Planning elective surgeries Analysis and comparison in a real case

This work focus on hospital surgical suite optimization, mainly in the efficient use of the operating rooms when planning elective surgeries. We studied a real case in a hospital in Lisbon. An integer linear programming model was developed to weekly schedule elective surgeries for the hospital surgical suite. The model was tested with real data collected from the hospital records. Non-optimal solutions obtained were improved with a simple and efficient improving heuristic. All solutions have actually improved through this process. These results were finally analyzed and compared with the ones the hospital really performed. The analysis shows that the solutions obtained by our approach improve the use of the surgical suite while respecting the conditions imposed by the hospital. The analysis also shows that the plans obtained by the proposed approach can be implemented

Turismo e desenvolvimento: o caso da Beira Interior

The Portuguese region Beira Interior strategically located in relation to Europe, in general, and to Spain, in particular, is one of the most varied regions in Portugal. Possessing a great diversity and richness concerning landscape, heritage, and culture, this region has abundant water and cynegetic resources. As potential tourism developers, these elements have to be combined in a integrated perspective within a local and regional strategy. In this context, this study aims to reassess tourism potentialities and hindrances in Beira Interior as well as to contribute, with some proposals, to its development in a sustained and integrated perspective of regional development.La région portugaise Beira Interior ayant une position géostratégique privilégiée par rapport à l 'Europe, en général, et à l 'Espagne, en particulier, c'est une des régions les plus diverses au Portugal. Détentrice d'une grande diversité et richesse en ce qui concerne le paysage, le patrimoine et la culture, cette région possêde des ressources hydriques et cynégétiques trop abondants. Ces éléments, étant des promoteurs du développement touristique, doivent faire partie d'une perspective integrée, obéissant à une strategie locale et régionale. Dans ce contexte, cette étude vise à reévaluer les potentialités et les entraves touristiques de la région Beira Interior et à contribuer, avec des propositions, à son développement dans une perspective soutenue et integrée de développement régional.A Beira Interior, com uma situação geográfica estratégica em relação à Europa, em geral, e à Espanha, em particular, é uma das regiões mais variadas de Portugal. Possuidora de grande diversidade e riqueza paisagística, patrimonial e cultural, dispõe de abundantes recursos hídricos e cinegéticos. Tais elementos, potenciadores do desenvolvimento turístico, devem ser enquadrados numa perspectiva integrada, obedecendo a uma estratégia local e regional. Neste contexto, este trabalho procura reequacionar as potencialidades e estrangulamentos turísticos da Beira Interior, e contribuir, com algumas propostas, para o seu desenvolvimento, numa perspectiva sustentada e integrada de desenvolvimento regional

Clitic omission and clitic placement in French-Portuguese bilingual children

UID/LIN/03213/2013 PD/BD/113973/2015publishersversionpublishe

Retrospective evaluation of implant-supported overdenture treatments: prosthetic complications

Objectives: The objectives of this work are to determine the prevalence of prosthetic complications in implant-supported overdentures, and to compare the maintenance needs of retentive bar-clip and independent abutment systems.Methods: Thirty-seven patients, with 43 implant-supported overdentures (23 maxillary and 20 mandibular) with different retention systems (bar-clip and independent abutments), were clinically evaluated. The total number of maintenance visits and their causes were taken from the clinical file of patients and were evaluated retrospectively. Statistical analysis was done with IBM (R) SPSS (R) vs.22.0 software, considering alpha = 0.05 and using Fisher exact test, Mann-Whitney test and Spearman correlation.Results: Treatments with implant-supported overdentures present a high frequency of prosthetic complications: substitution of retainers (79.1%), overdenture repair or rebasing (53.5%), gingival hyperplasia (34.9%), tightening or fractured screws (20.9%), replacement of the prosthesis (16.3%), changing of retentive system (9.3%) and infrastructure fracture (4.7%). There are significant associations with bar system for gingival hyperplasia and for replacing clips, and with location in the maxilla for replacement of prosthesis and retainers. There are no differences between retentive systems for the number of annual visits.Conclusions: Prosthetic long-term evaluation of treatment with implant overdentures can provide useful guidance to the dentist in the selection of the number of supporting implants, the retentive system and the design of the removable prosthesis.info:eu-repo/semantics/publishedVersio

Supervisão pedagógica e desenvolvimento profissional docente

O objetivo do presente estudo consiste em conhecer conceções, funções e papel da Supervisão Pedagógica no desenvolvimento profissional docente junto dos professores, em particular dos coordenadores de departamento, atendendo às funções de liderança que exercem. Procedeu-se   a uma investigação por inquérito com recurso a entrevista a onze coordenadores de departamento de Escolas que se destacaram positivamente no acompanhamento da prática letiva, no âmbito da Avaliação Externa de Escolas. A análise de conteúdo das entrevistas revela que a supervisão implementada inscreve-se predominantemente no modelo colaborativo sendo percecionada como promotora de aprendizagem/integração de novos saberes e competências e melhoria da prática pedagógic

Predicted and Seasonal Dynamics of Hedgerow Olive Orchard Water use in Response to Applied Water

Olive trees are usually irrigated in southern Portugal and given the area devoted to this perennial crop it represents a large demand on regional water resources. Several very intensive hedgerow (1700 to 2000 trees per ha) orchards have recently been established in the region to take advantage of the European Commission decision of allowing the expansion of Portuguese olive tree planting quota. With enhanced olive production and yield depending on irrigation, a precise estimation of transpiration (Ep) under non-limiting conditions is required to set up the upper limit of irrigation requirements and chart deficit irrigation water use. A distinct feature of Ep of olives is the tight coupling to the atmosphere, modulated by canopy conductance and vapour pressure deficit. For the hedgerow (cv. Arbequina) olive orchard of this study this was evaluated in 2012 by predicting daily Ep with the Penman-Monteith ’big leaf’ equation coupled to the Orgaz et al. (2007) model of bulk daily canopy conductance (Gc) for unstressed canopies (PM-model). Dynamics of predicted Ep were compared to daily Ep field values obtained from sap velocity data from a regulated deficit irrigation (treatment A) and a sustained deficit irrigation (treatment B). Daily Ep at the stand scale (mm/day) was obtained by dividing tree transpiration by the area of tree planting (3.75 × 1.35m). Tree rows were supplied with water by a single drip irrigation line serviced by 2.3 (treatment A) and 1.6 l h!1 (treatment B) emitters, respectively, spaced 0.75 m apart throughout the entire length of the emitter row lines. The PM-model effectively simulated and traced out the seasonal variability of Ep, validating the model’s applicability to hedgerow orchards in southern Portugal. Results show that transpiration of treatment A trees was not limited by water availability except at pit hardening, from end of June to the end of July, when the regulated deficit was applied as convenient for this low sensitive period to water stress. Conversely, tree transpiration of treatment B was limited by water availability throughout the irrigation season, from mid June to the end of September. Evolution of midday stem water potential and stom- atal conductance corroborated the seasonal dynamics of Ep for both treatments, suggesting a good irrigation supply for treatment A and a sustained deficit irrigation for treatment B. A total of 296 mm of irrigation water was applied to treatment A (1st June to September 30th) for an equivalent amount of 206 mm to treatment B. Cumulative tree Ep for the same period and treatment was 320 and 185 mm, respectively, while rainfall was 29.4 mm. The 30% difference in irrigation water application resulted in stem leaf water (ψst) differences between treatments. Also from June onward, treatment B midday leaf stomatal conductance (gs) quickly declined to lower values then treatment A, never re- covering and stayed rather flat and low throughout September. Results seem to indicate that the PM equation coupled to the Orgaz et al. (2007) model of bulk daily canopy conductance is capable of predicting irrigation requirements for unstressed olive canopies. Furthermore, in association with continuous tree sap flow velocity measurements, it can be used to set up the upper limit of irrigation requirements and chart deficit irrigation applications in hedgerow olive orchards of cv. Arbequina in southern Portugal

Cancro ginecológico – protocolos de diagnóstico e terapêutica

O Instituto Português de Oncologia de Francisco Gentil – Centro Regional Oncológico de Lisboa S.A acolhe anualmente cerca de mulheres portadoras de Cancro Ginecológico. O Serviço de Ginecologia tem, desde a sua criação, fomentado a existência de um Grupo Multidisciplinar dos Tumores Ginecológicos que engloba não só os Ginecologistas como Oncologistas Médicos, Radioterapeutas Oncológicos, Anátomo-Patologistas, Imagiologistas e outros Especialistas com competência em Oncologia Ginecológica. A Comissão de Protocolos de Diagnóstico e de Terapêutica é a emanação prática desta filosofia. Assim, a revisão e actualização dos Protocolos elaborados por esta Comissão e agora publicados traduzem a metodologia usada no Serviço e baseiam-se nos protocolos de Instituições Oncológicas Internacionais de referência e na experiência acumulada na nossa Instituição, considerando a capacidade técnica e meios materiais existentes. Pretendem, tanto quanto possível, uniformizar procedimentos e agilizar a colaboração com todas as Instituições que nos referenciam as suas doentes, tendo como fim último o tratamento correcto do Cancro Ginecológico, com um aproveitamento racional dos recursos humanos e técnicos

Water use, transpiration and crop coefficients for irrigated hedgerow olives grown in Southern Portugal

Olive trees are well adapted to the Mediterranean-type agro-ecosystems of southern Portugal and have traditionally been cultivated in areas with no irrigation. According to the 2009 agricultural census, the olive tree cultivation area was around 336,000 ha, of which 164,000 ha are in the southern province of Alentejo. In this southern region of semi arid Mediterranean climate where the erratic annual precipitation of around 300 to 550 mm is not enough to fulfil crop water requirements when needed, summer irrigation is a necessity to prevent crop water stress and ensure profitable yields. Hundreds of high and also very high tree-density hedgerow orchards of the Spanish cultivar Arbequina have recently been established in the region to take advantage of the European Commission decision 2000/406/CE (Official Journal L 154, 27/06/2000 P. 0033-0033) that allowed the expansion of Portuguese olive tree planting quota to 30,000 ha of new orchards. With enhanced olive production and yield depending on irrigation water supply and management, estimating hedgerow olive orchard water uptake in southern Portugal and appropriately scheduling irrigation have since been the primary concern of researchers, farmers and water resources managers. The objective of this study was to establish relationships between olive transpiration and crop transpiration coefficients of very high tree-density hedgerow orchard grown in Alentejo under well-irrigated treatment A (3.05 mm d-1) and sustained deficit irrigation treatment B (2.12 mm d-1) regimes, to understand and improve their irrigation management. On both treatments, daily transpiration at the stand scale (mm day-1) was obtained by sap flow and by dividing the tree transpiration by the area of the planting pattern. The results were compared to the daily outputs obtained with the Penman-Monteith “big leaf” equation coupled with the Orgaz et al. (2007) specific model of bulk daily canopy conductance (Gc) for unstressed olive canopies. With the Willmott index of agreement IA and the root-mean-square error RMSE above 0.8 and below 0.4 mm d-1, respectively (Willmott, 1982), the synthetic model proved sufficiently precise to be used as an appropriate simulation tool for predicting olive stand transpiration for the region. Crop and stress transpiration coefficients were proposed for both treatments

Microaerophilic growth characteristics of Pseudomonas aeruginosa importance to the successful treatment of chronic infections in cystic fibrosis lungs

Patients with CF lung disease are susceptible to chronic infections by various pathogens, such as Pseudomonas aeruginosa. This pathogen is able to adaptat to the environment in CF lungs, characterized by inflammatory defences, oxygen restriction, and poor nutrient availability. It is well established that, once P. aeruginosa infection is installed in the lungs, it is almost impossible to eradicate, due to sophisticated genotypic and phenotypic adaptation mechanisms that develop according to the stage of infection. Understanding those changes and the identification of specific characteristics that allow P. aeruginosa eradication before the onset of chronic infection is urgent. In this work, P. aeruginosa adaptation under microaerophilic and anaerobic conditions was assessed in terms of phenotypic charatceristics, antibiotic susceptibility and expression of antibiotic resistance mechanisms (mexAB operon). Results showed, when compared with aerobic conditions, similar growth and emergence of intermediate resistance profiles for ciprofloxacin and imipenem, but no significant variation in operon mexAB expression. It was also observed an increase of colony morphotypes with the decrease of oxygen availability, mainly in 5% O2. Nevertheless oxygen depletion has no significant effect on P. aeruginosa growth and mexAB expression, affecting, however, the phenotypic characteristics and antibiotic susceptibility profiles. Despite the overall observations, the microaerophilic environment with 5% O2, seems to demonstrate a transient distinct behaviourwhich can be a point of evolution into chronic infection and as such a possible treatment target

Automatic miniaturized flow methodology with in-line solid-phase extraction for quinine determination in biological samples

The present work describes an analytical platform based on a multipumping flow injection analysis (MPFS) technique combined with in-line solid-phase extraction (SPE). The flow network has been tested with the determination of quinine in biological samples using fluorometry as the detection technique. Amberlite XAD-4 resin has been used as a solid phase and the implementation of a pH control strategy resulted in a simple and environmental approach for the preconcentration of quinine. Two solenoid valves allowed the deviation of the flow towards the resin column to carry out SPE procedures. The influence of parameters such as concentration, flow rate and volume of the different solutions on the sensitivity and performance of the MPFS was studied. Dynamic calibration ranges (0.78–150 ng mL 1) for quinine determination were applied by using a variable sample volume (120– 1000 mL). The developed methodology provided high relative extraction recoveries from human urine samples (85–115%). The proposed automatic methodology turns out to be very efficient and sustainable compared to the available procedures and it could prove to be an attractive alternative tool to perform in-line sample pre-treatment and subsequent direct determination of relevant organic compounds in pharmaceutical and clinical analyses