Utilização de georadar na caracterização da evolução do dano estrutural de uma parede: ensaio à escala real

Ao longo do tempo o património edificado deteriora-se devido a causas naturais ou antrópicas. A acção sísmica é um factor que pode provocar danos estruturais nas paredes das construções tradicionais, por vezes até imperceptíveis à vista desarmada. A Geofísica aplicada proporciona técnicas de elevada resolução que permitem detectar alvos de pequenas dimensões, como por exemplo fendas na estrutura interna de paredes. O georadar, técnica não invasiva, utiliza impulsos electromagnéticos de frequências variando de dezenas de MHz a GHz que permitem uma elevada resolução dos meios a investigar. A utilização destas técnicas na caracterização interna de paredes exige a utilização de gamas de frequências elevadas (> 1GHz) de forma que pequenas fissuras sejam detectadas. A evolução do dano de uma estrutura tradicional de alvenaria sujeita a diferentes solicitações, como as acções sísmicas, pode ser monitorizada por medidas de georadar. Por outro lado, poderá ainda ser viável a utilização de medidas de georadar na avaliação da eficácia de soluções de reparação de fissuras por injecção de caldas. Na região de Aveiro as paredes estruturais eram tradicionalmente realizadas em adobe. Para avaliar a viabilidade da aplicação do georadar na caracterização interna destas estruturas, no Departamento de Engenharia Civil da Universidade de Aveiro foi construída uma parede em adobe, com blocos de adobe recuperados das construções existentes, e segundo as técnicas e métodos tradicionais. Esta parede foi inicialmente sujeita a uma solicitação cíclica de amplitude crescente que lhe produziu danos estruturais significativos. Estes danos foram posteriormente reparados com recurso à injecção de uma calda à base de cal hidráulica. Após reparação dos danos, a parede foi reforçada com uma malha polimérica embebida no reboco e esta foi sujeita a um ensaio cíclico de amplitude crescente até ao seu colapso. Foram recolhidos dados de georadar (1.6 GHz) sobre a parede, antes e durante o ensaio da parede reforçada, que permitiram caracterizar os danos iniciais, a eficiência da injecção da calda na colmatação das fissuras e a evolução dos danos estruturais provocados ao longo do ensaio. Os resultados são discutidos e permitem justificar plenamente a utilização do georadar na caracterização interna de estruturas de paredes. Demonstra-se que o georadar é uma ferramenta não intrusiva de elevada resolução a utilizar na avaliação do dano em construções existentes

Holocene sea level fluctuations and coastal evolution in the central Algarve (southern Portugal)

In Armação de Pêra Bay, southern Portugal, environmental changes during the Holocene can be interpreted based on the morphological and sedimentological similarities between older geomorphic features (cemented beach and dune rocks) and present coastal features. Using knowledge of the present beach and dune processes, we propose a two-step model for the evolution of Armação de Pêra Bay. First, during the rapid sea level rise between about 8800 and 6600 yr cal BP, the bay changed from a positive to a negative budget littoral cell and transgressive dunes formed, favoured by drought conditions. At about 5000 yr cal BP, during a sea level maximum, beach width was less than the critical fetch and dunes stabilized and underwent cementation during the wetter Atlantic climatic event. The second phase of dune accumulation started at about 3200 yr cal BP, due to a regression of sea level during which the bay changed back to a positive budget littoral cell in which beach width was greater than the critical fetch. Currently, the beach width is less than the critical fetch, dunes are inactive, and the sedimentary budget is negative due to sediment storage in local river systems.Fundação para a Ciência e a Tecnologia. FEDER, and OE (Project POCTI/CTA/34162/2000

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

A high resolution GPR experiment to characterize the internal structure of a damaged adobe wall

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Development of a Prognostic AI-Monitor for Metastatic Urothelial Cancer Patients Receiving Immunotherapy

Background: Immune checkpoint inhibitor efficacy in advanced cancer patients remains difficult to predict. Imaging is the only technique available that can non-invasively provide whole body information of a patient's response to treatment. We hypothesize that quantitative whole-body prognostic information can be extracted by leveraging artificial intelligence (AI) for treatment monitoring, superior and complementary to the current response evaluation methods. Methods: To test this, a cohort of 74 stage-IV urothelial cancer patients (37 in the discovery set, 37 in the independent test, 1087 CTs), who received anti-PD1 or anti-PDL1 were retrospectively collected. We designed an AI system [named prognostic AI-monitor (PAM)] able to identify morphological changes in chest and abdominal CT scans acquired during follow-up, and link them to survival. Results: Our findings showed significant performance of PAM in the independent test set to predict 1-year overall survival from the date of image acquisition, with an average area under the curve (AUC) of 0.73 (p < 0.001) for abdominal imaging, and 0.67 AUC (p < 0.001) for chest imaging. Subanalysis revealed higher accuracy of abdominal imaging around and in the first 6 months of treatment, reaching an AUC of 0.82 (p < 0.001). Similar accuracy was found by chest imaging, 5-11 months after start of treatment. Univariate comparison with current monitoring methods (laboratory results and radiological assessments) revealed higher or similar prognostic performance. In multivariate analysis, PAM remained significant against all other methods (p < 0.001), suggesting its complementary value in current clinical settings. Conclusions: Our study demonstrates that a comprehensive AI-based method such as PAM, can provide prognostic information in advanced urothelial cancer patients receiving immunotherapy, leveraging morphological changes not only in tumor lesions, but also tumor spread, and side-effects. Further investigations should focus beyond anatomical imaging. Prospective studies are warranted to test and validate our findings

Seismic retrofitting solution of an adobe masonry wall

Adobe constructions represent a high percentage of the national patrimony, with high historical, cultural and architectonic value. Well preserved adobe structures can exhibit a particular architecture with very attractive geometric characteristics while also incorporating natural materials. However, the behavior of these structures is deficient under horizontal loads, such as those induced by an earthquake, which endangers their structural integrity and human lives. To develop a seismic retrofit solution, a real-scale wall was characterized and tested by considering permanent vertical actions with cyclic horizontal forces of increasing amplitude. To retrofit the wall, repair and seismic reinforcement solutions were developed and combined to evaluate their efficiencies. To repair the damages, hydraulic lime gum was injected by pressure into the cracks. The reinforcement solution included the use of a synthetic mesh in the wall. The retrofitted wall was then tested, and the results indicated that the retrofit solutions significantly improved the seismic performance of the wall. This study contributes to the characterization of walls constructed with adobe masonry and their behavior under horizontal actions. Furthermore, an economic, sustainable and efficient solution is presented for the retrofitting of adobe walls, with significant performance improvements obtained

Prognostic Value of Deep Learning-Mediated Treatment Monitoring in Lung Cancer Patients Receiving Immunotherapy

Background Checkpoint inhibitors provided sustained clinical benefit to metastatic lung cancer patients. Nonetheless, prognostic markers in metastatic settings are still under research. Imaging offers distinctive advantages, providing whole-body information non-invasively, while routinely available in most clinics. We hypothesized that more prognostic information can be extracted by employing artificial intelligence (AI) for treatment monitoring, superior to 2D tumor growth criteria. Methods A cohort of 152 stage-IV non-small-cell lung cancer patients (NSCLC) (73 discovery, 79 test, 903CTs), who received nivolumab were retrospectively collected. We trained a neural network to identify morphological changes on chest CT acquired during patients' follow-ups. A classifier was employed to link imaging features learned by the network with overall survival. Results Our results showed significant performance in the independent test set to predict 1-year overall survival from the date of image acquisition, with an average area under the curve (AUC) of 0.69 (p < 0.01), up to AUC 0.75 (p < 0.01) in the first 3 to 5 months of treatment, and 0.67 AUC (p = 0.01) for durable clinical benefit (6 months progression-free survival). We found the AI-derived survival score to be independent of clinical, radiological, PDL1, and histopathological factors. Visual analysis of AI-generated prognostic heatmaps revealed relative prognostic importance of morphological nodal changes in the mediastinum, supraclavicular, and hilar regions, lung and bone metastases, as well as pleural effusions, atelectasis, and consolidations. Conclusions Our results demonstrate that deep learning can quantify tumor- and non-tumor-related morphological changes important for prognostication on serial imaging. Further investigation should focus on the implementation of this technique beyond thoracic imaging