Results of radiation protection programmes on mammography

In this paper, we present the results of mammography quality control tests related to the work with Portuguese mammography equipment, either in conventional or in digital mammography computed radiography, showing the main differences in the tested equipments. Quality control in mammography is a very special area of quality control in radiology, which demands relatively high knowledge on physics. Digital imaging is changing the standards of the radiographic imaging. Regarding mammography, this is yet a controversial issue owing to some limitations of the digital detectors, like the resolution for instance. A complete set of results regarding radiation protection of the patients submitted to mammography diagnosis is presented. A discussion of the quality image parameters and its interpretation in conventional and digital mammography is presented. In conclusion, we present a sample of results that can be considered as characteristics of mammography equipment in Portugal.

Comparison of different breast planning techniques and algorithms for radiation therapy treatment

This work aims at investigating the impact of treating breast cancer using different radiation therapy (RT) techniques – forwardly-planned intensity-modulated, f-IMRT, inversely-planned IMRT and dynamic conformal arc (DCART) RT – and their effects on the whole-breast irradiation and in the undesirable irradiation of the surrounding healthy tissues. Two algorithms of iPlan BrainLAB treatment planning system were compared: Pencil Beam Convolution (PBC) and commercial Monte Carlo (iMC). Seven left-sided breast patients submitted to breast-conserving surgery were enrolled in the study. For each patient, four RT techniques – f-IMRT, IMRT using 2-fields and 5-fields (IMRT2 and IMRT5, respectively) and DCART – were applied. The dose distributions in the planned target volume (PTV) and the dose to the organs at risk (OAR) were compared analyzing dose–volume histograms; further statistical analysis was performed using IBM SPSS v20 software. For PBC, all techniques provided adequate coverage of the PTV. However, statistically significant dose differences were observed between the techniques, in the PTV, OAR and also in the pattern of dose distribution spreading into normal tissues. IMRT5 and DCART spread low doses into greater volumes of normal tissue, right breast, right lung and heart than tangential techniques. However, IMRT5 plans improved distributions for the PTV, exhibiting better conformity and homogeneity in target and reduced high dose percentages in ipsilateral OAR. DCART did not present advantages over any of the techniques investigated. Differences were also found comparing the calculation algorithms: PBC estimated higher doses for the PTV, ipsilateral lung and heart than the iMC algorithm predicted.

Image upsampling algorithms applied on Nuclear Medicine: comparision of hqnx and nxSaI algorithms families with two interpolation algorithms - nearest neighbour and bicubic interpolation

Introduction: Image resizing is a normal feature incorporated into the Nuclear Medicine digital imaging. Upsampling is done by manufacturers to adequately fit more the acquired images on the display screen and it is applied when there is a need to increase - or decrease - the total number of pixels. This paper pretends to compare the “hqnx” and the “nxSaI” magnification algorithms with two interpolation algorithms – “nearest neighbor” and “bicubic interpolation” – in the image upsampling operations. Material and Methods: Three distinct Nuclear Medicine images were enlarged 2 and 4 times with the different digital image resizing algorithms (nearest neighbor, bicubic interpolation nxSaI and hqnx). To evaluate the pixel’s changes between the different output images, 3D whole image plot profiles and surface plots were used as an addition to the visual approach in the 4x upsampled images. Results: In the 2x enlarged images the visual differences were not so noteworthy. Although, it was clearly noticed that bicubic interpolation presented the best results. In the 4x enlarged images the differences were significant, with the bicubic interpolated images presenting the best results. Hqnx resized images presented better quality than 4xSaI and nearest neighbor interpolated images, however, its intense “halo effect” affects greatly the definition and boundaries of the image contents. Conclusion: The hqnx and the nxSaI algorithms were designed for images with clear edges and so its use in Nuclear Medicine images is obviously inadequate. Bicubic interpolation seems, from the algorithms studied, the most suitable and its each day wider applications seem to show it, being assumed as a multi-image type efficient algorithm.

Machine Learning Algorithms at Myocardial Perfusion Imaging - a Preliminary Study

Introduction: A major focus of data mining process - especially machine learning researches - is to automatically learn to recognize complex patterns and help to take the adequate decisions strictly based on the acquired data. Since imaging techniques like MPI – Myocardial Perfusion Imaging on Nuclear Cardiology, can implicate a huge part of the daily workflow and generate gigabytes of data, there could be advantages on Computerized Analysis of data over Human Analysis: shorter time, homogeneity and consistency, automatic recording of analysis results, relatively inexpensive, etc.Objectives: The aim of this study relates with the evaluation of the efficacy of this methodology on the evaluation of MPI Stress studies and the process of decision taking concerning the continuation – or not – of the evaluation of each patient. It has been pursued has an objective to automatically classify a patient test in one of three groups: “Positive”, “Negative” and “Indeterminate”. “Positive” would directly follow to the Rest test part of the exam, the “Negative” would be directly exempted from continuation and only the “Indeterminate” group would deserve the clinician analysis, so allowing economy of clinician’s effort, increasing workflow fluidity at the technologist’s level and probably sparing time to patients. Methods: WEKA v3.6.2 open source software was used to make a comparative analysis of three WEKA algorithms (“OneR”, “J48” and “Naïve Bayes”) - on a retrospective study using the comparison with correspondent clinical results as reference, signed by nuclear cardiologist experts - on “SPECT Heart Dataset”, available on University of California – Irvine, at the Machine Learning Repository. For evaluation purposes, criteria as “Precision”, “Incorrectly Classified Instances” and “Receiver Operating Characteristics (ROC) Areas” were considered. Results: The interpretation of the data suggests that the Naïve Bayes algorithm has the best performance among the three previously selected algorithms. Conclusions: It is believed - and apparently supported by the findings - that machine learning algorithms could significantly assist, at an intermediary level, on the analysis of scintigraphic data obtained on MPI, namely after Stress acquisition, so eventually increasing efficiency of the entire system and potentially easing both roles of Technologists and Nuclear Cardiologists. In the actual continuation of this study, it is planned to use more patient information and significantly increase the population under study, in order to allow improving system accuracy.

Practical Quality Control: Comparision of Methods on the Quantification of Stationary Phases in Paper and Thin-Layer Chromatographic Systems

Introduction: Paper and thin layer chromatography methods are frequently used in Classic Nuclear Medicine for the determination of radiochemical purity (RCP) on radiopharmaceutical preparations. An aliquot of the radiopharmaceutical to be tested is spotted at the origin of a chromatographic strip (stationary phase), which in turn is placed in a chromatographic chamber in order to separate and quantify radiochemical species present in the radiopharmaceutical preparation. There are several methods for the RCP measurement, based on the use of equipment as dose calibrators, well scintillation counters, radiochromatografic scanners and gamma cameras. The purpose of this study was to compare these quantification methods for the determination of RCP. Material and Methods: 99mTc-Tetrofosmin and 99mTc-HDP are the radiopharmaceuticals chosen to serve as the basis for this study. For the determination of RCP of 99mTc-Tetrofosmin we used ITLC-SG (2.5 x 10 cm) and 2-butanone (99mTc-tetrofosmin Rf = 0.55, 99mTcO4- Rf = 1.0, other labeled impurities 99mTc-RH RF = 0.0). For the determination of RCP of 99mTc-HDP, Whatman 31ET and acetone was used (99mTc-HDP Rf = 0.0, 99mTcO4- Rf = 1.0, other labeled impurities RF = 0.0). After the development of the solvent front, the strips were allowed to dry and then imaged on the gamma camera (256x256 matrix; zoom 2; LEHR parallel-hole collimator; 5-minute image) and on the radiochromatogram scanner. Then, strips were cut in Rf 0.8 in the case of 99mTc-tetrofosmin and Rf 0.5 in the case of 99mTc-HDP. The resultant pieces were smashed in an assay tube (to minimize the effect of counting geometry) and counted in the dose calibrator and in the well scintillation counter (during 1 minute). The RCP was calculated using the formula: % 99mTc-Complex = [(99mTc-Complex) / (Total amount of 99mTc-labeled species)] x 100. Statistical analysis was done using the test of hypotheses for the difference between means in independent samples. Results:The gamma camera based method demonstrated higher operator-dependency (especially concerning the drawing of the ROIs) and the measures obtained using the dose calibrator are very sensitive to the amount of activity spotted in the chromatographic strip, so the use of a minimum of 3.7 MBq activity is essential to minimize quantification errors. Radiochromatographic scanner and well scintillation counter showed concordant results and demonstrated the higher level of precision. Conclusions: Radiochromatographic scanners and well scintillation counters based methods demonstrate to be the most accurate and less operator-dependant methods.

A comprehensive approach to evaluate nutritional status in Crohn's patients in the era of biologic therapy: a case-control study

Objectives - Evaluate the nutritional status of patients with inactive or mildly active Crohn's disease (CD), and identify possible causes for potential deficiencies. Methods - A total of 78 CD patients and 80 healthy controls were evaluated in respect of nutritional status, dietary intake, and life styles factors. Results - These 73/78 CD patients were on immunomodulating therapies. Mean body mass index (BMI) was lower in patients as compared to controls (P= 0.006) but 32% of CD patients and 33.8% of controls had a BMI > 25, whereas 8% and 23.8% in each group, respectively, were obese (BMI > 30Kg/m(2)). Fat free mass was significantly decreased in both genders (P < 0.05) whereas fat mass was decreased only in males (P= 0.01). Energy intake was significantly lower in CD patients (P < 0.0001) and we observed significantly lower adjusted mean daily intakes of carbohydrates, monounsaturated fat, fiber, calcium, and vitamins C, D, E, and K (P < 0.05). 29% of patients had excluded grains from their usual diet, 28% milk, 18% vegetables, and 11% fruits. Milk exclusion resulted in a significantly lower consumption of calcium and vitamin K (P < 0.001) and the exclusion of vegetables was associated to a lower consumption of vitamins C and E (P < 0.05). Physical activity was significantly lower in CD patients (P= 0.01) and this lack of physical activity was inversely correlated with increased fat mass percentage (r=-0.315, P= 0.001). Conclusions - Results showed that the most prevalent form of malnutrition in CD patients was an excess of body weight, which was concomitant with an inadequate dietary intake, namely micronutrients, clearly related to dietary exclusion of certain foods.

Validação da versão portuguesa do método 'Internacional Chemical Control Toolkit'

Em Portugal, como em outros países, podem ser encontrados milhares de trabalhadores com doenças e outros problemas resultantes da exposição aos compostos orgânicos voláteis (COV’s). No entanto são poucos os estudos aplicados à actividade industrial. Neste trabalho validou-se/estimou-se a exposição ocupacional a COV´s dos trabalhadores que executam a tarefa de ‘aplicação de revestimento do mobiliário’, mais conhecida por ‘acabamento de móveis’ na secção de acabamentos do sector de mobiliário de madeira, que se situa nos concelhos de Paços de Ferreira e Paredes, concelhos do Norte de Portugal. A amostra foi constituída por 17 empresas e foram avaliados 34 tarefas que corresponde ao mesmo número de trabalhadores, uma vez que eles executam essa tarefa durante as oito horas diárias de trabalho. Para avaliar a exposição dos trabalhadores foram utilizadas duas abordagens da higiene do trabalho: a pragmática, através da aplicação do método Toolkit e a tradicional com recurso a amostragens de ar e análises laboratoriais. Os resultados obtidos sugerem que o Toolkit é uma boa ferramenta para ser utilizada pelas Pequenas e Médias Empresas (PME’s), que trabalhem com substâncias em pó ou líquidas. É um método expedito e que não acarreta grandes esforços financeiros. Verificou-se ainda que a maioria dos trabalhadores estão em risco de exposição a COV’s. Sendo necessário tomar medidas de controlo.

Dominio cultural del autocuidado en diabeticos tipo 2 con y sin control glucémico en México

OBJETIVO: Analisar los principales elementos relacionados con el dominio cultural del autocuidado de la salud, entre pacientes con diabetes tipo 2 con y sin controle glucémico. MÉTODOS: Estudio descriptivo en 57 diabéticos controlados y 76 sin control glucémico, con promedio de 60 años de edad en una clínica del Seguro Social en México en 2003. Se aplicaron técnicas de antropología cognitiva de listas libres y cuestionario estructurado para obtener modelo semántico y promedio de conocimiento cultural a seis preguntas sobre su padecimiento por análisis de consenso. RESULTADOS: Los datos sociodemográficos de ambos grupos no mostraron diferencias significativas. Todos los modelos de respuesta comparados presentaron estructuras semánticas similares, con excepción a: "Qué se entiende como ejercicio" (p<0.05). El promedio de conocimiento cultural sobre los aspectos analizados fue similar en ambos grupos, solamente el nivel de conocimiento relacionado a "Cómo debe ayudar la familia a un adulto para estar sano" fue estadísticamente significativamente mayor en pacientes controlados. CONCLUSIONES: Los hallazgos muestran a diferente estructura semántica sobre la concepción del ejercicio entre los grupos de pacientes y la diferencia en el promedio de conocimiento cultural sobre el apoyo familiar para la salud de paciente. Estas informaciones deben ser tomadas en cuenta al elaborar programas educativos, de auto atención y atención médica adaptados a la cultura del paciente con diabetes tipo 2.

Coletores de distribuição e sua otimização hidráulica, aplicados a uma instalação de produção de água arrefecida em sistemas de AVAC ( Fórum Picoas)

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

Quality assurance and quality control in mammography: a review of available guidance worldwide

Objectives - Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Methods - Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Results - Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. Conclusions - The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources.

Framework de controlo de acessos para Triple-stores com interface Sail API

Grande parte dos triples-stores são open source e desenvolvidos em Java, disponibilizando interfaces standards e privadas de acesso. A grande maioria destes sistemas não dispõe de mecanismos de controlo de acessos nativos, o que dificulta ou impossibilita a sua adopção em ambientes em que a segurança dos factos é importante (e.g. ambiente empresarial). Complementarmente observa-se que o modelo de controlo de acesso a triplos e em particular a triplos descritos por ontologias não está standardizado nem sequer estabilizado, havendo diversos modelos de descrição e algoritmos de avaliação de permissões de acesso. O trabalho desenvolvido nesta tese/dissertação propõe um modelo e interface de controlo de acesso que permite e facilite a sua adopção por diferentes triple-stores já existentes e a integração dos triples-stores com outros sistemas já existentes na organização. Complementarmente, a plataforma de controlo de acesso não impõe qualquer modelo ou algoritmo de avaliação de permissões, mas pelo contrário permite a adopção de modelos e algoritmos distintos em função das necessidades ou desejos. Finalmente demonstra-se a aplicabilidade e validade do modelo e interface propostos, através da sua implementação e adopção ao triple-store SwiftOWLIM já existente, que não dispõe de mecanismo de controlo de acessos nativo.

Locus of control and contraceptive knowledge, attitude and practice among university students

OBJECTIVE: To assess the relationship between locus of control and knowledge, attitude and practice regarding pill and condom use among university students. METHODS: The inquiry was developed in Campinas, a city in Southeastern Brazil, in 2006. A total of 295 adolescent newcomers to a public university answered a structured questionnaire and Levenson's multidimensional locus of control scale. The scores of the dimensions of locus of control were calculated and Spearman's correlation coefficient was used to assess their correlation with knowledge and practice concerning pill and condom use. In order to assess the relationship between the dimensions of locus of control and sociodemographic variables and variables related to the individuals' sex life, Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: Male adolescents had higher scores of powerful others externality when compared to female adolescents (p=0.01). Students living alone had lower internality (p=0.01). When locus of control was compared to condom use in the first intercourse, considering only the 102 students who informed the age of the beginning of sexual activity, greater internality was found among male adolescents who did not use condoms (p<0.05). When the locus of control scores were correlated with contraceptive knowledge and practice, it was found that the higher the powerful others externality locus, the lower the adequate use of contraceptive methods (r = -0.22, p=0.03). CONCLUSIONS: The powerful others externality locus influences the practice of contraceptive use in this group of adolescents.

Physical activity during pregnancy and fetal outcomes: a case-control study

OBJECTIVE: To investigate the relationship between physical activity during the second trimester pregnancy and low birth weight, preterm birth, and intrauterine growth restriction. METHODS: Case-control study including 273 low birth weight newborns and 546 controls carried out in the city of São Paulo, Southeastern Brazil, in 2005. Low birth weight cases were grouped into two subsamples: preterm birth (n=117) and intrauterine growth restriction (n=134), with their related controls. Information was collected by means of interviews with mothers shortly after birth and transcription of medical records. Data were analyzed using conditional multiple and hierarchical logistic regression. RESULTS: Light physical activity for over 7 hours per day was shown to be protective against low birth weight (adjusted OR=0.61; 95% CI 0.39-0.94) with a dose-response relationship (p-value for trend=0.026). A similar trend was found for intrauterine growth restriction (adjusted OR=0.51; 95% CI 0.26-0.97). Homemaking activities were associated as a protective factor for both low birth weight and preterm birth (p-value for trend=0.013 and 0.035, respectively). Leisure-time walking was found to be protective against preterm birth. CONCLUSIONS: Mild physical activity during the second trimester of pregnancy such as walking has an independent protective effect on low birth weight, preterm birth, and intrauterine growth restriction.

A literature review on the optimization of legged robots

Over the last two decades the research and development of legged locomotion robots has grown steadily. Legged systems present major advantages when compared with ‘traditional’ vehicles, because they allow locomotion in inaccessible terrain to vehicles with wheels and tracks. However, the robustness of legged robots, and especially their energy consumption, among other aspects, still lag behind mechanisms that use wheels and tracks. Therefore, in the present state of development, there are several aspects that need to be improved and optimized. Keeping these ideas in mind, this paper presents the review of the literature of different methods adopted for the optimization of the structure and locomotion gaits of walking robots. Among the distinct possible strategies often used for these tasks are referred approaches such as the mimicking of biological animals, the use of evolutionary schemes to find the optimal parameters and structures, the adoption of sound mechanical design rules, and the optimization of power-based indexes.