Search results for: Cesar Ferreira Amorim
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 261

Search results for: Cesar Ferreira Amorim

111 Multi-Objective Optimization for the Green Vehicle Routing Problem: Approach to Case Study of the Newspaper Distribution Problem

Authors: Julio C. Ferreira, Maria T. A. Steiner

Abstract:

The aim of this work is to present a solution procedure referred to here as the Multi-objective Optimization for Green Vehicle Routing Problem (MOOGVRP) to provide solutions for a case study. The proposed methodology consists of three stages to resolve Scenario A. Stage 1 consists of the “treatment” of data; Stage 2 consists of applying mathematical models of the p-Median Capacitated Problem (with the objectives of minimization of distances and homogenization of demands between groups) and the Asymmetric Traveling Salesman Problem (with the objectives of minimizing distances and minimizing time). The weighted method was used as the multi-objective procedure. In Stage 3, an analysis of the results is conducted, taking into consideration the environmental aspects related to the case study, more specifically with regard to fuel consumption and air pollutant emission. This methodology was applied to a (partial) database that addresses newspaper distribution in the municipality of Curitiba, Paraná State, Brazil. The preliminary findings for Scenario A showed that it was possible to improve the distribution of the load, reduce the mileage and the greenhouse gas by 17.32% and the journey time by 22.58% in comparison with the current scenario. The intention for future works is to use other multi-objective techniques and an expanded version of the database and explore the triple bottom line of sustainability.

Keywords: Asymmetric Traveling Salesman Problem, Green Vehicle Routing Problem, Multi-objective Optimization, p-Median Capacitated Problem

Procedia PDF Downloads 91
110 Utility of Optical Coherence Tomography (OCT) and Visual Field Assessment in Neurosurgical Patients

Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

Abstract:

Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

Procedia PDF Downloads 37
109 Testing Nature Based Solutions for Air Quality Improvement: Aveiro Case Study

Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

Abstract:

Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

Procedia PDF Downloads 217
108 Wear Performance of SLM Fabricated 1.2709 Steel Nanocomposite Reinforced by TiC-WC for Mould and Tooling Applications

Authors: Daniel Ferreira, José M. Marques Oliveira, Filipe Oliveira

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Wear phenomena is critical in injection moulding processes, causing failure of the components, and making the parts more expensive with an additional wasting time. When very abrasive materials are being injected inside the steel mould’s cavities, such as polymers reinforced with abrasive fibres, the consequences of the wear are more evident. Maraging steel (1.2709) is commonly employed in moulding components to resist in very aggressive injection conditions. In this work, the wear performance of the SLM produced 1.2709 maraging steel reinforced by ultrafine titanium and tungsten carbide (TiC-WC), was investigated using a pin-on-disk testing apparatus. A polypropylene reinforced with 40 wt.% fibreglass (PP40) disk, was used as the counterpart material. The wear tests were performed at 40 N constant load and 0.4 ms-1 sliding speed at room temperature and humidity conditions. The experimental results demonstrated that the wear rate in the 18Ni300-TiC-WC composite is lower than the unreinforced 18Ni300 matrix. The morphology and chemical composition of the worn surfaces was observed by 3D optical profilometry and scanning electron microscopy (SEM), respectively. The resulting debris, caused by friction, were also analysed by SEM and energy dispersive X-ray spectroscopy (EDS). Their morphology showed distinct shapes and sizes, which indicated that the wear mechanisms, may be different in maraging steel produced by casting and SLM. The coefficient of friction (COF) was recorded during the tests, which helped to elucidate the wear mechanisms involved.

Keywords: selective laser melting, nanocomposites, injection moulding, polypropylene with fibreglass

Procedia PDF Downloads 131
107 Seismic Vulnerability Assessment of Masonry Buildings in Seismic Prone Regions: The Case of Annaba City, Algeria

Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente

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Seismic vulnerability assessment of masonry buildings is a fundamental issue even for moderate to low seismic hazard regions. This fact is even more important when dealing with old structures such as those located in Annaba city (Algeria), which the majority of dates back to the French colonial era from 1830. This category of buildings is in high risk due to their highly degradation state, heterogeneous materials and intrusive modifications to structural and non-structural elements. Furthermore, they are usually shelter a dense population, which is exposed to such risk. In order to undertake a suitable seismic risk mitigation strategies and reinforcement process for such structures, it is essential to estimate their seismic resistance capacity at a large scale. In this sense, two seismic vulnerability index methods and damage estimation have been adapted and applied to a pilot-scale building area located in the moderate seismic hazard region of Annaba city: The first one based on the EMS-98 building typologies, and the second one derived from the Italian GNDT approach. To perform this task, the authors took the advantage of an existing data survey previously performed for other purposes. The results obtained from the application of the two methods were integrated and compared using a geographic information system tool (GIS), with the ultimate goal of supporting the city council of Annaba for the implementation of risk mitigation and emergency planning strategies.

Keywords: Annaba city, EMS98 concept, GNDT method, old city center, seismic vulnerability index, unreinforced masonry buildings

Procedia PDF Downloads 597
106 Proposal of Blue and Green Infrastructure for the Jaguaré Stream Watershed, São Paulo, Brazil

Authors: Juliana C. Alencar, Monica Ferreira do Amaral Porto

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The blue-green infrastructure in recent years has been pointed out as a possibility to increase the environmental quality of watersheds. The regulation ecosystem services brought by these areas are many, such as the improvement of the air quality of the air, water, soil, microclimate, besides helping to control the peak flows and to promote the quality of life of the population. This study proposes a blue-green infrastructure scenario for the Jaguaré watershed, located in the western zone of the São Paulo city in Brazil. Based on the proposed scenario, it was verified the impact of the adoption of the blue and green infrastructure in the control of the peak flow of the basin, the benefits for the avifauna that are also reflected in the flora and finally, the quantification of the regulation ecosystem services brought by the adoption of the scenario proposed. A survey of existing green areas and potential areas for expansion and connection of these areas to form a network in the watershed was carried out. Based on this proposed new network of green areas, the peak flow for the proposed scenario was calculated with the help of software, ABC6. Finally, a survey of the ecosystem services contemplated in the proposed scenario was made. It was possible to conclude that the blue and green infrastructure would provide several regulation ecosystem services for the watershed, such as the control of the peak flow, the connection frame between the forest fragments that promoted the environmental enrichment of these fragments, improvement of the microclimate and the provision of leisure areas for the population.

Keywords: green and blue infrastructure, sustainable drainage, urban waters, ecosystem services

Procedia PDF Downloads 97
105 Medical Imaging Fusion: A Teaching-Learning Simulation Environment

Authors: Cristina Maria Ribeiro Martins Pereira Caridade, Ana Rita Ferreira Morais

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The use of computational tools has become essential in the context of interactive learning, especially in engineering education. In the medical industry, teaching medical image processing techniques is a crucial part of training biomedical engineers, as it has integrated applications with healthcare facilities and hospitals. The aim of this article is to present a teaching-learning simulation tool developed in MATLAB using a graphical user interface for medical image fusion that explores different image fusion methodologies and processes in combination with image pre-processing techniques. The application uses different algorithms and medical fusion techniques in real time, allowing you to view original images and fusion images, compare processed and original images, adjust parameters, and save images. The tool proposed in an innovative teaching and learning environment consists of a dynamic and motivating teaching simulation for biomedical engineering students to acquire knowledge about medical image fusion techniques and necessary skills for the training of biomedical engineers. In conclusion, the developed simulation tool provides real-time visualization of the original and fusion images and the possibility to test, evaluate and progress the student’s knowledge about the fusion of medical images. It also facilitates the exploration of medical imaging applications, specifically image fusion, which is critical in the medical industry. Teachers and students can make adjustments and/or create new functions, making the simulation environment adaptable to new techniques and methodologies.

Keywords: image fusion, image processing, teaching-learning simulation tool, biomedical engineering education

Procedia PDF Downloads 96
104 Economic Impact of Mediation: Analyzing the Strengths and Weaknesses of Portuguese Mediation System

Authors: M. L. Mesquita, V. H. Ferreira, C. M. Cebola

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Mediation is an increasingly important mechanism, particularly in the European context, as demonstrated, for example, by the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. From the economic point of view, competitive negotiation can generate negative external effects in social terms. Not always the solution found in court is the most efficient solution taking into account all elements of society. On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. In the Portuguese legal system, legislative frameworks for mediation display a state committed to creating a new architecture for the administration of justice, based on the construction of a multi-faceted legal system for dispute resolution mechanisms. Understanding the way in which the system of mediation in Portugal was introduced, allows us to point out that our internal ordering is creating the legal instruments which can assist citizens in the effective protection of their rights. However, data on the use of mediation in concrete proceedings and the consequent effectiveness of mediation in settling disputes, reveal a mechanism that is still far from the ideal results that were initially sought.

Keywords: access to justice, alternative dispute resolution, mediation, litigation

Procedia PDF Downloads 141
103 NanoSat MO Framework: Simulating a Constellation of Satellites with Docker Containers

Authors: César Coelho, Nikolai Wiegand

Abstract:

The advancement of nanosatellite technology has opened new avenues for cost-effective and faster space missions. The NanoSat MO Framework (NMF) from the European Space Agency (ESA) provides a modular and simpler approach to the development of flight software and operations of small satellites. This paper presents a methodology using the NMF together with Docker for simulating constellations of satellites. By leveraging Docker containers, the software environment of individual satellites can be easily replicated within a simulated constellation. This containerized approach allows for rapid deployment, isolation, and management of satellite instances, facilitating comprehensive testing and development in a controlled setting. By integrating the NMF lightweight simulator in the container, a comprehensive simulation environment was achieved. A significant advantage of using Docker containers is their inherent scalability, enabling the simulation of hundreds or even thousands of satellites with minimal overhead. Docker's lightweight nature ensures efficient resource utilization, allowing for deployment on a single host or across a cluster of hosts. This capability is crucial for large-scale simulations, such as in the case of mega-constellations, where multiple traditional virtual machines would be impractical due to their higher resource demands. This ability for easy horizontal scaling based on the number of simulated satellites provides tremendous flexibility to different mission scenarios. Our results demonstrate that leveraging Docker containers with the NanoSat MO Framework provides a highly efficient and scalable solution for simulating satellite constellations, offering not only significant benefits in terms of resource utilization and operational flexibility but also enabling testing and validation of ground software for constellations. The findings underscore the importance of taking advantage of already existing technologies in computer science to create new solutions for future satellite constellations in space.

Keywords: containerization, docker containers, NanoSat MO framework, satellite constellation simulation, scalability, small satellites

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102 Evaluation of Electro-Flocculation for Biomass Production of Marine Microalgae Phaodactylum tricornutum

Authors: Luciana C. Ramos, Leandro J. Sousa, Antônio Ferreira da Silva, Valéria Gomes Oliveira Falcão, Suzana T. Cunha Lima

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The commercial production of biodiesel using microalgae demands a high-energy input for harvesting biomass, making production economically unfeasible. Methods currently used involve mechanical, chemical, and biological procedures. In this work, a flocculation system is presented as a cost and energy effective process to increase biomass production of Phaeodactylum tricornutum. This diatom is the only species of the genus that present fast growth and lipid accumulation ability that are of great interest for biofuel production. The algae, selected from the Bank of Microalgae, Institute of Biology, Federal University of Bahia (Brazil), have been bred in tubular reactor with photoperiod of 12 h (clear/dark), providing luminance of about 35 μmol photons m-2s-1, and temperature of 22 °C. The medium used for growing cells was the Conway medium, with addition of silica. The seaweed growth curve was accompanied by cell count in Neubauer camera and by optical density in spectrophotometer, at 680 nm. The precipitation occurred at the end of the stationary phase of growth, 21 days after inoculation, using two methods: centrifugation at 5000 rpm for 5 min, and electro-flocculation at 19 EPD and 95 W. After precipitation, cells were frozen at -20 °C and, subsequently, lyophilized. Biomass obtained by electro-flocculation was approximately four times greater than the one achieved by centrifugation. The benefits of this method are that no addition of chemical flocculants is necessary and similar cultivation conditions can be used for the biodiesel production and pharmacological purposes. The results may contribute to improve biodiesel production costs using marine microalgae.

Keywords: biomass, diatom, flocculation, microalgae

Procedia PDF Downloads 309
101 Outcomes in New-Onset Diabetic Foot Ulcers Stratified by Etiology

Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

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Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

Procedia PDF Downloads 414
100 Heterologous Expression of a Clostridium thermocellum Proteins and Assembly of Cellulosomes 'in vitro' for Biotechnology Applications

Authors: Jessica Pinheiro Silva, Brenda Rabello De Camargo, Daniel Gusmao De Morais, Eliane Ferreira Noronha

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The utilization of lignocellulosic biomass as source of polysaccharides for industrial applications requires an arsenal of enzymes with different mode of action able to hydrolyze its complex and recalcitrant structure. Clostridium thermocellum is gram-positive, thermophilic bacterium producing lignocellulosic hydrolyzing enzymes in the form of multi-enzyme complex, termed celulossomes. This complex has several hydrolytic enzymes attached to a large and enzymically inactive protein known as Cellulosome-integrating protein (CipA), which serves as a scaffolding protein for the complex produced. This attachment occurs through specific interactions between cohesin modules of CipA and dockerin modules in enzymes. The present work aims to construct celulosomes in vitro with the structural protein CipA, a xylanase called Xyn10D and a cellulose called CelJ from C.thermocellum. A mini-scafoldin was constructed from modules derived from CipA containing two cohesion modules. This was cloned and expressed in Escherichia coli. The other two genes were cloned under the control of the alcohol oxidase 1 promoter (AOX1) in the vector pPIC9 and integrated into the genome of the methylotrophic yeast Pichia pastoris GS115. Purification of each protein is being carried out. Further studies regarding enzymatic activity of the cellulosome is going to be evaluated. The cellulosome built in vitro and composed of mini-CipA, CelJ and Xyn10D, can be very interesting for application in industrial processes involving the degradation of plant biomass.

Keywords: cellulosome, CipA, Clostridium thermocellum, cohesin, dockerin, yeast

Procedia PDF Downloads 214
99 Study of a Complete Free Route Implementation in the European Airspace

Authors: Cesar A. Nava-Gaxiola, C. Barrado

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Harmonized with SESAR (Single European Sky Research) initiatives, a new concept related with airspace structures have been introduced in Europe, the Free Route Airspace. The key of free route is based in an airspace where users may freely plan a route between a defined entry and exit waypoint, with the possibility of routing via intermediate points, the free route flights remain subject to air traffic control (ATC) for the established separations. Free route airspace does not present anymore fixed airways to airspace users, as a consequence it brings a new paradigm for managing safe separations of aircrafts inside these airspace blocks . Nowadays, several European nations have been introduced the concept, some of them in a complete or partial stage, but finally offering limited benefits to airspace users for this condition. This research evaluates the future scenario of free route implementation across Europe, considering a unique airspace block configuration with a complete upper airspace with free route. The paper is centered in investigating the benefits for airspace users, and the study of possible increments of Air Traffic Controllers task loads with a full application. In this research, fast time simulations are carrying out for discovering how much flight time and distance aircrafts can save with an overall free route establishment. In the other side, the paper explains the evolution of conflicts derivate from possible separation losses between aircrafts in this new environment. Free route conflicts can emerges in any points of the airspace, requiring a great effort for solving it, in comparison with fixed airways, where conflicts normally were found by controllers in known waypoints, and they solved using the fixed network as reference. The airspace configuration modelled in this study take into account the actual navigation waypoints structure, moving into a future scenario, where new ones waypoints are added and new traffic flow patterns appears. In this sense, this research explores the advantages and unknown difficulties that a large scale application of free route concept can carry out in the European airspace.

Keywords: ATC conflicts, efficiency, free route airspace, SESAR

Procedia PDF Downloads 168
98 Canine Neonatal Mortality at the São Paulo State University Veterinary Hospital, Botucatu, São Paulo, Brazil – Preliminary Data

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

The neonatal mortality rates in dogs are considered high, varying between 5.7 and 21.2% around the world, and the causes of the deaths are often unknown. Data regarding canine neonatal mortality are scarce in Brazil. This study aims at describing the neonatal mortality rates in dogs, as well as the main causes of death. The study included 152 litters and 669 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil between January 2018 and September 2019. The overall mortality rate was 16.7% (112/669), with 40% (61/152) of the litters presenting at least one case of stillbirth or neonatal mortality. The rate of stillbirths was 7.7% (51/669), while the neonatal mortality rate was 9% (61/669). The early mortality rate (0 to 2 days) was 13.7% (92/669), accounting for 82.1% (92/112) of all deaths. The late mortality rate (3 to 30 days) was 2.7% (18/669), accounting for 16% (18/112) of all deaths. Infection was the causa mortis in 51.8% (58/112) of the newborns, of which 30.3% (34/112) were caused by bacterial sepsis, and 21.4% (24/112) were caused by other bacterial, viral or parasite infections. Other causes of death included congenital malformations (15.2%, 17/112), of which 5.3% (6/112) happened through euthanasia due to malformations incompatible with life; asphyxia/hypoxia by dystocia (9.8%, 11/112); wasting syndrome in debilitated newborns (6.2%, 7/112); aspiration pneumonia (3.6%, 4/112); agalactia (2.7%, 3/112); trauma (1.8%, 2/112); administration of contraceptives to the mother (1.8%, 2/112) and unknown causes (7.1%, 8/112). The neonatal mortality rate was considered high, but they may be even higher in locations without adequate care for the mothers and neonates. Therefore, prenatal examinations and early neonatal care are of utmost importance for the survival of these patients.

Keywords: neonate dogs, puppies, mortality rate, neonatal death

Procedia PDF Downloads 183
97 Aeronautical Noise Management inside an Aerodrome: Analysis of Sound Exposure on Aviation Professional’s Health

Authors: Rafael Felipe Guatura da Silva, José Luis Gomes da Silva, Luiz Antonio, Ferreira Perrone de Brito

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Noise can cause serious damage to human health, such as hearing loss, stress, irritability, fatigue, and others. Aviation is a place where your entire process should be work out with the utmost attention and commitment of human resources, thus the need to study the effects of noise in this sector, as aeronautical noise levels are high. This study aimed to evaluate the impact of noise pollution on the performance of professionals regarding the fatigue generated by aeronautical noise and time to noise exposure. The methodology used consists of measurements of sound pressure levels at 42 points of the aerodrome. The selected points are located inside the hangars and outside the airfield hangars. All points chosen are close to the professionals' work areas, seeking to identify the sound pressure levels to which they submitted. The other part of the research used the principle on the application of a self-report questionnaire to a sample of 207 people working inside the aerodrome. The 207 professionals surveyed consist of aircraft mechanics, pilots, maintenance managers, and administrative professionals. The questionnaire was intended to evaluate the knowledge that professionals have about health risks caused by sound exposure as well as to identify diseases that professionals have, and that may be associated with exposure to high levels of sound pressure. Preliminary results identify points with sound pressure levels of up to 91.7 dB, thus highlighting the need for the use of personal protective equipment that reduces noise exposure. It was also identified a large number of professionals who are bothered by the sound exposure and approximately 25% of professionals interviewed reported having a hearing disorder.

Keywords: aeronautical noise, fatigue, noise and health, noise management

Procedia PDF Downloads 127
96 Toxicological Interactions of Silver Nanoparticles and Non-Essential Metals in Human Hepatocarcinoma Cell Line

Authors: Renata Rank Miranda, Arandi Ginane Bezerra, Ciro Alberto Oliveira Ribeiro, Marco AntôNio Ferreira Randi, Carmen Lúcia Voigt, Lilian Skytte, Kaare Lund Rasmussen, Francisco Filipak Neto, Frank Kjeldsen

Abstract:

Synergetic and antagonistic effects of drugs are well-known concerns in pharmacological assessments of dose and toxicity. Similar approach should be used in assessing cellular uptake and cytotoxicity of nanoparticles. Since nanoparticles are released into the aquatic environment they may interact with existing xenobiotics. Here we used biochemical assays and quantitative proteomics to assess the cytotoxicity of silver nanoparticles (AgNP) when human hepatoma HepG2 cells were co-exposed to 2 nm AgNP together with either Cd2+ or Hg2+ ions. Time-course experiments (2h, 4h, and 24h) were conducted to assess the first response to the exposure studies. The general trend was that a synergetic toxicological response was observed in cells exposed to both AgNP and Cd2+ or Hg2+, with AgNP and Cd2+ being more toxic. This was observed by a significant increase in the ROS and superoxide level of >35% in the case of AgNP+Cd2+ compared to the sum of responses of AgNP and Cd2+, individually. Metabolic activity and viability also dropped more for AgNP+Cd2+ (>10%) than for AgNP and Cd2+ combined. We used inductively coupled plasma mass spectrometry to investigate if AgNP facilitates larger influx of toxic metal ions into HepG2 cells. Only Hg2+ ions was found to be more efficiently engulfed as the concentration of Hg2+ was found 2.8 times larger compared to exposure experiments with only Hg2+. This effect was not observed for Cd2+. We now continue with deep proteomics studies to obtain wider details on the mechanism of the toxicity related to AgNP, Cd2+, and AgNP+Cd2+, respectively.

Keywords: nanotoxicology, silver nanoparticles, proteomics, human cell line

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95 Price Gouging in Time of Covid-19 Pandemic: When National Competition Agencies are Weak Institutions that Exacerbate the Effects of Exploitative Economic Behaviour

Authors: Cesar Leines

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The social effects of the pandemic are significant and diverse, most of those effects have widened the gap of economic inequality. Without a doubt, each country faces difficulties associated with the strengths and weaknesses of its own institutions that can address these causes and consequences. Around the world, pricing practices that have no connection to production costs have been used extensively in numerous markets beyond those relating to the supply of essential goods and services, and although it is not unlawful to adjust pricing considering the increased demand of certain products, shortages and disruption of supply chains, illegitimate pricing practices may arise and these tend to transfer wealth from consumers to producers that affect the purchasing power of the former, making people worse off. High prices with no objective justification indicate a poor state of the competitive process in any market and the impact of those underlying competition issues leading to inefficiency is increased when national competition agencies are weak and ineffective in enforcing competition in law and policy. It has been observed that in those countries where competition authorities are perceived as weak or ineffective, price increases of a wide range of products and services were more significant during the pandemic than those price increases observed in countries where the perception of the effectiveness of the competition agency is high. When a perception is created of a highly effective competition authority, one which enforces competition law and its non-enforcement activities result in the fulfillment of its substantive functions of protecting competition as the means to create efficient markets, the price rise observed in markets under its jurisdiction is low. A case study focused on the effectiveness of the national competition agency in Mexico (COFECE) points to institutional weakness as one of the causes leading to excessive pricing. There are many factors that contribute to its low effectiveness and which, in turn, have led to a very significant price hike, potentiated by the pandemic. This paper contributes to the discussion of these factors and proposes different steps that overall help COFECE or any other competition agency to increase the perception of effectiveness for the benefit of the consumers.

Keywords: agency effectiveness, competition, institutional weakness, price gouging

Procedia PDF Downloads 155
94 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

Procedia PDF Downloads 182
93 Computational System for the Monitoring Ecosystem of the Endangered White Fish (Chirostoma estor estor) in the Patzcuaro Lake, Mexico

Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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92 Optimization of Quercus cerris Bark Liquefaction

Authors: Luísa P. Cruz-Lopes, Hugo Costa e Silva, Idalina Domingos, José Ferreira, Luís Teixeira de Lemos, Bruno Esteves

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The liquefaction process of cork based tree barks has led to an increase of interest due to its potential innovation in the lumber and wood industries. In this particular study the bark of Quercus cerris (Turkish oak) is used due to its appreciable amount of cork tissue, although of inferior quality when compared to the cork provided by other Quercus trees. This study aims to optimize alkaline catalysis liquefaction conditions, regarding several parameters. To better comprehend the possible chemical characteristics of the bark of Quercus cerris, a complete chemical analysis was performed. The liquefaction process was performed in a double-jacket reactor heated with oil, using glycerol and a mixture of glycerol/ethylene glycol as solvents, potassium hydroxide as a catalyst, and varying the temperature, liquefaction time and granulometry. Due to low liquefaction efficiency resulting from the first experimental procedures a study was made regarding different washing techniques after the filtration process using methanol and methanol/water. The chemical analysis stated that the bark of Quercus cerris is mostly composed by suberin (ca. 30%) and lignin (ca. 24%) as well as insolvent hemicelluloses in hot water (ca. 23%). On the liquefaction stage, the results that led to higher yields were: using a mixture of methanol/ethylene glycol as reagents and a time and temperature of 120 minutes and 200 ºC, respectively. It is concluded that using a granulometry of <80 mesh leads to better results, even if this parameter barely influences the liquefaction efficiency. Regarding the filtration stage, washing the residue with methanol and then distilled water leads to a considerable increase on final liquefaction percentages, which proves that this procedure is effective at liquefying suberin content and lignocellulose fraction.

Keywords: liquefaction, Quercus cerris, polyalcohol liquefaction, temperature

Procedia PDF Downloads 317
91 Informal Carers in Telemonitoring of Users with Pacemakers: Characteristics, Time of Services Provided and Costs

Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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90 Affordable Aerodynamic Balance for Instrumentation in a Wind Tunnel Using Arduino

Authors: Pedro Ferreira, Alexandre Frugoli, Pedro Frugoli, Lucio Leonardo, Thais Cavalheri

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The teaching of fluid mechanics in engineering courses is, in general, a source of great difficulties for learning. The possibility of the use of experiments with didactic wind tunnels can facilitate the education of future professionals. The objective of this proposal is the development of a low-cost aerodynamic balance to be used in a didactic wind tunnel. The set is comprised of an Arduino microcontroller, programmed by an open source software, linked to load cells built by students from another project. The didactic wind tunnel is 5,0m long and the test area is 90,0 cm x 90,0 cm x 150,0 cm. The Weq® electric motor, model W-22 of 9,2 HP, moves a fan with nine blades, each blade 32,0 cm long. The Weq® frequency inverter, model WEGCFW 08 (Vector Inverter) is responsible for wind speed control and also for the motor inversion of the rotational direction. A flat-convex profile prototype of airfoil was tested by measuring the drag and lift forces for certain attack angles; the air flux conditions remained constant, monitored by a Pitot tube connected to a EXTECH® Instruments digital pressure differential manometer Model HD755. The results indicate a good agreement with the theory. The choice of all of the components of this proposal resulted in a low-cost product providing a high level of specific knowledge of mechanics of fluids, which may be a good alternative to teaching in countries with scarce educational resources. The system also allows the expansion to measure other parameters like fluid velocity, temperature, pressure as well as the possibility of automation of other functions.

Keywords: aerodynamic balance, wind tunnel, strain gauge, load cell, Arduino, low-cost education

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89 The Management of Care by People with Type 2 Diabetes versus the Professional Care at Primary Health Care in Brazil

Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima

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Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.

Keywords: diabetes mellitus, primary health care, nursing, management of care

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88 Dental Education in Brazil: A Systematic Literature Review

Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

Procedia PDF Downloads 506
87 Design of Reinforced Concrete with Eurocode 2

Authors: Carla Maria Costa Ferreira, Maria Helena Freitas Melao Barros

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The rules implemented in Europe regarding structural design are termed Structural Eurocodes and deal with the several materials available for construction. Particularly regarding the very used in Europe concrete with steel reinforcement, it is named the Eurocode 2 – Design of Concrete Structures, usually known as EC2. The need of tables and abacuses to help in the design of reinforced concrete was due to the fact that the evolution and the study of new procedures and higher strength concrete showed that the previous tables needed to be improved. Reinforced concrete structures have particular aspects in the design that come from the nonlinear behavior of the concrete and steel and, in the case of concrete, also by the very low tensile strength. The design of reinforced concrete structures is made in terms of evaluating the ultimate strength and how it behaves under service conditions. As a matter of fact, the use of higher-strength concrete and steel classes showed that these serviceability design that was important for prestressed structures may be relevant in reinforced concrete structures. For these aspects, there are tables and design charts used for the ultimate limit design of reinforced concrete sections under bending moments and axial forces, and also auxiliary design diagrams able to evaluate the stress of the steel and the concrete at a section and the ductility for service limit states verification. For practical use, here are presented tables and design charts for the ultimate limit design of reinforced concrete sections and also auxiliary interaction diagrams for verification of the serviceability conditions. These kinds of aid for design were only available to engineers before the development of computers and, nowadays, yet an important tool in the universities for the students' use. Usually, in the reinforced concrete design, it is needed to obtain the area of the steel longitudinal reinforcement to be placed in the structure. The quantity and the position of the steel area may have different solutions and these tables and abacuses permit to obtain many possibilities in order to optimize the solution in economic or ductility terms.

Keywords: design examples, Eurocode 2, reinforced concrete, section design

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86 A Low Cost Education Proposal Using Strain Gauges and Arduino to Develop a Balance

Authors: Thais Cavalheri Santos, Pedro Jose Gabriel Ferreira, Alexandre Daliberto Frugoli, Lucio Leonardo, Pedro Americo Frugoli

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This paper presents a low cost education proposal to be used in engineering courses. The engineering education in universities of a developing country that is in need of an increasing number of engineers carried out with quality and affordably, pose a difficult problem to solve. In Brazil, the political and economic scenario requires academic managers able to reduce costs without compromising the quality of education. Within this context, the elaboration of a physics principles teaching method with the construction of an electronic balance is proposed. First, a method to develop and construct a load cell through which the students can understand the physical principle of strain gauges and bridge circuit will be proposed. The load cell structure was made with aluminum 6351T6, in dimensions of 80 mm x 13 mm x 13 mm and for its instrumentation, a complete Wheatstone Bridge was assembled with strain gauges of 350 ohms. Additionally, the process involves the use of a software tool to document the prototypes (design circuits), the conditioning of the signal, a microcontroller, C language programming as well as the development of the prototype. The project also intends to use an open-source I/O board (Arduino Microcontroller). To design the circuit, the Fritizing software will be used and, to program the controller, an open-source software named IDE®. A load cell was chosen because strain gauges have accuracy and their use has several applications in the industry. A prototype was developed for this study, and it confirmed the affordability of this educational idea. Furthermore, the goal of this proposal is to motivate the students to understand the several possible applications in high technology of the use of load cells and microcontroller.

Keywords: Arduino, load cell, low-cost education, strain gauge

Procedia PDF Downloads 281
85 Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: cancer, complementary and alternative medicine , ozone therapy, palliative care, PEMF therapy

Procedia PDF Downloads 133
84 A Case Report on Neonatal Conjunctivitis in Pugs

Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

Procedia PDF Downloads 114
83 Experiences of Homophobia, Machismo and Misogyny in Tourist Destinations: A Netnography in a Facebook Community of LGBT Backpackers

Authors: Renan De Caldas Honorato, Ana Augusta Ferreira De Freitas

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Homosexuality is still criminalized in a large number of countries. In some of them, being gay or lesbian can even be punished by death. Added to this context, the experiences of social discrimination faced by the LGBT population, including homophobia, machismo and misogyny, cause numerous restrictions throughout their lives. The possibility of confronting these challenges in moments that should be pleasant, such as on a trip or on vacation, is unpleasant, to say the least. In the current scenario of intensifying the use of Social network sites (SNSs) to search for information, including in the tourist area, this work aims to analyze the sharing of tourist experiences with situations of confrontation and perceptions of homophobia, machismo and misogyny, and restrictions suffered in tourist destinations. The fieldwork is a community of LGBT backpackers based on Facebook. Netnography was the core method adopted. A qualitative approach was conducted and 463 publications posted from January to December 2020 were assessed through the computer-mediated discourse analysis (CMDA). The results suggest that these publications exist to identify the potential exposure to these offensive behaviors while traveling. Individuals affirm that the laws, positive or not, in relation to the LGBT public are not the only factors for a place to be defined as safe or not for gay travelers. The social situation of a country and its laws are quite different and this is the main target of these publications. The perception of others about the chosen destination is more important than knowing your rights and the legal status of each country and it also lessens uncertainty, even when they are never totally confident when choosing a travel destination. In certain circumstances, sexual orientation also needs to be protected from the judgment of hosts and residents. The systemic treatment of homophobic behavior and the construction of a more inclusive society are urgent.

Keywords: homophobia, hospitality, machismo, misogyny

Procedia PDF Downloads 169
82 Early Childhood Developmental Delay in 63 Low- and Middle-Income Countries: Prevalence and Inequalities Estimated from National Health Surveys

Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

Procedia PDF Downloads 102