Relação entre a catastrofização da dor, percepção da intensidade da dor e incapacidade funcional em utentes com cdor crónica cervical

RESUMO: Introdução/Objectivo: A influência dos factores psicossociais, e nomeadamente da catastrofização da dor, na percepção da intensidade da dor e na incapacidade funcional, auto-reportada por indivíduos com dor crónica cervical (DCC), tem sido alvo de estudo em vários países, evidenciando o constructo multidimensional da DCC. Neste sentido, esta investigação pretende estudar se a catastrofização da dor, é uma variável preditiva relativamente à percepção da intensidade da dor, e à incapacidade funcional. Secundariamente procurou-se averiguar se as relações encontradas se mantêm estáveis antes e após exposição a uma intervenção em fisioterapia. Metodologia: Neste estudo participaram 40 indivíduos com DCC de origem músculo-esquelética e causa não traumática, que foram expostos a uma intervenção em fisioterapia no Centro de Medicina de Reabilitação do Alcoitão e na Clinica AlcaisFisio, que cumpriram os critérios de inclusão e aceitarem participar livremente no mesmo. A recolha de dados realizou-se em dois momentos distintos, antes e após exposição à intervenção em fisioterapia. A catastrofização da dor foi avaliada por meio da Escala de Catastrofização da Dor (PCS), a intensidade da dor pela Escala Numérica da Dor (END), sendo realizada a medição da incapacidade funcional através do Neck Disability Index versão Portuguesa (NDI-PT). A análise estatística incluiu duas fases: fase descritiva e fase inferencial. Foram desenvolvidos modelos de regressão linear com vista a testar o poder preditivo da catastrofização da dor sobre a intensidade da dor e a incapacidade funcional. O nível de significância para o qual os valores se consideraram satisfatórios foi de p<0,05. O tratamento dos dados foi realizado no software PASW versão 18. Resultados: Observou-se que existe uma relação moderada, positiva e significativa, nos dois momentos de avaliação, entre a catastrofização da dor e a percepção da intensidade da dor (p<0,001), apresentando um poder preditivo de 27,9% e 46,7%, das pontuações da intensidade da dor, antes e após exposição à intervenção em fisioterapia, espectivamente. Observou-se que a catastrofização da dor tem uma relação forte, positiva e significativa com a incapacidade funcional, nos dois momentos de avaliação (p<0,001), predizendo 51,8% e 61,8%, das pontuações da incapacidade funcional, antes e após exposição à intervenção em fisioterapia, respectivamente. Conclusão: A catastrofização da dor é um factor psicossocial que apresenta relação moderada com a percepção da intensidade da dor, e forte com a incapacidade funcional auto-reportada por indivíduos com DCC de origem músculo-esquelética e causa não traumática, antes e após exposição à intervenção em fisioterapia. Os resultados do estudo sugerem, assim, uma importante influência da catastrofização da dor sobre a percepção da intensidade da dor e a incapacidade funcional em indivíduos com DCC, realçando o constructo multidimensional da DCC. ------------ABSTRACT: Background and Purpose: The influence of psychosocial factors, particularly, the pain catastrophizing, on pain intensity and functional disability in individuals with chronic neck pain (CNP) has been report among recent research literature. The first aim of this research was to verify the predictive value of pain catastrophizing on pain intensity and patient’s functional disability. Secondly it aimed to verify the stability of these relations before and after a physiotherapy treatment. Methodology: A sample of 40 subjects with CNP of musculoskeletal and non-traumatic causes was recruited from the patient’s list of two private clinics in Lisbon district following verification of the inclusion criteria. All participants agree to participate in the study and signed a consent form. Data was collected immediately before and after a period of physiotherapy treatment. Pain catastrophizing was assessed by the Pain Catastrophizing Scale (PCS-PT), patient perception of pain intensity was measured by the Numerical Rating Scale (NRS), and functional disability was measured through the Neck Disability Index (NDI-PT). Data was analyzed through descriptive and inferential statistics. Linear regression models were developed in order to test the predictive power of pain catastrophizing on pain intensity and functional disability. The minimal level of significance established was p<0,05. Data analysis was performed using the software PASW version 18. Results: A positive moderate relationship between pain catastrophizing and pain intensity was founded in both moments, before and after physiotherapy intervention, of data collection (p<0,001) with a predictive power of 27,9% and 46,7%, respectively. A positive strong relationship between pain catastrophizing and functional disability was founded in both moments, before and after physiotherapy intervention, of data collection (p<0,001), with a predictive power of 51,8% and 61,8%, respectively. Conclusion: Pain catastrophizing is a psychosocial factor that is correlated moderately with the perception of pain intensity and strongly with self-reported functionaldisability for individuals with CNP musculoskeletal origin and non-traumatic causes,before and after a physiotherapy intervention. The results of this study suggest that pain catastrophizing has an important influence on the report levels of pain intensity and functional disability in CNP patients. These results also emphasize the multidimensional nature of chronic neck pain.

Critical Velocity obtained using Simplified Models of the Railway Track: Viability and Applicability

Increased demands on the capacity of the railway network gave rise to new issues related to the dynamic response of railway tracks subjected to moving vehicles. Thus, it becomes important to evaluate the applicability of traditionally used simplified models which have a closed form solution. Regarding simplified models, transversal vibrations of a beam on a visco-elastic foundation subjected to a moving load are considered. Governing equations are obtained by Hamilton’s principle. Shear distortion, rotary inertia and effect of axial force are accounted for. The load is introduced as a time varying force moving at a constant velocity. Transversal vibrations induced by the load are solved by the normal-mode analysis. Reflected waves at the extremities of the full beam are avoided by introduction of semi-infinite elements. Firstly, the critical velocity obtained from this model is compared with results of an undamped Euler- Bernoulli formulation with zero axial force. Secondly, a finite element model in ABAQUS is examined. The new contribution lies in the introduction of semi- infinite elements and in the first step to a systematic comparison, which have not been published so fa

Deteção e previsão de falhas em equipamentos de produção industrial

As empresas nacionais deparam-se com a necessidade de responder ao mercado com uma grande variedade de produtos, pequenas séries e prazos de entrega reduzidos. A competitividade das empresas num mercado global depende assim da sua eficiência, da sua flexibilidade, da qualidade dos seus produtos e de custos reduzidos. Para se atingirem estes objetivos é necessário desenvolverem-se estratégias e planos de ação que envolvem os equipamentos produtivos, incluindo: a criação de novos equipamentos complexos e mais fiáveis, alteração dos equipamentos existentes modernizando-os de forma a responderem às necessidades atuais e a aumentar a sua disponibilidade e produtividade; e implementação de políticas de manutenção mais assertiva e focada no objetivo de “zero avarias”, como é o caso da manutenção preditiva. Neste contexto, o objetivo principal deste trabalho consiste na previsão do instante temporal ótimo da manutenção de um equipamento industrial – um refinador da fábrica de Mangualde da empresa Sonae Industria, que se encontra em funcionamento contínuo 24 horas por dia, 365 dias por ano. Para o efeito são utilizadas medidas de sensores que monitorizam continuamente o estado do refinador. A principal operação de manutenção deste equipamento é a substituição de dois discos metálicos do seu principal componente – o desfibrador. Consequentemente, o sensor do refinador analisado com maior detalhe é o sensor que mede a distância entre os dois discos do desfibrador. Os modelos ARIMA consistem numa abordagem estatística avançada para previsão de séries temporais. Baseados na descrição da autocorrelação dos dados, estes modelos descrevem uma série temporal como função dos seus valores passados. Neste trabalho, a metodologia ARIMA é utilizada para determinar um modelo que efetua uma previsão dos valores futuros do sensor que mede a distância entre os dois discos do desfibrador, determinando-se assim o momento ótimo da sua substituição e evitando paragens forçadas de produção por ocorrência de uma falha por desgaste dos discos. Os resultados obtidos neste trabalho constituem uma contribuição científica importante para a área da manutenção preditiva e deteção de falhas em equipamentos industriais.

Estudo e integração de business models e a sua aplicação em smart-ups e projetos portugueses

Dissertação apresentada ao Instituto Superior de Contabilidade e Administração do Porto para obtenção do Grau de Mestre em Gestão das Organizações, Ramo Gestão de Empresas Orientador: Professor Doutor Eduardo Manuel Lopes de Sá e Silva Co-orientador: Mestre Maria de Fátima Mendes Monteiro

Estimation Models for the adoption and use of information technology: internet-related technologies at firm level in the Portuguese and European context

Dissertação apresentada como requisito parcial para obtenção do grau de Doutor em Gestão de Informação

A microscope for the data center

Nowadays, data centers are large energy consumers and the trend for next years is expected to increase further, considering the growth in the order of cloud services. A large portion of this power consumption is due to the control of physical parameters of the data center (such as temperature and humidity). However, these physical parameters are tightly coupled with computations, and even more so in upcoming data centers, where the location of workloads can vary substantially due, for example, to workloads being moved in the cloud infrastructure hosted in the data center. Therefore, managing the physical and compute infrastructure of a large data center is an embodiment of a Cyber-Physical System (CPS). In this paper, we describe a data collection and distribution architecture that enables gathering physical parameters of a large data center at a very high temporal and spatial resolution of the sensor measurements. We think this is an important characteristic to enable more accurate heat-flow models of the data center and with them, find opportunities to optimize energy consumptions. Having a high-resolution picture of the data center conditions, also enables minimizing local hot-spots, perform more accurate predictive maintenance (failures in all infrastructure equipments can be more promptly detected) and more accurate billing. We detail this architecture and define the structure of the underlying messaging system that is used to collect and distribute the data. Finally, we show the results of a preliminary study of a typical data center radio environment.

Behavioral and synaptic circuit analysis in models of neuropsychiatric disorders: Dissecting the in vivo role of the postsynaptic density proteins nArgBP2 and Shank3 using genetic engineered mice

Dissertation presented to obtain the Ph.D degree in Biology

Models for pheromone evaluation in Ant Systems for Mobile Ad-hoc networks

On a mobile ad-hoc network environment, where the resources are scarce, the knowledge about the network's link state is essential to optimize the routing procedures. This paper presents a study about different pheromone evaluation models and how they react to possible changes in traffic rate. Observing how the pheromone value on a link changes, it could be possible to identify certain patterns which can indicate the path status. For this study, the behavior of the Ant System evaluation model was compared with a Temporal Active Pheromone model (a biological approach) and a Progressive Pheromone Reduction model with and without a maximum pheromone limit.

Mathematical modelling of shallow flows: closure models drawn from grain-scale mechanics of sediment transport and flow hydrodynamics

Canadian Journal of Civil Engineering 36(10) 1605–16

Maturity models in the hospital information systems management initial research

Os modelos de maturidade são instrumentos facilitadores da gestão das organizações, incluindo a gestão da sua função sistemas de informação, não sendo exceção as organizações hospitalares. Neste artigo apresenta-se uma investigação inicial que visa o desenvolvimento de um abrangente modelo de maturidade para a gestão dos sistemas de informação hospitalares. O desenvolvimento deste modelo justifica-se porque os modelos de maturidade atuais no domínio da gestão dos sistemas informação hospitalares ainda se encontram numa fase embrionária de desenvolvimento, sobretudo porque são pouco detalhados, não disponibilizam ferramentas para determinação da maturidade e não apresentam as características dos estágios de maturidade estruturadas por diferentes fatores de influência.

Predictive Variables Affecting Transfusion Requirements in Orthotopic Liver Transplantation

INTRODUCTION AND AIMS: Adult orthotopic liver transplantation (OLT) is associated with considerable blood product requirements. The aim of this study was to assess the ability of preoperative information to predict intraoperative red blood cell (RBC) transfusion requirements among adult liver recipients. METHODS: Preoperative variables with previously demonstrated relationships to intraoperative RBC transfusion were identified from the literature: sex, age, pathology, prothrombin time (PT), factor V, hemoglobin (Hb), and platelet count (plt). These variables were then retrospectively collected from 758 consecutive adult patients undergoing OLT from 1997 to 2007. Relationships between these variables and intraoperative blood transfusion requirements were examined by both univariate analysis and multiple linear regression analysis. RESULTS: Univariate analysis confirmed significant associations between RBC transfusion and PT, factor V, Hb, Plt, pathology, and age (P values all < .001). However, stepwise backward multivariate analysis excluded variables Plt and factor V from the multiple regression linear model. The variables included in the final predictive model were PT, Hb, age, and pathology. Patients suffering from liver carcinoma required more blood products than those suffering from other pathologies. Yet, the overall predictive power of the final model was limited (R(2) = .308; adjusted R(2) = .30). CONCLUSION: Preoperative variables have limited predictive power for intraoperative RBC transfusion requirements even when significant statistical associations exist, identifying only a small portion of the observed total transfusion variability. Preoperative PT, Hb, age, and liver pathology seem to be the most significant predictive factors but other factors like severity of liver disease, surgical technique, medical experience in liver transplantation, and other noncontrollable human variables may play important roles to determine the final transfusion requirements.

Probabilistic models for mechanical properties of prestressing strands

This study focus on the probabilistic modelling of mechanical properties of prestressing strands based on data collected from tensile tests carried out in Laboratório Nacional de Engenharia Civil (LNEC), Portugal, for certification purposes, and covers a period of about 9 years of production. The strands studied were produced by six manufacturers from four countries, namely Portugal, Spain, Italy and Thailand. Variability of the most important mechanicalproperties is examined and the results are compared with the recommendations of the ProbabilisticModel Code, as well as the Eurocodes and earlier studies. The obtained results show a very low variability which, of course, benefits structural safety. Based on those results, probabilistic modelsfor the most important mechanical properties of prestressing strands are proposed.

Prognostic Value of a New Cardiopulmonary Exercise Testing Parameter in Chronic Heart Failure: Oxygen Uptake Efficiency at Peak Exercise - Comparison with Oxygen Uptake Efficiency Slope

INTRODUCTION: A growing body of evidence shows the prognostic value of oxygen uptake efficiency slope (OUES), a cardiopulmonary exercise test (CPET) parameter derived from the logarithmic relationship between O(2) consumption (VO(2)) and minute ventilation (VE) in patients with chronic heart failure (CHF). OBJECTIVE: To evaluate the prognostic value of a new CPET parameter - peak oxygen uptake efficiency (POUE) - and to compare it with OUES in patients with CHF. METHODS: We prospectively studied 206 consecutive patients with stable CHF due to dilated cardiomyopathy - 153 male, aged 53.3±13.0 years, 35.4% of ischemic etiology, left ventricular ejection fraction 27.7±8.0%, 81.1% in sinus rhythm, 97.1% receiving ACE-Is or ARBs, 78.2% beta-blockers and 60.2% spironolactone - who performed a first maximal symptom-limited treadmill CPET, using the modified Bruce protocol. In 33% of patients an cardioverter-defibrillator (ICD) or cardiac resynchronization therapy device (CRT-D) was implanted during follow-up. Peak VO(2), percentage of predicted peak VO(2), VE/VCO(2) slope, OUES and POUE were analyzed. OUES was calculated using the formula VO(2) (l/min) = OUES (log(10)VE) + b. POUE was calculated as pVO(2) (l/min) / log(10)peakVE (l/min). Correlation coefficients between the studied parameters were obtained. The prognosis of each variable adjusted for age was evaluated through Cox proportional hazard models and R2 percent (R2%) and V index (V6) were used as measures of the predictive accuracy of events of each of these variables. Receiver operating characteristic (ROC) curves from logistic regression models were used to determine the cut-offs for OUES and POUE. RESULTS: pVO(2): 20.5±5.9; percentage of predicted peak VO(2): 68.6±18.2; VE/VCO(2) slope: 30.6±8.3; OUES: 1.85±0.61; POUE: 0.88±0.27. During a mean follow-up of 33.1±14.8 months, 45 (21.8%) patients died, 10 (4.9%) underwent urgent heart transplantation and in three patients (1.5%) a left ventricular assist device was implanted. All variables proved to be independent predictors of this combined event; however, VE/VCO2 slope was most strongly associated with events (HR 11.14). In this population, POUE was associated with a higher risk of events than OUES (HR 9.61 vs. 7.01), and was also a better predictor of events (R2: 28.91 vs. 22.37). CONCLUSION: POUE was more strongly associated with death, urgent heart transplantation and implantation of a left ventricular assist device and proved to be a better predictor of events than OUES. These results suggest that this new parameter can increase the prognostic value of CPET in patients with CHF.