Empirical evidence of bias in the design of experimental stroke studies: a metaepidemiologic approach

Background and Purpose: At least part of the failure in the transition from experimental to clinical studies in stroke has been attributed to the imprecision introduced by problems in the design of experimental stroke studies. Using a metaepidemiologic approach, we addressed the effect of randomization, blinding, and use of comorbid animals on the estimate of how effectively therapeutic interventions reduce infarct size. Methods: Electronic and manual searches were performed to identify meta-analyses that described interventions in experimental stroke. For each meta-analysis thus identified, a reanalysis was conducted to estimate the impact of various quality items on the estimate of efficacy, and these estimates were combined in a meta meta-analysis to obtain a summary measure of the impact of the various design characteristics. Results: Thirteen meta-analyses that described outcomes in 15 635 animals were included. Studies that included unblinded induction of ischemia reported effect sizes 13.1% (95% CI, 26.4% to 0.2%) greater than studies that included blinding, and studies that included healthy animals instead of animals with comorbidities overstated the effect size by 11.5% (95% CI, 21.2% to 1.8%). No significant effect was found for randomization, blinded outcome assessment, or high aggregate CAMARADES quality score. Conclusions: We provide empirical evidence of bias in the design of studies, with studies that included unblinded induction of ischemia or healthy animals overestimating the effectiveness of the intervention. This bias could account for the failure in the transition from bench to bedside of stroke therapies.

Quality of life in institutionalized elderly undergoing an active aging program

Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. This study aims to assess the quality of life of institutionalized elderly undergoing to an active aging program. Methods: We have developed a semi-experimental study that considers the quantitative methodology in which the following instruments were used to measure the quality of life: Eurohis-Qol-8 (Pereira, Melo, Gameiro, & Canavarro, 2011) and Whoqol-Old (Vilar et al., 2010), to which sociodemographic and clinical questions were added. Assessments were made in two different moments, before and after the intervention program, in a sample of 37 institutionalized elderly. Results: Concerning the assessment of quality of life related to health (Eurohis-Qol-8), significant higher scores were obtained in the second moment (p = 0.004). Regarding the quality of life related to the elderly significant better scores were also obtained in the second assessment (p = 0.001). Conclusions: The results obtained allow us to conclude that using either of the measuring scales of Eurohis-Qol-8 or Whoqol-old, there is a perceived improvement in quality of life in those using the active aging program. Thus, institutionalized elderly must be the main target in the design and implementation of active aging programs.

Sleep quality and stress levels among higher education students

A good night sleep enables to achieve physical and mental wellbeing (Paiva, 2015). The preservation of sleep quality is paramount as who sleeps well has a high adaptation capacity to adverse circumstances such as stress and anxiety, amongst others. There is an impacting relationship between reduced sleeping hours and high levels of anxiety, depression and stress (Pinto et al., 2012). Measure the sleep quality and stress levels amongst higher education students.Quantitative study with a descriptive-correlational and transversal design. A socio-demographic record, the Pittsburgh Sleep Quality Index (PSQI) from Ramalho (2008) and the Anxiety, Depression and Stress Scale (EADS-21) from Ribeiro, Honrado and Leal (2004) were applied. The sample included 358 students. 54% of the students present a bad sleep quality, go to bed on average at 1am, take about 19 minutes to fall asleep and sleep on average 7 hours effectively. Female students have a 48% higher probability of having bad sleep quality. Stress, anxiety and depression levels were considered disperse with stress presenting the higher average. The majority of the students that refer having a bad sleep quality present an average score of 6.57 on the stress scale being approximately double of the students that refer having a good sleep quality (3.35). Stress, anxiety and depression are positively and with statistic signiicance correlated to the sleep quality index where a higher score means worse sleep quality.

THE DEVELOPMENT EFFECTIVENESS OF INTERNATIONAL WATER AND SANITATION INFRASTRUCTURE PROJECTS: DEFINING “QUALITY AT ENTRY” OF WORLD BANK PROJECTS.

Over the past 15 years, the number of international development projects aimed at combating global poverty has increased significantly. Within the water and sanitation sector however, and despite heightened global attention and an increase in the number of infrastructure projects, over 800 million people remain without access to appropriate water and sanitation facilities. The majority of donor aid in the water supply and sanitation sector of developing countries is delivered through standalone projects. The quality of projects at the design and preparation stage is a critical determinant in meeting project objectives. The quality of projects at early stage of design, widely referred to as quality at entry (QAE), however remains unquantified and largely subjective. This research argues that water and sanitation infrastructure projects in the developing world tend to be designed in the absence of a specific set of actions that ensure high QAE, and consequently have relatively high rates of failure. This research analyzes 32 cases of water and sanitation infrastructure projects implemented with partial or full World Bank financing globally from 2000 – 2010. The research uses categorical data analysis, regression analysis and descriptive analysis to examine perceived linkages between project QAE and project development outcomes and determines which upstream project design factors are likely to impact the QAE of international development projects in water supply and sanitation. The research proposes a number of specific design stage actions that can be incorporated into the formal review process of water and sanitation projects financed by the World Bank or other international development partners.

Holistic Design In High-Speed Optical Interconnects

Integrated circuit scaling has enabled a huge growth in processing capability, which necessitates a corresponding increase in inter-chip communication bandwidth. As bandwidth requirements for chip-to-chip interconnection scale, deficiencies of electrical channels become more apparent. Optical links present a viable alternative due to their low frequency-dependent loss and higher bandwidth density in the form of wavelength division multiplexing. As integrated photonics and bonding technologies are maturing, commercialization of hybrid-integrated optical links are becoming a reality. Increasing silicon integration leads to better performance in optical links but necessitates a corresponding co-design strategy in both electronics and photonics. In this light, holistic design of high-speed optical links with an in-depth understanding of photonics and state-of-the-art electronics brings their performance to unprecedented levels. This thesis presents developments in high-speed optical links by co-designing and co-integrating the primary elements of an optical link: receiver, transmitter, and clocking.

In the first part of this thesis a 3D-integrated CMOS/Silicon-photonic receiver will be presented. The electronic chip features a novel design that employs a low-bandwidth TIA front-end, double-sampling and equalization through dynamic offset modulation. Measured results show -14.9dBm of sensitivity and energy efficiency of 170fJ/b at 25Gb/s. The same receiver front-end is also used to implement source-synchronous 4-channel WDM-based parallel optical receiver. Quadrature ILO-based clocking is employed for synchronization and a novel frequency-tracking method that exploits the dynamics of IL in a quadrature ring oscillator to increase the effective locking range. An adaptive body-biasing circuit is designed to maintain the per-bit-energy consumption constant across wide data-rates. The prototype measurements indicate a record-low power consumption of 153fJ/b at 32Gb/s. The receiver sensitivity is measured to be -8.8dBm at 32Gb/s.

Next, on the optical transmitter side, three new techniques will be presented. First one is a differential ring modulator that breaks the optical bandwidth/quality factor trade-off known to limit the speed of high-Q ring modulators. This structure maintains a constant energy in the ring to avoid pattern-dependent power droop. As a first proof of concept, a prototype has been fabricated and measured up to 10Gb/s. The second technique is thermal stabilization of micro-ring resonator modulators through direct measurement of temperature using a monolithic PTAT temperature sensor. The measured temperature is used in a feedback loop to adjust the thermal tuner of the ring. A prototype is fabricated and a closed-loop feedback system is demonstrated to operate at 20Gb/s in the presence of temperature fluctuations. The third technique is a switched-capacitor based pre-emphasis technique designed to extend the inherently low bandwidth of carrier injection micro-ring modulators. A measured prototype of the optical transmitter achieves energy efficiency of 342fJ/bit at 10Gb/s and the wavelength stabilization circuit based on the monolithic PTAT sensor consumes 0.29mW.

Lastly, a first-order frequency synthesizer that is suitable for high-speed on-chip clock generation will be discussed. The proposed design features an architecture combining an LC quadrature VCO, two sample-and-holds, a PI, digital coarse-tuning, and rotational frequency detection for fine-tuning. In addition to an electrical reference clock, as an extra feature, the prototype chip is capable of receiving a low jitter optical reference clock generated by a high-repetition-rate mode-locked laser. The output clock at 8GHz has an integrated RMS jitter of 490fs, peak-to-peak periodic jitter of 2.06ps, and total RMS jitter of 680fs. The reference spurs are measured to be –64.3dB below the carrier frequency. At 8GHz the system consumes 2.49mW from a 1V supply.

Design of Nanophotonic Antireflection Coatings for III-V Thin-Film Photovoltaics

Thin-film photovoltaics have provided a critical design avenue to help decrease the overall cost of solar power. However, a major drawback of thin-film solar cell technology is decreased optical absorption, making compact, high-quality antireflection coatings of critical importance to ensure that all available light enters the cell. In this thesis, we describe high efficiency thin-film InP and GaAs solar cells that utilize a periodic array of nanocylinders as antireflection coatings. We use coupled optical and electrical simulations to find that these nanophotonic structures reduce the solar-weighted average reflectivity of InP and GaAs solar cells to around 1.3 %, outperforming the best double-layer antireflection coatings. The coupling between Mie scattering resonances and thin-film interference effects accurately describes the optical enhancement provided by the nanocylinders. The spectrally resolved reflectivity and J-V characteristics of the devices under AM1.5G solar illumination are determined via the coupled optical and electrical simulations, resulting in predicted power conversion efficiencies > 23 %. We conclude that the nanostructured coatings reduce reflection without negatively affecting the electronic properties of the InP and GaAs solar cells by separating the nanostructured optical components from the active layer of the device.

Design de comunicação na criação de uma marca

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Comunicação, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.

Design editorial para crianças dos 6 aos 8 anos

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Comunicação, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.

Adaptive lighting design as a holistic approach to public lighting

Dissertação para obtenção do grau de Doutor em Design, apresentada na Universidade de Lisboa - Faculdade de Arquitetura.

Design of composites for thermal management: Aluminum reinforced with diamond-containing bimodal particle mixtures

A new design route is proposed in order to fabricate aluminum matrix diamond-containing composite materials with optimized values of thermal conductivity (TC) for thermal management applications. The proper size ratio and proportions of particulate diamond–diamond and diamond–SiC bimodal mixtures are selected based on calculations with predictive schemes, which combine two main issues: (i) the volume fraction of the packed particulate mixtures, and (ii) the influence of different types of particulates (with intrinsically different metal/reinforcement interfacial thermal conductances) on the overall thermal conductivity of the composite material. The calculated results are validated by comparison with measurements on composites fabricated by gas pressure infiltration of aluminum into preforms of selected compositions of particle mixtures. Despite the relatively low quality (low price) of the diamond particles used in this work, outstanding values of TC are encountered: a maximum of 770 W/m K for Al/diamond–diamond and values up to 690 W/m K for Al/diamond–SiC.

Design gráfico da pluma de contaminação por compostos orgânicos voláteiss utilizando software CAD na investigação de passivo ambiental em um posto revendedor de combustíveis em Natal/RN

Among the potentially polluting economic activities that compromise the quality of groundwater are the gas stations. The city of Natal has about 120 gas stations, of which only has an environmental license for operation. Discontinuities in the offices were notified by the Public Ministry of Rio Grande do Norte to carry out the environmental adaptations, among which is the investigation of environmental liabilities. The preliminary and confirmatory stages of this investigation consisted in the evaluation of soil gas surveys with two confirmatory chemical analysis of BTEX, PAH and TPH. To get a good evaluation and interpretation of results obtained in the field, it became necessary three-dimensional representation of them. We used a CAD software to graph the equipment installed in a retail service station fuel in Natal, as well as the plumes of contamination by volatile organic compounds. The tool was concluded that contamination is not located in the current system of underground storage of fuel development, but reflects the historical past in which tanks were removed not tight gasoline and diesel

Computer Aided Design Algorithmic Technique for Very Large Scale Integrated Circuit Design and Smart Home Embedded System Design

To tackle the challenges at circuit level and system level VLSI and embedded system design, this dissertation proposes various novel algorithms to explore the efficient solutions. At the circuit level, a new reliability-driven minimum cost Steiner routing and layer assignment scheme is proposed, and the first transceiver insertion algorithmic framework for the optical interconnect is proposed. At the system level, a reliability-driven task scheduling scheme for multiprocessor real-time embedded systems, which optimizes system energy consumption under stochastic fault occurrences, is proposed. The embedded system design is also widely used in the smart home area for improving health, wellbeing and quality of life. The proposed scheduling scheme for multiprocessor embedded systems is hence extended to handle the energy consumption scheduling issues for smart homes. The extended scheme can arrange the household appliances for operation to minimize monetary expense of a customer based on the time-varying pricing model.

Continuous quality improvement in a Maltese hospital using logical framework analysis

Purpose: The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital. Design/methodology/approach: This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings. Second, objective trees are formed suggesting solutions to the quality issues. Third, project plan template using logical framework (LOGFRAME) is created for each setting. Findings: This study shows substantial improvement in quality across the three settings. LFA proved to be effective to analyse quality issues and suggest improvement measures objectively. Research limitations/implications: This paper applies LFA in specific, albeit, diverse settings in one hospital. For validation purposes, it would be ideal to analyse in other settings within the same hospital, as well as in several hospitals. It also adopts a bottom-up approach when this can be triangulated with other sources of data. Practical implications: LFA enables top management to obtain an integrated view of performance. It also provides a basis for further quantitative research on quality management through the identification of key performance indicators and facilitates the development of a business case for improvement. Originality/value: LFA is a novel approach for the implementation of CQI programs. Although LFA has been used extensively for project development to source funds from development banks, its application in quality improvement within healthcare projects is scant.

Design of maintenance structures for rural electrification with solar home systems. The case of the Moroccan program.

n decentralised rural electrification through solar home systems, private companies and promoting institutions are faced with the problem of deploying maintenance structures to operate and guarantee the service of the solar systems for long periods (ten years or more). The problems linked to decentralisation, such as the dispersion of dwellings, difficult access and maintenance needs, makes it an arduous task. This paper proposes an innovative design tool created ad hoc for photovoltaic rural electrification based on a real photovoltaic rural electrification program in Morocco as a special case study. The tool is developed from a mathematical model comprising a set of decision variables (location, transport, etc.) that must meet certain constraints and whose optimisation criterion is the minimum cost of the operation and maintenance activity assuming an established quality of service. The main output of the model is the overall cost of the maintenance structure. The best location for the local maintenance headquarters and warehouses in a given region is established, as are the number of maintenance technicians and vehicles required.

Design principles for maximizing photovoltage in metal-oxide-protected water-splitting photoanodes

Metal oxide protection layers for photoanodes may enable the development of large-scale solar fuel and solar chemical synthesis, but the poor photovoltages often reported so far will severely limit their performance. Here we report a novel observation of photovoltage loss associated with a charge extraction barrier imposed by the protection layer, and, by eliminating it, achieve photovoltages as high as 630mV, the maximum reported so far for water-splitting silicon photoanodes. The loss mechanism is systematically probed in metal-insulator-semiconductor Schottky junction cells compared to buried junction p(+) n cells, revealing the need to maintain a characteristic hole density at the semiconductor/insulator interface. A leaky-capacitor model related to the dielectric properties of the protective oxide explains this loss, achieving excellent agreement with the data. From these findings, we formulate design principles for simultaneous optimization of built-in field, interface quality, and hole extraction to maximize the photovoltage of oxide-protected water-splitting anodes.