, especially during the rainy season; as well as health education programs in order to improve water quality at the point of consumption by periodic cleaning of domestic containers.

A methodology for linking 2D overland flow models with the sewer network model SWMM 5.1 based on dynamic link libraries.

Pluvial flooding in urban areas is characterized by a gradually varying inundation process caused by surcharge of the sewer manholes. Therefore urban flood models need to simulate the interaction between the sewer network and the overland flow in order to accurately predict the flood inundation extents. In this work we present a methodology for linking 2D overland flow models with the storm sewer model SWMM 5. SWMM 5 is a well-known free open-source code originally developed in 1971. The latest major release saw its structure re-written in C ++ allowing it to be compiled as a command line executable or through a series of calls made to function inside a dynamic link library (DLL). The methodology developed herein is written inside the same DLL in C + +, and is able to simulate the bi-directional interaction between both models during simulation. Validation is done in a real case study with an existing urban flood coupled model. The novelty herein is that the new methodology can be added to SWMM without the need for editing SWMM's original code. Furthermore, it is directly applicable to other coupled overland flow models aiming to use SWMM 5 as the sewer network model.

Characterization of the hydraulic performance of a gully under drainage conditions.

During rainfall events with low return periods (1-20 years) the drainage system can provide some degree of protection to urban areas. The system design is based not only on good hydraulic performance of the surface and the sewer network but also on their linking elements. Although the linking elements are of utmost importance as they allow the exchange of flow between the surface and the sewer network, there is a lack of studies that thoroughly characterize them. One crucial structural part of those elements is the gully. State-of-the-art dual-drainage models often use simplified formulae to replicate the gully hydraulic behaviour that lacks proper validation. This work focuses on simulating, both numerically and experimentally, the hydraulic performance of a 0.6 × 0.3 × 0.3 [m] (L × W × D) gully located inside an 8 × 0.5 × 0.5 [m] rectangular channel. The numerical simulations are conducted with the OpenFOAM toolbox and validated with water level measurements in the Multiple-Linking-Element experimental installation located at the Laboratory of Hydraulics of the University of Coimbra. The results provide a complete three-dimensional insight of the hydraulic behaviour of the flow inside the gully, and discharge coefficient formulae are disclosed that can be directly applied in dual-drainage models as internal boundary conditions.

Automated detection of proliferative retinopathy in clinical practice.

Timely intervention for diabetic retinopathy (DR) lessens the possibility of blindness and can save considerable costs to health systems. To ensure that interventions are timely and effective requires methods of screening and monitoring pathological changes, including assessing outcomes. Fractal analysis, one method that has been studied for assessing DR, is potentially relevant in today's world of telemedicine because it provides objective indices from digital images of complex patterns such as are seen in retinal vasculature, which is affected in DR. We introduce here a protocol to distinguish between nonproliferative (NPDR) and proliferative (PDR) changes in retinal vasculature using a fractal analysis method known as local connected dimension (D(conn)) analysis. The major finding is that compared to other fractal analysis methods, D(conn) analysis better differentiates NPDR from PDR (p = 0.05). In addition, we are the first to show that fractal analysis can be used to differentiate between NPDR and PDR using automated vessel identification. Overall, our results suggest this protocol can complement existing methods by including an automated and objective measure obtainable at a lower level of expertise that experts can then use in screening for and monitoring DR.

Automated segmentation of retinal blood vessels and identification of proliferative diabetic retinopathy.

Proliferative diabetic retinopathy can lead to blindness. However, early recognition allows appropriate, timely intervention. Fluorescein-labeled retinal blood vessels of 27 digital images were automatically segmented using the Gabor wavelet transform and classified using traditional features such as area, perimeter, and an additional five morphological features based on the derivatives-of-Gaussian wavelet-derived data. Discriminant analysis indicated that traditional features do not detect early proliferative retinopathy. The best single feature for discrimination was the wavelet curvature with an area under the curve (AUC) of 0.76. Linear discriminant analysis with a selection of six features achieved an AUC of 0.90 (0.73-0.97, 95% confidence interval). The wavelet method was able to segment retinal blood vessels and classify the images according to the presence or absence of proliferative retinopathy.

Retinal vessel segmentation using the 2-D Gabor wavelet and supervised classification.

We present a method for automated segmentation of the vasculature in retinal images. The method produces segmentations by classifying each image pixel as vessel or nonvessel, based on the pixel's feature vector. Feature vectors are composed of the pixel's intensity and two-dimensional Gabor wavelet transform responses taken at multiple scales. The Gabor wavelet is capable of tuning to specific frequencies, thus allowing noise filtering and vessel enhancement in a single step. We use a Bayesian classifier with class-conditional probability density functions (likelihoods) described as Gaussian mixtures, yielding a fast classification, while being able to model complex decision surfaces. The probability distributions are estimated based on a training set of labeled pixels obtained from manual segmentations. The method's performance is evaluated on publicly available DRIVE (Staal et al., 2004) and STARE (Hoover et al., 2000) databases of manually labeled images. On the DRIVE database, it achieves an area under the receiver operating characteristic curve of 0.9614, being slightly superior than that presented by state-of-the-art approaches. We are making our implementation available as open source MATLAB scripts for researchers interested in implementation details, evaluation, or development of methods.