The Robson Ten-group Classification System For Appraising Deliveries At A Tertiary Referral Hospital In Brazil.

To evaluate the distribution of women according to the Robson 10-group classification system (RTGCS) and the occurrence of severe maternal morbidity (SMM) by mode of delivery at a tertiary referral hospital. A retrospective cross-sectional study was conducted of all women admitted to the Women's Hospital at the University of Campinas (Campinas, Brazil) for delivery between January 2009 and July 2013. Women were grouped according to RTGCS. Mode of delivery and SMM (defined as need for admission to the intensive care unit) were assessed. Among 12 771 women, 5957 (46.6%) delivered by cesarean. Overall, 3594 (28.1%) women were in group 1 (nulliparous, single pregnancy, cephalic, term, spontaneous labor), 2328 (18.2%) in group 5 (≥1 previous cesarean, single pregnancy, cephalic, term), and 2112 (16.5%) in group 3 (multiparous excluding previous cesarean, single pregnancy, cephalic, term, spontaneous labor). Group 5 contributed the most cesarean deliveries (1626 [27.3%]), followed by group 2 (nulliparous, single pregnancy, cephalic, term, induced labor or cesarean before labor; 1049 [17.6%]). SMM was more common among women undergoing cesarean delivery than among those delivering vaginally in groups 1-5. The RTGCS allowed the identification of groups with the highest frequency of cesarean delivery and an assessment of SMM. This should be considered in related health policies.

Indications For In Vitro Fertilization At A Public Center For Reproductive Health In Campinas, Brazil.

To assess the sociodemographic profile and gynecologic and obstetric characteristics of women referred to a public reference center in Campinas, Brazil, for in vitro fertilization (IVF). Women referred between April 1, 2008, and October 31, 2009, were eligible for inclusion in a cross-sectional study. Participants were interviewed about sociodemographic characteristics, obstetric and gynecologic history, and etiologic factors resulting in the referral. Preliminary clinical examinations performed elsewhere were evaluated. A total of 176 women were included, of whom 129 (73.3%) presented with tubal factor infertility. Tubal ligation had been performed in 66 (37.5%) women. Overall, 121 (68.8%) women were aged 30 years old or less, 110 (62.5%) had received more than 8 years of schooling, 123 (69.6%) had had infertility for up to 5 years, and 99 (56.3%) did not have any children. Moreover, 25 (14.2%) women had endometriosis and 25 (14.2%) had a male factor issue. A previous ectopic pregnancy was reported for 20 (11.4%) women and pelvic inflammatory disease for 49 (27.8%). Tubal factor infertility was the most common indication for IVF. Preventive measures are required, in addition to policies that ensure access to high-complexity treatments in the public sector.

Severe Maternal Morbidity And Near Miss Due To Postpartum Hemorrhage In A National Multicenter Surveillance Study.

To assess the occurrence of severe maternal complications owing to postpartum hemorrhage (PPH) and its associated factors. A secondary analysis of data from a multicenter cross-sectional prospective surveillance study included 9555 cases of severe maternal morbidity at 27 centers in Brazil between July 2009 and June 2010. Complications of PPH, conditions of severity management, and sociodemographic and obstetric characteristics were assessed. Factors independently associated with severe maternal outcome (SMO) were identified using multiple regression analysis. Overall, 1192 (12.5%) of the 9555 women experienced complications owing to PPH (981 had potentially life-threatening conditions, 181 maternal near miss, and 30 had died). The SMO ratio was 2.6 per 1000 live births among women with PPH and 8.5 per 1000 live births among women with other complications. Women with PPH had a higher risk of blood transfusion and return to the operating theater than did those with complications from other causes. Maternal age, length of pregnancy, previous uterine scar, and cesarean delivery were the main factors associated with an increased risk of SMO secondary to PPH. PPH frequently leads to severe maternal morbidity. A surveillance system can identify the main causes of morbidity and could help to improve care, especially among women identified as being at high risk of PPH.

HDL concentration, lipid transfer to HDL, and HDL size in normolipidemic nonobese menopausal women

Objective: To determine the impact of menopause on lipid transfer from donor lipoproteins to high-density lipoproteins (HDLs)-a process that is related to the protective function of HDL-and the size of HDL particles. Method: Plasma from 22 prernenopausal and 18 postmenopausal nonobese, normolipidemic women paired for age (40-50 years) was incubated in an artificial nanoemulsion labeled with radioactive lipids. Then the HDL fraction was assessed for radioactivity; the percentage of radioactive lipids transferred from the nanoemulsion to HDL was determined; and the size of HDL particles was measured by laser light scattering. Results: There were no differences between the 2 groups in serum concentration of HDL cholesterol (61 12 mg/dL vs 61 +/- 14 mg/dL) or apolipoprotein A(1) (1.5 +/- 0.3 g/L vs 1.5 +/- 0.2 g/L); lipid transfer to HDL; or size of HDL particles (8.8 +/- 0.8 vs 9.0 +/- 0.5 nm). Conclusion: Menopause was not found to affect HDL cholesterol plasma concentration, lipid transfer to HDL, or size of HDL particles in normolipidemic nonobese women. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd.All rights reserved.

ANN based support for distributed energy resources scheduling in smart grids

The future scenarios for operation of smart grids are likely to include a large diversity of players, of different types and sizes. With control and decision making being decentralized over the network, intelligence should also be decentralized so that every player is able to play in the market environment. In the new context, aggregator players, enabling medium, small, and even micro size players to act in a competitive environment, will be very relevant. Virtual Power Players (VPP) and single players must optimize their energy resource management in order to accomplish their goals. This is relatively easy to larger players, with financial means to have access to adequate decision support tools, to support decision making concerning their optimal resource schedule. However, the smaller players have difficulties in accessing this kind of tools. So, it is required that these smaller players can be offered alternative methods to support their decisions. This paper presents a methodology, based on Artificial Neural Networks (ANN), intended to support smaller players’ resource scheduling. The used methodology uses a training set that is built using the energy resource scheduling solutions obtained with a reference optimization methodology, a mixed-integer non-linear programming (MINLP) in this case. The trained network is able to achieve good schedule results requiring modest computational means.

Concepção e instalação de tabelas multifunções para recintos desportivos cobertos

Mestrado em Engenharia Electrotécnica – Sistemas Eléctricos de Energia

A wireless sensor network platform for structural health monitoring: enabling accurate and synchronized measurements through COTS+custom-based design

Structural health monitoring has long been identified as a prominent application of Wireless Sensor Networks (WSNs), as traditional wired-based solutions present some inherent limitations such as installation/maintenance cost, scalability and visual impact. Nevertheless, there is a lack of ready-to-use and off-the-shelf WSN technologies that are able to fulfill some most demanding requirements of these applications, which can span from critical physical infrastructures (e.g. bridges, tunnels, mines, energy grid) to historical buildings or even industrial machinery and vehicles. Low-power and low-cost yet extremely sensitive and accurate accelerometer and signal acquisition hardware and stringent time synchronization of all sensors data are just examples of the requirements imposed by most of these applications. This paper presents a prototype system for health monitoring of civil engineering structures that has been jointly conceived by a team of civil, and electrical and computer engineers. It merges the benefits of standard and off-the-shelf (COTS) hardware and communication technologies with a minimum set of custom-designed signal acquisition hardware that is mandatory to fulfill all application requirements.

Remote experimentation: integrating research, education, and industrial application

This paper presents a low-cost scaled model of a silo for drying and airing cereal grains. It allows the control and monitor of several parameters associated to the silo's operation, through a remote accessible infrastructure. The scaled model consists of a 2.50 m wide × 2.10 m long plant with all control and monitor capacities provided by micro-Web servers. An application running on the micro-Web servers enables storing all parameters in a data basis for later analysis. The implemented model aims to support a remote experimentation facility for technological education, research-oriented tutorials, and industrial applications. Given the low-cost requirement, this remote facility can be easily replicated in other institutions to support a network of remote labs, which encompasses the concurrent access of several users (e.g. students).

Expectativas sobre la regulación de la independencia del auditor en el processo de fortalecimiento de la auditoría. Implicaciones para España y Portugal

Este trabajo pretende concretar las expectativas sobre el refuerzo de la independencia de los auditores en la Unión Europa como medio escogido para poder abordar los conflictos de intereses inherentes al panorama actual, caracterizado por factores como el nombramiento de los auditores por la empresa auditada, bajos niveles de rotación o la prestación de servicios distintos a la auditoría. En este momento de crisis, la “International Federation of Accountants” (IFAC) reclama a la profesión auditora que desempeñe un papel activo en el desarrollo de organizaciones, mercados financieros y economías estables y sostenibles; por su parte, la Unión Europea considera conveniente seguir debatiendo la función de las auditorías como garante de la veracidad de la solidez financiera de las empresas. Nuestro objetivo es concretar la incidencia de las propuestas de modificación de la Octava Directiva provocará en la normativa interna de España y Portugal. Se definen cambios importantes, sobre todo en el caso de las Entidades consideradas de Interés Público (EIP), en temas como la rotación obligatoria, el fortalecimiento del Comité de Auditoría o la prohibición de la prestación de servicios adicionales. Se concluye que la Comisión Europea se encuentra en un momento histórico en el que debe plantear si modifica o no las reglas de juego de la prestación de servicios de auditoría que busquen reforzar esa imagen del auditor como un servicio de interés público.

Sequencing cutting patterns with colored interval graphs

The problem addressed here originates in the industry of flat glass cutting and wood panel sawing, where smaller items are cut from larger items accordingly to predefined cutting patterns. In this type of industry the smaller pieces that are cut from the patterns are piled around the machine in stacks according to the size of the pieces, which are moved to the warehouse only when all items of the same size have been cut. If the cutting machine can process only one pattern at a time, and the workspace is limited, it is desirable to set the sequence in which the cutting patterns are processed in a way to minimize the maximum number of open stacks around the machine. This problem is known in literature as the minimization of open stacks (MOSP). To find the best sequence of the cutting patterns, we propose an integer programming model, based on interval graphs, that searches for an appropriate edge completion of the given graph of the problem, while defining a suitable coloring of its vertices.

Real-time Energy Resource Scheduling considering a Real Portuguese Scenario

The development in power systems and the introduction of decentralized generation and Electric Vehicles (EVs), both connected to distribution networks, represents a major challenge in the planning and operation issues. This new paradigm requires a new energy resources management approach which considers not only the generation, but also the management of loads through demand response programs, energy storage units, EVs and other players in a liberalized electricity markets environment. This paper proposes a methodology to be used by Virtual Power Players (VPPs), concerning the energy resource scheduling in smart grids, considering day-ahead, hour-ahead and real-time scheduling. The case study considers a 33-bus distribution network with high penetration of distributed energy resources. The wind generation profile is based on a real Portuguese wind farm. Four scenarios are presented taking into account 0, 1, 2 and 5 periods (hours or minutes) ahead of the scheduling period in the hour-ahead and realtime scheduling.

Dynamic Approach and Testbed for Small and Medium Players Simulation in Smart Grid Environments

The Smart Grid environment allows the integration of resources of small and medium players through the use of Demand Response programs. Despite the clear advantages for the grid, the integration of consumers must be carefully done. This paper proposes a system which simulates small and medium players. The system is essential to produce tests and studies about the active participation of small and medium players in the Smart Grid environment. When comparing to similar systems, the advantages comprise the capability to deal with three types of loads – virtual, contextual and real. It can have several loads optimization modules and it can run in real time. The use of modules and the dynamic configuration of the player results in a system which can represent different players in an easy and independent way. This paper describes the system and all its capabilities.

Ovarian Borderline Tumor and Fertility-Sparing Surgery

Ovarian borderline tumors (OBTs) are frequently diagnosed in women of reproductive age. There is no consensus about their management, and it sometimes represents a dilemma aboutwhat should be done: fertility sparing surgery or a hysterectomy with salpingo-oophorectomy? Case: A 32-year-old nulligravida, diagnosed with a right ovarian borderline tumor is presented. She underwent pelvic washings, right salpingo-oophorectomy, appendectomy, and omental and peritoneal biopsies (laparotomic approach). Macroscopically, the left ovary was normal and subsequent exploration for staging was also normal, including the lymph nodes. Intraoperatively, frozen section examination was unclear, suggesting an OBT. Results: The final histopathologic diagnosis was ovarian borderline tumor, stage IIC (International Federation of Gynecology and Obstetrics [FIGO] staging). The patient expressed a desire to preserve her fertility. Thirty-six months postsurgery, she became pregnant spontaneously and delivered a healthy newborn at term. Conclusions: Conservative surgery can be performed in young patients treated for an OBT, provided they are closely followed up and that this surgery is performed after careful consideration and informed consent. It is, however, controversial with respect to performing hysterectomy and salpingo-oopherectomy upon the patient’s completion of childbearing.

Declaració sobre la crisi econòmica global i el seu impacte en les compres consorciades (19 de gener de 2009)

Redactada en nom dels molts consorcis de biblioteques de tot el món que participen a l'ICOLC, aquesta declaració té dos propòsits. Té la intenció d'ajudar als editors i altres proveïdors de contingut amb els quals tenim accés als recursos d'informació electrònica (d'ara en endavant simplement anomenats editors) a entendre millor com l'actual crisi econòmica única afecta a la comunitat de la informació de tot el món. El segon propòsit és suggerir un ventall de propostes que creiem són de benefici comú per a les biblioteques i els proveïdors de serveis d'informació.

Pautes revisades per mesurar estadísticament l'ús de recursos d'informació basats en web

L'ús de recursos d'informació electrònics de pagament continuarà creixent i en alguns casos es convertiran en els instruments principals o exclusius d’accés al contingut. L'entorn electrònic, com es posa de manifest a través del World Wide Web, ofereix una oportunitat de millorar la mesura de l'ús d'aquests recursos. En el terreny electrònic podem determinar acuradament a quina informació s'està accedint i quina informació s'utilitza. Sense infringir cap norma de privacitat o confidencialitat podem reforçar la nostra comprensió sobre l'ús de la informació de manera espectacular.