Prioritising alternatives for maintenance of water distribution networks: A group decision approach

Difficulties related to the group decision-making process in the water supply sector, such as physical and economic losses, irrational use of water and maintenance costs, highlight the need to develop procedures to support decisions, reducing unnecessary water use and wastage. This study focused on the rational use of water resources and reduction of water losses, based on the assumption that it is far more economical to develop and improve existing systems rather than build new systems in parallel to the existing one. This study aimed to support a group decision-making process in the maintenance section of a water supply company. A model is proposed consisting of 2 phases, which aggregates individual preferences to achieve a group decision. The first phase is based on the ELECTRE II method, analysing individual preferences, while the second is based on the COPELAND method to aggregate individual preferences. From this model, we developed a software program to prioritise alternatives, simultaneously taking into account subjective and objective criteria, and thereby giving decision makers a clear and comprehensive overview of alternatives, indicating the most suitable alternative based on the preferences of group members from different areas

Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal

Vulnerability of Brazilian municipalities to hantavirus infections based on multi‑criteria decision analysis

Background: Hantavirus infection is an emerging zoonosis transmitted by wild rodents. In Brazil, high case-fatality rates among humans infected with hantavirus are of serious concern to public health authorities. Appropriate preventive measures partly depend on reliable knowledge about the geographical distribution of this disease. Methods: Incidence of hantavirus infections in Brazil (1993–2013) was analyzed. Epidemiological, socioeconomic, and demographic indicators were also used to classify cities’ vulnerability to disease by means of multi-criteria decision analysis (MCDA). Results: From 1993 to 2013, 1752 cases of hantavirus were registered in 16 Brazilian states. The highest incidence of hantavirus was observed in the states of Mato Grosso (0.57/100,000) and Santa Catarina (0.13/100,000). Based on MCDA analysis, municipalities in the southern, southeastern, and midwestern regions of Brazil can be classified as highly vulnerable. Most municipalities in northern and northeastern Brazil were classified as having low vulnerability to hantavirus cardiopulmonary syndrome. Conclusions: Although most human infections by hantavirus registered in Brazil occurred in the southern region of the country, a greater vulnerability to hantavirus was found in the Brazilian Midwest. This result reflects the need to strengthen surveillance where the disease has thus far gone unreported

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Primary Care Sensitive Hospitalization: users detect flaws on the access to services

The aim of this study is to analyze and understand the reasons for the occurrence of sensitive hospitalizations in accordance with users. Qualitative study conducted with users who were admitted to Pedreira General Hospital, in São Paulo. The data was collected through semi structured interviews and thereafter, transcribed and processed in the electronic program Alceste. When analyzing the content, the access was seized fundamentally as an empirical category, bringing up problems that later deserved, from the Brazilian Ministry of Health, a specific Program to improve the quality and access to primary care. The hierarchical and pyramidal organization shape from the health system in the city of São Paulo can be one of the important aspects for the access matter and established as an important restricting factor in the primary care role in reducing or even preventing the occurrence of these hospitalizations

Análise das ocorrências das lesões no trânsito e fatores relacionados segundo resultados da Pesquisa Nacional por Amostra de Domicílios (PNAD) Brasil, 2008

O objetivo foi descrever as estimativas de ocorrência de lesões decorrentes do trânsito e os fatores relacionados à população brasileira a partir dos dados obtidos na Pesquisa Nacional por Amostra de Domicílios (PNAD). Trata-se de amostra probabilística em três estágios: municípios, setores censitários e domicílios. Foram entrevistadas 391.868 pessoas. As variáveis acidente de trânsito (AT) e uso de cinto de segurança foram descritas segundo dados sociodemográficos e de região de residência. Calcularam-se as proporções, intervalos de confiança de 95%, teste c2 e valor de p. 2,5% (IC95% 2,4-2,6) da população relataram a ocorrência de AT, com maior acometimento da população masculina (3,5%; IC95%: 3,4-3,6), jovens (4,4%; IC95%: 4,2-4,6) e residentes da região Centro-Oeste (3,3%; IC95%: 3,0-3,6). Os AT predominaram entre condutores ou ocupantes de automóveis/vans (53,9%) e de motocicletas (30,1%), seguidos de ciclistas (7,6%) e pedestres (5,2%). O uso de cinto de segurança dianteiro foi relatado por 73,2% (IC95%: 72,2-74,2) e o cinto traseiro por 37,4% (IC95% 36.6-38,2). O AT determinou o afastamento das atividades habituais em 30,7% dos acometidos. A magnitude das lesões no trânsito justifica avançar em medidas preventivas e legislativas para a redução dos eventos.The study describes the estimates of occurrence of injury due to traffic accidents among the Brazilian population based on data obtained from the National Household Sample Survey (PNAD). It is a probabilistic sample, in which 391,868 people were interviewed. in three stages, namely municipalities, census sectors and households. The traffic accident (TA) and the safety belt usage variables were described according to socio-demographic variables and region of residence. Proportions, 95% confidence intervals, c² tests and p values were calculated. 2.5% (CI95% 2.4-2.6%) of the population reported higher traffic accident (TA) incidence among males (3.5%; CI95%: 3.4-3.6), youths (4.4%; CI95%: 4.2-4.6) and residents in the Central-West region (3.3% CI95%3.0-3.6). Most of the events involved drivers or passengers of cars or vans (53.9%), followed by motorcyclists or pillion passengers (30.1%), cyclists (7.6%) and pedestrians (5.25%). The front seat safety belt is used by 73.2% (CI95% 72.2-74.2) and the rear seat safety belt is only used by 37.4% (CI95% 36.6-38.2). Traffic accidents led to the abandonment of their habitual activities by 30.7% of those involved. The severity of injuries in traffic accidents demands further preventive and legislative measures to reduce such incidents