Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Geração de renda e ocupações na cadeia agroindustrial de castanha de caju no Rio Grande do Norte: o caso do sertão de Apodi

This work is part of the research group studying agribusiness chains, by characterizing agroindustrial chain of cashew nuts in Rio Grande do Norte, with special emphasis on Sertão de Apodi Citizenship Territory, showing their different flows and linkages and analyzes generating jobs and income in the production of this good, from the experience of COOPAPI, using as a methodology for analyzing the input-output matrix. And this is justified by the fact that Brazil is in the context as the world's fifth largest producer of cashew nuts and the production of this product focus in the Northeast, especially the Rio Grande do Norte, which is the second largest producer of region, behind only the state of Ceará, which is the largest producer in the country. Moreover, in recent years the state has increased its insertion in international markets this product, particularly the Mossoró-Assu Territory, which constitutes the largest producer in the state, particularly the municipality of Serra do Mel, which has an arrangement different yield, based on the model of integrated rural development, embodied in family farming. Nevertheless, the Sertão de Apodi Citizenship appear as the fourth among the Citizenship territories of Rio Grande do Norte in the ranking of the production of cashew nuts, but the prevailing model of Cooperatives in the Territory, based on the Solidarity Economy, i,e, different from the old cooperative, which is based on the precepts as patronage, with cooperative owners, favor, etc.., encourages scientific research. In this, after a careful analysis of data from field research, it was noticed that among the links in the chain, the production link is what generates the most jobs, while the processing link commands to generate income, but a portion meaningful occupations and income are generated outside the territory, especially out of state RN, denouncing the gap in supply of some specific demands within the chain

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Controle adaptativo robusto para um modelo desacoplado de um robô móvel

This thesis presents a new structure of robust adaptive controller applied to mobile robots (surface mobile robot) with nonholonomic constraints. It acts in the dynamics and kinematics of the robot, and it is split in two distinct parts. The first part controls the robot dynamics, using variable structure model reference adaptive controllers. The second part controls the robot kinematics, using a position controller, whose objective is to make the robot to reach any point in the cartesian plan. The kinematic controller is based only on information about the robot configuration. A decoupling method is adopted to transform the linear model of the mobile robot, a multiple-input multiple-output system, into two decoupled single-input single-output systems, thus reducing the complexity of designing the controller for the mobile robot. After that, a variable structure model reference adaptive controller is applied to each one of the resulting systems. One of such controllers will be responsible for the robot position and the other for the leading angle, using reference signals generated by the position controller. To validate the proposed structure, some simulated and experimental results using differential drive mobile robots of a robot soccer kit are presented. The simulator uses the main characteristics of real physical system as noise and non-linearities such as deadzone and saturation. The experimental results were obtained through an C++ program applied to the robot soccer kit of Microrobot team at the LACI/UFRN. The simulated and experimental results are presented and discussed at the end of the text

Técnicas de inteligência artificial para a geração dinâmica de set points para uma coluna de destilação

Artificial Intelligence techniques are applied to improve performance of a simulated oil distillation system. The chosen system was a debutanizer column. At this process, the feed, which comes to the column, is segmented by heating. The lightest components become steams, by forming the LPG (Liquefied Petroleum Gas). The others components, C5+, continue liquid. In the composition of the LPG, ideally, we have only propane and butanes, but, in practice, there are contaminants, for example, pentanes. The objective of this work is to control pentane amount in LPG, by means of intelligent set points (SP s) determination for PID controllers that are present in original instrumentation (regulatory control) of the column. A fuzzy system will be responsible for adjusting the SP's, driven by the comparison between the molar fraction of the pentane present in the output of the plant (LPG) and the desired amount. However, the molar fraction of pentane is difficult to measure on-line, due to constraints such as: long intervals of measurement, high reliability and low cost. Therefore, an inference system was used, based on a multilayer neural network, to infer the pentane molar fraction through secondary variables of the column. Finally, the results shown that the proposed control system were able to control the value of pentane molar fraction under different operational situations

Contribuições à análise de robustez de sistemas de controle usando redes neurais

This work develops a robustness analysis with respect to the modeling errors, being applied to the strategies of indirect control using Artificial Neural Networks - ANN s, belong to the multilayer feedforward perceptron class with on-line training based on gradient method (backpropagation). The presented schemes are called Indirect Hybrid Control and Indirect Neural Control. They are presented two Robustness Theorems, being one for each proposed indirect control scheme, which allow the computation of the maximum steady-state control error that will occur due to the modeling error what is caused by the neural identifier, either for the closed loop configuration having a conventional controller - Indirect Hybrid Control, or for the closed loop configuration having a neural controller - Indirect Neural Control. Considering that the robustness analysis is restrict only to the steady-state plant behavior, this work also includes a stability analysis transcription that is suitable for multilayer perceptron class of ANN s trained with backpropagation algorithm, to assure the convergence and stability of the used neural systems. By other side, the boundness of the initial transient behavior is assured by the assumption that the plant is BIBO (Bounded Input, Bounded Output) stable. The Robustness Theorems were tested on the proposed indirect control strategies, while applied to regulation control of simulated examples using nonlinear plants, and its results are presented

Determinação dos parâmetros do controlador preditivo generalizado com função de pesos variante no tempo através de algoritmos genéticos

The predictive control technique has gotten, on the last years, greater number of adepts in reason of the easiness of adjustment of its parameters, of the exceeding of its concepts for multi-input/multi-output (MIMO) systems, of nonlinear models of processes could be linearised around a operating point, so can clearly be used in the controller, and mainly, as being the only methodology that can take into consideration, during the project of the controller, the limitations of the control signals and output of the process. The time varying weighting generalized predictive control (TGPC), studied in this work, is one more an alternative to the several existing predictive controls, characterizing itself as an modification of the generalized predictive control (GPC), where it is used a reference model, calculated in accordance with parameters of project previously established by the designer, and the application of a new function criterion, that when minimized offers the best parameters to the controller. It is used technique of the genetic algorithms to minimize of the function criterion proposed and searches to demonstrate the robustness of the TGPC through the application of performance, stability and robustness criterions. To compare achieves results of the TGPC controller, the GCP and proportional, integral and derivative (PID) controllers are used, where whole the techniques applied to stable, unstable and of non-minimum phase plants. The simulated examples become fulfilled with the use of MATLAB tool. It is verified that, the alterations implemented in TGPC, allow the evidence of the efficiency of this algorithm

Controle inteligente de pressão para uma rede sem reservatório de abastecimento urbano de água

The sanitation companies from Brazil has a great challenge for the XXI century: seek to mitigate the rate of physical waste (water, chemicals and electricity) and financial waste caused by inefficient operating systems drinking water supply, considering that currently we already face, in some cases, the scarcity of water resources. The supply systems are increasingly complex as they seek to minimize waste and at the same time better serve the growing number of users. However, this technological change is to reduce the complexity of the challenges posed by the need to include users with higher quality and efficiency in services. A major challenge for companies of water supplies is to provide a good quality service contemplating reducing expenditure on electricity. In this situation we developed a research by a method that seeks to control the pressure of the distribution systems that do not have the tank in your setup and the water comes out of the well directly to the distribution system. The method of pressure control (intelligent control) uses fuzzy logic to eliminate the waste of electricity and the leaks from the production of pumps that inject directly into the distribution system, which causes waste of energy when the consumption of households is reduced causing the saturation of the distribution system. This study was conducted at Green Club II condominium, located in the city of Parnamirim, state of Rio Grande do Norte, in order to study the pressure behavior of the output of the pump that injects water directly into the distribution system. The study was only possible because of the need we had to find a solution to some leaks in the existing distribution system and the extensions of the respective condominium residences, which sparked interest in developing a job in order to carry out the experiments contained in this research

Avaliação da remoção de sulfeto de hidrogênio do gás natural em uma coluna de absorção

Natural gas, although basically composed by light hydrocarbons, also presents in its composition gaseous contaminants such as CO2 (carbon dioxide) and H2S (hydrogen sulfide). Hydrogen sulfide, which commonly occurs in oil and gas exploration and production activities, besides being among the gases that are responsible by the acid rain and greenhouse effect, can also cause serious harm to health, leading even to death, and damages to oil and natural gas pipelines. Therefore, the removal of hydrogen sulfide will significantly reduce operational costs and will result in oil with best quality to be sent to refinery, thereby resulting in economical, environmental, and social benefits. These factors highlight the need for the development and improvement of hydrogen sulfide sequestrating agents to be used in the oil industry. Nowadays there are several procedures for hydrogen sulfide removal from natural gas used by the petroleum industry. However, they produce derivatives of amines that are harmful to the distillation towers, form insoluble precipitates that cause pipe clogging and produce wastes of high environmental impact. Therefore, the obtaining of a stable system, in inorganic or organic reaction media, that is able to remove hydrogen sulfide without forming by-products that affect the quality and costs of natural gas processing, transport and distribution is of great importance. In this context, the evaluation of the kinetics of H2S removal is a valuable procedure for the treatment of natural gas and disposal of the byproducts generated by the process. This evaluation was made in an absorption column packed with Raschig ring, where natural gas with H2S passes through a stagnant solution, being the contaminant absorbed by it. The content of H2S in natural gas in column output was monitored by an H2S analyzer. The comparison between the obtained curves and the study of the involved reactions have not only allowed to determine the efficiency and mass transfer controlling step of the involved processes but also make possible to effect a more detailed kinetic study and evaluate the commercial potential of each reagent

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

Projeto de Sistemas Integrados de Propósito Geral Baseados em Redes em Chip Expandindo as Funcionalidades dos Roteadores para Execução de Operações: A plataforma IPNoSys

It bet on the next generation of computers as architecture with multiple processors and/or multicore processors. In this sense there are challenges related to features interconnection, operating frequency, the area on chip, power dissipation, performance and programmability. The mechanism of interconnection and communication it was considered ideal for this type of architecture are the networks-on-chip, due its scalability, reusability and intrinsic parallelism. The networks-on-chip communication is accomplished by transmitting packets that carry data and instructions that represent requests and responses between the processing elements interconnected by the network. The transmission of packets is accomplished as in a pipeline between the routers in the network, from source to destination of the communication, even allowing simultaneous communications between pairs of different sources and destinations. From this fact, it is proposed to transform the entire infrastructure communication of network-on-chip, using the routing mechanisms, arbitration and storage, in a parallel processing system for high performance. In this proposal, the packages are formed by instructions and data that represent the applications, which are executed on routers as well as they are transmitted, using the pipeline and parallel communication transmissions. In contrast, traditional processors are not used, but only single cores that control the access to memory. An implementation of this idea is called IPNoSys (Integrated Processing NoC System), which has an own programming model and a routing algorithm that guarantees the execution of all instructions in the packets, preventing situations of deadlock, livelock and starvation. This architecture provides mechanisms for input and output, interruption and operating system support. As proof of concept was developed a programming environment and a simulator for this architecture in SystemC, which allows configuration of various parameters and to obtain several results to evaluate it

Seleção de atributos em comitês de classificadores utilizando algoritmos genéticos

Classifier ensembles are systems composed of a set of individual classifiers and a combination module, which is responsible for providing the final output of the system. In the design of these systems, diversity is considered as one of the main aspects to be taken into account since there is no gain in combining identical classification methods. The ideal situation is a set of individual classifiers with uncorrelated errors. In other words, the individual classifiers should be diverse among themselves. One way of increasing diversity is to provide different datasets (patterns and/or attributes) for the individual classifiers. The diversity is increased because the individual classifiers will perform the same task (classification of the same input patterns) but they will be built using different subsets of patterns and/or attributes. The majority of the papers using feature selection for ensembles address the homogenous structures of ensemble, i.e., ensembles composed only of the same type of classifiers. In this investigation, two approaches of genetic algorithms (single and multi-objective) will be used to guide the distribution of the features among the classifiers in the context of homogenous and heterogeneous ensembles. The experiments will be divided into two phases that use a filter approach of feature selection guided by genetic algorithm