Impacto na epidemiologia da sepse tardia após a mudança do protocolo de antimicrobianos em uma UTIN de um serviço universitário

Advances in neonatology resulted in reducing the mortality rate and the consequent increase in survival of newborn pre terms (PTN). On the other hand, there was also a considerable increase in the risk of developing health care-related infection (HAI) in its most invasive, especially for bloodstream. This situation is worrying, and prevent the occurrence of it is a challenge and becomes one of the priorities in the Neonatal Intensive Care Unit (NICU). Sepsis is the main cause of death in critical neonates and affects more than one million newborns each year, representing 40% of all deaths in neonates. The incidence of late sepsis can reach 50% in NICUs. Currently the major responsible for the occurrence of sepsis in developed countries is the coagulase negative Staphylococcus (CoNS), followed by S. aureus. The cases of HAIs caused by resistant isolates for major classes of antimicrobial agents have been increasingly frequent in the NICU. Therefore, vancomycin has to be prescribed more frequently, and, today, the first option in the treatment of bloodstream infections by resistant Staphylococcus. The objectives of this study were to assess the impact on late sepsis in epidemiology III NICU after the change of the use of antimicrobials protocol; check the frequency of multiresistant microorganisms; assess the number of neonates who came to death. This study was conducted in NICU Level III HC-UFU. three study groups were formed based on the use of the proposed late sepsis treatment protocol, with 216 belonging to the period A, 207 B and 209 to the C. The work was divided into three stages: Period A: data collected from neonates admitted to the unit between September 2010 to August 2011. was using treatment of late sepsis: with oxacillin and gentamicin, oxacillin and amikacin, oxacillin and cefotaxime. Period B: data were collected from March 2012 to February 2013. Data collection was started six months after protocol change. Due to the higher prevalence of CoNS, the initial protocol was changed to vancomycin and cefotaxime. Period C: data were collected from newborns inteerne in the unit from September 2013 to August 2014. Data collection was started six months after the protocol change, which occurred in March 2013. From the 632 neonates included in this study, 511 (80,8%) came from the gynecology and obstetrics department of the HC-UFU. The mean gestational age was 33 weeks and the prevailing sex was male (55,7%). Seventy-nine percent of the studied neonates were hospitalized at the NICU HC-UFU III because of complications related to the respiratory system. Suspicion of sepsis took to hospitalization in the unit of 1,9% of newborns. In general, the infection rate was 34,5%, and the most frequent infectious sepsis syndrome 81,2%. There was a tendency to reduce the number of neonates who died between periods A 11 and C (p = 0,053). From the 176 cases of late sepsis, 73 were clinical sepsis and 103 had laboratory confirmation, with greater representation of Gram positive bacteria, which corresponded to 67.2% of the isolates and CoNS the most frequent micro-organism (91,5%). There was a statistically significant difference in the reduction of isolation of Gram positive microorganisms between periods A and C (p = 0,0365) as well as in reducing multidrug-resistant CoNS (A and B period p = 0,0462 and A and C period, p = 0,158). This study concluded that: the CoNS was the main microorganism responsible for the occurrence of late sepsis in neonates in the NICU of HC-UFU; the main risk factors for the occurrence of late sepsis were: birth weight <1500 g, use of PICC and CUV, need for mechanical ventilation and parenteral nutrition, SNAPPE> 24 and length of stay more than seven days; the new empirical treatment protocol late sepsis, based on the use of vancomycin associated cefepime, it was effective, since promoted a reduction in insulation CoNS blood cultures between the pre and post implementation of the Protocol (A and C, respectively); just as there was a reduction in the number of newborns who evolved to death between periods A and C.

Holocene experiment with coupled atmosphere-ocean-model ECHAM5/MPI-OM

Changes in the Earth's orbit lead to changes in the seasonal and meridional distribution of insolation. We quantify the influence of orbitally induced changes on the seasonal temperature cycle in a transient simulation of the last 6000 years - from the mid-Holocene to today - using a coupled atmosphere-ocean general circulation model (ECHAM5/MPI-OM) including a land surface model (JSBACH). The seasonal temperature cycle responds directly to the insolation changes almost everywhere. In the Northern Hemisphere, its amplitude decreases according to an increase in winter insolation and a decrease in summer insolation. In the Southern Hemisphere, the opposite is true. Over the Arctic Ocean, decreasing summer insolation leads to an increase in sea-ice cover. The insulating effect of sea ice between the ocean and the atmosphere leads to decreasing heat flux and favors more "continental" conditions over the Arctic Ocean in winter, resulting in strongly decreasing temperatures. Consequently, there are two competing effects: the direct response to insolation changes and a sea-ice insulation effect. The sea-ice insulation effect is stronger, and thus an increase in the amplitude of the seasonal temperature cycle over the Arctic Ocean occurs. This increase is strongest over the Barents Shelf and influences the temperature response over northern Europe. We compare our modeled seasonal temperatures over Europe to paleo reconstructions. We find better agreements in winter temperatures than in summer temperatures and better agreements in northern Europe than in southern Europe, since the model does not reproduce the southern European Holocene summer cooling inferred from the paleo reconstructions. The temperature reconstructions for northern Europe support the notion of the influence of the sea-ice insulation effect on the evolution of the seasonal temperature cycle.

Development of sustainable, innovative and energy-efficient concrete, based on the integration of all-waste materials: SUS-CON panels for building applications

The building sector requires the worldwide production of 4 billion tonnes of cement annually, consuming more than 40% of global energy and accounting for about 8% of the total CO2 emissions. The SUS-CON project aimed at integrating waste materials in the production cycle of concrete, for both ready-mixed and pre-cast applications, resulting in an innovative light-weight, ecocompatible and cost-effective construction material, made by all-waste materials and characterized by enhanced thermal insulation performance and low embodied energy and CO2. Alkali activated “cementless” binders, which have recently emerged as eco-friendly construction materials, were used in conjunction with lightweight recycled aggregates to produce sustainable concrete for a range of applications. This paper presents some results from the development of a concrete made with a geopolymeric binder (alkali activated fly ash) and aggregate from recycled mixed plastic. Mix optimisation was achieved through an extensive investigation on production parameters for binder and aggregate. The mix recipe was developed for achieving the required fresh and hardened properties. The optimised mix gave compressive strength of about 7 MPa, flexural strength of about 1.3 MPa and a thermal conductivity of 0.34 W/mK. Fresh and hardened properties were deemed suitable for the industrial production of precast products. Precast panels were designed and produced for the construction of demonstration buildings. Mock-ups of about 2.5 x 2.5 x 2.5 m were built at a demo park in Spain both with SUS-CON and Portland cement concrete, monitoring internal and external temperatures. Field results indicate that the SUS-CON mock-ups have better insulation. During the warmest period of the day, the measured temperature in the SUS-CON mock-ups was lower.

Review and analysis of solar thermal facades

Harnessing solar energy to provide for the thermal needs of buildings is one of the most promising solutions to the global energy issue. Exploiting the additional surface area provided by the building’s façade can significantly increase the solar energy output. Developing a range of integrated and adaptable products that do not significantly affect the building’s aesthetics is vital to enabling the building integrated solar thermal market to expand and prosper. This work reviews and evaluates solar thermal facades in terms of the standard collector type, which they are based on, and their component make-up. Daily efficiency models are presented, based on a combination of the Hottel Whillier Bliss model and finite element simulation. Novel and market available solar thermal systems are also reviewed and evaluated using standard evaluation methods, based on experimentally determined parameters ISO 9806. Solar thermal collectors integrated directly into the facade benefit from the additional wall insulation at the back; displaying higher efficiencies then an identical collector offset from the facade. Unglazed solar thermal facades with high capacitance absorbers (e.g. concrete) experience a shift in peak maximum energy yield and display a lower sensitivity to ambient conditions than the traditional metallic based unglazed collectors. Glazed solar thermal facades, used for high temperature applications (domestic hot water), result in overheating of the building’s interior which can be reduced significantly through the inclusion of high quality wall insulation. For low temperature applications (preheating systems), the cheaper unglazed systems offer the most economic solution. The inclusion of brighter colour for the glazing and darker colour for the absorber shows the lowest efficiency reductions (<4%). Novel solar thermal façade solutions include solar collectors integrated into balcony rails, shading devices, louvers, windows or gutters.

Thermobonded Fabrics

In 2009 Avella created a series of innovative fabrics for the Yves St Laurent (YSL) collection, deploying techniques from vehicle engineering to generate new materials for a range of garments. Studying the bonding of layers of material in ceramic plate thermobonding technology, Avella conducted a series of experiments with textiles such as flannel, silk and synthetics, and material such as leather, layered with polyamide foam and textile substrate to create new, textured and insulating fabrics with beautiful surfaces and interesting forms. The lightweight properties of the foam enabled the maximum insulation/weight ratio, and the panel moulding technology brought new forms of draping prêt-a-porter fashion design. Exclusive to YSL, this technique was patented and then shown at the Premiere Vision textiles trade fair in 2010. Much documented in specialist journals this innovation also breached the trade-culture barrier and was reported and documented in mainstream newspapers (New York Herald Tribune). Avella’s background in textile workshop studio experimentation at the RCA brought to YSL textiles research for manufacture, the innovative collaboration between fashion couture and engineering laboratory experiments from vehicle design.

Otimização do comportamento térmico de edifícios do tipo LSF

No panorama energético atual, medidas de desenvolvimento sustentável têm uma preponderância cada vez mais significativa e, sendo os edifícios responsáveis por 40% da energia consumida na EU, enquadra-se o desafio de integrar medidas de eficiência energética nos novos edifícios desde a fase de conceção. Sendo que este setor se encontra em contínua expansão, a redução dos consumos passará largamente pela otimização do comportamento térmico dos edifícios e dos sistemas energéticos que os equipam. No presente trabalho estudou-se o papel da inércia térmica na redução das necessidades de energia para climatização de edifícios com o objetivo de identificar estratégias destinadas ao melhoramento do comportamento térmico e desempenho energético de edifícios construídos com recurso à técnica construtiva LSF, caracterizados por uma fraca inércia térmica quando comparados com edifícios em tudo semelhantes mas construídos recorrendo a tecnologias convencionais sem esquecer as questões relacionadas com a respetiva viabilidade económica. Com resultado geral destaca-se desde logo a importância do local onde é mais benéfico adicionar massa térmica (paredes exteriores, cobertura, paredes interiores), assim como a necessidade de utilização de um material com elevada densidade energética e baixo custo. A análise comparativa dos diferentes modelos de edifício simulados com recurso ao software DesignBuilder/EnergyPlus, foi realizada recorrendo a uma metodologia em que cada modelo construtivo é avaliado considerando quatro níveis de isolamento térmico e duas condições de cargas térmicas internas. A análise energética e económica foi realizada tendo como referência um período de 20 anos. O custo das soluções construtivas foi maioritariamente obtido através da ferramenta computacional Gerador de Preços, da Cype, SA©, tendo-se considerado um consumo energético anual constante e igual às necessidades de climatização anuais, assim como taxas de atualização de capital e de inflação do custo da energia constantes. De uma forma geral conclui-se que edifícios do tipo LSF melhorados através da adição criteriosa de massa térmica em determinados elementos construtivos, apresentam necessidades de climatização anuais na maioria dos casos estudados, inferiores àquelas verificadas em edifícios convencionais com inércia térmica média/forte. Conclui-se, também, que o método construtivo LSF se apresenta mais eficaz em termos energéticos e económicos quando comparado com soluções semelhantes construídas com recurso a um método convencional. Na secção seguinte são identificadas as principais conclusões deste trabalho.

Desempenho térmico de coberturas: Um estudo comparativo entre as telhas de material reciclado, de fibra e betume, fibrocimento e cerâmica

This study aims to compare the thermal performance of tiles made from recycled material (waste packaging cardboard with aluminized film) with the tiles of fiber and bitumen, fiber cement and red ceramic with the aim of verifying the suitability of tile to be used in hot and humid climate of low latitude. The samples were selected according to the availability from Natal - RN market, as they are sold to the consumers. The methodology was based on studies that used experimental apparatus composed of thermal chambers heated by banks of incandescent bulbs, to analyze the thermal performance of materials. The tiles in the study were submitted to analysis of thermal performance, thermophysical properties and absorptance, using chambers of thermal performance, measuring the thermophysical properties and portable spectrometer, respectively. Comparative analysis of thermal performance between two samples of the recycled material with dimple sizes and different amounts of aluminum were made, in order to verify, if these characteristics had some interference on the thermal performance of them; the results showed no significant performance differences between the samples. The data obtained in chambers of thermal performance and confirmed by statistical analysis, showed, that the tile of recycled material have similar thermal performance to the tile of fiber cement. In addition to these tests was carried out the automatic monitoring of a building covered with tiles of recycled material, to verify its thermal performance in a real situation. The results showed that recycled shingles must be used with technical criteria similar to those used for fiber cement tiles, with regard to the heat gain into the building. Within these criteria should be taken into account local characteristics, especially in regions with hot and humid climate, and its use must be associated, according to the literature, to elements of thermal insulation and use of passive techniques such as vented attics, ceilings and right foot higher

SPACE-DEPLOYED, THIN-WALLED ENCLOSURE FOR A CRYOGENICALLY-COOLED HIGH TEMPERATURE SUPERCONDUCTING COIL

The interaction of magnetic fields generated by large superconducting coils has multiple applications in space, including actuation of spacecraft or spacecraft components, wireless power transfer, and shielding of spacecraft from radiation and high energy particles. These applications require coils with major diameters as large as 20 meters and a thermal management system to maintain the superconducting material of the coil below its critical temperature. Since a rigid thermal management system, such as a heat pipe, is unsuitable for compact stowage inside a 5 meter payload fairing, a thin-walled thermal enclosure is proposed. A 1.85 meter diameter test article consisting of a bladder layer for containing chilled nitrogen vapor, a restraint layer, and multilayer insulation was tested in a custom toroidal vacuum chamber. The material properties found during laboratory testing are used to predict the performance of the test article in low Earth orbit. Deployment motion of the same test article was measured using a motion capture system and the results are used to predict the deployment in space. A 20 meter major diameter and coil current of 6.7 MA is selected as a point design case. This design point represents a single coil in a high energy particle shielding system. Sizing of the thermal and structural components of the enclosure is completed. The thermal and deployment performance is predicted.

Análise crítica do consumo de energia na indústria de faiança

Com este trabalho pretende-se analisar o consumo de energia na indústria de faiança e identificar medidas de poupança energética. Em 2014, o consumo específico foi de 191 kgep/t e a intensidade carbónica 2,15 tCO2e/t, tendo havido uma redução de, respectivamente, 50,2% e 1,3%, comparativamente a 2010. O consumo total correspondeu a 1108 tep, sendo 66% relativo ao consumo de gás natural. Foi utilizado um analisador de energia eléctrica nos principais equipamentos consumidores, e na desagregação de consumos térmicos, efectuaram-se leituras no contador geral de gás natural e foram utilizados dados das auditorias ambiental e energética. O processo de cozedura é responsável por 58% do consumo térmico da instalação, seguido da pintura com 24%. A conformação é o sector com maior consumo de energia eléctrica, correspondendo a 23% do consumo total. As perdas térmicas pelos gases de exaustão dos equipamentos de combustão e pela envolvente do forno, considerando os mecanismos de convecção natural e radiação, correspondem a cerca de 6% do consumo térmico total, sendo necessário tomar medidas a nível do isolamento térmico e da redução do excesso de ar. A instalação de variadores de velocidade nos ventiladores do ar de combustão do forno poderia resultar em poupanças significativas, em particular, no consumo de gás natural – redução de 4 tep/ano e cerca de 2500€/ano– tendo um tempo de retorno do investimento inferior a 1 ano. Deverá ser, no entanto, garantida a alimentação de ar combustão a todos os queimadores, bem como, a combustão completa do gás natural. O funcionamento contínuo do forno poderia resultar no aumento da sua eficiência energética, com redução de custos de operação e manutenção, sendo necessário avaliar os custos adicionais de stock e de mão de obra. Verificou-se que as medidas relacionadas com a monitorização de consumos, eliminação de fugas de ar comprimido e a instalação de variadores de velocidade nos ventiladores do ar de combustão do forno poderiam resultar em reduções de consumo de 26 tep e de emissões de 66tCO2e, num total de quase 14 000€.

A deformation model of flexible, high area-to-mass ratio debris under perturbations and validation method

A new type of space debris was recently discovered by Schildknecht in near -geosynchronous orbit (GEO). These objects were later identified as exhibiting properties associated with High Area-to-Mass ratio (HAMR) objects. According to their brightness magnitudes (light curve), high rotation rates and composition properties (albedo, amount of specular and diffuse reflection, colour, etc), it is thought that these objects are multilayer insulation (MLI). Observations have shown that this debris type is very sensitive to environmental disturbances, particularly solar radiation pressure, due to the fact that their shapes are easily deformed leading to changes in the Area-to-Mass ratio (AMR) over time. This thesis proposes a simple effective flexible model of the thin, deformable membrane with two different methods. Firstly, this debris is modelled with Finite Element Analysis (FEA) by using Bernoulli-Euler theory called “Bernoulli model”. The Bernoulli model is constructed with beam elements consisting 2 nodes and each node has six degrees of freedom (DoF). The mass of membrane is distributed in beam elements. Secondly, the debris based on multibody dynamics theory call “Multibody model” is modelled as a series of lump masses, connected through flexible joints, representing the flexibility of the membrane itself. The mass of the membrane, albeit low, is taken into account with lump masses in the joints. The dynamic equations for the masses, including the constraints defined by the connecting rigid rod, are derived using fundamental Newtonian mechanics. The physical properties of both flexible models required by the models (membrane density, reflectivity, composition, etc.), are assumed to be those of multilayer insulation. Both flexible membrane models are then propagated together with classical orbital and attitude equations of motion near GEO region to predict the orbital evolution under the perturbations of solar radiation pressure, Earth’s gravity field, luni-solar gravitational fields and self-shadowing effect. These results are then compared to two rigid body models (cannonball and flat rigid plate). In this investigation, when comparing with a rigid model, the evolutions of orbital elements of the flexible models indicate the difference of inclination and secular eccentricity evolutions, rapid irregular attitude motion and unstable cross-section area due to a deformation over time. Then, the Monte Carlo simulations by varying initial attitude dynamics and deformed angle are investigated and compared with rigid models over 100 days. As the results of the simulations, the different initial conditions provide unique orbital motions, which is significantly different in term of orbital motions of both rigid models. Furthermore, this thesis presents a methodology to determine the material dynamic properties of thin membranes and validates the deformation of the multibody model with real MLI materials. Experiments are performed in a high vacuum chamber (10-4 mbar) replicating space environment. A thin membrane is hinged at one end but free at the other. The free motion experiment, the first experiment, is a free vibration test to determine the damping coefficient and natural frequency of the thin membrane. In this test, the membrane is allowed to fall freely in the chamber with the motion tracked and captured through high velocity video frames. A Kalman filter technique is implemented in the tracking algorithm to reduce noise and increase the tracking accuracy of the oscillating motion. The forced motion experiment, the last test, is performed to determine the deformation characteristics of the object. A high power spotlight (500-2000W) is used to illuminate the MLI and the displacements are measured by means of a high resolution laser sensor. Finite Element Analysis (FEA) and multibody dynamics of the experimental setups are used for the validation of the flexible model by comparing with the experimental results of displacements and natural frequencies.

Transforming transformation optics via generalised refraction

Generalised refraction is a topic which has, thus far, garnered far less attention than it deserves. The purpose of this thesis is to highlight the potential that generalised refraction has to offer with regards to imaging and its application to designing new passive optical devices. Specifically in this thesis we will explore two types of gener- alised refraction which takes place across a planar interface: refraction by generalised confocal lenslet arrays (gCLAs), and refraction by ray-rotation sheets. We will show that the corresponding laws of refraction for these interfaces produce, in general, light-ray fields with non-zero curl, and as such do not have a corresponding outgoing waveform. We will then show that gCLAs perform integral, geometrical imaging, and that this enables them to be considered as approximate realisations of metric tensor interfaces. The concept of piecewise transformation optics will be introduced and we will show that it is possible to use gCLAs along with other optical elements such as lenses to design simple piecewise transformation-optics devices such as invisibility cloaks and insulation windows. Finally, we shall show that ray-rotation sheets can be interpreted as performing geometrical imaging into complex space, and that as a consequence, ray-rotation sheets and gCLAs may in fact be more closely related than first realised. We conclude with a summary of potential future projects which lead naturally from the results of this thesis.

Numerical analysis of wooden slabs with perforations under fire conditions

Wood is considered an ideal solution for floors and roofs building construction, due the mechanical and thermal properties, associated with acoustic conditions. These constructions have good sound absorption, heat insulation and relevant architectonic characteristics. They are used in many civil applications: concert and conference halls, auditoriums, ceilings, walls… However, the high vulnerability of wooden elements submitted to fire conditions requires the evaluation of its structural behaviour with accuracy. The main objective of this work is to present a numerical model to assess the fire resistance of wooden cellular slabs with different perforations. Also the thermal behaviour of the wooden slabs will be compared considering different material insulation, with different sizes, inside the cavities. A transient thermal analysis with nonlinear material behaviour will be solved using ANSYS© program. This study allows to verify the fire resistance, the temperature evolution and the char-layer, throughout a wooden cellular slab with perforations and considering the insulation effect inside the cavities.

Estudo da resistência à corrosão do aço inoxidável ferrítico AISI 444 para aplicação como biomaterial

Tese (Doutorado em Tecnologia Nuclear)

Adição de vermiculita expandida mícron em pastas de baixa densidade para cimentação de poços de petróleo

The northeastern region of Brazil has a large number of wells producing oil using a method of secondary recovery steam injection, since the oil produced in this region is essentially viscous. This recovery method puts the cement / coating on thermal cycling, due to the difference in coefficient of thermal expansion between cement and metal coating causes the appearance of cracks at this interface, allowing the passage of the annular fluid, which is associated with serious risk socioeconomic and environmental. In view of these cracks, a correction operation is required, resulting in more costs and temporary halt of production of the well. Alternatively, the oil industry has developed technology for adding new materials in cement pastes, oil well, providing high ductility and low density in order to withstand the thermo-mechanical loads generated by the injection of water vapor. In this context, vermiculite, a clay mineral found in abundance in Brazil has been applied in its expanded form in the construction industry for the manufacture of lightweight concrete with excellent insulation and noise due to its high melting point and the presence of air in their layers lamellar. Therefore, the vermiculite is used for the purpose of providing low-density cement paste and withstand high temperatures caused by steam injection. Thus, the present study compared the default folder containing cement and water with the folders with 6%, 8% and 10% vermiculite micron conducting tests of free water, rheology and compressive strength where it obtained the concentration of 8 % with the best results. Subsequently, the selected concentration, was compared with the results recommended by the API standard tests of filtered and stability. And finally, analyzed the results from tests of specific gravity and time of thickening. Before the study we were able to make a folder with a low density that can be used in cementing oil well in order to withstand the thermo-mechanical loads generated by steam injection

Caracterização Microestrutural e Tribocorrosiva de Sistemas Metalocerâmicos Odontológicos do Tipo Ni-Cr/Porcelana E Ni-Cr/Ti/Porcelana

The partial fixed prosthodontics restoration is used to rehabilitate form and function of partial or total compromised teeth, having to remain permanently joined to remainder tooth. The most useful material on prosthodontics is the feldspar porcelain, commercialized as aluminosilicate powders. Dental porcelains are presented with limited mechanical properties to rehabilitate extensive spaces. The association with Ni-Cr metallic systems (metal-ceramic system) allows that the metallic substructure compensates the fragile porcelain nature, preserving the thermal insulation and aesthetics desirable, as well as reducing the possibility of cracking during matication efforts. Cohesive flaws by low mechanical strength connect the metallic substructure to the oral environment, characterized by a electrolytic solution (saliva), by aggressive temperature, pH cyclic changes and mechanical requests. This process results on ionic liberation that could promote allergic or inflammatory responses, and/or clinical degradation of ceramometal system. The aim of this study was to evaluate the presence of an intermediate titanium layer on the microscopic fracture behavior of porcelains on ceramometal systems. Plasma deposition of titanium films result in regular passivating oxide layers which act as barriers to protect the metallic substrate against the hazardous effects of corrosive saliva. Tribocorrosion tests were performed to simulate the oral environment and mechanical stress, making it possible the early detection of crack formation and growth on metal-ceramic systems, which estimate the adherence between the compounds of this system. Plain samples consisting of dental feldspar porcelain deposited either onto metallic substrates or titanium films were fired and characterized by scanning electron microscopy. The result showed that the titanium film improved the adherence of the system compared to conventional metal-ceramic interfaces, thus holding crack propagation