Proposta de Implementação de Ferramentas da Qualidade num Comando Distrital de Operações de Socorro

O fenómeno da globalização e o consequente aumento da competitividade, faz com que as organizações, tanto privadas como públicas, procurem prestar um melhor serviço e/ou disponibilizar um melhor produto com menores custos. Na Proteção Civil, a estrutura de gestão assume uma importância destacada, uma vez que as ferramentas de gestão e técnicas, que possam ser utilizadas e potenciadas pelos seus colaboradores, permitem estabelecer e fortalecer a cultura organizacional. Os CDOS são um exemplo dessa organização, onde estas técnicas podem ser desenvolvidas e implementadas tendo em vista a uniformização de práticas de gestão que tenham expressão semelhante em todo o território nacional onde a ANEPC tem estruturas desconcentradas. O seu papel no contexto da dependência da ANEPC, devido ao relacionamento e interação mais próximos da sociedade civil e organismos institucionais, representa uma necessidade permanente de resolução de problemas e constrangimentos. Assim, reconhece-se como de vital importância a utilização das melhores práticas de gestão e instrumentos de melhoria contínua que permitam a resolução de problemas e identificação de oportunidades de forma participada. Neste sentido, com este trabalho académico, pretende-se refletir e implementar os indicadores assentes na perspetiva de melhoria contínua num CDOS, utilizando como estudo de caso do CDOS de Viseu. Para isso, foram estudadas rotinas diárias e dificuldades de gestão, assim como identificadas as áreas com maior necessidade de intervenção na gestão e operação para os diferentes processos, com o propósito final de complementarmente criar indicadores-chave de desempenho (Key Performance Indicators - KPI). Estes KPI apoiarão diretamente os órgãos de gestão e simultaneamente promoverão critérios de gestão e organização interna, que permitam gerir mais adequadamente os seus processos, recursos e controlar os impactos internos e externos da sua atividade.info:eu-repo/semantics/publishedVersio

Vasculitis and breast cancer: mind the hint

© 2021 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.Diffuse alveolar haemorrhage related to an anti-neutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis is an extremely rare form of presentation of breast cancer. Here we report the case of a 77-year-old woman with a histological diagnosis of a papillary ductal carcinoma of the breast presenting with a diffuse alveolar haemorrhage secondary to a perinuclear ANCA-associated vasculitis. To our knowledge, this is the first case ever reported of a diffuse alveolar haemorrhage related to an ANCA-associated small vessel vasculitis as a form of presentation of breast cancer. The therapeutic approach of this paraneoplastic vasculitis included the use of corticosteroids and plasmapheresis, a very useful technique to remove endothelial aggressors (circulating antibodies) as a strategy to earn time for a proper therapeutic decision specifically directed for disease modification, but that can also be associated with several severe adverse effects, which are illustrated in our case.info:eu-repo/semantics/publishedVersio

Osteosarcoma pathogenesis leads the way to new target treatments

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Osteosarcoma (OS) is a rare condition with very poor prognosis in a metastatic setting. Basic research has enabled a better understanding of OS pathogenesis and the discovery of new potential therapeutic targets. Phase I and II clinical trials are already ongoing, with some promising results for these patients. This article reviews OS pathogenesis and new potential therapeutic targets.info:eu-repo/semantics/publishedVersio

Avaliação neurocognitiva de doente submetida a DBS-ANT para tratamento de epilepsia refractária : contributo do núcleo anterior do tálamo na cognição

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016O tálamo tem papel activo na regulação da actividade cortical relacionada com diversas funções. Especificamente, o grupo nuclear anterior do tálamo (GNAT) aparenta participar na cognição, tendo em conta as suas aferências corticais, as suas conexões recíprocas com o cíngulo anterior e as suas eferências dirigidas para o córtex pré-frontal. A estimulação cerebral profunda do GNAT (DBS-ANT) é uma oportunidade para avaliar o efeito da modulação do GNAT sobre a cognição, permitindo comparar o desempenho dos doentes em tarefas cognitivas com o dispositivo em modo ON e OFF. Avaliou-se uma doente submetida a DBS-ANT para tratamento de epilepsia refractária através da realização de uma prova de atenção selectiva em dois períodos, um com o estimulador em modo OFF e outro em modo ON contínuo. Observou-se uma tendência para uma maior capacidade de concentração aquando da realização da prova com o dispositivo em modo ON contínuo. Não existiram, aparentemente, diferenças na resistência à fadiga ao longo da prova entre os dois períodos. A DBS-ANT poderá ter efeitos sobre a cognição, mais particularmente sobre a atenção selectiva. O desenvolvimento de um protocolo para estudar casos como este, a inclusão de um maior número de doentes, e a comparação com um grupo de controlo poderá permitir compreender melhor estes efeitos.Thalamus plays an active role in the regulation of the cortical activity associated with several functions. Specifically, the anterior nucleus of the thalamus (ANT) seems to participate on cognition, considering its cortical inputs, its reciprocal connections with the anterior cingulate and its outputs to prefrontal cortex. Deep brain stimulation of the anterior nucleus of the thalamus (DBS-ANT) is an opportunity to study the effect of the modulation of ANT on cognition, allowing the comparison of the performance of patients in cognitive tests either with the stimulator ON or with the stimulator OFF. We tested a patient undergoing DBS-ANT for the treatment of refractory epilepsy. The assessment was caracterized by a selective attention test that was completed by the patient in two periods, one with the stimulator ON and other with the stimulator OFF. We found a tendency for better capacity of concentration when the test was completed with the stimulator ON. There weren’t significant differences in the resistance to fatigue during the test between the two periods. DBS-ANT may have effects on cognition, particularly on selective attention. Developing a protocol to assess these patients, including a bigger number of patients and comparing the results with a control group could allow a better understanding of these effects

On the Relevance of Soft Tissue Sarcomas Metabolic Landscape Mapping

Soft tissue sarcomas (STS) prognosis is disappointing, with current treatment strategies being based on a "fit for all" principle and not taking distinct sarcoma subtypes specificities and genetic/metabolic differences into consideration. The paucity of precision therapies in STS reflects the shortage of studies that seek to decipher the sarcomagenesis mechanisms. There is an urge to improve STS diagnosis precision, refine STS classification criteria, and increase the capability of identifying STS prognostic biomarkers. Single-omics and multi-omics studies may play a key role on decodifying sarcomagenesis. Metabolomics provides a singular insight, either as a single-omics approach or as part of a multi-omics strategy, into the metabolic adaptations that support sarcomagenesis. Although STS metabolome is scarcely characterized, untargeted and targeted metabolomics approaches employing different data acquisition methods such as mass spectrometry (MS), MS imaging, and nuclear magnetic resonance (NMR) spectroscopy provided important information, warranting further studies. New chromatographic, MS, NMR-based, and flow cytometry-based methods will offer opportunities to therapeutically target metabolic pathways and to monitorize the response to such metabolic targeting therapies. Here we provide a comprehensive review of STS omics applications, comprising a detailed analysis of studies focused on the metabolic landscape of these tumors.publishe

Large-Area Paper Batteries with Ag and Zn/Ag Screen-Printed Electrodes

This work was partially funded by H2020-ICT-2014-1, RIA, ERC-CoG-2014, and FEDER funds through the COMPETE 2020 Program and National Funds through FCT -Portuguese Foundation for Science and Technology under the project UID/CTM/50025/2019.Large-area paper batteries have been explored in this paper, correlating electrode materials and screen printing with the electrochemical performances. The use of office paper embedded in salt solution with two electrodes performed by an easy and large-scale application technique opens doors to a new concept of energy storage. The proposed device is Li-free and uses zinc and silver powder-based screen printable pastes to deposit the electrodes. Cyclic voltammetry and charge-discharge curves reveal the performance of the produced devices using NaCl and KOH solutions in different concentrations. The simulation of electrochemical impedance spectroscopy measurements gave clue of a similar working mechanism to conventional Li-ion batteries. After charging, a single paper battery achieves 1.83 V with 60 mA/cm2 and 90.6% charge-discharge efficiency. As a proof of concept, a small paper battery and a set integrated in series and parallel were used to power a commercial red light-emitting diode.publishersversionpublishe

Immunotherapy around the Clock: Impact of Infusion Timing on Stage IV Melanoma Outcomes

Although the impact of circadian timing on immunotherapy has yet to be integrated into clinical practice, chronoimmunotherapy is an emerging and promising field as circadian oscillations are observed in immune cell numbers as well as the expression of immunotherapy targets, e.g., programmed cell death protein-1 and its ligand programmed death ligand 1. Concurrent retrospective studies suggest that morning infusions may lead to higher effectiveness of immune checkpoint inhibitors in melanoma, non-small cell lung cancer, and kidney cancer. This paper discusses the results of a retrospective study (2016-2022) exploring the impact of infusion timing on the outcomes of all 73 patients with stage IV melanoma receiving immunotherapy at a particular medical center. While the median overall survival (OS) was 24.2 months (95% confidence interval [CI] 9.04-39.8), for a median follow-up of 15.3 months, our results show that having more than 75% of infusions in the afternoon results in shorter median OS (14.9 vs. 38.1 months; hazard ratio 0.45 [CI 0.23-0.86]; p < 0.01) with more expressive impacts on particular subgroups: women, older patients, and patients with a lower tumor burden at the outset of immunotherapy. Our findings highlight the potential benefits of follow-up validation in prospective and translational randomized studies

Immunotherapy around the clock: impact of infusion timing on stage IV melanoma outcomes

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Although the impact of circadian timing on immunotherapy has yet to be integrated into clinical practice, chronoimmunotherapy is an emerging and promising field as circadian oscillations are observed in immune cell numbers as well as the expression of immunotherapy targets, e.g., programmed cell death protein-1 and its ligand programmed death ligand 1. Concurrent retrospective studies suggest that morning infusions may lead to higher effectiveness of immune checkpoint inhibitors in melanoma, non-small cell lung cancer, and kidney cancer. This paper discusses the results of a retrospective study (2016-2022) exploring the impact of infusion timing on the outcomes of all 73 patients with stage IV melanoma receiving immunotherapy at a particular medical center. While the median overall survival (OS) was 24.2 months (95% confidence interval [CI] 9.04-39.8), for a median follow-up of 15.3 months, our results show that having more than 75% of infusions in the afternoon results in shorter median OS (14.9 vs. 38.1 months; hazard ratio 0.45 [CI 0.23-0.86]; p < 0.01) with more expressive impacts on particular subgroups: women, older patients, and patients with a lower tumor burden at the outset of immunotherapy. Our findings highlight the potential benefits of follow-up validation in prospective and translational randomized studies.info:eu-repo/semantics/publishedVersio

Elaboração de um manual técnico de conceção e execução de instalações elétricas em baixa tensão

Dissertação de mestrado integrado em Engenharia Eletrónica Industrial e ComputadoresO objetivo da presente dissertação é a realização de um manual técnico para a execução e conceção de projetos de instalações elétricas. Um projeto de instalação elétrica implica, da parte do projetista, um cuidado constante em fazê-lo em conformidade com as leis e regras existentes para esse tipo de instalações. Documentos de legislação como as Regras Técnicas de Instalações Elétricas de Baixa Tensão, ou RTIEBT, terão de ser seguidos rigorosamente. A legislação nacional sofreu várias atualizações ao longo da sua existência. Por esta razão, o projetista terá de se manter atualizado. Após a apresentação do manual técnico a seguir para o cumprimento de todas as leis aplicáveis à instalação elétrica, será apresentado um exemplo. A obra em estudo será um edifício dividido em três pisos: a cave, o piso zero e o piso um. A cave será destinada ao parque de estacionamento de viaturas, o piso zero será um call-center da empresa Altice, uma multinacional de telecomunicações holandesa, e o piso um terá como finalidade uma incubadora de empresas. A obra está localizada no concelho de Vieira do Minho, distrito de Braga.This dissertation`s objective is to elaborate a technical manual to the project, exploration and the execution of electrical installations. An electrical installation implies, from the draftsman, a constant care on projecting the installations in conformity with the laws. Documents such as Regras Técnicas de Instalações Elétricas de Baixa Tensão, RTIEBT, must be strictly followed. This national legislation suffered many changes throughout its existence. For that reason, the draftsman will have to be aware of these changes. After the presentation of the technical manual, which is to be followed in order to obey to the applied laws to the electrical installation, an example of those technical laws application will be presented. The building in study has three floors: the basement, ground floor and first floor. In the basement there will be the parking lot. In the ground floor will be installed a call-center of the Altice company, a Dutch telecommunications multinational company. The building is located in Vieira do Minho, Braga’s district