Novel system for distant assessment of cataract surgical quality in rural China

BACKGROUND: This study aims to assess the quality of various steps of manual small incision cataract surgery and predictors of quality, using video recordings.
DESIGN: This paper applies a retrospective study.
PARTICIPANTS: Fifty-two trainees participated in a hands-on small incision cataract surgery training programme at rural Chinese hospitals.
METHODS: Trainees provided one video each recorded by a tripod-mounted digital recorder after completing a one-week theoretical course and hands-on training monitored by expert trainers. Videos were graded by two different experts, using a 4-point scale developed by the International Council of Ophthalmology for each of 12 surgical steps and six global factors. Grades ranged from 2 (worst) to 5 (best), with a score of 0 if the step was performed by trainers.
MAIN OUTCOME MEASURES: Mean score for the performance of each cataract surgical step rated by trainers.
RESULTS: Videos and data were available for 49/52 trainees (94.2%, median age 38 years, 16.3% women and 77.5% completing > 50 training cases). The majority (53.1%, 26/49) had performed ≤ 50 cataract surgeries prior to training. Kappa was 0.57∼0.98 for the steps (mean 0.85). Poorest-rated steps were draping the surgical field (mean ± standard deviation = 3.27 ± 0.78), hydro-dissection (3.88 ± 1.22) and wound closure (3.92 ± 1.03), and top-rated steps were insertion of viscoelastic (4.96 ± 0.20) and anterior chamber entry (4.69 ± 0.74). In linear regression models, higher total score was associated with younger age (P = 0.015) and having performed >50 independent manual small incision cases (P = 0.039).
CONCLUSIONS: More training should be given to preoperative draping, which is poorly performed and crucial in preventing infection. Surgical experience improves ratings.© 2015 Royal Australian and New Zealand College of Ophthalmologists.

The Effect of Seat Location in Lecture Theatres on Academic Performance

The purpose of this research study was to investigate and identify possible patterns relating to academic performance on the effects of university students self-selecting where to sit in a lecture theatre.
The key research questions are:
1. Does seating position affect student performance?
2. Do the most academically able and engaged students regularly sit at the front of lecture theatres?
Academic achievement
Preliminary results suggest significant assessment score differences between those that sit at the front and those that sit further the back. Of those that received a grade of 75%+ (Grade A) 6.67% regularly sat at the back. With the same group 46.67% regularly sat at the front. Of the group that scored less than 50% (Grade D) 0% of students regularly sat at the front. 12.50% regularly sat in the middle zones with 37.50% sitting at the back. It was also observed that the remaining numbers did not consistently sit in the same zone.

Temporal movement
There is little evidence of movement between seating zones of the Grade A group throughout the 24 week period. However there was considerable movement with the Grade D group. Although still under analysis there appears be a pattern of students in this group graduating towards the back seating positions over the course of the programme.

Engagement
The frequency of completed entries on PinPoint was also used as an indicator of engagement. With the Grade A group 75% of them regularly completed an entry whereas in the Grade D group this drops to less than 50%.
Further analysis on the attitudinal factors in relational to seating position and performance are ongoing, but preliminary results suggest that those students that scored highly in attitude tended to sit at the front and middle sections.
It would indeed appear that the more highly engaged and academically capable students voluntarily sit at the front for most lectures. Interestingly as the course progresses those who had lesser engagement and below average midterm results tend to began to sit progressively toward the back. If this is a repeatable pattern then a linear regression analysis of the seating positions and midterm results could help predict students in danger of failing.

Automated retinal image quality assessment on the UK Biobank dataset for epidemiological studies

Morphological changes in the retinal vascular network are associated with future risk of many systemic and vascular diseases. However, uncertainty over the presence and nature of some of these associations exists. Analysis of data from large population based studies will help to resolve these uncertainties. The QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) retinal image analysis system allows automated processing of large numbers of retinal images. However, an image quality assessment module is needed to achieve full automation. In this paper, we propose such an algorithm, which uses the segmented vessel map to determine the suitability of retinal images for use in the creation of vessel morphometric data suitable for epidemiological studies. This includes an effective 3-dimensional feature set and support vector machine classification. A random subset of 800 retinal images from UK Biobank (a large prospective study of 500,000 middle aged adults; where 68,151 underwent retinal imaging) was used to examine the performance of the image quality algorithm. The algorithm achieved a sensitivity of 95.33% and a specificity of 91.13% for the detection of inadequate images. The strong performance of this image quality algorithm will make rapid automated analysis of vascular morphometry feasible on the entire UK Biobank dataset (and other large retinal datasets), with minimal operator involvement, and at low cost.

Assessment of biocompatibility of selected ferroelectric ceramics

Desde há muitas décadas que é sabido que os organismos vivos, em especial os tecidos, reagem fisicamente a estímulos eléctricos, podendo esses efeitos reproduzirem-se numa libertação de químicos endógenos, ou deformar a sua estrutura física. O tecido ósseo por si só é considerado um material/tecido piezoeléctrico, deformando-se mecanicamente quando lhe é induzido um estímulo eléctrico e vice-versa, ou seja, produz um potencial eléctrico quando sofre uma tracção ou compressão mecânica. A hipótese de que um material ferroeléctrico possa vir a produzir efeitos no desempenho deste tipo de tecidos é então proposta, como por exemplo, para uma melhor, mais rápida e eficaz regeneração óssea. Estes mesmos materiais ferroeléctricos podem porventura alterar as cargas de superfície dos tecidos vivos de modo a atrair, atrasar ou até impedir o fluxo iónico de elementos químicos específicos responsáveis pelo processo de regeneração. São escolhidos então o niobato de lítio e o tantalato de lítio como cerâmicos ferroeléctricos e foi estudada pela primeira vez a sua bioactividade in vitro, esperando-se encontrar pistas relativas à sua bioactividade in vivo. Estes cerâmicos ferroeléctricos foram seleccionados devido às suas importantes propriedades piezoeléctricas e ferroeléctricas. Estas propriedades podem abrir um novo e importante leque de aplicações biomédicas caso estes cerâmicos sejam bioactivos. Este trabalho foi dividido em 3 fases: (i) sintetização dos pós de niobato de lítio e tantalato de lítio, (ii) caracterização dos pós e (iii) preparação das amostras e (iv) estudo da bioactividade destes cerâmicos ferroeléctricos. Os pós foram produzidos através de um processo simples de mistura/moagem seguido de calcinação. Foram estudadas as fases cristalinas presentes através de Difracção de raios-X (DRX) e avaliadas as características morfológicas destes pós, nomeadamente o diâmetro de partículas e área superficial específica. De modo a simular o ambiente do plasma humano, foi produzido sinteticamente um “Simulated Body Fluid” (SBF). Seguidamente as amostras foram imersas nesse ambiente líquido por 1, 3, 7, 15 e 21 dias. Após remoção dos pós foram realizadas uma série de análises de modo a estudar a sua bioactividade. De entre estes testes destacam-se a microscopia electrónica de varrimento (SEM/EDS), DRX e espectroscopia de Infravermelho por transformada de Fourier com reflectância total atenuada (FTIR-ATR). Embora não tenham sido detectadas alterações no DRX realizado aos pós, verificou-se a formação de aglomerados de fosfato de cálcio na superfície dos pós através do SEM, resultados estes, reforçados pelo EDS e FTIR-ATR. Estes precipitados de fosfato de cálcio indiciam a capacidade destes pós cerâmicos ferroeléctricos se comportarem como bioactivos em contacto com tecidos ósseos in vivo.

Ecological assessment of the red deer population in the Lousã Mountain

Durante o último século, as populações de cervídeos têm aumentado substancialmente um pouco por toda a Europa. O veado Cervus elaphus não foi exceção, apresentando atualmente uma ampla distribuição geográfica. Após a quase extinção de todas as populações selvagens desta espécie em Portugal, o número de efetivos de veado e a área de distribuição da espécie têm aumentado significativamente nas últimas décadas. Esta proliferação deveu-se fundamentalmente aos processos de reintrodução implementados em algumas zonas do país, como foi o caso da Serra da Lousã. Dez anos após a reintrodução, a expansão geográfica e demográfica é já uma realidade e a espécie assume um papel relevante tanto do ponto de vista cinegético como turístico. Com o aumento das populações de ungulados, surge a necessidade de aumentar o conhecimento existente sobre estas espécies, particularmente ao nível das estimativas populacionais, do uso e seleção de habitat, do comportamento e da fisiologia das populações. Neste sentido, um dos objetivos foi comparar quatro métodos de contagem de excrementos em termos de estimativa populacional, aplicabilidade e eficiência. Face aos resultados obtidos, o método de transectos lineares com distance sampling revelou-se o mais eficiente, providenciando uma boa precisão num menor tempo. Relativamente ao uso e seleção do habitat, recorrendo a transectos de contagem de excrementos e a observações diretas, verificou-se que o veado seleciona positivamente habitats que lhe proporcionam simultaneamente alimento e refúgio, como é o caso das áreas de ecótono. A preferência por áreas de ecótono evidencia um comportamento adaptativo de maximização de energia, no qual os animais optam por procurar refúgio na proximidade das áreas de alimentação de forma a minimizarem os dispêndios energéticos. Em termos de dinâmica populacional, verificou-se uma relação entre a densidade de veado e o tamanho dos seus grupos, bem como o efeito nos mesmos do coberto vegetal. Contudo, dado o seu alto dimorfismo sexual em termos de tamanho corporal, as preferências de habitat podem também ser em parte responsáveis pela segregação sexual fora da época de reprodução. Face aos resultados obtidos através do método de observação direta de animais, a segregação sexual surge como consequência da interação entre fatores sociais e de habitat, que resultam de diferentes estratégias reprodutivas por parte de ambos os sexos. As diferentes estratégias reprodutivas são também notórias em termos de condição física e imunológica, com os machos a aumentarem a sua condição durante as épocas de primavera e verão de forma a melhorarem a sua performance durante o cio, e as fêmeas a viverem grande parte do ano no limiar da condição física devido ao seu investimento na sobrevivência da sua descendência. Globalmente, o veado apresenta uma boa adaptação à Serra da Lousã e representa um importante recurso natural para esta região. Contudo, para que a proliferação desta população selvagem continue, é necessária a implementação de medidas de gestão adequadas a este ecossistema mediterrâneo.

Assessment of higher plant species suitability for ecological restoration following major disturbance

O presente trabalho é constituído por uma revisão bibliográfica e uma série de estudos científicos experimentais visando a melhoria do conhecimento da ecologia de germinação e resposta ao estresse hídrico em arbustos autóctones. Estes estudos pretendem contribuir para o conhecimento da ecologia de espécies autóctones na fase de germinação e estabelecimento inicial das plântulas através da comparação da resposta de sementes de diferentes proveniências. Os primeiros três capítulos focam-se no estudo dos efeitos de pré-tratamentos na germinação de espécies arbustivas com diferentes estratégias de regeneração e dormência da semente, enquanto os dois últimos capítulos incidem sobre o efeito de diferentes condições de disponibilidade de água na germinação e estabelecimento inicial de plântulas com potencial para restauro ecológico. Este estudo procura abordar aspetos importantes para o estudo e validação do uso de espécies alvo para o restauro ecológico em zonas Mediterrânicas, contribuindo deste modo para a melhoria do conhecimento da ecologia destas espécies. A germinação foi estimulada por pré-tratamentos de calor em quatro das cinco espécies cuja época de dispersão da semente na primavera-verão. As sementes provenientes do sul tenderam a germinar melhor, sendo ao mesmo tempo mais pequenas. Por outro lado, a germinação em espécies cuja dispersão da semente ocorre no outono-inverno variou de acordo com o tipo de dormência da semente. A germinação foi em geral favorecida pela estratificação a frio na espécie apresentando dormência fisiológica mas foi negativamente afetada na espécie que não apresenta dormência. Esta resposta não foi, no entanto, inequívoca pois foi dependente da proveniência estudada. O efeito da estratificação a frio teve em geral um efeito mais positivo ou menos negativo nas sementes provenientes do norte em comparação com as outras proveniências. O stress-osmótico teve um efeito negativo consistente na germinação de Pistacia lentiscus e outro fator que também afetou significativamente a germinação foi a variabilidade intra-populacional entre plantas mãe. As duas proveniências apresentaram diferentes graus de associação entre a germinação e/ou caracteres morfológicos da semente ou planta mãe. Quanto à fase de estabelecimento inicial, o baixo conteúdo em água teve um claro efeito negativo no investimento relativo em biomassa acima do solo e um efeito positivo no investimento relativo em biomassa abaixo do solo em Arbutus unedo. Esta resposta não foi inequívoca, uma vez que as proveniências diferiram em adaptações morfológicas ao baixo conteúdo em água. As plântulas da proveniência mais húmida revelaram uma taxa de crescimento relativo superior mas, ao mesmo tempo, uma fraca adaptação às condições de baixa disponibilidade de água, quando comparadas com as outras proveniências. Ao contrário, as plântulas da proveniência seca com verão mais quente apresentaram semelhantes diâmetro do colo da raiz, peso seco de folhas e performance fisiológica sob os dois regimes de irrigação. Os resultados obtidos revelam diferenças significativas na germinação e desenvolvimento inicial entre as distintas proveniências que poderão estar relacionadas com adaptações ao clima dos locais de origem. Os desenvolvimentos futuros do estudo dos mecanismos subjacentes às adaptações observadas poderiam contribuir para a melhoria das previsões de sucesso do estabelecimento inicial em diferentes populações de plantas, permitindo aumentar a confiança e efetividade de custos nas decisões relacionadas com ações de restauro ecológico em cenários de alterações climáticas.

Seismic vulnerability assessment of slender masonry structures

Slender masonry structures are distributed all over the world and constitute a relevant part of the architectural and cultural heritage of humanity. Their protection against earthquakes is a topic of great concern among the scientific community. This concern mainly arises from the strong damage or complete loss suffered by this group of structures due to catastrophic events and the need and interest to preserve them. Although the great progress in technology, and in the knowledge of seismology and earthquake engineering, the preservation of these brittle and massive structures still represents a major challenge. Based on the research developed in this work it is proposed a methodology for the seismic risk assessment of slender masonry structures. The proposed methodology was applied for the vulnerability assessment of Nepalese Pagoda temples which follow very simple construction procedure and construction detailing in relation to seismic resistance requirements. The work is divided in three main parts. Firstly, particular structural fragilities and building characteristics of the important UNESCO classified Nepalese Pagoda temples which affect their seismic performance and dynamic properties are discussed. In the second part the simplified method proposed for seismic vulnerability assessment of slender masonry structures is presented. Finally, the methodology proposed in this work is applied to study Nepalese Pagoda temples, as well as in the efficiency assessment of seismic performance improvement solution compatible with original cultural and technological value.

Hygrothermal performance of wood-hemp insulation in timber frame wall panels with and without a vapour barrier

An in situ experiment on a full-scale timber frame test building was carried out to study the hygrothermal performance of wood-hemp composite insulation in timber frame wall panels with and without a vapour barrier. The heat transfer properties and the likelihood of mould growth and condensation in the panels were compared. Step changes in the internal relative humidity were performed to explore the effects of high, normal and low internal moisture loads on the wall panels. No significant difference in the average equivalent thermal transmittance (U-values) between the panels with and without a vapour barrier was observed. The average equivalent U-values of the panels were close to the U-values calculated from the manufacturers’ declared thermal conductivity values of the insulation. The likelihood of condensation was higher at the interface of the wood-hemp insulation and the oriented strand board (OSB) in the panel without a vapour barrier. In terms of the parametric assessment of the mould germination potential, the relative humidity, the temperature and the exposure conditions in the insulation-OSB interfaces of the panel without a vapour barrier were found to be more favourable to the germination of mould spores. Nonetheless, when the insulations were dismantled, no mould was visually detected.

The comparative in situ hygrothermal performance of Hemp and Stone Wool insulations in vapour open timber frame wall panels

An in situ experiment in a full scale timber frame test building was carried out to compare the hygrothermal performance of Hemp and Stone Wool insulations of identical thermal conductivity. Hemp and Stone Wool insulations were installed in timber frame wall panels without vapour barrier. The comparison was made in terms of heat transfer properties, likelihood of mould growth and condensation. Step changes in internal relative humidity were performed to explore the effect of high and normal internal moisture load on the wall panels. No significant difference between the average equivalent thermal transmittance (U-values) of the panels incorporating Hemp and Stone Wool insulations was observed. The average equivalent U-values of the panels were closer to the calculated U-values of the panels based on the manufacturers’ declared thermal conductivity of Hemp and Stone Wool insulations. It was observed that the placement of heat flux sensor along the depth of the insulation had significant influence on the measured equivalent U-value of the panels during high internal moisture load. The frequency and likelihood of condensation was higher in the interface of Stone Wool and Oriented Strand Board (OSB). In terms of the parametric assessment of mould germination potential, relative humidity, temperature and exposure conditions in the insulation-OSB interfaces were found to be favourable to germination of mould spore. However, when the insulations were dismantled, no mould was visually detected.

Incongruence between clinicians’ assessment and self-reported functioning is related with psychopathology among patients diagnosed with gastrointestinal disorders

In a previous exploratory study we observed no relevant differences in psychopathology, personality, and functioning between inpatients diagnosed with gastrointestinal motor disorders (GMDs) or functional gastrointestinal disorders (FGDs) [1]. However, we observed higher levels of incongruence between clinician-assessed performance status and patients’ self-reported levels of functioning among patients diagnosed with FGDs. Likewise, research in other medical conditions has shown incongruences between self-reported and clinician-reported or objective measures [2]. Furthermore, in a study on chronic depression, the authors found that discrepancies between patients’ and physicians’ assessments of medical comorbidities were related to higher levels of depressive symptomatology [3]. In this line, the aim of this study was to explore whether the inconsistencies between clinician-assessed and patient self-reported levels of functioning could be related to psychopathology among patients admitted for evaluation of gastrointestinal motility.

Adding value to performance measurement by using system dynamics and multicriteria analysis

Tese de dout., Filosofia, Department of Management Science, University of Strathclyde, 2004

Dual-tracking multi-constellation GNSS front-end for high-performance receiver applications

This paper presents the design and implementation of a dual–tracking Radio Frequency (RF) front–end for a multi–constellation Global Navigation Satellite Systems (GNSS) receiver. The RF frond–end is based on the direct RF conversion architecture, which employs sub–Nyquist sampling (also known as subsampling) at RF. The dual–tracking RF front–end is composed of a few RF components that are duplicated to form the two RF channels. Employing a dual–channel Analogue–to–Digital Converter (ADC) enables synchronisation of the RF channels and minimises the errors resulting from the differences in the satellite clocks and the propagation delay between the two RF channels. The digitised GNSS signals are processed by two separate acquisition and tracking engines that are driven by the front–end’s master clock. This setup provides two synchronised receivers that are integrated onto one piece of hardware. The hardware is intended to be used for research applications such as multipath mitigation, scintillation assessment, and advanced satellite clock and spatial frame transformation modelling.

Personality and performance on digit span tests in online and offline settings.

This paper describes two studies examining links between personality and performance on a cognitive test in online and laboratory settings. Study 1 was completed online. 345 participants passively recruited through a personality assessment website completed a Five Factor Model personality inventory derived from the International Personality Item Pool. They then completed an online text-based digit span test. This required participants to repeat increasingly longer strings of digits, either in the same order (forward) or in the opposite of the presentation order (reverse). Conventional digit span tasks ask participants to respond verbally; in this instance they responded by typing the digits. Agreeableness and Openness to Experience each had small but significant associations with forward and reverse digit span. In a second, laboratory based, study, 103 participants completed paper versions of the IPIP Five Factor inventory, the NEO-FFI, and a battery of cognitive tests including the WAIS 4 digit span test. In this instance, Agreeableness and Openness to Experience were not significantly correlated with digit span measures. Taken together, these studies suggest that personality characteristics may influence performance on an online cognitive test. This effect was not seen in an offline version of the study. The paper will consider potential implications for online testing, for equivalence of online and offline methods, and for links between personality and performance on this cognitive test.

Drink availability is associated with enhanced examination performance in adults

While dehydration has negative effects on memory and attention, few studies have investigated whether drinking water can enhance cognitive performance, and none have addressed this in a real-world setting. In this study we explored the potential benefits of the availability of water for undergraduates. The exam performance of students who brought drinks in to exams was compared with those that did not for three cohorts of undergraduates (N = 447). We employed earlier coursework marks as a measure of underlying ability. Students who brought water to the exam achieved better grades than students who did not. When coursework marks were covaried, this effect remained statistically significant, suggesting that this finding was not simply due to more able students being more likely to bring in water. This implies that water consumption may facilitate performance in real-world settings, and, therefore, have specific implications for the assessment of undergraduate learners under examination conditions, but further research is required to evaluate this hypothesis.

Association between birth weight and neuromotor performance: a twin study

The development of neonatal intensive care has led to an increase in the prevalence of children with low birth weight and associated morbidity. The objectives of this study are to verify (1) The association between birth weight (BW) and neuromotor performance? (2) Is the neuromotor performance of twins within the normal range? (3) Are intra-pair similarities in neuromotor development of Monozygotic (MZ) and Disygotic (DZ) twins of unequal magnitude? The sample consisted of 191 children (78 MZ and 113 DZ), 8.9+3.1 years of age and with an average BW of 2246.3+485.4g. In addition to gestational characteristics, sports participation and Zurich Neuromotor Assessment (ZNA) were observed at childhood age. The statistical analysis was carried out with software SPSS 18.0, the STATA 10 and the ZNA performance scores. The level of significance was 0.05. For the neuromotor items high intra and inter-investigator reliabilities were obtained (0.793performance performance.