Lipid-lowering therapy following major cardiac events: progress and deficits

Objective: To assess hospital prescribing of lipid-lowering agents in a tertiary hospital, and examine continuation of, or changes to, such therapy in the 6-18 months following discharge. Design: Retrospective data extraction from the hospital records of patients admitted from October 1998 to April 1999. These patients and their general practitioners were then contacted to obtain information about ongoing management after discharge. Setting: Tertiary public hospital and community. Participants: 352 patients admitted to hospital with acute myocardial infarction or unstable angina, and their GPs. Main outcome measures: Percentage of eligible patients discharged on lipid-lowering therapy and percentage of patients continuing or starting such therapy 6-18 months after discharge. Results: 10% of inpatients with acute coronary syndromes did not have lipid-level estimations performed or arranged during admission. Documentation of lipid levels in discharge summaries was poor. Eighteen per cent of patients with a total serum cholesterol level greater than 5.5 mmol/L did not receive a discharge prescription for a cholesterol-lowering agent. Compliance with treatment on follow-up was 88% in the group discharged on treatment. However, at follow-up, 70% of patients discharged without therapy had not been commenced on lipid-lowering treatment by their GPs. Conclusions: Prescribing of lipid-lowering therapy for secondary prevention following acute coronary syndromes remains suboptimal. Commencing treatment in hospital is likely to result in continuing therapy in the community. Better communication of lipid-level results, treatment and treatment aims between hospitals and GPs might encourage optimal treatment practices.

Estudo da camada limite atmosférica em regiões metropolitanas costeiras com simulações de brisa marítima

O principal objetivo deste trabalho foi identificar e caracterizar a evolução diária da Camada Limite Atmosférica (CLA) na Região da Grande Vitória (RGV), Estado do Espírito Santo, Brasil e na Região de Dunkerque (RD), Departamento Nord Pas-de-Calais, França, avaliando a acurácia de parametrizações usadas no modelo meteorológico Weather Research and Forecasting (WRF) em detectar a formação e atributos da Camada Limite Interna (CLI) que é formada pelas brisas marítimas. A RGV tem relevo complexo, em uma região costeira de topografia acidentada e uma cadeia de montanhas paralela à costa. A RD tem relevo simples, em uma região costeira com pequenas ondulações que não chegam a ultrapassar 150 metros, ao longo do domínio de estudos. Para avaliar os resultados dos prognósticos feitos pelo modelo, foram utilizados os resultados de duas campanhas: uma realizada na cidade de Dunkerque, no norte da França, em Julho de 2009, utilizando um sistema light detection and ranging (LIDAR), um sonic detection and ranging (SODAR) e dados de uma estação meteorológica de superfície (EMS); outra realizada na cidade de Vitória – Espírito Santo, no mês de julho de 2012, também usando um LIDAR, um SODAR e dados de uma EMS. Foram realizadas simulações usando três esquemas de parametrizações para a CLA, dois de fechamento não local, Yonsei University (YSU) e Asymmetric Convective Model 2 (ACM2) e um de fechamento local, Mellor Yamada Janjic (MYJ) e dois esquemas de camada superficial do solo (CLS), Rapid Update Cycle (RUC) e Noah. Tanto para a RGV quanto para a RD, foram feitas simulações com as seis possíveis combinações das três parametrizações de CLA e as duas de CLS, para os períodos em que foram feitas as campanhas, usando quatro domínios aninhados, sendo os três maiores quadrados com dimensões laterais de 1863 km, 891 km e 297 km, grades de 27 km, 9 km e 3 km, respectivamente, e o domínio de estudo, com dimensões de 81 km na direção Norte-Sul e 63 km na Leste-Oeste, grade de 1 km, com 55 níveis verticais, até um máximo de, aproximadamente, 13.400 m, mais concentrados próximos ao solo. Os resultados deste trabalho mostraram que: a) dependendo da configuração adotada, o esforço computacional pode aumentar demasiadamente, sem que ocorra um grande aumento na acurácia dos resultados; b) para a RD, a simulação usando o conjunto de parametrizações MYJ para a CLA com a parametrização Noah produziu a melhor estimativa captando os fenômenos da CLI. As simulações usando as parametrizações ACM2 e YSU inferiram a entrada da brisa com atraso de até três horas; c) para a RGV, a simulação que usou as parametrizações YSU para a CLA em conjunto com a parametrização Noah para CLS foi a que conseguiu fazer melhores inferências sobre a CLI. Esses resultados sugerem a necessidade de avaliações prévias do esforço computacional necessário para determinadas configurações, e sobre a acurácia de conjuntos de parametrizações específicos para cada região pesquisada. As diferenças estão associadas com a capacidade das diferentes parametrizações em captar as informações superficiais provenientes das informações globais, essenciais para determinar a intensidade de mistura turbulenta vertical e temperatura superficial do solo, sugerindo que uma melhor representação do uso de solo é fundamental para melhorar as estimativas sobre a CLI e demais parâmetros usados por modelos de dispersão de poluentes atmosféricos.

Guitar solo tracker

A motivação para este trabalho vem da necessidade que o autor tem em poder registar as notas tocadas na guitarra durante o processo de improviso. Quando o músico está a improvisar na guitarra, muitas vezes não se recorda das notas tocadas no momento, este trabalho trata o desenvolvimento de uma aplicação para guitarristas, que permita registar as notas tocadas na guitarra eléctrica ou clássica. O sinal é adquirido a partir da guitarra e processado com requisitos de tempo real na captura do sinal. As notas produzidas pela guitarra eléctrica, ligada ao computador, são representadas no formato de tablatura e/ou partitura. Para este efeito a aplicação capta o sinal proveniente da guitarra eléctrica a partir da placa de som do computador e utiliza algoritmos de detecção de frequência e algoritmos de estimação de duração de cada sinal para construir o registo das notas tocadas. A aplicação é desenvolvida numa perspectiva multi-plataforma, podendo ser executada em diferentes sistemas operativos Windows e Linux, usando ferramentas e bibliotecas de domínio público. Os resultados obtidos mostram a possibilidade de afinar a guitarra com valores de erro na ordem de 2 Hz em relação às frequências de afinação standard. A escrita da tablatura apresenta resultados satisfatórios, mas que podem ser melhorados. Para tal será necessário melhorar a implementação de técnicas de processamento do sinal bem como a comunicação entre processos para resolver os problemas encontrados nos testes efectuados.

What drives corporate default risk premia? Evidence from the CDS market

This paper studies the evolution of the default risk premia for European firms during the years surrounding the recent credit crisis. We employ the information embedded in Credit Default Swaps (CDS) and Moody’s KMV EDF default probabilities to analyze the common factors driving this risk premia. The risk premium is characterized in several directions: Firstly, we perform a panel data analysis to capture the relationship between CDS spreads and actual default probabilities. Secondly, we employ the intensity framework of Jarrow et al. (2005) in order to measure the theoretical effect of risk premium on expected bond returns. Thirdly, we carry out a dynamic panel data to identify the macroeconomic sources of risk premium. Finally, a vector autoregressive model analyzes which proportion of the co-movement is attributable to financial or macro variables. Our estimations report coefficients for risk premium substantially higher than previously referred for US firms and a time varying behavior. A dominant factor explains around 60% of the common movements in risk premia. Additionally, empirical evidence suggests a public-to-private risk transfer between the sovereign CDS spreads and corporate risk premia.

Effect of the number of shells on the pressure and energy of two-dimensional free bubble clusters

We have performed Surface Evolver simulations of two-dimensional hexagonal bubble clusters consisting of a central bubble of area lambda surrounded by s shells or layers of bubbles of unit area. Clusters of up to twenty layers have been simulated, with lambda varying between 0.01 and 100. In monodisperse clusters (i.e., for lambda = 1) [M.A. Fortes, F Morgan, M. Fatima Vaz, Philos. Mag. Lett. 87 (2007) 561] both the average pressure of the entire Cluster and the pressure in the central bubble are decreasing functions of s and approach 0.9306 for very large s, which is the pressure in a bubble of an infinite monodisperse honeycomb foam. Here we address the effect of changing the central bubble area lambda. For small lambda the pressure in the central bubble and the average pressure were both found to decrease with s, as in monodisperse clusters. However, for large,, the pressure in the central bubble and the average pressure increase with s. The average pressure of large clusters was found to be independent of lambda and to approach 0.9306 asymptotically. We have also determined the cluster surface energies given by the equation of equilibrium for the total energy in terms of the area and the pressure in each bubble. When the pressures in the bubbles are not available, an approximate equation derived by Vaz et al. [M. Fatima Vaz, M.A. Fortes, F. Graner, Philos. Mag. Lett. 82 (2002) 575] was shown to provide good estimations for the cluster energy provided the bubble area distribution is narrow. This approach does not take cluster topology into account. Using this approximate equation, we find a good correlation between Surface Evolver Simulations and the estimated Values of energies and pressures. (C) 2008 Elsevier B.V. All rights reserved.

Influence of reconstruction parameters during filtered backprojection and ordered-subset expectation maximization in the measurement of the left-ventricular volumes and function during gated SPECT

A crucial method for investigating patients with coronary artery disease (CAD) is the calculation of the left ventricular ejection fraction (LVEF). It is, consequently, imperative to precisely estimate the value of LVEF--a process that can be done with myocardial perfusion scintigraphy. Therefore, the present study aimed to establish and compare the estimation performance of the quantitative parameters of the reconstruction methods filtered backprojection (FBP) and ordered-subset expectation maximization (OSEM). Methods: A beating-heart phantom with known values of end-diastolic volume, end-systolic volume, and LVEF was used. Quantitative gated SPECT/quantitative perfusion SPECT software was used to obtain these quantitative parameters in a semiautomatic mode. The Butterworth filter was used in FBP, with the cutoff frequencies between 0.2 and 0.8 cycles per pixel combined with the orders of 5, 10, 15, and 20. Sixty-three reconstructions were performed using 2, 4, 6, 8, 10, 12, and 16 OSEM subsets, combined with several iterations: 2, 4, 6, 8, 10, 12, 16, 32, and 64. Results: With FBP, the values of end-diastolic, end-systolic, and the stroke volumes rise as the cutoff frequency increases, whereas the value of LVEF diminishes. This same pattern is verified with the OSEM reconstruction. However, with OSEM there is a more precise estimation of the quantitative parameters, especially with the combinations 2 iterations × 10 subsets and 2 iterations × 12 subsets. Conclusion: The OSEM reconstruction presents better estimations of the quantitative parameters than does FBP. This study recommends the use of 2 iterations with 10 or 12 subsets for OSEM and a cutoff frequency of 0.5 cycles per pixel with the orders 5, 10, or 15 for FBP as the best estimations for the left ventricular volumes and ejection fraction quantification in myocardial perfusion scintigraphy.

Caracterização da pescaria do peixe-espada preto nos Açores de 2008 a 2012

Dissertação de Mestrado, Estudos Integrados dos Oceanos, 13 de Fevereiro de 2014, Universidade dos Açores.

Fatty liver characterization and classification by ultrasound

Steatosis, also known as fatty liver, corresponds to an abnormal retention of lipids within the hepatic cells and reflects an impairment of the normal processes of synthesis and elimination of fat. Several causes may lead to this condition, namely obesity, diabetes, or alcoholism. In this paper an automatic classification algorithm is proposed for the diagnosis of the liver steatosis from ultrasound images. The features are selected in order to catch the same characteristics used by the physicians in the diagnosis of the disease based on visual inspection of the ultrasound images. The algorithm, designed in a Bayesian framework, computes two images: i) a despeckled one, containing the anatomic and echogenic information of the liver, and ii) an image containing only the speckle used to compute the textural features. These images are computed from the estimated RF signal generated by the ultrasound probe where the dynamic range compression performed by the equipment is taken into account. A Bayes classifier, trained with data manually classified by expert clinicians and used as ground truth, reaches an overall accuracy of 95% and a 100% of sensitivity. The main novelties of the method are the estimations of the RF and speckle images which make it possible to accurately compute textural features of the liver parenchyma relevant for the diagnosis.

Avaliação preliminar do potencial eólico com recurso a um modelo de Mesoescala

Mestrado em Engenharia Química. Ramo optimização energética na indústria química.

Tissue composition and density impact on the clinical parameters for 125I prostate implants dosimetry

The MCNPX code was used to calculate the TG-43U1 recommended parameters in water and prostate tissue in order to quantify the dosimetric impact in 30 patients treated with (125)I prostate implants when replacing the TG-43U1 formalism parameters calculated in water by a prostate-like medium in the planning system (PS) and to evaluate the uncertainties associated with Monte Carlo (MC) calculations. The prostate density was obtained from the CT of 100 patients with prostate cancer. The deviations between our results for water and the TG-43U1 consensus dataset values were -2.6% for prostate V100, -13.0% for V150, and -5.8% for D90; -2.0% for rectum V100, and -5.1% for D0.1; -5.0% for urethra D10, and -5.1% for D30. The same differences between our water and prostate results were all under 0.3%. Uncertainties estimations were up to 2.9% for the gL(r) function, 13.4% for the F(r,θ) function and 7.0% for Λ, mainly due to seed geometry uncertainties. Uncertainties in extracting the TG-43U1 parameters in the MC simulations as well as in the literature comparison are of the same order of magnitude as the differences between dose distributions computed for water and prostate-like medium. The selection of the parameters for the PS should be done carefully, as it may considerably affect the dose distributions. The seeds internal geometry uncertainties are a major limiting factor in the MC parameters deduction.

Entity localization and tracking: a sensor fusion-based mechanism in WSNs

Knowing exactly where a mobile entity is and monitoring its trajectory in real-time has recently attracted a lot of interests from both academia and industrial communities, due to the large number of applications it enables, nevertheless, it is nowadays one of the most challenging problems from scientific and technological standpoints. In this work we propose a tracking system based on the fusion of position estimations provided by different sources, that are combined together to get a final estimation that aims at providing improved accuracy with respect to those generated by each system individually. In particular, exploiting the availability of a Wireless Sensor Network as an infrastructure, a mobile entity equipped with an inertial system first gets the position estimation using both a Kalman Filter and a fully distributed positioning algorithm (the Enhanced Steepest Descent, we recently proposed), then combines the results using the Simple Convex Combination algorithm. Simulation results clearly show good performance in terms of the final accuracy achieved. Finally, the proposed technique is validated against real data taken from an inertial sensor provided by THALES ITALIA.

Assessing usual dietary intake in complex sample design surveys: the National Dietary Survey

The National Cancer Institute (NCI) method allows the distributions of usual intake of nutrients and foods to be estimated. This method can be used in complex surveys. However, the user must perform additional calculations, such as balanced repeated replication (BRR), in order to obtain standard errors and confidence intervals for the percentiles and mean from the distribution of usual intake. The objective is to highlight adaptations of the NCI method using data from the National Dietary Survey. The application of the NCI method was exemplified analyzing the total energy (kcal) and fruit (g) intake, comparing estimations of mean and standard deviation that were based on the complex design of the Brazilian survey with those assuming simple random sample. Although means point estimates were similar, estimates of standard error using the complex design increased by up to 60% compared to simple random sample. Thus, for valid estimates of food and energy intake for the population, all of the sampling characteristics of the surveys should be taken into account because when these characteristics are neglected, statistical analysis may produce underestimated standard errors that would compromise the results and the conclusions of the survey.

Optimization study of hybrid spot-welded/bonded single-lap joints

Joining of components with structural adhesives is currently one of the most widespread techniques for advanced structures (e.g., aerospace or aeronautical). Adhesive bonding does not involve drilling operations and it distributes the load over a larger area than mechanical joints. However, peak stresses tend to develop near the overlap edges because of differential straining of the adherends and load asymmetry. As a result, premature failures can be expected, especially for brittle adhesives. Moreover, bonded joints are very sensitive to the surface treatment of the material, service temperature, humidity and ageing. To surpass these limitations, the combination of adhesive bonding with spot-welding is a choice to be considered, adding a few advantages like superior static strength and stiffness, higher peeling and fatigue strength and easier fabrication, as fixtures during the adhesive curing are not needed. The experimental and numerical study presented here evaluates hybrid spot-welded/bonded single-lap joints in comparison with the purely spot-welded and bonded equivalents. A parametric study on the overlap length (LO) allowed achieving different strength advantages, up to 58% compared to spot-welded joints and 24% over bonded joints. The Finite Element Method (FEM) and Cohesive Zone Models (CZM) for damage growth were also tested in Abaqus® to evaluate this technique for strength prediction, showing accurate estimations for all kinds of joints.

Health care costs of domestic violence against women – evidence from Portugal

Our main objective is to estimate the additional health care costs to the Portuguese National Health Service (NHS) due to domestic violence against women. We collected information through a survey addressed to health care centres’ female users. Both victims and non-victims of violence were inquired. We estimate costs according to five different groups – consultation costs, health care treatment and therapeutic costs, costs of complementary and diagnostic exams, drugs costs and transport costs. The estimations have been split into two perspectives – the NHS perspective (public perspective) and private perspective of inquired women (out of pocket payments). The timeframe of our calculations is one year, referring to all costs generated by domestic violence situations in the last twelve months. Essentially costs were estimated through the product of total number of episodes by the average estimated price per episode. Additionally, for the private costs, we also considered the costs originated by income losses, the opportunity cost of time spent on health care treatments and the work inability caused by sickness. The results suggest that the victims of domestic violence’s additional demand for health care is valued €140 per annum, that is about 22% higher than health care costs of non-victims. These results match those of similar studies for the United States, taking account of per capita differences in health care spending. A large proportion (90%) of the additional costs associated with domestic violence is supported by the NHS, where consultations and drugs are the most important contributors of such costs. Health consequences of domestic violence result from losses in quality of life and worst health status of victims and correspond to additional permanent economic costs of domestic violence episodes.

Experimental assessment of pressure drop in air stripping columns

One important step in the design of air stripping operations for the removal of VOC is the choice of operating conditions, which are based in the phase ratio. This parameter sets on directly the stripping factor and the efficiency of the operation. Its value has an upper limit determined by the flooding regime, which is previewed using empirical correlations, namely the one developed by Eckert. This type of approach is not suitable for the development of algorithms. Using a pilot scale column and a convenient solution, the pressure drop was determined in different operating conditions and the experimental values were compared with the estimations. This particular research will be incorporated in a global model for simulating the dynamics of air stripping using a multi variable distributed parameter system.