Qualidade dos sistemas de informação no serviço de radiologia do Hospital de Curry Cabral: um estudo de caso

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde

A numerical analysis of generalized Boussinesq-type equation using continuos/discontinuous FEM

An improved class of Boussinesq systems of an arbitrary order using a wave surface elevation and velocity potential formulation is derived. Dissipative effects and wave generation due to a time-dependent varying seabed are included. Thus, high-order source functions are considered. For the reduction of the system order and maintenance of some dispersive characteristics of the higher-order models, an extra O(mu 2n+2) term (n ??? N) is included in the velocity potential expansion. We introduce a nonlocal continuous/discontinuous Galerkin FEM with inner penalty terms to calculate the numerical solutions of the improved fourth-order models. The discretization of the spatial variables is made using continuous P2 Lagrange elements. A predictor-corrector scheme with an initialization given by an explicit RungeKutta method is also used for the time-variable integration. Moreover, a CFL-type condition is deduced for the linear problem with a constant bathymetry. To demonstrate the applicability of the model, we considered several test cases. Improved stability is achieved.

Implementation of a new reference values database for semiquantification in123I-FP-CIT brain single emission tomography

Brain dopamine transporters imaging by Single Emission Tomography (SPECT) with 123I-FP-CIT (DaTScanTM) has become an important tool in the diagnosis and evaluation of Parkinson syndromes.This diagnostic method allows the visualization of a portion of the striatum – where healthy pattern resemble two symmetric commas - allowing the evaluation of dopamine presynaptic system, in which dopamine transporters are responsible for dopamine release into the synaptic cleft, and their reabsorption into the nigrostriatal nerve terminals, in order to be stored or degraded. In daily practice for assessment of DaTScan TM, it is common to rely only on visual assessment for diagnosis. However, this process is complex and subjective as it depends on the observer’s experience and it is associated with high variability intra and inter observer. Studies have shown that semiquantification can improve the diagnosis of Parkinson syndromes. For semiquantification, analysis methods of image segmentation using regions of interest (ROI) are necessary. ROIs are drawn, in specific - striatum - and in nonspecific – background – uptake areas. Subsequently, specific binding ratios are calculated. Low adherence of semiquantification for diagnosis of Parkinson syndromes is related, not only with the associated time spent, but also with the need of an adapted database of reference values for the population concerned, as well as, the examination of each service protocol. Studies have concluded, that this process increases the reproducibility of semiquantification. The aim of this investigation was to create and validate a database of healthy controls for Dopamine transporters with DaTScanTM named DBRV. The created database has been adapted to the Nuclear Medicine Department’s protocol, and the population of Infanta Cristina’s Hospital located in Badajoz, Spain.

Estrutura a partir do Movimento em Sistemas Autónomos

Mestrado em Engenharia Electrotécnica e de Computadores - Ramo de Sistemas Autónomos

Distributed Intelligent Management of Microgrids using a Multi-Agent Simulation Platform

Multi-agent approaches have been widely used to model complex systems of distributed nature with a large amount of interactions between the involved entities. Power systems are a reference case, mainly due to the increasing use of distributed energy sources, largely based on renewable sources, which have potentiated huge changes in the power systems’ sector. Dealing with such a large scale integration of intermittent generation sources led to the emergence of several new players, as well as the development of new paradigms, such as the microgrid concept, and the evolution of demand response programs, which potentiate the active participation of consumers. This paper presents a multi-agent based simulation platform which models a microgrid environment, considering several different types of simulated players. These players interact with real physical installations, creating a realistic simulation environment with results that can be observed directly in the reality. A case study is presented considering players’ responses to a demand response event, resulting in an intelligent increase of consumption in order to face the wind generation surplus.

A reconstrução tomográfica em SPECT com utilização dos novos métodos iterativos “WBR”: comparação com métodos analíticos

Os métodos utilizados pela Medicina moderna no âmbito da Imagem Molecular e na sua capacidade de diagnosticar a partir da “Função do Orgão” em vez da “Morfologia do Orgão”, vieram trazer á componente fundamental desta modalidade da Imagiologia Médica – A Medicina Nuclear – uma importância acrescida, que se tem traduzido num aumento significativo no recurso á sua utilização nas diferentes formas das suas aplicações clínicas. Para além dos aspectos meramente clínicos, que só por si seriam suficientes para ocupar várias dissertações como a presente; a própria natureza desta técnica de imagem, com a sua inerente baixa resolução e tempos longos de aquisição, vieram trazer preocupações acrescidas quanto ás questões relacionadas com a produtividade (nº de estudos a realizar por unidade de tempo); com a qualidade (aumento da resolução da imagem obtida) e, com os níveis de actividade radioactiva injectada nos pacientes (dose de radiação efectiva sobre as populações). Conhecidas que são então as limitações tecnológicas associadas ao desenho dos equipamentos destinados á aquisição de dados em Medicina Nuclear, que apesar dos avanços introduzidos, mantêm mais ou menos inalteráveis os conceitos base de funcionamento de uma Câmara Gama, imaginou-se a alteração significativa dos parâmetros de aquisição (tempo, resolução, actividade), actuando não ao nível das condições técnico-mecânicas dessa aquisição, mas essencialmente ao nível do pós-processamento dos dados adquiridos segundo os métodos tradicionais e que ainda constituem o estado da arte desta modalidade. Este trabalho tem então como objectivo explicar por um lado, com algum pormenor, as bases tecnológicas que desde sempre têm suportado o funcionamento dos sistemas destinados á realização de exames de Medicina Nuclear, mas sobretudo, apresentar as diferenças com os inovadores métodos, que aplicando essencialmente conhecimento (software), permitiram responder ás questões acima levantadas.

Automated image tagging through tag propagation

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial Para obtenção do grau de Mestre em Engenharia Informática

Models and tools for value systems analysis in collaborative environments

Dissertation to obtain the degree of Doctor in Electrical and Computer Engineering, specialization of Collaborative Networks

Identification of Cryptosporidium spp. oocysts in fecal smears stained with Heidenhain's iron hematoxylin

There is no paucity of methods for diagnosing Cryptosporidium spp. infection. The merits of immunoassays notwithstanding, microscopic identification of Cryptosporidium spp. oocysts in fecal samples remains an important diagnostic procedure. It owes the persistence of its use to such characteristics as dispensing with expensive equipment and kits, requiring only basic laboratory facilities, and having a low probability of false positive results when permanent slides are prepared, which can be re-examined in case of doubt. Cryptosporidium spp. oocysts can be readily identified in fecal smears prepared according to a regressive iron hematoxylin staining technique. The number of steps and their duration, as well as costs, were reduced to a minimum without loss of image quality and permanence of the preparations.

Protecção radiológica do doente em tomografia computorizada

RESUMO - A preocupação com os conhecimentos, atitudes, crenças e práticas, no que concerne à utilização de radiações ionizantes para fins de diagnóstico, e a sensibilização de todos os agentes envolvidos, médicos, técnicos, físicos, utentes e responsáveis pela Saúde Publica, relativamente aos níveis de radiação emitida nos exames de Tomografia Computorizada (TC), assume particular importância no domínio da Saúde Pública, na medida em que é necessário influenciar o desenvolvimento de práticas que promovam, auditem e garantam a prestação do controlo da qualidade radiológica e dosimétrica nos serviços de Radiologia a nível Nacional. Para tal, e no âmbito da publicação de estudos já realizados ao nível da União Europeia, ―Orientações Europeias dos Critérios de Qualidade para a Tomografia Computorizada (1999) ‖, é proposto estabelecer orientações na realização de estudos que permitam, numa primeira fase, estabelecer a comparação com os resultados obtidos pelos mecanismos de Controlo da Qualidade (CQ), analisar e proceder aos ajustes (se necessário) e, numa segunda fase, implementar uma moldura sistemática de avaliação periódica dos níveis de dose de radiação por exame TC e que permita a monitorização dos dados. Nesse sentido, propõe-se a realização de um Estudo Nacional que envolva a rede hospitalar pública, privada e universitária, partindo da metodologia utilizada em estudos prévios noutros países da Europa, como seja, selecção do equipamento de TC existente na Instituição Hospitalar, onde serão reunidas informações através do preenchimento de questionários relativos ao equipamento a utilizar. Serão recolhidos dados relativos ao utente, ao equipamento e parâmetros de aquisição de imagem, que permitam identificar os níveis de referência de diagnóstico (NRD) em TC, na realidade Portuguesa. Foi efectuado um estudo piloto numa instituição EPE e os valores obtidos não são significativos, nem podem assumir valor preditivo dado o reduzido tamanho da amostra. Apesar disso, sugerem a existência de parâmetros que podem ser alterados e com isso podem fazer variar a dose de radiação utilizada. ENSP/UNL Maria de Fátima Vaz de Carvalho 5 Espera-se obter com este estudo, como foi referido, a base do estabelecimento dos NRD em TC em Portugal. ----------------- ABSTRACT - The purpose of this study, in an empirical point of view, emerges from concern with the knowledge, attitudes, beliefs and practices regarding the use of ionizing radiation for diagnostic purposes and awareness of all actors involved, medical physical, technical, and responsible public health for the development of practices that promote, audited and ensure the provision of radiological quality control and dosing in radiology service at national level. In view of the complexity and characteristics involved in relation to ionizing radiation, all assume their part in protecting the physical integrity of each user and a global perspective, to ensure the safeguarding of public health, while global and globalizing factor. To this end, and in the context of the publication of studies already carried out at European Union level, "European guidelines for quality criteria for computed tomography", it is proposed to establish guidelines in conducting studies to initially establish the comparison with the results obtained by QC and make adjustments if necessary, and subsequently implement a systematic periodic assessment frame that allows monitoring of data. Accordingly, it is proposed to conduct a national study involving the public network, private and University hospitals, that extends from the methodology used in previous studies in other countries of Europe, as is, selection of equipment of existing CT in Hospital Institution, where information will be gathered by filling out questionnaires concerning the equipment to be used. Data will be collected for the wearer, equipment and parameters of image acquisition, identifying diagnostic reference levels (NRD) in CT in Portuguese fact. A pilot study was carried out in an institution EPE and the values obtained are not significant, nor can they take predictive value given the small sample size. Despite this, suggest the existence of parameters that can be changed and this can vary the dose of radiation used It is hoped to get with this study, as mentioned, the basis of the establishment of NRD in CT in Portugal.

Constraint-based verification of imperative programs

work presented in the context of the European Master’s program in Computational Logic, as the partial requirement for obtaining Master of Science degree in Computational Logic

Impact of dams and irrigation schemes in Anopheline (Diptera: Culicidae) bionomics and malaria epidemiology

Irrigation schemes and dams have posed a great concern on public health systems of several countries, mainly in the tropics. The focus of the present review is to elucidate the different ways how these human interventions may have an effect on population dynamics of anopheline mosquitoes and hence, how local malaria transmission patterns may be changed. We discuss different studies within the three main tropical and sub-tropical regions (namely Africa, Asia and the Pacific and the Americas). Factors such as pre-human impact malaria epidemiological patterns, control measures, demographic movements, human behaviour and local Anopheles bionomics would determine if the implementation of an irrigation scheme or a dam will have negative effects on human health. Some examples of successful implementation of control measures in such settings are presented. The use of Geographic Information System as a powerful tool to assist on the study and control of malaria in these scenarios is also highlighted.

Assessing self-organization and emergence in Evolvable Assembly Systems (EAS)

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

Dynamics of serotonergic neurons revealed by fiber photometry

This work was developed in the context of the MIT Portugal Program, area of Bioengineering Systems, in collaboration with the Champalimaud Research Programme, Champalimaud Center for the Unknown, Lisbon, Portugal. The project entitled Dynamics of serotonergic neurons revealed by fiber photometry was carried out at Instituto Gulbenkian de Ciência, Oeiras, Portugal and at the Champalimaud Research Programme, Champalimaud Center for the Unknown, Lisbon, Portugal

‘Wooden Man’? : Masculinities in the Work of J. M. Coetzee (Boyhood, Youth and Summertime)

In seeking to advance the possibility of justice, gender and postcolonial studies have argued for the importance of the study of masculinities, through the acknowledgment that a richer understanding of such gendered formations may provide the basis for recognition of the Other and that, left uncriticised, such formations may be continuously delineated by the reproduction of systems of domination. The current study finds as its object the representations of masculinities in J. M. Coetzee’s Boyhood (1997), Youth (2002) and Summertime (2009). As works of transition in terms of Coetzee’s oeuvre - post-apartheid and post-Disgrace - the trilogy provides an account of the development of a man through several stages of life. While portraying the tensions of different geographical and cultural locations, such as apartheid South Africa and the London of the Sixties, the trilogy articulates the various norms that impact in the formation of gender, particularly of masculinities, through a complex system of power relations. The adherence to such norms is never linear, as the trilogy provides imaginative accounts of the contradictions that assist in the formulation of gender, depicting both the allure and the terror that constitute hegemonic masculinity. Located in the intersection of gender and postcolonial studies, the present study is based on the works by Raewyn Connell on masculinities. Animated by such a critical framework, the main research question of the present study is whether the trilogy advances a notion of masculinity that differs from the traditional rigid model, that is, whether there is resistance to hegemonic masculinity and what the spaces inhabited by the subaltern are. It is suggested that the trilogy presents the reader with instances of resistance to normative formulations of masculinity, by contrasting domination with the possibility of justice, and advancing an understanding of the often fatal consequences of gender norms to one’s sense of being in the world.