Impacto da síncope na qualidade de vida: validação duma escala de avaliação em doentes submetidos a teste de inclinação em mesa basculante

Introdução e objetivos: A síncope recorrente tem um impacto significativo na qualidade de vida. O desenvolvimento de escalas de medida de fácil aplicabilidade clínica para avaliar este impacto é fundamental. O objetivo do presente estudo é a validação preliminar da escala Impact of Syncope on Quality of Life, para a população portuguesa. Métodos: O instrumento foi submetido a um processo de tradução, validação, adequação cultural e cognitive debriefing. Participaram 39 doentes com história de síncopes recorrentes (>1 ano de evolução), submetidos a teste de inclinação em mesa basculante (teste de tilt), que constitui uma amostra de conveniência, com idade de 52,1±16,4 anos (21-83; 43,5% do sexo masculino), a maioria com uma situação profissional ativa (n=18) ou reformados (n=13). A versão portuguesa resultou numa versão semelhante unidimensional à original com 12 itens agregados num único somatório, tendo passado por validação estatística, com avaliação da fidelidade, validade e estabilidade no tempo. Resultados: Em relação à fidelidade, a consistência interna da escala é de 0,9. Avaliámos a validade convergente, tendo obtido resultados estatisticamente significativos (p<0,01). Avaliámos a validade divergente tendo obtido resultados estatisticamente significativos. Relativamente à estabilidade no tempo foi efetuado um teste-reteste do instrumento aos seis meses após o teste de inclinação com 22 doentes desta amostra não submetidos a intervenção clínica, que não mostrou alterações estatisticamente significativas da qualidade de vida. Conclusões: Os resultados obtidos indicam a pertinência da utilização deste instrumento em contexto português na avaliação da qualidade de vida de doentes com síncope recorrente.

Validation of a measurement scale for the relationship between the orientation to corporate social responsibility and other business strategic variables

The importance of Social Responsibility (SR) is higher if this business variable is related with other ones of strategic nature in business activity (competitive success that the company achieved, performance that the firms develop and innovations that they carries out). The hypothesis is that organizations that focus on SR are those who get higher outputs and innovate more, achieving greater competitive success. A scale for measuring the orientation to SR has defined in order to determine the degree of relationship between above elements. This instrument is original because previous scales do not exist in the literature which could measure, on the one hand, the three classics sub-constructs theoretically accepted that SR is made up and, on the other hand, the relationship between SR and the other variables. As a result of causal relationships analysis we conclude with a scale of 21 indicators, validated scale with a sample of firms belonging to the Autonomous Community of Extremadura and it is the first empirical validation of these dimensions we know so far, in this context.

Influence of reconstruction parameters during filtered backprojection and ordered-subset expectation maximization in the measurement of the left-ventricular volumes and function during gated SPECT

A crucial method for investigating patients with coronary artery disease (CAD) is the calculation of the left ventricular ejection fraction (LVEF). It is, consequently, imperative to precisely estimate the value of LVEF--a process that can be done with myocardial perfusion scintigraphy. Therefore, the present study aimed to establish and compare the estimation performance of the quantitative parameters of the reconstruction methods filtered backprojection (FBP) and ordered-subset expectation maximization (OSEM). Methods: A beating-heart phantom with known values of end-diastolic volume, end-systolic volume, and LVEF was used. Quantitative gated SPECT/quantitative perfusion SPECT software was used to obtain these quantitative parameters in a semiautomatic mode. The Butterworth filter was used in FBP, with the cutoff frequencies between 0.2 and 0.8 cycles per pixel combined with the orders of 5, 10, 15, and 20. Sixty-three reconstructions were performed using 2, 4, 6, 8, 10, 12, and 16 OSEM subsets, combined with several iterations: 2, 4, 6, 8, 10, 12, 16, 32, and 64. Results: With FBP, the values of end-diastolic, end-systolic, and the stroke volumes rise as the cutoff frequency increases, whereas the value of LVEF diminishes. This same pattern is verified with the OSEM reconstruction. However, with OSEM there is a more precise estimation of the quantitative parameters, especially with the combinations 2 iterations × 10 subsets and 2 iterations × 12 subsets. Conclusion: The OSEM reconstruction presents better estimations of the quantitative parameters than does FBP. This study recommends the use of 2 iterations with 10 or 12 subsets for OSEM and a cutoff frequency of 0.5 cycles per pixel with the orders 5, 10, or 15 for FBP as the best estimations for the left ventricular volumes and ejection fraction quantification in myocardial perfusion scintigraphy.

Measurement of Photo Capacitance in Amorphous Silicon Photodiodes

This paper discusses the photodiode capacitance dependence on imposed light and applied voltage using different devices. The first device is a double amorphous silicon pin-pin photodiode; the second one a crystalline pin diode and the last one a single pin amorphous silicon diode. Double amorphous silicon diodes can be used as (de)multiplexer devices for optical communications. For short range applications, using plastic optical fibres, the WDM (wavelength-division multiplexing) technique can be used in the visible light range to encode multiple signals. Experimental results consist on measurements of the photodiode capacitance under different conditions of imposed light and applied voltage. The relation between the capacitive effects of the double diode and the quality of the semiconductor internal junction will be analysed. The dynamics of charge accumulations will be measured when the photodiode is illuminated by a pulsed monochromatic light.

The impact of financial disclosures in the measurement of notional interest rate swaps in the period of 2007-2012

Mestrado em Contabilidade

Uma análise das diferenças em termos da cultura e dos interesses profissionais a partir do projeto de substituiçao das IAS 39: Financial Instruments - Recognition and Measurement

Mestrado em Contabilidade

A checklist for patient safety rounds at the care pathway level

Objective - To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals. Design - We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors. Setting and Participants - A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated. Main outcome measures - Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR). Results - Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level. Conclusion - The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).

Benchmark exact solutions for the static analysis of multi-layered piezoelectric composite using PVDF

The three-dimensional (3D) exact solutions developed in the early 1970s by Pagano for simply supported multilayered orthotropic composite plates and later in the 1990s extended to piezoelectric plates by Heyliger have been extremely useful in the assessment and development of advanced laminated plate theories and related finite element models. In fact, the well-known test cases provided by Pagano and by Heyliger in those earlier works are still used today as benchmark solutions. However, the limited number of test cases whose 3D exact solutions have been published has somewhat restricted the assessment of recent advanced models to the same few test cases. This work aims to provide additional test cases to serve as benchmark exact solutions for the static analysis of multilayered piezoelectric composite plates. The method introduced by Heyliger to derive the 3D exact solutions has been successfully implemented using symbolic computing and a number of new test cases are here presented thoroughly. Specifically, two multilayered plates using PVDF piezoelectric material are selected as test cases under two different loading conditions and considering three plate aspect ratios for thick, moderately thick and thin plate, in a total of 12 distinct test cases. (C) 2013 Elsevier Ltd. All rights reserved.

Design of a laminated composite multi-cel structure subjected to torsion

Laminate composite multi-cell structures have to support both axial and shear stresses when sustaining variable twist. Thus the properties and design of the laminate may not be the most adequate at all cross-sections to support the torsion imposed on the cells. In this work, the effect of some material and geometric parameters on the optimal mechanical behaviour of a multi-cell composite laminate structure is studied when torsion is present. A particle swarm optimization technique is used to maximize the multi-cell structure torsion constant that can be used to obtain the angle of twist of the composite laminate profile.

Optimization of magneto-electro-elastic composite structures using differential evolution

Magneto-electro-elastic structures are built from materials that provide them the ability to convert in an interchangeable way, magnetic, electric and mechanical forms of energy. This characteristic can therefore provide an adaptive behaviour to a general configuration elastic structure, being commonly used in association with any type of composite material in an embedded or surface mounted mode, or by considering the usage of multiphase materials that enable achieving different magneto-electro-elastic properties. In a first stage of this work, a few cases studies will be considered to enable the validation of the model considered and the influence of the coupling characteristics of this type of adaptive structures. After that we consider the application of a recent computational intelligence technique, the differential evolution, in a deflection profile minimization problem. Studies on the influence of optimization parameters associated to the problem considered will be performed as well as the adoption of an adaptive scheme for the perturbation factor. Results are also compared with those obtained using an enhanced particle swarm optimization technique. (C) 2013 Elsevier Ltd. All rights reserved.

18F-FDG measurement in primary lung cancer: SUV normalization to different distribution volumes

Introduction: Standard Uptake Value (SUV) is a measurement of the uptake in a tumour normalized on the basis of a distribution volume and is used to quantify 18F-Fluorodeoxiglucose (FDG) uptake in tumors, such as primary lung tumor. Several sources of error can affect its accuracy. Normalization can be based on body weight, body surface area (BSA) and lean body mass (LBM). The aim of this study is to compare the influence of 3 normalization volumes in the calculation of SUV: body weight (SUVW), BSA (SUVBSA) and LBM (SUVLBM), with and without glucose correction, in patients with known primary lung tumor. The correlation between SUV and weight, height, blood glucose level, injected activity and time between injection and image acquisition is evaluated. Methods: Sample included 30 subjects (8 female and 22 male) with primary lung tumor, with clinical indication for 18F-FDG Positron Emission Tomography (PET). Images were acquired on a Siemens Biography according to the department’s protocol. Maximum pixel SUVW was obtained for abnormal uptake focus through semiautomatic VOI with Quantification 3D isocontour (threshold 2.5). The concentration of radioactivity (kBq/ml) was obtained from SUVW, SUVBSA, SUVLBM and the glucose corrected SUV were mathematically obtained. Results: Statistically significant differences between SUVW, SUVBSA and SUVLBM and between SUVWgluc, SUVBSAgluc and SUVLBMgluc were observed (p=0.000<0.05). The blood glucose level showed significant positive correlations with SUVW (r=0.371; p=0.043) and SUVLBM (r=0.389; p=0.034). SUVBSA showed independence of variations with the blood glucose level. Conclusion: The measurement of a radiopharmaceutical tumor uptake normalized on the basis of different distribution volumes is still variable. Further investigation on this subject is recommended.

alpha-Co(OH)(2)/carbon nanofoam composite as electrochemical capacitor electrode operating at 2 V in aqueous medium

In this work, alpha-Co(OH)(2) is electrodeposited onto carbon nanofoam forming a composite electrode operating in a potential window of 2 V in aqueous medium. Prior to electrodeposition, the carbon nanofoam substrate is subjected to a functionalization process, which leads to an increase of about 40% in its specific capacitance value. Formation of cobalt hydroxide clusters onto the functionalized carbon nanofoam by pulse electrodeposition further enhances the specific capacitance of the electrode. The combination of these factors with an enlarged working potential window, results in a material with specific capacitance close to 300 F g(-1) at current density of 1 A g(-1), considering the total mass loading of the composite. This suggests the potential application of the prepared composites in high energy density electrochemical supercapacitors. (c) 2015 Elsevier B.V. All rights reserved.

Biofunctional composite coating architectures based on polycaprolactone and nanohydroxyapatite for controlled corrosion activity and enhanced biocompatibility of magnesium AZ31 alloy

In this work a biofunctional composite coating architecture for controlled corrosion activity and enhanced cellular adhesion of AZ31 Mg alloys is proposed. The composite coating consists of a polycaprolactone (PCL) matrix modified with nanohydroxyapatite (HA) applied over a nanometric layer of polyetherimide (PEI). The protective properties of the coating were studied by electrochemical impedance spectroscopy (EIS), a non-disturbing technique, and the coating morphology was investigated by field emission scanning electron microscopy (FE-SEM). The results show that the composite coating protects the AZ31 substrate. The barrier properties of the coating can be optimized by changing the PCL concentration. The presence of nanohydroxyapatite particles influences the coating morphology and decreases the corrosion resistance. The biocompatibility was assessed by studying the response of osteoblastic cells on coated samples through resazurin assay, confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). The results show that the polycaprolactone to hydroxyapatite ratio affects the cell behavior and that the presence of hydroxyapatite induces high osteoblastic differentiation. (C) 2014 Elsevier B.V. All rights reserved.

Layerwise mixed models for analysis of multilayered piezoelectric composite plates using least-squares formulation

This work provides an assessment of layerwise mixed models using least-squares formulation for the coupled electromechanical static analysis of multilayered plates. In agreement with three-dimensional (3D) exact solutions, due to compatibility and equilibrium conditions at the layers interfaces, certain mechanical and electrical variables must fulfill interlaminar C-0 continuity, namely: displacements, in-plane strains, transverse stresses, electric potential, in-plane electric field components and transverse electric displacement (if no potential is imposed between layers). Hence, two layerwise mixed least-squares models are here investigated, with two different sets of chosen independent variables: Model A, developed earlier, fulfills a priori the interiaminar C-0 continuity of all those aforementioned variables, taken as independent variables; Model B, here newly developed, rather reduces the number of independent variables, but also fulfills a priori the interlaminar C-0 continuity of displacements, transverse stresses, electric potential and transverse electric displacement, taken as independent variables. The predictive capabilities of both models are assessed by comparison with 3D exact solutions, considering multilayered piezoelectric composite plates of different aspect ratios, under an applied transverse load or surface potential. It is shown that both models are able to predict an accurate quasi-3D description of the static electromechanical analysis of multilayered plates for all aspect ratios.

Multiobjective design of viscoelastic laminated composite sandwich panels

The optimal design of laminated sandwich panels with viscoelastic core is addressed in this paper, with the objective of simultaneously minimizing weight and material cost and maximizing modal damping. The design variables are the number of layers in the laminated sandwich panel, the layer constituent materials and orientation angles and the viscoelastic layer thickness. The problem is solved using the Direct MultiSearch (DMS) solver for multiobjective optimization problems which does not use any derivatives of the objective functions. A finite element model for sandwich plates with transversely compressible viscoelastic core and anisotropic laminated face layers is used. Trade-off Pareto optimal fronts are obtained and the results are analyzed and discussed.