Development of a Computational Tool for the Analysis of Hydro-Sanitary Designs

The high demand for hydro-sanitary designs to be analyzed by the public system, in addition to the long time it takes to complete such analyses, reveals that the employed verification methodology and bureaucratic procedures are obsolete. The main objective of this work was to develop a computational tool for releasing and analyzing hydro-sanitary systems, seeking to automate the process. The methodology was initiated with the creation of an electronic archive of the rules and laws pertinent to the subject, followed by the identification of the work routines for hydro-sanitary designs, the programming of the tool, the creation of an electronic repository for objects and, finally, the validation of the software through testing. As a result, the computational model will automatically retrieve project data in the BIM platform and assess information of designs developed in CAD. Based on this work, the conclusion can be drawn that the automation of the release and analysis processes of hydro-sanitary designs is possible and achievable

Interpreting neurologic outcomes in a changing trial design landscape: An analysis of HeartWare left ventricular assist device using a hybrid intention to treat population

Randomized controlled trials can provide optimal clinical evidence to assess the benefits of new devices, and it is these data that often shape device usage in real-world practice. However, individual clinical trial results sometimes appear discordant for the same device, and alternative devices are sometimes not employed in similar patient populations. To make sound evidence-based decisions, clinicians routinely rely on cross-trial comparisons from different trials of similar but not identical patient populations to assess competing technology when head-to-head randomized comparisons are unavailable

A clinical risk score for prediction of stent thrombosis.

The aim was to develop a clinically useful patient risk score predictive for stent thrombosis (ST). Using readily available baseline clinical and angiographic characteristics, a Cox proportional hazards multivariate model was used to identify significant (p28 mm, moderate to severe lesion calcification, and reference vessel diameterhigh, indicated by an area under the receiver-operator characteristic curve of 0.819. Stratification of patients into low-, medium-, and high-risk groups showed that ST developed in 0.8% of patients with a scoreor=14. In conclusion, using 8 readily available clinical and angiographic characteristics, we defined an ST risk score for patients receiving a DES during the first year. Analysis of patients from ARRIVE 1 and 2 showed that most (73%) were in the lowest risk category, with 25% in the moderate risk category. Less than 2% were at highest risk of developing ST

An Analysis of Driveline Infections with Left Ventricular Assist Devices Utilizing Carbothane versus Pellethane Driveline Sheaths

Purpose: Strategies underlying the use of Left ventricular assist devices (LVAD) for patients with end-stage heart failure include its use as bridge to transplant (BTT) or as destination therapies (DT). Survival outcomes of patients undergoing these LVAD implant strategies were evaluated and compared. Methods: A retrospective analysis of single center database heart transplant patients that received LVADs from Nov. 2009 to Sep. 2020 (n=137). Patients were placed into the following cohorts based on the implant strategy: 1) BTT (n=31), 2) DT (n=106). Demographics were compared between groups for significance. Kaplan Meier curves were calculated and compared via log rank tests, and Cox Regression Analysis was performed. P-values \u3c0.05 was considered significant. Results: Demographics between the groups were: diagnosis (p=0.257), CPB time (p=0.957), XC time (p=0.763), ischemic time (p=0.478), warm ischemic time (p=0.332), age (p=0.323), race (p=0.067), length of stay (p=0.355) and PRA (p=0.701). Of 137 patients that received LVADs used for BTT or DT prior to heart transplant, the BTT group had better survival outcomes than DT (p=0.0467). Median survival time for DT group was 2554 days, and median survival time for BTT group was 3030 days. The type of LVADs used between the two groups were significantly different (p=0.0009), therefore cox regression was run to control for statistically significant variables, with device showing no significant effect on survival. In cox regression BTT had a protective effect over DT with a hazard ratio of 1.439, p=0.0364. Conclusion: Implant strategies for LVAD as BTT or DT show a difference in survival outcomes for end-stage heart failure patients, however both had reasonable outcomes. This paper supports the current literature in that LVADs are viable for use in patients of all types, with slightly better effects in BTT patients

An Analysis of Post-Implant Severe Right Heart Failure in Real-World Use of the HeartWare (TM) HVAD (TM) System in Destination Therapy

Purpose: Patients with the HeartWare HVAD require careful medical management in order to maintain an INR within therapeutic range (2-3) and prevent thrombotic events. We compared the incidence of epistaxis in patients with the HVAD and HeartMate 3 using propensity score matching (PSM). Methods: Ninety-eight patients implanted with a left ventricular assist device (LVAD) from 2015-2020 were included in this study. Patients were matched on the basis of baseline characteristics, including age, gender, body mass index (BMI), indication, etiology, concomitant procedures, and the right ventricular assist device (RVAD) usage. Results: To our knowledge, this is the first study to perform a PSM comparison of epistaxis events in patients with the HVAD and HeartMate 3. After matching, there were no significant differences in any of the baseline characteristics between groups ( P \u3e0.05 for all). Patients with the HVAD were more likely to suffer from epistaxis than HeartMate 3 patients (43% vs 18%, P = 0.027), an absolute risk increase of 25% (95% CI 5.7-44.3%) and a number needed to harm of 4 patients (95% CI 2.3-17.6). In both the univariate and multivariate analyses, HVAD usage was significantly associated with epistaxis ( P \u3c0.05). Independent predictors of epistaxis were found to be HVAD usage (OR 3.39, 95% CI 1.13-11.15, P = 0.034) and out of range INR at discharge (OR 7.16, 95% CI 2.46-23.09, P \u3c0.001). Out of range INR was also associated with a significantly longer length of stay ( P = 0.01). Between patients with the HVAD and those with the HeartMate 3, there were no significant differences in length of stay, survival, and whether INR at discharge was in therapeutic range ( P \u3e0.05 for all). Conclusion: Patients with the HVAD may be at a greater risk for developing epistaxis than those with the HeartMate 3. However, other outcomes such as length of stay and survival are comparable. Prospective, multi-center studies should be done to accurately assess the impact of device type on clinical outcomes following LVAD implantation

A Clinical Risk Score for the Prediction of Very Late Stent Thrombosis in Drug Eluting Stent Patients

AIMS: Very late stent thrombosis (VLST; \u3e1 year) is an infrequent but potentially serious complication, whose risk factors have not been fully elucidated. This investigation sought to develop a clinically useful risk stratification score for VLST following drug eluting stent (DES) placement. METHODS AND RESULTS: A Cox proportional hazards multivariate model of VLST was developed based on follow-up into a second year of patients enrolled in the ARRIVE registries, utilising readily available baseline clinical and angiographic characteristics. ST predictors between one and two years were identified among 7,459 consecutively enrolled patients who received a TAXUS® Express2™ (Boston Scientific, Natick, MA, USA) DES. Six significant predictors were found: presence of renal disease, prior myocardial infarction, multiple stenting, bifurcation lesions, prior CABG, and smoking at baseline. Each predictor was assigned a score, then summed for a maximum possible score of 10. Stratification into low and high risk groups revealed that VLST developed in 0.5% of 6,759 patients with score

A framework to select innovations in patents to improve temporary edge protection systems in buildings

This article presents a selection method of existing innovations in patents that propose improvements in Temporary Edge Protection Systems (TEPS). The method was divided into three stages. In stage 1, records were collected related to TEPS from the patent filing databases of the Instituto Nacional da Propriedade Industrial (National Institute of Industrial Property, Brazil), the United States Patent and Trademark Office and the European Patent Office. In stage 2, patents were selected based on the TEPS evaluation protocol created by Peñaloza, Formoso and Saurin (2017), which examines safety, efficiency and flexibility criteria. In stage 3, four patents were selected among the 20 patents found related to guard rails and three related to protection nets. Based on the results, one invention stands out that uses hollow posts in protection barriers, which allows for modular movement with safety and flexibility. The framework proposed in this research is a useful resource for disseminating techniques included in TEPS patent databases

Análise da produção científica brasileira sobre a Modelagem da Informação da Construção

A difusão acadêmica da Modelagem da Informação da Construção (BIM) no Brasil configurou-se em um relevante vetor de crescimento na última década. Entretanto, embora seu acervo indique robustez, constata-se o escasso monitoramento da produção científica nacional. Devido à falta de apropriação de indicadores de desenvolvimento e aos entraves na identificação de lacunas de conhecimento dos estudos já realizados, observa-se ausência de diretrizes que condicionem novas investigações. Nesse âmbito, o presente trabalho tem como objetivo analisar a produção científica brasileira sobre BIM no país. Trata-se de uma pesquisa exploratória de caráter bibliográfico que apresenta o levantamento da produção científica brasileira em um intervalo temporal definido entre 2000 e 2015. Por meio do uso de indicadores bibliométricos e cientométricos, as contribuições geradas destacam (i) a evolução temporal da produção bibliográfica e de formação de recursos humanos; (ii) os níveis de produção bibliográfica por pesquisador e produção de formação de pesquisadores por região e instituição; (iii) as palavras-chave mais utilizadas; e (iv) os métodos científicos empregados em dissertações e teses. Analisa-se, dessa forma, o perfil evolutivo da produção científica no Brasil