Categoria: Artigos Científicos

Abstract: The COVID-19 increased the importance of patient’s continuous assessment of health outcomes. In 2021 WHO proposed some Digital Health guidelines arguing that health systems should consider the use of emergent technologies in health care services. This health environment is providing intelligent systems to guide patients in self-care. One example of that is the chatbot which is, a conversational agent that have been assuming an important role in how to improve health knowledge, reducing the incidence of diseases and avoiding new ones. Pregnant women are a profile where the self-care referred before is a critical issue. Prenatal services reveal to be an important part of the care process where most complications for that women happen. This article aims to comprehend how pregnant women interact with a conversational agent and how relevant this Digital Health tool is for primary health care services. The study presents the process and results of a systematic literature review about the user experience with of a chatbot in pregnant women self-care context; a summary of GISSA intelligent chatbot development including the use of technologies such as DialogFlow; and the process and results of GISSA usability evaluation in research field. Results show that a small amount of articles was gathered and the chatbot as a tool is a relevant opportunity for primary care health services in Brasil.

Abstract: Coronavirus disease 2019 was identified as a pandemic and Brazil is one of the major epicentres. One of the Brazilian states affected is Ceará, where this research group works. This group was challenged by a Hospital stakeholder to develop a communication channel with the health professionals and the coronavirus disease 2019 patient’s family. This article presents a part of this whole project. The main methodological approach was the user-centred design based on user experience elements. Benchmarking was applied to understand the state-of-art of Brazilian apps that were related to coronavirus disease 2019. The research process was based on a systematic approach that was carried out by a multidisciplinary team that worked through four work cycles (identification, classification, screening, analysis). This work was based on two main points: (a) World Health Organization digital health guidelines, specifically digital health interventions (b) System Usability Scale. As a result, apps features were gathered according to the digital health interventions and their experiences were analysed on System Usability Scale. This work has provided an overview of apps that were available and how they support the coronavirus disease 2019 context. Another valuable contribution is the understanding of how the industry was satisfying the user’s needs. These two results can provide a holistic view for future product development that can be used in different contexts of health issues. One of the highlighted conclusions was that digital health interventions should be adapted to the local context because these World Health Organization guidelines were open. Moreover, the System Usability Scale is an effective method to compare different digital health solutions.

Abstract: The Internet of Things (IoT)-based intelligent medical system contains confidential and sensitive information of patients. Most of the data is related to the patient’s medical information and physical information with a high degree of privacy. Therefore, the security and privacy of the data are very important. This study focuses on the privacy protection on information of data of patients during medical data sharing. First, the module structure of the IoT-based telemedicine system is analyzed. A lightweight and fine-grained retrieval and data sharing scheme is designed based on the Wireless Bodyarea Network (WBAN). The Ciphertext Policy Attribute Based Encryption (CP-ABE) scheme is improved mainly by incorporating a partial hidden encryption algorithm, and the improved one is defined as Attribute Partially Hidden Access Control (APHAC). Data users can only access the data when their attributes match the access policy formulated by the data owner. The simulation experiment factors into the storage overhead and computational overhead. The results show that when the number of attributes reaches 100, the APHAC scheme can save about 500 ​ms compared with the traditional CP-ABE scheme. As the number of attributes increases, only this scheme is stable, so it is more suitable for mobile devices. It can be concluded that the encrypted access control strategy proposed in this study avoids the excessive expenditure of end users in computing and storage resources while enabling users to have flexible access control.

Resumo: Este estudo descreve aspectos epidemiológicos da Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P) associada à Covid-19 e óbitos por Covid-19 em crianças (0-9 anos de idade) e adolescentes (10-19 anos de idade). As fontes de dados, de 2020-2021, foram os Sistemas de Vigilância Epidemiológica para SIM-P e de Informação sobre Mortalidade para Covid-19, gerenciados pelo Ministério da Saúde. Foram notificados 1.503 casos, mais frequentes em crianças (77%) do que em adolescentes (23%); e 93 óbitos por SIM-P em 26 das 27 Unidades da Federação. O maior número de casos em crianças foi notificado em São Paulo (268), contudo, a maior incidência ocorreu no Distrito Federal (7,8/100 mil habitantes). A proporção de óbitos por SIM-P foi 5,4% em crianças e 8,7% em adolescentes. No período avaliado, houve 2.329 óbitos por Covid-19 em menores de 20 anos de idade, com maior taxa em adolescentes (4,4/100 mil habitantes) do que em crianças (2,7/100 mil habitantes), com maiores taxas em Roraima. Recomenda-se intensificação da imunização contra Covid-19 nessa população, aumentando a proteção contra os efeitos negativos dessa doença e da SIM-P, que podem apresentar consequências em curto, médio e/ou longo prazo, de modo a não comprometer a inserção plena destes cidadãos na sociedade.

Dear Editor, Immunoglobulin M (IgM) antibodies typically appear in the early stageof infection and have a short maintenance time, so IgM is frequentlyused as a diagnostic criterion for acute or recent disease.1However,unconventional IgM‐specific responses have been described in SARS‐CoV‐2 infection, raising doubts about the use of IgM as a biomarkerfor COVID‐19 and the role of this antibody in immunity to SARS‐CoV‐2

Resumo: Este artigo analisa o processo de trabalho da Estratégia Saúde da Família (ESF) na pandemia da Covid-19 segundo o atributo do vínculo longitudinal da Atenção Primária à Saúde. Estudo transversal, de caráter descritivo e analítico, com levantamento de dados primários, coletados mediante inquérito nacional por meio de um survey eletrônico, de abrangência nacional, realizado no 2º semestre de convivência com a doença. No presente recorte, incluíram-se o Ceará e a Paraíba, estados do Nordeste com mais de 84% de cobertura da ESF. Prevaleceram as participações de trabalhadoras (962), sendo agentes comunitários de saúde (29%) e enfermeiras (26,61%), mulheres (81,19%), de 18 a 39 anos (61,85%), servidoras estatutárias (48,75%), atuantes em territórios urbanos (58,63%). Das participantes, 92,54% trabalhavam no período, sendo apenas 4,7% a distância. Em relação às atividades, 51,53% declararam estar ‘realizando atividades de rotina, como antes’; e 31,42% revelaram estar ‘priorizando atividades relacionadas a Covid-19’. Novos cadastros do Cartão SUS foram efetivados segundo 67,94% das participantes. A pesquisa confirma que a ESF é porta de entrada muito frequente, se não a principal, de casos de Covid-19 e que embora atenda às dimensões do atributo, está fragilizada em sua efetivação para o cuidado dos usuários adscritos.

Abstract: We evaluated the longitudinal dynamics of antibody response to the SARS-CoV-2 vaccine CoronaVac and the effect of a booster dose of BNT162b2 vaccine. We found a robust antibody response after the second dose of CoronaVac that wanes over time. The response was recovered by BNT162b2, which boosted anti-spike antibody titers.

Abstract: CoronaVac was the first vaccine approved in Brazil for use in healthcare workers (HCWs). However, there is limited information about it, with little long-term evidence on post-vaccination antibody persistence. This study evaluated the antibody response to SARS-CoV-2 in 1237 HCWs after the first (1D), second dose (2D), and 6 months postvaccination (6mA2D) with CoronaVac. The seropositivity was 88% at 1D, increasing to 99.8% at 2D, but decreasing to 97.9% at 6mA2D, which was also observed at the analyzed antibody levels. Interestingly, the levels in females were higher than males, and we found a positive correlation with previous SARS-CoV-2 infection. Participants with comorbidities had lower levels suggesting the need to monitor for a potential booster dose. Our findings suggest that CoronaVac induced a robust antibody response that wanes significantly over time. Further longitudinal studies are needed to identify whether the antibodies will decline or plateau at a lower level.

Resumo: Esse estudo apresenta uma proposta de avaliação de impacto na APS a partir da análise contextual da atenção primaria em duas grandes cidades do Ceará, visto que Fortaleza (gestão incremental por OSs) e Sobral (Gestão Pública) representam ambientes privilegiados para a aplicação de modelos avaliativos visando mensurar o impacto, a eficiência, a efetividade e a resolutividade aplicáveis em diferentes contextos da APS do Brasil.

Resumo: Este trabalho apresenta o Revive Negócio, uma plataforma associada a uma metodologia para o cadastro e impulsionamento de ideias e de startups, com foco na retomada da economia. São descritas a implementação da plataforma e a especificação de uma metodologia de sete níveis. No Revive Negócio a ideia e a startup cadastradas são criteriosamente analisadas, recebem os devidos aconselhamentos técnicos e de gestão, apoio no modelo de negócio e participação no mercado, etc., para composição do ecossistema de inovação e melhoria socioeconômica do Estado. O Revive Negócio já se encontra operacional, resultado de uma parceria entre o Iracema Digital, o Instituto Federal do Ceará (IFCE), o Aracati Digital, a APSV Advogados e o Governo do Ceará.