Propriedades Psicométricas da Versão Portuguesa do Kansas City Cardiomyopathy Questionnaire na Miocardiopatia Dilatada com Insuficiência Cardíaca Congestiva

Several studies have shown that patients with congestive heart failure (CHF) have a compromised health-related quality of life (HRQL), and this, in recent years, has become a primary endpoint when considering the impact of treatment of chronic conditions such as CHF. OBJECTIVES: To evaluate the psychometric properties of the Portuguese version of a new specific instrument to measure HRQL in patients hospitalized for CHF: the Kansas City Cardiomyopathy Questionnaire (KCCQ). METHODS: The KCCQ was applied to a sample of 193 consecutive patients hospitalized for CHF. Of these, 105 repeated the assessment 3 months after admission, with no events during this period. Mean age was 64.4 +/- 12.4 years (21-88), and 72.5% were 72.5% male. CHF was of ischemic etiology in 4% of cases. RESULTS: This version of the KCCQ was subjected to statistical validation, with assessment of reliability and validity, similar to the American version. Reliability was assessed by the internal consistency of the domains and summary scores, which showed similar values of Cronbach alpha (0.50-0.94). Validity was assessed by convergence, sensitivity to differences between groups and sensitivity to changes in clinical condition. We evaluated the convergent validity of all domains related to functionality, through the relationship between them and a measure of functionality, the New York Heart Association (NYHA) classification. Significant correlations were found (p < 0.01) for this measure of functionality i patients with CHF. Analysis of variance between the physical limitation domain, the summary scores and NYHA class was performed and statistically significant differences were found (F = 23.4; F = 36.4; F = 37.4, p = 0.0001) in the ability to discriminate severity of clinical condition. A second evaluation was performed on 105 patients at the 3-month follow-up outpatient appointment, and significant changes were observed in the mean scores of the domains assessed between hospital admission and the clinic appointment (differences from 14.9 to 30.6 on a scale of 0-100), indicating that the domains assessed are sensitive to changes in clinical condition. The correlation between dimensions of quality of life in the KCCQ is moderate, suggesting that the dimensions are independent, supporting the multifactorial nature of HRQL and the suitability of this measure for its evaluation. CONCLUSION: The KCCQ is a valid instrument, sensitive to change and a specific measure of HRQL in a population with dilated cardiomyopathy and CHF.

Fractional State Space Analysis of Economy Systems

This paper examines modern economic growth according to the multidimensional scaling (MDS) method and state space portrait (SSP) analysis. Electing GDP per capita as the main indicator for economic growth and prosperity, the long-run perspective from 1870 to 2010 identifies the main similarities among 34 world partners’ modern economic growth and exemplifies the historical waving mechanics of the largest world economy, the USA. MDS reveals two main clusters among the European countries and their old offshore territories, and SSP identifies the Great Depression as a mild challenge to the American global performance, when compared to the Second World War and the 2008 crisis.

A Modular Programming Approach for IoTBased Wireless Sensor Networks

Poster presented in 12th European Conference on Wireless Sensor Network (EWSN 2015). 9 to 11, Feb, 2015. Porto, Portugal.

Avaliação da Performance Cirúrgica: Como Fazer?

Assessment of surgical performance is a must for every surgical practice nowadays and can be done by using scientific methods imported mostly from the Quality control tools that have been in use for long in industry. Surgical performance comprises several dimensions including clinical activity (mortality and morbidity as end points), academic activities, research and, more and more, efficiency. Stable long time results (efficacy), reducing error (safety) and meeting patient expectations (patient satisfaction) are among other performance components. This paper focus on the precise definitions of mortality and morbidity related to surgical activities and on the tools to evaluate patient complexity and assess pre operative risk. Some graphic representations are suggested to compare performance profiles of surgeons and to define individual performance profiles. Strong emphasis is put on pre operative risk assessment and its crucial role to interpret divergent surgical results. Where risk assessment is not possible or is unavailable, observed / expected ratios (O/E) for a given endpoint , be it mortality, length of stay or morbidity, must be established and routinely used to refer results and to identify performance outliers. Morbidity is being pointed out as a most valuable performance indicator in surgery because it is sensitive and comprises efficiency, safety and quality, at large.

O Papel dos Protocolos como Indicador de "Processo" num Serviço de Anestesia. Exemplo de um Protocolo Anestésico no Transplante Pulmonar

Mais do que a transcrição de um protocolo anestésico, o nosso objectivo foi salientar a importância dos protocolos anestésicos em geral e do transplante pulmonar em particular como indicador de processo na qualidade de cuidados anestésicos perioperatórios. Para isso exemplificamos a forma como foi elaborado um protocolo específico como o do transplante pulmonar e evidenciamos a necessidade de articulação com as diferentes especialidades e grupos profissionais directamente envolvidos.

Effect of sialic acid loss on dendritic cell maturation

Sialic acids are key structural determinants and contribute to the functionality of a number of immune cell receptors. Previously, we demonstrated that differentiation of human dendritic cells (DCs) is accompanied by an increased expression of sialylated cell surface structures, putatively through the activity of the ST3Gal.I and ST6Gal.I sialyltransferases. Furthermore, DC endocytosis was reduced upon removal of the cell surface sialic acid residues by neuraminidase. In the present work, we evaluate the contribution of the sialic acid modifications in DC maturation. We demonstrate that neuraminidase-treated human DCs have increased expression of major histocompatibility complex (MHC) and costimulatory molecules, increased gene expression of specific cytokines and induce a higher proliferative response of T lymphocytes. Together, the data suggest that clearance of cell surface sialic acids contributes to the development of a T helper type 1 proinflammatory response. This postulate is supported by mouse models, where elevated MHC class II and increased maturation of specific DC subsets were observed in DCs harvested from ST3Gal.I(-/-) and ST6Gal.I(-/-) mice. Moreover, important qualitative differences, particularly in the extent of reduced endocytosis and in the peripheral distribution of DC subsets, existed between the ST3Gal.I(-/-) and ST6Gal.I(-/-) strains. Together, the data strongly suggest not only a role of cell surface sialic acid modifications in maturation and functionality of DCs, but also that the sialic acid linkages created by different sialyltransferases are functionally distinct. Consequently, with particular relevance to DC-based therapies, cell surface sialylation, mediated by individual sialyltransferases, can influence the immunogenicity of DCs upon antigen loading.

Ferramenta Inteligente de Recolha de Dados

À medida que são feitas modificações nas legislações em vigor em relação às energias renováveis, de forma a incentivar o uso destas, surge a necessidade de sincronização do consumo da instalação com a sua própria produção. As empresas líderes de mercado já possuem soluções que permitem a recolha de dados das instalações fotovoltaicas para posterior monitorização e disponibilização ao cliente. Contudo, estas soluções possuem pontos negativos tais como o preço e limitações na potência instalada permitida. Neste contexto, este documento apresenta a descrição de uma solução que serve como uma alternativa muito mais barata às soluções apresentadas pelas principais marcas mundiais no âmbito desta área, além de ser a única solução disponível desenvolvida em território nacional. Como prova da funcionalidade da solução, são descritos e apresentados diferentes tipos de testes, que simulam a interação de um utilizador com a solução desenvolvida, levados a cabo em instalações solares fotovoltaicas reais, sendo os seus resultados analisados e evidenciando a facilidade de utilização desta solução.

Relatório de Estágio: Análise da eficiência do Sistema de controlo de tráfego da cidade do Porto

No âmbito da unidade curricular Dissertação/Estágio/Projeto, foi desenvolvido, durante um estágio na Câmara Municipal do Porto, o estudo da eficiência do sistema inteligente de controlo de tráfego implementado na cidade. Este sistema é designado como Sistema Inteligente de Gestão Autónoma - SIGA e tem como base de funcionamento o software de gestão de tráfego GERTRUDE da empresa GERTRUDE SAEM. O sistema de controlo de tráfego encontra-se repartido em 10 zonas interligadas, focadas essencialmente no centro da cidade do Porto. O estudo foi aplicado apenas a uma parte da zona da Constituição, nomeadamente a rua da Constituição, desde a Praça Marquês até à rua Antero de Quental. A eficiência mediu-se pela comparação de duas situações, a circulação e comportamento das correntes de tráfego com o sistema em funcionamento normal e com o sistema desativado. Por sua vez, o indicador utilizado que permitiu avaliar o sistema, foi o nível de serviço obtido pelo atraso médio por veículo em cada ramo de cada interseção. Para determinação do atraso, foram testados diferentes métodos, para se tentar perceber qual aquele que melhor se adequava à situação e que exigia menor número de recursos humanos. À frente serão exaradas algumas conclusões acerca da metodologia de cada um deles e condicionantes que levaram à não utilização de todos os métodos. Depois de aplicadas as metodologias que permitiram determinar o nível de serviço em cada grupo semafórico das diferentes interseções, percebeu-se que existe uma grande diferença na circulação entre as duas situações, sendo que a mais-valia que este sistema apresenta é a coordenação das diferentes interseções que se encontram abrangidas pelas 10 zonas pertencentes ao SIGA.

A potentiometric magnetic immunoassay for rapid detection of Salmonella typhimurium

Potentiometric detection with homemade polymeric membrane microelectrodes was coupled to a magnetic sandwich immunoassay for Salmonella typhimurium determination. Cadmium and sodium ion selective electrodes were used respectively as indicator and pseudo-reference electrodes and were prepared in pipette tips to allow potentiometric measurements in microliter sample volumes. In the proposed method, the concentration of S. typhimurium was proportional to the amount of cadmium released upon dissolution of a CdS nanoparticle labeled to the secondary detection antibody. The limit of detection was 2 cells per 100 μL. The immunomagnetic assay with potentiometric detection is suitable for sensitive and rapid (average total time per assay of 75 minutes) detection of S. typhimurium in milk samples. The proposed method is easy to perform, safe, sensitive, and low cost and has potential for in situ analysis.

Using Quicktrace to collect runtime execution traces easily and automatically

IEEE Real-Time Systems Symposium (RTSS 2015). 1 to 4, Dec, 2015. U.S.A.

Avaliação da maturidade da business intelligence nas organizações

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação

Epidemiological and ecological aspects related to malaria in the area of influence of the lake at Porto Primavera dam, in western São Paulo State, Brazil

A study was carried out in the area of influence of the Porto Primavera Hydroelectric Power Station, in western São Paulo State, to investigate ecological and epidemiological aspects of malaria in the area and monitor the profile of the anopheline populations following the environmental changes brought about by the construction of the lake. Mosquitoes captured were analyzed by standardized indicator species analysis (ISA) before and during different flooding phases (253 m and 257 m elevations). The local human population was studied by means of parasitological (thin/thick blood smears), molecular (PCR) and serological tests. Serological tests consisted of Enzyme Linked Immunosorbent Assay (ELISA) with synthetic peptides of the circumsporozoite protein (CSP) from classic Plasmodium vivax, P. vivax variants (VK247 and "vivax-like"), P. malariae and P. falciparum and Indirect Immunofluorescence Assay (IFA) with asexual forms of P. vivax, P. malariae and P. falciparum. The results of the entomological survey indicated that, although the Anopheles darlingi population increased after the flooding, the population density remained very low. No malaria, parasite infection or DNA was detected in the inhabitants of the study area. However, there was a low frequency of antibodies against asexual forms and a significant prevalence of antibodies against P. vivax, P. vivax variants, P. falciparum and P. malariae; the presence of these antibodies may result from recent or less recent contact with human or simian Plasmodium (a parallel study in the same area revealed the existence of a sylvatic cycle). Nevertheless, these results suggest that, as in other places where malaria is present and potential vectors circulate, the local epidemiological conditions observed could potentially support the transmission of malaria in Porto Primavera Lake if infected individuals are introduced in sufficient numbers. Further studies are required to elucidate the phenomena described in this paper.

Impact of RIFLE Classification in Liver Transplantation

Acute renal failure (ARF) is common after orthotopic liver transplantation (OLT). The aim of this study was to evaluate the prognostic value of RIFLE classification in the development of CKD, hemodialysis requirement, and mortality. Patients were categorized as risk (R), injury (I) or failure (F) according to renal function at day 1, 7 and 21. Final renal function was classified according to K/DIGO guidelines. We studied 708 OLT recipients, transplanted between September 1992 and March 2007; mean age 44 +/- 12.6 yr, mean follow-up 3.6 yr (28.8% > or = 5 yr). Renal dysfunction before OLT was known in 21.6%. According to the RIFLE classification, ARF occurred in 33.2%: 16.8% were R class, 8.5% I class and 7.9% F class. CKD developed in 45.6%, with stages 4 or 5d in 11.3%. Mortality for R, I and F classes were, respectively, 10.9%, 13.3% and 39.3%. Severity of ARF correlated with development of CKD: stage 3 was associated with all classes of ARF, stages 4 and 5d only with severe ARF. Hemodialysis requirement (23%) and mortality were only correlated with the most severe form of ARF (F class). In conclusion, RIFLE classification is a useful tool to stratify the severity of early ARF providing a prognostic indicator for the risk of CKD occurrence and death.

Stochastic modelling of the reservoir lithological and petrophysical attributes. A case study of the Middle East carbonate reservoir

Dissertação para obtenção do Grau de Mestre em Engenharia Geológica (Georrecursos)

Decision making processes based on innovation indicators: which implications for technology assessment?

Based on the report for “Project IV” unit of the PhD programme on Technology Assessment. This thesis research has the supervision of António Moniz (FCT-UNL and ITAS-KIT) and Manuel Laranja (ISEG-UTL). Other members of the thesis committee are Stefan Kuhlmann (Twente University), Leonhard Hennen (Karlsruhe Institute of Technology-ITAS), Tiago Santos Pereira (Universidade de Coimbra/CES) and Cristina Sousa (FCT-UNL).