Objective: To evaluate the profile of femur fractures in older adults in Brazil between 2008 and 2018. Methods: Population-based time series study with data from the Department of Informatics of the Unified Health System (Datasus), including 480,652 hospitalizations, of adults from 60 years and over, with hip fracture (ICD10-S72). Results: There was an increase of 76.9% in the hospitalization register (mean 5.87%/year) and an average incidence rate of 19.46 fractures for every 10,000 older adults. In total, 68% of hospitalizations were female, 28% from São Paulo. The average length of stay was 8.9 days, being higher in the Northern Region (11.8) and in the Federal District (18.7). Average mortality rate was 5%, being higher in men (5.45%) and over 80 years old. Northeast Region had the lowest mortality rate (3.54%). Southeast Region had the highest rate (5.53%). Total cost of hospitalizations was R$ 1.1 billion, with an average of R$ 100 million/year. Average cost per hospitalization was higher in the Southern Region (R$ 2,491.00). Conclusion: Femoral fracture is an important cause of mortality among older adults, with a higher incidence in women but higher mortality in men, with high cost to the system and regional differences. Level of Evidence II, Economic and decision analyses - developing an economic or decision model.
This paper proposes a methodology to repair crews dispatch during distribution feeders restoration immediately after remotely controlled actions have been taken. Our method determines the sectors patrol sequence using the expected number of faults for each sector considering a previously calculated fault probability. Next, a road graph mapping of the buses is obtained by associating each bus with its real-world position. The crews’ route inside each sector is determined by the application of the nearest neighbor algorithm on that mapping. The case studies analyzed 24 real faults available in the database of a Brazilian power distribution company, and, a comparison was made between the time spent to locate the failures by simulating both the proposed methodology and the usual greedy strategy. The average time spent in localizing all the failures was from 9.49 % to 41.81 % shorter than in the usual method. Moreover, the speed and distance of repair crews showed weak influence in the crew dispatch methodology efficiency. Such results indicate an enhancement of the power distribution QoS indicators by using the proposed methodology to deal with faults.
Ao meu orientador e amigo Prof. Dr. Carlos Dias Maciel, por acreditar em mim, por me conceder essa oportunidade única e por proporcionar tudo o que foi necessário para esse trabalho. Às minhas filhas Ana Carolina e Flávia, pela compreensão pelo tempo indisponível e pela extrema colaboração no cumprimento das suas responsabilidades. À minha esposa Giselda, com amor, pelo incansável apoio e pelo carinho alentador. À minha chefe e colega de trabalho, Ana Paula Gervásio Silveira, pelo incentivo e por colaborar na viabilização de parte das condições necessárias para o desenvolvimento da presente pesquisa. Aos colegas do Laboratório de Processamento de Sinais, pelo inigualável espírito de equipe, pela ajuda, pelas informações, pelo companheirismo e pelas inestimáveis trocas de conhecimento. "Wyrd bið ful araed". "O destino é inexorável".
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