Kinematic analysis and dimensional optimization of a 2R2T parallel manipulator

International audienceThe need of a device providing two translational (2T) and two rotational (2R) movements led us to the design a 3UPS-1RPU parallel manipulator. The manipulator consisted on a mobile platform connected to a base through four legs. That is, the manipulator layout has one central leg and three external legs at the same radial distance. By studying different locations of the legs anchoring point, we improved the first layout design, yet not the optimal one. On this basis, this paper focus on the optimal dimensional design of the manipulator. To this end, we put forward the kinematics equations of the manipulator in accordance to the anchoring points coordinates. Through a numerical approach, the equations enable to find the manipulator workspace. Also, we find a global manipulability index using a local dexterity measure. The latter index serves as optimal function. The optimization process considers joint constraints. Thus, we built a nonlinear optimization problem solved through sequential quadratic programming algorithms. We start by optimizing only a small set of parameters rather than the entire set, which gives us insights on the initial guess to optimize using the entire set. The optimal design layout varies from the original layout. Findings suggest that a task-oriented reconfiguration strategy can improve manipulator performance

A Colaboração Interprofissional no contexto da Saúde da Família no Brasil e em Portugal: Um estudo de casos comparados / Interprofessional Collaboration in the context of Family Health in Brazil and Portugal: A comparative case study

O propósito deste estudo foi compreender a dinâmica da Colaboração Interprofissional no contexto do trabalho da Estratégia Saúde da Família (Brasil) e das Unidades de Saúde Familiar (Portugal). A Colaboração Interprofissional envolve aspetos relacionais, organizacionais e estratégicos que configuram o trabalho em equipe e a governança clínica no cotidiano dos serviços. Desenvolveu-se um estudo de casos comparados, observando-se políticas e serviços de saúde e a adaptação de um modelo de avaliação da Colaboração Interprofissional. Para a coleta de dados utilizou-se pesquisa documental, entrevistas semiestruturadas, observação direta e questionário. Observou-se que: a) os esforços para a cogestão democrática da equipe, contribuem para a efetivação da qualidade do cuidado; b) há um distanciamento dos órgãos gestores em relação ao trabalho cotidiano das equipes, suas lutas e desafios concretos; c) diferenças marcantes na governança clínica e do trabalho colaborativo entre os dois casos.

Complications after radiotherapy in the ENT area

[ES] Introducción: La radioterapia forma parte del complejo tratamiento que requiere la patología tumoral de cabeza y cuello, siendo útil como estrategia terapéutica y complementaria. Es posible asociarla a quimioterápicos o radiosensibilizantes para aumentar su efectividad así como también utilizar medidas de radioprotección para evitar la sobreexposición de tejidos sanos. Sin embargo y a pesar de todo esto existen descritas múltiples complicaciones secundarias al uso de la radioterapia. Materiales y métodos: A continuación exponemos una serie de complicaciones que se presentaron en la fase tardía del tratamiento radioterápico en 4 pacientes. Resultados: un total de 4 pacientes de los cuales 3 presentaran el diagnostico de carcinoma de cavum y uno de ellos de carcinoma de cuerdas vocales, los cuales presentaran como complicaciones: estenosis critica de arteria carótida derecha, fístula cutánea a nivel cervical más radionecrosis de vértebras C5 y C6, radionecrosis de musculatura pre-vertebral y de vértebras C1 y C2 y pseudoaneurisma de arteria carótida izquierda. Conclusiones: en nuestra serie la utilización de cámara hiperbárica favoreció la mejoría en cuanto a necrosis tisular, en cuanto a la estenosis crítica el paciente requirió tratamiento anticoagulante, mientras que el pseudoaneurisma requirió embolización por parte de radiología intervencionista. Por lo tanto es incuestionable el efecto terapéutico de la radioterapia en el campo de la oncología de cabeza y cuello, pero las complicaciones a causa de esta deben ser tenidas en cuenta a la hora de valorar de forma sucesiva al paciente. [EN] Introduction: Radiotherapy is part of the treatment of oncological pathology of head and neck, being useful as therapeutic and supplementary strategy. It is possible associate to chemotherapeutic or radiosensitizing to enhance their effectiveness as well as radiation protection measures used to prevent overexposure of tissues. However, despite all this there are multiple potential complications secondary to the use of radiotherapy.Materials and Methods: Here we present a series of complications that occurred in the late phase of radiation therapy in 4 patients.Results: A total of 4 patients of which 3 presented the diagnosis of nasopharyngeal carcinoma and one vocal cord carcinoma, which presented complications: critical stenosis of left carotid artery in the cervical cutaneous fistula more radionecrosis of vertebrae C5 and C6, radionecrosis of pre-vertebral muscles and C1 and C2 vertebrae and left carotid artery pseudoaneurysm.Conclusions: In our series the hyperbaric chamber favored the improvement in terms of tissue necrosis, in terms of critical stenosis the patient required anticoagulation, while the pseudoaneurysm required embolization by interventional radiology. So unquestionably the therapeutic effect of radiotherapy in the field of head and neck oncology, but complications because of this should be taken into account when assessing the patient successively

Photodeposition of silver on Zinc/Calcium ferrite nanoparticles: A contribution to efficient effluent remediation and catalyst reutilization

The efficient photodegradation of textile dyes is still a challenge, especially considering resistant azo dyes. In this work, zinc/calcium mixed ferrite nanoparticles prepared by the sol-gel method were coupled with silver by a photodeposition method to enhance the photocatalytic potency. The obtained zinc/calcium ferrites are mainly cubic-shaped nanoparticles sized 15 ± 2 nm determined from TEM and XRD and an optical bandgap of 1.6 eV. Magnetic measurements indicate a superparamagnetic behavior with saturation magnetizations of 44.22 emu/g and 27.97 emu/g, respectively, for Zn/Ca ferrite and Zn/Ca ferrite with photodeposited silver. The zinc/calcium ferrite nanoparticles with photodeposited silver showed efficient photodegradation of the textile azo dyes C.I. Reactive Blue 250 and C.I. Reactive Yellow 145. Subsequent cycles of the use of the photocatalyst indicate the possibility of magnetic recovery and reutilization without a significant loss of efficiency.This work was supported by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding of CF-UM-UP (UIDB/04650/2020) and research project PTDC/QUI-QFI/28020/2017 (POCI-01-0145-FEDER-028020) funded by FCT, FEDER, PORTUGAL2020, and COMPETE2020

Os custos da aterosclerose em Portugal

Copyright © 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved.© 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa ̃na, S.L.U. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Introduction and objectives: Cardiovascular disease is the leading cause of death in Portugal and atherosclerosis is the most common underlying pathophysiological process. The aim of this study was to quantify the economic impact of atherosclerosis in Portugal by estimating disease-related costs. Methods: Costs were estimated based on a prevalence approach and following a societal perspective. Three national epidemiological sources were used to estimate the prevalence of the main clinical manifestations of atherosclerosis. The annual costs of atherosclerosis included both direct costs (resource consumption) and indirect costs (impact on population productivity). These costs were estimated for 2016, based on data from the Hospital Morbidity Database, the health care database (SIARS) of the Regional Health Administration of Lisbon and Tagus Valley including real-world data from primary care, the 2014 National Health Interview Survey, and expert opinion. Results: The total cost of atherosclerosis in 2016 reached 1.9 billion euros (58% and 42% of which was direct and indirect costs, respectively). Most of the direct costs were associated with primary care (55%), followed by hospital outpatient care (27%) and hospitalizations (18%). Indirect costs were mainly driven by early exit from the labor force (91%). Conclusions: Atherosclerosis has a major economic impact, being responsible for health expenditure equivalent to 1% of Portuguese gross domestic product and 11% of current health expenditure in 2016.info:eu-repo/semantics/publishedVersio

The Performance of Academic Leagues Linked to the Brazilian Association of Plastic Surgery Leagues

Introduction: The Academic Leagues are non-profit autonomous civil and scientific student entities, of indefinite duration, which brings together medical students and professors. The Brazilian Association of Plastic Surgery Leagues (ABLCP) is an organization linked to the Brazilian Society of Plastic Surgery (SBCP), considered its academic segment, thus establishing the proximity between Academic Leagues of Plastic Surgery (PSL) and SBCP. The present study aims to describe the profile of the associated leagues. Methods: This was a cross-sectional, descriptive, multicenter study with qualitative and quantitative approach through application of an online questionnaire with 19 questions. Duplicated or unfinished records were excluded. Results: It was observed that there are 78 PSLs and 1873 binders, present in 58 cities arranged in 20 federative units, being the Southeast region with the largest number of alloys and binders and the one with the smallest number was the North region. In addition, it was observed that 78.2% of the PSLs linked to the ABLCP presented activities in the three axes (Education, Research and Extension/Assistance) simultaneously. In general, the Leagues obtained less participation in research. Conclusions: ABLCPs performance in relation to LCPs has the objective of seeking alignment, inspection and stimulus for their activities, since alloys have an important role in medical education

Metabolic plasticity for subcutaneous fat accumulation in a long-distance migratory bird traced by 2H2O

La comilona migratoria de cola negra (Limosa limosa) tradicionalmente utilizaba humedales naturales en la Península Ibérica para prepararse para los vuelos migratorios alimentándose principalmente en estuarios. En las últimas décadas, esta especie se ha vuelto cada vez más dependiente de los campos de arroz, confiando así en una dieta basada en plantas para alimentar. Los ácidos grasos en la dieta (FA) parecen ser determinantes para la composición de la grasa subcutánea acumulada en las aves migratorias. Aún no está claro si la plasticidad metabólica permite la modificación y / o síntesis de la FA, lo que contribuye a un perfil lipídico que permite un rendimiento migratorio exitoso. El agua deuterada se administró a las monitas de cola negra cautivas sometidas a dos dietas (larvas de mosca versus arroz) y se analizó la incorporación de deuterio (2H) en los triglicéridos subcutáneos mediante RMN. Un método de biopsia localizada recientemente desarrollado para muestrear grasa subcutánea se empleó con la posterior liberación exitosa de todas las aves en el medio silvestre. La estructura química promedio reflejó principalmente una mezcla de FA saturada y monoinsaturada de 16 y 18 carbonos, un perfil que se encuentra con frecuencia en las aves migratorias. Se observaron niveles significativamente más altos de FA poliinsaturada, así como niveles detectables de FA n-3, en aves alimentadas con larvas de mosca. El exceso de enriquecimiento con 2H en FA reveló tasas significativamente más altas de lipogénesis de novo fraccional y capacidad de desaturación de FA en aves alimentadas con arroz. Este novedoso y no letal método trazador reveló la capacidad de esta especie para alterar su metabolismo lipídico para compensar una contribución de lípidos en la dieta más deficiente. Debido a su versatilidad, la adaptación de este método a otros escenarios y / u otras especies migratorias se considera factible y rentable.The migrant black-tailed godwit (Limosa limosa) traditionally used natural wetlands in the Iberian Peninsula to prepare for migratory flights by feeding mainly in estuaries. In recent decades, this species has become increasingly dependent on rice fields, thereby relying on a plant-based diet for fuelling. Dietary fatty acids (FA) seem to be determinant to the composition of accumulated subcutaneous fat in migratory birds. It is still unclear whether metabolic plasticity allows for modification and/or synthesis of FA, contributing to a lipid profile that enables a successful migratory performance. Deuterated water was administered to captive black-tailed godwits submitted to two diets (fly larvae versus rice) and the incorporation of deuterium (2H) into subcutaneous triglycerides was analyzed by NMR. A recently developed localized biopsy method for sampling subcutaneous fat was employed with later successful release of all birds into the wild. The average chemical structure reflected mostly a mixture of saturated and monounsaturated 16- and 18-carbon FA, a profile frequently found in migrant birds. Significantly higher levels of polyunsaturated FA, as well as detectable levels of n-3 FA, were observed in fly-larvae-fed birds. Excess 2H-enrichments in FA revealed significantly higher rates of fractional de novo lipogenesis and FA desaturation capacity in rice-fed birds. This novel and nonlethal tracer method revealed the capacity of this species to alter its lipid metabolism to compensate for a poorer dietary lipid contribution. Because of its versatility, adapting this method to other scenarios and/or other migratory species is considered feasible and costeffective.• Fundação para a Ciência e Tecnologia. Beca SFRH / BPD / 90032/2012, para Iván Daniel dos Santos Martins Viegas • Fundação para a Ciência e Tecnologia. Beca SFRH / BD / 69238/2010, para Pedro Miguel Mendes Araujo • Fundação para a Ciência e Tecnologia. Beca SFRH / BD / 74228/2010, para Afonso D. Rocha • Fundação para a Ciência e Tecnologia. Beca SFRH / BPD / 91527/2012, para José Albino Alves • Fundação para a Ciência e Tecnologia. Proyecto de investigación EXCL / DTP-PIC / 0069/2012peerReviewe

Caracterização dos idosos internados em unidade de terapia intensiva por doença respiratória aguda / Characterization of elderly people in a unit of intensive therapy for acute respiratory disease

Introdução: Mais da metade das admissões em unidades de terapia intensiva é de indivíduos com 65 anos ou mais. Uma das principais etiologias de hospitalização e de mortalidade entre as pessoas acima dos 60 anos são as infecções do trato respiratório e suas complicações. Objetivo: Traçar o perfil clínico, sociodemográfico de idosos internados em Unidades de Terapia Intensiva por doença respiratória aguda (DRA) num Hospital Regional do Sertão da Paraíba. Métodos: Estudo de campo descritivo, documental e retrospectivo com abordagem quantitativa. A pesquisa foi realizada na Unidade de Terapia Intensiva do Hospital Regional do Sertão da Paraíba. Foram analisados 24 prontuários de pacientes admitidos no período de janeiro de 2018 a Janeiro de 2019, a partir de fichas de avaliação de prontuário. Adotou-se uma amostra não probabilística intencional baseada nos critérios de inclusão: pacientes idosos acima de 60 anos atendidos no período de janeiro de 2018 a Janeiro de 2019 com diagnóstico de doença respiratória aguda. Resultados: Constatou-se que o perfil sociodemográfico dos idosos internados UTI por (DRA) HRSP foi de pacientes com idade média de 70,52 anos, do sexo masculino, casados, de raça parda, que não informaram as suas profissões, que ficaram internados em média por 10,041 dias na UTI, que tiveram como principal diagnóstico pneumonia e que apresentaram como desfecho em 75% dos casos o óbito. Conclusão: Pode-se concluir que o índice de mortalidade encontrado nesse grupo é mais alto que o encontrado em outros estudos