Water treatments in semi-closed cooling circuits and their impact on the quality of effluents discharged by CERN

Mestrado integrado em Engenharia do Ambiente, perfil: Gestão de Sistemas Ambientais

Impact of ultra-processed foods on micronutrient content in the Brazilian diet

OBJECTIVE To evaluate the impact of consuming ultra-processed foods on the micronutrient content of the Brazilian population’s diet.METHODS This cross-sectional study was performed using data on individual food consumption from a module of the 2008-2009 Brazilian Household Budget Survey. A representative sample of the Brazilian population aged 10 years or over was assessed (n = 32,898). Food consumption data were collected through two 24-hour food records. Linear regression models were used to assess the association between the nutrient content of the diet and the quintiles of ultra-processed food consumption – crude and adjusted for family incomeper capita.RESULTS Mean daily energy intake per capita was 1,866 kcal, with 69.5% coming from natural or minimally processed foods, 9.0% from processed foods and 21.5% from ultra-processed foods. For sixteen out of the seventeen evaluated micronutrients, their content was lower in the fraction of the diet composed of ultra-processed foods compared with the fraction of the diet composed of natural or minimally processed foods. The content of 10 micronutrients in ultra-processed foods did not reach half the content level observed in the natural or minimally processed foods. The higher consumption of ultra-processed foods was inversely and significantly associated with the content of vitamins B12, vitamin D, vitamin E, niacin, pyridoxine, copper, iron, phosphorus, magnesium, selenium and zinc. The reverse situation was only observed for calcium, thiamin and riboflavin.CONCLUSIONS The findings of this study highlight that reducing the consumption of ultra-processed foods is a natural way to promote healthy eating in Brazil and, therefore, is in line with the recommendations made by the Guia Alimentar para a População Brasileira (Dietary Guidelines for the Brazilian Population) to avoid these foods.

Impact of long-stay beds on the performance of a tertiary hospital in emergencies

ABSTRACT OBJECTIVE To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index – 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) – the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors.

Budget impact from the incorporation of positron emission tomography – computed tomography for staging lung cancers

OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.RESULTS The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively.CONCLUSIONS The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

Methods and challenges for the health impact assessment of vaccination programs in Latin America

ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

The impact of Sinogram-Affirmed Iterative Reconstruction on patient dose and image quality compared to filtered back projection: a narrative review

Objective: Summarize all relevant findings in published literature regarding the potential dose reduction related to image quality using Sinogram-Affirmed Iterative Reconstruction (SAFIRE) compared to Filtered Back Projection (FBP). Background: Computed Tomography (CT) is one of the most used radiographic modalities in clinical practice providing high spatial and contrast resolution. However it also delivers a relatively high radiation dose to the patient. Reconstructing raw-data using Iterative Reconstruction (IR) algorithms has the potential to iteratively reduce image noise while maintaining or improving image quality of low dose standard FBP reconstructions. Nevertheless, long reconstruction times made IR unpractical for clinical use until recently. Siemens Medical developed a new IR algorithm called SAFIRE, which uses up to 5 different strength levels, and poses an alternative to the conventional IR with a significant reconstruction time reduction. Methods: MEDLINE, ScienceDirect and CINAHL databases were used for gathering literature. Eleven articles were included in this review (from 2012 to July 2014). Discussion: This narrative review summarizes the results of eleven articles (using studies on both patients and phantoms) and describes SAFIRE strengths for noise reduction in low dose acquisitions while providing acceptable image quality. Conclusion: Even though the results differ slightly, the literature gathered for this review suggests that the dose in current CT protocols can be reduced at least 50% while maintaining or improving image quality. There is however a lack of literature concerning paediatric population (with increased radiation sensitivity). Further studies should also assess the impact of SAFIRE on diagnostic accuracy.

Impact of different moodle course designs on students? Performance

This work describes the impact of different teachers’ approaches in using Moodle, for supporting their courses, at the Polytechnic of Porto - School of Engineering. The study covers five different courses, from different degrees and different years, and includes a number of Moodle resources especially supporting laboratory classes. These and other active resources are particularly analyzed in order to evaluate students’ adherence to them. One particular course includes a number of remote experiments, made available through VISIR (Virtual Instrument Systems in Reality) and directly accessible through links included in the Moodle course page. The collected data have been correlated with students’ classifications in the lab component and in the exam, each one weighting 50% of their final marks. This analysis benefited from the existence of different teachers’ approaches, which resulted in a diversity of Moodle-supported environments. Conclusions point to the existence of a positive correlation factor between the number of Moodle accesses and the final exam grade, although the quality of the resources made available by the teachers seems to be preponderant over its quantity. In addition, different students perspectives were found regarding active resources: while some seem to encourage students to participate (for instance online quiz or online reports), others, more demanding, are unable to stimulate the majority of them.

Addressing software impact in the design of remote laboratories

Remote Laboratories or WebLabs constitute a first-order didactic resource in engineering faculties. However, in many cases, they lack a proper software design, both in the client and server side, which degrades their quality and academic usefulness. This paper presents the main characteristics of a Remote Laboratory, analyzes the software technologies to implement the client and server sides in a WebLab, and correlates these technologies with the characteristics to facilitate the selection of a technology to implement a WebLab. The results obtained suggest the adoption of a Service Oriented Laboratory Architecture-based approach for the design of future Remote Laboratories so that client-agnostic Remote Laboratories and Remote Laboratory composition are enabled. The experience with the real Remote Laboratory, WebLab-Deusto, is also presented.

The influence of the boundary conditions on low-velocity impact composite damage

The objective of this work was to study the influence of the boundary conditions on low-velocity impact behaviour of carbon-epoxy composite plates. Experimental work and numerical analysis were performed on [04,904]s laminates. The influence of different boundary conditions on the impacted plates was analysed considering rectangular and square plates. The X-radiography was used as a non-destructive technique to evaluate the internal damage caused by impact loading. A three-dimensional numerical analysis was also performed considering progressive damage modelling. The model includes three-dimensional solid elements and interface finite elements including a cohesive mixed-mode damage model, which allows simulating delamination between different oriented layers. It was verified that plate’s boundary conditions have influence on the delaminated area. Good agreement between experimental and numerical analysis for shape, orientation and size of the delamination was obtained.

Avaliação de riscos ambientais e profissionais na indústria metalomecânica

A preservação e proteção do ambiente são, cada vez mais, de elevada importância. Para fazer face ao grande consumo de bens, que se verifica nos dias de hoje, a atividade industrial tem aumentado, assim como os resíduos, as emissões, os efluentes e ainda os resíduos de produtos em fim de vida, provocando impactes no meio ambiente, com alterações significativas que se manifestam a nível das condições climáticas e, consequentemente, afetam a qualidade de vida das pessoas a sua segurança e saúde, bem como a fauna e a flora. O presente estudo tem por objetivo identificar as principais atividades desenvolvidas na indústria metalomecânica, identificar os principais aspetos e impactes ambientais, bem como os perigos e riscos profissionais associados às atividades deste setor, identificar a principal legislação em vigor em matéria ambiental e de segurança e saúde no trabalho, selecionar e analisar metodologias de avaliação de riscos ambientais e profissionais e aplicar estas metodologias num estudo de caso numa empresa metalomecânica, tendo em vista comparar os resultados das avaliações, por duas metodologias diferentes, dos riscos ambientais e profissionais e daí tirar conclusões. A vantagem da aplicação de duas metodologias diferentes na avaliação de riscos ambientais e profissionais é a de poder aferir se os resultados são idênticos independentemente da metodologia utilizada. Após a aplicação das duas metodologias, com critérios de avaliação diferentes, selecionadas para avaliação dos riscos ambientais, concluiu-se que as metodologias apresentam resultados semelhantes, o mesmo aconteceu com as duas metodologias, com critérios de avaliação, também, diferentes, selecionadas para avaliação dos riscos profissionais em que as duas metodologias apresentaram os mesmos resultados.

Land use/ land cover change and its impact on soil erosion process in Begnas Tal Rupa Tal watershed using geospatial tools, Kaski district, Nepal

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Human and climatic change impact modelling on the habitat suitability for the chimpanzee (Pan troglodytes ellioti) – Case study: The proposed Mount Cameroon National Park

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

How remote labs impact on course outcomes: various practices using VISIR

As technology is increasingly being seen as a facilitator to learning, open remote laboratories are increasingly available and in widespread use around the world. They provide some advantages over traditional hands-on labs or simulations. This paper presents the results of integrating the open remote laboratory VISIR into several courses, in various contexts and using various methodologies. These integrations, all related to higher education engineering, were designed by teachers with different perspectives to achieve a range of learning outcomes. The degree to which these VISIR-related outcomes were accomplished is discussed. The results reflect the levels of student engagement and learning and of teacher involvement. From the analysis, a connection between these two aspects was traced, although only related to the user profiles. VISIR is shown to be always of benefit for more motivated students, but this benefit can be maximized under particular conditions and characteristics.

The impact of national cultures on international marketing strategy and subsidiary performance of portuguese SME’s

The dynamic of the international business and its multidimensional nature requires the understanding of the complexities of different contexts dictated by cultural differences between countries. The purpose of this paper is to study, in depth howsmall and medium-sized companies develop their international marketing mix strategy in their overseas subsidiaries. We use the theoretical construct of Hofstede (1980, 1991) in the dimensions of Power Distance (PD), Uncertainty Avoidance (UA), Individualism (IND), Masculinity (MASC) and Long-Term Orientation (LTO) to assess the cross cultural differences between countries and the business practices to analyze the adaptation or standardization of the international marketing mix strategy of foreign Portuguese subsidiaries. Ourstudy uses an exploratoryand qualitative methodology. We conducted semi-structured interviews in order to achieve a good understanding ofinternational marketing mix strategy of four companies from different sectors. Our results show that the national cultural differences have great influence in the marketing strategy of the subsidiary. The business practices adjustments in the subsidiary company that proved to be necessary conditions for their performance are conducted by the products augmented offerings concerning the characteristics of the product, design and brand name in order to meet the requirements and specificities of the host country of the subsidiary.

Insignificant impact of prescribed fire on surface soil in a Pinus pinaster plantation, northern Portugal

Following a prescribed fire in a Pinus pinaster forest site located in the north-west Portugal, monitoring of any changes in selected soil characteristics and soil hydrology was undertaken to assess the effects of burning on the following: pH, electrical conductivity, water content, organic carbon and porosity. Thirty plots were established on a regular grid. At each sample plot before and after the fire, samples were collected (disturbed samples from depths of 0-1cm and 1-5cm; undisturbed core samples from 0-5cm). The results indicate that there was no measurable impact on the properties of the soil following this carefully conducted prescribed fire. The fire only affected the litter layer, as intended. Confirmation of this minimal impact on the soil was provided by regrowth of grasses and herbs already occurring two months after the fire. The implication is, therefore, that provided this wildfire-risk reduction strategy is carried out under existing strict guidelines, any impact on soil quality will be minimal.