Analysis and verification of process variables as causes for macroinclusions and scrapping in a special steel melt shop

The technology used in manufacturing steel for mechanical constructions has made great progress in recent years, resulting in a remarkable reduction of the impurities in special steel. One of these impurities is known as macroinclusion, the presence of which can cause serious defects in the steel structure. In a melt shop, where the semi-finished product is formed, there are several variables that can cause the formation of impurities in the steel and must be controlled. Therefore, by analyzing the influence of the primary melt shop variables, including: the iron and manganese oxides of the ladle slag (FeO+MnO), the stopper rod level variation and the argon pressure in the shroud between ladle and tundish in continuous casting; it was possible to establish a relationship between scrap generation and these process variables, through the creation of an investigation method. As result it was possible to identify the scrapping relationship with the presence of high FeO and MnO contents in the slag, during ladle furnace starting operations, along with stopper rod level variation in the tundish

Exploratory study on sequestration of some essential metals by indigo carmine food dye

Índigo carmim forma complexos estáveis com diferentes íons e a constante de estabilidade dos complexos foi avaliada como log K igual 5,75; 5,00; 4,89 e 3,89, respectivamente, para os complexos com os íons Cu(II), Ni(II), Co(II) e Zn(II) em solução tampão carbonato 0,1 mol L-1, pH 10. A interação entre o íon Cu(II) e índigo carmin (IC) em meio alcalino resultou na formação do complexo Cu2(IC) monitorado por método espectrofotométrico, com razão estequiométrica entre o índigo carmim e o íon metálico de 2:1 (metal-ligante). O método relatado também tem sido testado com sucesso para determinação de cobre em compostos farmacêuticos à base de cobre-gliconato sem qualquer pré-tratamento.Indigo carmine forms a stable complex with different ions, and the stability constant of the complexes were evaluated as log K equal to 5.75; 5.00; 4.89 and 3.89 for complexes with Cu(II), Ni(II), Co(II) and Zn(II) ions, respectively, in 0.1 mol L-1 carbonate buffer solution at pH 10. The interaction between Cu(II) ions and indigo carmine (IC) in alkaline medium resulted in the formation of the Cu2(IC) complex, measured by the spectrophotometric method, with a stoichiometric ratio between indigo carmine and metal ions of 2:1 (metal-ligand). The reported method has also been successfully tested for determination of copper in pharmaceutical compounds based on copper-gluconate without pre-treatment

Longitudinal study of patients with chronic Chagas cardiomyopathy in Brazil (SaMi-Trop project): a cohort profile.

PurposeWe have established a prospective cohort of 1959 patients with chronic Chagas cardiomyopathy to evaluate if a clinical prediction rule based on ECG, brain natriuretic peptide (BNP) levels, and other biomarkers can be useful in clinical practice. This paper outlines the study and baseline characteristics of the participants.ParticipantsThe study is being conducted in 21 municipalities of the northern part of Minas Gerais State in Brazil, and includes a follow-up of 2 years. The baseline evaluation included collection of sociodemographic information, social determinants of health, health-related behaviours, comorbidities, medicines in use, history of previous treatment for Chagas disease, functional class, quality of life, blood sample collection, and ECG. Patients were mostly female, aged 50-74 years, with low family income and educational level, with known Chagas disease for >10 years; 46% presented with functional class >II. Previous use of benznidazole was reported by 25.2% and permanent use of pacemaker by 6.2%. Almost half of the patients presented with high blood cholesterol and hypertension, and one-third of them had diabetes mellitus. N-terminal of the prohormone BNP (NT-ProBNP) level was >300 pg/mL in 30% of the sample.Findings to dateClinical and laboratory markers predictive of severe and progressive Chagas disease were identified as high NT-ProBNP levels, as well as symptoms of advanced heart failure. These results confirm the important residual morbidity of Chagas disease in the remote areas, thus supporting political decisions that should prioritise in addition to epidemiological surveillance the medical treatment of chronic Chagas cardiomyopathy in the coming years. The São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) represents a major challenge for focused research in neglected diseases, with knowledge that can be applied in primary healthcare.Future plansWe will continue following this patients' cohort to provide relevant information about the development and progression of Chagas disease in remotes areas, with social and economic inequalities.Trial registration numberNCT02646943; Pre-results

Towards a reusable architecture for message exchange in pervasive healthcare

The main objective of this paper is to present a reusable architecture for message exchange in pervasive healthcare environments meant to be generally applicable to different applications in the healthcare domain. This architecture has been designed by integrating different concepts and technologies of ubiquitous computing, software agents, and openEHR archetypes, in order to provide interoperability between healthcare systems. The architecture was demonstrated and evaluated in controlled experiments that we conducted at three cardiology clinics, an analysis laboratory, and the cardiology sector of a hospital located in Marília (São Paulo, Brazil). Three applications were developed to evaluate this architecture, and the results showed that the architecture is suitable to facilitate the development of healthcare systems by offering generic and powerful message exchange capabilities. The reusable architecture speeds up the development of new applications, reducing the number of mistakes and the development time. The proposed architecture facilitates message exchanging between caregivers, contributing in this way to the development of pervasive healthcare systems that allow healthcare to be available anywhere, anytime, and to anyone

Potencialidades y limitaciones del desempeño de las enfermeras en el Centro Parto Normal

Objective: To know the potentialities and limitations of the nurse’s performance in the Center for Normal Birth (CPN). Method: Qualitative approach, exploratory-descriptive type, carried out in 2018, with six nurses working in public intra-hospital CPN in the metropolitan region of Fortaleza, Ceará, Brazil. The collection of information occurred through individual interview, with analysis from the assumptions of the sociology of professions, focusing on the themes: knowledge and autonomy; credentialism; division of labor; labor market and value chart. Result: The nurse’s performance in the Center for Normal Birth (CPN)enhances good practices for childbirth and birth, as well as increases the importance and visibility of this professional in maternal and child care. Clinical care and management emerge as the focus of the nurse’s action in the CPN. However, even with the induction of the State to this action, there is still the need for recognition of the competencies and autonomy of the nurse in obstetric care by other professionals. Conclusion and implications for practice: There are challenges that need to be overcome such as the expansion of autonomy and respect for the accreditation of the nurse to work in the CPN and the harmonization between the management of the work process and management of clinical care by this professional.Objetivo: Conhecer as potencialidades e limitações da atuação do enfermeiro no Centro de Parto Normal (CPN). Método: abordagem qualitativa, do tipo exploratório e descritivo, realizado em 2018, com seis enfermeiras atuantes em CPN intrahospitalar público na região metropolitana de Fortaleza, Ceará, Brasil. A coleta das informações ocorreu por meio de entrevista individual, com análise a partir dos pressupostos da sociologia das profissões, com foco nos temas: conhecimento e autonomia; credencialismo; divisão do trabalho; mercado de trabalho e quadro de valores. Resultado: A atuação do enfermeiro no CPN potencializa as boas práticas para o parto e nascimento, bem como amplia a importância e visibilidade deste profissional no cuidado materno-infantil. O cuidado clínico e a gestão emergem como foco da ação do enfermeiro no CPN. No entanto, mesmo com a indução do Estado para essa atuação, ainda há a necessidade de reconhecimento das competências e autonomia do enfermeiro no cuidado obstétrico por outros profissionais. Conclusão e implicações para a prática: Há desafios que precisam ser superados como a ampliação da autonomia e do respeito ao credenciamento do enfermeiro para atuação no CPN e a harmonização entre a gestão do processo de trabalho e gestão do cuidado clínico por este profissional.Objetivo: Conocer las potencialidades y limitaciones del desempeño de la enfermera en el Centro de Parto Normal (CPN). Método: Enfoque cualitativo, del tipo exploratorio-descriptivo, realizado en 2018, con seis enfermeras que trabajan en el CPN intrahospitalario público en la región metropolitana de Fortaleza, Ceará, Brasil. La recopilación de información se realizó mediante una entrevista individual, con análisis basado en los supuestos de la sociología de las profesiones, centrándose en los temas: conocimiento y autonomía; credencialismo; división del trabajo; mercado de trabajo y tabla de valores. Resultado: El desempeño de la enfermera en la CPN mejora las buenas prácticas para el parto y el nacimiento, así como aumenta la importancia y la visibilidad de este profesional en el cuidado de la madre y el niño. El cuidado clínico y la gestión surgen como el foco de la acción de la enfermera en la CPN. Sin embargo, incluso con la inducción del Estado a esta acción, sigue siendo necesario que otros profesionales reconozcan las aptitudes y la autonomía de la enfermera en la atención obstétrica por otros profesionales. Conclusión e implicaciones para la práctica: Hay desafíos que deben superarse, como el aumento de la autonomía y el respeto de la acreditación de las enfermeras para trabajar en la CPN y la armonización de la gestión del proceso de trabajo y la gestión de la atención clínica por parte de este profesional.info:eu-repo/semantics/publishedVersio

Gamma knife radiosurgery for vestibular schwannomas: evaluation of planning using the sphericity degree of the target volume

This study explores the possibility of a relationship between the sphericity degree of a target volume with the dose distribution. This relationship is evaluated based on the ratio isodose volume / target volume (IV/TV) and the metrics coverage, i.e., selectivity, gradient index, conformity index and mean dose when planning radiosurgery for vestibular schwannoma. Methods: Sphericity degree (φ) was calculated for each target volume (TV) of 64 patients who underwent stereotactic radiosurgery (SRS) for vestibular schwannoma. The calculation of this parameter was developed using the theoretical definition for operational sphericity φ = VP/VCS. The values found are evaluated considering the following metrics:-Coverage (C), selectivity (S), gradient index (GI), Paddick conformity index (CIPaddick) and dose distribution (IV/TV). The planning was also carried out considering a spherical target volume defined in a spherical phantom. The spherical volume is the same as the target used in the treatment plan. The planning of the spherical target was considered as a reference plan to evaluate the dose distribution inside and outside the volume. Results: It was possible to observe that the majority of target volumes has (.) around 0,66.0,77, corresponding to 54,7% of the total. Considering the mean values for metrics, the results are: C = 0,98, S = 0,78, GI = 3,11 and CI = 0,81. The dose distribution was equivalent for treatment plans and reference plans. Quantitative analysis for IV/TV shows that these values are higher than 30% for treatment plans where shot density is large. Conclusion: This study demonstrates that de sphericity degree (φ) can be related to the dose distribution (IV/TV). Therefore the sphericity degree is a good parameter to evaluate the dose distribution of a plan for vestibular schwannoma treatment, considering the reference plan as being a spherical target using a leksell gamma knife® perfexion (LGKP). This study shows that the sphericity degree offers important information of the dose distribution outside and inside the target volume. This is not evaluated by the other parameters already implemented as metric to analyzing the GKP plans15

Progressão da fibrose hepática em portadores de coinfecção HIV/vírus da hepatite C com níveis de aminotransferases normais

INTRODUCTION: Approximately 30% of hepatitis C virus (HCV) monoinfected patients present persistently normal alanine aminotransferase (ALT) levels. Most of these patients have a slow progression of liver fibrosis. Studies have demonstrated the rate of liver fibrosis progression in hepatitis C virus-human immunodeficiency virus (HCV-HIV) coinfected patients is faster than in patients infected only by HCV. Few studies have evaluated the histological features of chronic hepatitis C in HIV-infected patients with normal ALT levels. METHODS: HCV-HIV coinfected patients (HCV-RNA and anti-HIV positive) with known time of HCV infection (intravenous drugs users) were selected. Patients with hepatitis B surface antigen (HBsAg) positive or hepatitis C treatment before liver biopsy were excluded. Patients were considered to have a normal ALT levels if they had at least 3 normal determinations in the previous 6 months prior to liver biopsy. All patients were submitted to liver biopsy and METAVIR scale was used. RESULTS: Of 50 studied patients 40 (80%) were males. All patients were treated with antiretroviral therapy. The ALT levels were normal in 13 (26%) patients. HCV-HIV co-infected patients with normal ALT levels had presented means of the liver fibrosis stages (0.77±0.44 versus 1.86±1.38; p<0.001) periportal inflammatory activity (0.62±0.77 versus 2.24±1.35; p<0.001) and liver fibrosis progression rate (0.058±0.043 fibrosis unit/year versus 0.118±0.102 fibrosis unit/year) significantly lower as compared to those with elevated ALT. CONCLUSIONS: HCV-HIV coinfected patients with persistently normal ALTs showed slower progression of liver fibrosis. In these patients the development of liver cirrhosis is improbable.INTRODUÇÃO: Aproximadamente, 30% dos portadores de hepatite crônica C apresentam níveis de aminotransferases persistentemente normais (APNL). A maioria destes pacientes tem lenta progressão da fibrose hepática. Em portadores de coinfecção VHC-HIV, estudos têm demonstrado que a progressão da fibrose hepática é mais rápida que a observada em indivíduos infectados somente pelo VHC. Há poucos estudos que verificaram as características histológicas da hepatite crônica C em pacientes coinfectados pelo HIV APNL. MÉTODOS: Portadores de coinfecção VHC-HIV (HCV-RNA e anti-HIV positivos) com tempo de infecção pelo VHC conhecido (uso de drogas intravenosas) foram selecionados. Aqueles com hepatitis B surface antigen (HbsAg) positivo ou que tenham sido submetidos à terapia antiviral para hepatite C antes da biópsia hepática foram excluídos. Pacientes com pelo menos 3 determinações normais da ALT nos últimos 6 meses antes da biópsia hepática foram considerados como tendo APNL. Todos foram submetidos a biópsia hepática que foi classificada de acordo com a escala METAVIR. RESULTADOS: Foram incluídos 50 pacientes, 40 (80%) homens. Todos receberam terapia antirretroviral. Os níveis de ALT foram persistentemente normais em 13 (26%) pacientes. Pacientes coinfectados com APNL apresentaram menor média dos estágiosde fibrose hepática (0,77±0,44 versus 1,86±1,38; p<0,001), dos índices de atividade inflamatória periportal (0,62±0,77 versus 2,24±1,35; p<0,001) e progressão mais lenta da fibrose hepática (0,058±0,043 unidades de fibrose /ano versus 0,118±0,102 unidades de fibrose/ano) quando comparados àqueles com aminotransferases elevadas. CONCLUSÕES: Portadores de coinfecção VHC-HIV com APNL apresentam progressão mais lenta da fibrose hepática. Nesses pacientes o desenvolvimento de cirrose hepática é improvável.Universidade Federal de Juiz de Fora Centro de Referência em Hepatologia Departamento de GastroenterologiaUniversidade Federal de Juiz de Fora Unidade de Endoscopia DigestivaUniversidade Federal de São Paulo (UNIFESP) Divisão de Gastroenterologia Seção de HepatitesUNIFESP, Divisão de Gastroenterologia Seção de HepatitesSciEL

An architecture for message exchange in pervasive healthcare based on the use of intelligent agents

Aims: This paper proposes an architecture for the exchange of context-aware messages in Pervasive Healthcare environments.\ud \ud Materials and methods: In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime, and to anyone. Ubiquitous Computing technologies allow efficient and safe information exchange amongst caregivers and their patients in communities, homes and hospitals. Since health systems may offer their health records in various electronic formats, the openEHR foundation has proposed a dual model to achieve semantic interoperability between such systems. Intelligent Agents is a technology that has been applied to simulate human skills in healthcare procedures. This architecture is based on technologies from Ubiquitous Computing and Intelligent Agents, and complies with the openEHR dual model.\ud \ud Results: This architecture was demonstrated and evaluated in a controlled experiment that we conducted in the cardiology department of a hospital located in the city of Marília (São Paulo, Brazil).\ud \ud Conclusion: An application was developed to evaluate this architecture, and the results showed that the architecture is suitable for facilitating the development of healthcare systems by offering generic resources and powerful solution to integrate these systems