Diagnostic performance of visual screening tests in the elderly

This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. This study is defined as study of diagnostic performance. The diagnostic accuracy of 5 visual tests -near convergence point, near accommodation point, stereopsis, contrast sensibility and amsler grid—was evaluated by means of the ROC method (receiver operating characteristics curves), sensitivity, specificity, positive and negative likelihood ratios (LR+/LR−). Visual acuity was used as the reference standard. A sample of 44 elderly aged 76.7 years (±9.32), who were institutionalized, was collected. The curves of contrast sensitivity and stereopsis are the most accurate (area under the curves were 0.814−p = 0.001, C.I.95%[0.653;0.975]— and 0.713−p = 0.027, C.I.95%[0,540;0,887], respectively). The scores with the best diagnostic validity for the stereopsis test were 0.605 (sensitivity 0.87, specificity 0.54; LR+ 1.89, LR−0.24) and 0.610 (sensitivity 0.81, specificity 0.54; LR+1.75, LR−0.36). The scores with higher diagnostic validity for the contrast sensibility test were 0.530 (sensitivity 0.94, specificity 0.69; LR+ 3.04, LR−0.09). The contrast sensitivity and stereopsis test's proved to be clinically useful in detecting vision loss in the elderly.

Diagnostic performance of visual screening tests in the elderly

The aging of Portuguese population is characterized by an increase of individuals aged older than 65 years. Preventable visual loss in older persons is an important public health problem. Tests used for vision screening should have a high degree of diagnostic validity confirmed by means of clinical trials. The primary aim of a screening program is the early detection of visual diseases. Between 20% and 50% of older people in the UK have undetected reduced vision and in most cases is correctable. Elderly patients do not receive a systematic eye examination unless a problem arises with their glasses or suspicion vision loss. This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. Furthermore, it pretends to define the ability to find the subjects affected with vision loss as positive and the subjects not affected with the same disease as negative. The ideal vision screening method should have high sensitivity and specificity for early detection of risk factors. It should be also low cost and easy to implement in all geographic and socioeconomic regions. Sensitivity is the ability of an examination to identify the presence of a given disease and specificity is the ability of the examination to identify the absence of a given disease. It was not an aim of this study to detect abnormalities that affect visual acuity. The aim of this study was to find out what´s the best test for the identification of any vision loss.

Environmental life cycle assessment of concrete made with fine recycled concrete aggregates

The majority of worldwide structures use concrete as its main material. This happens because concrete is economically feasible, due to its undemanding production technology and case Of use. However, it is widely recognized that concrete production has a strong environmental impact in the planet. Natural aggregates use is one of the most important problems of concrete production nowadays, since they are obtained from limited, and in some countries scarce, resources. In Portugal, although there are enough stone quarries to cover coarse aggregates needs for several more years, Supplies of fine aggregates are becoming scarcer, especially in the northern part of the country. On the other hand, as concrete structures' life cycle comes to an end, an urgent need emerges to establish technically and economically viable solutions for demolition debris, other than for use as road base and quarry fill. This paper presents a partial life cycle assessment (LCA) of concrete made with fine recycled concrete aggregates performed with EcoConcrete tool. EcoConcrete is a tailor-made, interactive, learning and communications tool promoted by the Joint Project Group (JPG) on the LCA of concrete, to qualify and quantify the overall environment impact of concrete products. It consists of an interactive Excel-spreadsheet in which several environmental inputs (material quantities, distances from origin to production Site, production processes) and outputs (material, energy, emissions to air, water, soil or waste) are collected in a life cycle inventory, and are then processed to determine the environmental impact (assessment) of the analysed concrete, in terms of ozone layer depletion, smog or "greenhouse" effect.

Sistema de apoio à decisão para a classificação de risco em projectos de tecnologias de informação

O trabalho que a seguir se apresenta tem como objectivo descrever a criação de um modelo que sirva de suporte a um sistema de apoio à decisão sobre o risco inerente à execução de projectos na área das Tecnologias de Informação (TI) recorrendo a técnicas de mineração de dados. Durante o ciclo de vida de um projecto, existem inúmeros factores que contribuem para o seu sucesso ou insucesso. A responsabilidade de monitorizar, antever e mitigar esses factores recai sobre o Gestor de Projecto. A gestão de projectos é uma tarefa difícil e dispendiosa, consome muitos recursos, depende de numerosas variáveis e, muitas vezes, até da própria experiência do Gestor de Projecto. Ao ser confrontado com as previsões de duração e de esforço para a execução de uma determinada tarefa, o Gestor de Projecto, exceptuando a sua percepção e intuição pessoal, não tem um modo objectivo de medir a plausibilidade dos valores que lhe são apresentados pelo eventual executor da tarefa. As referidas previsões são fundamentais para a organização, pois sobre elas são tomadas as decisões de planeamento global estratégico corporativo, de execução, de adiamento, de cancelamento, de adjudicação, de renegociação de âmbito, de adjudicação externa, entre outros. Esta propensão para o desvio, quando detectada numa fase inicial, pode ajudar a gerir melhor o risco associado à Gestão de Projectos. O sucesso de cada projecto terminado foi qualificado tendo em conta a ponderação de três factores: o desvio ao orçamentado, o desvio ao planeado e o desvio ao especificado. Analisando os projectos decorridos, e correlacionando alguns dos seus atributos com o seu grau de sucesso o modelo classifica, qualitativamente, um novo projecto quanto ao seu risco. Neste contexto o risco representa o grau de afastamento do projecto ao sucesso. Recorrendo a algoritmos de mineração de dados, tais como, árvores de classificação e redes neuronais, descreve-se o desenvolvimento de um modelo que suporta um sistema de apoio à decisão baseado na classificação de novos projectos. Os modelos são o resultado de um extensivo conjunto de testes de validação onde se procuram e refinam os indicadores que melhor caracterizam os atributos de um projecto e que mais influenciam o risco. Como suporte tecnológico para o desenvolvimento e teste foi utilizada a ferramenta Weka 3. Uma boa utilização do modelo proposto possibilitará a criação de planos de contingência mais detalhados e uma gestão mais próxima para projectos que apresentem uma maior propensão para o risco. Assim, o resultado final pretende constituir mais uma ferramenta à disposição do Gestor de Projecto.

Desenvolvimento do sistema de tracção de um veículo eléctrico ecológico com travagem regenerativa

Nesta dissertação descreve-se uma metodologia de dimensionamento do sistema de tracção para equipar um veículo eléctrico ecológico (VEECO) com inclusão de um sistema de travagem regenerativa. Apresenta-se uma perspectiva geral de diversas topologias de sistemas de tracção utilizadas nos veículos eléctricos e realiza-se a sua comparação através do estudo e análise dos acionamentos electromecânicos que podem ser utilizados nesses sistemas de tracção eléctrica. Utilizando ferramentas de simulação numérica, estuda-se o modelo matemático de um veículo eléctrico com travagem regenerativa. A partir deste modelo matemático é adoptado uma possível configuração para o seu sistema de tracção eléctrica e são obtidas características teóricas de desempenho do veículo eléctrico, através da análise de testes padrão ao veículo. Em banco de ensaios, constrói-se um sistema de tracção eléctrica que permite a validação experimental do modelo matemático do veículo eléctrico. Para a construção deste banco de ensaios foram concebidos os sistemas de tracção eléctrica, de carga mecânica e de controlo e monitorização do banco de ensaios. A validação experimental realiza-se através dos mesmos testes padrão ao veículo eléctrico, como o teste NEDC (New European Driving Cycle), o teste de aceleração entre 0 e 100km/h e o teste de gradeabilidade. Desenvolve-se o dimensionamento do sistema de tracção eléctrica a equipar o VEECO, através da componente de modelação paramétrica do modelo matemático do veículo eléctrico. Com esta metodologia é adoptado um conjunto de variáveis paramétricas relacionadas com os elementos que constituem o sistema de tracção eléctrica do VEECO. Estuda-se a influência destas variáveis paramétricas nas características de desempenho pretendidas para o VEECO. Como resultado da análise de modelação paramétrica é apresentada uma solução para o sistema de tracção eléctrica do VEECO que cumpre a execução do NEDC, apresenta um tempo de aceleração entre 0 e 100km/h inferior a 10 segundos, supera uma gradeabilidade de 10% e uma autonomia de 200 km. O sistema de tracção do VEECO também permite realizar a travagem regenerativa com rendimento até 33%. Possui controlo de tracção e anti bloqueio da roda motora, através de uma unidade de controlo que permite reduzir a potência transmitida ao veio, quando a velocidade da roda de tracção difere do valor de referência da velocidade do veículo. Os conhecimentos adquiridos através do processo de investigação e desenvolvimento, para a realização da presente dissertação permitem apresentar perspectivas de desenvolvimento futuro com aplicação nos sistemas de tracção de veículos eléctricos rodoviários.

New Steel Alloys for the Design of Heat Recovery Steam Generator Components of Combined Cycle Gas Plants

Demand for power is growing every day, mainly due to emerging economies in countries such as China, Russia, India, and Brazil. During the last 50 years steam pressure and temperature in power plants have been continuously raised to improve thermal efficiency. Recent efforts to improve efficiency leads to the development of a new generation of heat recovery steam generator, where the Benson once-through technology is applied to improve the thermal efficiency. The main purpose of this paper is to analyze the mechanical behavior of a high pressure superheater manifold by applying finite element modeling and a finite element analysis with the objective of analyzing stress propagation, leading to the study of damage mechanism, e.g., uniaxial fatigue, uniaxial creep for life prediction. The objective of this paper is also to analyze the mechanical properties of the new high temperature resistant materials in the market such as 2Cr Bainitic steels (T/P23 and T/P24) and also the 9-12Cr Martensitic steels (T/P91, T/P92, E911, and P/T122). For this study the design rules for construction of power boilers to define the geometry of the HPSH manifold were applied.

Moodle and multiple-choice tests

Multiple-Choice items are used in many different kinds of tests in several areas of knowledge. They can be considered an interesting tool to the self-assessing or as an alternative or complementary instrument to the traditional methods for assessing knowledge. The objectivity and accuracy of the multiple-choice tests is an important reason to think about. They are especially useful when the number of students to evaluate is too large. Moodle (Modular Object-Oriented Dynamic Learning Environment) is an Open Source course management system centered around learners' needs and designed to support collaborative approaches to teaching and learning. Moodle offers to the users a rich interface, context-specific help buttons, and a wide variety of tools such as discussion forums, wikis, chat, surveys, quizzes, glossaries, journals, grade books and more, that allow them to learn and collaborate in a truly interactive space. Come together the interactivity of the Moodle platform and the objectivity of this kind of tests one can easily build manifold random tests. The proposal of this paper is to relate our journey in the construction of these tests and share our experience in the use of the Moodle platform to create, take advantage and improve the multiple-choices tests in the Mathematic area.

Multiple-choice tests: a tool in assessing knowledge

The purpose of this paper is to analyse if Multiple-Choice Tests may be considered an interesting alternative for assessing knowledge, particularly in the Mathematics area, as opposed to the traditional methods, such as open questions exams. In this sense we illustrate some opinions of the researchers in this area. Often the perception of the people about the construction of this kind of exams is that they are easy to create. But it is not true! Construct well written tests it’s a hard work and needs writing ability from the teachers. Our proposal is analyse the construction difficulties of multiple - choice tests as well some advantages and limitations of this type of tests. We also show the frequent critics and worries, since the beginning of this objective format usage. Finally in this context some examples of Multiple-Choice Items in the Mathematics area are given, and we illustrate as how we can take advantage and improve this kind of tests.

Capacidade de modificar parâmetros espaço-temporais do ciclo da marcha após modificação de componentes intrínsecas ao membro inferior em indivíduos com sequelas de acidente vascular encefálico - intervenção na reeducação da marcha em treadmill

Objectivo: A realização deste estudo tem como objectivo identificar a capacidade de modificação dos parâmetros do ciclo da marcha após intervenção a nível dos componentes do membro inferior e uma abordagem na reeducação da marcha no tapete rolante (treadmill). Métodos: Este estudo é um estudo de série de casos, constituído por três indivíduos com sequelas de Acidente Vascular Encefálico (AVE), com comprometimento a nível do membro inferior, capazes de realizar marcha. Os instrumentos de avaliação foram o teste de marcha de 10 metros (10-M), o teste de marcha de 6 minutos (6-Min) e o Time Up and Go (TUG). Os indivíduos receberam intervenção da fisioterapia baseada no conceito de Bobath e na reeducação de marcha no treadmill. Resultados: Após a intervenção verificou-se um aumento da velocidade e cadência da marcha, assim como uma maior tolerância e resistência na capacidade da sua realização. Conclusão: A intervenção realizada a nível dos componentes do membro inferior e na reeducação da marcha utilizando o treadmill permitiu modificar alguns parâmetros espaço-temporais do ciclo da marcha, aumentando a velocidade e cadência da marcha. A utilização conjunta de diferentes abordagens na intervenção ao indivíduo com sequelas de AVE deve ser sempre considerada uma vez que pode trazer benefícios na sua independência e qualidade de vida.

Influence of environmental temperature and humidity on the acute ventilatory response to exercise in asthmatic adolescents

Asthma is a chronic inflammatory disorder of the respiratory airways affecting people of all ages, and constitutes a serious public health problem worldwide (6). Such a chronic inflammation is invariably associated with injury and repair of the bronchial epithelium known as remodelling (11). Inflammation, remodelling, and altered neural control of the airways are responsible for both recurrent exacerbations of asthma and increasingly permanent airflow obstruction (11, 29, 34). Excessive airway narrowing is caused by altered smooth muscle behaviour, in close interaction with swelling of the airway walls, parenchyma retractile forces, and enhanced intraluminal secretions (29, 38). All these functional and structural changes are associated with the characteristic symptoms of asthma – cough, chest tightness, and wheezing –and have a significant impact on patients’ daily lives, on their families and also on society (1, 24, 29). Recent epidemiological studies show an increase in the prevalence of asthma, mainly in industrial countries (12, 25, 37). The reasons for this increase may depend on host factors (e.g., genetic disposition) or on environmental factors like air pollution or contact with allergens (6, 22, 29). Physical exercise is probably the most common trigger for brief episodes of symptoms, and is assumed to induce airflow limitations in most asthmatic children and young adults (16, 24, 29, 33). Exercise-induced asthma (EIA) is defined as an intermittent narrowing of the airways, generally associated with respiratory symptoms (chest tightness, cough, wheezing and dyspnoea), occurring after 3 to 10 minutes of vigorous exercise with a maximal severity during 5 to 15 minutes after the end of the exercise (9, 14, 16, 24, 33). The definitive diagnosis of EIA is confirmed by the measurement of pre- and post-exercise expiratory flows documenting either a 15% fall in the forced expiratory volume in 1 second (FEV1), or a ≥15 to 20% fall in peak expiratory flow (PEF) (9, 24, 29). Some types of physical exercise have been associated with the occurrence of bronchial symptoms and asthma (5, 15, 17). For instance, demanding activities such as basketball or soccer could cause more severe attacks than less vigorous ones such as baseball or jogging (33). The mechanisms of exercise-induced airflow limitations seem to be related to changes in the respiratory mucosa induced by hyperventilation (9, 29). The heat loss from the airways during exercise, and possibly its post-exercise rewarming may contribute to the exercise-induced bronchoconstriction (EIB) (27). Additionally, the concomitant dehydration from the respiratory mucosa during exercise leads to an increased interstitial osmolarity, which may also contribute to bronchoconstriction (4, 36). So, the risk of EIB in asthmatically predisposed subjects seems to be higher with greater ventilation rates and the cooler and drier the inspired air is (23). The incidence of EIA in physically demanding coldweather sports like competitive figure skating and ice hockey has been found to occur in up to 30 to 35% of the participants (32). In contrast, swimming is often recommended to asthmatic individuals, because it improves the functionality of respiratory muscles and, moreover, it seems to have a concomitant beneficial effect on the prevalence of asthma exacerbations (14, 26), supporting the idea that the risk of EIB would be smaller in warm and humid environments. This topic, however, remains controversial since the chlorified water of swimming pools has been suspected as a potential trigger factor for some asthmatic patients (7, 8, 20, 21). In fact, the higher asthma incidence observed in industrialised countries has recently been linked to the exposition to chloride (7, 8, 30). Although clinical and epidemiological data suggest an influence of humidity and temperature of the inspired air on the bronchial response of asthmatic subjects during exercise, some of those studies did not accurately control the intensity of the exercise (2, 13), raising speculation of whether the experienced exercise overload was comparable for all subjects. Additionally, most of the studies did not include a control group (2, 10, 19, 39), which may lead to doubts about whether asthma per se has conditioned the observed results. Moreover, since the main targeted age group of these studies has been adults (10, 19, 39), any extrapolation to childhood/adolescence might be questionable regarding the different lung maturation. Considering the higher incidence of asthma in youngsters (30) and the fact that only the works of Amirav and coworkers (2, 3) have focused on this age group, a scarcity of scientific data can be identified. Additionally, since the main environmental trigger factors, i.e., temperature and humidity, were tested separately (10, 28, 39) it would be useful to analyse these two variables simultaneously because of their synergic effect on water and heat loss by the airways (31, 33). It also appears important to estimate the airway responsiveness to exercise within moderate environmental ranges of temperature and humidity, trying to avoid extreme temperatures and humidity conditions used by others (2, 3). So, the aim of this study was to analyse the influence of moderate changes in air temperature and humidity simultaneously on the acute ventilatory response to exercise in asthmatic children. To overcome the above referred to methodological limitations, we used a 15 minute progressive exercise trial on a cycle ergometer at 3 different workload intensities, and we collected data related to heart rate, respiratory quotient, minute ventilation and oxygen uptake in order to ensure that physiological exercise repercussions were the same in both environments. The tests were done in a “normal” climatic environment (in a gymnasium) and in a hot and humid environment (swimming pool); for the latter, direct chloride exposition was avoided.

Avaliação da integridade estrutural de uma prótese cimentada por emissão acústica

Mestrado em Engenharia Electrotécnica e de Computadores

A incidência da avaliação sumativa externa (provas de aferição) nas práticas docentes do 1.º ciclo do Ensino Básico e nos projetos curriculares de turma

Dissertação de Mestrado, Educação (Desenvolvimento e Concepção de Projectos Educativos), 19 de Março de 2013, Universidade dos Açores.

Tubulin cofactor A gene silencing in mammalian cells induces changes in microtubule cytoskeleton, cell cycle arrest and cell death

Microtubules are polymers of alpha/beta-tubulin participating in essential cell functions. A multistep process involving distinct molecular chaperones and cofactors produces new tubulin heterodimers competent to polymerise. In vitro cofactor A (TBCA) interacts with beta-tubulin in a quasi-native state behaving as a molecular chaperone. We have used siRNA to silence TBCA expression in HeLa and MCF-7 mammalian cell lines. TBCA is essential for cell viability and its knockdown produces a decrease in the amount of soluble tubulin, modifications in microtubules and G1 cell cycle arrest. In MCF-7 cells, cell death was preceded by a change in cell shape resembling differentiation.

Efeitos de um programa de exercícios específico no domicílio, em indivíduos com doença arterial coronária, na composição corporal, gordura abdominal, perfil lipídico, glicose e nível de atividade física

contribuindo para o aumento da gordura abdominal, e consequentes complicações metabólicas. O exercício físico permite quebrar este ciclo através da estimulação da lipólise e da utilização de ácidos gordos. Objetivo: Verificar os efeitos de um programa de exercícios no domicílio, em indivíduos com doença arterial coronária, na composição corporal, gordura abdominal, perfil lipídico, glicose, e nível de atividade física. Métodos: Estudo experimental composto por 20 indivíduos, aleatorizados grupo experimental (GE) e grupo de controlo (GC), ambos com 10, tendo o GE sido sujeito ao programa durante 8 semanas. Realizou-se uma avaliação inicial e final, através da bioimpedância, Tomografia Computorizada (TC) abdominal, perimetria, adipometria, análises sanguíneas e acelerómetro. Resultados: Numa análise intergrupal, verificouse uma diminuição da percentagem (%) de gordura total (GT) calculado pela adipometria (p<0.01), na prega supra-ilíaca (p=0.005), na prega abdominal horizontal (p=0.001) e vertical (p=0.003) no GE, e da % de tempo em atividades moderadas no GC (p=0.035). Após 8 semanas o GE diminuiu a %GT (p=0.008); a massa gorda (MG) (p=0.002); perímetro abaixo da última costela (p=0.037) e acima das cristas-ilíacas (p=0.021); %GT calculado (p=0.002); pregas supra-ilíaca (p=0.008), abdominal horizontal (p=0.002) e vertical (p=0.033); TC abdominal subcutâneo (p=0.031) e %de tempo em atividades vigorosas (p=0.031). O GC diminuiu a %GT (p=0.002) e MG (p=0.008); aumentou o perímetro ao nível dos grandes trocânteres (p=0.008), diminuiu o rácio cintura/anca (p=0.002), e a %de tempo em atividades moderadas (p=0.031) e vigorosas (p=0.008). Parece existir uma tendência no GE para diminuição do rácio cintura/anca, c-LDL, triglicerídeos e aumento do nível de atividade moderado. Conclusão: O programa de exercícios no domicílio demonstrou uma diminuição da gordura abdominal, alteração da composição corporal, e parece promover uma melhoria no perfil lipídico e no aumento do nível de atividade física moderado.

Modèles animaux pour l’évaluation préclinique des dispositifs médicaux en radiologie interventionnelle au CR21 AP-HP INRA

Dissertação de Mestrado, Engenharia Zootécnica, 14 de Maio de 2015, Universidade dos Açores.