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Geração de dados totalmente sintéticos para alta segura neonatal: uma metodologia orientada por conhecimento baseada em redes bayesianas

2026-07-30T00:00:00Z

Título: Geração de dados totalmente sintéticos para alta segura neonatal: uma metodologia orientada por conhecimento baseada em redes bayesianas Autor(es): Santos, Jean Louis Silva Abstract: Context: Neonatal hospital discharge is a critical stage in the transition of care, requiring multidimensional assessment of biophysiological, preventive, and healthcare-related conditions. Problem: Although Artificial Intelligence-based Clinical Decision Support Systems have the potential to reduce variability in professional judgment, their development in neonatology is limited by the scarcity of labeled records, legal restrictions on the use of sensitive health data, and the cold start problem. Motivation: The generation of fully synthetic data emerges as an alternative to support research, simulation, and computational development without direct exposure of real medical records. Justification: In sensitive domains such as neonatology, synthetic approaches guided only by data may depend on prior real datasets, reproduce biases, or generate clinically implausible combinations, making a knowledge-driven, interpretable, and auditable strategy relevant. Methodology: This dissertation proposes and evaluates a Bayesian Network-based methodology for generating fully synthetic data applied to decision support in safe neonatal discharge, without using real medical records in the modeling process. The methodology was developed incrementally, starting from an initial model with 11 clinical variables (Core11) and advancing to an expanded version with 18 variables (Core18). The causal network topology, Conditional Probability Tables (CPTs), normative weights, and clinical audit rules were defined based on specialized literature, normative documents, and clinical knowledge curation. The evaluation used internal validation protocols, including statistical fidelity, conditional inference, predictive utility under a Train on Synthetic, Test on Synthetic (TSTS) regime, SHAP-based explainability, threshold analysis, borderline case auditing, multivariate topological fidelity, and clinical edit checks. Results: The main experiments were conducted with 10,000 synthetic records in each model version. In Core11, the results indicated approval in protocols S1 and S2, a mean Kappa of 0.9445 in protocol S3, Hellinger Distance approved in 11/11 variables, and PCD-MAD of 0.0088 in protocol S7. In Core18, the expansion maintained good statistical, topological, and inferential fidelity, with S1 approved in 7/7 tests, S2 approved in 14/14 cases, a mean Kappa of 0.9209, Hellinger Distance approved in 18/18 variables, and PCD-MAD of 0.0097. However, relevant limitations were also observed, including divergence between explanatory importance and normative weights in S3SHAP, instability of decision thresholds in protocols S4 and S5, and the occurrence of clinical edit check violations in 36.9% of the synthetic records. Conclusions: It is concluded that the proposed approach is promising as a privacy-by-design synthetic data generation methodology for neonatal cold start scenarios, especially because it preserves probabilistic and topological properties of the model without relying on real patient data. At the same time, the findings show that global statistical coherence alone does not guarantee full individual clinical plausibility. Thus, the main contribution of this dissertation lies not only in generating synthetic neonatal data, but also in formulating an auditable pipeline for modeling, validation, and identification of methodological limits, indicating the need for future mechanisms of calibration, clinical filtering, conditional resampling, and expert validation.

Distribuição espacial e tendência temporal da tuberculose em pessoas privadas de liberdade no Brasil

2026-07-30T00:00:00Z

Título: Distribuição espacial e tendência temporal da tuberculose em pessoas privadas de liberdade no Brasil Autor(es): Carvalho, Kaique Máximo de Oliveira Abstract: Introduction: tuberculosis (TB) is a major public health problem, especially in vulnerable populations. The prison environment, characterized by overcrowding, inadequate ventilation, high turnover, and limited access to health services, enhances disease transmission and challenges its control. In Brazil, the growth of the inmate population in recent decades has been accompanied by an increase in the TB burden within this group, reinforcing the need for analyses that integrate epidemiological, temporal, and spatial aspects. Objective: to analyze the epidemiological, temporal, and spatial patterns of TB among persons deprived of liberty (PDL) in Brazil from 2014 to 2024. Methods: population-based ecological study with temporal and spatial components, using secondary data from the Notifiable Diseases Information System and the National Penitentiary Information System, aggregated by Federative Unit. All new cases of TB reported between 2014 and 2024 were included. Incidence rates were calculated based on the estimated prison population. Temporal trends were analyzed using segmented regression (Joinpoint), estimating the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC), with their respective 95% confidence intervals. Spatial distribution was assessed through choropleth maps of the mean incidence by Federative Unit. Sociodemographic, clinical, and diagnostic characteristics, comorbidities, associated conditions, and treatment outcomes were also analyzed. Results: a total of 821,172 new cases of TB were analyzed in Brazil, of which 78,034 occurred among PDL. There was a predominance of male individuals (97.03%), aged between 20 and 49 years (94.86%), non-white (63.10%), and with low educational level. The pulmonary clinical form was predominant (95.34%). Laboratory confirmation was high (81.78%), although gaps were identified in testing, such as culture and molecular rapid test, which was not performed in 46.08% of cases. Incidence showed an increasing trend during the analyzed period (AAPC: 4.79%; 95%CI: 0.21–9.58), with an inflection point in 2017, followed by stabilization. The highest incidence rates and growth trends were observed in the North and Northeast regions. Spatial distribution revealed a concentration of high rates in states such as Rio Grande do Norte, Pará, Sergipe, and Rio de Janeiro. Regarding outcomes, a higher proportion of cure was observed among PPL (73.69%) compared to the nondeprived population (68.45%). Conclusion: TB among PDL shows high magnitude, an increasing trend, and significant territorial inequality in Brazil. These findings highlight the need to strengthen epidemiological surveillance actions, expand early diagnosis, improve the quality of care, and implement intersectoral public policies aimed at reducing structural vulnerabilities in the prison system.

Vestindo competitividade com técnicas de marketing : analisando como as técnicas de marketing se relacionam com a competitividade das PMEs do Polo de Moda Itabaianinha/SE

2026-09-28T00:00:00Z

Título: Vestindo competitividade com técnicas de marketing : analisando como as técnicas de marketing se relacionam com a competitividade das PMEs do Polo de Moda Itabaianinha/SE Autor(es): Souza, Phellipe Ramon Menezes Abstract: Small and Medium-Sized Enterprises play a significant role in economic and social development, particularly through employment generation, income creation, and the stimulation of local economies. Despite their importance, they face resource constraints and increasing competitive challenges, making marketing techniques a strategic element for their survival, especially when examined within Local Productive Arrangements, where geographical proximity and cooperative relationships can enhance outcomes. The main objective of this dissertation was to analyze how the marketing techniques adopted by Small and Medium-Sized Enterprises in the Polo Moda Itabaianinha, Sergipe, relate their competitiveness. To this end, a sequential research design consisting of two interconnected studies was adopted. The first stage, of a theoretical nature, was conducted through an Integrative Systematic Literature Review, which analyzed 65 articles and organized the evidence into four analytical categories: marketing innovation, digital transformation, customer orientation, and sustainable marketing, interpreted as organizational capabilities that strengthen competitiveness. In the second stage, of a theoretical-empirical nature, a survey was conducted with managers and owners of Small and Medium-Sized Enterprises in the Polo Moda Itabaianinha, Sergipe, using a sample of 51 firms selected from the 89 active members of the sector's representative association. The data were analyzed using Partial Least Squares Structural Equation Modeling to test the association between marketing techniques related to marketing innovation, relationship marketing, network cooperation, and social media marketing, and organizational competitiveness. The results showed that the network cooperation construct exhibited a statistically positive association with competitiveness (β = 0.53; p < 0.001), whereas marketing innovation, relationship marketing, and social media marketing did not present sufficient evidence. The model explained 63% of the variance in competitiveness (R² = 0.63). The findings reinforce competitiveness as a multidimensional phenomenon and highlight the central role of interorganizational cooperation for Small and Medium-Sized Enterprises operating within Local Productive Arrangements, providing theoretical contributions to the field of marketing as well as managerial and public policy implications aimed at strengthening the competitiveness of these organizations.

Ambidestria organizacional na gestão pública : equilibrando inovação e eficiência operacional no Instituto Federal de Educação, Ciência e Tecnologia de Sergipe (IFS)!?

2026-08-24T00:00:00Z

Título: Ambidestria organizacional na gestão pública : equilibrando inovação e eficiência operacional no Instituto Federal de Educação, Ciência e Tecnologia de Sergipe (IFS)!? Autor(es): Paim, Rodrigo Diego Gois Abstract: This study aimed to investigate how the Federal Institute of Education, Science and Technology of Sergipe (IFS) balances exploration and exploitation, the central dimensions of organizational ambidexterity. Exploration was understood as the pursuit of new knowledge, experimentation, learning, and institutional adaptation, whereas exploitation was associated with the improvement of existing processes, operational efficiency, standardization, control, and continuity in the provision of public educational services. The research adopted a qualitative, descriptive, and exploratory approach and was designed as an embedded single-case study, with the Rector’s Office, Aracaju Campus, and Propriá Campus as its subunits of analysis. Data were collected through semi-structured interviews and document analysis, encompassing institutional and normative documents, management reports, resolutions, and meeting minutes. Content analysis, conducted with the support of ATLAS.ti, enabled the cross-analysis of evidence from interviews and documents. The results indicate that ambidexterity at IFS is not predominantly manifested through disruptive innovations or separate structures dedicated to innovation and efficiency, but rather through incremental, collaborative, and adaptive practices developed in the day-to-day activities of administrative and educational management. Exploration was identified in practices involving cooperation and institutional articulation, organizational learning, technological and administrative modernization, and adaptation in response to constraints. Exploitation, in turn, was manifested through operational efficiency, control and monitoring, institutional governance, process standardization, and adaptive bureaucracy. It is concluded that, at IFS, ambidexterity can be understood as a situated institutional capability built upon the organization’s concrete operating conditions and the articulation between stability and adaptation, systemic coordination and local autonomy, and control and learning. As a theoretical contribution, the study broadens the understanding of ambidexterity in public educational contexts by demonstrating that its operationalization can occur through incremental, collaborative, and adaptive practices conditioned by institutional constraints and by tensions between systemic coordination and local autonomy. As a practical contribution, the study proposes guidelines for operationalizing ambidexterity at IFS, whose elements may support reflection and further research in other public educational contexts with similar characteristics.