Causas de no trombolisis en ataque cerebrovascular

Introducción. El ataque cerebrovascular (ACV) ocupa el primer lugar en frecuencia entre todas las enfermedades neurológicas de la vida adulta, y el tercer lugar como causa más frecuente de muerte. Se aprobó para el manejo agudo, la terapia con activador del plasminógeno tisular recombinante (t-PA) en las primeras 4,5 horas después del inicio de los síntomas, demostrando mayor sobrevida y menos niveles de discapacidad. Sin embargo solo el 5-10% de pacientes reciben este manejo. Por estas razones es necesario conocer que factores se asocian con la no intervención terapéutica. Objetivo. Describir los factores asociados con la no trombolisis en pacientes con ataque cerebrovascular en un hospital de IV nivel en Bogotá, Colombia. Métodos. Estudio analítico de corte transversal, en un centro de cuarto nivel en Bogotá entre enero de 2009 y enero de 2011. Resultados. Se encontraron 178 pacientes en un promedio de edad de 65,9 años (DE± 10 años) con una relación hombre-mujer 1:1, la principal causa de no trombolisis fue la ventana mayor a 4.5 horas, 33,7% (n=60), 26,4% por cambios en imágenes diagnosticas, y 14% por puntajes leves o severos en las escala National Institute of Health Stroke Scale (NIHSS), historia quirúrgica 7.3% y laboratorios 4.5%. El tiempo promedio de atención fue 23 minutos (DE ± 21 min) para la activación del código de ACV, 39 minutos para valoración por neurología (DE ± 25 min), 46 minutos (DE ± 19,1 min) para toma de paraclínicos, 66 minutos para toma de imágenes y 97 minutos para trombolisis (DE ± 21min, DE ± 17 min, respectivamente). Se realizó trombolisis en 17 pacientes, 9,6%. No se encontró asociación significativa entre cultura de organización con trombolisis ni de tiempos de atención con trombolisis. Conclusiones. La principal razón de no trombolisis, fue la ventana mayor a 4.5 horas, no se encontró relación entre cultura de organización institucional con trombolisis. El tiempo promedio de trombolisis fue de 90 minutos. Deben instaurarse medidas para reducir el tiempo de llegada al hospital, y los tiempos de atención en urgencias. Deben realizarse nuevas evaluaciones del código ACV posterior a las estrategias de mejoría.

Somos patrimonio somos ciudad - marketing social del patrimonio cultural urbano: Plan del Eje Ambiental de la Avenida Gonzalo Jiménez de Quesada

En la actualidad, el patrimonio cultural se encuentra inmerso en un entorno dinámico y cambiante, caracterizado por la globalización y la diversidad, que planeta nuevos retos a su gestión. En el plano internacional dos modelos de marketing han dado algunas respuestas a esto, el economicista o tradicional y el específico de las artes y la cultura. Ambos modelos se basan en una noción materialista del patrimonio cultural, concebido como producto o como recurso patrimonial, y la existencia de cuatro elementos comunes de contexto: El mercado, la organización, el sistema de información y el marketing mix. Sin embargo, estos enfoques no le son aplicables al patrimonio urbano colombiano, porque su contexto es diferente, caracterizado por una dinámica nula o de mercado inexistente, sin fuerzas de mercado que atiendan por su valoración, conservación y preservación o garanticen su sostenibilidad, que está referido a bienes de carácter público, por cuyo consumo nadie está dispuesto a pagar de manera directa, cuya tutela está atribuida al Estado y frente al cual coexiste una pluralidad de actores. Por lo anterior, un modelo de marketing aplicable a dicho patrimonio cultural, debe construirse sobre lineamientos conceptuales de mayor complejidad e hibridación, que permitan una concepción integral de aquel y de su gestión.

Turismo em São Tomé e Príncipe: realidade ou utopia?

O turismo em São Tomé e Príncipe foi eleito como objecto de estudo desta investigação que tem como intenção principal explorar como este sector tem vindo a responder aos actuais desafios propostos pela Organização Mundial do Turismo – OMT, no que respeita à melhoria da qualidade de vida da população. Os resultados demonstram que os sectores implicados, quer públicos, quer privados, têm a concepção da importância do turismo, mas apresentam dificuldades na operacionalização do mesmo, muito particularmente o Estado. Além da falta de informação e de apoio, o Estado não possui instrumentos de gestão que incentivem o desenvolvimento harmonioso do turismo no país, apesar de esta questão estar presente nas suas directrizes estratégicas. Sendo assim, a pesquisa demonstrou uma grande distância entre o discurso e a prática na procura pelo turismo. Percebe-se que os sectores públicos têm vindo a praticar acções pontuais que resultam em pouco ou nenhum desenvolvimento do turismo e em pouca visibilidade na mudança das condições de bem-estar das comunidades são-tomenses. Pode dizer-se que o país ainda não conta com o turismo para alcançar o desenvolvimento, não apresenta uma actuação que possa ser caracterizada como bem sucedida no que se refere às dimensões social, cultural e económica. ABSTRACT: Tourism in Sao Tome and Principe was chosen as the subject of this research, which explore how this sector are responding to current challenges posed by the World Tourism Organization - WTO, with regard to improving the quality of life. The results show that the sectors involved, both public and private, have the conception of the importance of tourism, but have difficulties in operating the same, particularly the state. Besides the lack of information and support, the state lacks management tools that promote the harmonious development of tourism in the country, although this issue is present in its strategic guidelines. Thus, the survey showed a big gap between discourse and practice in the pursuit of tourism. It is perceived that public sectors have been practicing off actions that result in little or no development of tourism and little visibility on the changing conditions of well-being of Sao Tome. It can be said that the country still relies on tourism for development, does not present an action that could be characterized as successful in relation to social, cultural and economic.

Pollination and other ecosystem services produced by mobile organisms: a conceptual framework for the effects of land-use change

Many ecosystem services are delivered by organisms that depend on habitats that are segregated spatially or temporally from the location where services are provided. Management of mobile organisms contributing to ecosystem services requires consideration not only of the local scale where services are delivered, but also the distribution of resources at the landscape scale, and the foraging ranges and dispersal movements of the mobile agents. We develop a conceptual model for exploring how one such mobile-agent-based ecosystem service (MABES), pollination, is affected by land-use change, and then generalize the model to other MABES. The model includes interactions and feedbacks among policies affecting land use, market forces and the biology of the organisms involved. Animal-mediated pollination contributes to the production of goods of value to humans such as crops; it also bolsters reproduction of wild plants on which other services or service-providing organisms depend. About one-third of crop production depends on animal pollinators, while 60-90% of plant species require an animal pollinator. The sensitivity of mobile organisms to ecological factors that operate across spatial scales makes the services provided by a given community of mobile agents highly contextual. Services vary, depending on the spatial and temporal distribution of resources surrounding the site, and on biotic interactions occurring locally, such as competition among pollinators for resources, and among plants for pollinators. The value of the resulting goods or services may feed back via market-based forces to influence land-use policies, which in turn influence land management practices that alter local habitat conditions and landscape structure. Developing conceptual models for MABES aids in identifying knowledge gaps, determining research priorities, and targeting interventions that can be applied in an adaptive management context.

Mechanisms and function of flower and inflorescence reversion

Flower and inflorescence reversion involve a switch from floral development back to vegetative development, thus rendering flowering a phase in an ongoing growth pattern rather than a terminal act of the meristem. Although it can be considered an unusual event, reversion raises questions about the nature and function of flowering. It is linked to environmental conditions and is most often a response to conditions opposite to those that induce flowering. Research on molecular genetic mechanisms underlying plant development over the last 15 years has pinpointed some of the key genes involved in the transition to flowering and flower development. Such investigations have also uncovered mutations which reduce floral maintenance or alter the balance between vegetative and floral features of the plant. How this information contributes to an understanding of floral reversion is assessed here. One issue that arises is whether floral commitment (defined as the ability to continue flowering when inductive conditions no longer exist) is a developmental switch affecting the whole plant or is a mechanism which assigns autonomy to individual meristems. A related question is whether floral or vegetative development is the underlying default pathway of the plant. This review begins by considering how studies of flowering in Arabidopsis thaliana have aided understanding of mechanisms of floral maintenance. Arabidopsis has not been found to revert to leaf production in any of the conditions or genetic backgrounds analysed to date. A clear-cut reversion to leaf production has, however, been described in Impatiens balsamina. It is proposed that a single gene controls whether Impatiens reverts or can maintain flowering when inductive conditions are removed, and it is inferred that this gene functions to control the synthesis or transport of a leaf-generated signal. But it is also argued that the susceptibility of Impatiens to reversion is a consequence of the meristem-based mechanisms controlling development of the flower in this species. Thus, in Impatiens, a leaf-derived signal is critical for completion of flowering and can be considered to be the basis of a plant-wide floral commitment that is achieved without accompanying meristem autonomy. The evidence, derived from in vitro and other studies, that similar mechanisms operate in other species is assessed. It is concluded that most species (including Arabidopsis) are less prone to reversion because signals from the leaf are less ephemeral, and the pathways driving flower development have a high level of redundancy that generates meristem autonomy even when leaf-derived signals are weak. This gives stability to the flowering process, even where its initiation is dependent on environmental cues. On this interpretation, Impatiens reversion appears as an anomaly resulting from an unusual combination of leaf signalling and meristem regulation. Nevertheless, it is shown that the ability to revert can serve a function in the life history strategy (perenniality) or reproductive habit (pseudovivipary) of many plants. In these instances reversion has been assimilated into regular plant development and plays a crucial role there.

The role of the Hellenic food safety authority in Greece: implementation strategies

During the last 15 years, a series of food scares and crises (BSE, dioxin. foot and mouth disease) have seriously under-mined public confidence in food producers and operators and their capacity to produce safe food. As a result, food safety has become a top priority of the European legislative authorities and systems of national food control have been tightened up and have included the establishment of the European Food Safety Authority. In Greece a law creating the Hellenic Food Safety Authority has been approved. The main objectives of this Authority are to promote the food security to consumers and inform them of any changes or any development in the food and health sector. The paper reviews the general structure of the current food control system in Greece. It describes the structure and the mission of the Hellenic Food Safety Authority and explains the strategy to carry out inspections and the analysis of the preliminary results of such inspections. Details are also given of the personnel training and certification and accreditation standards to be met by the Authority by the end of 2004. (c) 2005 Elsevier Ltd. All rights reserved.

A low clock frequency FFT core implementation for multiband full-rate ultra-wideband (UWB) receivers

This paper discusses the design, implementation and synthesis of an FFT module that has been specifically optimized for use in the OFDM based Multiband UWB system, although the work is generally applicable to many other OFDM based receiver systems. Previous work has detailed the requirements for the receiver FFT module within the Multiband UWB ODFM based system and this paper draws on those requirements coupled with modern digital architecture principles and low power design criteria to converge on our optimized solution particularly aimed at a low-clock rate implementation. The FFT design obtained in this paper is also applicable for implementation of the transmitter IFFT module therefore only needing one FFT module in the device for half-duplex operation. The results from this paper enable the baseband designers of the 200Mbit/sec variant of Multiband UWB systems (and indeed other OFDM based receivers) using System-on-Chip (SoC), FPGA and ASIC technology to create cost effective and low power consumer electronics product solutions biased toward the very competitive market.

Technologies for biological containment of GM and Non-GM crops

International Perspective The development of GM technology continues to expand into increasing numbers of crops and conferred traits. Inevitably, the focus remains on the major field crops of soybean, maize, cotton, oilseed rape and potato with introduced genes conferring herbicide tolerance and/or pest resistance. Although there are comparatively few GM crops that have been commercialised to date, GM versions of 172 plant species have been grown in field trials in 31 countries. European Crops with Containment Issues Of the 20 main crops in the EU there are four for which GM varieties are commercially available (cotton, maize for animal feed and forage, and oilseed rape). Fourteen have GM varieties in field trials (bread wheat, barley, durum wheat, sunflower, oats, potatoes, sugar beet, grapes, alfalfa, olives, field peas, clover, apples, rice) and two have GM varieties still in development (rye, triticale). Many of these crops have hybridisation potential with wild and weedy relatives in the European flora (bread wheat, barley, oilseed rape, durum wheat, oats, sugar beet and grapes), with escapes (sunflower); and all have potential to cross-pollinate fields non-GM crops. Several fodder crops, forestry trees, grasses and ornamentals have varieties in field trials and these too may hybridise with wild relatives in the European flora (alfalfa, clover, lupin, silver birch, sweet chestnut, Norway spruce, Scots pine, poplar, elm, Agrostis canina, A. stolonifera, Festuca arundinacea, Lolium perenne, L. multiflorum, statice and rose). All these crops will require containment strategies to be in place if it is deemed necessary to prevent transgene movement to wild relatives and non-GM crops. Current Containment Strategies A wide variety of GM containment strategies are currently under development, with a particular focus on crops expressing pharmaceutical products. Physical containment in greenhouses and growth rooms is suitable for some crops (tomatoes, lettuce) and for research purposes. Aquatic bioreactors of some non-crop species (algae, moss, and duckweed) expressing pharmaceutical products have been adopted by some biotechnology companies. There are obvious limitations of the scale of physical containment strategies, addressed in part by the development of large underground facilities in the US and Canada. The additional resources required to grow plants underground incurs high costs that in the long term may negate any advantage of GM for commercial productioNatural genetic containment has been adopted by some companies through the selection of either non-food/feed crops (algae, moss, duckweed) as bio-pharming platforms or organisms with no wild relatives present in the local flora (safflower in the Americas). The expression of pharmaceutical products in leafy crops (tobacco, alfalfa, lettuce, spinach) enables growth and harvesting prior to and in the absence of flowering. Transgenically controlled containment strategies range in their approach and degree of development. Plastid transformation is relatively well developed but is not suited to all traits or crops and does not offer complete containment. Male sterility is well developed across a range of plants but has limitations in its application for fruit/seed bearing crops. It has been adopted in some commercial lines of oilseed rape despite not preventing escape via seed. Conditional lethality can be used to prevent flowering or seed development following the application of a chemical inducer, but requires 100% induction of the trait and sufficient application of the inducer to all plants. Equally, inducible expression of the GM trait requires equally stringent application conditions. Such a method will contain the trait but will allow the escape of a non-functioning transgene. Seed lethality (‘terminator’ technology) is the only strategy at present that prevents transgene movement via seed, but due to public opinion against the concept it has never been trialled in the field and is no longer under commercial development. Methods to control flowering and fruit development such as apomixis and cleistogamy will prevent crop-to-wild and wild-to-crop pollination, but in nature both of these strategies are complex and leaky. None of the genes controlling these traits have as yet been identified or characterised and therefore have not been transgenically introduced into crop species. Neither of these strategies will prevent transgene escape via seed and any feral apomicts that form are arguably more likely to become invasives. Transgene mitigation reduces the fitness of initial hybrids and so prevents stable introgression of transgenes into wild populations. However, it does not prevent initial formation of hybrids or spread to non-GM crops. Such strategies could be detrimental to wild populations and have not yet been demonstrated in the field. Similarly, auxotrophy prevents persistence of escapes and hybrids containing the transgene in an uncontrolled environment, but does not prevent transgene movement from the crop. Recoverable block of function, intein trans-splicing and transgene excision all use recombinases to modify the transgene in planta either to induce expression or to prevent it. All require optimal conditions and 100% accuracy to function and none have been tested under field conditions as yet. All will contain the GM trait but all will allow some non-native DNA to escape to wild populations or to non-GM crops. There are particular issues with GM trees and grasses as both are largely undomesticated, wind pollinated and perennial, thus providing many opportunities for hybridisation. Some species of both trees and grass are also capable of vegetative propagation without sexual reproduction. There are additional concerns regarding the weedy nature of many grass species and the long-term stability of GM traits across the life span of trees. Transgene stability and conferred sterility are difficult to trial in trees as most field trials are only conducted during the juvenile phase of tree growth. Bio-pharming of pharmaceutical and industrial compounds in plants Bio-pharming of pharmaceutical and industrial compounds in plants offers an attractive alternative to mammalian-based pharmaceutical and vaccine production. Several plantbased products are already on the market (Prodigene’s avidin, β-glucuronidase, trypsin generated in GM maize; Ventria’s lactoferrin generated in GM rice). Numerous products are in clinical trials (collagen, antibodies against tooth decay and non-Hodgkin’s lymphoma from tobacco; human gastric lipase, therapeutic enzymes, dietary supplements from maize; Hepatitis B and Norwalk virus vaccines from potato; rabies vaccines from spinach; dietary supplements from Arabidopsis). The initial production platforms for plant-based pharmaceuticals were selected from conventional crops, largely because an established knowledge base already existed. Tobacco and other leafy crops such as alfalfa, lettuce and spinach are widely used as leaves can be harvested and no flowering is required. Many of these crops can be grown in contained greenhouses. Potato is also widely used and can also be grown in contained conditions. The introduction of morphological markers may aid in the recognition and traceability of crops expressing pharmaceutical products. Plant cells or plant parts may be transformed and maintained in culture to produce recombinant products in a contained environment. Plant cells in suspension or in vitro, roots, root cells and guttation fluid from leaves may be engineered to secrete proteins that may be harvested in a continuous, non-destructive manner. Most strategies in this category remain developmental and have not been commercially adopted at present. Transient expression produces GM compounds from non-GM plants via the utilisation of bacterial or viral vectors. These vectors introduce the trait into specific tissues of whole plants or plant parts, but do not insert them into the heritable genome. There are some limitations of scale and the field release of such crops will require the regulation of the vector. However, several companies have several transiently expressed products in clinical and pre-clinical trials from crops raised in physical containment.

The regional strategies of British multinational subsidiaries in South East Asia

We compare the strategies of manufacturing and service multinational enterprise (MNE) subsidiaries in South East Asia to investigate whether they follow global versus regional strategy. We examine foreign direct investment (FDI) motives, types of FDI, product and service offerings, and sales strategies of these two groups. Using a unique primary data set of 101 British MNE subsidiaries in six South East Asian countries over the five-year period (2003–2007), we find that manufacturing and service subsidiaries pursue regional strategies. Both groups have a strong regional focus in their sales. We explore the possible reasons for the relative lack of global strategy of these subsidiaries.

Generation of nonvernal-obligate, faster-cycling Noccaea caerulescens lines through fast neutron mutagenesis

Noccaea caerulescens (formerly Thlaspi caerulescens) is a widely studied metal hyperaccumulator. However, molecular genetic studies are challenging in this species because of its vernal-obligate biennial life cycle of 7-9 months. Here, we describe the development of genetically stable, faster cycling lines of N. caerulescens which are nonvernal-obligate. A total of 5500 M(0) seeds from Saint Laurent Le Minier (France) were subjected to fast neutron mutagenesis. Following vernalization of young plants, 79 of plants survived to maturity. In all, 80 000 M(2) lines were screened for flowering in the absence of vernalization. Floral initials were observed in 35 lines, with nine flowering in < 12 wk. Two lines (A2 and A7) were selfed to the M(4) generation. Floral initials were observed 66 and 87 d after sowing (DAS) in A2 and A7, respectively. Silicle development occurred for all A2 and for most A7 at 92 and 123 DAS, respectively. Floral or silicle development was not observed in wild-type (WT) plants. Leaf zinc (Zn) concentration was similar in WT, A2 and A7 lines. These lines should facilitate future genetic studies of this remarkable species. Seed is publicly available through the European Arabidopsis Stock Centre (NASC).

Research data management and openness: the role of data sharing in developing institutional policies and practices

Purpose: To investigate the relationship between research data management (RDM) and data sharing in the formulation of RDM policies and development of practices in higher education institutions (HEIs). Design/methodology/approach: Two strands of work were undertaken sequentially: firstly, content analysis of 37 RDM policies from UK HEIs; secondly, two detailed case studies of institutions with different approaches to RDM based on semi-structured interviews with staff involved in the development of RDM policy and services. The data are interpreted using insights from Actor Network Theory. Findings: RDM policy formation and service development has created a complex set of networks within and beyond institutions involving different professional groups with widely varying priorities shaping activities. Data sharing is considered an important activity in the policies and services of HEIs studied, but its prominence can in most cases be attributed to the positions adopted by large research funders. Research limitations/implications: The case studies, as research based on qualitative data, cannot be assumed to be universally applicable but do illustrate a variety of issues and challenges experienced more generally, particularly in the UK. Practical implications: The research may help to inform development of policy and practice in RDM in HEIs and funder organisations. Originality/value: This paper makes an early contribution to the RDM literature on the specific topic of the relationship between RDM policy and services, and openness – a topic which to date has received limited attention.

Transcriptome analysis of Taenia solium cysticerci using Open Reading Frame ESTs (ORESTES)

Background: Human infection by the pork tapeworm Taenia solium affects more than 50 million people worldwide, particularly in underdeveloped and developing countries. Cysticercosis which arises from larval encystation can be life threatening and difficult to treat. Here, we investigate for the first time the transcriptome of the clinically relevant cysticerci larval form. Results: Using Expressed Sequence Tags (ESTs) produced by the ORESTES method, a total of 1,520 high quality ESTs were generated from 20 ORESTES cDNA mini-libraries and its analysis revealed fragments of genes with promising applications including 51 ESTs matching antigens previously described in other species, as well as 113 sequences representing proteins with potential extracellular localization, with obvious applications for immune-diagnosis or vaccine development. Conclusion: The set of sequences described here will contribute to deciphering the expression profile of this important parasite and will be informative for the genome assembly and annotation, as well as for studies of intra- and inter-specific sequence variability. Genes of interest for developing new diagnostic and therapeutic tools are described and discussed.

e-infrastruktur som stöd för hemtjänsten

The annual cost of home care services of transport in Falun/Borlänge, is now at 31 million kronor. It is clear from previous research that it is possible to reduce these costs through a restructuring of the existing home-help service. The restructuring aims to have a higher proportion of older people, who are in need of care, to live in special accommodation, in order to reduce transport costs. Therefore there is a need for systems that allow home-help service to plan their operations in such a way that transport is working as efficiently as possible. Through better planning, there are profits to be done. The rewards are not only of an economic nature but also include a reduced environmental impact, better working environment, improving road safety, and better service. One way to achieve this is to give home-help service personnel better navigation aid when they move between the customers. The thesis describes such a solution through a developed prototype based on a standardized interaction between a planning and a navigation service. The thesis describes such a solution through a developed prototype based on a standardized interaction between a planning and a navigation service. Development work has also been a first step in developing a standardized information infrastructure for home-help service. The purpose of the thesis is, on the basis of theory and the experience we have acquired through the development of the prototype, to discuss general issues which are of interest when developing standardized information infrastructure.

Akademisk kvalitet, vad är det? : Om utarmningen av den akademiska autonomin

What is academic quality? On the decline of academic autonomy In light of the transformations that universities currently undergo, with Bologna as a keyword, the following questions are put: What ideals lie behind the assessment of academic “excellence” and “quality”? What agents have the ability to define what is good science and education today? These questions are approached through Pierre Bourdieus concept of field. Looking at the development the last decade, traditional academic values, such as the ideal of universal knowledge as (personal and collective) enrichment and the intellectual independence “of all political authority and economic power”, as stated in the Magna Charta Universitatum, seem to have emerged into the shadow of employability, knowledge control, competitiveness, and economic benefit. In connection with the formation of concepts such as “the knowledge society” and “knowledge based economies” the university has received a somewhat different and more central role in society. The university has come to take the role more of a knowledge producing enterprise clearly directed towards the surrounding society. There are higher demands on academic knowledge to contribute to economic, regional or national development and competitiveness. When the university is regarded as a knowledge company whose task is to accoun tfor the requests of the students, the labour market, and the business world it undertakes to follow trends and short term social phases rather than to critically examine them, which has been a traditional task for the university. If the academic work is guided by the market economical principle, that the client requests decide what quality is, instead of the experts on the academic field themselves (i.e. the scientists,) it is obviously not scientific ideals that constitute the criteria for what is good science and education.

Método de otimização de produtos e processos medidos por múltiplas características de qualidade

Esta dissertação pretende consolidar um método quantitativo, flexível e genérico que possa ser útil na otimização experimental dos mais variados produtos e processos industriais medidos por múltiplas variáveis de resposta. O que se pretende com o método é identificar o ajuste ótimo dos fatores controláveis, ou seja, aquele que reduz os custos devido à má qualidade de um produto considerando também os custos de matéria-prima e energia gastos na fabricação desse produto. A redução dos custos gerados pela má qualidade de um produto é alcançada através da minimização dos desvios das variáveis de resposta dos seus valores alvos e maximização da robustez do produto ou processo aos fatores de ruído e a possíveis oscilações nos fatores controláveis, pois toda vez que uma variável de resposta desvia-se do seu valor alvo ou apresenta variabilidade, existe uma perda financeira experimentada pelo seu usuário. Ao longo do texto, faz-se uma revisão da literatura existente sobre o assunto, apresentam-se as etapas do método que devem ser cumpridas e algumas ferramentas consideradas eficientes no cumprimento dessas etapas. Logo após, realizam-se estudos práticos para validar o método e, baseado nesses estudos e no referencial teórico, conclui-se sobre o assunto.