Aplicação dos critérios de adequação (appropriateness criteria) a um laboratório de ecocardiografia de grande volume de um hospital privado

Mestrado em Tecnologia de Diagnóstico e Intervenção. Área de especialização: Ultrassonografia Cardiovascular.

O desenvolvimento do conceito de área: um estudo com alunos do 3.º ano de escolaridade

O objetivo desta investigação é compreender como é que alunos do 3.º ano de escolaridade desenvolvem o conceito de área com ênfase em conhecimentos sobre figuras e propriedades geométricas. Para melhor objetivar o estudo, formulei três questões que orientaram a investigação. Pretendo (1) compreender como é que os alunos mobilizam conhecimentos sobre as propriedades das figuras geométricas no estudo da área de uma figura plana? A que estratégias recorrem? Que dificuldades sentem? (2) que compreensão é que os alunos têm sobre o processo de medição? e (3) que ideias e/ou experiências são relevantes no desenvolvimento do conceito de área? Este é um estudo que se insere no paradigma interpretativo e que segue uma abordagem qualitativa, pelo que não visa generalização de resultados, mas uma descrição compreensiva dos processos vivenciados, tendo em conta os contextos pessoais e sociais. Optei por realizar dois Estudos de Caso. Os dados foram recolhidos através de fontes diversificadas, donde se destacam a observação participante e a análise de registos audiovisuais e escritos dos alunos. A análise dos dados teve por referência categorias criadas com base em contributos da literatura de referência. As conclusões desta investigação centram-se numa análise acerca das estratégias a que os alunos em estudo tendencialmente mais recorrem, visando também algumas das suas dificuldades mais relevantes e sobre as quais importa refletir. Destaca-se que ambos os alunos foram capazes de recorrer a raciocínios baseados e não baseados na medida, embora seja evidente uma tendência para raciocínios baseados na medida. É igualmente importante referir que os dois alunos revelaram um bom conhecimento acerca do processo de medição, mesmo quando ele implicava a definição de uma unidade de medida adequada e/ou mudança de unidade. É dado, também, destaque às experiências matemáticas que devem ser proporcionadas aos alunos no sentido do desenvolvimento de um conhecimento amplo e flexível do conceito de área. - Abstract The purpose of this investigation is to understand the development of 3rd year students’ concept of area based on their knowledge of geometrical properties and figures. As means to orientate the present study, the following investigation questions were formulated: 1) how do students use their knowledge about geometrical properties in order to understand geometrical shape’s areas? Which strategies do they use? What do they struggle with? (2) What is their understanding about measurement? And (3) what are the most relevant mathematical reasonings and classroom tasks in the development of the concept of area? This is a study that follows a qualitative approach: it does not intend to be a generalization, but a fully comprehensive description of the witnessed learning processes, bearing in mind the social and personal contexts. As such, two study-cases were developed. The data were collected through various sources, such as direct observation and analysis of audiovisual records or written worksheets. The scrutiny of the generated data was undertaken following criteria based on the literature of reference. The conclusions of this investigation are centered on the most used strategies as well as the students’ difficulties upon which it is important to discuss. It was noticed that the two students were able to use both measurement and non measurement thinking – although, preferably, they tend to use the first one. On the other hand, it is equally demonstrated that the two students have shown good acquaintance about measurement, even if obliged to the establishment of a suitable unit of measurement and/or change of units. At last, it is also referred which mathematical classroom tasks are important to develop a sustained and comprehensive concept of area.

Inclusão e currículo - as práticas curriculares dos professores dos 2º e 3º ciclos do ensino básico, decorrentes da inclusão de alunos com N.E..E.

Dissertação de mestrado em ciências da educação especialidade educação especial

Multi-criteria design optimization study of solvent extraction in mixer–settler units

Solvent extraction is considered as a multi-criteria optimization problem, since several chemical species with similar extraction kinetic properties are frequently present in the aqueous phase and the selective extraction is not practicable. This optimization, applied to mixer–settler units, considers the best parameters and operating conditions, as well as the best structure or process flow-sheet. Global process optimization is performed for a specific flow-sheet and a comparison of Pareto curves for different flow-sheets is made. The positive weight sum approach linked to the sequential quadratic programming method is used to obtain the Pareto set. In all investigated structures, recovery increases with hold-up, residence time and agitation speed, while the purity has an opposite behaviour. For the same treatment capacity, counter-current arrangements are shown to promote recovery without significant impairment in purity. Recycling the aqueous phase is shown to be irrelevant, but organic recycling with as many stages as economically feasible clearly improves the design criteria and reduces the most efficient organic flow-rate.

Multi-criteria optimization manipulator trajectory planning

In the last twenty years genetic algorithms (GAs) were applied in a plethora of fields such as: control, system identification, robotics, planning and scheduling, image processing, and pattern and speech recognition (Bäck et al., 1997). In robotics the problems of trajectory planning, collision avoidance and manipulator structure design considering a single criteria has been solved using several techniques (Alander, 2003). Most engineering applications require the optimization of several criteria simultaneously. Often the problems are complex, include discrete and continuous variables and there is no prior knowledge about the search space. These kind of problems are very more complex, since they consider multiple design criteria simultaneously within the optimization procedure. This is known as a multi-criteria (or multiobjective) optimization, that has been addressed successfully through GAs (Deb, 2001). The overall aim of multi-criteria evolutionary algorithms is to achieve a set of non-dominated optimal solutions known as Pareto front. At the end of the optimization procedure, instead of a single optimal (or near optimal) solution, the decision maker can select a solution from the Pareto front. Some of the key issues in multi-criteria GAs are: i) the number of objectives, ii) to obtain a Pareto front as wide as possible and iii) to achieve a Pareto front uniformly spread. Indeed, multi-objective techniques using GAs have been increasing in relevance as a research area. In 1989, Goldberg suggested the use of a GA to solve multi-objective problems and since then other researchers have been developing new methods, such as the multi-objective genetic algorithm (MOGA) (Fonseca & Fleming, 1995), the non-dominated sorted genetic algorithm (NSGA) (Deb, 2001), and the niched Pareto genetic algorithm (NPGA) (Horn et al., 1994), among several other variants (Coello, 1998). In this work the trajectory planning problem considers: i) robots with 2 and 3 degrees of freedom (dof ), ii) the inclusion of obstacles in the workspace and iii) up to five criteria that are used to qualify the evolving trajectory, namely the: joint traveling distance, joint velocity, end effector / Cartesian distance, end effector / Cartesian velocity and energy involved. These criteria are used to minimize the joint and end effector traveled distance, trajectory ripple and energy required by the manipulator to reach at destination point. Bearing this ideas in mind, the paper addresses the planning of robot trajectories, meaning the development of an algorithm to find a continuous motion that takes the manipulator from a given starting configuration up to a desired end position without colliding with any obstacle in the workspace. The chapter is organized as follows. Section 2 describes the trajectory planning and several approaches proposed in the literature. Section 3 formulates the problem, namely the representation adopted to solve the trajectory planning and the objectives considered in the optimization. Section 4 studies the algorithm convergence. Section 5 studies a 2R manipulator (i.e., a robot with two rotational joints/links) when the optimization trajectory considers two and five objectives. Sections 6 and 7 show the results for the 3R redundant manipulator with five goals and for other complementary experiments are described, respectively. Finally, section 8 draws the main conclusions.

Feature Discretization with Relevance and Mutual Information Criteria

Feature discretization (FD) techniques often yield adequate and compact representations of the data, suitable for machine learning and pattern recognition problems. These representations usually decrease the training time, yielding higher classification accuracy while allowing for humans to better understand and visualize the data, as compared to the use of the original features. This paper proposes two new FD techniques. The first one is based on the well-known Linde-Buzo-Gray quantization algorithm, coupled with a relevance criterion, being able perform unsupervised, supervised, or semi-supervised discretization. The second technique works in supervised mode, being based on the maximization of the mutual information between each discrete feature and the class label. Our experimental results on standard benchmark datasets show that these techniques scale up to high-dimensional data, attaining in many cases better accuracy than existing unsupervised and supervised FD approaches, while using fewer discretization intervals.

Schistosomiasis: predisposing cause for the formation of hepatic abscesses? Case report

An adult patient with chronic schistosomiasis from an endemic area, complained about a seven day fever, along with jaundice and lumbar backache on the right side. Image exams showed multiple pyogenic liver abscesses. All the classic etiologies were discarded through clinical, radiological and laboratorial criteria. Schistosomiasis can cause pylephlebitis as a complication, along with immunesuppression, granulomatous reaction with central lobular liver necrosis and a greater risk of infection. The authors suggest that schistosomiasis in its chronic form may be the predisposing cause of multiple pyogenic liver abscesses, especially in endemic areas.

Ontology methodology building criteria for crowdsourcing innovation intermediaries

Crowdsourcing innovation intermediaries are organizations that mediate the communication and relationship between companies that aspire to solve some problem or to take advantage of any business opportunity with a crowd that is prone to give ideas based on their knowledge, experience and wisdom. A significant part of the activity of these intermediaries is carried out by using a web platform that takes advantage of web 2.0 tools to implement its capabilities. Thus, ontologies are presented as an appropriate strategy to represent the knowledge inherent to this activity and therefore the accomplishment of interoperability between machines and systems. In this paper we present an ontology roadmap for developing crowdsourcing innovation ontology of the intermediation process. We start making a literature review on ontology building, analyze and compare ontologies that propose the development from scratch with the ones that propose reusing other ontologies, and present the criteria for selecting the methodology. We also review enterprise and innovation ontologies known in literature. Finally, are taken some conclusions and presented the roadmap for building crowdsourcing innovation intermediary ontology.

Defying Standard Criteria for Digital Replantation: A Case Series

INTRODUCTION: There is much controversy regarding the current indications and contraindications for digital replantation. PRESENTATION OF CASE: Three patients with absolute contraindications for digital replantation according to classical criteria are presented (Case 1: multilevel amputation of the hand and fingers; Case 3: avulsion of the thumb; Case 4: index amputation proximal to the insertion of the flexor digitorum superficialis). In addition a patient with a very distal digital amputation (Case 2), whose indication for replantation is controversial is also presented. In all cases, the patients were replanted and showed good functional and aesthetical results. DISCUSSION: Most authors advocate that the classical indications for replantation have been validated by experience, are predicated on the potential for long-term function, and should be followed in most if not all cases. However, some surgeons have been adopting a more liberal attitude with good results. CONCLUSION: The clinical cases presented in this paper suggest that the standard criteria for digital replantation should not be followed rigidly but instead should be regarded as a general guide.

Adequate Seal and No Endoleak on the First Postoperative Computed Tomography Angiography as Criteria for No Additional Imaging Up to 5 Years after Endovascular Aneurysm Repair

OBJECTIVE: Intensive image surveillance after endovascular aneurysm repair is generally recommended due to continued risk of complications. However, patients at lower risk may not benefit from this strategy. We evaluated the predictive value of the first postoperative computed tomography angiography (CTA) characteristics for aneurysm-related adverse events as a means of patient selection for risk-adapted surveillance. METHODS: All patients treated with the Low-Permeability Excluder Endoprosthesis (W. L. Gore & Assoc, Flagstaff, Ariz) at a tertiary institution from 2004 to 2011 were included. First postoperative CTAs were analyzed for the presence of endoleaks, endograft kinking, distance from the lowermost renal artery to the start of the endograft, and for proximal and distal sealing length using center lumen line reconstructions. The primary end point was freedom from aneurysm-related adverse events. Multivariable Cox regression was used to test postoperative CTA characteristics as independent risk factors, which were subsequently used as selection criteria for low-risk and high-risk groups. Estimates for freedom from adverse events were obtained using Kaplan-Meier survival curves. RESULTS: Included were 131 patients. The median follow-up was 4.1 years (interquartile range, 2.1-6.1). During this period, 30 patients (23%) sustained aneurysm-related adverse events. Seal length <10 mm and presence of endoleak were significant risk factors for this end point. Patients were subsequently categorized as low-risk (proximal and distal seal length ≥10 mm and no endoleak, n = 62) or high-risk (seal length <10 mm or presence of endoleak, or both; n = 69). During follow-up, four low-risk patients (3%) and 26 high-risk patients (19%) sustained events (P < .001). Four secondary interventions were required in three low-risk patients, and 31 secondary interventions in 23 high-risk patients. Sac growth was observed in two low-risk patients and in 15 high-risk patients. The 5-year estimates for freedom from aneurysm-related adverse events were 98% for the low-risk group and 52% for the high-risk group. For each diagnosis, 81.7 image examinations were necessary in the low-risk group and 8.2 in the high-risk group. CONCLUSIONS: Our results suggest that the first postoperative CTA provides important information for risk stratification after endovascular aneurysm repair when the Excluder endoprosthesis is used. In patients with adequate seal and no endoleaks, the risk of aneurysm-related adverse events was significantly reduced, resulting in a large number of unnecessary image examinations. Adjusting the imaging protocol beyond 30 days and up to 5 years, based on individual patients' risk, may result in a more efficient and rational postoperative surveillance.

Acute disseminated encephalomyelitis in classic dengue

Neurological manifestation is uncommon in dengue infection. The pathogenesis of central nervous system involvement is controversial. We report a rare case of acute disseminated encephalomyelitis in classic dengue, with isolation of serotype 3 in liquor. This condition was associated with significant structural damage detected by magnetic resonance.

Clinical and epidemiological characterization of dengue hemorrhagic fever cases in northeastern, Brazil

INTRODUCTION: The dengue hemorrhagic dengue (DHF) remains an important public health problem in Brazil. The objective of this study was to analyze the epidemiological characteristics of DHF cases during the 2003 epidemic in Ceará. METHODS: Suspected DHF cases with onset of symptoms between January and December 2003 were investigated. RESULTS: 37,964 classic dengue cases and 291 DHF cases were reported. Among the cases discarded, 75.5% were serologically positive but did not meet the criteria recommended by the World Health Organization (WHO). The DHF patients' median age was 30 years (2 - 88). Among the hemorrhagic manifestations, petechiae were the most (32.6%) frequent. Cases of gastrointestinal bleeding, ascites, pericardial pleural effusion, hepatomegaly, hypotension and shock showed higher risk of progression to death (p <0.05). CONCLUSIONS: The introduction of a new serotype (DENV-3) in Ceará, which encountered a susceptible population and high vector density, may have been the primary agent responsible for the magnitude of the epidemic. Timely and appropriate medical care, along with an organized care structure are essential for reducing its lethality.

A multi-criteria decision support system for a routing problem in waste collection

Autor proof

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.

Síntese de novas tieno[3,2-b]piridinas com potencial atividade biológica contendo 1,2,3-triazoles 1,4-dissubstituídos obtidos por reação "click" de ciclioadição azida-alquino catalisada por Cu(I)-CuAAC

Dissertação de mestrado em Química Medicinal