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Network human operators’ decision-making during grid outages requires significant attention and the ability to perceive real-time feedback from multiple information sources to minimize the number of control actions required to restore service, while maintaining the system and people safety. Data-driven event and alarm management have the potential to reduce human operator cognitive burden. However, the high complexity of events, the data semantics, and the large variety of equipment and technologies are key barriers for the application of Artificial Intelligence (AI) to raw SCADA data. In this context, this paper proposes a methodology to convert a large volume of alarm events into data mining terminology, creating the conditions for the application of modern AI techniques to alarm data. Moreover, this work also proposes two novel data-driven applications based on SCADA data: (i) identification of anomalous behaviors regarding the performance of the protection relays of primary substations, during circuit breaker tripping alarms in High Voltage (HV) and Medium Voltage (MV) lines; (ii) unsupervised learning to cluster similar events in HV line panels, classify new event logs based on the obtained clusters and membership grade with a control parameter that helps to identify rare events. Important aspects associated with data handling and pre-processing are also covered. The results for real data from a Distribution System Operator (DSO) showed: (i) that the proposed method can detect unexpected relay pickup events, e.g., one substation with nearly 41% of the circuit breaker alarms had an ‘atypical’ event in their context (revealed an overlooked problem on the electrification of a protection relay); (ii) capability to automatically detect and group issues into specific clusters, e.g., SF6 low-pressure alarms and blocks with abnormal profiles caused by event time-delay problems.

Introduction Holiender and Hirsch defined hysterical psychosis in 1964 and, while hysteria has a contemporary equivalent in somatoform/dissociation disorder, hysterical psychosis remains set adrift in the nosological understanding of psychiatric disorders. Objectives To present a case report of a hysterical psychosis and to review this nosological construct. Methods Clinical interview, consultation of clinical records and review of literature using the Pubmed platform. Results The authors present a case of a 38 year-old woman, admitted in a psychiatric emergency department for bizarre behavior, restlessness, auditory (pseudo)hallucinations and emotional lability, starting 1 week after a personal development retreat. This is the second episode of this nature, the first being a 15-day hospitalization 7 years ago, with rapid stabilization, extensive examination and restitium ad integrum. The patient initiated Olanzapine and was referred to an outpatient clinic, with rapid stabilization and restitium ad integrum throughout follow-up. Given the episode and patient characteristics, a hysterical psychosis diagnosis may be accurate, taking into account the acute onset and course, the pleomorphic nature of symptoms and the presence of a disturbing life event. The authors propose reviewing the concept of hysterical psychosis regarding its clinical implications and debating its therapeutic and prognostic utility. Conclusions Hysterical psychosis may not be a mere historic footnote and encompasses an entity with distinctive diagnostic, prognostic and therapeutic characteristics. While its etiology may not be understood, its clinical implications ensure the need for future research. Disclosure No significant relationships.

Abstract Background Neck circumference (NC) is associated with traditional cardiovascular risk factors (CVRF), but its usefulness to identify earlier atherogenic risk has been scarcely examined. Associations of NC with non-traditional CVRF were investigated in participants at low-to-moderate risk from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods 807 individuals (35–54 years) without obesity, diabetes or cardiovascular disease was stratified into quartiles of NC (cut-off for men: 36.5; 37.9 and 39.5 cm; women: 31.4; 32.5 and 34 cm) and traditional and non-traditional risk factors (lipoprotein subfractions by Vertical Auto Profile, adiponectin, leptin, E-selectin) were compared across groups. In linear regression models, associations of NC with non-traditional risk factors were tested for the entire sample and for low-risk group (≤ 2 CVRF). Results In both sexes, BMI, waist circumference, systolic and diastolic blood pressure, fasting and 2-h plasma glucose, HOMA-IR, triglycerides, leptin, E-selectin, small dense LDL-cholesterol, IDL-cholesterol, VLDL3-cholesterol and TG/HDL ratio increased significantly, while HDL2-cholesterol and HDL3-cholesterol decreased across NC quartiles. In linear regression models, a direct association [β(95% CI)] of NC with leptin [(0.155 (0.068–0.242); 0.147 (0.075–0.220)], E-selectin [(0.105 (0.032–0.177); 0.073 (0.006 to 0.140)] and small-dense LDL [(1.866 (0.641–3.091); 2.372 (1.391–3.353)] and an inverse association with HDL2-cholesterol [(− 0.519 (− 0.773 to − 0.266); − 0.815 (− 1.115 to 0.515)] adjusted for age were detected for men and women, respectively. Conclusion Our findings indicate that measurement of NC may be useful for an earlier identification of unfavorable atherogenic metabolic profile in middle-aged individuals at lower cardiovascular risk level.

We investigated the impact of lifestyle goal achievement on cardiovascular risk factors after a 2-year behavioral intervention program applied to 394 adults (113 with diabetes, mean age 60.2 ± 11.4 years, 56% women) and targeting four goals: ≥5% weight loss; ≥150 min/week physical activities;

We evaluated the relationship of leptin with hypertension adjusted for body mass index (BMI) and/or waist circumference in a population of Japanese-Brazilian women aged > or = 30 years with centrally distributed adiposity. After excluding diabetic subjects, the study subjects - who participated in a population-based study on the prevalence of metabolic syndrome - showed prevalence rates of obesity (BMI > or = 25 kg/m²) and central adiposity (waist > or = 80 cm) of 32.0 and 37.8%, respectively. The hypertensive group (N = 162) was older, had higher BMI (24.9 ± 4.2 vs 23.3 ± 3.4 kg/m², P < 0.001), waist circumference (81.1 ± 10.1 vs 76.3 ± 8.2 cm, P < 0.001) and insulin levels (8.0 ± 6.2 vs 7.1 ± 4.9 µU/mL, P < 0.05) than the normotensive group (N = 322) and showed an unfavorable metabolic profile (higher 2-h plasma glucose, C-reactive protein and non-HDL cholesterol levels). Leptin did not differ between groups (8.2 ± 6.8 vs 7.2 ± 6.6 ng/mL, P = 0.09, for hypertensive vs normotensive, respectively) and its levels correlated significantly with anthropometric variables but not with blood pressure. Logistic regression analysis indicated that age and waist were independently associated with hypertension but not with homeostasis model assessment of insulin resistance or leptin levels. The lack of an independent association of hypertension with metabolic parameters (2-h glucose, C-reactive protein and non-HDL cholesterol) after adjustment for central adiposity suggested that visceral fat deposition may be the common mediator of the disturbances of the metabolic syndrome. Our data indicate that age and waist are major determinants of hypertension in this population of centrally obese (waist > or = 80 cm) Japanese-Brazilian women, but do not support a role for leptin in the elevation of blood pressure.

Introdução: O aumento da incidência de sífilis constitui um problema de saúde pública e populações imunossuprimidas podem ser acometidas, com risco de doença grave e manifestações atípicas. Apesar do grande número de pessoas submetidas a transplantes renais (TxR), os dados sobre a sífilis nesta população são escassos. Objetivo: Apresentar manifestação de quadro atípico de sífilis em paciente imunossuprimido. Método: Homem, 24 anos, procurou o pronto-socorro com uma úlcera genital indolor há 20 dias, evoluindo com múltiplas pápulas eritematosas não pruriginosas em tronco, membros superiores e região palmo-plantar, além de paralisia facial periférica à direita. O paciente fora submetido ao TxR há 18 meses e fazia uso de imunossupressores (tacrolimo, micofenolato, prednisona). Referia ser heterossexual, negava relações sexuais nos últimos 3 meses e episódios prévios de sífilis. O exame sérico treponêmico de quimioluminescência (CLIA) pré-TxR era não reagente, assim como o teste sérico não treponêmico VDRL do seu doador falecido. Na investigação sorológica do quadro, o VDRL (1:16) e a CLIA resultaram reagentes. O estudo do líquor evidenciou discreta hiperleucorraquia linfomonocitária, hiperproteinorraquia, hipoglicorraquia, VDRL não reagente e FTA-ABS IgG reagente. A avaliação oftalmológica mostrou edema de papila em olho direito, sugerindo acometimento por sífilis. A biópsia de pele em tronco demonstrou padrão de dermatite de interface, com infiltrado linfocitário perivascular e perianexial. A imuno-histoquímica anti-Treponema revelou-se positiva. O paciente foi tratado com penicilina G intravenosa, 4 milhões de UI a cada 4 horas, por 14 dias. Ao final do tratamento, notou-se completa cicatrização da lesão peniana, melhora importante das outras lesões dermatológicas e da paralisia facial. Resultados: A sífilis sexualmente adquirida normalmente segue seu curso clínico natural, com fases bem definidas, sequencialmente caracterizadas como primária, secundária, latente e, em até 40% dos casos, pela fase terciária. Em populações imunodeprimidas, a apresentação clínica mostra-se atípica. Apenas seis relatos de sífilis adquirida após o TxR foram identificados na literatura, todos casos graves e disseminados. O caso relatado trouxe apresentações inéditas da sífilis: o acometimento primário e secundário simultaneamente, acometimento neurológico e oftálmico, a paralisia facial periférica, além do VDRL falso-negativo em LCR. Deve-se estar atento as apresentações atípicas em pacientes submetidos ao TOS.

Efectuou-se uma pesquisa, a qual teve como objectivo principal verificar o valor da consulta de enfermagem na identificação de problemas de saúde. Utilizou-se como metodologia, o Histórico de Enfermagem, adoptado de Horta, a partir do qual se elaborou um formulário, que foi aplicado em visitação domiciliária, numa amostra probabilística, a 50 % da população diabética seguida na consulta de especialidade de Centro de Saúde de Cuba, e residente na freguesia do mesmo nome. Através da análise estatística em termos quantitativos, dos dados obtidos, foram confirmadas as hipóteses formuladas, que permitiram concluir que a consulta de enfermagem e mais válida do que o sistema habitualmente empregue no registo de dados sobre os doentes.

Increasing economic and population growth has put immense pressure on energy, water and land resources to satisfy national and supra-national demand. Through trade, a large proportion of such a demand is fulfilled. With trade as one of its key priorities, the China Belt and Road Initiative is a long-term transcontinental investment program. The initiative gained significant attention due to greater opportunities for economic development, large population and different levels of resource availability. The nexus approach has appeared as a new viewpoint in discussions on balancing the competing sectoral demands. However, following years of work, constraints exist in the scope and focus of studies. The newly developed multi-regional input–output (MRIO) models covering the world’s economy and its use of resources permit a comprehensive analysis of resource usage by production and consumption at different levels, and bring more knowledge about resource nexus problems. Using the MRIO model, this work simultaneously tracks energy, water and land use flows and investigates the transnational resource nexus. A nexus strength indicator is proposed which depends on ternary diagrams to grade countries based on their combined resources’ use and sectoral weighting. Equal sectoral weighting is assigned. The analysis presented a sectorally balanced nexus approach. Findings support existing work by recognizing energy, water and land as the robust transnational connections, from both production and consumption points of view. Resource nexus issues differ from country to country owing to inequalities in industrial set-up, preferences in economic policy and resource endowments. The paper outlines how key resource nexus problems can be identified and prioritized in view of alternative and often opposing interests.

Sports performance is a multifactorial trait that can be associated with individual and environmental characteristics. In this study, the sample comprised 35 male runners, enrolled in the “InTrack” project. Information regarding variables related to runners’ training was obtained via an online questionnaire, while anthropometric and body composition variables, as well as physical fitness components (muscular power, isometric strength, local muscular endurance, agility, and aerobic capacity) were measured, and a global physical fitness score (based on physical fitness components measured) was computed. The Weltman test (3200 m) was used to estimate runners’ pace and their stride frequency. Linear regression was used, taking the running pace as dependent variable. The final model, comprising biological, physical fitness, spatiotemporal, and training variables, explained 86% of the running performance variance. Muscular power (β = −1.02; 95% CI = (−1.69)–(−0.35)), abdominal muscle endurance (β = −4.81; 95% CI = (−7.52)–(−2.10)), isometric strength (β = −422.95; 95% CI = (−689.65)–(−156.25)), global physical fitness (β = 27.14; 95% CI = 9.52–45.03), and stride frequency (β = −2.99; 95% CI = (−4.29)–(−1.69)) were significantly associated with performance, meaning that better results in tests and increasing the stride frequency leads to better performance. Individual characteristics and physical fitness components were demonstrated to be significant predictors for running performance.