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Miranda AC, Santana JCC, Yamamura CLK, Rosa JM, Tambourgi EB, Ho LL, Berssaneti FT. Application of neural network to simulate the behavior of hospitalizations and their costs under the effects of various polluting gases in the city of São Paulo. Air Qual Atmos Health 2021; 14:2091-2099. [PMID: 34745381 PMCID: PMC8556003 DOI: 10.1007/s11869-021-01077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/11/2021] [Indexed: 05/13/2023]
Abstract
This work aims to obtain an artificial neural network to simulate hospitalizations for respiratory diseases influenced by pollutant gaseous such as CO, PM10, PM2.5, NO2, O3, and SO2 emitted from 2011 to 2017, in the city of São Paulo. The hospitalization costs were also be calculated. MLP and RBF neural networks have been tested by varying the number of neurons in the hidden layer and the type of equation of the output function. The following pollutants and its concentration range were collected considering the supervision of Alto Tiete station set, in several neighborhoods in the city of São Paulo, from in the period 2011 to 2017: 28-63 µg/m3 of PM2.5, 52-110 µg/m3 of PM10, 49-135 µg/m3 of O3, 0.8-2.6 ppm CO, 41-98 µg/m3 of NO2, and 3-16 µg/m3 of SO2. Results showed that a RBF neural network with 6 input neurons, 13 hidden layer neurons, and 1 output neuron, using BFGS algorithm and a Gaussian function to neuronal activation, was the best fitted to the experimental datasets. So, knowing the monthly concentration of gaseous pollutions was possible to predict the hospitalization of 1464 to 3483 ± 510 patients, with costs between 570,447 and 1,357,151 ± 198,171 USD per month. This way, it is possible to use this neural network to predict the costs of hospitalizing patients for respiratory diseases and to contribute to the decision-making of how much the government should spend on health care.
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Affiliation(s)
- Amanda Carvalho Miranda
- Department of Pharmaceutical Sciences, Nine July University, São Paulo, Brazil
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - José Carlos Curvelo Santana
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
- Department of Management Engineering, Federal University of ABC, University Mall, São Bernardo do Campo, 09606-045 Brazil
| | - Charles Lincoln Kenji Yamamura
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - Jorge Marcos Rosa
- School of Textile Technology of SENAI, Rua Correia de Andrade, 232 Brás, São Paulo, SP 03008-020 Brazil
- School of Chemical Engineering, State University of Campinas, Barão Geraldo, Campinas, SP 13083-970 Brazil
| | - Elias Basile Tambourgi
- School of Chemical Engineering, State University of Campinas, Barão Geraldo, Campinas, SP 13083-970 Brazil
| | - Linda Lee Ho
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - Fernando Tobal Berssaneti
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
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Costa FA, Ramos C, Murteira R, Almodovar T, Passos-Coelho JL, Carvalho MI, Costa L, Brito MJ, Ramos S, Ferreira M, Miranda AC. The cancer registry as an ally in monitoring treatment effectiveness. Pulmonology 2018; 25:3-8. [PMID: 30361162 DOI: 10.1016/j.pulmoe.2018.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/25/2018] [Accepted: 05/18/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate if the cancer registry database can be used to monitor treatment effectiveness using nivolumab treatment of non-small cell lung cancer (NSCLC) as an example. METHOD An observational inception cohort was used, where all registered cases of NSCLC with authorisation to initiate treatment with nivolumab were monitored retrospectively to evaluate disease characteristics and response to prior treatments. Current exposure to nivolumab was prospectively characterised and treatment outcomes classified based on the clinical information registered in the patient medical record. The main outcome measure used to assess treatment effectiveness was overall survival (OS). Secondary outcomes considered were progression free survival (PFS) as a measure of effectiveness and occurrence of Adverse Drug Reaction (ADRs) as a measure of safety. Data were analysed using SPSS, version 24. RESULTS A total of 115 patients received treatment with nivolumab for NSCLC, between November 1st 2015 and July 31st 2016, and were registered in the database. The majority were non-squamous type (n=107). The median OS was 11.4 months {CI95%: 11.1-11.7}, with a 1-year survival of 44%, in line with clinical trial data. Median PFS was 5.4 months {CI95%: 2.8-7.9}. Treatment was discontinued in 82 cases, most frequently due to disease progression. There were 38 cases of ADRs documented in the patient medical chart, 21 of which led to treatment discontinuation. CONCLUSION The analysed data suggest that the cancer registry is a powerful tool to monitor treatment effectiveness, although considerable investment is needed to improve the medical culture of recording treatment exposure, particularly documentation of ADRs.
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Affiliation(s)
- F A Costa
- Registo Oncológico Nacional, Portugal.
| | - C Ramos
- Registo Oncológico Nacional, Portugal
| | | | - T Almodovar
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal
| | | | | | - L Costa
- Centro Hospitalar de Lisboa Norte, Portugal
| | | | - S Ramos
- Centro Hospitalar de Lisboa Ocidental, Portugal
| | - M Ferreira
- Hospital Prof. Doutor Fernando da Fonseca, Portugal
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Rodrigues TN, Miranda AC, Ramos MT, Godoi FN, Almeida FQ. Blood Biochemistry and Hemogasometry of Horses Performing Incremental Jumping and Velocity Tests. Equine Vet J 2014. [DOI: 10.1111/evj.12267_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- TN Rodrigues
- Universidade Federal Rural do Rio de Janeiro; Rio de Janeiro Brazil
| | - AC Miranda
- Universidade Federal Rural do Rio de Janeiro; Rio de Janeiro Brazil
| | - MT Ramos
- Universidade Federal Rural do Rio de Janeiro; Rio de Janeiro Brazil
| | - FN Godoi
- Universidade Federal Rural do Rio de Janeiro; Rio de Janeiro Brazil
| | - FQ Almeida
- Universidade Federal Rural do Rio de Janeiro; Rio de Janeiro Brazil
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Alfaiate D, Miranda AC, Rijo J, Fernandes D, Borges F, Farinha H, Mansinho K. The impact of late presentation: analysis of a cohort of 313 Portuguese patients. J Int AIDS Soc 2010. [PMCID: PMC3112954 DOI: 10.1186/1758-2652-13-s4-p174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Guimarães MMQ, Azevedo MB, Cohen F, Miranda AC, Souza E, Santos FBA, Mansur LM, Senna AL, Butter A, Carvalho M. Nosocomial pneumonia and the main victim: the older person – measures for ventilator-associated pneumonia control. Crit Care 2009. [PMCID: PMC4085440 DOI: 10.1186/cc7842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Miranda AC, Almeida I, Mendez J, Mota M, Teofilo E, Vera J, Diniz A, Maltez F, Marques R, Mansinho K, Sarmento-Castro R, Camacho R, Manata MJ, Delgado C. Efficacy, safety and tolerability of enfuvirtide in a population of Portuguese HIV-1 chronically infected patients. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Miranda AC, Teixeira MS, Santos RB, Teles RM. [Expectations of hospitalized patients as to their relationship with the nursing team]. Rev Bras Enferm 1997; 50:183-96. [PMID: 9775932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
This research has been made in infectious-parasitary disease sector of a public university hospital in Rio de Janeiro on the first semester of 1995. The logbook research has been introduced to 5 adult clients, from both sexes, who had been interned in the construction of two categories, which are: a) Category I: Feelings and expectations of the client and; b) Category II: Communication and relationship between client and nurse. The results found in the first category were: 1) Lack of affection; 2) Affection, fear and anxiety; 3) Loneliness and depression; 4) Reflection; 5) Insecurity; 6) Worry about the equipment, to be cut, to be impersonally treated, lose self-control and physical dependence. The results found in the second category were: 1) Doubts and interests in information about their disease, its evolution and how long they will stay in hospital: 2) Opportunity to express feelings and ideas; 3) Comprehension of the message given by the nurse. We emphasize the increase of interchange of information, ideas, beliefs, feelings and acts in nurse-client interaction to develop the therapeutic relationship aiming at helping the client to fulfill his basic needs.
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Affiliation(s)
- A C Miranda
- Escola de Enfermagem Anna Nery da Universidade Federal do Rio de Janeiro
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Abstract
A factory for producing the pesticide hexachlorocyclohexane (HCR) in its technical grade (mix of the alpha, beta, gamma, and delta isomers), that belonged to the former Institute of Malaria Sciences, then Ministry of Education and Health, located in the "Cidade dos Meninos", county of Duque de Caxias, State of Rio de Janeiro, was closed down in 1955. Part of its production and wastes - many tons this mix - were left behind on the site. The action of winds and rain as well as the movement of the local inhabitants - approximately 1,000 people, including 400 children, have caused the scaltering of this agent. Blood specimens from the inhabitants showed a high human contamination levels, with the highest concentration (beta isomers) being found in people living within a 100 meter radius of the ruin of the factory. Local soil and pasture samples taken at distances of less than 100 m from the ruin of the former factory showed HCH isomer concentrations of the order of thousands of ppb, thus providing evidence of high environmental contamination.
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Affiliation(s)
- R M Oliveira
- Departamento de Saneamento e Saúde Ambiental da Escola Nacional de Saúde Pública, Brasil
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Abstract
BACKGROUND Consultation waiting rooms and similar medical settings, either public or private, are places where children have higher probability of acquiring some infectious diseases, especially during outbreaks. METHODS During a measles outbreak which occurred in Lisbon in 1989 a case-control study was carried out in a major paediatric hospital to estimate the risk of measles infection associated with the exposure in medical settings. The statistical analysis was performed with data matched on age, using conditional logistic regression, to reach a multivariate model which explains the risk in the presence of the main variables of interest. RESULTS The crude odds ratio (OR), based upon 72 cases and 216 controls, in children younger than 12 years, was 4.1 (P < 0.001). Hospital emergency settings had an OR of 4.9 (P < 0.001) and private physicians' offices an OR of 1.4 (P = 0.689). Non-whites showed a 2.4-fold increase in the crude probability of getting measles, although this was not statistically significant (P = 0.118). Children who had a recent contact with cases of measles had an OR of 14.7 (P = 0.005). Immunization against measles was an important protective factor (OR = 0.1; P < 0.001), as was attendance at kindergartens or wet nurses, although less significant (OR = 0.4; P = 0.051). CONCLUSIONS This study supports the need for children to avoid unnecessary exposure in medical settings during measles outbreaks, especially if those settings are crowded and result in long waiting periods before a consultation.
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Abstract
The present case-control study was designed mainly to estimate the risk of gastric cancer associated with consumption of alcoholic beverages. Seventy-four cases were selected from patients undergoing endoscopy with a histologically confirmed diagnosis of gastric cancer and matched by age and sex to a pool of controls (193) from three different sources, at the same hospital ward. After adjustment for several confounders, consumption of more than one bottle of red wine per day 20 years prior to the interview showed an odds ratio (OR) = 2.61 (P = 0.049), with a dose-response relationship increasing from 1.36 for those consuming less than one glass of wine per meal, up to 3.67 if the daily consumption exceeded one bottle of red wine. Other statistically significant determinants of the disease occurrence were low education level (OR = 4.33; P = 0.0008) and low social class (OR = 2.77; P = 0.016), as well as the regular practice of preserving food by smoke at home (OR = 1.91; P = 0.032).
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Affiliation(s)
- J M Falcao
- Division of Epidemiology, General Directorate of Health, Lisboa, Portugal
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De La Cueva OS, Miranda AC. Metro Manila and Nueva Ecija women favor the pill. Fpop Bull 1987; 17:14. [PMID: 12268886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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