Guidance for the implementation of best practice for the care of patients with tuberculosis

The first two chapters of Best practice for the care of patients with tuberculosis: a guide for low-income countries include an introduction and guidance regarding implementation of best practice. The background to how the guide was developed is significant, as it was developed in collaboration with nurses and other health workers working in the most challenging settings. It therefore provides realistic and practical guidance for best practice where patient loads are large and resources are stretched. Guidance regarding standard setting and clinical audit is an important part of enabling people to recognise the strengths that already exist in their practice and approach those areas that require change in a systematic and practical way. The guide itself consists of a series of standards covering different aspects of patient care, from the moment they seek health care with symptoms to their diagnosis to early stages of treatment, directly observed treatment, the continuation phase and transfer of treatment. There are also standards relating specifically to HIV testing and the care of patients co-infected with tuberculosis and HIV. The standards themselves will appear in full in the subsequent chapters of this series.

Redundancy and Observability Analysis of Conventional and PMU Measurements

This letter shows that the matrix can be used for redundancy and observability analysis of metering systems composed of PMU measurements and conventional measurements (power and voltage magnitude measurements). The matrix is obtained via triangular factorization of the Jacobian matrix. Observability analysis and restoration is carried out during the triangular factorization of the Jacobian matrix, and the redundancy analysis is made exploring the matrix structure. As a consequence, the matrix can be used for metering system planning considering conventional and PMU measurements. These features of the matrix will be outlined and illustrated by numerical examples.

Fault Detection in Power Distribution Systems Using Automated Integration of Computational Intelligence Tools

The main purpose of this paper is to present architecture of automated system that allows monitoring and tracking in real time (online) the possible occurrence of faults and electromagnetic transients observed in primary power distribution networks. Through the interconnection of this automated system to the utility operation center, it will be possible to provide an efficient tool that will assist in decisionmaking by the Operation Center. In short, the desired purpose aims to have all tools necessary to identify, almost instantaneously, the occurrence of faults and transient disturbances in the primary power distribution system, as well as to determine its respective origin and probable location. The compilations of results from the application of this automated system show that the developed techniques provide accurate results, identifying and locating several occurrences of faults observed in the distribution system.

Effect of Organic Load on the Performance and Methane Production of an AnSBBR Treating Effluent from Biodiesel Production

Currently, there is an increasing demand for the production of biodiesel and, consequently, there will be an increasing need to treat wastewaters resulting from the production process of this biofuel. The main objective of this work was, therefore, to investigate the effect of applied volumetric organic load (AVOL) on the efficiency, stability, and methane production of an anaerobic sequencing batch biofilm reactor applied to the treatment of effluent from biodiesel production. As inert support, polyurethane foam cubes were used in the reactor and mixing was accomplished by recirculating the liquid phase. Increase in AVOL resulted in a drop in organic matter removal efficiency and increase in total volatile acids in the effluent. AVOLs of 1.5, 3.0, 4.5 and 6.0 g COD L(-1) day(-1) resulted in removal efficiencies of 92%, 81%, 67%, and 50%, for effluent filtered samples, and 91%, 80%, 63%, and 47%, for non-filtered samples, respectively, whereas total volatile acids concentrations in the effluent amounted to 42, 145, 386 and 729 mg HAc L(-1), respectively. Moreover, on increasing AVOL from 1.5 to 4.5 g COD L(-1) day(-1) methane production increased from 29.5 to 55.5 N mL CH(4) g COD(-1). However, this production dropped to 36.0 N mL CH(4) g COD(-1) when AVOL was increased to 6.0 g COD L(-1) day(-1), likely due to the higher concentration of volatile acids in the reactor. Despite the higher concentration of volatile acids at the highest AVOL, alkalinity supplementation to the influent, in the form of sodium bicarbonate, at a ratio of 0.5-1.3 g NaHCO(3) g COD (fed) (-1) , was sufficient to maintain the pH near neutral and guarantee process stability during reactor operation.

Morphological and molecular characterization of cyanobacteria from a Brazilian facultative wastewater stabilization pond and evaluation of microcystin production

The cyanobacterial population in the Cajati waste stabilization pond system (WSP) from Sao Paulo State, Brazil was assessed by cell isolation and direct microscope counting techniques. Ten strains, belonging to five genera (Synechococcus, Merismopedia, Leptolyngbya, Limnothrix, and Nostoc), were isolated and identified by morphological and molecular analyses. Morphological identification of the isolated strains was congruent with their phylogenetic analyses based on 16S rDNA gene sequences. Six cyanobacterial genera (Synechocystis, Aphanocapsa, Merismopedia, Lyngbya, Phormidium, and Pseudanabaena) were identified by direct microscope inspection. Both techniques were complementary, since, of the six genera identified by direct microscopic inspection, only Merismopedia was isolated, and the four other isolated genera were not detected by direct inspection. Direct microscope counting of preserved cells showed that cyanobacteria were the dominant members (> 90%) of the phytoplankton community during both periods evaluated (summer and autumn). ELISA tests specific for hepatotoxicmicrocystins gave positive results for six strains (Synechococcus CENA108, Merismopedia CENA106, Leptolyngbya CENA103, Leptolyngbya CENA112, Limnothrix CENA109, and Limnothrix CENA110), and for wastewater samples collected from raw influent (3.70 mu g microcystins/l) and treated effluent (3.74 mu g microcystins/l) in summer. Our findings indicate that toxic cyanobacteria in WSP systems are of concern, since the treated effluent containing cyanotoxins will be discharged into rivers, irrigation channels, estuaries, or reservoirs, and can affect human and animal health.

Environmental assessment of residential buildings with an emphasis on water conservation

The construction, operation and demolition of buildings represent one of the most damaging human activities in the global environment nowadays and water use and conservation is one of the most representative environmental loads to be considered. Brazil, unlike some other countries, has not yet implemented its own body building environmental assessment. The development of an environmental assessment system requires the identification of the most important topics to be considered in each theme for each country or region, due to local environmental agenda. This article presents a summary of the main topics concerning water conservation considered in some international environmental building assessment systems and presents a proposal of topics to take into account in a Brazilian assessment system. Practical application: The civil construction industry is not only one of the biggest sectors in the economy but is also one of the greatest polluters. Along with standardisation, it is also necessary to establish measures to attract significantly higher levels in different topics related to sustainable construction. New mechanisms that allow users to recognise the difference between buildings with different sustainable performance levels need to be developed. This article will be used as a base for the development of a Brazilian system of assessment and rating for building environmental performance and sustainability in terms of water use and conservation.

Model to predict the chloride penetration in concrete with profile forming peak: verification of its precision

Chloride attack in marine environments or in structures where deicing salts are used will not always show profiles with concentrations that decrease from the external surface to the interior of the concrete. Some profiles show an increase in chloride concentrations from when a peak is formed. This type of profile must be analyzed in a different way from the traditional model of Fick`s second law to generate more precise service life models. A model for forecasting the penetration of chloride ions as a function of time for profiles having formed a peak. To confirm the efficiency of this model, it is necessary to observe the behavior of a chloride profile with peak in a specific structure over a period of time. To achieve this, two chloride profiles with different ages (22 and 27 years) were extracted from the same structure. The profile obtained from the 22-year sample was used to estimate the chloride profile at 27 years using three models: a) the traditional model using Fick`s second law and extrapolating the value of C(S)-external surface chloride concentration; b) the traditional model using Fick`s second law and shifting the x-axis to the peak depth; c) the previously proposed model. The results from these models were compared with the actual profile measured in the 27-year sample and the results were analyzed. The model was presented with good precision for this study of case, requiring to be tested with other structures in use.

Multiobjective Particle Swarm Approach for the Design of a Brushless DC Wheel Motor

The roots of swarm intelligence are deeply embedded in the biological study of self-organized behaviors in social insects. Particle swarm optimization (PSO) is one of the modern metaheuristics of swarm intelligence, which can be effectively used to solve nonlinear and non-continuous optimization problems. The basic principle of PSO algorithm is formed on the assumption that potential solutions (particles) will be flown through hyperspace with acceleration towards more optimum solutions. Each particle adjusts its flying according to the flying experiences of both itself and its companions using equations of position and velocity. During the process, the coordinates in hyperspace associated with its previous best fitness solution and the overall best value attained so far by other particles within the group are kept track and recorded in the memory. In recent years, PSO approaches have been successfully implemented to different problem domains with multiple objectives. In this paper, a multiobjective PSO approach, based on concepts of Pareto optimality, dominance, archiving external with elite particles and truncated Cauchy distribution, is proposed and applied in the design with the constraints presence of a brushless DC (Direct Current) wheel motor. Promising results in terms of convergence and spacing performance metrics indicate that the proposed multiobjective PSO scheme is capable of producing good solutions.

Specification of Supervisory Control Systems for Ventricular Assist Devices

One of the most important recent improvements in cardiology is the use of ventricular assist devices (VADs) to help patients with severe heart diseases, especially when they are indicated to heart transplantation. The Institute Dante Pazzanese of Cardiology has been developing an implantable centrifugal blood pump that will be able to help a sick human heart to keep blood flow and pressure at physiological levels. This device will be used as a totally or partially implantable VAD. Therefore, an improvement on device performance is important for the betterment of the level of interaction with patient`s behavior or conditions. But some failures may occur if the device`s pumping control does not follow the changes in patient`s behavior or conditions. The VAD control system must consider tolerance to faults and have a dynamic adaptation according to patient`s cardiovascular system changes, and also must attend to changes in patient conditions, behavior, or comportments. This work proposes an application of the mechatronic approach to this class of devices based on advanced techniques for control, instrumentation, and automation to define a method for developing a hierarchical supervisory control system that is able to perform VAD control dynamically, automatically, and securely. For this methodology, we used concepts based on Bayesian network for patients` diagnoses, Petri nets to generate a VAD control algorithm, and Safety Instrumented Systems to ensure VAD system security. Applying these concepts, a VAD control system is being built for method effectiveness confirmation.

DESIGN OF CONCRETE PLATFORMS OFFSHORE USING THE THREE-LAYER SHELL THEORY

The concrete offshore platforms, which are subjected a several loading combinations and, thus, requires an analysis more generic possible, can be designed using the concepts adopted to shell elements, but the resistance must be verify in particular cross-sections to shear forces. This work about design of shell elements will be make using the three-layer shell theory. The elements are subject to combined loading of membrane and plate, totalizing eight components of internal forces, which are three membrane forces, three moments (two out-of-plane bending moments and one in-plane, or torsion, moment) and two shear forces. The design method adopted, utilizing the iterative process proposed by Lourenco & Figueiras (1993) obtained from equations of equilibrium developed by Gupta (1896) , will be compared to results of experimentally tested shell elements found in the literature using the program DIANA.

Adaptable Strut-and-Tie Model for Design and Verification of Four-Pile Caps

A large percentage of pile caps support only one column, and the pile caps in turn are supported by only a few piles. These are typically short and deep members with overall span-depth ratios of less than 1.5. Codes of practice do not provide uniform treatment for the design of these types of pile caps. These members have traditionally been designed as beams spanning between piles with the depth selected to avoid shear failures and the amount of longitudinal reinforcement selected to provide sufficient flexural capacity as calculated by the engineering beam theory. More recently, the strut-and-tie method has been used for the design of pile caps (disturbed or D-region) in which the load path is envisaged to be a three-dimensional truss, with compressive forces being supported by concrete compressive struts between the column and piles and tensile forces being carried by reinforcing steel located between piles. Both of these models have not provided uniform factors of safety against failure or been able to predict whether failure will occur by flexure (ductile mode) or shear (fragile mode). In this paper, an analytical model based on the strut-and-tie approach is presented. The proposed model has been calibrated using an extensive experimental database of pile caps subjected to compression and evaluated analytically for more complex loading conditions. It has been proven to be applicable across a broad range of test data and can predict the failures modes, cracking, yielding, and failure loads of four-pile caps with reasonable accuracy.

Toxicity-directed approach of polyester manufacturing industry wastewater provides useful information for conducting treatability studies

A broader characterization of industrial wastewaters, especially in respect to hazardous compounds and their potential toxicity, is often necessary in order to determine the best practical treatment (or pretreatment) technology available to reduce the discharge of harmful pollutants to the environment or publicly owned treatment works. Using a toxicity-directed approach, this paper sets the base for a rational treatability study of polyester resin manufacturing. Relevant physical and chemical characteristics were determined. Respirometry was used for toxicity reduction evaluation after physical and chemical effluent fractionation. Of all the procedures investigated, only air stripping was significantly effective in reducing wastewater toxicity. Air stripping in pH 7 reduced toxicity in 18.2%, while in pH 11 a toxicity reduction of 62.5% was observed. Results indicated that toxicants responsible for the most significant fraction of the effluent`s instantaneous toxic effect to unadapted activated sludge were organic compounds poorly or not volatilized in acid conditions. These results led to useful directions for conducting treatability studies which will be grounded on actual effluent properties rather than empirical or based on the rare specific data on this kind of industrial wastewater. (C) 2008 Elsevier B.V. All rights reserved.

On the wake-induced vibration of tandem circular cylinders: the vortex interaction excitation mechanism

The mechanism of wake-induced vibrations (WIV) of a pair of cylinders in a tandem arrangement is investigated by experiments. A typical WIV response is characterized by a build-up of amplitude persisting to high reduced velocities; this is different from a typical vortex-induced vibration (VIV) response, which occurs in a limited resonance range. We suggest that WIV of the downstream cylinder is excited by the unsteady vortex-structure interactions between the body and the upstream wake. Coherent vortices interfering with the downstream cylinder induce fluctuations in the fluid force that are not synchronized with the motion. A favourable phase lag between the displacement and the fluid force guarantees that a positive energy transfer from the flow to the structure sustains the oscillations. If the unsteady vortices are removed from the wake of the upstream body then WIV will not be excited. An experiment performed in a steady shear flow turned out to be central to the understanding of the origin of the fluid forces acting on the downstream cylinder.

Quantification of MgO surface excess on the SnO(2) nanoparticles and relationship with nanostability and growth

In this work, we experimentally showed that the spontaneous segregation of MgO as surface excess in MgO doped SnO(2) nanoparticles plays an important role in the system`s energetics and stability. Using Xray fluorescence in specially treated samples, we quantitatively determined the fraction of MgO forming surface excess when doping SnO(2) with several different concentrations and established a relationship between this amount and the surface energy of the nanoparticles using the Gibbs approach. We concluded that the amount of Mg ions on the surface was directly related to the nanoparticles total free energy, in a sense that the dopant will always spontaneously distribute itself to minimize it if enough diffusion is provided. Because we were dealing with nanosized particles, the effect of MgO on the surface was particularly important and has a direct effect on the equilibrium particle size (nanoparticle stability), such that the lower the surface energy is, the smaller the particle sizes are, evidencing and quantifying the thermodynamic basis of using additives to control SnO(2) nanoparticles stability. (C) 2010 Elsevier B.V. All rights reserved.

Microstructure and texture assessment of Al-Mn-Fe-Si (3003) aluminum alloy produced by continuous and semicontinuous casting processes

Aluminum sheets are currently produced by the direct-chill process (DC). The need for low-cost aluminum sheets is a challenge for the development of new materials produced by the twin roll caster (TRC) process. It is expected that sheets produced from these different casting procedures will differ in their microstructure. These differences in microstructure and in the crystallographic texture have great impact on sheet mechanical properties and formability. The present study investigated microstructure and evaluated texture of two strips of Al-Mn-Fe-Si (3003) aluminum alloy produced by TRC and by hot-rolling processes. It was possible to notice that the microstructure, morphology, and grain size of the TRC sample were more homogenous than those found in hot-rolled samples. Both strips, obtained by the two processes, showed strong texture gradient across the thickness.