Síndroma dos edifícios doentes: estudo da qualidade do ar interior e despiste da eventual existência de SED entre a população do edifício “E” de um estabelecimento de ensino superior

Mestrado em Segurança e Higiene no Trabalho.

Determination of pharmocotherapeutical complexity in institutionalized elderly

The phenomenon of aging is nowadays society as acquired the status of a social problem, with growing attention and concern, leading to an increase number of studies dedicated to the elderly. The lack of domestic, familiar or social support often lead elderly to nursing homes. Institutionalization is in many cases the only opportunity to have access to health care and life quality. Aging is also associated with a higher prevalence of chronic diseases that require long term medication sometimes for life. Frequently the onset of multiple pathologies at the same time require different therapies and the phenomenon of polypharmacy (five ou more drugs daily) can occur. Even more, the slow down of physiological and cognitives mechanisms associated with these chronic diseases can interphere, in one hand, with the pharmacocinetic of many medications and, on the other hand, with the facility to accomplish the therapeutical regimen. All of these realities contribute to an increase of pharmacotherapeutical complexity, decreasing the adherence and effectiveness of treatment. The pharmacotherapeutical complexity of an individual is characterized by the conciliator element of different characteristics of their drug therapy, such as: the number of medications used; dosage forms; dosing frequency and additional indications. It can be measured by the Medication Regimen Complexity Index (MRCI), originally validated in English.

Drug therapy complexity: the importance of pharmacotherapeutic follow-up

Nowadays, the phenomenon of population ageing represents an worldwide problem, which assumes particular significance in Portugal. As they get older, individuals present more comorbidities and consequently consume an increasing number of drugs, which contributes to a growing drug therapy complexity. The institutionalized elders are particularly affected by this occurrence. Drug therapy complexity is defined as the conciliator of several characteristics of the pharmacotherapy and can affect patient’s safety and medication adherence. It can be measured with Medication Regimen Complexity Index (MRCI). This study aims to determine the drug therapy complexity of institutionalized elders in order to assess the need of pharmacotherapeutic follow-up.

Impact of the background Region of Interest in the relative renal function

Renal scintigraphy with 99mTc-dimercaptosuccinic acid (99mTc-DMSA) is performed with the aim of detect cortical abnormalities related to urinary tract infection and accurately quantify relative renal function (RRF). For this quantitative assessment Nuclear Medicine Technologist should draw regions of interest (ROI) around each kidney (KROI) and peri-renal background (BKG) ROI although controversy still exists about BKG-ROI. The aim of this work was to evaluate the effect of the normalization procedure, number and location of BKG-ROI on the RRF in 99mTc-DMSA scintigraphy.

Topological Complexity and Predictability in the Dynamics of a Tumor Growth Model with Shilnikov's Chaos

Dynamical systems modeling tumor growth have been investigated to determine the dynamics between tumor and healthy cells. Recent theoretical investigations indicate that these interactions may lead to different dynamical outcomes, in particular to homoclinic chaos. In the present study, we analyze both topological and dynamical properties of a recently characterized chaotic attractor governing the dynamics of tumor cells interacting with healthy tissue cells and effector cells of the immune system. By using the theory of symbolic dynamics, we first characterize the topological entropy and the parameter space ordering of kneading sequences from one-dimensional iterated maps identified in the dynamics, focusing on the effects of inactivation interactions between both effector and tumor cells. The previous analyses are complemented with the computation of the spectrum of Lyapunov exponents, the fractal dimension and the predictability of the chaotic attractors. Our results show that the inactivation rate of effector cells by the tumor cells has an important effect on the dynamics of the system. The increase of effector cells inactivation involves an inverse Feigenbaum (i.e. period-halving bifurcation) scenario, which results in the stabilization of the dynamics and in an increase of dynamics predictability. Our analyses also reveal that, at low inactivation rates of effector cells, tumor cells undergo strong, chaotic fluctuations, with the dynamics being highly unpredictable. Our findings are discussed in the context of tumor cells potential viability.

Comparative study between two distinct methods for attenuation correction and the use of no-attenuation correction for the assessment of relative uptake of 99mTc-DMSA on pediatric patients

Introduction: Although relative uptake values aren’t the most important objective of a 99mTc-DMSA scan, they are important quantitative information. In most of the dynamic renal scintigraphies attenuation correction is essential if one wants to obtain a reliable result of the quantification process. Although in DMSA scans the absent of significant background and the lesser attenuation in pediatric patients, makes that this attenuation correction techniques are actually not applied. The geometric mean is the most common method, but that includes the acquisition of an anterior (extra) projection, which it is not acquired by a large number of NM departments. This method and the attenuation factors proposed by Tonnesen will be correlated with the absence of attenuation correction procedures. Material and Methods: Images from 20 individuals (aged 3 years +/- 2) were used and the two attenuation correction methods applied. The mean time of acquisition (time post DMSA administration) was 3.5 hours +/- 0.8h. Results: The absence of attenuation correction showed a good correlation with both attenuation methods (r=0.73 +/- 0.11) and the mean difference verified on the uptake values between the different methods were 4 +/- 3. The correlation was higher when the age was lower. The attenuation correction methods correlation was higher between them two than with the “no attenuation correction” method (r=0.82 +/- 0.8), and the mean differences of the uptake values were 2 +/- 2. Conclusion: The decision of not doing any kind of attenuation correction method can be justified by the minor differences verified on the relative kidney uptake values. Nevertheless, if it is recognized that there is a need for an accurate value of the relative kidney uptake, then an attenuation correction method should be used. Attenuation correction factors proposed by Tonnesen can be easily implemented and so become a practical and easy to implement alternative, namely when the anterior projection - needed for the geometric mean methodology – is not acquired.

A loucura e o cinema: representações cinematográficas de personalidade limite

Dissertação apresentada à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Audiovisual e Multimédia.

Aferição do desempenho operacional de parques eólicos (Referência: D0708-047)

A verificação das Características Garantidas associadas aos equipamentos, em especial dos aerogeradores, incluídos no fornecimento de Parques Eólicos, reveste-se de particular importância devido, principalmente, ao grande volume de investimento em jogo, ao longo período necessário ao retorno do mesmo, à incerteza quanto à manutenção futura das actuais condições de remuneração da energia eléctrica produzida e ainda à falta de dados históricos sobre o período de vida útil esperado para os aerogeradores. Em face do exposto, é usual serem exigidas aos fornecedores, garantias do bom desempenho dos equipamentos, associadas a eventuais penalidades, quer para o período de garantia, quer para o restante período de vida útil, de modo a minimizar o risco associado ao investimento. No fornecimento de Parques Eólicos existem usualmente três tipos de garantias, nomeadamente, garantia de Curva de Potência dos aerogeradores, garantia de Disponibilidade dos equipamentos ou garantia de Produção de Energia. Estas poderão existir isoladamente ou em combinação, dependendo das condições contratuais acordadas entre o Adjudicatário e o Fornecedor. O grau de complexidade e/ou trabalho na implementação das mesmas é variável, não sendo possível afirmar qual delas é a mais conveniente para o Adjudicatário, nem qual a mais exacta em termos de resultados. Estas dúvidas surgem em consequência das dificuldades inerentes à recolha dos próprios dados e também da relativamente ampla margem de rearranjo dos resultados permitido pelas normas existentes, possibilitando a introdução de certo tipo de manipulações nos dados (rejeições e correlações), as quais podem afectar de forma considerável as incertezas dos resultados finais dos ensaios. Este trabalho, consistiu no desenvolvimento, execução, ensaio e implementação de uma ferramenta informática capaz de detectar de uma forma simples e expedita eventuais desvios à capacidade de produção esperada para os aerogeradores, em função do recurso verificado num dado período. Pretende ser uma ferramenta manuseável por qualquer operador de supervisão, com utilização para efeitos de reparações e correcção de defeitos, não constituindo contudo uma alternativa a outros processos abrangidos por normas, no caso de aplicação de penalidades. Para o seu funcionamento, são utilizados os dados mensais recolhidos pela torre meteorológica permanente instalada no parque e os dados de funcionamento dos aerogeradores, recolhidos pelo sistema SCADA. Estes são recolhidos remotamente sob a forma de tabelas e colocados numa directoria própria, na qual serão posteriormente lidos pela ferramenta.

Ligand-Induced structural changes in TEM‑1 probed by molecular dynamics and relative binding free energy calculations

The TEM family of enzymes has had a crucial impact on the pharmaceutical industry due to their important role in antibiotic resistance. Even with the latest technologies in structural biology and genomics, no 3D structure of a TEM- 1/antibiotic complex is known previous to acylation. Therefore, the comprehension of their capability in acylate antibiotics is based on the protein macromolecular structure uncomplexed. In this work, molecular docking, molecular dynamic simulations, and relative free energy calculations were applied in order to get a comprehensive and thorough analysis of TEM-1/ampicillin and TEM-1/amoxicillin complexes. We described the complexes and analyzed the effect of ligand binding on the overall structure. We clearly demonstrate that the key residues involved in the stability of the ligand (hot-spots) vary with the nature of the ligand. Structural effects such as (i) the distances between interfacial residues (Ser70−Oγ and Lys73−Nζ, Lys73−Nζ and Ser130−Oγ, and Ser70−Oγ−Ser130−Oγ), (ii) side chain rotamer variation (Tyr105 and Glu240), and (iii) the presence of conserved waters can be also influenced by ligand binding. This study supports the hypothesis that TEM-1 suffers structural modifications upon ligand binding.

Accessing complexity from genome information

This paper studies the information content of the chromosomes of 24 species. In a first phase, a scheme inspired in dynamical system state space representation is developed. For each chromosome the state space dynamical evolution is shed into a two dimensional chart. The plots are then analyzed and characterized in the perspective of fractal dimension. This information is integrated in two measures of the species’ complexity addressing its average and variability. The results are in close accordance with phylogenetics pointing quantitative aspects of the species’ genomic complexity.

Job phasing aware preemption deferral

Preemptions account for a non-negligible overhead during system execution. There has been substantial amount of research on estimating the delay incurred due to the loss of working sets in the processor state (caches, registers, TLBs) and some on avoiding preemptions, or limiting the preemption cost. We present an algorithm to reduce preemptions by further delaying the start of execution of high priority tasks in fixed priority scheduling. Our approaches take advantage of the floating non-preemptive regions model and exploit the fact that, during the schedule, the relative task phasing will differ from the worst-case scenario in terms of admissible preemption deferral. Furthermore, approximations to reduce the complexity of the proposed approach are presented. Substantial set of experiments demonstrate that the approach and approximations improve over existing work, in particular for the case of high utilisation systems, where savings of up to 22% on the number of preemption are attained.

Simulation relations, interface complexity, and resource optimality for real-time hierachical systems

Compositional schedulability analysis of hierarchical realtime systems is a well-studied problem. Various techniques have been developed to abstract resource requirements of components in such systems, and schedulability has been addressed using these abstract representations (also called component interfaces). These approaches for compositional analysis incur resource overheads when they abstract components into interfaces. In this talk, we define notions of resource schedulability and optimality for component interfaces, and compare various approaches.

Slow down or race to halt: towards managing complexity of real-time energy management decisions

Existing work in the context of energy management for real-time systems often ignores the substantial cost of making DVFS and sleep state decisions in terms of time and energy and/or assume very simple models. Within this paper we attempt to explore the parameter space for such decisions and possible constraints faced.

Self-organization and complexity theory to support evolvable production systems

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Electrotécnica e de Computadores

Medication regimen complexity in institutionalized elderly people in an aging society

Background: Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective: To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting: Five nursing homes in mainland Portugal. Methods: A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure: Medication regimen complexity index. Results: The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion: Medication regimen complexity proved to be high. There is certainly potential for the pharmacist's intervention to reduce it as part as the medication review routine in all the patients.