Segurança nos trabalhos de betonagem em estaleiro

Os acidentes de trabalho na construção continuam a ser uma trágica realidade em Portugal, sendo grande parte das fatalidades resultantes de quedas em altura e esmagamento. Os trabalhos de betonagem de elementos estruturais de edifícios continuam a expor os trabalhadores da construção a riscos que podiam ser evitados, ou minorados, e a contribuir para a elevada sinistralidade neste sector de actividade. Numa análise efectuada aos métodos de trabalho e equipamentos de protecção, actualmente utilizados durante as betonagens, foi possível constatar algumas insuficiências. Neste trabalho aborda-se esta problemática e apresentam-se soluções de prevenção para os riscos profissionais, desenvolvidas no âmbito de um projecto de investigação em curso

Collaborative care model versus usual care for the management of musculoskeletal and co-existing mental health conditions: a randomised feasibility mixed-methods study.

This study aimed to assess the feasibility of a future trial comparing the collaborative care model with usual care for patients with musculoskeletal conditions and co-existing symptoms of anxiety and depression. A single-centre, parallel-arm, one-to-one, randomised controlled trial design using a mixed-methods approach was used. semistructured interviews and focus groups were conducted post intervention with all participants and staff respectively to explore acceptability towards the model and identify recommendations for improvements. An orthopaedic rehabilitation outpatient tertiary hospital. Adult patients with musculoskeletal conditions and co-existing moderate or severe symptoms of anxiety and depression attending outpatient therapy appointments. The collaborative care model consisted of a tailored management programme to facilitate the integration of care provided by physical and mental healthcare professionals. A case manager screened and coordinated targeted mental health support for participants. Participants allocated to usual care had no support from the case manager. Feasibility indicators (rates of recruitment, randomisation and retention), acceptability of clinical outcome measures, usage of additional resources and cost of intervention implementation. Of the 89 patients who provided consent to take part, 40 participants who matched the eligibility criteria were randomised to either the intervention (n=20) or usual care arm (n=20). Overall adherence to the intervention was 58.82%, while the withdrawal rate was 37.5% at 6 months. All of the 27 participants who were retained completed self-reported outcomes. Qualitative data highlighted that integrated mental health support was favourably perceived. In addition to prenegotiating protected psychology time, the need for operationalised communication between the case manager and clinicians was identified as a recommendation for a future trial. The trial and intervention were acceptable to patients and healthcare professionals. While the findings demonstrate the feasibility of trial recruitment, a future trial will require optimised retention strategies to improve adherence and withdrawal rates. NCT05018039. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

pH influence on oxygen mass transfer coefficient in a bubble column. Individual characterization of kL and a

Experiments were performed in a laboratory scale bubble column (10 L), to investigate the pH influence on oxygen mass transfer coefficient, in order to achieve a better control of biological processes. The liquid-side mass transfer coefficient, kL, and the specific interfacial area, a, were studied individually. The specific interfacial area was obtained using the new automatic image analysis technique developed by Ferreira et al. (2012). The pH was changed by the addition to the system of the most common acids and base used in biological process: hydrochloric acid (HCl), phosphoric acid (H3PO4) and potassium hydroxide (KOH). The results show that aqueous systems containing HCl, H3PO4 or KOH present lower volumetric liquid side mass transfer coefficient, kLa, in relation to pure systems (distilled water), this decrease being not linear. It was found that the specific interfacial area presents higher values in KOH and HCl solutions in comparison with distilled water. However, an opposite behavior was observed in the liquid-side mass transfer coefficient values. The kL behavior on the impure systems was explained based on bubble surface contamination. Higbie's and Fröessling's equations were adapted in the present work in order to be used in bubble dispersion systems

The use of non-standard CT conversion ramps for Monte Carlo verification of 6 MV prostate IMRT plans

Monte Carlo (MC) dose calculation algorithms have been widely used to verify the accuracy of intensity-modulated radiotherapy (IMRT) dose distributions computed by conventional algorithms due to the ability to precisely account for the effects of tissue inhomogeneities and multileaf collimator characteristics. Both algorithms present, however, a particular difference in terms of dose calculation and report. Whereas dose from conventional methods is traditionally computed and reported as the water-equivalent dose (Dw), MC dose algorithms calculate and report dose to medium (Dm). In order to compare consistently both methods, the conversion of MC Dm into Dw is therefore necessary. This study aims to assess the effect of applying the conversion of MC-based Dm distributions to Dw for prostate IMRT plans generated for 6 MV photon beams. MC phantoms were created from the patient CT images using three different ramps to convert CT numbers into material and mass density: a conventional four material ramp (CTCREATE) and two simplified CT conversion ramps: (1) air and water with variable densities and (2) air and water with unit density. MC simulations were performed using the BEAMnrc code for the treatment head simulation and the DOSXYZnrc code for the patient dose calculation. The conversion of Dm to Dw by scaling with the stopping power ratios of water to medium was also performed in a post-MC calculation process. The comparison of MC dose distributions calculated in conventional and simplified (water with variable densities) phantoms showed that the effect of material composition on dose-volume histograms (DVH) was less than 1% for soft tissue and about 2.5% near and inside bone structures. The effect of material density on DVH was less than 1% for all tissues through the comparison of MC distributions performed in the two simplified phantoms considering water. Additionally, MC dose distributions were compared with the predictions from an Eclipse treatment planning system (TPS), which employed a pencil beam convolution (PBC) algorithm with Modified Batho Power Law heterogeneity correction. Eclipse PBC and MC calculations (conventional and simplified phantoms) agreed well (<1%) for soft tissues. For femoral heads, differences up to 3% were observed between the DVH for Eclipse PBC and MC calculated in conventional phantoms. The use of the CT conversion ramp of water with variable densities for MC simulations showed no dose discrepancies (0.5%) with the PBC algorithm. Moreover, converting Dm to Dw using mass stopping power ratios resulted in a significant shift (up to 6%) in the DVH for the femoral heads compared to the Eclipse PBC one. Our results show that, for prostate IMRT plans delivered with 6 MV photon beams, no conversion of MC dose from medium to water using stopping power ratio is needed. In contrast, MC dose calculations using water with variable density may be a simple way to solve the problem found using the dose conversion method based on the stopping power ratio

Desempenho da cultivar de soja BRS 285 no Estado de Mato Grosso do Sul.

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A Hybrid-Telerehabilitation Versus a Conventional Program for Urinary Incontinence: a Randomized Trial during COVID-19 Pandemic

Introduction and hypothesis This study aimed to compare the effectiveness of a hybrid telerehabilitation program with a traditional face to face model in women with stress urinary incontinence (SUI) and mixed incontinence (MUI) with a predominance of SUI. The authors hypothesized that home pelvic floor muscle training (PFMT) would have a similar benefit to outpatient PFMT. Methods Parallel randomized controlled trial including 58 patients consecutively admitted to a tertiary academic hospital for pelvic floor rehabilitation consultation from 1 January to 30 April 2021 for conservative treatment of UI. Participants randomized to the intervention were submitted to a 12-week PFMT program: (1) a hybrid telerehabilitation program of two individual face-to-face sessions followed by 2-weekly sessions of video-telerehabilitation with a follow-up by a specialized physiotherapist, including one individual face-to-face session at 8 weeks; (2) a re-evaluation teleconsultation at 6 and 16 weeks; (3) a face-to-face consultation at 12 weeks. The control group had two initial individual sessions followed by twice-weekly group classes, and consultations were face to face. The primary outcome measure (at baseline and 12 weeks) was UI-related quality of life using the Portuguese Version of the King's Health Questionnaire. Results At baseline the intervention (n = 18) and control (n = 17) groups were similar. UI-related quality of life significantly improved in both the intervention and control groups betweenbaseline (T0) and the end of the 12-week PFMT program (T12) (p = 0.002, p < 0.001, respectively), although the magnitude of the improvement was not significantly different between groups (–10.0 vs. –9.5 points, p = 0.918, respectively). Conclusion This hybrid telerehabilitation protocol showed effectiveness comparable to the traditional model in improving UI-related quality of life. Trial registration at www.ClinicalTrials.gov, no. NCT05114395

Extracellular matrix in skin diseases: the road to new therapies

"Article in Press"Background: The extracellular matrix (ECM) is a vital structure with a dynamic and complex organization that plays an essential role in tissue homeostasis. In the skin, the ECM is arranged into two types of com- partments: interstitial dermal matrix and basement membrane (BM). All evidence in the literature sup- ports the notion that direct dysregulation of the composition, abundance or structure of one of these types of ECM, or indirect modifications in proteins that interact with them is linked to a wide range of human skin pathologies, including hereditary, autoimmune, and neoplastic diseases. Even though the ECMâ s key role in these pathologies has been widely documented, its potential as a therapeutic target has been overlooked. Aim of review: This review discusses the molecular mechanisms involved in three groups of skin ECM- related diseases - genetic, autoimmune, and neoplastic â and the recent therapeutic progress and oppor- tunities targeting ECM. Key scientific concepts of review: This article describes the implications of alterations in ECM components and in BM-associated molecules that are determinant for guaranteeing its function in different skin dis- orders. Also, ongoing clinical trials on ECM-targeted therapies are discussed together with future oppor- tunities that may open new avenues for treating ECM-associated skin diseases.This work was supported by ERC Consolidator Grant – ECM_INK (ERC-2016-COG-726061) (A. P. Marques and FCT with grant SFRH/ BD/137766/2018 (M. D. Malta) and contract from Norte-01-0145- FEDER-02219015 (M. T. Cerqueira)