La estabilidad del frente de excavación de un túnel en terrenos heterogéneos o con un criterio de rotura no-lineal

El frente de un túnel puede colapsar si la presión aplicada sobre el es inferior a un valor limite denominado presión “critica” o “de colapso”. En este trabajo se desarrolla y presenta un mecanismo de rotura rotacional generado punto a punto para el cálculo de la presión de colapso del frente de túneles excavados en terrenos estratificados o en materiales que siguen un criterio de rotura nolineal. La solución propuesta es una solución de contorno superior en el marco del Análisis Límite y supone una generalización del mecanismo de rotura mas reciente existente en la bibliografía. La presencia de un terreno estratificado o con un criterio de rotura no-lineal implica una variabilidad espacial de las propiedades resistentes. Debido a esto, se generaliza el mecanismo desarrollado por Mollon et al. (2011b) para suelos, de tal forma que se puedan considerar valores locales del ángulo de rozamiento y de la cohesión. Además, la estratificación del terreno permite una rotura parcial del frente, por lo que se implementa esta posibilidad en el mecanismo, siendo la primera solución que emplea un mecanismo de rotura que se ajusta a la estratigrafía del terreno. Por otro lado, la presencia de un material con un criterio de rotura no-lineal exige introducir en el modelo, como variable de estudio, el estado tensional en el frente, el cual se somete al mismo proceso de optimización que las variables geométricas del mecanismo. Se emplea un modelo numérico 3D para validar las predicciones del mecanismo de Análisis Limite, demostrando que proporciona, con un esfuerzo computacional significativamente reducido, buenas predicciones de la presión critica, del tipo de rotura (global o parcial) en terrenos estratificados y de la geometría de fallo. El mecanismo validado se utiliza para realizar diferentes estudios paramétricos sobre la influencia de la estratigrafía en la presión de colapso. Igualmente, se emplea para elaborar cuadros de diseño de la presión de colapso para túneles ejecutados con tuneladora en macizos rocosos de mala calidad y para analizar la influencia en la estabilidad del frente del método constructivo. Asimismo, se lleva a cabo un estudio de fiabilidad de la estabilidad del frente de un túnel excavado en un macizo rocoso altamente fracturado. A partir de el se analiza como afectan las diferentes hipótesis acerca de los tipos de distribución y de las estructuras de correlación a los resultados de fiabilidad. Se investiga también la sensibilidad de los índices de fiabilidad a los cambios en las variables aleatorias, identificando las mas relevantes para el diseño. Por ultimo, se lleva a cabo un estudio experimental mediante un modelo de laboratorio a escala reducida. El modelo representa medio túnel, lo cual permite registrar el movimiento del material mediante una técnica de correlación de imágenes fotográficas. El ensayo se realiza con una arena seca y se controla por deformaciones mediante un pistón que simula el frente. Los resultados obtenidos se comparan con las estimaciones de la solución de Análisis Límite, obteniéndose un ajuste razonable, de acuerdo a la literatura, tanto en la geometría de rotura como en la presión de colapso. A tunnel face may collapse if the applied support pressure is lower than a limit value called the ‘critical’ or ‘collapse’ pressure. In this work, an advanced rotational failure mechanism generated ‘‘point-by-point” is developed to compute the collapse pressure for tunnel faces in layered (or stratified) grounds or in materials that follow a non-linear failure criterion. The proposed solution is an upper bound solution in the framework of limit analysis which extends the most advanced face failure mechanism in the literature. The excavation of the tunnel in a layered ground or in materials with a non-linear failure criterion may lead to a spatial variability of the strength properties. Because of this, the rotational mechanism recently proposed by Mollon et al. (2011b) for Mohr-Coulomb soils is generalized so that it can consider local values of the friction angle and of the cohesion. For layered soils, the mechanism needs to be extended to consider the possibility for partial collapse. The proposed methodology is the first solution with a partial collapse mechanism that can fit to the stratification. Similarly, the use of a nonlinear failure criterion introduces the need to introduce new parameters in the optimization problem to consider the distribution of normal stresses along the failure surface. A 3D numerical model is employed to validate the predictions of the limit analysis mechanism, demonstrating that it provides, with a significantly reduced computational effort, good predictions of critical pressure, of the type of collapse (global or partial) in layered soils, and of its geometry. The mechanism is then employed to conduct parametric studies of the influence of several geometrical and mechanical parameters on face stability of tunnels in layered soils. Similarly, the methodology has been further employed to develop simple design charts that provide the face collapse pressure of tunnels driven by TBM in low quality rock masses and to study the influence of the construction method. Finally, a reliability analysis of the stability of a tunnel face driven in a highly fractured rock mass is performed. The objective is to analyze how different assumptions about distributions types and correlation structures affect the reliability results. In addition, the sensitivity of the reliability index to changes in the random variables is studied, identifying the most relevant variables for engineering design. Finally, an experimental study is carried out using a small-scale laboratory model. The problem is modeled in half, cutting through the tunnel axis vertically, so that displacements of soil particles can be recorded by a digital image correlation technique. The tests were performed with dry sand and displacements are controlled by a piston that supports the soil. The results of the model are compared with the predictions of the Limit Analysis mechanism. A reasonable agreement, according to literature, is obtained between the shapes of the failure surfaces and between the collapse pressures observed in the model tests and computed with the analytical solution.

Análise de confiabilidade de estruturas com paredes portantes de concreto pré-moldado

O método construtivo com painéis portantes de concreto é economicamente viável, porém relativamente novo no cenário nacional, sobretudo no caso dos pré-moldados. As incertezas referentes às peculiaridades desse método, bem como a nova norma brasileira de painéis pré-moldados, ainda em elaboração, vem a motivar uma análise probabilística dos critérios de projeto disponíveis. Utilizando-se a técnica da confiabilidade estrutural, é possível propagar as incertezas referentes às variáveis a uma resposta final no índice de confiabilidade, sendo um cálculo totalmente probabilístico. Neste trabalho, emprega-se tal técnica com informações estatísticas referentes a lajes de concreto moldadas in loco para verificar, de maneira mais verossímil, a segurança dos critérios de projeto impostos pelo Precast Concrete Institute Design Handbook - Precast and Prestressed Concrete - 7th Edition (2010) às fases transitórias (desforma, transporte e içamento) e pela Norma Brasileira ABNT NBR 6118: 2014 - Projeto de estruturas de concreto, à fase em uso. Prossegue-se a uma análise crítica dos resultados bem como sugestões para diminuir a variação dos resultados, sobretudo pela calibração de novos coeficientes parciais de segurança, processo para o qual este trabalho pode servir de base.

Identificação do risco de deterioração fisiológica no pré-hospitalar

Enquadramento – A Early Warning Scores é uma escala de alerta, baseada num sistema de atribuição de pontos (scores) aos parâmetros vitais e deterioração do SNC, sendo a sua principal finalidade a identificação precoce do risco de deterioração fisiológica do doente. Objetivos – Determinar os parâmetros da escala que foram avaliados; identificar a periodicidade de avaliação dos parâmetros da escala; determinar as situações identificadas como risco de deterioração fisiológica; avaliar as propriedades psicométricas da escala Early Warning Scores (validade e fiabilidade). Material e Método – Estudo quantitativo e descritivo-correlacional, cuja população alvo consistiu nos doentes vítimas de acidente ou doença súbita, submetidos a atendimentos por parte de enfermeiros afetos ao INEM, nomeadamente nas ambulâncias de Suporte Imediato de Vida, mediante ativação via 112. O instrumento de avaliação utilizado consiste na Escala Early Warning Scores. Resultados – Verificou-se que o índice de fiabilidade se traduziu num valor de alfa de Cronbach, para a globalidade da escala, fraco (α=0.462). Concluiu-se que houve uma redução progressiva dos scores, em termos de risco, indicando a ocorrência de uma deteção precoce da degradação clínica dos 214 doentes, o que se traduziu numa atuação mais eficaz no pré-hospitalar. Conclusão - A redução progressiva dos scores, em termos de risco ao longo dos três momentos de avaliação com a Early Warning Scores, sugere que houve uma deteção precoce da degradação clínica dos doentes, resultando numa atuação mais eficaz no pré-hospitalar. Palavras-chave: Pré-hospitalar; Risco de deterioração fisiológica; Early Warning Scores.

An algorithm for FHR estimation from foetal phonocardiographic signals

The long-term foetal surveillance is often to be recommended. Hence, the fully non-invasive acoustic recording, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the recorded heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. In this paper, we present a new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings. A filtering is employed as a first step of the algorithm to reduce the background noise. A block for first heart sounds enhancing is then used to further reduce other components of foetal heart sound signals. A complex logic block, guided by a number of rules concerning foetal heart beat regularity, is proposed as a successive block, for the detection of most probable first heart sounds from several candidates. A final block is used for exact first heart sound timing and in turn foetal heart rate estimation. Filtering and enhancing blocks are actually implemented by means of different techniques, so that different processing paths are proposed. Furthermore, a reliability index is introduced to quantify the consistency of the estimated foetal heart rate and, based on statistic parameters; [,] a software quality index is designed to indicate the most reliable analysis procedure (that is, combining the best processing path and the most accurate time mark of the first heart sound, provides the lowest estimation errors). The algorithm performances have been tested on phonocardiographic signals recorded in a local gynaecology private practice from a sample group of about 50 pregnant women. Phonocardiographic signals have been recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by our algorithm and the other provided by cardiotocographic device). Our results show that the proposed algorithm, in particular some analysis procedures, provides reliable foetal heart rate signals, very close to the reference cardiotocographic recordings. © 2010 Elsevier Ltd. All rights reserved.

RELIBILITY ANALYSIS OF SIMPLE SLOPES AND SOIL-STRUCTURES WITH LINEAR LIMIT STATES

The first objective of this research was to develop closed-form and numerical probabilistic methods of analysis that can be applied to otherwise conventional methods of unreinforced and geosynthetic reinforced slopes and walls. These probabilistic methods explicitly include random variability of soil and reinforcement, spatial variability of the soil, and cross-correlation between soil input parameters on probability of failure. The quantitative impact of simultaneously considering the influence of random and/or spatial variability in soil properties in combination with cross-correlation in soil properties is investigated for the first time in the research literature. Depending on the magnitude of these statistical descriptors, margins of safety based on conventional notions of safety may be very different from margins of safety expressed in terms of probability of failure (or reliability index). The thesis work also shows that intuitive notions of margin of safety using conventional factor of safety and probability of failure can be brought into alignment when cross-correlation between soil properties is considered in a rigorous manner. The second objective of this thesis work was to develop a general closed-form solution to compute the true probability of failure (or reliability index) of a simple linear limit state function with one load term and one resistance term expressed first in general probabilistic terms and then migrated to a LRFD format for the purpose of LRFD calibration. The formulation considers contributions to probability of failure due to model type, uncertainty in bias values, bias dependencies, uncertainty in estimates of nominal values for correlated and uncorrelated load and resistance terms, and average margin of safety expressed as the operational factor of safety (OFS). Bias is defined as the ratio of measured to predicted value. Parametric analyses were carried out to show that ignoring possible correlations between random variables can lead to conservative (safe) values of resistance factor in some cases and in other cases to non-conservative (unsafe) values. Example LRFD calibrations were carried out using different load and resistance models for the pullout internal stability limit state of steel strip and geosynthetic reinforced soil walls together with matching bias data reported in the literature.

Développement d’un questionnaire cognitif bref, le FaCE (The Fast Cognitive Evaluation), selon la modélisation Rasch adapté aux patients avec cancer

Les déficits cognitifs sont présents chez les patients atteints de cancer. Les tests cognitifs tels que le Montreal Cognitive Assessment se sont révélés peu spécifiques, incapables de détecter des déficits légers et ne sont pas linéaires. Pour suppléer à ces limitations nous avons développé un questionnaire cognitif simple, bref et adapté aux dimensions cognitives atteintes chez les patients avec un cancer, le FaCE « The Fast Cognitif Evaluation », en utilisant la modélisation Rasch (MR). La MR est une méthode mathématique probabiliste qui détermine les conditions pour qu’un outil soit considéré une échelle de mesure et elle est indépendante de l’échantillon. Si les résultats s’ajustent au modèle, l’échelle de mesure est linéaire avec des intervalles égaux. Les réponses sont basées sur la capacité des sujets et la difficulté des items. La carte des items permet de sélectionner les items les plus adaptés pour l’évaluation de chaque aspect cognitif et d’en réduire le nombre au minimum. L’analyse de l’unidimensionnalité évalue si l’outil mesure une autre dimension que celle attendue. Les résultats d’analyses, conduites sur 165 patients, montrent que le FaCE distingue avec une excellente fiabilité et des niveaux suffisamment différents les compétences des patients (person-reliability-index=0.86; person-separation-index=2.51). La taille de la population et le nombre d’items sont suffisants pour que les items aient une hiérarchisation fiable et précise (item-reliability=0.99; item-séparation-index=8.75). La carte des items montre une bonne dispersion de ceux-ci et une linéarité du score sans effet plafond. Enfin, l’unidimensionnalité est respectée et le temps d’accomplissement moyen est d’environ 6 minutes. Par définition la MR permet d’assurer la linéarité et la continuité de l’échelle de mesure. Nous avons réussi à développer un questionnaire bref, simple, rapide et adapté aux déficits cognitifs des patients avec un cancer. Le FaCE pourrait, aussi, servir de mesure de référence pour les futures recherches dans le domaine.

Tradução e adaptação para português da escala de grupo de susceptibilidade hipnótica de harvard: Versão A

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade em Psicologia Clínica

Validity and reliability of the Portuguese version of the Epilepsy Medication Treatment Complexity Index for Brazil

We evaluated the reliability and validity of a Brazilian-Portuguese version of the Epilepsy Medication Treatment Complexity Index (EMTCI). Interrater reliability was evaluated with the intraclass correlation coefficient (ICC), and validity was evaluated by correlation of mean EMTCI scores with the following variables: number of antiepileptic drugs (AEDs), seizure control, patients` perception of seizure control, and adherence to the therapeutic regimen as measured with the Morisky scale. We studied patients with epilepsy followed in a tertiary university-based hospital outpatient clinic setting, aged 18 years or older, independent in daily living activities, and without cognitive impairment or active psychiatric disease. ICCs ranged from 0.721 to 0.999. Mean EMTCI scores were significantly correlated with the variables assessed. Higher EMTCI scores were associated with an increasing number of AEDs, uncontrolled seizures, patients` perception of lack of seizure control, and poorer adherence to the therapeutic regimen. The results indicate that the Brazilian-Portuguese EMTCI is reliable and valid to be applied clinically in the country. The Brazilian-Portuguese EMTCI version may be a useful tool in developing strategies to minimize treatment complexity, possibly improving seizure control and quality of life in people with epilepsy in our milieu. (C) 2011 Elsevier Inc. All rights reserved.

Intra and inter-examiner reliability of the subacromial impingement index

The present study aimed to assess the reliability of intra and inter-examiner subacromial impingement index (SII) measures obtained from radiographs. Thirty-six individuals were enrolled and divided into two groups: control group, composed of 18 volunteers in good general health without shoulder problems, and a group of 18 patients with subacromial impingement syndrome (SIS). Radiographic images were taken with the dominant upper limb in neutral rotation, while the volunteers held their arm at 90A degrees of abduction in the frontal plane. The beam of radiation at 30A degrees craniocaudal inclination was used to provide an antero-posterior image view. Three blinded examiners each performed three measurements from the subacromial space (SS) and the anatomical neck of the humerus (NH). The SII was calculated as the ratio of the SS and the NH measures. The mean values of SII were compared using t-tests. The intra-class correlation coefficient (ICC) was used to assess intra- and inter-examiner reliability of the measures. The mean values of SII were greater for the control group (0.12) than for the SIS group (0.08; p = 0.0071). SII measurements showed excellent intra (0.96-0.99) and inter-examiner reliability (0.94) for both the control and SIS group. The results of this study show the potential use of the SII; a greater mean value for the control group compared to the SIS group and excellent reliability for intra- and inter-examiner measurement. Validation studies of the index should be conducted to correlate the index with clinical findings from subacromial impingement syndrome.

Reliability of scores between stroke patients and significant others on the Reintegration to Normal Living (RNL) Index

Purpose: This study measured reliability between stroke patients' and significant others' scores on items on the Reintegration to Normal Living (RNL) Index and whether there were any scoring biases. Method The 11-item RNL Index was administered to 57 pairs of patients and significants six months after stroke rehabilitation. The index was scored using a 10-point visual analogue scale. Patient and significant other demographic information and data on patients' clinical, functional and cognitive status were collected. Reliability was measured using the intra-class correlation coefficient (ICC) and percent agreement. Results: Overall poor reliability was found for the RNL Index total score (ICC=.36, 95% CI. 07 to .59) and the daily functioning subscale (ICC=.24, 95% CI -.003 to .46) and moderate reliability was found for the perception of self subscale (ICC=.55, 95 % CI .28 to .73). There was a moderate bias for patients to rate themselves as achieving better reintegration than was indicated by significant others, although no demographic or clinical factors were associated with this bias. Exact match agreement was best for the subjective items and worse for items reflecting mobility around the community and participation in a work activity. Conclusions: Caution is needed when interpreting patient information reported by significant others on the RNL Index. The use of a shorter scale to rate the RNL Index requires investigation.

Reliability and convergent validity of the Childhood Anxiety Sensitivity Index in children and adolescents

OBJECTIVE: The purpose of this study was to examine the reliability and the convergent validity of the Children Anxiety Sensitivity Index (CASI) with DSM-IV anxiety disorder symptoms, by comparison with the Screen for Child Anxiety Related Emotional Disorders (SCARED), in a community sample of Brazilian children and adolescents. METHODS: Children and adolescents from five schools were selected from a larger study that aimed to assess different aspects of childhood anxiety disorders. All participants completed the CASI and the SCARED. RESULTS: This study supported the reliability of the CASI total score. Girls reported higher total anxiety sensitivity scores than boys and there were no differences in total anxiety sensitivity scores between children and adolescents. This study showed moderate to high correlations between the CASI scores with SCARED scores, all correlations coefficients being positive and significant. CONCLUSIONS: Our findings demonstrate an appropriate reliability and evidence of convergent validity in the CASI in a sample of Brazilian children and adolescents.

Validity, reliability and responsiveness of the French language translation of the Western Ontario Shoulder Instability Index (WOSI).

BACKGROUND: The WOSI (Western Ontario Shoulder Instability Index) is a self-administered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder instability, as well as to measure the effect of an intervention on any particular patient. It is validated and is reliable and sensitive. As it is designed to measure subjective outcome, it is important that translation should be methodologically rigorous, as it is subject to both linguistic and cultural interpretation. OBJECTIVE: To produce a French language version of the WOSI that is culturally adapted to both European and North American French-speaking populations. MATERIALS AND METHODS: A validated protocol was used to create a French language WOSI questionnaire (WOSI-Fr) that would be culturally acceptable for both European and North American French-speaking populations. Reliability and responsiveness analyses were carried out, and the WOSI-Fr was compared to the F-QuickDASH-D/S (Disability of the Arm, Shoulder and Hand-French translation), and Walch-Duplay scores. RESULTS: A French language version of the WOSI (WOSI-Fr) was accepted by a multinational committee. The WOSI-Fr was then validated using a total of 144 native French-speaking subjects from Canada and Switzerland. Comparison of results on two WOSI-Fr questionnaires completed at a mean interval of 16 days showed that the WOSI-Fr had strong reliability, with a Pearson and interclass correlation of r=0.85 (P=0.01) and ICC=0.84 [95% CI=0.78-0.88]. Responsiveness, at a mean 378.9 days after surgical intervention, showed strong correlation with that of the F-QuickDASH-D/S, with r=0.67 (P<0.01). Moreover, a standardized response means analysis to calculate effect size for both the WOSI-Fr and the F-QuickDASH-D/S showed that the WOSI-Fr had a significantly greater ability to detect change (SRM 1.55 versus 0.87 for the WOSI-Fr and F-QuickDASH-D/S respectively, P<0.01). The WOSI-Fr showed fair correlation with the Walch-Duplay. DISCUSSION: A French-language translation of the WOSI questionnaire was created and validated for use in both Canadian and Swiss French-speaking populations. This questionnaire will facilitate outcome assessment in French-speaking settings, collaboration in multinational studies and comparison between studies performed in different countries. TYPE OF STUDY: Multicenter cohort study. LEVEL OF EVIDENCE: II.

French version of the addiction severity index (5th Edition): validity and reliability among Swiss opiate-dependent patients. French validation of the Addiction Severity Index.

OBJECTIVE: The aim of the study was to validate a French adaptation of the 5th version of the Addiction Severity Index (ASI) instrument in a Swiss sample of illicit drug users. PARTICIPANTS AND SETTING: The participants in the study were 54 French-speaking dependent patients, most of them with opiates as the drug of first choice. Procedure: Analyses of internal consistency (convergent and discriminant validity) and reliability, including measures of test-retest and inter-observer correlations, were conducted. RESULTS: Besides good applicability of the test, the results on composite scores (CSs) indicate comparable results to those obtained in a sample of American opiate-dependent patients. Across the seven dimensions of the ASI, Cronbach's alpha ranged from 0.42 to 0.76, test-retest correlations coefficients ranged from 0.48 to 0.98, while for CSs, inter-observer correlations ranged from 0.76 to 0.99. CONCLUSIONS: Despite several limitations, the French version of the ASI presents acceptable criteria of applicability, validity and reliability in a sample of drug-dependent patients.

The inter-rater reliability of the Pulmonary Embolism Severity Index.

The Pulmonary Embolism Severity Index (PESI) is a validated clinical prognostic model for patients with acute pulmonary embolism (PE). Our goal was to assess the PESI's inter-rater reliability in patients diagnosed with PE. We prospectively identified consecutive patients diagnosed with PE in the emergency department of a Swiss teaching hospital. For all patients, resident and attending physician raters independently collected the 11 PESI variables. The raters then calculated the PESI total point score and classified patients into one of five PESI risk classes (I-V) and as low (risk classes I/II) versus higher-risk (risk classes III-V). We examined the inter-rater reliability for each of the 11 PESI variables, the PESI total point score, assignment to each of the five PESI risk classes, and classification of patients as low versus higher-risk using kappa (κ) and intra-class correlation coefficients (ICC). Among 48 consecutive patients with an objective diagnosis of PE, reliability coefficients between resident and attending physician raters were > 0.60 for 10 of the 11 variables comprising the PESI. The inter-rater reliability for the PESI total point score (ICC: 0.89, 95% CI: 0.81-0.94), PESI risk class assignment (κ: 0.81, 95% CI: 0.66-0.94), and the classification of patients as low versus higher-risk (κ: 0.92, 95% CI: 0.72-0.98) was near perfect. Our results demonstrate the high reproducibility of the PESI, supporting the use of the PESI for risk stratification of patients with PE.