Influence of environmental temperature and humidity on the acute ventilatory response to exercise in asthmatic adolescents

Asthma is a chronic inflammatory disorder of the respiratory airways affecting people of all ages, and constitutes a serious public health problem worldwide (6). Such a chronic inflammation is invariably associated with injury and repair of the bronchial epithelium known as remodelling (11). Inflammation, remodelling, and altered neural control of the airways are responsible for both recurrent exacerbations of asthma and increasingly permanent airflow obstruction (11, 29, 34). Excessive airway narrowing is caused by altered smooth muscle behaviour, in close interaction with swelling of the airway walls, parenchyma retractile forces, and enhanced intraluminal secretions (29, 38). All these functional and structural changes are associated with the characteristic symptoms of asthma – cough, chest tightness, and wheezing –and have a significant impact on patients’ daily lives, on their families and also on society (1, 24, 29). Recent epidemiological studies show an increase in the prevalence of asthma, mainly in industrial countries (12, 25, 37). The reasons for this increase may depend on host factors (e.g., genetic disposition) or on environmental factors like air pollution or contact with allergens (6, 22, 29). Physical exercise is probably the most common trigger for brief episodes of symptoms, and is assumed to induce airflow limitations in most asthmatic children and young adults (16, 24, 29, 33). Exercise-induced asthma (EIA) is defined as an intermittent narrowing of the airways, generally associated with respiratory symptoms (chest tightness, cough, wheezing and dyspnoea), occurring after 3 to 10 minutes of vigorous exercise with a maximal severity during 5 to 15 minutes after the end of the exercise (9, 14, 16, 24, 33). The definitive diagnosis of EIA is confirmed by the measurement of pre- and post-exercise expiratory flows documenting either a 15% fall in the forced expiratory volume in 1 second (FEV1), or a ≥15 to 20% fall in peak expiratory flow (PEF) (9, 24, 29). Some types of physical exercise have been associated with the occurrence of bronchial symptoms and asthma (5, 15, 17). For instance, demanding activities such as basketball or soccer could cause more severe attacks than less vigorous ones such as baseball or jogging (33). The mechanisms of exercise-induced airflow limitations seem to be related to changes in the respiratory mucosa induced by hyperventilation (9, 29). The heat loss from the airways during exercise, and possibly its post-exercise rewarming may contribute to the exercise-induced bronchoconstriction (EIB) (27). Additionally, the concomitant dehydration from the respiratory mucosa during exercise leads to an increased interstitial osmolarity, which may also contribute to bronchoconstriction (4, 36). So, the risk of EIB in asthmatically predisposed subjects seems to be higher with greater ventilation rates and the cooler and drier the inspired air is (23). The incidence of EIA in physically demanding coldweather sports like competitive figure skating and ice hockey has been found to occur in up to 30 to 35% of the participants (32). In contrast, swimming is often recommended to asthmatic individuals, because it improves the functionality of respiratory muscles and, moreover, it seems to have a concomitant beneficial effect on the prevalence of asthma exacerbations (14, 26), supporting the idea that the risk of EIB would be smaller in warm and humid environments. This topic, however, remains controversial since the chlorified water of swimming pools has been suspected as a potential trigger factor for some asthmatic patients (7, 8, 20, 21). In fact, the higher asthma incidence observed in industrialised countries has recently been linked to the exposition to chloride (7, 8, 30). Although clinical and epidemiological data suggest an influence of humidity and temperature of the inspired air on the bronchial response of asthmatic subjects during exercise, some of those studies did not accurately control the intensity of the exercise (2, 13), raising speculation of whether the experienced exercise overload was comparable for all subjects. Additionally, most of the studies did not include a control group (2, 10, 19, 39), which may lead to doubts about whether asthma per se has conditioned the observed results. Moreover, since the main targeted age group of these studies has been adults (10, 19, 39), any extrapolation to childhood/adolescence might be questionable regarding the different lung maturation. Considering the higher incidence of asthma in youngsters (30) and the fact that only the works of Amirav and coworkers (2, 3) have focused on this age group, a scarcity of scientific data can be identified. Additionally, since the main environmental trigger factors, i.e., temperature and humidity, were tested separately (10, 28, 39) it would be useful to analyse these two variables simultaneously because of their synergic effect on water and heat loss by the airways (31, 33). It also appears important to estimate the airway responsiveness to exercise within moderate environmental ranges of temperature and humidity, trying to avoid extreme temperatures and humidity conditions used by others (2, 3). So, the aim of this study was to analyse the influence of moderate changes in air temperature and humidity simultaneously on the acute ventilatory response to exercise in asthmatic children. To overcome the above referred to methodological limitations, we used a 15 minute progressive exercise trial on a cycle ergometer at 3 different workload intensities, and we collected data related to heart rate, respiratory quotient, minute ventilation and oxygen uptake in order to ensure that physiological exercise repercussions were the same in both environments. The tests were done in a “normal” climatic environment (in a gymnasium) and in a hot and humid environment (swimming pool); for the latter, direct chloride exposition was avoided.

Alterações da curvatura da coluna vertebral: influência da fisioterapia, a nível neuromuscular

Mestrado em Fisioterapia

Trajectórias de profissionalidade e ciclo de vida profissional: um contributo para o conhecimento dos professores de educação especial

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências da Educação - Especialidade Educação Especial

Classification and staging of chronic liver disease from multimodal data

Chronic liver disease (CLD) is most of the time an asymptomatic, progressive, and ultimately potentially fatal disease. In this study, an automatic hierarchical procedure to stage CLD using ultrasound images, laboratory tests, and clinical records are described. The first stage of the proposed method, called clinical based classifier (CBC), discriminates healthy from pathologic conditions. When nonhealthy conditions are detected, the method refines the results in three exclusive pathologies in a hierarchical basis: 1) chronic hepatitis; 2) compensated cirrhosis; and 3) decompensated cirrhosis. The features used as well as the classifiers (Bayes, Parzen, support vector machine, and k-nearest neighbor) are optimally selected for each stage. A large multimodal feature database was specifically built for this study containing 30 chronic hepatitis cases, 34 compensated cirrhosis cases, and 36 decompensated cirrhosis cases, all validated after histopathologic analysis by liver biopsy. The CBC classification scheme outperformed the nonhierachical one against all scheme, achieving an overall accuracy of 98.67% for the normal detector, 87.45% for the chronic hepatitis detector, and 95.71% for the cirrhosis detector.

The usefulness of ultrasound in the classification of chronic liver disease

Chronic Liver Disease is a progressive, most of the time asymptomatic, and potentially fatal disease. In this paper, a semi-automatic procedure to stage this disease is proposed based on ultrasound liver images, clinical and laboratorial data. In the core of the algorithm two classifiers are used: a k nearest neighbor and a Support Vector Machine, with different kernels. The classifiers were trained with the proposed multi-modal feature set and the results obtained were compared with the laboratorial and clinical feature set. The results showed that using ultrasound based features, in association with laboratorial and clinical features, improve the classification accuracy. The support vector machine, polynomial kernel, outperformed the others classifiers in every class studied. For the Normal class we achieved 100% accuracy, for the chronic hepatitis with cirrhosis 73.08%, for compensated cirrhosis 59.26% and for decompensated cirrhosis 91.67%.

An adaptive educational system for higher education

The main objective of an Adaptive System is to adequate its relation with the user (content presentation, navigation, interface, etc.) according to a predefined but updatable model of the user that reflects his objectives, preferences, knowledge and competences [Brusilovsky, 2001], [De Bra, 2004]. For Educational Adaptive Systems, the emphasis is placed on the student knowledge in the domain application and learning style, to allow him to reach the learning objectives proposed for his training [Chepegin, 2004]. In Educational AHS, the User Model (UM), or Student Model, has increased relevance: when the student reaches the objectives of the course, the system must be able to readapt, for example, to his knowledge [Brusilovsky, 2001]. Learning Styles are understood as something that intent to define models of how given person learns. Generally it is understood that each person has a Learning Style different and preferred with the objective of achieving better results. Some case studies have proposed that teachers should assess the learning styles of their students and adapt their classroom and methods to best fit each student's learning style [Kolb, 2005], [Martins, 2008]. The learning process must take into consideration the individual cognitive and emotional parts of the student. In summary each Student is unique so the Student personal progress must be monitored and teaching shoul not be not generalized and repetitive [Jonassen, 1991], [Martins, 2008]. The aim of this paper is to present an Educational Adaptive Hypermedia Tool based on Progressive Assessment.

Otimização do processo de projeto de uma ferramenta progressiva para a estampagem de componentes metálicos

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Avaliação dos contributos do neuromarketing na gestão da marca

Dissertação de Mestrado em Ciências Económicas e Empresariais.

Desenvolvimento lexical: perspectivas e práticas de professores no 1.º ciclo do ensino básico

Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção de grau de Mestre em Didática da Língua Portuguesa no 1.º e 2.º Ciclos do Ensino Básico

Viver no singular

Dissertação de Mestrado, Ciências Sociais, 12 de Março de 2015, Universidade dos Açores.

Modelling and aerodynamic simulation of a vehicle and failure analysis of a laminated front fender

Master Thesis in Mechanical Engineering field of Maintenance and Production

Optimização de recursos numa industria de curtumes

O presente relatório descreve o trabalho de estágio efectuado na empresa Curtumes Aveneda, Lda com o objectivo de optimizar recursos como a água e energia. Foi realizado um diagnóstico energético que permitiu concluir que o consumo de energia na empresa é de 300 tep/ano, pelo que a empresa não é obrigada a adoptar as medidas de Regulamento de Gestão do Consumo de Energia (RGCE). O mesmo diagnóstico aponta para a existência de ineficiências, nomeadamente na tinturaria. Assim, foi projectado um sistema de controlo para adição de água na tinturaria com o intuito de reduzir o consumo de energia e água, e também melhorar a qualidade dos processos de tinturaria, dado que a adição de água é feita manualmente sem controlo de quantidade. Após consulta de fornecedor, o investimento em equipamento para tal sistema é de 10.012,00€ Foi desenvolvido um processo de recurtume compacto no sentido de promover a redução do consumo de água e de energia. Tal processo, quando comparado com um processo normal da empresa, gera uma redução de energia eléctrica no valor de 6.157,05 €/ano, uma redução no consumo de energia térmica da ordem de 904,00 €/ano, e ainda uma redução do consumo de água na ordem de 962 m3/ano correspondente a uma redução de 2.998,76 €/ano no tratamento de efluentes. Outras medidas foram sugeridas, mas sem uma fundamentação técnica e científica suficiente pelo que carecem de um estudo pormenorizado, como a instalação de arrancadores progressivos nos motores dos fulões, a optimização do aquecimento do ar de secagem na estufa com eventual recurso a painéis solares, e a optimização do funcionamento da caldeira dado o seu baixo rendimento.

Discriminação laboral sobre as mulheres no mercado de trabalho micaelense

Dissertação de Mestrado, Ciências Sociais, 18 de Março de 2016, Universidade dos Açores.

Prática de ensino supervisionado no 1.º e 2.º ciclo do ensino básico: a influência da planificação no desenvolvimento da escrita de textos

Relatório Final de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção do grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

A actual conjuntura económico-financeira e os mercados de futuros sobre o petróleo

Mestrado em Contabilidade e Análise Financeira