A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.

Tipologia, instalação, funcionamento e manutenção dos diversos tipos de aparelhos de apoio em obras de arte

Trabalho Final para a obtenção do grau de Mestre em Engenharia Civil

Projecto de execução de estruturas e fundações de uma obra de arte corrente em betão armado e pré-esforçado

Trabalho de Projecto para obtenção do grau de Mestre em Engenharia Civil.

Implementation of thr INSPIRE Directive on road infrastructure in Portugal

Prémio - CEN/TC 287 AWARD FOR EXCELLENCE IN INSIRE 2012 Implementation of the INSPIRE Directive on Road Infrastructure in Portugal Inês Soares, aluna de Mestrado em engenharia civil do ISEL, Instituto Superior de Engenharia de Lisboa e Paulo Martins, e o seu orientador, receberam um prémio europeu, no dia 27 de junho, em Istambul na Turquia, numa conferência internacional organizada pela Comissão Europeia e pelo governo Turco.  A jovem portuguesa foi escolhida entre cerca de 20 candidatos de vários países. Paulo Matos Martins, professor no ISEL, além de mentor do trabalho premiado, foi orientador de mestrado da aluna e explica que se trata de um estudo sobre a aplicação da Diretiva comunitária INSPIRE à infraestrutura rodoviária nacional que contou com a estreita colaboração do InIR, Instituto da Infraestrutura Rodoviária através da coorientação da engenheira Adelaide Costa e colaboração técnica do engenheiro Rui Luso Soares.  O projeto-piloto correspondeu à criação de uma aplicação informática que permite aceder a informação geográfica harmonizada relativa à infraestrutura rodoviária nacional, de acordo com as disposições de execução INSPIRE, dando cumprimento aos requisitos impostos pela Diretiva às entidades responsáveis por este tipo de informação, entre as quais se incluem diversos organismos públicos (podendo no futuro vir a incluir as autarquias), permitindo aos decisores políticos e a todos os cidadãos o fácil acesso a informação de qualidade sobre as infraestruturas, o território e o ambiente. 

Gestão da segurança e saúde no trabalho em trabalhos de beneficiação rodoviária: perfil de autoestrada e a aplicação dos princípios gerais da prevenção à fase de execução da obra

Mestrado em Segurança e Higiene no Trabalho

Is ambient intelligence a truly human-centric paradigm in industry? Current research and application scenario

Based on the paper presented at the International Conference “Autonomous Systems: inter-relations of technical and societal issues”, organized by IET with the support of the Portuguese-German collaboration project on “Technology Assessment of Autonomous Robotics” (DAAD/CRUP) at FCT-UNL, Biblioteca da UNL, Campus de Caparica on 5-6 November 2009.

Fire safety barrier availability analysis

This paper shows several ways to analyse the performance of a safety barrier, depending on the objective to be achieved and present a method to analyse binary components usually present on sensor systems of safety barriers. An application example of a water-based fire system is presented and the Probability of Failure on Demand (PFD) of the sensor system is determined based on the analysis of pressure switches installed in this safety barrier. The knowledge of such information will allow the determination of safety barrier’s availability.

Safety climate and its relationship with furniture companies’ safety performance and workers’ risk acceptance

This study aims to analyse the relationship between safety climate and the level of risk acceptance, as well as its relationship with workplace safety performance. The sample includes 14 companies and 403 workers. The safety climate assessment was performed by the application of a Safety Climate in Wood Industries questionnaire and safety performance was assessed with a checklist. Judgements about risk acceptance were measured through questionnaires together with four other variables: trust, risk perception, benefit perception and emotion. Safety climate was found to be correlated with workgroup safety performance, and it also plays an important role in workers’ risk acceptance levels. Risk acceptance tends to be lower when safety climate scores of workgroups are high, and subsequently, their safety performance is better. These findings seem to be relevant, as they provide Occupational, Safety and Health practitioners with a better understanding of workers’ risk acceptance levels and of the differences among workgroups.

Proposal of abolition of the skin sensitivity test before equine rabies immune globulin application

An epizootic outbreak of rabies occurred in 1995 in Ribeirão Preto, SP, with 58 cases of animal rabies (54 dogs, 3 cats and 1 bat) confirmed by the Pasteur Institute of São Paulo, and one human death. The need to provide care to a large number of people for the application of equine rabies immune globulin (ERIG) prevented the execution of the skin sensitivity test (SST) and often also the execution of desensitization, procedures routinely used up to that time at the Emergency Unit of the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (EU-UHFMRP-USP), a reference hospital for the application of heterologous sera. In view of our positive experience of several years with the abolition of SST and of the use of premedication before the application of antivenom sera, we used a similar schedule for ERIG application. Of the 1489 victims of animal bites, 1054 (71%) received ERIG; no patient was submitted to SST and all received intravenously anti-histamines (anti-H1 + anti-H2) and corticosteroids before the procedure. The patients were kept under observation for 60 to 180 minutes and no adverse reaction was observed. On the basis of these results, since December 1995 ERIG application has been decentralized in Ribeirão Preto and has become the responsibility of the Emergency Unit of the University Hospital and the Central Basic Health Unit, where the same routine is used. Since then, 4216 patients have received ERIG (1818 at the Basic Health Unit and 2398 at the EU-UHFMRP), with no problems. The ideal would be the routine use of human rabies immune globulin (HRIG) in public health programs, but this is problematic, because of their high cost. However, while this does not occur, the use of SST is no longer justified at the time of application of ERIG, in view of the clinical evidence of low predictive value and low sensitivity of SST involving the application of heterologous sera. It is very important to point out that a negative SST result may lead the health team to a feeling of false safety that no adverse reaction will occur, but this is not true for the anaphylactoid reactions. The decision to use premedication, which is based on knowledge about anaphylaxis and on the pharmacology of the medication used, is left to the judgment of health professionals, who should always be prepared for eventual untoward events.

Application of Visual-Inertial SLAM for 3D Mapping of Underground Environments

The underground scenarios are one of the most challenging environments for accurate and precise 3d mapping where hostile conditions like absence of Global Positioning Systems, extreme lighting variations and geometrically smooth surfaces may be expected. So far, the state-of-the-art methods in underground modelling remain restricted to environments in which pronounced geometric features are abundant. This limitation is a consequence of the scan matching algorithms used to solve the localization and registration problems. This paper contributes to the expansion of the modelling capabilities to structures characterized by uniform geometry and smooth surfaces, as is the case of road and train tunnels. To achieve that, we combine some state of the art techniques from mobile robotics, and propose a method for 6DOF platform positioning in such scenarios, that is latter used for the environment modelling. A visual monocular Simultaneous Localization and Mapping (MonoSLAM) approach based on the Extended Kalman Filter (EKF), complemented by the introduction of inertial measurements in the prediction step, allows our system to localize himself over long distances, using exclusively sensors carried on board a mobile platform. By feeding the Extended Kalman Filter with inertial data we were able to overcome the major problem related with MonoSLAM implementations, known as scale factor ambiguity. Despite extreme lighting variations, reliable visual features were extracted through the SIFT algorithm, and inserted directly in the EKF mechanism according to the Inverse Depth Parametrization. Through the 1-Point RANSAC (Random Sample Consensus) wrong frame-to-frame feature matches were rejected. The developed method was tested based on a dataset acquired inside a road tunnel and the navigation results compared with a ground truth obtained by post-processing a high grade Inertial Navigation System and L1/L2 RTK-GPS measurements acquired outside the tunnel. Results from the localization strategy are presented and analyzed.

A New Electronic Approach for the Surgical Safety Checklist

To improve surgical safety, and to reduce the mortality and surgical complications incidence, the World Health Organization (WHO) developed the Surgical Safety Checklist (SSC). The SSC is a support of information that aids health professionals to reduce the number of complications, induction of anaesthesia, period before skin incision and period before leaving the operating room (OR). The SSC was tested in several countries of the world and their results shown that after introduction of the SSC the incidence of patient complication lowered from 11.0% to 7.0% (P<0.001), the rate of death declined from 1.5% to 0.8% (P = 0.003) and the nurses recognized that patients identity was more often con rmed (81.6% to 94.2%, P<0.01) in many institutions. Recently the SSC was also implemented in Portuguese hospitals, which led us to its study in the real clinical environment. An observational study was performed: several health professionals were observed and interviewed, to understand the functioning of the SSC in an OR, during the clinical routine. The objective of this study was to understand the current use of the SSC, and how it may be improved in terms of usability, taking advantage of the technological advancements such as mobile applications. During two days were observed 14 surgeries, only 2 surgeries met the requirements for the three phases of the SSC, as de ned by the WHO. Of the remaining 12 observed surgeries, 9 surgeries completed the last phase at the correct time. It was also observed that only in 2 surgeries all the phases of the SSC were read aloud to the team and that, in 7 surgeries, several items were read aloud and answered but no one was checking the SSC, only after the end of the phase. The observational study results disclose that several health professionals do not meet with rules of the WHO manual. This study demonstrates that it is urgent to change the mindset of health professionals, and that di erent features in the SSC may be useful to make it more easy to use. With the results of the observational study, a SSC application proposal was developed with new functionalities to improve and aid the health professional in its use. In this application the user can chose between a SSC already created to a speci c surgery or to create a new SSC, adding and adapting some questions from the WHO standard. To create a new SSC, the application is connected to an online questionnaire builder (JotForm). The choice for this online questionnaire builder went through three essential characteristics: number of types of questions, mainly checkbox, radio button and text; the possibility of to create sections inside sections and the API. In addition, in this proposal the improvements are focused in forcing the user to focus in the work ow of the SSC and to save the input timestamps and any actions made by them. Therefore, the following features was implemented to achieve that goal: display one item of the SSC at a time; display the stage where the SSC is; do not allow going back to the previous step; do not allow going forward to the next item if the current is not lled; do not allow going forward to the next item if the time it took to ll the item was too short and log any action made by the user.

Safety evaluation of SPF66 malaria vaccine in Brazil

The frequency and description of side effects secondaiy to the subcutaneous application of SPf66 malaria vaccine and placebo are reported for each dose of application in the participants of the vaccine efficacy trial in Brazil. Side effects evaluated two hours after each application were detected in 8.0%, 30.2% and 8.8%, for the Is', and 3"' dose, respectively, in the SPf66group, and in 7.0%, 8.5% and 2.9% in the placebo group. Local reactions such as mild inflammation, nodule and pain or erythema frequently accompanied by pruritus were the most common reactions detected in both groups (3-8%, 29.1% and 8.5% in the SPf66 group and 4.0%, 7.6% and 2.5% in the placebo group). Among vaccinees, local side effects after the 2nd dose were more frequent in females. Systemic side effects were expressed mainly through general symptoms referred by the participants and were most frequent after the 1st dose in both groups (4.3% in the SPf66 group and 3-0% in the placebo group). Muscle aches and fever were refewred by few participants. No severe adverse reactions were detected for either dose of application or group.

An investigation of safety design practices of metal machines

BACKGROUND: Machinery safety issues are a challenge facing manufacturers who are supposed to create and provide products in a better and faster way. In spite of their construction and technological advance, they still contribute to many potential hazards for operators and those nearby. OBJECTIVE: The aim of this study is to investigate safety aspects of metal machinery offered for sale on Internet market according to compliance with minimum and fundamental requirements. METHODS: The study was carried out with the application of a checklist prepared on the basis of Directive 2006/42/EC and Directive 2009/104/EC and regulations enforcing them into Polish law. RESULTS: On the basis of the study it was possible to reveal the safety aspects that were not met in practice. It appeared that in the case of minimum requirements the most relevant problems concerned information, signal and control elements, technology and machinery operations, whereas as far as fundamental aspects are concerned it was hard to assure safe work process. CONCLUSIONS: In spite of the fact that more and more legal acts binding in the Member Countries of the European Union are being introduced to alleviate the phenomenon, these regulations are often not fulfilled.

Economic evaluation of occupational safety preventive measures in a hospital

BACKGROUND: When an organization performs an integrated analysis of risks through its Occupational Health and Safety Management System, several steps are suggested to address the implications of the identified risks. Namely, the organization should make a detailed analysis of the monetary impact for the organization of each of the preventive measures considered. However, it is also important to perform an analysis of the impact of each measure on society (externalities). OBJECTIVE: The aim of this paper is to present a case study related to the application of the proposed economic evaluation methodology. METHODS: An analysis of the work accidents in a hospital has been made. Three of the major types of accidents have been selected: needle stings, falls and excessive strain. Following the risk assessment, some preventive measures have been designed. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organization’s perspective) and in economic terms (including the benefits for the worker and for the Society). RESULTS: While the financial ratio is only advantageous in some cases, when the externalities are taken into account, the B/C ratio increases significantly. CONCLUSIONS: It is important to consider external

Environment, health and safety policy in small construction sites: an analysis of the situation in Brazil

This paper analyzes the safety, environmental and occupational health of workers in the small construction industry in Brazil. In this sector there are still many unsafe practices, which are very common in small work sites. We used a qualitative approach to understand these problems by long interviews with people who work directly in small construction sites, including occupational physicians, civil engineers, safety engineers, safety technicians, general foremen, construction workers, labor unionists and auditors. This paper aims to demonstrate that the "invisibility" of the small sites workers makes them less safe and therefore more prone to accidents, also weakening their health. The results show that small constructions workers are less visible to society and supervision because of their short periods of work. Therefore, they are also uncovered to the rigorous applicability of principles of safety and accident prevention. Thus, it has been seen in this field of work a precarious application of NR - 18, which was specifically made for the construction sites and it needs simplification to meet normative characteristics of small construction sites. In the State of Rio de Janeiro, some laws on small sites were recently created and implemented. This study concludes that the rules to work are not being taken as seriously as the legislation determinates, remaining practically unknown by many professionals, from the plot command, supervisors, engineers, architects and technicians who work on construction sites. This ignorance creates space for the lack of safety and consequently to accidents, leading to by weakness in the workers health. Therefore, the work process needs to be modified, the safety regulation must be disseminated through safer practices, promoting employee health and ensure that the work of small sites can be visible, especially ensuring the construction workers health and safety.