Design of mechatronic system for handling bedridden people

Dissertação de mestrado em Engenharia Mecatrónica

Advances in preservation of fruits and vegetables with bioactive coatings

Bioactive compounds are a large group of compounds (antimicrobials, antioxidants, nutrients, etc.), but its use in edible fi lms and coatings for application on fruits and vegetables has been very important because nowadays the consumers demand fruits and vegetables that are fresh, healthy, high quality and easy to prepare. A number of investigations have shown that the use of additives in edible fi lms and coatings improve its functionability and provide compounds for human health. However, it is necessary to continue research that can generate specifi c or tailor-made edible fi lms and coatings for each product with the best characteristics for preservation. In this review we present and analyze the concepts, progress and perspectives in the design and application of edible fi lms and coatings for fruits and vegetables in order to defi ne the challenges and opportunities that this topic of study in the fi eld of science, technology and food engineering.

Green furniture: sustainable design guidelines for the Irish furniture and wood products industry.

This thesis presents the research and development of sustainable design guidelines for the furniture and wood products industry, suitable for sustainably enhancing design, manufacturing and associated activities. This sustainable guideline is based on secondary research conducted on subject areas such as ‘eco’ design, ‘green’ branding and ‘green’ consumerism, as well as an examination of existing certifications and sustainable tools techniques and methodologies, national and international drivers for sustainable development and an overview of sustainability in the Irish furniture manufacturing context. The guideline was further developed through primary research. This consisted of a focus group attended by leading Irish designers, manufacturers and academics in the area of furniture and wood products. This group explored the question of ‘green branding’ saturation in the market and the viability of investing in sustainability just yet. Participants stated that they felt the market for ‘green’ products is evolving very slowly and that there is no metric or legal framework present to audit whether or not companies are producing products that really embody sustainability. All the participants believed that developing and introducing a new certification process to incorporate a sustainable design process was a viable and necessary solution to protecting Irish furniture and wood manufacturers going forward. For the purposes of the case study, the author investigated a ‘sustainable’ design process for Team woodcraft, Ltd., through the design and development of a ‘sustainable’ children’s furniture range. The case study followed a typical design and development process; detailing customer design specifications, concept development and refinement and cumulating in final prototype, as well as associated engineering drawings. Based on this primary and secondary research, seven fundamental core principles for this sustainable guideline have been identified by the author. The author then used these core principles to expand into guidelines for the basis of proposed new Irish sustainable design guidelines for the furniture and wood products industry, the concept of which the author has named ‘Green Dot’. The author suggests that the ‘Green Dot’ brand or logo could be used to market an umbrella network of Irish furniture designers and manufactures who implement the recommended sustainable techniques.

Design of a bifurcated stent graft, with its accompanying delivery system.

Abdominal Aortic Aneurysms (AAA) haemorhaging is a life-threatening disease. An aneurysm is a permanent swelling of an artery due to a weakness in its wall. Current surgical repair involves opening the chest or abdomen, gaining temporary vascular control of the aorta and suturing a prosthetic graft to the healthy aorta within the aneurysm itself The outcome of this surgical approach is not perfect, and the quality of life after this repair is impaired by postoperative pain, sexual dysfunction, and a lengthy hospital stay resulting in high health costs. All these negative effects are related to the large incision and extensive tissue dissection. Endovascular grafting is an alternative to the standard surgical method. This treatment is a less invasive method of treating aortic aneurysms. It involves a surgical exposure of the common femoral arteries where the stent graft can be inserted through by an over-the-wire technique. All manipulations are controlled from a remote place by the use of a catheter and this technique avoids the need to directly expose the diseased artery through a large incision or an extensive dissection. The proposed design method outlined in this project is to develop the endovascular approach. The main aim is to design an unitary bifurcated stent graft (1 e- bifurcated graft as a single component) to treat these Abdominal Aortic Aneurysms. This includes the delivery system and deployment mechanism necessary to first accurately position the stent graft across the aneurysm sac and also across the iliac bifurcation, and secondly fix the stent graft in position by using expandable metal stents. Thus, excluding the aneurysm from the circulation and therefore preventing rupture. Miniaturisation is a critical aspect of this design, as the smaller the crimped stent graft the easier to guide through the vascular system to the desired location. Biocompatibility is an important aspect. The preferred materials for this prosthesis are to use Shape Memory Alloys for the stent and a multifilament fabric for the graft. A taper design is applied for the geometry as this gives a favourable flow characteristic and reduced wave reflections. Adequate testing of the stent graft to prove its durability and the ease of the method of deployment is a prerequisite. A bench test facility has being designed and build to replicate the cardiovascular system and the disease in question aortic aneurysms at the iliac bifurcation. The testing here shows the feasibility of the proposed delivery system and the durability of the stent graft across the aneurysm sac. Finally, these endovascular treatments offer the economic advantage of short hospital stays or even treatment as an outpatient, as well as elimination of the need for postoperative intensive care The risk of developing an aneurysm increases with age, that is one of the mam reasons to look for less invasive ways of treating aneurysms. Consequently, there is enormous pressure to develop and use these devices rapidly.

Two new species of Drosophila belonging to the canalinea group (Diptera, rosophilidae)

Drosophila piratininga sp. nov. and Drosophila sampa sp. nov., belonging to the canalinea group of the subgenus Drosophila, are described based mostly on wild-caught specimens collected at a forest reserve of the Cidade Universitária "Armando de Salles Oliveira", an urban remnant of the montane Atlantic Forest located at west São Paulo city, state of São Paulo, Brazil. The two species are readily distinguished from each other mostly by having different wing patterns: the main crossveins being remarkably clouded in the first one and unclouded in the latter. Illustrations of terminalia are also provided.

1st National Accessiblity Plan 2004-2012: achieving equal opportunities and full participation through design for all

According to official statistics, disabled people in Spain number 3.5 million and make up 8.8% of the Spanish population. This group of people are increasingly being recognised as members of society with equal rights, and many of their demands are gradually being transformed into solutions that benefit society as a whole. One example is improved accessibility. Accessible built environments are more human and inclusive places, as well as being easier to get around. Improved accessibility is now recognised as a requirement shared by all members of society, although it is achieved thanks to the demands of disabled people and their representatives. The 1st National Accessibility Plan is a strategic framework for action aimed at ensuring that new products, services and built environments are designed to be accessible for as many people as possible (Design for All) and that existing ones are gradually duly adapted.

Mediterranean populations of the lesser white-toothed shrew (Crocidura suaveolens group): an unexpected puzzle of Pleistocene survivors and prehistoric introductions.

An earlier study revealed the strong phylogeographical structure of the lesser white-toothed shrew (Crocidura suaveolens group) within the northern Palaearctic. Here, we aim to reconstruct the colonization history of Mediterranean islands and to clarify the biogeography and phylogeographical relationships of the poorly documented Middle East region with the northern Palaearctic. We performed analyses on 998-bp-long haplotypes of the mitochondrial cytochrome b gene of 143 samples collected around the Mediterranean basin, including islands and the Middle East. The analyses suggest that the Cypriot shrew belongs to the rare group of relict insular Pleistocene mammal taxa that have survived to the present day. In contrast, the Cretan, Corsican and Menorcan populations were independently introduced from the Middle East during the Holocene. The phylogeographical structure of this temperate Palaearctic species within the Middle East appears to be complex and rich in diversity, probably reflecting fragmentation of the area by numerous mountain chains. Four deeply divergent clades of the C. suaveolens group occur in the area, meaning that a hypothetical contact zone remains to be located in central western Iran.

A new Culicoides of the stigmalis group (Diptera: Ceratopogonidae)

Notes are presented on the three known Neotropical species of the Culicoides stigmalis group of boodsucking midges: alvarezi Ortiz, fluviatilis (Lutz), stigmalis Wirth, and on deanei n.sp., which is described from the state of Rio de Janeiro, Brazil. A diagnosis is given for the group, as well as a key for identification and comparative phtographs of the female wings.

Harmonization guidelines for HLA-peptide multimer assays derived from results of a large scale international proficiency panel of the Cancer Vaccine Consortium.

PURPOSE: The Cancer Vaccine Consortium of the Cancer Research Institute (CVC-CRI) conducted a multicenter HLA-peptide multimer proficiency panel (MPP) with a group of 27 laboratories to assess the performance of the assay. EXPERIMENTAL DESIGN: Participants used commercially available HLA-peptide multimers and a well characterized common source of peripheral blood mononuclear cells (PBMC). The frequency of CD8+ T cells specific for two HLA-A2-restricted model antigens was measured by flow cytometry. The panel design allowed for participants to use their preferred staining reagents and locally established protocols for both cell labeling, data acquisition and analysis. RESULTS: We observed significant differences in both the performance characteristics of the assay and the reported frequencies of specific T cells across laboratories. These results emphasize the need to identify the critical variables important for the observed variability to allow for harmonization of the technique across institutions. CONCLUSIONS: Three key recommendations emerged that would likely reduce assay variability and thus move toward harmonizing of this assay. (1) Use of more than two colors for the staining (2) collect at least 100,000 CD8 T cells, and (3) use of a background control sample to appropriately set the analytical gates. We also provide more insight into the limitations of the assay and identified additional protocol steps that potentially impact the quality of data generated and therefore should serve as primary targets for systematic analysis in future panels. Finally, we propose initial guidelines for harmonizing assay performance which include the introduction of standard operating protocols to allow for adequate training of technical staff and auditing of test analysis procedures.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

Early mother-child interaction and later quality of attachment in infants with an orofacial cleft compared to infants without cleft.

Objective : The main objective of this study was to assess mother-child patterns of interaction in relation to later quality of attachment in a group of children with an orofacial cleft compared with children without cleft. Design : Families were contacted when the child was 2 months old for a direct assessment of mother-child interaction and then at 12 months for a direct assessment of the child's attachment. Data concerning socioeconomical information and posttraumatic stress symptoms in mothers were collected at the first appointment. Participants : Forty families of children with a cleft and 45 families of children without cleft were included in the study. Families were recruited at birth in the University Hospital of Lausanne. Results : Results showed that children with a cleft were more difficult and less cooperative during interaction at 2 months of age with their mother compared with children without a cleft. No significant differences were found in mothers or in dyadic interactive styles. Concerning the child's attachment at 12 months old, no differences were found in attachment security. However, secure children with a cleft were significantly more avoidant with their mother during the reunion episodes than secure children without cleft. Conclusion : Despite the facial disfigurement and the stress engendered by treatment during the first months of the infant's life, children with cleft and their mothers are doing as well as families without cleft with regard to the mothers' mental health, mother-child relationships, and later quality of attachment. A potential contribution for this absence of difference may be the pluridisciplinary support that families of children with cleft benefit from in Lausanne.

Strategies to promote translational research within the European Organisation for Research and Treatment of Cancer (EORTC) Head and Neck Cancer Group: a report from the Translational Research Subcommittee.

Head and neck squamous cell cancer (HNSCC) is the sixth leading cause of cancer-related deaths worldwide. These tumors are commonly diagnosed at advanced stages and mortality rates remain high. Even cured patients suffer the consequences of aggressive treatment that includes surgery, chemotherapy, and radiotherapy. In the past, in clinical trials, HNSCC was considered as a single disease entity. Advances in molecular biology with the development of genomic and proteomic approaches have demonstrated distinct prognostic HNSCC patient subsets beyond those defined by traditional clinical-pathological factors such as tumor subsite and stage [Cho W (ed). An Omics Perspective on Cancer Research. New York/Berlin: Springer 2010]. Validation of these biomarkers in large prospective clinical trials is required before their clinical implementation. To promote this research, the European Organisation for Research and Treatment of Cancer (EORTC) Head and Neck Cancer Program will develop the following strategies-(i) biobanking: prospective tissue collection from uniformly treated patients in the setting of clinical trials; (ii) a group of physicians, physician-scientists, and EORTC Headquarters staff devoted to patient-oriented head and neck cancer research; (iii) a collaboration between the basic scientists of the Translational Research Division interested in head and neck cancer research and the physicians of the Head and Neck Cancer Group; and (iv) funding through the EORTC Grant Program and the Network Core Institutions Consortium. In the present report, we summarize our strategic plans to promote head and neck cancer research within the EORTC framework.

The ethnography of study abroad: what is study abroad as a cultural event?

Recent research in the field of study abroad shows that study abroad participation among all U.S. students increased 20% since 2001 and nearly 200,000 U.S. students currently go abroad each year. Additionally, about 8% of all undergraduate degree recipients receive part of their education abroad. Although quantitative studies have dominated research on study abroad, my research project calls for a qualitative approach since the goal is to understand what study abroad is as a cultural event, what authentic cultural immersion is, how program stakeholders understand and perceive cultural immersion, and how cultural immersion in programs can be improved. Following the tradition of ethnographic and case study approaches in study abroad research, my study also pivots on ethnography. As an ethnographer I collected data mainly through participant observation, semi-structured interviews, and document analysis. The study abroad participants were a group of undergraduate native speakers of English studying Spanish for seven weeks in Cádiz, a small costal city in southern Spain, as well as program coordinators, host community members, and professors. I also examined the specific program design features, particularly the in-class and out-of-class activities that students participated in. The goal was to understand if these features were conducive to authentic immersion in the language and culture. Eventually, I elaborated an ethnographic evaluation of the study abroad program and its design features suggesting improvements in order to enhance the significance and value of study abroad as a cultural event. Among other things, I discussed the difficulties that students had at the beginning of their sojourn to understand local people, get used to their host families’ small apartments, get adjusted to new schedules and eating habits, and venture out from the main group to individually explore the new social and cultural fabric and interact with the host community. The program evaluation revealed the need for carefully-designed pre-departure preparation sessions, pre-departure credit-bearing courses in intercultural communication, and additional language practice abroad and opportunities to come in contact with the local community through internships, volunteer or field work. My study gives an important contribution in study abroad research and education. It benefits students, teachers, and study abroad directors and coordinators in suggesting ideas on how to improve the program and optimize the students’ cultural experiences abroad. This study is also important because it investigated how US undergraduate learners studying the Spanish language and culture approach and perceive the study abroad experience in Spain.

A Cluster Randomised Controlled Trial to Evaluate a Policy of Making Hip Protectors Available to Residents of Nursing Homes

Objectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes. Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation. Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland. Participants: 40 homes in the intervention group (representing 1,366 occupied beds) and 87 homes in the control group (representing 2,751 occupied beds). Interventions: a policy of making hip protectors available free of charge to residents of nursing homes and supporting the implementation process by employing a nurse facilitator to encourage staff in the homes to promote their use, over a 72-week period. Main outcome measures: the rate of hip fractures in intervention and control homes, and the level of adherence to use of hip protectors. Results: there were 85 hip fractures in the intervention homes and 163 in the control homes. The mean fracture rate per 100 residents was 6.22 in the intervention homes and 5.92 in the control homes, giving an adjusted rate ratio for the intervention group compared to the control group of 1.05 (95% CI 0.77, 1.43, P = 0.76). Initial acceptance of the hip protectors was 37.2% (508/1,366) with adherence falling to 19.9% (272/1,366) at 72 weeks.Conclusions: making hip protectors available to residents of nursing and residential homes did not reduce the rate of hip fracture. This research does not support the introduction of a policy of providing hip protectors to residents of nursing homes.

Use of phylogeny to resolve the taxonomy of the widespread and highly polymorphic African giant shrews (Crocidura olivieri group, Crocidurinae, Mammalia).

The aim of this study is to provide a better understanding of the genetic relationships within the widespread and highly polymorphic group of African giant shrews (Crocidura olivieri group). We sequenced 769 base pairs (bp) of the mitochondrial cytochrome b gene and 472 bp of the mitochondrial control region over the entire geographic range from South Africa to Morocco. The analyses reveal four main clades associated with different biomes. The largest clade occurs over a range covering Northwest and Central Africa and includes samples of C. fulvastra, C. olivieri, and C. viaria. The second clade is composed of C. goliath from Gabon, while South African C. flavescens, and C. hirta form two additional clades. On the basis of these results, the validity of some taxa in the C. olivieri group should be re-evaluated.