Clinicians' attitudes to clinical practice guidelines

To the Editor: In their systematic review of clinicians' attitudes to clinical practice guidelines, Farquhar et al1 found that, although healthcare providers reported high satisfaction with guidelines, a significant number also expressed concerns about their practicality, their role in cost-cutting and their potential for increasing litigation. The review, however, did not address other potentially significant concerns of clinicians regarding the perceived validity of guidelines and the influence of external agencies (such as the pharmaceutical industry) on treatment recommendations.

Medições de dose no cristalino e na tiróide em tomografia computorizada: projecto

Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Área de especialização: Protecção Contra Radiações

Autonomic computing for scheduling in manufacturing systems

We describe a novel approach to scheduling resolution by combining Autonomic Computing (AC), Multi-Agent Systems (MAS) and Nature Inspired Optimization Techniques (NIT). Autonomic Computing has emerged as paradigm aiming at embedding applications with a management structure similar to a central nervous system. A natural Autonomic Computing evolution in relation to Current Computing is to provide systems with Self-Managing ability with a minimum human interference. In this paper we envisage the use of Multi-Agent Systems paradigm for supporting dynamic and distributed scheduling in Manufacturing Systems with Autonomic properties, in order to reduce the complexity of managing systems and human interference. Additionally, we consider the resolution of realistic problems. The scheduling of a Cutting and Treatment Stainless Steel Sheet Line will be evaluated. Results show that proposed approach has advantages when compared with other scheduling systems.

HACCP numa indústria corticeira: implementação, identificação de pontos críticos e proposta de acções correctivas

Mestrado em Engenharia Química

Aurícula direita: mecânica e sobrecarga de volume

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

Mix design process of polyester polymer mortars modified with recycled GFRP waste materials

In this study, the effect of incorporation of recycled glass fibre reinforced plastics (GFRP) waste materials, obtained by means of shredding and milling processes, on mechanical behaviour of polyester polymer mortars (PM) was assessed. For this purpose, different contents of GFRP recyclates, between 4% up to 12% in weight, were incorporated into polyester PM materials as sand aggregates and filler replacements. The effect of the addition of a silane coupling agent to resin binder was also evaluated. Applied waste material was proceeding from the shredding of the leftovers resultant from the cutting and assembly processes of GFRP pultrusion profiles. Currently, these leftovers as well as non-conform products and scrap resulting from pultrusion manufacturing process are landfilled, with additional costs to producers and suppliers. Hence, besides the evident environmental benefits, a viable and feasible solution for these wastes would also conduct to significant economic advantages. Design of experiments and data treatment were accomplish by means of full factorial design approach and analysis of variance ANOVA. Experimental results were promising toward the recyclability of GFRP waste materials as partial replacement of aggregates and reinforcement for PM materials, with significant improvements on mechanical properties of resultant mortars with regards to waste-free formulations.

Autonomous behaviors for an unmanned mini-aerial vehicle

This thesis aims at addressing the development of autonomous behaviors, for search and exploration with a mini-UAV (Unmanned Aerial Vehicle), or also called MAV (Mini Aerial Vehicle) prototype, in order to gather information in rescue scenarios. The platform used in this work is a four rotor helicopter, known as quad-rotor from the German company Ascending Technologies GmbH, which is later assembled with a on-board processing unit (i.e. a tiny light weight computer) and a on-board sensor suite (i.e. 2D-LIDAR and Ultrasonic Sonar). This work can be divided into two phases. In the first phase an Indoor Position Tracking system was settled in order to obtain the Cartesian coordinates (i.e. X, Y, Z) and orientation (i.e.heading) which provides the relative position and orientation of the platform. The second phase was the design and implementation of medium/high level controllers on each command input in order to autonomously control the aircraft position, which is the first step towards an autonomous hovering flight, and any autonomous behavior (e.g. Landing, Object avoidance, Follow the wall). The main work is carried out in the Laboratory ”Intelligent Systems for Emergencies and Civil Defense”, in collaboration with ”Dipartimento di Informatica e Sistemistica” of Sapienza Univ. of Rome and ”Istituto Superiore Antincendi” of the Italian Firemen Department.

Diagnóstico ambiental de duas empresas

Mestrado em Engenharia Química - Ramo Tecnologias de Protecção Ambiental

Melhoria do processo produtivo numa metalomecânica

Este projeto foi realizado na Empresa Fernando Jesus Mourão & Cª Lda, durante o ano de 2012, e teve como objetivo a melhoria do processo produtivo. Esta melhoria assentou na identificação de possíveis pontos de desperdício, no estudo e avaliação de soluções e por fim na definição de propostas de melhoria globais que visem ajustar o fluxo do processo produtivo à procura e simultaneamente minimizar custos operacionais. De forma a atingir estas metas, foi feito um levantamento exaustivo do processo produtivo e das respetivas operações. Neste estudo, apesar do elevado numero de oportunidades de melhoria, foi possível identificar duas áreas que se revelaram criticas e fundamentais para a introdução da filosofia de melhoria continua na empresa. Estas áreas que são o objeto de estudo desta dissertação são: o corte laser e a organização do pavilhão 3. Uma vez identificados as áreas críticas, procedeu-se a uma análise e definição das ações de melhoria a empreender de modo a melhorar o fluxo produtivo e a sua organização, e simultaneamente reduzir custos. Na área de corte laser procurou-se implementar a filosofia de produção “Lean” nomeadamente através da ferramenta de análise PDCA (Plan-Do-Check-Act), como ferramenta auxiliar do estudo para elaborar um plano de ação, implementar as ações, analisar os resultados e procurar a manutenção dos mesmos. Na intervenção do pavilhão 3 foi usada a técnica dos 5S para organizar e agilizar o funcionamento do mesmo. Todo o trabalho assenta na filosofia Lean e nos seus princípios, tendo-se por isso utilizado as ferramentas especificas Lean na concretização das tarefas executadas no seu âmbito. Para medir os resultados, antes e depois das ações implementadas, foi utilizada o indicador de eficiência (Overall Equipment Effectiveness) para o caso do processo de corte laser. Após a implementação das medidas definidas no processo de corte laser foi possível observar uma melhoria do indicador OEE de cerca de 20 por cento. Por outro lado as melhorias implementadas através da ferramenta dos 5S no pavilhão 3, trouxe ganhos visíveis de aumento de produtividade que beneficiaram o tempo de resposta da empresa.

Eco-efficiency approaches towards a sustainable composite materials manufacturing industry’

In this study the potential eco-efficiency performance of a pultrusion manufacturing company was assessed. Indicators values and eco-efficiency ratios were estimated taking into account the implementation of new proceedings and procedures in the production process of glass fibre reinforced polymers (GFRP) pultrusion profiles. Two different approaches were foreseen: 1)Adoption of a new heating system for pultrusion die in the manufacturing process, more effective and with minor heat losses; and 2) Recycling approach, with partial waste reuse of scrap material derived from manufacturing, cutting and assembly processes of GFRP profiles. These features lead to significant improvements on the sequent assessed eco-efficiency ratios of the present case study, yielding to a more sustainable product and manufacturing process of pultruded GFRP profiles.

A case study on the improvement of eco-efficiency ratios: application to a composite processing industry

The World Business Council for Sustainable Development (WBCSD) defines Eco-Efficiency as follows: ‘Eco- Efficiency is achieved by the delivery of competitively priced-goods and services that satisfy human needs and bring quality of life, while progressively reducing ecological impacts and resource intensity throughout the life-cycle to a level at least in line with the earth’s estimated carrying capacity’. Eco-Efficiency is under this point of view a key concept for sustainable development, bringing together economic and ecological progress. Measuring the Eco-Efficiency of a company, factory or business, is a complex process that involves the measurement and control of several and relevant parameters or indicators, globally applied to all companies in general, or specific according to the nature and specificities of the business itself. In this study, an attempt was made in order to measure and evaluate the eco-efficiency of a pultruded composite processing company. For this purpose the recommendations of WBCSD [1] and the directives of ISO 14301 standard [2] were followed and applied. The analysis was restricted to the main business branch of the company: the production and sale of standard GFRP pultrusion profiles. The main general indicators of eco-efficiency, as well as the specific indicators, were defined and determined according to ISO 14031 recommendations. With basis on indicators’ figures, the value profile, the environmental profile, and the pertinent eco-efficiency’s ratios were established and analyzed. In order to evaluate potential improvements on company eco-performance, new indicators values and ecoefficiency ratios were estimated taking into account the implementation of new proceedings and procedures, both in upstream and downstream of the production process, namely: a) Adoption of new heating system for pultrusion die in the manufacturing process, more effective and with minor heat losses; b) Implementation of new software for stock management (raw materials and final products) that minimize production failures and delivery delays to final consumer; c) Recycling approach, with partial waste reuse of scrap material derived from manufacturing, cutting and assembly processes of GFRP profiles. In particular, the last approach seems to significantly improve the eco-efficient performance of the company. Currently, by-products and wastes generated in the manufacturing process of GFRP profiles are landfilled, with supplementary added costs to this company traduced by transport of scrap, landfill taxes and required test analysis to waste materials. However, mechanical recycling of GFRP waste materials, with reduction to powdered and fibrous particulates, constitutes a recycling process that can be easily attained on heavy-duty cutting mills. The posterior reuse of obtained recyclates, either into a close-looping process, as filler replacement of resin matrix of GFRP profiles, or as reinforcement of other composite materials produced by the company, will drive to both costs reduction in raw materials and landfill process, and minimization of waste landfill. These features lead to significant improvements on the sequent assessed eco-efficiency ratios of the present case study, yielding to a more sustainable product and manufacturing process of pultruded GFRP profiles.

Design of experiments applied to the mix design process of polymer mortar materials modified with GFRP recyclates

In this work, the effect of incorporation of recycled glass fibre reinforced plastics (GFRP) waste materials, obtained by means of shredding and milling processes, on mechanical behavior of polyester polymer mortar (PM) materials was assessed. For this purpose, different contents of GFRP recyclates (between 4% up to 12% in mass), were incorporated into polyester PM materials as sand aggregates and filler replacements. The effect of silane coupling agent addition to resin binder was also evaluated. Applied waste material was proceeding from the shredding of the leftovers resultant from the cutting and assembly processes of GFRP pultrusion profiles. Currently, these leftovers, jointly with unfinished products and scrap resulting from pultrusion manufacturing process, are landfilled, with supplementary added costs. Thus, besides the evident environmental benefits, a viable and feasible solution for these wastes would also conduct to significant economic advantages. Design of experiments and data treatment were accomplish by means of full factorial design approach and analysis of variance ANOVA. Experimental results were promising toward the recyclability of GFRP waste materials as aggregates and reinforcement for PM materials, with significant improvements on mechanical properties with regard to non-modified formulations.

Projecto de sistema de fixação de punções para quinadoras hidráulicas

Mestrado em Engenharia Mecânica - Construções Mecânicas

Otimização do processo de corte de chapa a laser na SERMEC LASER

O presente trabalho visa apresentar a temática da otimização da produção de corte laser numa empresa do ramo da indústria metalomecânica, denominada Sermec Laser e situada no concelho da Maia no Distrito do Porto. Para alcançar este objetivo foi necessário conhecer o funcionamento atual do processo, como por exemplo, os seus intervenientes, as taxas de ocupação do equipamento de corte a laser e os procedimentos. Só depois de ser explorada essa vertente será possível desenvolver um plano com vista a melhorar esse processo. Este projeto espera criar um plano de melhoria que será testado e, quando for validado, será implementado. As melhorias propostas por este plano passam pelo aumento da eficiência do processo de corte a laser e a alteração de parte do layout da empresa de forma a facilitar e agilizar este mesmo processo. O objetivo final será acrescentar mais valor ao processo, reduzindo os seus desperdícios. Com esta melhoria a empresa ficará a ganhar, pois irá produzir de forma mais ajustada às suas necessidades.

Utilidade de Ecocardiografia da Sobrecarga Farmacológica com Dobutamina nas Cardiomiopatias Dilatadas não Isquémicas

INTRODUCTION: Low-dose dobutamine stress echocardiography is a common and useful technique to assess myocardial viability in patients with ischemic cardiomyopathy. OBJECTIVE: To evaluate the use of low-dose dobutamine stress echocardiography in determining the functional status of patients with idiopathic dilated cardiomyopathy (IDCM). METHODS: Prospective study of 28 patients with IDCM by transthoracic echocardiography (2D), low-dose dobutamine stress echocardiography, cardiopulmonary exercise testing (CPET) and measurement of pro-BNP. RESULTS: The mean age of the population was 50.3 +/- 11.5 years, 9 female and 19 male. Mean ejection fraction was 32.1 +/- 9.8%. All were in sinus rhythm. The following parameters were analyzed in 2D echocardiography and after dobutamine: dimensions of left atrium (LA) and of left ventricle in diastole and systole, shortening fraction (%), left ventricular end-diastolic (EDV) and end-systolic volumes (ESV), ejection fraction (EF), and mitral inflow (E, A, E/A ratio and deceleration time). In CPET, we considered the following parameters: peak VO2 and % maximal peak VO2 attained. We compared echo results with CPET. There was a correlation between age and peak VO2 (r = -0.38 with p = 0.049). In 2D echo, there was a correlation between baseline EF and LA dimensions and peak VO2 (r = 0.45 / p = 0.004 and r = -0.49 / p = 0.014, respectively). After dobutamine echo, there was a correlation between some echo parameters and peak VO2: EF - r = 0.59 / p = 0.001, LA dimensions - r = 0.56 / p = 0.007, and ESV - r = -0.45 / p = 0.026. Percentage maximal peak VO2 attained correlated with LA dimensions measured in 2D echo and after dobutamine (r = -0.398 / p = 0.036 and r = -0.674 / p = 0.02 respectively) and EF after dobutamine (r = -0.389 / p = 0.04). The value of pro-BNP correlated with LA dimensions and baseline EF (r = 0.44 / p = 0.02 and r = -0.57 / p = 0.002, respectively), and the correlation was maintained after inotropic stimulation with dobutamine (r = 0.57 / p = 0.001 and r = -0.55 / p = 0.0039). CONCLUSION: Low-dose dobutamine stress echocardiography showed stronger correlations with cardiopulmonary exercise testing than the parameters evaluated by conventional echocardiography and could be used to determine the functional status of patients with dilated cardiomyopathy; patients with greater ejection fraction after inotropic stimulation had better cardiopulmonary tests.