Managing an Acute Pain Unit Based on the Balanced Scorecard

The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

COVID-19 Pandemic Influence on Toddlers and Preschoolers’ Screen Time

The average daily screen time (ST) has been increasing in children, even at young ages. This seems to be associated with a higher incidence of neurodevelopmental disorders, and as the time of exposure increases, the greater is the functional impact. This study aims to compare the daily ST of toddlers and preschoolers previously and during the COVID-19 pandemic. A questionnaire was applied by telephone to parents/caregivers of children between 1 and 5 years old, followed up at four primary care units belonging to the Group of Primary Health Care Centers of Western Porto, Portugal. A total of 520 children were included: 52.9% male, mean age 39.4 ± 13.9 months. The mean age of first exposure to screens was 13.9 ± 8.0 months, and most of the children were exposed to more than one screen daily. Considering the WHO recommendations, before the COVID-19 pandemic, 385 (74.0%) and 408 (78.5%) children had excessive ST during the week and the weekend, respectively; during the lockdown, these values increased to 495 (95.2%) and 482 (92.7%). Maternal education and both the child's median age and the median age of first exposure to screens had a statistically significant association with excessive ST, with OR 0.2 (p = 0.03, CI 95% 0.07-0.86), OR 1.1 (p = 0.01, 95% CI 1.05-1.14) and OR 0.9 (p = 0.05, 95% CI 0. 87-0.98), respectively. Most children in this sample had a higher than recommended ST, which increased with the onset of the COVID-19 pandemic. These results are worrisome and point to the need for urgent intervention.

A Numerical Study of the Interaction between Residual Stress Profiles Induced by Quasi-Static Plastification

One of the most relevant phenomena in manufacturing is the residual stress state development through the manufacturing chain. In most cases, the residual stresses have their origin in the heterogenous plastification produced by the processes. Although a few manufacturing processes have been successfully approached by numerical modeling, there is still lack of understanding on how these processes' interactions will affect the final stress state. The objective of this work is to analyze the effect of the grinding procedure on the residual stress state generated by a quasi-static indentation. The model consists in a simplified approach of shot peening, modeling four cases with variations in indenter size and force. This model was validated through topography, measured by optical 3D focus-variation. The indentation model configured with two loads was then exposed to two grinding procedures and the result was analyzed. It was observed that the grinding procedure will have a significant effect on the stress state.

Advanced Palliative Aquatics Care Multi-Device AuBento for Symptom and Pain Management by Sensorial Integration and Electromagnetic Fields: A Preliminary Design Study

Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Assessment of Aminopolyether on 18F-FDG Samples

The quality control procedures of a radiopharmaceutical include the assessment of its chemical purity. The method suggested by international pharmacopeias consists of a thin layer chromatographic run. In this paper, the method proposed by the United States Pharmacopeia (USP) is compared to a direct method to determine the final concentration of aminopolyether in Fludeoxyglucose (18F-FDG) preparations. The approach (no chromatographic run) was achieved by placing the thin-layer chromatography (TLC) plate directly on an iodine vapor chamber. Both methods were validated and they showed adequate results to determine the concentration of aminopolyether in 18F-FDG preparations. However, the direct method is more sensitive, faster and simpler when compared to the reference method (with chromatographic run), and it may be chosen for use in routine quality control of 18F-FDG.

Observatory of Sustainability of the Algarve Region for Tourism: Proposal for Environmental and Sociocultural Indicators

The Observatory of Sustainability of the Algarve Region for Tourism (OBSERVE) will be a valuable tool to assess the sustainability of this region. The OBSERVE tool is designed to provide data and maintain an up-to-date, consistent set of indicators defined to describe the region on the environmental, sociocultural, economic and institutional domains. This ongoing two-year project has the active participation of the Algarve’s stakeholders, since they were consulted and asked to participate in the discussion for the indicators proposal. The environmental and sociocultural indicators chosen must indicate the characteristics of the region and should be in alignment with other global systems used to monitor the sustainability. This paper presents a review of sustainability indicators systems that support the first proposal for the environmental and sociocultural indicators. Others constraints are discussed, namely the existing data and the data available in digital platforms in a format suitable for automatic importation to the platform of OBSERVE. It is intended that OBSERVE will be a valuable tool to assess the sustainability of the region of Algarve.

Influence of Concrete Cracking in the Tensile Strength of Cast-in Headed Anchors

Headed reinforcement bars are increasingly used for anchorage in concrete structures. Applications include connections in composite steel-concrete structures, such as beam-column joints, in several strengthening situations as well as in more traditional uses in cast-in-place and precast structural systems. This paper investigates the reduction in the ultimate tensile capacity of embedded cast-in headed anchors due to concrete cracking. A series of nine laboratory tests are carried out to evaluate the influence of cracking on the concrete breakout strength in tension. The experimental results show that cracking affects both the resistance and load-slip response of the headed bar anchors. The strengths measured in these tests are compared to theoretical resistances calculated following the recommendations presented by fib Bulletin no. 58 (2011), ETAG 001 (2010) and ACI 318 (2014). The influences of parameters such as the effective embedment depth (hef), bar diameter (ds), and the concrete compressive strength (fc) are analysed and discussed. The theoretical recommendations are shown to be over-conservative for both embedment depths and were, in general, inaccurate in comparison to the experimental trends. The ACI 318 (2014) was the design code which presented the best performance regarding to the predictions of the ultimate load, with an average of 1.42 for the ratio between the experimental and estimated strengths, standard deviation of 0.36, and coefficient of variation equal to 0.25.

Association of Smoking with Chest Radiographic and Lung Function Findings in Retired Bauxite Mining Workers

Inhalation hazards are associated with potentially injurious exposure and increased risk for lung diseases, within the bauxite mining industry, especially for the smelter workers. Smoking is related to decreased lung function and leads to chronic lung diseases. This study had the objective to evaluate whether smoking is related to functional and radiographic respiratory changes in retired bauxite mining workers. Methods: This was a retrospective and cross-sectional study involving the analysis of database information of 140 retired bauxite mining workers from Poços de Caldas-MG evaluated at Worker’s Health Reference Center and at the Social Security Brazilian National Institute, from July 1st, 2015 until June 30th, 2016. The workers were divided into three groups: non-smokers (n = 47), ex-smokers (n = 46), and smokers (n = 47). The data included: age, gender, spirometry results, and the presence or not of pulmonary pleural and/or parenchymal changes in chest radiographs. Chi-Squared test was used (p < 0,05). Results: In the smokers’ group, 83% of spirometry tests and 64% of chest x-rays were altered. In the non-smokers’ group, 19% of spirometry tests and 13% of chest x-rays were altered. In the ex-smokers’ group, 35% of spirometry tests and 30% of chest x-rays were altered. Most of the results were statistically significant. Results demonstrated a significant difference between smokers’ and non-smokers’ groups in regard to spirometric and radiographic pulmonary alterations. Ex-smokers’ and non-smokers’ group demonstrated better results when compared to the smokers’ group in relation to altered spirometry and radiograph findings. These data may contribute to planning strategies to enhance smoking cessation programs within the bauxite mining industry.

Comparison of Irradiance Decomposition and Energy Production Methods in a Solar Photovoltaic System

Installations of solar photovoltaic systems have increased considerably in the last decade. Therefore, it has been noticed that monitoring of meteorological data (solar irradiance, air temperature, wind velocity, etc.) is important to predict the potential of a given geographical area in solar energy production. In this sense, the present work compares two computational tools that are capable of estimating the energy generation of a photovoltaic system through correlation analyzes of solar radiation data: PVsyst software and an algorithm based on the PVlib package implemented in MATLAB. In order to achieve the objective, it was necessary to obtain solar radiation data (measured and from a solarimetric database), analyze the decomposition of global solar irradiance in direct normal and horizontal diffuse components, as well as analyze the modeling of the devices of a photovoltaic system (solar modules and inverters) for energy production calculations. Simulated results were compared with experimental data in order to evaluate the performance of the studied methods. Errors in estimation of energy production were less than 30% for the MATLAB algorithm and less than 20% for the PVsyst software.

Diagnosis on Environmental Impacts of Tourism at Caju Beach in Palmas, Tocantins, Brazil

Environmental impacts are the changes in the physical, chemical or biological properties of natural areas that are most often caused by human actions on the environment and which have consequences for human health, society and the elements of nature. The identification of the environmental impacts is important so that they are mitigated, and above all that the mitigating measures are applied in the area. This work aims to identify the environmental impacts generated in the Praia do Caju area in the city of Palmas/Brazil and show that the lack of structure on the beach intensifies the environmental impacts. The present work was carried out having as parameter, the typologies of exploratory and descriptive and quantitative research through a matrix of environmental impacts through direct observation and registration. The study took place during the holidays from August to December 2016 and photographic record of impacts. From the collected data it was possible to verify that Caju beach suffers constant degradation due to irregular deposition.

Program of Health/Safety Integration and the Total Worker Health Concept in the Improvement of Absenteeism of the Work Accommodation Management

Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Algorithm for Path Recognition in-between Tree Rows for Agricultural Wheeled-Mobile Robots

Machine vision has been widely used in recent years in agriculture, as a tool to promote the automation of processes and increase the levels of productivity. The aim of this work is the development of a path recognition algorithm based on image processing to guide a terrestrial robot in-between tree rows. The proposed algorithm was developed using the software MATLAB, and it uses several image processing operations, such as threshold detection, morphological erosion, histogram equalization and the Hough transform, to find edge lines along tree rows on an image and to create a path to be followed by a mobile robot. To develop the algorithm, a set of images of different types of orchards was used, which made possible the construction of a method capable of identifying paths between trees of different heights and aspects. The algorithm was evaluated using several images with different characteristics of quality and the results showed that the proposed method can successfully detect a path in different types of environments.

Evaluation of NH3-Slip from Diesel Vehicles Equipped with Selective Catalytic Reduction Systems by Neural Networks Approach

Selective catalytic reduction systems for nitrogen oxides reduction by ammonia has been the chosen technology by most of diesel vehicle (i.e. bus and truck) manufacturers in Brazil, as also in Europe. Furthermore, at some conditions, over-stoichiometric ammonia availability is also needed that increases the NH3 slips even more. Ammonia (NH3) by this vehicle exhaust aftertreatment system provides a maximum efficiency of NOx removal if a significant amount of NH3 is stored on its catalyst surface. In the other words, the practice shows that slightly less than 100% of the NOx conversion is usually targeted, so that the aqueous urea solution hydrolyzes to NH3 via other species formation, under relatively low temperatures. This paper presents a model based on neural networks integrated with a road vehicle simulator that allows to estimate NH3-slip emission factors for different driving conditions and patterns. The proposed model generates high NH3slips which are not also limited in Brazil, but more efforts needed to be made to elucidate the contribution of vehicle-emitted NH3 to the urban atmosphere.

Proposal for a Model of Economic Integration for the Development of Industry in Cabinda, Angola

This study aims to present a proposal for an economic integration model for the development of the manufacturing industry in Cabinda, Angola. It seeks to analyze the degree of economic integration of Cabinda and the dynamics of the manufacturing industry. Therefore, in the same way, to gather information to support the decision-making for public financing programs that will aim at the disengagement of the manufacturing industry in Angola and Cabinda in particular. The Cabinda Province is the 18th of Angola, the enclave is located in a privileged area of the African and arable land.

Evaluation of Electro-Flocculation for Biomass Production of Marine Microalgae Phaodactylum tricornutum

The commercial production of biodiesel using microalgae demands a high-energy input for harvesting biomass, making production economically unfeasible. Methods currently used involve mechanical, chemical, and biological procedures. In this work, a flocculation system is presented as a cost and energy effective process to increase biomass production of Phaeodactylum tricornutum. This diatom is the only species of the genus that present fast growth and lipid accumulation ability that are of great interest for biofuel production. The algae, selected from the Bank of Microalgae, Institute of Biology, Federal University of Bahia (Brazil), have been bred in tubular reactor with photoperiod of 12 h (clear/dark), providing luminance of about 35 μmol photons m-2s-1, and temperature of 22 °C. The medium used for growing cells was the Conway medium, with addition of silica. The seaweed growth curve was accompanied by cell count in Neubauer camera and by optical density in spectrophotometer, at 680 nm. The precipitation occurred at the end of the stationary phase of growth, 21 days after inoculation, using two methods: centrifugation at 5000 rpm for 5 min, and electro-flocculation at 19 EPD and 95 W. After precipitation, cells were frozen at -20 °C and, subsequently, lyophilized. Biomass obtained by electro-flocculation was approximately four times greater than the one achieved by centrifugation. The benefits of this method are that no addition of chemical flocculants is necessary and similar cultivation conditions can be used for the biodiesel production and pharmacological purposes. The results may contribute to improve biodiesel production costs using marine microalgae.

A Neuro-Automata Decision Support System for the Control of Late Blight in Tomato Crops

The use of decision support systems in agriculture may help monitoring large fields of crops by automatically detecting the symptoms of foliage diseases. In our work, we designed and implemented a decision support system for small tomatoes producers. This work investigates ways to recognize the late blight disease from the analysis of digital images of tomatoes, using a pair of multilayer perceptron neural networks. The networks outputs are used to generate repainted tomato images in which the injuries on the plant are highlighted, and to calculate the damage level of each plant. Those levels are then used to construct a situation map of a farm where a cellular automata simulates the outbreak evolution over the fields. The simulator can test different pesticides actions, helping in the decision on when to start the spraying and in the analysis of losses and gains of each choice of action.

Comparison of the Distillation Curve Obtained Experimentally with the Curve Extrapolated by a Commercial Simulator

True Boiling Point distillation (TBP) is one of the most common experimental techniques for the determination of petroleum properties. This curve provides information about the performance of petroleum in terms of its cuts. The experiment is performed in a few days. Techniques are used to determine the properties faster with a software that calculates the distillation curve when a little information about crude oil is known. In order to evaluate the accuracy of distillation curve prediction, eight points of the TBP curve and specific gravity curve (348 K and 523 K) were inserted into the HYSYS Oil Manager, and the extended curve was evaluated up to 748 K. The methods were able to predict the curve with the accuracy of 0.6%-9.2% error (Software X ASTM), 0.2%-5.1% error (Software X Spaltrohr).

Definition of a Computing Independent Model and Rules for Transformation Focused on the Model-View-Controller Architecture

This paper presents a model-oriented development approach to software development in the Model-View-Controller (MVC) architectural standard. This approach aims to expose a process of extractions of information from the models, in which through rules and syntax defined in this work, assists in the design of the initial model and its future conversions. The proposed paper presents a syntax based on the natural language, according to the rules agreed in the classic grammar of the Portuguese language, added to the rules of conversions generating models that follow the norms of the Object Management Group (OMG) and the Meta-Object Facility MOF.

A Neural Network Classifier for Estimation of the Degree of Infestation by Late Blight on Tomato Leaves

Foliage diseases in plants can cause a reduction in both quality and quantity of agricultural production. Intelligent detection of plant diseases is an essential research topic as it may help monitoring large fields of crops by automatically detecting the symptoms of foliage diseases. This work investigates ways to recognize the late blight disease from the analysis of tomato digital images, collected directly from the field. A pair of multilayer perceptron neural network analyzes the digital images, using data from both RGB and HSL color models, and classifies each image pixel. One neural network is responsible for the identification of healthy regions of the tomato leaf, while the other identifies the injured regions. The outputs of both networks are combined to generate the final classification of each pixel from the image and the pixel classes are used to repaint the original tomato images by using a color representation that highlights the injuries on the plant. The new images will have only green, red or black pixels, if they came from healthy or injured portions of the leaf, or from the background of the image, respectively. The system presented an accuracy of 97% in detection and estimation of the level of damage on the tomato leaves caused by late blight.