Collecting system percutaneous access using real-time tracking sensors: first pig model in vivo experience

Purpose: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. Materials and Methods: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. Results: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p ¼ 0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p ¼ 0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. Conclusions: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques

Anotação sintética, numa perspectiva de Direito Público, ao Acórdão n.º 63/2006, em Plenário, do Tribunal Constitucional (português), de 24 de Janeiro de 2006 - qual proibição constitucional de impostos retroactivos? A tese de Oliveira Salazar.

The present article aims to analyze the Judgment no. º 63/2006 of the Constitutional Court, of January 24, 2006, verifying the characteristics of the case, under reference abstract and concrete, of the constitutional principle of the prohibition of retroactive tax. It also examines the core aspects of the temporal validity of the legal and tax rules, brevitatis causa of legal and fiscal standards. Thus, it scrutinizes the call application of tax rules (and / or tax) within the application in time, consisting brief notes on the legal tradition-Lusitanian, from the standpoint of doctrine, from 1976 to 1985 including, recalling the Thesis Salazar on non-retroactivity of tax law. § O presente artigo pretende analisar o Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006, verificando de forma sintética as características do caso concreto, sob referência abstracta e concreta, do princípio constitucional da proibição de imposto retroativos, analisando ainda os aspectos nucleares da eficácia temporal das normas jurídico-tributárias, brevitatis causa, das normas jurídico-fiscais. Para tanto, se averigua a chamada aplicação das normas fiscais (e/ou tributárias) no seio da aplicação no tempo, constando breves notas sobre a tradição jurídico-lusitana, do ponto de vista da doutrina, a partir de 1976, designadamente até 1985, recordando a Tese de Salzar sobre a não retroatividade da lei fiscal.

Real-time 3D interactive segmentation of echocardiographic data through user-based deformation of B-spline explicit active surfaces

Image segmentation is an ubiquitous task in medical image analysis, which is required to estimate morphological or functional properties of given anatomical targets. While automatic processing is highly desirable, image segmentation remains to date a supervised process in daily clinical practice. Indeed, challenging data often requires user interaction to capture the required level of anatomical detail. To optimize the analysis of 3D images, the user should be able to efficiently interact with the result of any segmentation algorithm to correct any possible disagreement. Building on a previously developed real-time 3D segmentation algorithm, we propose in the present work an extension towards an interactive application where user information can be used online to steer the segmentation result. This enables a synergistic collaboration between the operator and the underlying segmentation algorithm, thus contributing to higher segmentation accuracy, while keeping total analysis time competitive. To this end, we formalize the user interaction paradigm using a geometrical approach, where the user input is mapped to a non-cartesian space while this information is used to drive the boundary towards the position provided by the user. Additionally, we propose a shape regularization term which improves the interaction with the segmented surface, thereby making the interactive segmentation process less cumbersome. The resulting algorithm offers competitive performance both in terms of segmentation accuracy, as well as in terms of total analysis time. This contributes to a more efficient use of the existing segmentation tools in daily clinical practice. Furthermore, it compares favorably to state-of-the-art interactive segmentation software based on a 3D livewire-based algorithm.

Annotation taken, in the perspective of criminal and constitutional law, as well as in criminology, to the decision of the portuguese constitutional court, of January 13, 2011 – with respect to the problems of “consent” and “medical act”

1 – Summary of the decision taken by the Portuguese Constitutional Court, of January 13, 2011; 2 – Complete text of the decision of the Portuguese Constitutional Court, of January 13, 2011, Judge Maria João ANTUNES (Reporter), Judge Carlos Pamplona de OLIVEIRA, Judge José Borges SOEIRO, Judge Gil GALVÃO, Judge Rui Manuel Moura RAMOS (President) –in terms of the tribunalconstitucional.pt, August 1, 2011; 3 – Brief annotation to the problem of the “medical act”; 3.1 – Plus some conclusions on the brief annotation to the problem of the “medical act”; 3.2 – Brief annotation to the problem of “consent”– continuation of the previous comments; 4 – Conclusions. It must never be forgotten that “consent” does not stand as the only cause of exclusion of unlawfulness.

The strategic management of creation process and of change: a theoretical contribute from the perspective of tourism

The entrepreneurship and innovation have been gradually gaining ground in the academic community as a field of study. However, the interpretations surrounding fragmented, without a univocal definition. In last decades, tourism has received greater attention from researchers in various sciences, varying only by the different emphases considered: economic, social, cultural and environmental. As other emerging sectors in a modern economy, tourism is a dynamic and ever-changing industry. The study has as purpose to provide a better understanding regarding the essence of entrepreneurship: theoretical and practical implications from the perspective of tourism. Regarding the methodology used here, this is a conceptual paper with a literature review that brings together the major components of entrepreneurship and its implications tourist perspective and conceptual model of the dynamic nature of the Triggering Process and innovation (e.g. iTravey, Interactive Stores, Tourist Transportable Tower).

Collecting system percutaneous access using real-time tracking sensors: first pig model in vivo experience

Purpose: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. Materials and Methods: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. Results: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p ¼ 0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p ¼ 0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. Conclusions: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques.

Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access

Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

Real-time hand tracking for rehabilitation and character animation

Hand and finger tracking has a major importance in healthcare, for rehabilitation of hand function required due to a neurological disorder, and in virtual environment applications, like characters animation for on-line games or movies. Current solutions consist mostly of motion tracking gloves with embedded resistive bend sensors that most often suffer from signal drift, sensor saturation, sensor displacement and complex calibration procedures. More advanced solutions provide better tracking stability, but at the expense of a higher cost. The proposed solution aims to provide the required precision, stability and feasibility through the combination of eleven inertial measurements units (IMUs). Each unit captures the spatial orientation of the attached body. To fully capture the hand movement, each finger encompasses two units (at the proximal and distal phalanges), plus one unit at the back of the hand. The proposed glove was validated in two distinct steps: a) evaluation of the sensors’ accuracy and stability over time; b) evaluation of the bending trajectories during usual finger flexion tasks based on the intra-class correlation coefficient (ICC). Results revealed that the glove was sensitive mainly to magnetic field distortions and sensors tuning. The inclusion of a hard and soft iron correction algorithm and accelerometer and gyro drift and temperature compensation methods provided increased stability and precision. Finger trajectories evaluation yielded high ICC values with an overall reliability within application’s satisfying limits. The developed low cost system provides a straightforward calibration and usability, qualifying the device for hand and finger tracking in healthcare and animation industries.

The role of cultural mega events in the enhancement of city’s image attributes: differences between engaged and attendee participants

In a time of fierce competition between regions, an image serve as a basis to develop a strong sense of community, which fosters trust and cooperation that can be mobilized for regional growth. A positive image and reputation could be used in the promotional activities of the region benefiting all the stakeholders as a whole. Mega cultural events are frequently used to attract tourists and investments to a region, but also to enhance the city’s image. This study adopts a marketing/communication perspective of city’s image, and intends to explain how the image of the city is perceived by their residents. Specifically, we intend to compare the perceptions of residents that effectively participated in the Guimarães European Capital of Culture (ECOC) 2012 (engaged residents), and the residents that only assisted to the event (attendees). Several significant findings are reported and their implications for event managers and public policy administrators presented, along with the limitations of the study.

Influence of foliar fertilization with manganese on germination, vigor and storage time of RR soybean seeds

ABSTRACTThis study aimed to evaluate the influence of foliar fertilizer doses containing Mn of phenological stages of suggested application in RR soybeans, to recover management damages with glyphosate at postemergence application on seed vigor in post-harvest and post six months storage. The seeds originated from a field experiment conducted , which included two applications of glyphosate, concomitant with foliar fertilizer in growth stages V4 and V6, with 0.00, 113.50 and 227.00 mg ha-1doses of Mn2+. Germination, GSI (Germination Speed Index), electrical conductivity tests and the first count of seeds were conducted. The application of Mn did not affect the physiological quality of RR soy in postharvest. However, in post-storage, higher doses of Mn had a negative effect on tests of abnormal seedlings, GSI and electrical conductivity. The applications of Mn, regardless of the developmental stage, did not interfere in the germination and first count tests, with and without storage. The electrical conductivity test showed a higher correlation with the seed germination test in the post-harvest treatment.

The international harmonization process of public accounting in Portugal: the perspective of different stakeholders

This paper investigates the reform of public accounting in Portugal through the IPSAS adoption highlighting the perception of different stakeholders. Two competing theories (NPM and the institutional theory) are used to understand public accounting changes within the Portuguese context. In general, different stakeholders agree with the favorable moment and the context of the reform. The context of financial crises and the great external pressures to cut public deficits and to improve the quality of financial information seem to be the most important factors to stimulate changes in public accounting. In addition, stakeholders recommend the use of different strategies to ensure success.

Foucault’s Perspective of Performance Appraisal in Public Administration

The main purpose of performance appraisal in organizations is, or should be, to improve the engagement, learning process and progress of the employees and to align individual with team and organizational performance. However, performance appraisal can also be interpreted as an instrument of normalization, discipline and surveillance. This study thus aims to explore and discuss the complex schema of intrinsic and extrinsic objectives of performance appraisal system of the Portuguese public organizations (SIADAP - Performance Evaluation Integrated System). We have developed an exploratory and qualitative case study to capture appraisers and appraises perceptions. The data were analyzed in light of foucauldian theories. According to the qualitative data, namely the discourses of the appraisers and their subordinates, the SIADAP is seen as an instrument of control and dominance that aims to introduce political rationalities, limiting the career progression of the employees. Though some key points of Foucault’s perspective were identified, foucauldian framework revealed some limitations to capture all the complexity inherent to performance appraisal. This study opens new perspectives about the SIADAP and can be of major importance as far as political reflection about performance appraisal in public organizations is concerned.

The internationally standardized process of public accounting: the perspective of different stakeholders in Portugal

New Public Management (NPM) led to great pressures for to introduce and adapt businesslike accounting in the public sector (Hood, 1995; Lapsley, 2008; Lapsley et al., 2009), specially the transition from cash basis to accrual-based accounting. In consequence, since the last 20 years we assist to a movement towards internationally standardized of public sector accounting that led to the publication of 32 International Public Sector Accounting Standards (IPSAS) for all public sector entities from national central governments to local governments (IFAC, 2008). These standards are accrual-basis and they emphasize the balance sheet approach, the fair value measurement and the revenue-expense approach (Hints, 2007). The main innovations are associated with the use of the balance sheet approach and the fair value measurement because, traditionally, public accounting systems are mainly focused on the revenue-expense approach and on historical cost valuation (Oulasvirta, 2014).

A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.