Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). METHOD: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. RESULTS: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. DISCUSSION: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.

Multiobjective Particle Swarm Approach for the Design of a Brushless DC Wheel Motor

The roots of swarm intelligence are deeply embedded in the biological study of self-organized behaviors in social insects. Particle swarm optimization (PSO) is one of the modern metaheuristics of swarm intelligence, which can be effectively used to solve nonlinear and non-continuous optimization problems. The basic principle of PSO algorithm is formed on the assumption that potential solutions (particles) will be flown through hyperspace with acceleration towards more optimum solutions. Each particle adjusts its flying according to the flying experiences of both itself and its companions using equations of position and velocity. During the process, the coordinates in hyperspace associated with its previous best fitness solution and the overall best value attained so far by other particles within the group are kept track and recorded in the memory. In recent years, PSO approaches have been successfully implemented to different problem domains with multiple objectives. In this paper, a multiobjective PSO approach, based on concepts of Pareto optimality, dominance, archiving external with elite particles and truncated Cauchy distribution, is proposed and applied in the design with the constraints presence of a brushless DC (Direct Current) wheel motor. Promising results in terms of convergence and spacing performance metrics indicate that the proposed multiobjective PSO scheme is capable of producing good solutions.

Reprocessing and reuse of single-use medical devices used during hemodynamic procedures in Brazil: A widespread and largely overlooked problem

Background. Several medical devices used during hemodynamic procedures, particularly angiographic diagnostic and therapeutic cardiac catheters, are manufactured for single use only. However, reprocessing and reuse of these devices has been reported, to determine the frequency of reuse and reprocessing of single-use medical devices used during hemodynamic procedures in Brazil and to evaluate how reprocessing is performed. Design. National survey, conducted from December 1999 to July 2001. Methods. Most of the institutions affiliated with the Brazilian Society of Hemodynamic and Interventional Cardiology were surveyed by use of a questionnaire sent in the mail. Results. The questionnaire response rate was 50% (119 of 240 institutions). Of the 119 institutions that responded, 116 (97%) reported reuse of single-use devices used during hemodynamic procedures, and only 26 (22%) reported use of a standardized reprocessing protocol. Cleaning, flushing, rinsing, drying, sterilizing and packaging methods varied greatly and were mostly inadequate. Criteria for discarding reused devices varied widely. Of the 119 institutions that responded, 80 (67%) reported having a surveillance system for adverse events associated with the reuse of medical devices, although most of these institutions did not routinely review the data, and only 38 (32%) described a training program for the personnel who reprocessed single-use devices. Conclusions. The reuse of single-use devices used during hemodynamic procedures was very frequent in hospitals in Brazil. Basic guidance on how to reuse and reprocess single-use medical devices is urgently needed, because, despite the lack of studies to support reusing and reprocessing single-use medical devices, such devices are necessary in limited-resource areas in which these practices are current.

Challenges and Recommendations for Placebo Controls in Randomized Trials in Physical and Rehabilitation Medicine A Report of the International Placebo Symposium Working Group

Compared with other specialties, the field of physical and rehabilitation medicine has not received the deserved recognition from clinicians and researchers in the scientific community. One of the reasons is the lack of sound evidence to support the traditional physical and rehabilitation medicine treatments. The best way to change this disadvantage is through a well conducted clinical research, such as standard placebo- or sham-controlled randomized clinical trials. Therefore, having placebo groups in clinical trials is essential to improve the level of evidence-based practice in physical and rehabilitation medicine that ultimately translates to better clinical care. To address the challenges for the use of placebo in physical and rehabilitation medicine and randomized clinical trials and to create useful recommendations, we convened a working group during the inaugural International Symposium in Placebo (February 2009, in Sao Paulo, Brazil) in which the following topics were discussed: (1) current status of randomized clinical trials in physical and rehabilitation medicine, (2) challenges for the use of placebo in physical and rehabilitation medicine, (3) bioethics, (4) use of placebo in acupuncture trials and for the treatment of low-back pain, (5) mechanisms of placebo, and (6) insights from other specialties. The current article represents the consensus report from the working group.

Osteoblastlike Cell Adhesion on Titanium Surfaces Modified by Plasma Nitriding

Purpose: The aim of this study was to evaluate the characteristics of various titanium surfaces modified by cold plasma nitriding in terms of adhesion and proliferation of rat osteoblastlike cells. Materials and Methods: Samples of grade 2 titanium were subjected to three different surface modification processes: polishing, nit riding by plasma direct current, and nitriding by cathodic cage discharge. To evaluate the effect of the surface treatment on the cellular response, the adhesion and proliferation of osteoblastlike cells (MC3T3) were quantified and the results were analyzed by Kruskal-Wallis and Friedman statistical tests. Cellular morphology was observed by scanning electron microscopy. Results: There was more MC3T3 cell attachment on the rougher surfaces produced by cathodic cage discharge compared with polished samples (P < .05). Conclusions: Plasma nitriding improves titanium surface roughness and wettability, leading to osteoblastlike cell adhesion. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:237-244

Os dois futuros do ato de governar: processos de descentraliza????o e recentraliza????o no ato de governar

As reformas do setor p??blico ajudaram a torn??-lo mais eficiente e eficaz, mas tamb??m geraram v??rios problemas. Tanto as reformas ao estilo do New Public Management quanto da governan??a contribu??ram para os problemas contempor??neos no ato de governar. Tais problemas t??m sido em grande parte pol??ticos, refletindo a tend??ncia de se enfatizar valores administrativos em detrimento dos valores democr??ticos. Os governos come??aram a reagir aos problemas reais e percebidos no setor p??blico desenvolvendo diversos instrumentos de ???meta-governan??a??? que podem ajudar a governar organiza????es p??blicas, mas que envolvem menos comando e controle diretos. Este artigo aborda as fun????es de governan??a contempor??neas na restaura????o da dire????o e coer??ncia nas pol??ticas e, ao mesmo tempo, no apoio ?? autonomia das organiza????es pol??ticas e no envolvimento de redes de pol??ticas no ato de governar.

O paradoxo da cidade monitorada : vigilância limitada e espaços públicos fragilizados a partir do estudo do sistema das câmeras do município de Vila Velha - ES

A dissertação aborda a fragilização dos espaços públicos num contexto de utilização de câmeras de vigilância, temática que será problematizada a partir da vigilância exercida pelas câmeras do município de Vila Velha – ES. Partimos da hipótese de que vivemos cercados por objetos técnicos que continuamente produzem informações sobre os sujeitos sociais e os seus espaços como forma de controle. As câmeras representam o exemplo mais conhecido desses objetos, embora sejam apresentadas pelos discursos das administrações públicas como ferramentas de auxílio à segurança. Utilizando como metodologia a observação participante para acompanhamento do trabalho realizado “por trás” das câmeras, concluímos que uma série de fatores desmistificam esses discursos: as câmeras que não são monitoradas, a ausência de manutenção dos equipamentos do sistema, os baixos salários e as condições trabalhistas daqueles que operam as câmeras, a ausência de articulação com os demais setores da prefeitura, a falta de credibilidade das câmeras com a polícia, etc. Por outro lado, ao fazermos um trabalho “na frente” das câmeras, observando o cotidiano de três áreas vigiadas nos bairros Praia da Costa, Glória e Riviera da Barra, bem como entrevistando transeuntes, moradores e comerciantes, concluímos que a maneira surpreendentemente indiferente com que as pessoas lidam com a vigilância é alimentada quando descobrimos que elas não oferecem a segurança pretendida. Se as câmeras não auxiliam a segurança pública, a sua utilização tem um efeito perverso na fragilização dos espaços públicos de Vila Velha, considerando que a vigilância representa ameaças potenciais e reais às condições que o pressupõem: a pluralidade e a liberdade, pois as câmeras atualizam um estado de vigilância permanente alimentando o estigma sobre determinados grupos sociais, que, por sua vez, são os alvos favoritos da vigilância, o que permite às câmeras, ainda, a potencial função de controle socioespacial direto (função admitida inclusive pelos cidadãos entrevistados) sobre os espaços vigiados; e a individualidade dos cidadãos, que é acintosamente violada. As câmeras, portanto, ao pretenderem garantir qualidade de vida à população (oferecendo segurança), produzem o efeito exatamente inverso

Simulation of rectifier voltage malfunction on OWECS, four-level converter, HVDC light link: Smart grid context tool

This paper presents a model for the simulation of an offshore wind system having a rectifier input voltage malfunction at one phase. The offshore wind system model comprises a variable-speed wind turbine supported on a floating platform, equipped with a permanent magnet synchronous generator using full-power four-level neutral point clamped converter. The link from the offshore floating platform to the onshore electrical grid is done through a light high voltage direct current submarine cable. The drive train is modeled by a three-mass model. Considerations about the smart grid context are offered for the use of the model in such a context. The rectifier voltage malfunction domino effect is presented as a case study to show capabilities of the model. (C) 2015 Elsevier Ltd. All rights reserved.

Retificador monofásico com fator de potência quase unitário

Dissertação para a obtenção do grau de Mestre em Engenharia Eletrotécnica Ramo de Automação e Eletrónica Industrial

Service-oriented mobility of java code in web services-based architectures

Dissertação apresentada na Faculdade de Ciências e Tecnologias da Universidade Nova de Lisboa para a obtenção do Grau de Mestre em Engenharia Informática

Modelação e identificação de motor DC

O modelo matemático de um sistema real permite o conhecimento do seu comportamento dinâmico e é geralmente utilizado em problemas de engenharia. Por vezes os parâmetros utilizados pelo modelo são desconhecidos ou imprecisos. O envelhecimento e o desgaste do material são fatores a ter em conta pois podem causar alterações no comportamento do sistema real, podendo ser necessário efetuar uma nova estimação dos seus parâmetros. Para resolver este problema é utilizado o software desenvolvido pela empresa MathWorks, nomeadamente, o Matlab e o Simulink, em conjunto com a plataforma Arduíno cujo Hardware é open-source. A partir de dados obtidos do sistema real será aplicado um Ajuste de curvas (Curve Fitting) pelo Método dos Mínimos Quadrados de forma a aproximar o modelo simulado ao modelo do sistema real. O sistema desenvolvido permite a obtenção de novos valores dos parâmetros, de uma forma simples e eficaz, com vista a uma melhor aproximação do sistema real em estudo. A solução encontrada é validada com recurso a diferentes sinais de entrada aplicados ao sistema e os seus resultados comparados com os resultados do novo modelo obtido. O desempenho da solução encontrada é avaliado através do método das somas quadráticas dos erros entre resultados obtidos através de simulação e resultados obtidos experimentalmente do sistema real.

Limitações dos sistemas de transmissão AC quando aplicados a parques eólicos offshore

De modo a garantir as metas propostas pela União Europeia de diminuição de emissão de gases poluentes, alguns países membros apostaram na tecnologia eólica offshore. Com a evolução tecnológica, estes países pretendem aumentar as potências instaladas nos parques eólicos offshore, garantindo a sua otimização ao estarem em águas profundas, tendo assim um maior aproveitamento do potencial eólico. Com esta dissertação, realizou-se um estudo para analisar, sob o ponto de vista de modelos, as limitações dos sistemas de transmissão em HVAC (High Voltage Alternating Current) quando estabelecidos em cabos submarinos. Os mecanismos dos sistemas de alimentação em HVAC, na forma tradicional (linhas aérea), são confrontados com condicionalismos. Este tipo de infraestrutura submarina impõe restrições, pelo simples facto dos parâmetros de capacidade e indutância serem bastante significativos, que para uma situação de trânsito de energia, inviabilizam o transporte de energia, devido ao elevado consumo de potência reativa, bem como os seus custos extremamente elevados. Assim, os sistemas de alimentação em HVAC quando aplicados a parques eólicos offshore apresentam limitações. O recurso à tecnologia HVDC (High Voltage Direct Current), poderá ser a solução que se revela mais adequada para os sistemas de transmissão de energia associados aos parques eólicos offshore. Para além dos fatores técnicos é fundamental considerar os custos associados à construção e exploração do parque eólico, sendo fundamental analisar todos os dados relacionados com o projeto.

Numerical prediction of diffusion and electric field-induced iron nanoparticle transport

Zero valent iron nanoparticles (nZVI) are considered very promising for the remediation of contaminated soils and groundwaters. However, an important issue related to their limited mobility remains unsolved. Direct current can be used to enhance the nanoparticles transport, based on the same principles of electrokinetic remediation. In this work, a generalized physicochemical model was developed and solved numerically to describe the nZVI transport through porous media under electric field, and with different electrolytes (with different ionic strengths). The model consists of the Nernst–Planck coupled system of equations, which accounts for the mass balance of ionic species in a fluid medium, when both the diffusion and electromigration of the ions are considered. The diffusion and electrophoretic transport of the negatively charged nZVI particles were also considered in the system. The contribution of electroosmotic flow to the overall mass transport was included in the model for all cases. The nZVI effective mobility values in the porous medium are very low (10−7–10−4 cm2 V−1 s−1), due to the counterbalance between the positive electroosmotic flow and the electrophoretic transport of the negatively charged nanoparticles. The higher the nZVI concentration is in the matrix, the higher the aggregation; therefore, low concentration of nZVI suspensions must be used for successful field application.

Simulation of a rectifier malfunction on a offshore wind system with HVDC transmission

A new integrated mathematical model for the simulation of an offshore wind system having a rectifier input voltage malfunction at one phase is presented in this paper. The mathematical model considers an offshore variable-speed wind turbine on a floating platform, equipped with a permanent magnet synchronous generator using full-power three-level converter to inject energy into the electric network, through a high voltage direct current transmission submarine cable. The model for the drive train is a discrete three mass, incorporating the dynamic of the moving surface. A case study is presented to access conclusion about the malfunction.

Biological markers in noninvasive brain stimulation trials in major depressive disorder: a systematic review

Objectives: The therapeutic effects of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation in patients with major depression have shown promising results; however, there is a lack of mechanistic studies using biological markers (BMs) as an outcome. Therefore, our aim was to review noninvasive brain stimulation trials in depression using BMs. Methods: The following databases were used for our systematic review: MEDLINE, Web of Science, Cochrane, and SCIELO. We examined articles published before November 2012 that used TMS and transcranial direct current stimulation as an intervention for depression and had BM as an outcome measure. The search was limited to human studies written in English. Results: Of 1234 potential articles, 52 articles were included. Only studies using TMS were found. Biological markers included immune and endocrine serum markers, neuroimaging techniques, and electrophysiological outcomes. In 12 articles (21.4%), end point BM measurements were not significantly associated with clinical outcomes. All studies reached significant results in the main clinical rating scales. Biological marker outcomes were used as predictors of response, to understand mechanisms of TMS, and as a surrogate of safety. Conclusions: Functional magnetic resonance imaging, single-photon emission computed tomography, positron emission tomography, magnetic resonance spectroscopy, cortical excitability, and brain-derived neurotrophic factor consistently showed positive results. Brain-derived neurotrophic factor was the best predictor of patients’ likeliness to respond. These initial results are promising; however, all studies investigating BMs are small, used heterogeneous samples, and did not take into account confounders such as age, sex, or family history. Based on our findings, we recommend further studies to validate BMs in noninvasive brain stimulation trials in MDD.