Numerical methods and tangible interfaces for pollutant dispersion simulation

Dissertação apresentada para obtenção do Grau de Doutor em Engenharia do Ambiente, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

A Pilot Cost-Effectiveness Analysis of Treatments in Newly Diagnosed High-Grade Gliomas: The Example of 5-Aminolevulinic Acid Compared With White-Light Surgery

BACKGROUND: High-grade gliomas are aggressive, incurable tumors characterized by extensive diffuse invasion of the normal brain parenchyma. Novel therapies at best prolong survival; their costs are formidable and benefit is marginal. Economic restrictions thus require knowledge of the cost-effectiveness of treatments. Here, we show the cost-effectiveness of enhanced resections in malignant glioma surgery using a well-characterized tool for intraoperative tumor visualization, 5-aminolevulinic acid (5-ALA). OBJECTIVE: To evaluate the cost-effectiveness of 5-ALA fluorescence-guided neurosurgery compared with white-light surgery in adult patients with newly diagnosed high-grade glioma, adopting the perspective of the Portuguese National Health Service. METHODS: We used a Markov model (cohort simulation). Transition probabilities were estimated with the use of data from 1 randomized clinical trial and 1 noninterventional prospective study. Utility values and resource use were obtained from published literature and expert opinion. Unit costs were taken from official Portuguese reimbursement lists (2012 values). The health outcomes considered were quality-adjusted life-years, lifeyears, and progression-free life-years. Extensive 1-way and probabilistic sensitivity analyses were performed. RESULTS: The incremental cost-effectiveness ratios are below €10 000 in all evaluated outcomes, being around €9100 per quality-adjusted life-year gained, €6700 per life-year gained, and €8800 per progression-free life-year gained. The probability of 5-ALA fluorescence-guided surgery cost-effectiveness at a threshold of €20000 is 96.0% for quality-adjusted life-year, 99.6% for life-year, and 98.8% for progression-free life-year. CONCLUSION: 5-ALA fluorescence-guided surgery appears to be cost-effective in newly diagnosed high-grade gliomas compared with white-light surgery. This example demonstrates cost-effectiveness analyses for malignant glioma surgery to be feasible on the basis of existing data.

Porokeratosis Ptychotropica of the Scrotum: Dermoscopic Evaluation of an Atypical Presentation

Porokeratosis ptychotropica is a rare variant of porokeratosis that is classically located on the gluteal and perianal regions, seldom extending to the genitalia. The authors report an atypical presentation of porokeratosis ptychotropica and discuss the use of dermoscopy in evaluating this dermatosis. Dermoscopic findings, although not specific to this variant of porokeratosis, are helpful in the differential diagnosis of other genital disorders. Histopathology, through the visualization of multiple cornoid lamellae, prevails as the gold standard for the definite diagnosis of porokeratosis ptychotropica.

Comparison of vigilance methods in three houses with different Triatoma infestans densities

Através da prova de 7 dias foi estudado o grau de resistência do Plasmodium falciparum à cloroquina, amodiaquina e sulfadoxina-pirimetamina em Porto Velho, Estado de Rondônia, Brasil. Não se observaram diferenças significativas nas médias de parasitas nos dias de seguimento e nas proporções de resistência entre os três medicamentos testados, fazendo com que os autores recomendem a manutenção das 4-aminoquinoleínas como drogas a serem usadas atualmente em infecções não graves por P. falciparum na área de Porto Velho.

Qualidade e satisfação do sistema de seguimento à distância de cardioversores-desfibrilhadores implantáveis

RESUMO - Com o aumento da esperança de vida e das doenças crónicas, cada vez se tem implantado mais cardioversores-desfibrilhadores (CDI) para prevenção de morte súbita. O aumento exponencial no número de implantes aumenta o número de seguimentos dos dispositivos, sobrecarregando os profissionais de saúde e comprometendo a qualidade dos serviços prestados. Segundo as recomendações internacionais, um CDI deverá ser vigiado a cada 3 meses, o que perfaz 4 consultas por ano/doente no mínimo, se não existirem episódios de “choques” ou “descompensações” clínicas, e mensalmente quando é atingido o indicador de substituição electiva do gerador. A evolução da tecnologia, de algoritmos, visualização de episódios e terapias requer recursos técnicos e humanos diferenciados e um gasto de tempo considerável no seguimento. Em países como os Estados Unidos da América, em que os doentes têm de percorrer distâncias muito grandes para aceder aos cuidados de saúde, tornou-se preemente a necessidade de um sistema de vigilância alternativo. Nesse sentido, e usando o conceito da telemedicina, foi criado o seguimento/monitorização à distância de dispositivos cardíacos. Este reduz os custos em consultas, deslocações e recursos humanos, uma vez que contempla apenas uma consulta presencial por ano. Por outro lado, aumenta a segurança do doente com a monitorização periódica e a criação de alarmes, permitindo uma assistência de qualidade e intervenção adequada imediata. Aproveitando as vantagens que este tipo de sistema de transmissão remota oferece, procedeu-se no meu serviço, à distribuição inicial de 62 comunicadores a doentes portadores de CDI´s ou com Ressincronizadores Cardíacos (TRC´s1). Apesar de ser considerada uma melhoria na qualidade dos serviços prestados, é também uma mudança importante na metodologia da consulta feita até aqui. Segundo vários autores, a avaliação da qualidade dos cuidados em saúde está intrinsecamente ligada ao grau de satisfação dos doentes com esses serviços, ou seja, à relação entre as suas expectativas e os resultados percebidos por eles, sendo considerado um importante indicador de qualidade dos serviços. Com este trabalho, pretende-se avaliar a percepção dos doentes face ao novo seguimento em termos de aceitação, satisfação, validade, segurança e confiança no novo sistema. Se este mantém os mesmos padrões de qualidade que o seguimento presencial. Trata-se de um estudo transversal com uma componente retrospectiva de avaliação da nova metodologia de consulta à distância. Para tal, foi elaborado um questionário, que foi aplicado a 40 doentes (17,5% do género feminino e 82,5% do género masculino; média de idades de 65 anos) que constituíram a amostra do estudo. Verificou-se uma média de 5 anos de tempo de implante do CDI. Dos dados obtidos, é de realçar que 70% dos inquiridos estão satisfeitos e 30% estão muito satisfeitos com esta nova metodologia de consulta e cerca 67,4% prefere a consulta à distância. Quando solicitados para comparar a qualidade do serviço prestado entre as duas consultas, 65% respondeu igual e 27,5% melhor. Todos os inquiridos responderam ter confiança e segurança com o sistema de consulta à distância. Cerca de 87,5% dos inquiridos vê-se mesmo a continuar com este tipo de consulta. Os resultados obtidos são bastante satisfatórios no que diz respeito à transição do modo como a consulta de CDI´s é feita. Reflectem também que a tecnologia não é necessariamente uma barreira no acesso aos profissionais de saúde, desde que suportada por algum contacto directo (telefone e através de uma consulta presencial por ano). 1 TRC – Terapia de Ressincronização Cardíaca

Bullwhip effect, in production control: a comparison between traditional methods and LPS

21th Annual Conference of the International Group for Lean Construction (IGLC 21), July 2013, Fortaleza, Brazil

Comparative analysis of multicriteria decision making methods

Dissertação para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores

Modeling and visualization of medical anesthesiology acts

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

The Edges of Areal Units: a case study in the heterogeneous effects of assessment district edges

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

Internationalization strategies and methods of construction firms – a comparative study between Hong Kong - Chinese and Portuguese – European approaches

Dissertação para obtenção do Grau Mestre em Engenharia Civil – Perfil de Construção

Mathematical and numerical methods for inverse problems using fundamental solutions techniques

Fundação para a Ciência e a Tecnologia - SFRH/BD/27914/2006

New visualization model for large scale biosignals analysis

Benefits of long-term monitoring have drawn considerable attention in healthcare. Since the acquired data provides an important source of information to clinicians and researchers, the choice for long-term monitoring studies has become frequent. However, long-term monitoring can result in massive datasets, which makes the analysis of the acquired biosignals a challenge. In this case, visualization, which is a key point in signal analysis, presents several limitations and the annotations handling in which some machine learning algorithms depend on, turn out to be a complex task. In order to overcome these problems a novel web-based application for biosignals visualization and annotation in a fast and user friendly way was developed. This was possible through the study and implementation of a visualization model. The main process of this model, the visualization process, comprised the constitution of the domain problem, the abstraction design, the development of a multilevel visualization and the study and choice of the visualization techniques that better communicate the information carried by the data. In a second process, the visual encoding variables were the study target. Finally, the improved interaction exploration techniques were implemented where the annotation handling stands out. Three case studies are presented and discussed and a usability study supports the reliability of the implemented work.

Comparison of in vitro activity of five antifungal agents against dermatophytes, using the agar dilution and broth microdilution methods

The purpose of this study was to compare the agar dilution and broth microdilution methods for determining the minimum inhibitory concentration (MIC) of fluconazole, itraconazole, ketoconazole, griseofulvin and terbinafine for 60 dermatophyte samples belonging to the species Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis. The percentage agreement between the two methods, for all the isolates with < 2 dilutions that were tested was 91.6% for ketoconazole and griseofulvin, 88.3% for itraconazole, 81.6% for terbinafine and 73.3% for fluconazole. One hundred percent agreement was obtained for Trichophyton mentagrophytes isolates evaluated with ketoconazole and griseofulvin. Thus, until a reference method for testing the in vitro susceptibility of dermatophytes is standardized, the similarity of the results between the two methods means that the agar dilution method may be useful for susceptibility testing on these filamentous fungi.

Analysis, testing and development of safe cleaning methods of rusted stone material

Three different treatments were applied on several specimens of dolomitic and calcitic marble, properly stained with rust to mimic real situations (the stone specimens were exposed to the natural environment for about six months in contact with rusted iron). Thirty six marble specimens, eighteen calcitic and eighteen dolomitic, were characterized before and after treatment and monitored throughout the cleaning tests. The specimens were characterized by SEM-EDS (Scanning Electron Microscopy coupled with Energy Dispersion System), XRD (XRay Diffraction), XRF (X-Ray Fluorescence), FTIR (Fourier Transform Infrared Spectroscopy) and color measurements. It was also made a microscopic and macroscopic analysis of the stone surface along with the tests of short and long term capillary absorption. A series of test trials were conducted in order to understand which concentrations and contact times best suits to this purpose, to confirm what had been written to date in the literature. We sought to develop new methods of treatment application, skipping the usual methods of applying chemical treatments on stone substrates, with the use of cellulose poultice, resorting to the agar, a gel already used in many other areas, being something new in this area, which possesses great applicability in the field of conservation of stone materials. After the application of the best methodology for cleaning, specimens were characterized again in order to understand which treatment was more effective and less harmful, both for the operator and the stone material. Very briefly conclusions were that for a very intense and deep penetration into the stone, a solution of 3.5% of SDT buffered with ammonium carbonate to pH around 7 applied with agar support would be indicated. For rust stains in its initial state, the use of Ammonium citrate at a concentration of 5% buffered with ammonium to pH 7 could be applied more than once until satisfactory results appear.

Analysis and visualization of energy use for university campus

The reduction of greenhouse gas emissions is one of the big global challenges for the next decades due to its severe impact on the atmosphere that leads to a change in the climate and other environmental factors. One of the main sources of greenhouse gas is energy consumption, therefore a number of initiatives and calls for awareness and sustainability in energy use are issued among different types of institutional and organizations. The European Council adopted in 2007 energy and climate change objectives for 20% improvement until 2020. All European countries are required to use energy with more efficiency. Several steps could be conducted for energy reduction: understanding the buildings behavior through time, revealing the factors that influence the consumption, applying the right measurement for reduction and sustainability, visualizing the hidden connection between our daily habits impacts on the natural world and promoting to more sustainable life. Researchers have suggested that feedback visualization can effectively encourage conservation with energy reduction rate of 18%. Furthermore, researchers have contributed to the identification process of a set of factors which are very likely to influence consumption. Such as occupancy level, occupants behavior, environmental conditions, building thermal envelope, climate zones, etc. Nowadays, the amount of energy consumption at the university campuses are huge and it needs great effort to meet the reduction requested by European Council as well as the cost reduction. Thus, the present study was performed on the university buildings as a use case to: a. Investigate the most dynamic influence factors on energy consumption in campus; b. Implement prediction model for electricity consumption using different techniques, such as the traditional regression way and the alternative machine learning techniques; and c. Assist energy management by providing a real time energy feedback and visualization in campus for more awareness and better decision making. This methodology is implemented to the use case of University Jaume I (UJI), located in Castellon, Spain.