Belo Horizonte Research Articles

Bridging the digital divide: mapping Internet connectivity evolution, inequalities, and resilience in six Brazilian cities

We investigate the evolution of Internet speed and its implications for access to key digital services, as well as the resilience of the network during crises, focusing on six major Brazilian cities: Belo Horizonte, Brasília, Fortaleza, Manaus, Rio de Janeiro, and São Paulo. Leveraging a unique dataset of Internet Speedtest® results provided by Ookla®, we analyze Internet speed trends from 2017 to 2023. Our findings reveal significant improvements in Internet speed across all cities. However, we find that prosperous areas generally exhibit better Internet access, and that the dependence of Internet quality on wealth have increased over time. Additionally, we investigate the impact of Internet quality on access to critical online services, focusing on e-learning. Our analysis shows that nearly 13% of catchment areas around educational facilities have Internet speeds below the threshold required for e-learning, with disadvantaged areas experiencing more significant challenges. Moreover, we investigate the network’s resilience during the COVID-19 pandemic, finding a sharp decline in network quality following the declaration of national emergency. We also find that less wealthy areas experience larger drops in network quality during crises. Overall, this study underscores the importance of addressing disparities in Internet access to ensure equitable digital services and enhance network resilience during crises.

Cultura, comunicação pública e cidadania: práticas de deliberação cidadã no campo das artes/cultura (Brasil-Canadá)

This study describes a stage of research linked to the international cooperation plan that investigates practices of citizen deliberation and public communication in municipal management planning documents and citizen mobilization practices — such as the culture and tourism plans in Brazil (Salvador and Belo Horizonte) and Canada (Montreal) — and online public consultations. It presupposes conflicting public administrations interests as sometimes they aim to implement public policies with a view to citizens, such as those to promote Arts/Culture and, on the other hand, strictly mercantile practices toward tourists and the construction of cities merchandise by place branding.

Peripheral Urbanization, Informal Real Estate Markets and Criminal Activities in Belo Horizonte (Mg, Brazil)

Peripheral Urbanization, Informal Real Estate Markets and Criminal Activities in Belo Horizonte (Mg, Brazil)

OVERVIEW OF CAREER MANAGEMENT IN DENTISTRY: CHALLENGES AND TRENDS FOR THE FUTURE FROM THE STUDENTS' PERSPECTIVE

Career management has faced several innovations, due to the economy, politics and social contexts. Such changes are justified by technological advances, globalization, communication processes, outsourcing, and unemployment (PEREZ, 2021). It is relevant to reflect and outline a career plan, in order to find a way to put it into practice, to have the attitude of moving towards the achievement of both personal and professional goals. To describe the perception of career management, as seen by students in the health area at a private university in Belo Horizonte. This is a quantitative research, with the purpose of obtaining results that answer the guiding problem of this study. All dentistry students from Brazilian public and private universities were included, who answered a semi-structured questionnaire, reaching the following results: Gender 76.9% of the interviewees are female and 23.1% male; Age 58% of the students are in the 25-year age group; working in the area represent 38%; 79.3% of these students are studying their first undergraduate degree; 20.7% are in their second degree. Regarding the income profile, 37.9% receive between 1 and 2 thousand reais per month, and 50.7% have a salaried employment relationship, and 70.9% have never taken a vocational test to choose dentistry. Therefore, it is possible to conclude that in the current times, important changes in the work scenario are visible. Having achieved the objectives of this study, evidencing the commitment of dentistry students, however, contrary to expectations, it was noted that the individual initiative to develop the career is unsatisfactory, as well as there is no promotion by the HEIs due to the lack of disciplines on clinical career management and offices during the course.

Intra-specific variations in Schistosoma mansoni and their possible contribution to inconsistent virulence and diverse clinical outcomes.

Schistosoma mansoni was introduced from Africa to the Americas during the transatlantic slave trade and remains a major public health problem in parts of South America and the Caribbean. This study presents a comprehensive comparative analysis of three S. mansoni strains with different geographical origins-from Liberia, Belo Horizonte and Puerto Rico. We demonstrated significant variation in virulence and host-parasite interactions. We investigated the phenotypic characteristics of the parasite and its eggs, as well as the immunopathologic effects on laboratory mouse organ systems. Our results show significant differences in worm morphology, worm burden, egg size, and pathologic organ changes between these strains. The Puerto Rican strain showed the highest virulence, as evidenced by marked liver and spleen changes and advanced liver fibrosis indicated by increased collagen content. In contrast, the strains from Liberia and Belo Horizonte had a less pathogenic profile with less liver fibrosis. We found further variations in granuloma formation, cytokine expression and T-cell dynamics, indicating different immune responses. Our study emphasizes the importance of considering intra-specific variations of S. mansoni for the development of targeted therapies and public health strategies. The different virulence patterns, host immune responses and organ pathologies observed in these strains provide important insights for future research and could inform region-specific interventions for schistosomiasis control.

Study on access to social protection policies by homeless people during the COVID-19 pandemic

Abstract The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector. Key messages • Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social. • Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.

Artificial intelligence to predict estimates of physical activity in small geographic areas

Abstract Background Artificial intelligence (AI) predictive models have been used to estimate the risk of a certain outcome occurring, using all available variables. Methods Using AI methods we have developed a small area estimation (SAE) technique to estimate the prevalence of leisure-time physical activity (LTPA), or who practices 150 minutes of LTPA per week, in small areas, in Belo Horizonte, Brazil, between 2009 and 2018, by the usage of k-means clustering. The VIGITEL, national telephone survey of Risk Factors for non-communicable diseases, was the main source. We applied available data to estimate prevalence of LTPA in 3300 census tracts, aggregated in 150 Primary Health Care (PHC) areas. The prevalence of PA was analyzed between two time periods, due to the low number of census tract interviews. With the available data, we estimate vulnerability clusters, derived from a Health Vulnerability Index (IVS), for the city of Belo Horizonte, according to socioeconomic, sanitation and health indicators, which measure the percentage of the population living in areas of vulnerability in the city. The index main purpose is to support public policy implementation. Results Nine clusters were identified according to the Silhouette coefficient analysis, i.e.: low (LO-0, LO-1), medium (ME-0, ME-1), high (HI-0, HI-1, HI-2) and very high) vulnerability (VH-0, VH-1. The prevalence of physical activity ranged from 23.7% (worst prevalence), in area of high vulnerability cluster (VH-1) to 45.5% in a low-risk cluster (LO-1) in period from 2009 to 2014. The prevalence of physical activity increased to 31.4% (high vulnerability cluster) to 52.81% (low-risk cluster) from 2014 to 2018. Conclusions The use of AI to estimate the prevalence of physical activity in small areas proved to be effective and highlighted important differences in the city. Thus, national surveys, with a small number of interviews per census sector, can be used to predict risks and health outcomes for small areas. Key messages • The study highlights the importance of using artificial intelligence to predict estimates of risk factors for chronic non-communicable diseases in small geographic areas. • The study showed less physical activity (PA) in areas of greater vulnerability. This can support health promotion policies and programs that encourage PA.

Machine learning algorithm approach to complete blood count can be used as early predictor of COVID-19 outcome.

Although the SARS-CoV-2 infection has established risk groups, identifying biomarkers for disease outcomes is still crucial to stratify patient risk and enhance clinical management. Optimal efficacy of COVID-19 antiviral medications relies on early administration within the initial five days of symptoms, assisting high-risk patients in avoiding hospitalization and improving survival chances. The complete blood count can be an efficient and affordable option to find biomarkers that predict the COVID-19 prognosis due to infection-induced alterations in various blood parameters. This study aimed to associate hematological parameters with different COVID-19 clinical forms and utilize them as disease outcome predictors. We performed a complete blood count in blood samples from 297 individuals with COVID-19 from Belo Horizonte, Brazil. Statistical analysis, as well as ROC Curves and machine learning Decision Tree algorithms were used to identify correlations, and their accuracy, between blood parameters and disease severity. In the initial four days of infection, traditional hematological COVID-19 alterations, such as lymphopenia, were not yet apparent. However, the monocyte percentage and granulocyte-to-lymphocyte ratio proved to be reliable predictors for hospitalization, even in cases where patients exhibited mild symptoms that later progressed to hospitalization. Thus, our findings demonstrate that COVID-19 patients with monocyte percentages lower than 7.7% and a granulocyte-to-lymphocyte ratio higher than 8.75 are assigned to the hospitalized group with a precision of 86%. This suggests that these variables can serve as important biomarkers in predicting disease outcomes and could be used to differentiate patients at hospital admission for managing therapeutic interventions, including early antiviral administration. Moreover, they are simple parameters that can be useful in minimally equipped health care units.

Factors associated with dentists' fear of infecting family members as a consequence of dental practice

Dentists are exposed to the risk of infection by respiratory diseases to aerosols potentially contaminated. The factors associated with dentists' fear of infecting relatives because of dental practice were investigated. Questionnaires structured in Google Forms were sent to dentists in Belo Horizonte city, Brazil, who worked before and during the COVID-19 pandemic. The dependent variable was “fear of infecting family members”. The independent variables were sociodemographic characteristics, use of personal protective equipment (PPE) before and during the pandemic, important actions to prevent infection, knowledge and feelings about the pandemic, and the future of the profession. Analyses were performed using Pearson's chi-square test and Fisher's exact test (p≤0.05). The prevalence of fear was 84.3%. Having changed the use of surgical masks (p=0.038) and N95/PFF2/PFF3 masks (p = 0.043), having not changed the use of lab coats (p=0.013), greater anxiety during the pandemic period (p=0.004), and fear of being infected by a patient or colleague (p<0.001) were associated with the fear of infecting family members. The fear of infecting relatives made the dentists more anxious, with the fear of infection by patients or co-workers as well as more careful about the use of PPE.

Water quality benefits of implementing Green and Blue Infrastructure in a peri-urban catchment – Case study of a Brazilian metropolis

This paper investigates the effectiveness of Green and Blue Infrastructure (GBI) in managing non-point source pollution in the 120 km2 catchment of the Vargem das Flores reservoir, which supplies water to 600,000 inhabitants in the Belo Horizonte metropolitan area, Brazil's third-largest metropolis. A calibrated water quality model within the Storm Water Management Model (SWMM) was used to simulate total suspended solids (TSS) and nutrients loads under different future land use scenarios. The first scenario reflects maximum urban development according to current legislation. An alternative scenario was proposed considering the protection of forest remnants and the adoption of the most cost-effective GBI techniques in newly developed areas. Results indicated a substantial contribution of diffuse pollution to the reservoir's water quality degradation, mainly due to TSS loads transported from the most urbanized subcatchments. The application of bioretention cells to treat 12.6 km2 new impervious areas effectively mitigated diffuse pollution, removing 52.1% of TSS, 19.5% of total phosphorus (TP), and 17.1% of chemical oxygen demand (COD) loads flowing into the reservoir. The GBI implementation would maintain pollutant loads similar to current levels despite the increased urbanization.

KeraRing Implantation with Femtosecond Laser in Keratoconus Treatment at Different Stages

Objective: To investigate the reliability and effectiveness of femtosecond laser-assisted KeraRing (Mediphacos, Belo Horizonte, Brazil) implantation in treating keratoconus. Methods: Intrastromal corneal ring segments (KeraRing, Mediphacos, Brazil) were implanted in 15 eyes of 14 patients unable to tolerate contact lenses. Femtosecond laser (Intralase, 60 Hz) was used for corneal tunnel creation. Based on the distribution of ectatic area on the cornea, dual segments were implanted in 9 eyes, while single segments were implanted in 6 eyes. Preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), objective and subjective refraction, and topographic corneal curvature (K) values of the cases were compared using the Wilcoxon test. Results: The mean age of patients was 25±7.46 (range: 15-39) years, with a mean postoperative follow-up period of 10.8±7.37 (range: 1-24 months). BCVA improved in all eyes during the follow-up period, increasing from a mean of 0.12±0.1 to 0.38±0.24 (p

The Impact of COVID-19 Restrictions on Reports of Domestic Violence Against Women in the Context of a Middle-Income Country: The Case of Belo Horizonte, Brazil.

The city of Belo Horizonte is a state capital in Brazil with 2.7 million people. The city is remarkable for its stubbornly high and stable levels of domestic violence, and for having implemented very restrictive responses to the COVID-19 pandemic. Using 260 weeks of data between 2017 and 2021, we used an Interrupted Time Series model to estimate the effect of the restrictive orders and their subsequent relief on reports of domestic violence against women. Results show that restrictive orders had a large and negative immediate impact on reports of domestic violence against women, which was immediately followed by a gradual increase towards their original level. The subsequent relief had no impact, as the series had already resumed its earlier trend by the time restrictions ended. We engage with theory and extant research from middle-income countries to consider why reports declined and why this decline was momentary. Findings contrast with research in high-income countries, which generally found increases in reports of domestic violence after implementing pandemic-related restrictions. However, results align with a single other study in Mexico, a medium-income country similar to Brazil. In light of our data's context and literature, we considered that reports of domestic violence may have declined not necessarily because of a reduction in actual incidents, but because the restrictions may have exacerbated the isolation of women in vulnerable domestic arrangements, limiting their ability to report their victimization. A stable trend in reports of domestic violence against women, which resumed even after a global pandemic, suggests that current policies have been ineffective and that addressing domestic violence requires a better understanding of related issues and evidence-based strategies. Our study also highlights the importance of considering the consequences of hastily implemented policies during a crisis. While necessary, such policies can inadvertently exacerbate issues such as social isolation.

RETRATAMENTO ENDODÔNTICO NÃOCIRÚRGICO EM MOLAR INFERIOR COM INFECÇÃO SECUNDÁRIA: CINCO ANOS DE ACOMPANHAMENTO

This study reported the repair of a periapical lesion after endodontic retreatment. A 42-year-old female patient was referred to an endodontic specialist for endodontic retreatment of tooth 36. Clinically, she was asymptomatic, and the periapical radiographic examination revealed radiopaque material similar to gutta percha and an inadequate filling of the canal (sub -root canal filling, in addition to a radiolucent image present in the apical region of the tooth. After anesthesia, the coronal opening was performed using ProDesign Logic RT #30/10, #.25/08, #.20 rotary instruments. /06 At that moment, the instrument fracture occurred in the mesio-lingual canal, which was removed with ultrasonic tips and a microscope. , Belo Horizonte, Brazil) at CRT. The foraminal debridement was performed with a Logic 25.01 instrument along the actual length of the tooth. Root canal filling was performed using the #30.05 single cone technique and Bio-C Sealer bioceramic endodontic cement. At the 5-year follow-up, the patient was asymptomatic and the radiographic examination confirmed complete repair of the periapical lesion.

Acute inflammatory and metabolic effect of high fructose intake in normal-weight women: A randomized, double-masked, crossover trial

We aimed to evaluate the acute effect of a fructose-rich single meal on metabolic and inflammatory biomarkers RESEARCH METHODS AND PROCEDURES: This single-center, double-masked, randomized crossover trial recruited females aged 20 to 47 with a normal body mass index and was conducted at Hospital das Clínicas (Belo Horizonte, MG, Brazil). Participants received a standardized meal with either sucrose, glucose, or a fructose overload. Blood samples were collected after overnight fasting (baseline) and at 30, 60, 120, and 240 minutes postprandial. Serum levels of glucose, triglycerides (primary outcome), total cholesterol, alanine aminotransferase, aspartate aminotransferase, adiponectin, leptin, resistin, interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-17, interferon-gamma, tumor necrosis factor, eotaxin, and total blood leukocytes were measured. This trial was completed with 25 enrolled participants, and three dropped out. The per-protocol analysis included 22 participants. As expected, postprandial glycemia increased 30 minutes after consuming meals rich in sucrose (P = 0.045) or glucose (P < 0.001). Triglyceride and leucocyte concentrations increased only at 240 minutes after consuming a high-fructose meal (P < 0.05). Regardless of the type of carbohydrate overload, leptin concentrations decreased postprandially compared to baseline at all time points (P < 0.05). Four participants reported adverse events after consuming the standardized meal with glucose or fructose, including nausea and malaise. Our findings indicate that a fructose-rich single meal leads to a more significant increase in triglyceride and leukocyte concentrations compared to glucose and sucrose in healthy women. These findings support concerns regarding the potential inflammatory and metabolic dysfunction associated with frequent consumption of high-fructose meals.

"BECAUSE WE ALSO HAVE OUR RIGHTS”: PHYSICAL-SPATIAL TRANSFORMATION WITH CHILDREN FROM MORRO DO PAPAGAIO

Although child participation in decision-making is a recognized right, children are often excluded from decision-making processes that will affect the quality of their lives, including those related to urban issues. In the Brazilian context, there is a lack of studies aimed at understanding child participation in the transformation of public spaces. This study aims to explore the repercussions of a physical-spatial transformation involving children aged 9 to 10 years, residents of the Morro do Papagaio favela (Belo Horizonte, Brazil). To this end, interviews, photo-elicitation, and participant observation were conducted. Inductive thematic analysis of the data revealed the value of physical-spatial transformation as a practice that enables the exercise of children's rights to participation, sociability, play, freedom, education, use of public spaces, beauty and well-being. Identifying how children experience public spaces in the favela became crucial to understanding how transforming spaces with children can promote their citizenship.

Protocol of Randomized Controlled Community Trial (RCCT) for obesity management in Brazilian primary health care.

Obesity is a chronic disease characterized by excess body fat and is a risk factor for other chronic non-communicable diseases. Its multifactorial and complex nature makes its management a challenge for health services. This manuscript presents an investigation protocol that aims to analyze the effectiveness of collective nutritional interventions for obesity management applicable to primary health care. Randomized Controlled Community Trial (RCCT) in a representative sample of users of the Programa Academia de Saúde (PAS), in Belo Horizonte, Minas Gerais, Brazil, with obesity. The research consists of four phases: (1) Screening to identify the participants eligible for the nutritional interventions (individuals with obesity, readiness for change to lose body weight, and willingness and interest to participate in a group activity for six months or more); (2) Baseline to characterize the participants; (3) Implementation of collective nutritional interventions; (4) Reassessment of the participants. Participants in the control group (CG) will receive the usual health service care, and participants in the intervention group (IG) will participate in collective nutritional interventions based on Therapeutic Group 1 (TG1) or Therapeutic Group 2 (TG2) of the "Instructive of Collective Approach for the obesity management in SUS". The strengths of the study include its robust RCCT design, which allows for longitudinal analyses and is suitable for investigating causal hypotheses and applying strategies to improve adherence to interventions. Furthermore, the study included a representative sample of a public health service and aims to evaluate therapeutic proposals from the Brazilian Ministry of Health, which can contribute to implementation and extension in the national territory. RBR-3vzsyqq and RBR-6pg682m.

7476 Clinical, Pathological and Biochemical Characteristics of patients with Neuroendocrine Neoplasms (NENs) at a University Hospital in Belo Horizonte, Brazil

Abstract Disclosure: R.D. Romanowski: None. F.P. Ribeiro: None. T.T. Mello: None. B.S. Soares: None. J.B. Drummond: None. Neuroendocrine neoplasms (NENs) are a group of rare, heterogeneous, and potentially aggressive neoplasms, whose incidence is on the rise, largely due to advances in diagnostic methods that allow for more precise and early identification. A recent comprehensive review focusing on the epidemiology, incidence and prevalence of NENs described global findings, however, it did not include any data from Latin America, particularly after WHO 2019 digestive system tumours classification. Methods: We carried a retrospective analysis in a single center aiming to evaluate different clinical, pathological and biochemical characteristics of a cohort of patients with NENs followed at the Neuroendocrinology Outpatient Clinic of the Federal University of Minas Gerais, Brazil, who were diagnosed between the years of 2004 and 2023. Results: The study sample (n=30) included 13 female patients (43%). The median (range) age at diagnosis was 42 (19-73) years old. The most common primary sites observed in the studied population were the pancreas (38%) and the stomach (24%). Twenty three percent of the patients had MEN1 associated NENs. Fourteen tumors (45%) were classified as G1 NENs, 7 tumors (23%) were classified as G2 NENs and two tumors (6,7%) were classified as neuroendocrine carcinomas, while tumor grade classification was not feasible in 7 patients (23%). One third of the patients had functional tumors and metastatic disease was present in 60% of the cases at the time of diagnosis. Conclusion: In general, the epidemiological characteristics here described for our patients align with the global trend. Concerning gender, we observed a higher prevalence of these tumors in men (57%), consistent with the male predominance of up to 3 times over females described around the world. Our patient population seems to be younger than the mean age reported in different case series. Tumoral grade classification was not feasible in a high proportion of patients and despite the high prevalence of well differentiated and low-grade NENs, metastases were commonly seen at diagnosis, in accordance with the literature. Presentation: 6/2/2024

High nutritional risk and mortality in a general hospital in belo horizonte, Brazil

High nutritional risk and mortality in a general hospital in belo horizonte, Brazil

Evolution of food deserts and food swamps in a Brazilian metropolis between 2008 and 2020.

The aim of the current ecological study is to assess the evolution of food deserts and food swamps in the metropolitan city of Belo Horizonte between 2008 and 2020. Food deserts were determined based on the density of healthy establishments per 10,000 inhabitants, whereas food swamps were set based on the density of ultra-processed food procurement establishments per 10,000 inhabitants. The rate of census tracts classified as food deserts has decreased between 2008 and 2020, whereas that of census tracts classified as food swamps has increased within this same period. Furthermore, despite the reduced number of food deserts, these areas have increased in census tracts living under lower socioeconomic vulnerability condition. Food swamps recorded sharp increase in census tracts living under higher vulnerability condition. The population living in the herein investigated city has been increasingly exposed to an unhealthy community food environment over 12 years. Monitoring changes in community food environment is key strategy to enable tracking the effectiveness and efficiency of actions taken in food environments to ensure the human right to adequate food.

LAND SURFACE TEMPERATURE FORECASTING IN THE CONTEXT OF THE DEVELOPMENT OF SUSTAINABLE CITIES AND COMMUNITIES

The article examines the aspects of land surface temperature forecasting for effective planning and development of sustainable cities and communities. The relevance of the research lies in the need to develop effective approaches to the analysis and forecasting of climate data, for the timely determination of existing problems and ways to solve them, in accordance with civilizational challenges. The trends of changes in the land surface temperature from the middle of the 20th to the beginning of the 21st century were analyzed, using the example of five megacities located in different regions: Tokyo (Japan), Lagos (Nigeria), Berlin (Germany), Singapore (Singapore) and Belo Horizonte (Brazil). The results of the analysis of changes in average monthly and average annual temperatures are presented. The factors affecting the formation of the temperature regime of each of the cities are determined. The role of urbanization as a key factor in the development of the city is described, the main challenges caused by it are considered. An overview of megacities from the point of view of sustainable development was carried out. Prospects for urban development and measures aimed at reducing the urban heat island effect are considered. The role of modern technologies, in particular machine learning for predicting the land surface temperature, is described. The expediency of land surface temperature forecasting, in order to implement strategies for mitigating negative consequences and achieving the goals of sustainable development, is substantiated. The conducted research makes it possible to be convinced of the need for a responsible approach to the design and development of sustainable cities and communities. The temperature of the earth’s surface is one of the key indicators that allows you to monitor the main trends of urban life and can be an indicator of the effectiveness of strategies used to increase comfort and sustainable development.