Growth and puberty after treatment for acute lymphoblastic leukemia

Over the last 20 years, after combining treatment of chemotherapy and radiotherapy, there has been an improvement in the survival rate of acute lymphoblastic leukemia patients, with a current cure rate of around 70%. Children with the disease have been enrolled into international treatment protocols designed to improve survival and minimize the serious irreversible late effects. Our oncology unit uses the international protocol: GBTLI LLA-85 and 90, with the drugs methotrexate, cytosine, arabinoside, dexamethasone, and radiotherapy. However, these treatments can cause gonadal damage and growth impairment. PATIENTS AND METHOD: The authors analyzed 20 children off therapy in order to determine the role of the various doses of radiotherapy regarding endocrinological alterations. They were divided into 3 groups according to central nervous system prophylaxis: Group A underwent chemotherapy, group B underwent chemotherapy plus radiotherapy (18 Gy), and group C underwent chemotherapy plus radiotherapy (24 Gy). Serum concentrations of LH, FSH, GH, and testosterone were determined. Imaging studies included bone age, pelvic ultrasound and scrotum, and skull magnetic resonance imaging. RESULTS: Nine of the patients who received radiotherapy had decreased pituitary volume. There was a significant difference in the response to GH and loss of predicted final stature (Bayley-Pinneau) between the 2 irradiated groups and the group that was not irradiated, but there was no difference regarding the radiation doses used (18 or 24 Gy). The final predicted height (Bayley-Pinneau) was significantly less (P = 0.0071) in both groups treated with radiotherapy. Two girls had precocious puberty, and 1 boy with delayed puberty presented calcification of the epididymis. CONCLUSION: Radiotherapy was been responsible for late side effects, especially related to growth and puberty.

New method for evaluation of cutaneous sensibility in diabetic feet: preliminary report

Diabetic neuropathy is an important complication of the disease, responsible for ulceration and amputation of the foot. Prevention of these problems is difficult mainly because there is no method to correctly access sensibility on the skin of the foot. The introduction of the Pressure-Specified Sensory Device (PSSD TM) in the last decade made possible the measurement of pressure thresholds sensed by the patient, such as touch, both static and in movement, on a continuous scale. This paper is the first in Brazil to report the use of this device to measure cutaneous sensibility in 3 areas of the foot: the hallux pulp, the calcaneus, and the dorsum, which are territories of the tibial and fibular nerves. METHOD: Non-diabetic patients were measured as controls, and 2 groups of diabetic patients - with and without ulcers - were compared. The PSSD TM was used to test the 3 areas described above. The following were evaluated: 1 PS (1-point static), 1 PD (1-point dynamic), 2 PS (2-points static), 2 PD (2-points dynamic). RESULTS: The diabetic group had poorer sensibility compared to controls and diabetics with ulcers had poorer sensibility when compared to diabetics without ulcers. The differences were statistically significant (P <.001). CONCLUSION: Due to the small number of patients compared, the results should be taken as a preliminary report.

O princípio da confidencialidade na mediação em matéria civil e comercial

The purpose of the following study is to analyze the relevance of the principle of confidentiality concerning mediation on civil and commercial matters developed in Portugal. We will, essentially, try to determine just how pivotal is this principle and how it affects the effectiveness of that method of alternative dispute resolution. We believe it is fundamental to understand the true extent of this principle and its goals, emphasizing the protection given to those who decide to resort to mediation and its impact on this process. For this dissertation, we have based our analysis on the interpretation of the set rules assembled by Law nr 29/2013, April 19th, while combining it with data gathered from other laws and regulations that had also addressed mediation. Furthermore, given the fact that this subject has been regulated by Directive 2008/52/EC, we deem pertinent to include references to other European mediation regulations, namely from Germany, Spain and France. With this study, we have established that, even though the Portuguese mediation law is based on a European Directive, we have determined a more restrictive regulation for the principle of confidentiality. We have concluded that the rules regarding this principle try to preserve, above all, the trust and honesty established during the course of the mediation, while restricting the possibility of using the information disclosed during these sessions on other cases. Additionally, we believe confidentiality is such a distinctive and relevant feature that its legal framework leads us to deem it as a true obstacle to the parties’ private autonomy and their power to determine how the mediation should be carried out.

A continuous solvent- and oil-free method to prepare injectable PEGylated fibrinogen cell-laden microparticles

Injectable biomaterials with in situ cross-linking reactions have been suggested to minimize the invasiveness associated with most implantation procedures. However, problems related with the rapid liquid-to-gel transition reaction can arise because it is difficult to predict the reliability of the reaction and its end products, as well as to mitigate cytotoxicity to the surrounding tissues. An alternative minimally invasive approach to deliver solid implants in vivo is based on injectable microparticles, which can be processed in vitro with high fidelity and reliability, while showing low cytotoxicity. Their delivery to the defect can be performed by injection through a small diameter syringe needle. We present a new methodology for the continuous, solvent- and oil-free production of photopolymerizable microparticles containing encapsulated human dermal fibroblasts. A precursor solution of cells in photo-reactive PEG-fibrinogen (PF) polymer was transported through a transparent injector exposed to light-irradiation before being atomized in a jet-in-air nozzle. Shear rheometry data provided the cross-linking kinetics of each PF/cell solution, which was then used to determine the amount of irradiation required to partially polymerize the mixture prior to atomization. The partially polymerized drops fell into a gelation bath for further polymerization. The system was capable of producing cell-laden microparticles with high cellular viability, with an average diameter of between 88.1 µm to 347.1 µm and a dispersity of between 1.1 and 2.4, depending on the parameters chosen.

Innovative method for the continuous monitoring of concrete viscoelastic properties since early ages: concept and pilot experiments

The experimental evaluation of viscoelastic properties of concrete is traditionally made upon creep tests that consist in the application of sustained loads either in compression or in tension. This kind of testing demands for specially devised rigs and requires careful monitoring of the evolution of strains, whereas assuring proper load constancy. The characterization of creep behaviour at early ages offers additional challenges due to the strong variations in viscoelastic behaviour of concrete during such stages, demanding for several testing ages to be assessed. The present research work aims to assist in reducing efforts for continuous assessment of viscoelastic properties of concrete at early ages, by application of a dynamic testing technique inspired in methodologies used in polymer science: Dynamic Mechanical Analyses. This paper briefly explains the principles of the proposed methodology and exhibits the first results obtained in a pilot application. The results are promising enough to encourage further developments.

Annoyance and welfare costs from the presence of renewable energy power plants: an application of the contingent valuation method

Sustainability is frequently defined by its three pillars: economically viable, socially equitable, and environmentally bearable. Consequently the evaluation of the sustainability of any decision, public or private, requires information on these three dimensions. This paper focuses on social sustainability. In the context of renewable energy sources, the examination of social sustainability requires the analysis of not only the efficiency but also the equity of its welfare impacts. The present paper proposes and applies a methodology to generate the information necessary to do a proper welfare analysis of the social sustainability of renewable energy production facilities. This information is key both for an equity and an efficiency analysis. The analysis focuses on the case of investments in renewable energy electricity production facilities, where the impacts on local residents’ welfare are often significantly different than the welfare effects on the general population. We apply the contingent valuation method to selected facilities across the different renewable energy power plants located in Portugal and conclude that local residents acknowledge differently the damage sustained by the type, location and operation of the plants. The results from these case studies attest to the need of acknowledging and quantifying the negative impacts on local communities when assessing the economic viability, social equity and environmental impact of renewable energy projects.

Typology based method for choosing old masonry walls inspection procedures

The diagnosis of historic masonry walls is an intricate and complex field and has been an object of research for many years. This paper aims to propose practical methodologies for the diagnosis of historic masonry walls, specifically based on their typological characteristics. In order to develop such procedures, information relating to historic masonry typologies in Portugal, classified as rural, urban and military was gathered and techniques for the assessment of historic masonry were studied. All information was integrated to develop a pattern typology oriented methodology. Developed methodology was tested and validated in a small diagnosis campaign carried out in the Guimarães Castle. Methodology was proven to be advantageous and although the study is limited and focused on the Portuguese architectural specificities, it still holds global classifications, and therefore can be useful for any diagnosis procedure of a historic masonry wall.

The potential field method and the nonlinear attractor dynamics approach: what are the differences?

One of the most popular approaches to path planning and control is the potential field method. This method is particularly attractive because it is suitable for on-line feedback control. In this approach the gradient of a potential field is used to generate the robot's trajectory. Thus, the path is generated by the transient solutions of a dynamical system. On the other hand, in the nonlinear attractor dynamic approach the path is generated by a sequence of attractor solutions. This way the transient solutions of the potential field method are replaced by a sequence of attractor solutions (i.e., asymptotically stable states) of a dynamical system. We discuss at a theoretical level some of the main differences of these two approaches.

A performance-based method for seismic evaluation of masonry walls strengthened with RC layers

A conventional method for seismic strengthening of masonry walls is externally application of reinforced concrete layer (shotcrete). However, due to the lack of analytical and experimental information on the behavior of strengthened walls, the design procedures are usually followed based on the empirical relations. Using these design procedures have resulted in massive strengthening details in retrofitting projects. This paper presents a computational framework for nonlinear analysis of strengthened masonry walls and its versatility has been verified by comparing the numerical and experimental results. Based on the developed numerical model and available experimental information, design relations and failure modes are proposed for strengthened walls in accordance with the ASCE 41 standard. Finally, a sample masonry structure has been strengthened using the proposed and available conventional methods. It has been shown that using the proposed method results in lower strengthening details and appropriate (ductile) failure modes

Prevention in underground construction with sequential excavation method

This paper aims to describe the Sequential Excavation Method, used for excava-tion in underground works, as well as the related risks and preventive measures. This method has characteristics that differentiate it from other tunnelling techniques: it uses a larger number of workers and equipment; it has a high concurrency of tasks with various workers and equip-ment quite exposed to hazards; and it uses many potentially aggressive chemicals. Firstly, it is given a broad overview of this issue. Afterwards, it will be presented the results of a survey to a sample of experienced technicians, aimed at gauging the relevance of a set of guidelines relat-ing to the design and work phases, applicable to the domestic market and prepared following technical visits to works abroad.

Combining data mining and evolutionary computation for multi-criteria optimization of earthworks

Earthworks tasks aim at levelling the ground surface at a target construction area and precede any kind of structural construction (e.g., road and railway construction). It is comprised of sequential tasks, such as excavation, transportation, spreading and compaction, and it is strongly based on heavy mechanical equipment and repetitive processes. Under this context, it is essential to optimize the usage of all available resources under two key criteria: the costs and duration of earthwork projects. In this paper, we present an integrated system that uses two artificial intelligence based techniques: data mining and evolutionary multi-objective optimization. The former is used to build data-driven models capable of providing realistic estimates of resource productivity, while the latter is used to optimize resource allocation considering the two main earthwork objectives (duration and cost). Experiments held using real-world data, from a construction site, have shown that the proposed system is competitive when compared with current manual earthwork design.

Methodology for real-time adaptation of tunnels support using the observational method

The observational method in tunnel engineering allows the evaluation in real time of the actual conditions of the ground and to take measures if its behavior deviates considerably from predictions. However, it lacks a consistent and structured methodology to use the monitoring data to adapt the support system in real time. The definition of limit criteria above which adaptation is required are not defined and complex inverse analysis procedures (Rechea et al. 2008, Levasseur et al. 2010, Zentar et al. 2001, Lecampion et al. 2002, Finno and Calvello 2005, Goh 1999, Cui and Pan 2012, Deng et al. 2010, Mathew and Lehane 2013, Sharifzadeh et al. 2012, 2013) may be needed to consistently analyze the problem. In this paper a methodology for the real time adaptation of the support systems during tunneling is presented. In a first step limit criteria for displacements and stresses are proposed. The methodology uses graphics that are constructed during the project stage based on parametric calculations to assist in the process and when these graphics are not available, since it is not possible to predict every possible scenario, inverse analysis calculations are carried out. The methodology is applied to the “Bois de Peu” tunnel which is composed by two tubes with over 500 m long. High uncertainty levels existed concerning the heterogeneity of the soil and consequently in the geomechanical design parameters. The methodology was applied in four sections and the results focus on two of them. It is shown that the methodology has potential to be applied in real cases contributing for a consistent approach of a real time adaptation of the support system and highlight the importance of the existence of good quality and specific monitoring data to improve the inverse analysis procedure.

A sixth-order finite volume method for the 1D biharmonic operator: application to intramedullary nail simulation

A new very high-order finite volume method to solve problems with harmonic and biharmonic operators for one- dimensional geometries is proposed. The main ingredient is polynomial reconstruction based on local interpolations of mean values providing accurate approximations of the solution up to the sixth-order accuracy. First developed with the harmonic operator, an extension for the biharmonic operator is obtained, which allows designing a very high-order finite volume scheme where the solution is obtained by solving a matrix-free problem. An application in elasticity coupling the two operators is presented. We consider a beam subject to a combination of tensile and bending loads, where the main goal is the stress critical point determination for an intramedullary nail.

Cross-language influences on new second language vocabulary acquisition: the effect of learning method

Dissertação de mestrado integrado em Psicologia