Influence of attenuation correction in the MPI image reconstructed by the ‘Evolution for Cardiac’™

The acquisition of a Myocardial Perfusion image (MPI) is of great importance for the diagnosis of the coronary artery disease, since it allows to evaluate which areas of the heart aren’t being properly perfused, in rest and stress situations. This exam is greatly influenced by photon attenuation which creates image artifacts and affects quantification. The acquisition of a Computerized Tomography (CT) image makes it possible to get an atomic images which can be used to perform high-quality attenuation corrections of the radiopharmaceutical distribution, in the MPI image. Studies show that by using hybrid imaging to perform diagnosis of the coronary artery disease, there is an increase on the specificity when evaluating the perfusion of the right coronary artery (RCA). Using an iterative algorithm with a resolution recovery software for the reconstruction, which balances the image quality, the administered activity and the scanning time, we aim to evaluate the influence of attenuation correction on the MPI image and the outcome in perfusion quantification and imaging quality.

Validation of a new reference values’s database for semiquantification of 123I‐FP‐CIT SPECT scans in one nuclear medicine department

The DatScanTM and its Semiquantification (SQ) can provide advantages in the diagnosis of Parkinsonian Syndromes (PS). To improve the SQ is recommended the creation of adapted database (DB) with reference values for the Nuclear Medicine Departments. Previously to this work was created a adapted database (DBRV) to Nuclear Medicine Department's protocol and population of Infanta Cristina's Hospital located in Badajoz, for patients between the ages of 60 and 75, and reference values of the SQ were calculated. Aim: To evaluate the discrimination capacity of a department's adapted DB reference's values of healthy controls for DatScanTM.

Clinical classification versus semiquantification with adapted reference values for 123I-FP-CIT SPECT in a nuclear medicine department

Semi quantification (SQ) in DaTScan® studies is broadly used in clinic daily basis, however there is a suspicious about its discriminative capability, and concordance with the diagnostic classification performed by the physician. Aim: Evaluate the discriminate capability of an adapted database and reference's values of healthy controls for the Dopamine Transporters (DAT) with 123I–FP-IT named DBRV adapted to Nuclear Medicine Department's protocol and population of Infanta Cristina's Hospital, and its concordance with the physician classification.

One-step in situ synthesis of polyamide microcapsules with inorganic payload and their transformation into responsive thermoplastic composite materials

Well-dispersed loads of finely powdered metals, metal oxides, several carbon allotropes or nanoclays are incorporated into highly porous polyamide 6 microcapsules in controllable amounts via an original one-step in situ fabrication technique. It is based on activated anionic polymerization (AAP) of ε-caprolactam in a hydrocarbon solvent performed in the presence of the respective micro- or nanosized loads. The forming microcapsules with typical diameters of 25-50 µm entrap up to 40 wt% of load. Their melt processing produces hybrid thermoplastic composites. Mechanical, electric conductivity and magnetic response measurements show that transforming of in situ loaded microcapsules into composites by melt processing (MP) is a facile and rapid method to fabricate materials with high mechanical resistance and electro-magnetic characteristics sufficient for many industrial applications. This novel concept requires low polymerization temperatures, no functionalization or compatibilization of the loads and it is easy to scale up at industrial production levels.

Aquisição de verbos da língua portuguesa, no primeiro ciclo de escolaridade, por crianças bilingues luso-alemãs e crianças monolingues alemãs

Tese de Doutoramento em Ciências da Linguagem (área de especialização em Linguística Aplicada).

Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study.

BACKGROUND: "Virtual" autopsy by postmortem computed tomography (PMCT) can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. These limitations might be overcome by adding multiphase PMCT angiography. OBJECTIVE: To compare virtual autopsy by multiphase PMCT angiography with medical autopsy. DESIGN: Prospective cohort study. (ClinicalTrials.gov: NCT01541995) SETTING: Single-center study at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, between 1 April 2012 and 31 March 2013. PATIENTS: Hospitalized patients who died unexpectedly or within 48 hours of an event necessitating cardiopulmonary resuscitation. MEASUREMENTS: Diagnoses from clinical records were compared with findings from both types of autopsy. New diagnoses identified by autopsy were classified as major or minor, depending on whether they would have altered clinical management. RESULTS: Of 143 eligible patients, 50 (35%) had virtual and medical autopsy. Virtual autopsy confirmed 93% of all 336 diagnoses identified from antemortem medical records, and medical autopsy confirmed 80%. In addition, virtual and medical autopsy identified 16 new major and 238 new minor diagnoses. Seventy-three of the virtual autopsy diagnoses, including 32 cases of coronary artery stenosis, were identified solely by multiphase PMCT angiography. Of the 114 clinical diagnoses classified as cardiovascular, 110 were confirmed by virtual autopsy and 107 by medical autopsy. In 11 cases, multiphase PMCT angiography showed "unspecific filling defects," which were not reported by medical autopsy. LIMITATION: These results come from a single center with concerted interest and expertise in postmortem imaging; further studies are thus needed for generalization. CONCLUSION: In cases of unexpected death, the addition of multiphase PMCT angiography increases the value of virtual autopsy, making it a feasible alternative for quality control and identification of diagnoses traditionally made by medical autopsy. PRIMARY FUNDING SOURCE: University Medical Center Hamburg-Eppendorf.

Occupational exposure to solar ultraviolet radiation of outdoor workers in France

Question: Outdoor occupational exposure could be associated with important cumulative and intense exposure to ultraviolet (UV) solar radiation. Such exposure would increase risk of skin cancer. However, little information exists on jobs associated with intense UV exposure. The objective of this study was to characterise occupational UV exposure in a representative sample in France. Methods: A population-based survey was conducted in May-June 2012 through computer-assisted telephonic interviews in population 25 to 69 years of age. Individual UV irradiation was computed with declared time and place of residence matched to UV records from satellite measurement (Eurosun project). We analysed factors influencing exposure to UV (annual average and seasonal peak). Results: A total of 1442 individuals declared having an occupational exposure to UV which represents 18% of population aged 25 to 69 years. Outdoor workers were more frequently men (58%), aged 40-54 (43%), with a phototype III or IV (69%). Occupations associated with highest UV exposure were: construction workers (annual daily average 62.8 Joules/m2), gardeners (62.6), farmers (52.8), culture/art/social sciences workers (52.0) and transport workers/mail carriers (49.5). The maximum of UVA exposure was found for occupation with a strong seasonality of exposure: culture, art or social sciences works (98.1 Joules/m2), construction works (97.2), gardening (96.7) and farming (95.0). Significant factors associated with high occupational UV exposure were gender (men vs. women: 53.6 vs. 42.6), phototype (IV vs. I: 51.9 vs. 45.5) and taking lunch outdoors (always vs. never: 59.8 vs. 48.6). Conclusion: Our study showed that some occupations were associated with particularly intense UV exposure such as farmers, gardeners, construction workers. Other unexpected occupations were also associated with high UV exposure such as transport workers, mail carriers and culture/art/social sciences workers.

Risk factors of sunburns from occupational sun exposure in outdoor workers

Question: Outdoor workers can be exposed to intense ultraviolet (UV) solar radiation likely to results to sunburns. As sunburn is an important risk factor for skin cancer, in particular melanoma, we investigated the causes of occupational sunburns (OS) in French outdoor workers. Methods: A population-based survey was conducted in May-June 2012 through computer-assisted telephonic interviews in population 25 to 69 years of age. History of sunburn from occupational exposure within the year preceding interview was collected. We analysed the risk of OS in multivariate logistic regression. Results: Out of 1442 individuals who declared having an occupational exposure to solar UV radiation, 403 (27.9%) reported a sunburn from occupational exposure in the year preceding the interview. Sunburns were more frequent in women (30% vs. 26.4% in men although not significant p = 0.14), in younger workers (p = 0.0099), in sensitive phototype (40% in phototype I/II vs. 23% in phototype III/IV, p < 0.001) and in workers taking lunch outdoor (p = 0.0355). Some occupations were more associated with OS (more than 30%): health occupations, managing, research/engineering, construction workers and culture/art/social sciences workers. In multivariate analysis, risk factors for OS are phototype (I vs. IV, OR = 4.30 95% CI [2.65-6.98]), sunburn during leisure time (OR = 3.46 95% CI [2.62-4.59]), seasonality of exposure (seasonal vs. constant exposure OR = 1.36 95% CI [1.02-1.81] and annual UVA exposure (OR for 10J/m² daily average increment 1.08 95% CI [1.02-1.14]). In multivariate analysis the type of occupation was not associated with increased OS. Conclusion: Sunburns from occupation was also observed in non sensitive population, phototype IV, which shows that outdoor workers are potentially exposed to intense UV radiations. This study suggests that prevention should target UV sensitive outdoor workers as well as those cumulating intense UV exposure.

Modeling the interplay between land use, bioenergy production and climate change

Land use has become a force of global importance, considering that 34% of the Earth’s ice-free surface was covered by croplands or pastures in 2000. The expected increase in global human population together with eminent climate change and associated search for energy sources other than fossil fuels can, through land-use and land-cover changes (LUCC), increase the pressure on nature’s resources, further degrade ecosystem services, and disrupt other planetary systems of key importance to humanity. This thesis presents four modeling studies on the interplay between LUCC, increased production of biofuels and climate change in four selected world regions. In the first study case two new crop types (sugarcane and jatropha) are parameterized in the LPJ for managed Lands dynamic global vegetation model for calculation of their potential productivity. Country-wide spatial variation in the yields of sugarcane and jatropha incurs into substantially different land requirements to meet the biofuel production targets for 2015 in Brazil and India, depending on the location of plantations. Particularly the average land requirements for jatropha in India are considerably higher than previously estimated. These findings indicate that crop zoning is important to avoid excessive LUCC. In the second study case the LandSHIFT model of land-use and land-cover changes is combined with life cycle assessments to investigate the occurrence and extent of biofuel-driven indirect land-use changes (ILUC) in Brazil by 2020. The results show that Brazilian biofuels can indeed cause considerable ILUC, especially by pushing the rangeland frontier into the Amazonian forests. The carbon debt caused by such ILUC would result in no carbon savings (from using plant-based ethanol and biodiesel instead of fossil fuels) before 44 years for sugarcane ethanol and 246 years for soybean biodiesel. The intensification of livestock grazing could avoid such ILUC. We argue that such an intensification of livestock should be supported by the Brazilian biofuel sector, based on the sector’s own interest in minimizing carbon emissions. In the third study there is the development of a new method for crop allocation in LandSHIFT, as influenced by the occurrence and capacity of specific infrastructure units. The method is exemplarily applied in a first assessment of the potential availability of land for biogas production in Germany. The results indicate that Germany has enough land to fulfill virtually all (90 to 98%) its current biogas plant capacity with only cultivated feedstocks. Biogas plants located in South and Southwestern (North and Northeastern) Germany might face more (less) difficulties to fulfill their capacities with cultivated feedstocks, considering that feedstock transport distance to plants is a crucial issue for biogas production. In the fourth study an adapted version of LandSHIFT is used to assess the impacts of contrasting scenarios of climate change and conservation targets on land use in the Brazilian Amazon. Model results show that severe climate change in some regions by 2050 can shift the deforestation frontier to areas that would experience low levels of human intervention under mild climate change (such as the western Amazon forests or parts of the Cerrado savannas). Halting deforestation of the Amazon and of the Brazilian Cerrado would require either a reduction in the production of meat or an intensification of livestock grazing in the region. Such findings point out the need for an integrated/multicisciplinary plan for adaptation to climate change in the Amazon. The overall conclusions of this thesis are that (i) biofuels must be analyzed and planned carefully in order to effectively reduce carbon emissions; (ii) climate change can have considerable impacts on the location and extent of LUCC; and (iii) intensification of grazing livestock represents a promising venue for minimizing the impacts of future land-use and land-cover changes in Brazil.

Potential Predictability and AMIP Implications of Midlatitude Climate Variability in Two General Circulation Models

Ensembles of extended Atmospheric Model Intercomparison Project (AMIP) runs from the general circulation models of the National Centers for Environmental Prediction (formerly the National Meteorological Center) and the Max-Planck Institute (Hamburg, Germany) are used to estimate the potential predictability (PP) of an index of the Pacific–North America (PNA) mode of climate change. The PP of this pattern in “perfect” prediction experiments is 20%–25% of the index’s variance. The models, particularly that from MPI, capture virtually all of this variance in their hindcasts of the winter PNA for the period 1970–93. The high levels of internally generated model noise in the PNA simulations reconfirm the need for an ensemble averaging approach to climate prediction. This means that the forecasts ought to be expressed in a probabilistic manner. It is shown that the models’ skills are higher by about 50% during strong SST events in the tropical Pacific, so the probabilistic forecasts need to be conditional on the tropical SST. Taken together with earlier studies, the present results suggest that the original set of AMIP integrations (single 10-yr runs) is not adequate to reliably test the participating models’ simulations of interannual climate variability in the midlatitudes.

European resarch school on large scale solar thermal - SHINE

The Solar HeatIntegration NEtwork (SHINE) is a European research school in which 13 PhDstudents in solar thermal technologies are funded by the EU Marie-Curie program.It has five PhD course modules as well as workshops and seminars dedicated to PhDstudents both within the project as well as outside of it. The SHINE researchactivities focus on large solar heating systems and new applications: ondistrict heating, industrial processes and new storage systems. The scope ofthis paper is on systems for district heating for which there are five PhDstudents, three at universities and two at companies. The PhD students allstarted during the early part of 2014 and their initial work has concentratedon literature studies and on setting up models and data collection to be usedfor validation purposes. The PhD students will complete their studies in2017-18.

A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults

Background. To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Methods. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse). Results. Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4–2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6–2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement. Conclusions. HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.