Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months

ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

Application of a Pid+fuzzy controller on the motion control system in machine tools

This work deals with an hybrid PID+fuzzy logic controller applied to control the machine tool biaxial table motions. The non-linear model includes backlash and the axis elasticity. Two PID controllers do the primary table control. A third PID+fuzzy controller has a cross coupled structure whose function is to minimise the trajectory contour errors. Once with the three PID controllers tuned, the system is simulated with and without the third controller. The responses results are plotted and compared to analyse the effectiveness of this hybrid controller over the system. They show that the proposed methodology reduces the contour error in a proportion of 70:1.

Modeling and control of multibody system with flexible appendages

The objective of this work is to describe the design and the implementation of an experiment to study the dynamics and the active control of a slewing multi-link flexible structure. The experimental apparatus was designed to be representative of a flexible space structure such as a satellite with multiple flexible appendages. In this study we describe the design procedures, the analog and digital instrumentation, the analytical modeling together with model validation studies carried out through experimental modal testing and parametric system identification studies in the frequency domain. Preliminary results of a simple positional control where the sensor and the actuator are positioned physically at the same point is also described.

Algorithm to determine the intersection curves between bezier surfaces by the solution of multivariable polynomial system and the differential marching method

The determination of the intersection curve between Bézier Surfaces may be seen as the composition of two separated problems: determining initial points and tracing the intersection curve from these points. The Bézier Surface is represented by a parametric function (polynomial with two variables) that maps a point in the tridimensional space from the bidimensional parametric space. In this article, it is proposed an algorithm to determine the initial points of the intersection curve of Bézier Surfaces, based on the solution of polynomial systems with the Projected Polyhedral Method, followed by a method for tracing the intersection curves (Marching Method with differential equations). In order to allow the use of the Projected Polyhedral Method, the equations of the system must be represented in terms of the Bernstein basis, and towards this goal it is proposed a robust and reliable algorithm to exactly transform a multivariable polynomial in terms of power basis to a polynomial written in terms of Bernstein basis .

A feature-based object-oriented expert system to model and support product design

In this paper a computer program to model and support product design is presented. The product is represented through a hierarchical structure that allows the user to navigate across the product’s components, and it aims at facilitating each step of the detail design process. A graphical interface was also developed, which shows visually to the user the contents of the product structure. Features are used as building blocks for the parts that compose the product, and object-oriented methodology was used as a means to implement the product structure. Finally, an expert system was also implemented, whose knowledge base rules help the user design a product that meets design and manufacturing requirements.

An Inspection System to Identify Fatigue Damage on Steel-Bridge Structures

Crack formation and growth in steel bridge structural elements may be due to loading oscillations. The welded elements are liable to internal discontinuities along welded joints and sensible to stress variations. The evaluation of the remaining life of a bridge is needed to make cost-effective decisions regarding inspection, repair, rehabilitation, and replacement. A steel beam model has been proposed to simulate crack openings due to cyclic loads. Two possible alternatives have been considered to model crack propagation, which the initial phase is based on the linear fracture mechanics. Then, the model is extended to take into account the elastoplastic fracture mechanic concepts. The natural frequency changes are directly related to moment of inertia variation and consequently to a reduction in the flexural stiffness of a steel beam. Thus, it is possible to adopt a nondestructive technique during steel bridge inspection to quantify the structure eigenvalue variation that will be used to localize the grown fracture. A damage detection algorithm is developed for the proposed model and the numerical results are compared with the solutions achieved by using another well know computer code.

Telerobotics: Methodology for the Development of a Through-the-Internet Robotic Teleoperated System

This work presents a methodology for the development of Teleoperated Robotic Systems through the Internet. Initially, it is presented a bibliographical review of the Telerobotic systems that uses Internet as way of control. The methodology is implemented and tested through the development of two systems. The first is a manipulator with two degrees of freedom commanded remotely through the Internet denominated RobWebCam (http://www.graco.unb.br/robwebcam). The second is a system which teleoperates an ABB (Asea Brown Boveri) Industrial Robot of six degrees of freedom denominated RobWebLink (http://webrobot.graco.unb.br). RobWebCam is composed of a manipulator with two degrees of freedom, a video camera, Internet, computers and communication driver between the manipulator and the Unix system; and RobWebLink composed of the same components plus the Industrial Robot. With the use of this technology, it is possible to move far distant positioning objects minimizing transport costs, materials and people; acting in real time in the process that is wanted to be controller. This work demonstrates that the teleoperating via Internet of robotic systems and other equipments is viable, in spite of using rate transmission data with low bandwidth. Possible applications include remote surveillance, control and remote diagnosis and maintenance of machines and equipments.

Substitution-Newton-Raphson method applied to the modeling of a vapour compression refrigeration system using different representations of the thermodynamic properties of R-134a

This paper gives a detailed presentation of the Substitution-Newton-Raphson method, suitable for large sparse non-linear systems. It combines the Successive Substitution method and the Newton-Raphson method in such way as to take the best advantages of both, keeping the convergence features of the Newton-Raphson with the low requirements of memory and time of the Successive Substitution schemes. The large system is solved employing few effective variables, using the greatest possible part of the model equations in substitution fashion to fix the remaining variables, but maintaining the convergence characteristics of the Newton-Raphson. The methodology is exemplified through a simple algebraic system, and applied to a simple thermodynamic, mechanical and heat transfer modeling of a single-stage vapor compression refrigeration system. Three distinct approaches for reproducing the thermodynamic properties of the refrigerant R-134a are compared: the linear interpolation from tabulated data, the use of polynomial fitted curves and the use of functions derived from the Helmholtz free energy.

Experimental validation of a 3-D vision-based measurement system applied to robot calibration

One of the problems that slows the development of off-line programming is the low static and dynamic positioning accuracy of robots. Robot calibration improves the positioning accuracy and can also be used as a diagnostic tool in robot production and maintenance. A large number of robot measurement systems are now available commercially. Yet, there is a dearth of systems that are portable, accurate and low cost. In this work a measurement system that can fill this gap in local calibration is presented. The measurement system consists of a single CCD camera mounted on the robot tool flange with a wide angle lens, and uses space resection models to measure the end-effector pose relative to a world coordinate system, considering radial distortions. Scale factors and image center are obtained with innovative techniques, making use of a multiview approach. The target plate consists of a grid of white dots impressed on a black photographic paper, and mounted on the sides of a 90-degree angle plate. Results show that the achieved average accuracy varies from 0.2mm to 0.4mm, at distances from the target from 600mm to 1000mm respectively, with different camera orientations.

Escape in a nonideal electro-mechanical system

In this work a particular system is investigated consisting of a pendulum whose point of support is vibrated along a horizontal guide by a two bar linkage driven from a DC motor, considered as a limited power source. This system is nonideal since the oscillatory motion of the pendulum influences the speed of the motor and vice-versa, reflecting in a more complicated dynamical process. This work comprises the investigation of the phenomena that appear when the frequency of the pendulum draws near a secondary resonance region, due to the existing nonlinear interactions in the system. Also in this domain due to the power limitation of the motor, the frequency of the pendulum can be captured at resonance modifying completely the final response of the system. This behavior is known as Sommerfeld effect and it will be studied here for a nonlinear system.

Petri Net approach for modelling system integration in intelligent buildings

In this paper, a Petri Net approach is introduced for modelling and simulation of control strategies in Intelligent Building. In this context, it is claimed that integration with other building systems can be achieved in a more systematic way considering a mechatronic approach (i.e. multidisciplinary concepts applied to the development of systems). The case study is the Ambulatory Building of Medical School Hospital of University of São Paulo. Particularly, the developed methodology is applied to the elevator system and to the HVAC (Heating, Ventilation and Air Conditioning) system. It is shown that using this approach, the control systems could be integrated, improving performance.

The developmental anatomy of the subterranean system in Mandevilla illustris (Vell.) Woodson and M. velutina (Mart. ex Stadelm.) Woodson (Apocynaceae)

Two species of Mandevilla from the savanna area of São Paulo State, Brazil were studied. These species have been prescribed as folk medicine as infusions or alcoholic extracts of the underground system for treatment of venomous snake bites. To explain the morphological nature of such a system, its ontogeny was described to determine which parts are involved in its formation. In both Mandevilla species examined, the underground system consists of a xylopodium whose basal region joins a tuberous root.

Are there evidences of a complex mimicry system among Asclepias curassavica (Apocynaceae), Epidendrum fulgens (Orchidaceae), and Lantana camara (Verbenaceae) in Southern Brazil?

The goal of this paper was to test the presence of mimicry in Asclepias curassavica L., Epidendrum fulgens Brong., and Lantana camara L. The study was carried out at the Parque Estadual de Itapeva, RS, southern Brazil, from 2004 to 2006. Flowering period of each of the three species was followed up; focal observations of butterflies visiting flowers, from fixed point and during random walks were carried out. We also estimated the frequency of pollinaria removal in the orchid, as well as its mode of reproduction. All these variables were important for testing the mimicry hypothesis. Despite some temporal coincidences in the flowering period of two plants in the system, there was no statistical association among the three plants as to flowering period. Twenty-nine species of butterflies, as potential pollinators, were recorded, particularly Agraulis vanillae maculosa, Dryas iulia alcionea, Urbanus simplicius, Tegosa claudina, and Heliconius erato phyllis, which were the more frequent visitors of the three plants. There was association between the number of visits to L. camara and E. fulgens, based on Pearson correlation (r = 0.4603; n = 19; P = 0.0473). Pollinaria removal of E. fulgens was low, as measured by the percentage of removal (range: 0 - 10%). The analysis of the mode of reproduction of this orchid showed its pollinator-dependence, since no fruits were formed by spontaneous self-pollination. In contrast, the percentage of fruit set that resulted from geitonogamy and xenogamy was, in average, 86%. The results here shown are not conclusive as to the occurrence of a mimicry system among the three plants.

Mating system in Myracrodruon urundeuva (Anarcadiaceae): implications for conservation genetics

The aims of this study were to investigate the mating system of a fragmented population of the dioecious tropical tree Myracrodruon urundeuva Allemão, using five microsatellite loci and the mixed mating and correlated mating models. The study was conducted in the Estação Ecológica de Paulo de Farias (436 ha), where the population occupies about 142 ha. The mating system was estimated using 514 open-pollinated offspring, collected from 30 seed-trees. Estimates of the multilocus outcrossing rate confirm that the species is dioecious (t m = 1.0). Low levels of mating among relatives were detected in the population (1 - t s = 0.020). The estimate of paternity correlation (r p(m)) indicated that offsprings were composed of mixtures of half-sibs and full-sibs, with the latter occurring at a low frequency (average of 0.148). The estimated coancestry coefficient within families (Θ = 0.147) was larger and the effective population size (Ne(v)) was lower (Ne(v) = 2.98) than expected in progenies from panmictic populations (Θ = 0.125, Ne(v) = 4, respectively). In terms of conservation, the results indicate that to retain an effective population size of 150, is necessary to collect seeds from at least 50 seed-trees.

Planktonic diatoms in lotic and lentic environments in the Lago dos Tigres hydrologic system (Britânia, Goiás, Brazil): Coscinodiscophyceae and Fragilariophyceae

A floristic study of Coscinodiscophyceae and Fragilariophyceae in the Lago dos Tigres hydrologic system is presented. Phytoplankton samples were collected with a plankton net (25 µm mesh) at 11 sampling stations, three in lotic areas and eight in lacustrine zones. Eleven species of Coscinodiscophyceae and eight of Fragilariophyceae were identified; descriptions, comments, their geographic distributions for the midwestern region of Brazil, type of environment (lentic/lotic), and illustrations are provided. Among the taxa found, 13 were recorded for the first time in midwestern Brazil: Aulacoseira alpigena, A. distans, A. granulata var. angustissima, A. granulata var. valida, A. muzzanensis, Discostella stelligera var. stelligera, Fragilaria capucina var. fragilarioides, F. delicatissima var. delicatissima, F. javanica, Pleurosira laevis, Staurosira acutirostrata, Staurosirella crassa, and Ulnaria ulna.