Risk factors for cesarean section by category of health service

OBJECTIVE: To analyze the rate of cesarean section and differences in risk factors by category of health service, either public or private. METHODS: A cross-sectional study was carried out including all pregnant women in labor admitted to hospitals in the city of Rio Grande, Southern Brazil, between January 1 and December 31, 2007. A pre-coded and pre-tested questionnaire was used to collect on social, demographic, obstetric and newborn care information. Two regression models were constructed: one for public users and the other one for private ones. Poisson regression was used in each model in the multivariate analysis. Prevalence rates and 95% confidence intervals were calculated for each adjusted factor. RESULTS: The rate of cesarean section was 43% and 86% among public and private users. Sociodemographic factors and twin births have a more significant impact among public users as well as number of pregnancies (25% vs. 13% reduction in public and private users, respectively) and previous cesarean section (86% vs. 24% increase in public and private users, respectively). Prenatal care visits and hospital admissions affected the outcome only in women users of public services. CONCLUSIONS: Cesarean section rates were high in both groups studied, but it was twice as high among women cared in the private sector. Associated factors differ in magnitude by category of service used.

Estratégias de implementação de plataformas de e-maintenance na indústria: desenvolvimento de uma aplicação para um sistema logístico de viaturas

Mestrado em Engenharia Electrotécnica – Sistemas Eléctricos de Energia

Maintenance and destrcution of R&D leadership

In the standard Schumpeterian-growth models only follower firms invest in R&D activities and larger economies grow faster. Since these results are counterfactual, this paper reveals that leader firms often support R&D activities and economic growth can be independent of the market size. In particular, the maintenance of R&D leadership increases with: (i) the technological-knowledge gap between leader and followers, since a firm-specific learning effect of accumulated technological knowledge from past R&D is considered, (ii) the leaders’ strategies that delay the next successful R&D supported by some follower firm, (iii) the market size, and (iv) the up-grade of each innovation.

Avaliação de fiabilidade de sistemas elétricos e de automação em instalações de frio industrial

Dissertação para a obtenção do grau de Mestre em Engenharia Electrotécnica Ramo de Energia/Automação e Eletrónica Industrial

The importance of control monitoring systems in wind parks maintenance

The objective of every wind energy producer is to reduce operational costs associated to the production as a way to increase profits. One other issue that must be looked carefully is the equipment maintenance. Increase the availability of wind turbines by reducing the downtime associated to failures is a good strategy to achieve the main goal of increase profits. As a way to help in the definition of the best maintenance strategies, condition monitoring systems (CMS) have an important role to play. Informatics tools to make the condition monitoring of the wind turbines were developed and are now being installed as a way to help producers reducing the operational costs. There are a lot of developed systems to do the monitoring of a wind turbine or the whole wind park, in this paper will be made an overview of the most important systems.

A high level e-maintenance architecture to support on-site teams

Emergent architectures and paradigms targeting reconfigurable manufacturing systems increasingly rely on intelligent modules to maximize the robustness and responsiveness of modern installations. Although intelligent behaviour significantly minimizes the occurrence of faults and breakdowns it does not exclude them nor can prevent equipment’s normal wear. Adequate maintenance is fundamental to extend equipments’ life cycle. It is of major importance the ability of each intelligent device to take an active role in maintenance support. Further this paradigm shift towards “embedded intelligence”, supported by cross platform technologies, induces relevant organizational and functional changes on local maintenance teams. On the one hand, the possibility of outsourcing maintenance activities, with the warranty of a timely response, through the use of pervasive networking technologies and, on the other hand, the optimization of local maintenance staff are some examples of how IT is changing the scenario in maintenance. The concept of e-maintenance is, in this context, emerging as a new discipline with defined socio-economic challenges. This paper proposes a high level maintenance architecture supporting maintenance teams’ management and offering contextualized operational support. All the functionalities hosted by the architecture are offered to the remaining system as network services. Any intelligent module, implementing the services’ interface, can report diagnostic, prognostic and maintenance recommendations that enable the core of the platform to decide on the best course of action.

Reason Maintenance Systems: Tools for Foundations-based Belief Revision

Dynamic and distributed environments are hard to model since they suffer from unexpected changes, incomplete knowledge, and conflicting perspectives and, thus, call for appropriate knowledge representation and reasoning (KRR) systems. Such KRR systems must handle sets of dynamic beliefs, be sensitive to communicated and perceived changes in the environment and, consequently, may have to drop current beliefs in face of new findings or disregard any new data that conflicts with stronger convictions held by the system. Not only do they need to represent and reason with beliefs, but also they must perform belief revision to maintain the overall consistency of the knowledge base. One way of developing such systems is to use reason maintenance systems (RMS). In this paper we provide an overview of the most representative types of RMS, which are also known as truth maintenance systems (TMS), which are computational instances of the foundations-based theory of belief revision. An RMS module works together with a problem solver. The latter feeds the RMS with assumptions (core beliefs) and conclusions (derived beliefs), which are accompanied by their respective foundations. The role of the RMS module is to store the beliefs, associate with each belief (core or derived belief) the corresponding set of supporting foundations and maintain the consistency of the overall reasoning by keeping, for each represented belief, the current supporting justifications. Two major approaches are used to reason maintenance: single-and multiple-context reasoning systems. Although in the single-context systems, each belief is associated to the beliefs that directly generated it—the justification-based TMS (JTMS) or the logic-based TMS (LTMS), in the multiple context counterparts, each belief is associated with the minimal set of assumptions from which it can be inferred—the assumption-based TMS (ATMS) or the multiple belief reasoner (MBR).

Establishment of optimal physical assets inspection frequency based on risk principles

Risk Based Inspection (RBI) is a risk methodology used as the basis for prioritizing and managing the efforts for an inspection program allowing the allocation of resources to provide a higher level of coverage on physical assets with higher risk. The main goal of RBI is to increase equipment availability while improving or maintaining the accepted level of risk. This paper presents the concept of risk, risk analysis and RBI methodology and shows an approach to determine the optimal inspection frequency for physical assets based on the potential risk and mainly on the quantification of the probability of failure. It makes use of some assumptions in a structured decision making process. The proposed methodology allows an optimization of inspection intervals deciding when the first inspection must be performed as well as the subsequent intervals of inspection. A demonstrative example is also presented to illustrate the application of the proposed methodology.

Maintenance of fire sprinkler systems based on the dynamic assessment of its condition

Safety is one of the major concerns of process safety engineers in most industrial facilities all over the world. To this scope, some events play an important role once the effect of their consequences can be assumed as totally undesirable. One of these events refers to the occurrence of a fire. Such event can result in catastrophic consequences for life, equipment, and continuity of activities or even leading to environmental damage. A fire protection equipment with low reliability means that this equipment are often unavailable and thus the risk of a fire increases. Maintenance of fire protection equipment is very important because this kind of systems is mostly in a dormant mode, which gives uncertainty about their operability when demanded in a real situation of fire. This article outlines the importance of tests, inspection, and maintenance operations in the context of a fire sprinkler system and proposes a methodology based on international standards and supported by test/inspection reports to correct the frequency of these actions according to the level of degradation of the components and regarding safety purposes. © 2015 American Institute of Chemical Engineers.

Study of a 9th century silver earrings set from Mikulčice: corrosion, conservation and maintenance

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Conservação e Restauro

COLONIZATION AND LABORATORY MAINTENANCE OFAnopheles albimanus WIEDEMANN IN VENEZUELA

Anopheles albimanus is one of the main vectors of malaria in Central America and the Caribbean, based on its importance, there are previous reports of the successful colonization of this species in Latin America countries. Mosquitoes were collected in the Aragua State of Venezuela colonized in the laboratory, using a simple and efficient maintenance method. Based on life table calculations under well established laboratory conditions, the Survival Rate Probability was constant and always close to 1 in immature stages, the Reproductive Net Rate (Ro) was 3.83, the generation time (Tc) was 24.5 days and the Intrinsic Growth Rate (rm) was 0.0558. This is the first report of the colonization of A. albimanus in Venezuela.

Probabilistic maintenance and optimization strategies for deteriorating civil infrastructures

In developed countries, civil infrastructures are one of the most significant investments of governments, corporations, and individuals. Among these, transportation infrastructures, including highways, bridges, airports, and ports, are of huge importance, both economical and social. Most developed countries have built a fairly complete network of highways to fit their needs. As a result, the required investment in building new highways has diminished during the last decade, and should be further reduced in the following years. On the other hand, significant structural deteriorations have been detected in transportation networks, and a huge investment is necessary to keep these infrastructures safe and serviceable. Due to the significant importance of bridges in the serviceability of highway networks, maintenance of these structures plays a major role. In this paper, recent progress in probabilistic maintenance and optimization strategies for deteriorating civil infrastructures with emphasis on bridges is summarized. A novel model including interaction between structural safety analysis,through the safety index, and visual inspections and non destructive tests, through the condition index, is presented. Single objective optimization techniques leading to maintenance strategies associated with minimum expected cumulative cost and acceptable levels of condition and safety are presented. Furthermore, multi-objective optimization is used to simultaneously consider several performance indicators such as safety, condition, and cumulative cost. Realistic examples of the application of some of these techniques and strategies are also presented.

Withdrawal of maintenance therapy for cytomegalovirus retinitis in AIDS patients exhibiting immunological response to HAART

BACKGROUND: Before the introduction of highly active antiretroviral therapy (HAART), CMV retinitis was a common complication in patients with advanced HIV disease and the therapy was well established; it consisted of an induction phase to control the infection with ganciclovir, followed by a lifelong maintenance phase to avoid or delay relapses. METHODS: To determine the safety of CMV maintenance therapy withdrawal in patients with immune recovery after HAART, 35 patients with treated CMV retinitis, on maintenance therapy, with CD4+ cell count greater than 100 cells/mm³ for at least three months, but almost all patients presented these values for more than six months and viral load < 30000 copies/mL, were prospectively evaluated for the recurrence of CMV disease. Maintenance therapy was withdrawal at inclusion, and patients were monitored for at least 48 weeks by clinical and ophthalmologic evaluations, and by determination of CMV viremia markers (antigenemia-pp65), CD4+/CD8+ counts and plasma HIV RNA levels. Lymphoproliferative assays were performed on 26/35 patients. RESULTS: From 35 patients included, only one had confirmed reactivation of CMV retinitis, at day 120 of follow-up. No patient returned positive antigenemia tests. No correlation between lymphoproliferative assays and CD4+ counts was observed. CONCLUSION: CMV retinitis maintenance therapy discontinuation is safe for those patients with quantitative immune recovery after HAART.

Integration of the project team in the classic maintenance cycle

A manutenção é uma área extremamente importante, principalmente na indústria. Devidamente organizada, permitirá um fluxo produtivo devidamente planeado e executado, que permitirá a qualquer empresa manter o nível de facturação desejado e o prazo de entrega acordado com os clientes. De outra forma, poderá originar o caos. No entanto, os desafios de gestão da produção mais correntes, nomeadamente através do Lean Manufacturing, passam a exigir um pouco mais do que uma simples manutenção. Torna-se obrigatório fazer análises económicas que permitam averiguar quando cada equipamento passa a exigir custos de manutenção excessivos, os quais poderão obrigar a um recondicionamento mais acentuado do equipamento, o qual pode passar inclusivamente por uma melhoria da sua performance. Nestes casos, terá que existir uma “cumplicidade” entre a Direcção de Produção e a Manutenção, no sentido de averiguar o melhor momento para proceder a uma melhoria do equipamento, numa perspectiva de funcionamento global em linha de produção, adaptando-o à performance que será exigida ao conjunto. Neste domínio, o Projecto passa a prestar um serviço valiosíssimo à empresa, integrando-se no conjunto Produção + Manutenção, criando valor na intervenção, através do desenvolvimento de um trabalho que permite não só repor o estado natural da produção, mas sim promover uma melhoria sustentada da mesma. Este trabalho pretende reflectir e avaliar a relevância do Projecto neste tipo de operações, contribuindo de uma forma sistemática e sustentada para a melhoria contínua dos processos de fabrico. É apresentado um caso de estudo que pretende validar todo o desenvolvimento anteriormente realizado na matéria.