986 resultados para CARDIAC-PERFORMANCE
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Com o acentuar da crise financeira (que se traduziu numa situação de recessão económica a nível mundial com efeitos consideráveis na economia portuguesa), cada empresa tem ainda mais em atenção a sua performance, como maximizar o seu valor, e talvez ainda mais importante nos dias que correm, como minimizar o risco de falência. Para tal, os gestores têm de ter em consideração todos os aspetos relevantes e que possam interferir com o sucesso do seu negócio. Nesse sentido, devem ter em seu poder o mais alargado leque de informação possível, para tomarem as decisões corretas tanto a curto como a médio longo prazo. A informação disponibilizada pela análise económico-financeira torna-se então um importante instrumento para a tomada de decisão embora não poderá ser apenas o único instrumento utilizado pelos decisores. Com o presente relatório de estágio pretende-se aferir da importância da análise económico-financeira na performance das empresas, tendo em consideração o estágio realizado na empresa Prime Century, Lda. Para além da já referida análise económico-financeira, iremos abordar, na sequência do trabalho desenvolvido durante o estágio, a criação de planos de negócios e a avaliação de empresas.
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Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Electrotécnica e Computadores
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Infective endocarditis (IE) is now rare in developed countries, but its prevalence is higher in elderly patients with prosthetic valves, diabetes, renal impairment, or heart failure. An increase in health-care associated IE (HCAIE) has been observed due to invasive maneuvers (30% of cases). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus are the most common agents in HCAIE, causing high mortality and morbidity. We review complications of IE and its therapy, based on a patient with acute bivalvular left-sided MRSA IE and a prosthetic aortic valve, aggravated by congestive heart failure, stroke, acute immune complex glomerulonephritis, Candida parapsilosis fungémia and death probably due to Serratia marcescens sepsis. The HCAIE was assumed to be related to three temporally associated in-hospital interventions considered as possible initial etiological mechanisms: overcrowding in the hospital environment,iv quinolone therapy and red blood cell transfusion. Later in the clinical course,C. parapsilosis and S. marcescens septicemia were considered to be possible secondary etiological mechanisms of HCAIE.
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Based on a case of a patient with angiosarcoma (AS) of the right atrium with superior vena cava syndrome associated with urticaria and polyarthralgias, who died soon after surgery, the authors present a brief review of the subject of cardiac AS, an extremely rare pathology, usually diagnosed late due to its non-specific symptomatology. Several topics are discussed, including mechanisms of clinical manifestations caused by blood flow obstruction and valve dysfunction, local invasion with arrhythmias and pericardial effusion, embolic phenomena and constitutional symptoms. Imaging and histopathologic methods of diagnosis are considered, as well as references to cytogenetic analysis. Surgery is the first treatment choice, but heart AS are frequently not completely resectable and concomitant metastases at the time of surgery are common, both usually leading to a dismal prognosis. Chemotherapy, radiotherapy and even heart transplantation do not substantially improve the survival of these patients. Urticaria is not generally assumed by most authors to be associated with malignancy, but there are rare reports of its association with some malignant tumors.
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An 80 years old man suffered a cardiac arrest shortly after arrival to his local health department. Basic Life Support was started promptly and nine minutes later, on evaluation by an Advanced Life Support team, the victim was defibrillated with a 200J shock. When orotracheal intubation was attempted, masseter muscle contraction was noticed: on reevaluation, the victim had pulse and spontaneous breathing.Thirty minutes later, the patient had been transferred to an emergency department. As he complained of chest pain, the ECG showed a ST segment depression in leads V4 to V6 and laboratory tests showed cardiac troponine I slightly elevated. A coronary angiography was performed urgently: significant left main plus three vessel coronary artery disease was disclosed.Eighteen hours after the cardiac arrest, a quadruple coronary artery bypass grafting operation was undertaken. During surgery, a fresh thrombus was removed from the middle left anterior descendent artery. Post-operative course was uneventful and the patient was discharged seven days after the procedure. Twenty four months later, he remains asymptomatic.In this case, the immediate call for the Advanced Life Support team, prompt basic life support and the successful defibrillation, altogether, contributed for the full recovery. Furthermore, the swiftness in the detection and treatment of the acute reversible cause (myocardial ischemia in this case) was crucial for long-term prognosis.
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Purpose: The purpose of this article is to discuss the impact of Supplier orientation and the resulting Supply Chain Management (SCM) approach, on the organizational performance of ISO 9001 Quality Management Systems certified organizations. Methodology/Approach: Following a literature review, a full structural conceptual model was proposed. An online survey was administered to managers of Portuguese organizations with certified ISO 9001 Quality Management Systems. Descriptive Statistics and Structural Model Equations were used to validate the proposed conceptual model. Findings: There are positive relationships between Organization Strategy and Supplier Orientation, between Supplier Orientation and Stakeholders Satisfaction, and between Stakeholders Satisfaction and Organizational Performance Orientation, supporting ISO 9001:2015. These findings provide insights that supplier orientation, mediated by stakeholder satisfaction, is an essential tool for organizational competitive sustainable advantage. Research Limitation/implication: The analysis was based on managers of ISO 9001 certified organizations perceptions, so additional studies with actual data and longitudinal studies should be useful for further validation. Originality/Value of paper: The importance of the overall organizational ecosystem is highlighted with potential impact on the more than 1 Million ISO 9001 organizations certified worldwide and in their suppliers.
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Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica
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Most energy spent in walking is due to step-to-step transitions. During this phase, the interlimb coordination assumes a crucial role to meet the demands of postural and movement control. The authors review studies that have been carried out regarding the interlimb coordination during gait, as well as the basic biomechanical and neurophysiological principles of interlimb coordination. The knowledge gathered from these studies is useful for understanding step-to-step transition during gait from a motor control perspective and for interpreting walking impairments and inefficiency related to pathologies, such as stroke. This review shows that unimpaired walking is characterized by a consistent and reciprocal interlimb influence that is supported by biomechanical models, and spinal and supraspinal mechanisms. This interlimb coordination is perturbed in subjects with stroke.
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This article presents a novel method for visualizing the control systems behavior. The proposed scheme uses the tools of fractional calculus and computes the signals propagating within the system structure as a time/frequency-space wave. Linear and nonlinear closed-loop control systems are analyzed, for both the time and frequency responses, under the action of a reference step input signal. Several nonlinearities, namely, Coulomb friction and backlash, are also tested. The numerical experiments demonstrate the feasibility of the proposed methodology as a visualization tool and motivate its extension for other systems and classes of nonlinearities.
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During myocardial ischemia and reperfusion both purines and pyrimidines are released into the extracellular milieu, thus creating a signaling wave that propagates to neighboring cells via membrane-bound P2 purinoceptors activation. Cardiac fibroblasts (CF) are important players in heart remodeling, electrophysiological changes and hemodynamic alterations following myocardial infarction. Here, we investigated the role UTP on calcium signaling and proliferation of CF cultured from ventricles of adult rats. Co-expression of discoidin domain receptor 2 and -smooth muscle actin indicate that cultured CF are activated myofibroblasts. Intracellular calcium ([Ca2+]i) signals were monitored in cells loaded with Fluo-4 NW. CF proliferation was evaluated by the MTT assay. UTP and the selective P2Y4 agonist, MRS4062, caused a fast desensitizing [Ca2+]i rise originated from thapsigargin-sensitive internal stores, which partially declined to a plateau providing the existence of Ca2+ in the extracellular fluid. The biphasic [Ca2+]i response to UTP was attenuated respectively by P2Y4 blockers, like reactive blue-2 and suramin, and by the P2Y11 antagonist, NF340. UTP and the P2Y2 receptor agonist MRS2768 increased, whereas the selective P2Y11 agonist NF546 decreased, CF growth; MRS4062 was ineffective. Blockage of the P2Y11receptor or its coupling to adenylate cyclase boosted UTP-induced CF proliferation. Confocal microscopy and Western blot analysis confirmed the presence of P2Y2, P2Y4 and P2Y11 receptors. Data indicate that besides P2Y4 and P2Y2 receptors which are responsible for UTP-induced [Ca2+]i transients and growth of CF, respectively, synchronous activation of the previously unrecognized P2Y11 receptor may represent an important target for anti-fibrotic intervention in cardiac remodeling.
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The objective of the thesis is to analyze the behaviour of the wind flow when it is passing beside the forest. To complete this analysis, a parametric study was done based upon generalized situations. Some abacus have been made, which are related to forest and wind characteristics. The abacus were compared with a particular real case, namely Alexandrovo (Bulgaria), where it was concluded that the applicability of the abacus in projects with complex terrain is low and they must be used, from a quantitative point of view, for flat terrain, being hc the most important parameter.
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This study aims to analyze and compare micro-firms’ organizational culture related to organizational performance. A case study methodology was used based on four firms, competitors among themselves in the Information Technology business, focusing on the years between 2008-2013. Findings pointed out many similarities to larger firms, but some specificities of micro-firms were found and propositions were defined: clan culture predominance is related to best performing micro-firms; the configuration of several culture types seemed to be the most suitable for obtaining good organizational results, provided that they do not focus only on hierarchy and market types of culture; the market culture predominance perception by employees is associated with low job satisfaction; and, after a certain time in business, micro-firms, as do larger companies, seek to standardize and control processes. Recognizing that organizational culture is considered important to firms’ results, this study sheds some light on that important factor for micro-firms.
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During the last years, several studies have been made aiming to assess the out-of-plane seismic response of unreinforced stone masonry structures. This fact led to the development of a wide variety of models and approaches, ranging from simple kinematic based analytical models up to complex numerical simulations. Nevertheless, for the sake of simplicity, the out-of-plane seismic response of a masonry wall pier may be obtained by means of a simple single-degree-of-freedom system while still providing good results. In fact, despite the assumptions associated with such a simple formulation, it is also true that the epistemic uncertainty inherent with the selection of appropriate input parameters in more complex models may render them truly ineffective. In this framework, this paper focuses on the study of the out-of-plane bending of unreinforced stone masonry walls (cantilevers) by proposing a simplified analytical approach based on the construction of a linearized four-branch model, which is used to characterize the linear and nonlinear response of such structural elements through an overturning moment-rotation relationship. The formulation of the four-branch model is presented and described in detail and the meaningful parameters used for its construction are obtained from a set of experimental laboratory tests performed on six full-scale unreinforced regular sacco stone masonry specimens. Moreover, a parametric analysis aiming to evaluate the effect of these parameters’ variation on the final configuration of the model is presented and critically discussed. Finally, the results obtained from the application of the developed four-branch model on real unreinforced regular sacco stone masonry walls are thoroughly analysed and the main conclusions obtained from its application are summarized.