412 research outputs found

    Comparación de tratamientos endourológicos para la estenosis pieloureteral congénita en el niño

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    Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 02/12/2015La hidronefrosis es una de las malformaciones congénitas más frecuentemente diagnosticadas en el periodo prenatal. La estenosis pieloureteral es la causa más común de hidronefrosis prenatal clínicamente significativa, cifrándose en 1/500 fetos vivos. Además, la estenosis pieloureteral es la estenosis más frecuente del sistema urinario en cualquier grupo de edad. Por ello es una de las causas más frecuentes de consulta en cirugía pediátrica. El procedimiento quirúrgico más utilizado mundialmente es la pieloplastia desmembrada como fue descrita por Anderson y Hynes en 1949, teniendo reportados unos porcentajes de éxito cercanos al 95% en la actualidad. Pese a sus buenos resultados, en las últimas décadas se han descrito una serie de abordajes mínimamente invasivos que buscan conseguir los mismos resultados con menos agresión para el paciente. Entre ellas, destacan las técnicas laparoscópicas y endourológicas, definidas como el conjunto de maniobras diagnósticas o terapéuticas, transuretrales o percutáneas, endoscópicas o imagenológicas, realizadas en la luz de las vías urinarias. Las distintas técnicas endourológicas para tratar las malformaciones de la unión pieloureteral podrían ser divididas en anterógradas y retrógradas según avancemos por la luz urinaria a favor o en contra de la orina. Así, las técnicas anterógradas exigirán obligatoriamente la punción percutánea de riñón para acceder a los cálices renales, mientras que las técnicas retrógradas exigirán el abordaje del meato ureteral tras cistoscopia...Hydronephrosis is one of the most frequently diagnosed congenital malformations in the prenatal period. Ureteropelvic junction obstruction is the most common cause of clinically significant prenatal hydronephrosis, being estimated to 1/500 live fetuses. In addition, ureteropelvic junction obstruction is the most common urinary tract stenosis in any age group. Therefore, it is one of the most frequent causes of consultation in pediatric surgery. The surgical procedure used worldwide is the dismembered pyeloplasty as was described by Anderson and Hynes in 1949, having reported a success rate close to 95%. Despite its success in recent decades they have described a series of minimally invasive approaches that seek to achieve the same results with less aggression to the patient. These projects include laparoscopic and endourological techniques, defined as set of percutaneous, endoscopic or imaging diagnostic or therapeutic maneuvers, transurethral or made inside of the urinary tract. Various endourological techniques for treating ureteropelvic junction malformations may be divided into antegrade and retrograde as we go inside urinary tract pro or against urine flow. Thus, antegrade techniques necessarily require kidney percutaneous puncture to access the renal chalices, while the retrograde techniques require to approach the ureteral orifice during cystoscopy...Depto. de CirugíaFac. de MedicinaTRUEunpu

    Bio-chemostratigraphy of the Barremian-Aptian shallow-water carbonates of the southern Apennines (Italy): pinpointing the OAE1a in a Tethyan carbonate platform

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    Low biostratigraphic resolution and lack of chronostratigraphic calibration hinder precise correlations between platform carbonates and coeval deep-water successions. These are the main obstacle when studying the record of Mesozoic oceanic anoxic events in carbonate platforms. In this paper carbon and strontium isotope stratigraphy areused to produce the first chronostratigraphic calibration of the Barremian-Aptian biostratigraphy of the Apenninic carbonate platform of southern Italy. According to this calibration, the segment of decreasing δ13C values, leading to the negative peak that is generally taken as the onset of the Selli event, starts a few metres above the last occurrence of Palorbitolina lenticularis and Voloshinoides murgensis. The following rise of δ13C values, corresponding to the interval of enhanced accumulation of organic matter in deep-water sections, ends just below the first acme of Salpingoporella dinarica, which roughly corresponds to the segment of peak δ13C values. The whole carbon isotope excursion associated with the oceanic anoxic event 1a is bracketed in the Apenninic carbonate platform between the last occurrence of Voloshinoides murgensis and the “Orbitolina level”, characterized by the association of Mesorbitolina parva and Mesorbitolina texana. Since these bioevents have been widely recognized beyond the Apenninic platform, the calibration presented in this paper can be used to pinpoint the interval corresponding to the Early Aptian oceanic anoxic event in other carbonate platforms of central and southern Tethys. This calibration will be particularly useful to interpret the record of the Selli event in carbonate platform sections for which a reliable carbon isotope stratigraphy is not available

    Optimização e dimensionamento de vãos envidraçados

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    Mestrado em Engenharia MecânicaAs tendências construtivas e o factor “moda” apontam para o hábito de vãos envidraçados de maiores dimensões. Assim sendo, até que ponto a tecnologia e o material a usar nos vãos envidraçados de um edifício causam impacto no seu desempenho energético? Como se enquadram as diferentes opções com as características do nosso clima e qual a relação custo/benefício? Para responder a todas estas questões, e à luz dos recentes regulamentos na área do consumo energético de edifícios, será necessária uma caracterização do desempenho dos vãos envidraçados em relação aos requisitos energéticos da legislação vigente e um conhecimento das funções e características da envolvente envidraçada, dando natural importância ao desempenho energético e económico, parâmetros muito importantes em qualquer tipo de edifício. O principal objectivo do presente estudo é analisar exclusivamente o sistema construtivo de vãos envidraçados em diferentes regiões climáticas de Portugal. Para tal, recorreu-se a uma análise paramétrica e sustentada no RCCTE (Decreto-Lei nº80/2006 de 4 de Abril) para avaliar energética e economicamente os diferentes tipos de opções a considerar na especificação de vãos envidraçados. Assim, tendo por base um conjunto de pressupostos devidamente fundamentados foi estabelecida, a escolha óptima da caixilharia e tipo de vidro a usar em função de cada zona climática. Na realidade, tornou-se muito difícil generalizar o desempenho de um vão envidraçado, pois existem muitas variáveis envolvidas e de naturezas diferentes. Ainda assim, é possível melhorar o desempenho e o conforto e por sua vez reduzir a factura energética de um edifício. Do estudo conclui-se que as melhores soluções energéticas são janelas de elevado desempenho com caixilho em PVC isolado e vidro baixo emissivo pois alcançam, de um modo geral, os melhores resultados em todas as regiões e para todos os tipos de construção (inércia térmica). Outro factor vantajoso das opções em PVC diz respeito aos valores razoáveis do indicador económico VAL (Valor Actualizado Liquido) quando comparado com uma solução base consistindo num vidro simples com caixilharia em alumínio sem corte térmico, principalmente em zonas com Invernos rigorosos. Conclui-se ainda que é a caixilharia em madeira, que apresenta a melhor relação custo/beneficio para todas as zonas de Portugal. ABSTRACT: Constructive trends and the "fashion" factor are leading to the habit of using glazed facades of large dimensions even in dwellings. To what extent does the technology and the material to use in the glazed facades of a building causes impact in its energy performing? How to fit the different options with the characteristics of our climate and what is the solution showing a best cost/benefit ratio? The present thesis is a first approach to answer these questions what will be done in the frame of the recent energy regulation in the area of the energy consumption of buildings. It will require the characterization of the glazed facades performance regarding to energy consumption of the respective building as well as a deep understanding of the glazed façade performance having in mind the energy and economical perspective, which are a very important parameters irrespectively of the building type. The main objective of the present study is to analyze different constructive options for windows (regarding glass and frame) of in different and representative climatic areas of Portugal. For that purpose, a parametric analysis was made based on the current national regulation calculation method (RCCTE, Decreto-Lei nº 80/2006 from April, 4th) to evaluate de energy and economical performance of different window options regarding frame materials and glass types. For a reference building typology the most advantageous windows option both regarding frame and glass type was determined for each climatic zone. However, it is very difficult to build a general algorithm aiming window selection because of the different physical nature of the relevant factors. Even though, it was possible to identify the most adequate constructive solution for windows in Portugal. The best energy option in all regions and all types of construction (thermal inertia) are high performance windows with PVC insulated frames and low emissivity glasses). Even from the economic standpoint this solution shows a reasonable NPV (Net Present Value) comparing to the cheapest solution (simple aluminium frame with a single clear glass) particularly in the regions with a more severe winter. In the other hand Wood frames, were found to have the greatest cost/benefit ratio for all climate regions in Portugal

    An Elephant in the Room: Using Sampling for Detecting Heavy-Hitters in Programmable Switches

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    The ability to detect elephant flows in the forwarding device itself, i.e., a switch, facilitates the deployment of new advanced applications such as load-balancing, per-flow QoS management, etc. Sketches and Space Saving summarization techniques are used for elephant flow detection. However, their memory and computing requirements force the cooperation of an external controller device, due to the scarce resources of current programmable switches. To overcome this limitation, we adapt Sketch and Space Saving elephant flow detection techniques to operate with instant notification and sampled traffic. We evaluate the performance of the resulting techniques with three real traffic traces. The use of sampling allows the identification of a large share of the total traffic corresponding to the elephant flows with a low memory footprint and a reduction of the computing requirements in two orders of magnitude compared to unsampled versions. In turn, we observe a slight increase in the number of false positives and the number of flow notifications.The work of Alberto García-Martínez and Marcelo Bagnulo was supported by the TRUE5G Project ('Evolución hacia redes y servicios auto-gestionados para el 5G del futuro') by the Spanish National Research Agency under Grant PID2019-108713RB-C52/AEI/10.13039/501100011033

    Bartolomeu: An SDN rebalancing system across multiple interdomain paths

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    Bartolomeu is a solution to enable stub networks to perform adaptive egress traffic load balancing across multiple interdomain routes by spreading the traffic across available paths according to a passive measurement of their performance. It defines a BGP-SDN architecture that increases the number of BGP routes that can be used by stub networks. Bartolomeu measures the available capacity of each path to any destination prefix, and allocates to each path a number of large flows that is proportional to its capacity. This strategy reduces the mean sojourn time, i.e., mean time to flow completion, compared to state-of-the-art traffic balancing techniques as ECMP. We develop a mathematical model to compute this time and compare with ECMP and single path (fast path) selection. An analysis of the traffic traces of two content providers was performed to ensure that our solution is deployable. An experiment with traffic exchange over the Internet is used to show that Bartolomeu can provide gains with real interfering traffic. A discrete-event simulator fed with the traces captured is used to asses Bartolomeu's gains with prefixes with different number of flows, and flows with different sizes and arrival time. We observe in this experiment that Bartolomeu can reduce the sojourn time, compared to ECMP, by half when path rates differ in a factor of 3, or to a sixth when path rates differ in a factor of 10. We compute the maximum number of per-flow entries and the maximum entry change request rate to show that the resources required fit in with the specifications of the current generation of SDN switches.The work of Pedro Rodrigues Torres-Jr. was partially supported by the Fundación Carolina, program Mobilidad SEGIB 2019. The work of Alberto García-Martínez was supported by the 5G-TRANSFORMER project, H2020-761536. The work of and Marcelo Bagnulo was supported in part by the 5G-TRANSFORMER project, and by the Spanish Ministry of Economy and Competitiveness under 5GCity project, TEC2016-76795-C6-3-R

    Arquitecturas de espaços comerciais. Concept Store

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    uma vontade constante de procura, organização e comparação de informação.Ainda que tenha passado por um processo de aprendizagem que resultou na obtençãode conhecimento, acabou por, na minha condição de estudante de arquitetura em faseterminal de mestrado, me levantar questões relativas a temáticas inerentes ao trabalhorealizado.Assim, pretendo passar para uma abordagem a essas temáticas no segundo capítuloda dissertação, com o intuito de fazer uma clarificação dos seus domínios.Parto inicialmente, para um estudo sobre a "experiência de compras", por esta se terrevelado como a componente específica e diferenciadora do modelo de comércio queeu adotei como objeto do estudo anteriormente apresentado.Tento perceber as lógicas e processos relativos a esta questão, procurando descobrir ocontexto originário da concepção da "concept store".Abordo os acontecimentos encadeados nas sociedades e os respetivosacompanhamentos e procedimentos por parte do sector do comércio. Para isso, tentoperceber quais as estratégias usadas nestes processos e o papel correspondente daarquitetura.Introduzo também o papel da internet nesses mesmos processos, percebendo a suarelevância contemporânea no seio das sociedades, analisando as consequências queprovoca nos modos de comportamento.Feito este percurso, aproveito aqui para estabelecer uma ponte para outra das questõesque me foram suscitadas, associada à relação entre esta plataforma virtual quecresce exponencialmente, e o panorama da informação. Uma vez que o meu ensaioprático recai sobre uma pesquisa que recorre exclusivamente à internet como fonte deinformação, questiono a credibilidade deste processo. Assim, parto para uma tentativade aferição da legitimidade da internet enquanto fonte de informação e conteúdo nostempos atuais. De facto não é " a internet" que está em causa mas sim "aquilo queestá disponível na internet", que é apenas um suporte de edição e distribuição deinformação. O seu carácter aberto e de acesso completamente livre, faz com que aípossa caber o repositório da investigação que se faz e publica numa universidade(dessa forma legitimado, portanto), como o maior embuste ou jogo publicitário ou ainstabilidade da opinião de senso comum. O investigador terá que ter o máximo deconsciência dessa diversidade e a maior atenção no entendimento das fontes.Sabendo que o ensaio prático ao qual eu me propus elaborar recai sobre umprocedimento que ultrapassa a análise e domínio das características unicamentearquitectónicas dos casos de estudo abordados, fica-me patente a vontade deperceber a pertinência e legitimidade dessa minha conduta. Pretendo assim chegara uma definição do plano profissional do arquiteto. A diversidade da informação quecircula na net pode ser preciosa para entender modelos e expectativas acerca de umdeterminado programa. Esta vontade surge também pela natural consciência implícitano meu contexto vivencial, das dificuldades que os arquitetos atualmente enfrentamno panorama laboral. Com isto, proponho questionar os limites do campo funcionaldo arquiteto, tentando perceber quais as atitudes que deve tomar no sentido de umaadaptação benéfica às circunstâncias vigentes.Assim, sabendo que me encontro no fim de um ciclo académico, pretendo que esteestudo me deixe mais consciente das ferramentas que me foram fornecidas nessepercurso, bem como das várias possibilidades de emprego dessas mesmas ferramentas,afim de ter uma iniciação no plano profissional mais objetiva e conseguida.It filled me with pleasure to elaborate this practical essay by approaching a theme thatraised a constant will of research, organization and information comparison.Although the learning process led me to obtain knowledge it also brought diversequestions inherent to this essay in particular, which is very interesting in this final phaseof my master's degree.Hence, I am willing to approach those themes in the second chapter of the dissertationwith the intent to clarify its domains.I begin with a study about the "shopping experience" because this theme revealed itselfas the most especific and differentiating factor of the commerce model, which I haveadopted as the study object previously introduced.I try to understand the logics and procedures related to this matter, in order to find outthe primary context of the "birth" of the "concept store".I approach the chain of events in societies and the respective follow-ups and proceduresby the commerce sector.To that end, I endeavor to perceive which strategies are used in those procedures andwhich role corresponds to architecture.In addition, I also introduce the role of the internet in the procedures, previouslymentioned, realizing their crutiality amidst society, analising the consequences in thebehavioural spectrum.By the end of this journey, I realized that it is opportune to establish a bridge to one ofthe questions that were raised, associated to the relation between this virtual platform,that grows exponentially, and the information overview.Since my practical essay leans over a research that turns, exclusively, to the internet asthe information source, I question the credibility of this process. Therefore, I embracean attempt to disclosure the legitimacy of the internet as an information source andcontents of the current era. In fact, it is not "the internet" that is at stake but "thecontents that are available on the internet", that is just a support for editing anddistribution information. Due to its open and utterly unrestricted access, it is possible toinsert a full repository of an investigation that you made and published in an university(becoming legitimate). On the other hand, you can also find the biggest hoax, publicitystunts or even random articles based precariously in, the very unstable, common sense.The investigator, must act fully aware of all of these obstacles by thoroughly checkingthe accuracy of the sources.Being mindful that the practical essay that I am elaborating turns to a procedure thatexceeds the architectural analysis and domaine of the case studies, it remains in methe will to realize the relevance and legitimacy of my conduct.I intend to establish a definition in the professional plan of the architect. The diversityof the information that flows on the internet can be useful to understand models andexpectations about an especific program.This will, urges also due to the natural conscience implied in my life context, which isfilled with multiple obstacles that architectures currently face in the labor overview.I propose the questioning of the boundaries of the functional field of the architect, byunderstanding which attitudes should be taken in order to achieve an advantageousadaptation to this current junture.To conclude, I have realized that by being the end of an academic cicle, I intend toobtain, through this particular study, more awareness of all the tolls that were given tome during this learning process, as well the several possibilities to aplly them, so that Ican initiate my professional career more sucessfuly

    The Long Pentraxin PTX3 as a Humoral Innate Immunity Functional Player and Biomarker of Infections and Sepsis

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    The first line of defense in innate immunity is provided by cellular and humoral mediators. Pentraxins are a superfamily of phylogenetically conserved humoral mediators of innate immunity. PTX3, the first long pentraxin identified, is a soluble pattern recognition molecule rapidly produced by several cell types in response to primary pro-inflammatory signals and microbial recognition. PTX3 acts as an important mediator of innate immunity against pathogens of fungal, bacterial and viral origin, and as a regulator of inflammation, by modulating complement activation and cell extravasation, and facilitating pathogen recognition by myeloid cells. In sepsis, PTX3 plasma levels are associated with severity of the condition, patient survival, and response to therapy. In combination with other established biomarkers, PTX3 could improve stratification of sepsis patients and thus, complement the system of classification and monitoring of this disease

    Long-Term Outcomes in Primary Obstructive Megaureter Treated by Endoscopic Balloon Dilation. Experience After 100 Cases

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    Aim: To assess long-term effectiveness, complications, and outcomes of primary obstructive megaureter (POM) treated by endoscopic balloon dilation (EBD) in the largest series reported.Patients and Methods: Hundred POM in 92 consecutive patients were treated by EBD between years 2004 and 2016. A total of 79 POM (73 patients) with more than 18 months of follow-up after treatment have been analyzed. EBD of the vesicoureteral junction was performed with semicompliant high-pressure balloon catheters (2.7FG) with minimum balloon diameter of 5 mm, followed by temporary Double-J stent placement. Follow-up protocol included periodical clinical reviews, US and MAG-3 renogram scans.Results: Median age at surgery was 4 months (15 days−3.6 years), with median operating time of 20 min (10–60) and hospital stay of 1 day (1–7). Initial renal function was preserved in all patients with significant improvement in renal drainage on the MAG-3 diuretic renogram after endoscopic treatment (p < 0.001 T-test). Significant post-operative differences were observed in hydronephrosis grade and ureteral diameter that were maintained in the long-term (p < 0.001 T-test). Endoscopic approach of POM had a long-term success rate of 87.3%, with a mean follow-up of 6.4 ± 3.8 years. Secondary VUR was found in 17 cases (21.5%), being successfully treated by endoscopic subureteral injection in 13 (76.4%). Nine cases developed long-term re-stenosis (12.2%) that were successfully treated with a new EBD in 8. Endoscopic management of POM failed in 10 cases (12.7%) that required ureteral reimplantation. Five were early failures (4 intraoperative technical problems and 1 double-J stent migration with severe re-stenosis), and 5 long-term (4 persistent VUR and 1 re-stenosis recurrence).Conclusion: EBD has shown to be an effective treatment of POM with few complications and good outcomes at long-term follow up. Main complication was secondary VUR that could also be treated endoscopically with a high success rate. In our opinion, EBD may be considered first-line treatment in POM
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