Health related quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization: type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the health-related quality of life (HRQL) are largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions that constitute HRQL are still a matter of discussion. Objective: To evaluate the impact of CRT on the HRQL of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT. Methods: 43 patients, submitted to successful implantation of CRT, were evaluated in hospital just before intervention and in the outpatient clinic within 6 months after CRT. HRQL was analyzed based on the Kansas City Cardiomyopathy Questionnaire (KCCQ). Patients were classified as super-responders (ejection fraction of left ventricle - LVEF - ≥45% post-CRT), n=15, responders (sustained improvement in functional class and LVEF increased by 15%), n=19, and non-responders (no clinical or LVEF improvement), n=9. Results: In the group of super-responders, CRT was associated with an improvement in HRQL for the various fields and sums assessed (ρ<0.05); in responders, CRT has been associated with an improvement of HRQL in the various fields and sums, except in the self-efficacy dimension (ρ<0.05); in non-responders, CRT was not associated with improvement of HRQL. Conclusion: In a population with severe CHF undergoing CRT, the patients with clinical and echocardiographic positive response, obtained a favorable impact in all dimensions of HRQL, while the group without response to CRT showed no improvement. These data reinforces the importance of HRQL as a multidimensional tool for assessment of benefits in clinical practice.

Evaluating the quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization regarding the type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the quality of life have been largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions of quality of life is still a matter of discussion. Objective: to evaluate the impact of CRT on the quality of life of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT.

Type of strabismus and changes to fusion measures

Assessing the range of vergence provides information about the patient’s ability to maintain the binocular vision. Disparity vergence measurements should be used to quantify control of an underlying eye misalignment. In the presence of a manifest deviation the testing is performed by first compensating the angle of deviation to determine prognosis. Type of deviation: a) in an exophoria there is an increase in the fast fusional convergence while in an esophoric deviation there is an increase in reflex fusional divergence to attain binocular single vision; b) convergence fusion amplitudes have been found to correlate with control of the exodeviation; c) there is a greater BO range for esos and greater BI range for exos.

O desenvolvimento da competência ortográfica para melhoria da produção textual

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

The influence of experience and training in a group of novice observers: a jackknife alternative free-response receiver operating characteristic analysis

Purpose - The study evaluates the pre- and post-training lesion localisation ability of a group of novice observers. Parallels are drawn with the performance of inexperienced radiographers taking part in preliminary clinical evaluation (PCE) and ‘red-dot’ systems, operating within radiography practice. Materials and methods - Thirty-four novice observers searched 92 images for simulated lesions. Pre-training and post-training evaluations were completed following the free-response the receiver operating characteristic (FROC) method. Training consisted of observer performance methodology, the characteristics of the simulated lesions and information on lesion frequency. Jackknife alternative FROC (JAFROC) and highest rating inferred ROC analyses were performed to evaluate performance difference on lesion-based and case-based decisions. The significance level of the test was set at 0.05 to control the probability of Type I error. Results - JAFROC analysis (F(3,33) = 26.34, p < 0.0001) and highest-rating inferred ROC analysis (F(3,33) = 10.65, p = 0.0026) revealed a statistically significant difference in lesion detection performance. The JAFROC figure-of-merit was 0.563 (95% CI 0.512,0.614) pre-training and 0.677 (95% CI 0.639,0.715) post-training. Highest rating inferred ROC figure-of-merit was 0.728 (95% CI 0.701,0.755) pre-training and 0.772 (95% CI 0.750,0.793) post-training. Conclusions - This study has demonstrated that novice observer performance can improve significantly. This study design may have relevance in the assessment of inexperienced radiographers taking part in PCE or commenting scheme for trauma.

Soliton-type and other travelling wave solutions for an improved class of nonlinear sixth-order Boussinesq equations

An improved class of nonlinear bidirectional Boussinesq equations of sixth order using a wave surface elevation formulation is derived. Exact travelling wave solutions for the proposed class of nonlinear evolution equations are deduced. A new exact travelling wave solution is found which is the uniform limit of a geometric series. The ratio of this series is proportional to a classical soliton-type solution of the form of the square of a hyperbolic secant function. This happens for some values of the wave propagation velocity. However, there are other values of this velocity which display this new type of soliton, but the classical soliton structure vanishes in some regions of the domain. Exact solutions of the form of the square of the classical soliton are also deduced. In some cases, we find that the ratio between the amplitude of this wave and the amplitude of the classical soliton is equal to 35/36. It is shown that different families of travelling wave solutions are associated with different values of the parameters introduced in the improved equations.

Statistical classification of road pavements using near field vehicle rolling noise measurements

Low noise surfaces have been increasingly considered as a viable and cost-effective alternative to acoustical barriers. However, road planners and administrators frequently lack information on the correlation between the type of road surface and the resulting noise emission profile. To address this problem, a method to identify and classify different types of road pavements was developed, whereby near field road noise is analyzed using statistical learning methods. The vehicle rolling sound signal near the tires and close to the road surface was acquired by two microphones in a special arrangement which implements the Close-Proximity method. A set of features, characterizing the properties of the road pavement, was extracted from the corresponding sound profiles. A feature selection method was used to automatically select those that are most relevant in predicting the type of pavement, while reducing the computational cost. A set of different types of road pavement segments were tested and the performance of the classifier was evaluated. Results of pavement classification performed during a road journey are presented on a map, together with geographical data. This procedure leads to a considerable improvement in the quality of road pavement noise data, thereby increasing the accuracy of road traffic noise prediction models.

Ash deposition during the co-firing of bituminous coal with pine sawdust and olive stones in a laboratory furnace

This article describes an experimental study on ash deposition during the co-firing of bituminous coal with pine sawdust and olive stones in a laboratory furnace. The main objective of this study was to relate the ash deposit rates with the type of biomass burned and its thermal percentage in the blend. The thermal percentage of biomass in the blend was varied between 10% and 50% for both sawdust and olive stones. For comparison purposes, tests have also been performed using only coal or only biomass. During the tests, deposits were collected with the aid of an air-cooled deposition probe placed far from the flame region, where the mean gas temperature was around 640 degrees C. A number of deposit samples were subsequently analyzed on a scanning electron microscope equipped with an energy dispersive X-ray detector. Results indicate that blending sawdust with coal decreases the deposition rate as compared with the firing of unblended coal due to both the sawdust low ash content and its low alkalis content. The co-firing of coal and sawdust yields deposits with high levels of silicon and aluminium which indicates the presence of ashes with high fusion temperature and, thus, with less capacity to adhere to the surfaces. In contrast, in the co-firing of coal with olive stones the deposition rate increases as compared with the firing of unblended coal and the deposits produced present high levels of potassium, which tend to increase their stickiness.

Durability performance of concrete made with fine recycled concrete aggregates

Fine recycled aggregates are seen as the last choice in recycling for concrete production. Many references quote their detrimental influence on the most important characteristics of concrete: compressive and tensile strength; modulus of elasticity; water absorption; shrinkage: carbonation and chloride penetration. These two last characteristics are fundamental in terms of the long-term durability of reinforced or prestressed concrete. In the experimental research carried out at IST, part of which has already been published, different concrete mixes (with increasing rates of substitution of fine natural aggregates sand - with fine recycled aggregates from crushed concrete) were prepared and tested. The results were then compared with those for a reference concrete with exactly the same composition and grading curve, but with no recycled aggregates. This paper presents the main results of this research for water absorption by immersion and capillarity, chloride penetration (by means of the chloride migration coefficient), and carbonation resistance, drawing some conclusions on the feasibility of using this type of aggregate in structural concrete, while taking into account any ensuing obvious positive environmental impact.

Lichens as biomonitors at indoor environments of primary schools

A biomonitoring study, using transplanted lichens Flavoparmelia caperata, was conducted to assess the indoor air quality in primary schools in urban (Lisbon) and rural (Ponte de Sor) Portuguese sites. The lichens exposure period occurred between April and June 2010 and two types of environments of the primary schools were studied: classrooms and outdoor/courtyard. Afterwards, the lichen samples were processed and analyzed by instrumental neutron activation analysis (INAA) to assess a total of 20 chemical elements. Accumulated elements in the exposed lichens were assessed and enrichment factors (EF) were determined. Indoor and outdoor biomonitoring results were compared to evaluate how biomonitors (as lichens) react at indoor environments and to assess the type of pollutants that are prevalent in those environments.

Sensor de glicose polarimétrico

Esta tese tem como principal objectivo a investigação teórica e experimental do desempenho de um sensor polarimétrico baseado num cristal líquido para medição da concentração de glicose. Recentemente uma série de sensores polarimétricos baseados em cristais líquidos foram propostos na literatura e receberam considerável interesse devido as suas características únicas. De facto, em comparação com outros moduladores electro-ópticos, o cristal líquido funciona com tensões mais baixas, tem baixo consumo de energia e maior ângulo de rotação. Além disso, este tipo de polarímetro pode ter pequenas dimensões que é uma característica interessante para dispositivos portáteis e compactos. Existem por outro lado algumas desvantagens, nomeadamente o facto do desempenho do polarímetro ser fortemente dependente do tipo de cristal líquido e da tensão a ele aplicada o que coloca desafios na escolha dos parâmetros óptimos de operação. Esta tese descreve o desenvolvimento do sensor polarimétrico, incluindo a integração dos componentes de óptica e electrónica, os algoritmos de processamento de sinal e um interface gráfico que facilita a programação de diversos parâmetros de operação e a calibração do sensor. Após a optimização dos parâmetros de operação verificou-se que o dispositivo mede a concentração da glicose em amostras com uma concentração de 8 mg/ml, com uma percentagem de erro inferior a 6% e um desvio padrão de 0,008o. Os resultados foram obtidos para uma amostra com percurso óptico de apenas 1 cm.

Autenticação de vídeo H.264/AVC

Hoje em dia, há cada vez mais informação audiovisual e as transmissões ou ficheiros multimédia podem ser partilhadas com facilidade e eficiência. No entanto, a adulteração de conteúdos vídeo, como informação financeira, notícias ou sessões de videoconferência utilizadas num tribunal, pode ter graves consequências devido à importância desse tipo de informação. Surge então, a necessidade de assegurar a autenticidade e a integridade da informação audiovisual. Nesta dissertação é proposto um sistema de autenticação de vídeo H.264/Advanced Video Coding (AVC), denominado Autenticação de Fluxos utilizando Projecções Aleatórias (AFPA), cujos procedimentos de autenticação, são realizados ao nível de cada imagem do vídeo. Este esquema permite um tipo de autenticação mais flexível, pois permite definir um limite máximo de modificações entre duas imagens. Para efectuar autenticação é utilizada uma nova técnica de autenticação de imagens, que combina a utilização de projecções aleatórias com um mecanismo de correcção de erros nos dados. Assim é possível autenticar cada imagem do vídeo, com um conjunto reduzido de bits de paridade da respectiva projecção aleatória. Como a informação de vídeo é tipicamente, transportada por protocolos não fiáveis pode sofrer perdas de pacotes. De forma a reduzir o efeito das perdas de pacotes, na qualidade do vídeo e na taxa de autenticação, é utilizada Unequal Error Protection (UEP). Para validação e comparação dos resultados implementou-se um sistema clássico que autentica fluxos de vídeo de forma típica, ou seja, recorrendo a assinaturas digitais e códigos de hash. Ambos os esquemas foram avaliados, relativamente ao overhead introduzido e da taxa de autenticação. Os resultados mostram que o sistema AFPA, utilizando um vídeo com qualidade elevada, reduz o overhead de autenticação em quatro vezes relativamente ao esquema que utiliza assinaturas digitais e códigos de hash.

Assessment of exposure to airborne ultrafine particles in the urban environment of Lisbon, Portugal

The aim of this study was the assessment of exposure to ultrafine in the urban environment of Lisbon, Portugal, due to automobile traffic, and consisted of the determination of deposited alveolar surface area in an avenue leading to the town center during late spring. This study revealed differentiated patterns for weekdays and weekends, which could be related with the fluxes of automobile traffic. During a typical week, ultrafine particles alveolar deposited surface area varied between 35.0 and 89.2 μm2/cm3, which is comparable with levels reported for other towns such in Germany and the United States. These measurements were also complemented by measuring the electrical mobility diameter (varying from 18.3 to 128.3 nm) and number of particles that showed higher values than those previously reported for Madrid and Brisbane. Also, electron microscopy showed that the collected particles were composed of carbonaceous agglomerates, typical of particles emitted by the exhaustion of diesel vehicles. Implications: The approach of this study considers the measurement of surface deposited alveolar area of particles in the outdoor urban environment of Lisbon, Portugal. This type of measurements has not been done so far. Only particulate matter with aerodynamic diameters <2.5 (PM2.5) and >10 (PM10) μm have been measured in outdoor environments and the levels found cannot be found responsible for all the observed health effects. Therefore, the exposure to nano- and ultrafine particles has not been assessed systematically, and several authors consider this as a real knowledge gap and claim for data such as these that will allow for deriving better and more comprehensive epidemiologic studies. Nanoparticle surface area monitor (NSAM) equipments are recent ones and their use has been limited to indoor atmospheres. However, as this study shows, NSAM is a very powerful tool for outdoor environments also. As most lung diseases are, in fact, related to deposition of the alveolar region of the lung, the metric used in this study is the ideal one.

Grid Integration of Offshore Wind Farms Using Modular Marx Multilevel Converters

This paper proposes the use of a Modular Marx Multilevel Converter, as a solution for energy integration between an offshore Wind Farm and the power grid network. The Marx modular multilevel converter is based on the Marx generator, and solves two typical problems in this type of multilevel topologies: modularity and dc capacitor voltage balancing. This paper details the strategy for dc capacitor voltage equalization. The dynamic models of the converter and power grid are presented in order to design the converter ac output voltages and the dc capacitor voltage controller. The average current control is presented and used for power flow control, harmonics and reactive power compensation. Simulation results are presented in order to show the effectiveness of the proposed (MC)-C-3 topology.

Convex Total Variation Denoising of Poisson Fluorescence Confocal Images With Anisotropic Filtering

Fluorescence confocal microscopy (FCM) is now one of the most important tools in biomedicine research. In fact, it makes it possible to accurately study the dynamic processes occurring inside the cell and its nucleus by following the motion of fluorescent molecules over time. Due to the small amount of acquired radiation and the huge optical and electronics amplification, the FCM images are usually corrupted by a severe type of Poisson noise. This noise may be even more damaging when very low intensity incident radiation is used to avoid phototoxicity. In this paper, a Bayesian algorithm is proposed to remove the Poisson intensity dependent noise corrupting the FCM image sequences. The observations are organized in a 3-D tensor where each plane is one of the images acquired along the time of a cell nucleus using the fluorescence loss in photobleaching (FLIP) technique. The method removes simultaneously the noise by considering different spatial and temporal correlations. This is accomplished by using an anisotropic 3-D filter that may be separately tuned in space and in time dimensions. Tests using synthetic and real data are described and presented to illustrate the application of the algorithm. A comparison with several state-of-the-art algorithms is also presented.