Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access

Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

Amadeus, Papa e Greve no Natal

O direito constitucional à greve está consagrado no art. 57º da Constituição. Desde que estejam assegurados os serviços mínimos – indispensáveis às necessidades sociais impreteríveis -, o direito à greve é absolutamente inalienável e não pode ser coarctado por uma qualquer “requisição civil”, em conjugação com o art. 18º/2 da Constituição; The constitutional right to strike is enshrined in art. 57 of the Constitution. Provided they are guaranteed the minimum services - indispensable to essential social needs - the right to strike is absolutely inalienable and can not be inhibited by any "civil requisition", in conjunction with art. 18/2 of the Constitution.

“Enriquecimento Injustificado”: simples ignorância ou disparatada incompetência?

Pelos fundamentos expostos no Acórdão nº 377/2015, de 27/7, o T.C. decidiu pronunciar-se pela inconstitucionalidade das normas constantes do n.º 1 do artigo 1º e do artigo 2º do Decreto da Assembleia da República nº 369/XII, por violação dos artigos 18º/2 (necessidade, adequação, proporcionalidade e intervenção mínima do Direito Criminal/Penal), 29º/1 (Princípio da Legalidade Criminal) e 32º/2 (Presunção da Inocência) da Constituição. Imagine-se que depois de se ser condenado pela Comunicação Social, ainda temos que provar a nossa inocência! § On those grounds in Judgment No 377/2015 of 27/7, the Constitutional Court decided to rule the unconstitutionality of the rules in paragraph 1 of Article 1 and Article 2 of Decree of the National Assembly No. 369 / XII, for violation of articles 18/2 (necessity, appropriateness, proportionality and minimum intervention of Criminal Law / Criminal), 29/1 (Principle of Criminal Legality) and 32/2 (Presumption of Innocence) of the Constitution. Imagine that after being convicted by the Social Communication, we still have to prove our innocence!

A Morte Saiu À Rua…

Diz a Lei 53/03, com última versão da Lei 60/15: “1 ‐ Quem praticar os factos previstos no n.º 1 do artigo 2.º, com a intenção nele referida, é punido com pena de prisão de 2 a 10 anos, ou com a pena correspondente ao crime praticado, agravada de um terço nos seus limites mínimo e máximo, se for igual ou superior àquela, não podendo a pena aplicada exceder o limite referido no n.º 2 do artigo 41.º do Código Penal”. § Says the Law 53/03, with the latest version of Law 60/15: "1 - Whoever commits the acts referred to in paragraph 1 of article 2, with the intention that it shall be punished with imprisonment from 2 to 10 years, or the penalty corresponding to the crime committed, increased by one third in its minimum and maximum limits, if it is equal or superior to, the penalty may not exceed the limit referred to in paragraph 2 of Article 41 of Penal code ".

Robust temporal alignment of multimodal cardiac sequences

Given the dynamic nature of cardiac function, correct temporal alignment of pre-operative models and intraoperative images is crucial for augmented reality in cardiac image-guided interventions. As such, the current study focuses on the development of an image-based strategy for temporal alignment of multimodal cardiac imaging sequences, such as cine Magnetic Resonance Imaging (MRI) or 3D Ultrasound (US). First, we derive a robust, modality-independent signal from the image sequences, estimated by computing the normalized crosscorrelation between each frame in the temporal sequence and the end-diastolic frame. This signal is a resembler for the left-ventricle (LV) volume curve over time, whose variation indicates di erent temporal landmarks of the cardiac cycle. We then perform the temporal alignment of these surrogate signals derived from MRI and US sequences of the same patient through Dynamic Time Warping (DTW), allowing to synchronize both sequences. The proposed framework was evaluated in 98 patients, which have undergone both 3D+t MRI and US scans. The end-systolic frame could be accurately estimated as the minimum of the image-derived surrogate signal, presenting a relative error of 1:6 1:9% and 4:0 4:2% for the MRI and US sequences, respectively, thus supporting its association with key temporal instants of the cardiac cycle. The use of DTW reduces the desynchronization of the cardiac events in MRI and US sequences, allowing to temporally align multimodal cardiac imaging sequences. Overall, a generic, fast and accurate method for temporal synchronization of MRI and US sequences of the same patient was introduced. This approach could be straightforwardly used for the correct temporal alignment of pre-operative MRI information and intra-operative US images.

A systematic procedure to enhance reproducibility of SWASV cycles in the determination of toxic metals in real samples

This work presents for the first time a systematic study on the optimization of the electrochemical cleaning time of a mercury film when it is used as a working electrode material in the analysis of toxic metals, such as Pb2+, used as model metal, in real samples by SWASV. The optimization study for the film’s cleaning time aimed at attaining a Pb2+ minimum value in the film after the re-oxidation step of the pre-concentrated metal, given the impossibility of complete removal of traces of the electroactive species from the film. This value was kept constant in each concentration range studied ensuring thus that all assays were performed in initial identical conditions. An assay performed on a synthetic sample was taken as reference. In it, given the absence of matrix effects, and after the electrochemical cleaning step, a direct proportionality was observed between the residual amounts of Pb2+ in the film (which for the cleaning time used was never completely removed) and Pb2+ concentration in the solution. This fact determined a high correlation between Pb2+ peak current and Pb2+ concentration which was not observed when real samples (tree leaves) were analyzed. This behavior may result from the presence of the interfering surfactants always present in real samples of complex matrix. Cleaning time optimization was performed for the following Pb2+ concentration ranges in the real samples of complex matrix: 0.006-0.020, 0.020-0.080, 0.060-0.200 and 0.100-0.600 ppb. As expected, in order to obtain identical levels of film’s cleaning efficiency, the need for longer cleaning times has been observed for higher concentrations. The optimized cleaning times for the concentration ranges under study were 120, 150, 180 e 300 s, respectively.

Mass- Radius Relation for Magnetized Strange Quarks Stars

We review the stability of magnetized strange quark matter (MSQM) within the phenomenological MIT bag model, taking into account the variation of the relevant input parameters, namely, the strange quark mass, baryon density, magnetic field and bag parameter. A comparison with magnetized asymmetric quark matter in beta-equilibrium as well as with strange quark matter (SQM) is presented. We obtain that the energy per baryon for MSQM decreases as the magnetic field increases, and its minimum value at vanishing pressure is lower than the value found for SQM, which implies that MSQM is more stable than non-magnetized SQM. The mass-radius relation for magnetized strange quark stars is also obtained in this framework.

Learning dependent sources using mixtures of Dirichlet: applications on hyperspectral unmixing

This paper is an elaboration of the DECA algorithm [1] to blindly unmix hyperspectral data. The underlying mixing model is linear, meaning that each pixel is a linear mixture of the endmembers signatures weighted by the correspondent abundance fractions. The proposed method, as DECA, is tailored to highly mixed mixtures in which the geometric based approaches fail to identify the simplex of minimum volume enclosing the observed spectral vectors. We resort then to a statitistical framework, where the abundance fractions are modeled as mixtures of Dirichlet densities, thus enforcing the constraints on abundance fractions imposed by the acquisition process, namely non-negativity and constant sum. With respect to DECA, we introduce two improvements: 1) the number of Dirichlet modes are inferred based on the minimum description length (MDL) principle; 2) The generalized expectation maximization (GEM) algorithm we adopt to infer the model parameters is improved by using alternating minimization and augmented Lagrangian methods to compute the mixing matrix. The effectiveness of the proposed algorithm is illustrated with simulated and read data.

Design of a sea-level tsunami detection network for the Gulf of Cadiz

The devastating impact of the Sumatra tsunami of 26 December 2004, raised the question for scientists of how to forecast a tsunami threat. In 2005, the IOC-UNESCO XXIII assembly decided to implement a global tsunami warning system to cover the regions that were not yet protected, namely the Indian Ocean, the Caribbean and the North East Atlantic, the Mediterranean and connected seas (the NEAM region). Within NEAM, the Gulf of Cadiz is the more sensitive area, with an important record of devastating historical events. The objective of this paper is to present a preliminary design for a reliable tsunami detection network for the Gulf of Cadiz, based on a network of sea-level observatories. The tsunamigenic potential of this region has been revised in order to define the active tectonic structures. Tsunami hydrodynamic modeling and GIS technology have been used to identify the appropriate locations for the minimum number of sea-level stations. Results show that 3 tsunameters are required as the minimum number of stations necessary to assure an acceptable protection to the large coastal population in the Gulf of Cadiz. In addition, 29 tide gauge stations could be necessary to fully assess the effects of a tsunami along the affected coasts of Portugal, Spain and Morocco.

A practical approach for profit-based unit commitment with emission limitations

This paper proposes a practical approach for profit-based unit commitment (PBUC) with emission limitations. Under deregulation, unit commitment has evolved from a minimum-cost optimisation problem to a profit-based optimisation problem. However, as a consequence of growing environmental concern, the impact of fossil-fuelled power plants must be considered, giving rise to emission limitations. The simultaneous address of the profit with the emission is taken into account in our practical approach by a multiobjective optimisation (MO) problem. Hence, trade-off Curves between profit and emission are obtained for different energy price profiles, in a way to aid decision-makers concerning emission allowance trading. Moreover, a new parameter is presented, ratio of change, and the corresponding gradient angle, enabling the proper selection of a compromise commitment for the units. A case study based on the standard IEEE 30-bus system is presented to illustrate the proficiency Of Our practical approach for the new competitive and environmentally constrained electricity supply industry.

Variation of magnetic properties in sedimentary rocks hosting the Foum Zguid dyke (southern Morocco): Combined effects of re-crystallization and Fe-metasomatism

The effects of dyke intrusion on the magnetic properties of host sedimentary rocks are still poorly understood. Therefore, we have evaluated bulk magnetic parameters of standard palaeomagnetic samples collected along several sections across the sediments hosting the Foum Zguid dyke in southern Morocco. The study has been completed with the evaluation of the magnetic fabric after laboratory application of sequential heating experiments. The present study shows that: (1) close to Fourn Zguid dykes, the variations of the bulk magnetic parameters and of the magnetic fabric is strongly related with re-crystallization and Fe-metasomatism intensity. (2) The thermal experiments on AMS of samples collected farther from the dyke and, thus, less affected by heating during dyke emplacement, indicate that 300-400 degrees C is the minimum experimental temperature necessary to trigger appreciable transformations of the pre-existing magnetic fabrics. For temperatures higher than ca. 580 degrees C, the magnetic fabric transformations are fully realized, with complete transposition of the initial fabric to a fabric similar to that of samples collected close to the dyke. Therefore, measured variations of the magnetic fabric can be used to evaluate re-crystallization temperatures experienced by the host sedimentary rock during dyke emplacement. The distinct magnetic behaviour observed along the cross-sections strongly suggests that samples collected farther from the dyke margins did not experience thermal episodes with temperatures higher than 300 degrees C after dyke emplacement. (3) AMS data shows a gradual variation of the magnetic fabric with distance from the dyke margin, from sub-horizontal K-3 away from the dyke to vertical K3 close to the dyke. Experimental heating shows that heat alone can be responsible for this strong variation. Therefore, such orientation changes should not be unequivocally interpreted as the result of a stress field (resulting from the emplacement of the dyke, for instance). (4) Magnetic studies prove to be a very sensitive tool to assess rock magnetic transformations, thermally and chemically induced by dyke intrusion in hosting sediments.

Child-care attendance and common morbidity: evidence of association in the literature and questions of design

Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

The Bambuí health and ageing study (BHAS): methodological approach and preliminary results of a population-based cohort study of the elderly in Brazil

OBJECTIVE: A cohort study has been designed to identify predictors of adverse health events in the elderly. The methodology of the study and preliminary descriptive results are presented. METHODS: The study population comprises all residents of Bambuí (Minas Gerais, Brazil), aged 60 or more years (n=1.742). From these, 92.2% were interviewed and 85.9% underwent clinical examination, consisting of haematological and biochemical tests, serology for Trypanosoma cruzi, anthropometric and blood pressure measures and electrocardiogram. Aliquots of serum, plasma and DNA were stored for future investigations. The baseline interview included sociodemographic characteristics, self-referred health condition and history of selected diseases, medication use, health service use, source of medical care, physical activities, smoking, drinking and eating habits, reproductive history, physical functioning, life events, social support and mental health. Individuals are being followed up annually. RESULTS: The following characteristics predominated among participants: women (60,0%), married (48.9%) or widowed (35.4%), people living in households with up to 2 residents (73.8%), heads of family (76.7%), people with monthly income between 1.00 and 2.99 Brazilian minimum wages (62.0%) and people with up to 4 years of schooling (89.1%). The median age was 68 years. Among the cohort members, only 1.7% were lost in the first follow-up. CONCLUSIONS: In general, the characteristics of the study population were very similar to those from other epidemiological studies of the elderly based on large Brazilian cities. The small number of losses to follow-up indicates that the choice of Bambuí was adequate, assuring the feasibility of a long term cohort study.

Infant mortality rates according to socioeconomic status in a Brazilian city

OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381) and infant deaths (total of 731) that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05). These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head), in particular the post-neonatal mortality rate (chi-square for trend, p<0.05). Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

Compact Stars and Magnetized CFL Matter

The stability of the color flavor locked phase in the presence of a strong magnetic field is investigated within the phenomenological MIT bag model. It is found that the minimum value of the energy per baryon in a color flavor locked state at vanishing pressure is lower than the corresponding one for unpaired magnetized strange quark matter and, as the magnetic field increases, the energy per baryon decreases. This implies that magnetized color flavor locked matter is more stable and could become the ground state inside neutron stars. The anisotropy of the pressures is discussed. The mass-radius relation for such stars is also studied.