Aplicação dos critérios de adequação (appropriateness criteria) a um laboratório de ecocardiografia de grande volume de um hospital privado

Mestrado em Tecnologia de Diagnóstico e Intervenção. Área de especialização: Ultrassonografia Cardiovascular.

Fórmula de cálculo do volume de ultrafiltrado extraído pela ultrafiltração modificada, em indivíduos adultos

O principal objectivo do estudo é determinar uma fórmula de cálculo para o volume de ultrafiltrado a retirar, pela Ultrafiltração Modificada (UFM), a doentes adultos submetidos a cirurgia cardíaca. A população-alvo é constituída por 489 casos relativos às cirurgias cardíacas realizadas entre Janeiro de 2003 e Dezembro de 2005, que cumprem os critérios de inclusão e exclusão definidos. Trata-se de um estudo retrospectivo, do tipo correlacional quantitativo com abordagem dedutiva, em que as variáveis estudadas foram obtidas através da consulta dos relatórios de perfusão cardiovascular do serviço de Cirurgia Cardiotorácica do Hospital de Santa Marta, EPE. A relação entre as variáveis em estudo foi analisada através da correlação e modelos de regressão linear. O modelo obtido para definir a fórmula de cálculo desejada tem por base a correlação existente entre o volume a retirar por UFM e a superfície corporal do doente, sendo este o único dos três modelos estudados que demonstra uma dependência, ainda que fraca, entre as variáveis, e exprimindo-se através da fórmula Y=545,4.X3, em que Y é o volume a retirar por UFM e X é o valor da superfície corporal de cada doente, e sendo representativo apenas para 4% da população em estudo.” O aumento médio de hemoglobina pós-UFM é de 1,9±1,09g/ dl, o que traduz eficácia da técnica na obtenção de hemoconcentração.

Conceito de volume

Este estudo analisa o modo como se desenvolve a aprendizagem do conceito de volume nos alunos do 6º ano de escolaridade, no quadro de uma proposta pedagógica que dá ênfase a actividades que apelam à visualização e ao raciocínio espacial. O seu objectivo principal foi o de compreender as ideias que os alunos do 6.º ano têm sobre volume e perceber como se desenvolvem quando são envolvidos numa experiência de ensino, tendo por base uma cadeia de tarefas que apelam à visualização e ao raciocínio espacial. O estudo seguiu uma metodologia de investigação qualitativa baseada em estudos de caso. A proposta pedagógica foi desenvolvida em quatro aulas; três de noventa minutos e uma de quarenta e cinco minutos, durante os 2º e 3º períodos do ano lectivo de 2009/2010. A recolha de dados envolveu a realização de gravações áudio, em ambiente de sala de aula, dos alunos que constituíram os estudos de caso, registo de observações do desempenho dos alunos e os documentos produzidos por estes. Os resultados mostram que, ao longo da proposta pedagógica, os alunos adquiriram estratégias de contagem que lhes permitiram criar estruturas, para compreender a organização dos paralelepípedos e desenvolver o conceito de volume. iii ABSTRACT This study examines how 6th graders’ students develop the concept of volume in a learning experience context which emphasizes the visualization and spatial reasoning. The main objective of this study is to understand the ideas of 6th grade students about volume and see how they develop them when they are involved in a learning experience, based on a sequence of tasks that call for visualization and spatial reasoning. The study followed a qualitative research methodology based on case studies. The learning experience was developed in four classes, three ninety minutes period and one forty-five minutes, during the 2nd and 3rd terms of the school year 2009/2010. Data collection involved the use of audio recordings in the classroom environment, recording observations of student performance and the documents produced by them. The results showed that, over the learning experience, students acquired counting strategies that allowed them to create structures for understanding the organization of cubes arrays and develop the concept of volume.

Equilibrium self-assembly of colloids with distinct interaction sites: Thermodynamics, percolation, and cluster distribution functions

We calculate the equilibrium thermodynamic properties, percolation threshold, and cluster distribution functions for a model of associating colloids, which consists of hard spherical particles having on their surfaces three short-ranged attractive sites (sticky spots) of two different types, A and B. The thermodynamic properties are calculated using Wertheim's perturbation theory of associating fluids. This also allows us to find the onset of self-assembly, which can be quantified by the maxima of the specific heat at constant volume. The percolation threshold is derived, under the no-loop assumption, for the correlated bond model: In all cases it is two percolated phases that become identical at a critical point, when one exists. Finally, the cluster size distributions are calculated by mapping the model onto an effective model, characterized by a-state-dependent-functionality (f) over bar and unique bonding probability (p) over bar. The mapping is based on the asymptotic limit of the cluster distributions functions of the generic model and the effective parameters are defined through the requirement that the equilibrium cluster distributions of the true and effective models have the same number-averaged and weight-averaged sizes at all densities and temperatures. We also study the model numerically in the case where BB interactions are missing. In this limit, AB bonds either provide branching between A-chains (Y-junctions) if epsilon(AB)/epsilon(AA) is small, or drive the formation of a hyperbranched polymer if epsilon(AB)/epsilon(AA) is large. We find that the theoretical predictions describe quite accurately the numerical data, especially in the region where Y-junctions are present. There is fairly good agreement between theoretical and numerical results both for the thermodynamic (number of bonds and phase coexistence) and the connectivity properties of the model (cluster size distributions and percolation locus).

Sistema de gestão de segurança para a prevenção de acidentes graves (SGSPAG): manual de implementação para o sector químico: volume I

A evolução dos acidentes graves envolvendo substâncias perigosas ocorridos no Sector Químico, não deixa dúvidas de que as características intrínsecas da própria actividade industrial podem estimular a ocorrência dos acidentes graves, proporcionando sérias consequências à Comunidade envolvente, à própria Propriedade e ao meio ambiente, cujas responsabilidades estão inseridas na Gestão Empresarial. Desta forma torna-se fundamental o desenvolvimento e implementação de um Sistema de Gestão de Segurança para a Prevenção de Acidentes Graves num Estabelecimento de Nível Superior de Perigosidade. O objectivo global deste trabalho, baseia-se no estabelecimento de um Quadro Metodológico de aplicação do Regime de Prevenção de Acidentes Graves ao Sector Químico, suportado num Sistema de Gestão de Segurança para a Prevenção de Acidentes Graves (SGSPAG) e no respectivo Manual de Implementação. Para tal foi realizado um enquadramento teórico, técnico-científico, e legal da prevenção de acidentes graves que envolvam substâncias perigosas, a concepção de um SGSPAG e elaboração do Manual de Implementação e a aplicação a um Caso de Estudo Industrial do SGSPAG com a correspondente análise crítica. O contexto específico foi o da Refinaria de Sines - Instalação de Dessulfuração de Gasóleo. A pesquisa foi acompanhada por um conjunto de métodos que permitiram uma visão mais actual do assunto no contexto seleccionado (dados adquiridos através de referências bibliográficas, da observação in-loco de auditorias de SGSPAG, da consulta de documentação relativa a auditorias SGSPAG e do estudo da legislação vigente e passada). Os resultados obtidos no Caso de Estudo Industrial, demonstraram que uma visão mais integradora e global podem contribuir para um melhor entendimento dos acidentes graves envolvendo substâncias perigosas e a sua prevenção, possibilitando um envolvimento maior e o comprometimento efectivo de todos, sejam eles trabalhadores (internos ou serviços subcontratados), Chefes de Secção, Responsáveis de Área, fornecedores, profissionais de outras áreas, Direcção da Empresa, representantes sindicais ou governamentais ou a própria Comunidade envolvente, estando o SGSPAG da Refinaria de Sines globalmente concebido, implementado e a demonstrar aptidão para, de uma forma consistente, cumprir os requisitos aplicáveis no DL nº 254/2007 e atingir os objectivos da Politica de Prevenção de Acidentes Graves.

Identification of tsunami-induced deposits using numerical modeling and rock magnetism techniques: A study case of the 1755 Lisbon tsunami in Algarve, Portugal

Storm- and tsunami-deposits are generated by similar depositional mechanisms making their discrimination hard to establish using classic sedimentologic methods. Here we propose an original approach to identify tsunami-induced deposits by combining numerical simulation and rock magnetism. To test our method, we investigate the tsunami deposit of the Boca do Rio estuary generated by the 1755 earthquake in Lisbon which is well described in the literature. We first test the 1755 tsunami scenario using a numerical inundation model to provide physical parameters for the tsunami wave. Then we use concentration (MS. SIRM) and grain size (chi(ARM), ARM, B1/2, ARM/SIRM) sensitive magnetic proxies coupled with SEM microscopy to unravel the magnetic mineralogy of the tsunami-induced deposit and its associated depositional mechanisms. In order to study the connection between the tsunami deposit and the different sedimentologic units present in the estuary, magnetic data were processed by multivariate statistical analyses. Our numerical simulation show a large inundation of the estuary with flow depths varying from 0.5 to 6 m and run up of similar to 7 m. Magnetic data show a dominance of paramagnetic minerals (quartz) mixed with lesser amount of ferromagnetic minerals, namely titanomagnetite and titanohematite both of a detrital origin and reworked from the underlying units. Multivariate statistical analyses indicate a better connection between the tsunami-induced deposit and a mixture of Units C and D. All these results point to a scenario where the energy released by the tsunami wave was strong enough to overtop and erode important amount of sand from the littoral dune and mixed it with reworked materials from underlying layers at least 1 m in depth. The method tested here represents an original and promising tool to identify tsunami-induced deposits in similar embayed beach environments.

Magma flow, exsolution processes and rock metasomatism in the Great Messejana-Plasencia dyke (Iberian Peninsula)

Magma flow in dykes is still not well understood; some reported magnetic fabrics are contradictory and the potential effects of exsolution and metasomatism processes on the magnetic properties are issues open to debate. Therefore, a long dyke made of segments with different thickness, which record distinct degrees of metasomatism, the Messejana-Plasencia dyke (MPD), was studied. Oriented dolerite samples were collected along several cross-sections and characterized by means of microscopy and magnetic analyses. The results obtained show that the effects of metasomatism on rock mineralogy are important, and that the metasomatic processes can greatly influence anisotropy degree and mean susceptibility only when rocks are strongly affected by metasomatism. Petrography, scanning electron microscopy (SEM) and bulk magnetic analyses show a high-temperature oxidation-exsolution event, experienced by the very early Ti-spinels, during the early stages of magma cooling, which was mostly observed in central domains of the thick dyke segments. Exsolution reduced the grain size of the magnetic carrier (multidomain to single domain transformation), thus producing composite fabrics involving inverse fabrics. These are likely responsible for a significant number of the 'abnormal' fabrics, which make the interpretation of magma flow much more complex. By choosing to use only the 'normal' fabric for magma flow determination, we have reduced by 50 per cent the number of relevant sites. In these sites, the imbrication angle of the magnetic foliation relative to dyke wall strongly suggests flow with end-members indicating vertical-dominated flow (seven sites) and horizontal-dominated flow (three sites).

Potential inundation of Lisbon downtown by a 1755-like tsunami

In this study, we present 10 m resolution tsunami flooding maps for Lisbon downtown and the Tagus estuary. To compute these maps we use the present bathymetry and topographic maps and a reasonable estimate for the maximum credible tsunami scenario. Tsunami modeling was made with a non-linear shallow water model using four levels of nested grids. The tsunami flood is discussed in terms of flow depth, run-up height and maximum inundation area. The results show that, even today, in spite of the significant morphologic changes in the city river front after the 1755 earthquake, a similar event would cause tsunami flow depths larger than one meter in a large area along the Tagus estuary and Lisbon downtown. Other areas along the estuary with a high population density would also be strongly affected. The impact of the tide on the extent of tsunami inundation is discussed, due to the large amplitude range of the tide in Lisbon, and compared with the historical descriptions of the 1755 event. The results presented here can be used to identify the potential tsunami inundation areas in Lisbon; this identification comprises a key element of the Portuguese tsunami emergency management system.

The source of the 1722 Algarve earthquake: evidence from MCS and tsunami data

The 27 December 1722 Algarve earthquake destroyed a large area in southern Portugal generating a local tsunami that inundated the shallow areas of Tavira. It is unclear whether its source was located onshore or offshore and, in any case, what was the tectonic source responsible for the event. We analyze available historical information concerning macroseismicity and the tsunami to discuss the most probable location of the source. We also review available seismotectonic knowledge of the offshore region close to the probable epicenter, selecting a set of four candidate sources. We simulate tsunamis produced by these candidate sources assuming that the sea bottom displacement is caused by a compressive dislocation over a rectangular fault, as given by the half-space homogeneous elastic approach, and we use numerical modeling to study wave propagation and run-up. We conclude that the 27 December 1722 Tavira earthquake and tsunami was probably generated offshore, close to 37 degrees 01'N, 7 degrees 49'W.

Image and color recognition using amorphous silicon p-i-n photodiodes

Large area hydrogenated amorphous silicon single and stacked p-i-n structures with low conductivity doped layers are proposed as monochrome and color image sensors. The layers of the structures are based on amorphous silicon alloys (a-Si(x)C(1-x):H). The current-voltage characteristics and the spectral sensitivity under different bias conditions are analyzed. The output characteristics are evaluated under different read-out voltages and scanner wavelengths. To extract information on image shape, intensity and color, a modulated light beam scans the sensor active area at three appropriate bias voltages and the photoresponse in each scanning position ("sub-pixel") is recorded. The investigation of the sensor output under different scanner wavelengths and varying electrical bias reveals that the response can be tuned, thus enabling color separation. The operation of the sensor is exemplified and supported by a numerical simulation.

Large area image sensing structures based on a-SiC : H: a dynamic characterization

In recent works large area hydrogenated amorphous silicon p-i-n structures with low conductivity doped layers were proposed as single element image sensors. The working principle of this type of sensor is based on the modulation, by the local illumination conditions, of the photocurrent generated by a light beam scanning the active area of the device. In order to evaluate the sensor capabilities is necessary to perform a response time characterization. This work focuses on the transient response of such sensor and on the influence of the carbon contents of the doped layers. In order to evaluate the response time a set of devices with different percentage of carbon incorporation in the doped layers is analyzed by measuring the scanner-induced photocurrent under different bias conditions.

Novel structure for large area image sensing

This work presents preliminary results in the study of a novel structure for a laser scanned photodiode (LSP) type of image sensor. In order to increase the signal output, a stacked p-i-n-p-i-n structure with an intermediate light-blocking layer is used. The image and the scanning beam are incident through opposite sides of the sensor and their absorption is kept in separate junctions by an intermediate light-blocking layer. As in the usual LSP structure the scanning beam-induced photocurrent is dependent on the local illumination conditions of the image. The main difference between the two structures arises from the fact that in this new structure the image and the scanner have different optical paths leading to an increase in the photocurrent when the scanning beam is incident on a region illuminated on the image side of the sensor, while a decreasing in the photocurrent was observed in the single junction LSP. The results show that the structure can be successfully used as an image sensor even though some optimization is needed to enhance the performance of the device.

Viability of Two New Mixture Design Methodologies for Self-Consolidating Concrete

This paper presents the results from an experimental study of the technical viability of two mixture designs for self-consolidating concrete (SCC) proposed by two Portuguese researchers in a previous work. The objective was to find the best method to provide the required characteristics of SCC in fresh and hardened states without having to experiment with a large number of mixtures. Five SCC mixtures, each with a volume of 25 L (6.61 gal.) were prepared using a forced mixer with a vertical axis for each of three compressive strength targets: 40, 55, and 70 MPa (5.80, 7.98, and 10.15 ksi). The mixtures' fresh state properties of fluidity, segregation resistance ability, and bleeding and blockage tendency, and their hardened state property of compressive strength were compared. For this study, the following tests were performed. slump-flow, V-funnel, L-box, box, and compressive strength. The results of this study made it possible to identify the most influential factors in the design of the SCC mixtures.

Influência do volume vesical na diminuição da dose recebida na bexiga e no PTV em doentes com tumor de reto tratados com belly-board

Introdução: O cancro retal continua a ser um dos principais problemas de saúde a nível mundial, sendo a toxicidade gastro-intestinal e génito-urinária os efeitos tardios da radioterapia mais reportados. A utilização da Belly-Board para minimizar essa toxicidade, reduzindo o volume de bexiga e intestino delgado irradiados é recomendada. No entanto, o protocolo mais adequado para o volume vesical nestes doentes é ainda tema de controvérsia. Objetivo: Avaliar a influência do volume vesical na dose recebida na bexiga e no PTV, em doentes com tumor de reto, posicionados em decúbito ventral, com belly-board. Materiais e Métodos: 38 doentes com tumor de reto tratados no CHBM, agrupados em dois grupos: o 1º grupo, com 19 doentes que realizaram tratamento com bexiga cheia e o 2º grupo, com 19 doentes que realizaram tratamento com bexiga vazia. Os dados foram obtidos através dos HDV’s e foram comparadas as doses máximas no PTV e a percentagem de volume de bexiga que recebe 50Gy. Foi utilizado o teste estatístico U-Mann Whitney com um nível de significância de 0,05. A hipótese de pesquisa deste estudo propõe que os dois grupos diferem significativamente entre si e a hipótese nula propõe que os dois grupos não diferem significativamente entre si, para ambas as variáveis. Resultados: Não se observaram diferenças estatisticamente significativas entre os grupos no que diz respeito à dose máxima no PTV. No que se refere à percentagem de volume de bexiga que recebe 50Gy verificaram-se diferenças estatisticamente significativas, tendo o grupo de doentes que realizaram tratamento com bexiga cheia apresentado valores mais baixos. Conclusões: Este estudo demonstrou o benefício da utilização do protocolo de bexiga cheia em doentes com tumor de reto tratados com belly-board, na diminuição da percentagem de volume de bexiga que recebe 50Gy.