O Treino de Ortostatismo (Tilt Training) Aumenta a Reserva Vasoconstritora em Doentes com Síncope Reflexa Neurocardiogénica

Neurocardiogenic syncope (NCS) is a common clinical entity resulting from an excessive reflex autonomic response, particularly during orthostatism. Treatment options are controversial and of limited effectiveness. Tilt training (TT) is a promising option to treat these patients. However, its mechanism of action and clinical impact remain unclear. OBJECTIVE: To characterize hemodynamic and autonomic responses during a TT program in patients with NCS refractory to conventional measures. METHODS: We studied 28 patients (50% male, mean age 41±14 years) without structural heart disease, with NCS documented by tilt testing. The TT program included 9 tilt sessions (3 times a week, 30 min) (60° - 6 sessions, 70° - 3 sessions), under ECG and blood pressure monitoring combined with home orthostatic self-training and 10° head-up during sleep. Systolic volume, cardiac output, total peripheral resistance, baroreflex sensitivity and heart-rate variability were computed. Patients were reassessed at 1 month and every 6 months for a maximum of 36 months (24±12 months). RESULTS: Over the course of the TT program there was a significant increase in total peripheral resistance (1485±225 vs. 1591±187 dyn·s·cm(-5), p<0.05), with a decrease in standard deviation (206±60 vs. 150±42, p<0.05). During follow-up, syncope recurred in five patients (19%), with a significant reduction in the number of episodes (4.0±3.2/patient in the 12 months before TT vs. 1.4±0.8/patient post-TT, p<0.05). CONCLUSION: In refractory NCS, TT may be an effective therapeutic option, with long-term benefits. These results appear to be due to an increase in vasoconstrictor reserve combined with a reduction in its variance

Towards e-cities. An Atlas to enhance the public realm through interactive urban cyber-physical devices

Cyber-physical devices are the backbone of a postdigital society in which the virtual and real spaces are seamlessly integrated by ubiquitous computing and networking. The incorporation of such devices in public space is a central subject of a strategic Research Project that gathers a multidisciplinary team from architecture, product design, polymer science and ICT R&D units. This paper frames the key roles of public space and ICTs for UN Sustainable Development Goals and sustainable smart cities. It also reports the architecture R&D unit review on the relations between public space, community, environment and digital interfaces. This review was materialized in an Atlas that collects, classifies and relates a corpus of heterogeneous urban cyber-physical projects case studies. We expand on three main framing concepts (Digital Twin, Interface, Awareness) and identify trends on the devices’ design and deployment strategies to counteract digitally hostile environments and early obsolescence. We also suggest the rising of new types of urban devices aiming at expanding the liveliness of urban places, the knowledge of urban life and the users’ environmental consciousness. The lessons learned from the Atlas fed the design guidelines for a developing demonstrator of a new breed of environmentally sensible interactive urban devices

Development of cellulose acetate membranes containing nanoparticles for water applications

The growth of human population and inherent activities, the improper industrialization practices, the direct addition of materials TO the waterway, and the excessive use of fertilizers containing phosphates to increase the production of crops are the main sources for the high input of phosphates in water bodies. These effects have been causing eutrophication, and bacterial contamination of the water. In fact, the bacteria present in the water can cause harmful disease, sickness or other problems to the human being. Moreover, the excess of phosphates in the aquatic system induces excessive growth of plants, which consume oxygen of the water body, thereby creating the state of hypoxia, which causes a reduction in specific fish and other animals. Therefore, the removal of phosphates from eutrophic waters and bacteria are crucial to avoid health problems, especially near urban areas[1]. The most common way to purify water is through membrane separation processes, in fact, cellulose acetate (CA) membranes have been used for reverse osmosis membranes [2] for converting impaired water into fresh-water. However, several components can be incorporated into cellulose structure to allow the development of membranes for different applications[3]. The present work aims to develop a hybrid membrane based on CA with embedded silver and/or aluminium nanoparticles, for the remediation of contaminated aquatic environments with microorganism, which can also be used for removal of water contaminated with phosphate ion. Therefore, CA membranes were obtained by solution casting, where silver and/or aluminium nanoparticles were chemical reduced in-situ. Silver nanoparticles (Ag-NPs) were synthesized using silver nitrate and sodium borohydride as reducing agent. Otherwise, aluminium nanoparticles (Al-NPs) were obtained using aluminium isopropoxide as the starting precursor in the presence of acid. The detection of Al-NPs in the membranes was carried out by FTIR spectra analysis, which showed that Al-O bonds were formed between the aluminium precursor and the CA. The study of phosphorus adsorption kinetics in membranes with embedded Al-NPs were proven to be efficient for the removal of phosphorus. This membrane showed considerable ability to remove phosphate ions from aqueous solutions at low aluminium nanoparticle content into the CA/Ag-NPs matrices. In-situ the developed membranes showed good antimicrobial behaviour preventing the growth of microorganisms. The results indicate that the synthesized CA/Ag-NPs/Al-NPs membranes could have potential to be used in the remediation of water resources

Relationship of Left Ventricular Global Longitudinal Strain with Cardiac Autonomic Denervation As Assessed by 123I-mIBG Scintigraphy in Patients with Heart Failure with Reduced Ejection Fraction Submitted to Cardiac Resynchronization Therapy: Assessment of Cardiac Autonomic Denervation by GLS in Patients with Heart Failure with Reduced Ejection Fraction Submitted to CRT

BACKGROUND: Heart failure (HF) is associated with cardiac autonomic denervation (AD), which can be non-invasively assessed by 123I-metaiodobenzylguanidine (123I-mIBG) scintigraphy and has prognostic implications. We aimed to study the relationship between myocardial contractility assessed by global longitudinal strain (GLS) and AD assessed by 123I-mIBG scintigraphy in advanced HF. METHODS/RESULTS: BETTER-HF is a prospective randomized clinical trial including HF patients (pts) submitted to cardiac resynchronization therapy (CRT) who are submitted to a clinical, echocardiographic, and scintigraphic assessment before and 6 months after CRT. 81 pts were included. An echocardiographic response (absolute increase in left ventricular ejection fraction ≥ 10%) was observed in 73.7% of pts. A higher baseline late heart-to-mediastinum ratio (HMR) was associated with a better echocardiographic response. There was a significant association between late HMR and GLS at baseline and 6 months. At baseline, GLS had an AUC of 0.715 for discrimination for a late HMR < 1.6. A GLS cut-off of - 9% maximized the likelihood of correctly classifying a pt as having severe AD (HMR < 1.6). CONCLUSION: Myocardial contractility as assessed by GLS is moderately correlated with AD as assessed by 123I-mIBG scintigraphy and has a good discrimination for the identification of severe cardiac denervation. GLS may allow for a more readily accessible estimation of the degree of AD in advanced HF pts.info:eu-repo/semantics/publishedVersio

K-Nearest Oracles Borderline Dynamic Classifier Ensemble Selection

Dynamic Ensemble Selection (DES) techniques aim to select locally competent classifiers for the classification of each new test sample. Most DES techniques estimate the competence of classifiers using a given criterion over the region of competence of the test sample (its the nearest neighbors in the validation set). The K-Nearest Oracles Eliminate (KNORA-E) DES selects all classifiers that correctly classify all samples in the region of competence of the test sample, if such classifier exists, otherwise, it removes from the region of competence the sample that is furthest from the test sample, and the process repeats. When the region of competence has samples of different classes, KNORA-E can reduce the region of competence in such a way that only samples of a single class remain in the region of competence, leading to the selection of locally incompetent classifiers that classify all samples in the region of competence as being from the same class. In this paper, we propose two DES techniques: K-Nearest Oracles Borderline (KNORA-B) and K-Nearest Oracles Borderline Imbalanced (KNORA-BI). KNORA-B is a DES technique based on KNORA-E that reduces the region of competence but maintains at least one sample from each class that is in the original region of competence. KNORA-BI is a variation of KNORA-B for imbalance datasets that reduces the region of competence but maintains at least one minority class sample if there is any in the original region of competence. Experiments are conducted comparing the proposed techniques with 19 DES techniques from the literature using 40 datasets. The results show that the proposed techniques achieved interesting results, with KNORA-BI outperforming state-of-art techniques.Comment: Paper accepted for publication on IJCNN 201

Portland cement clinker production using concentrated solar energy : a proof-of-concept approach

ABSTRACT: The aim of this work was to demonstrate the feasibility of producing Portland cement clinker upon direct exposure of the raw materials under concentrated solar radiation using the PSA high concentration solar furnace SF40. For this purpose, a short thermal cycle ( < 40 min) was devised including 5 min dwell times at temperatures in the range 900-950 degrees C and 1250-1300 degrees C, followed by 10-15 min at 1500-1550 degrees C. The chemical and mineralogical data of the grey clinker produced are encouraging since values of 51.0 +/- 6.9% C3S, 22.7 +/- 5.3% C2S, 8.6 +/- 0.4% C(3)A and 10.8 +/- 0.7% C(4)AF are similar to those observed for conventional clinker used for the production of Portland cement in accordance to EN 197-1 standard. White clinker, in turn, could not be produced by direct irradiation in this setup conditions because of its low absorptance of solar energy.info:eu-repo/semantics/publishedVersio

Effects of Vagal Stimulation on Induction and Termination of Atrial Fibrillation in an in Vivo Rabbit Heart Model

INTRODUCTION: Vagal activity is thought to influence atrial electrophysiological properties and play a role in the initiation and maintenance of atrial fibrillation (AF). In this study, we assessed the effects of acute vagal stimulation (vagus_stim) on atrial conduction times, atrial and pulmonary vein (PV) refractoriness, and vulnerability to induction of AF in the rabbit heart with intact autonomic innervation. METHODS: An open-chest epicardial approach was performed in 11 rabbits (New Zealand; 3.9-5.0 kg), anesthetized and artificially ventilated after neuromuscular blockade. A 3-lead ECG was obtained. Atrial electrograms were recorded along the atria, from right to left (four monopolar electrodes), together with a circular electrode adapted for proximal left PV assessment. Acute vagus nerve stimulation was obtained with bipolar electrodes (20 Hz). Epicardial activation was recorded in sinus rhythm, and the conduction time from right (RA) to left atrium (LA), and from RA to PVs, was measured in basal conditions and during vagus_stim. The atrial effective refractory period (ERP) and dispersion of refractoriness (Disp_A) were analyzed. Vulnerability to AF induction was assessed at the right (RAA) and left (LAA) atrial appendages and the PVs. Atrial stimulation (50 Hz) was performed alone or combined with vagus_stim. Heart rate and blood pressure were monitored. RESULTS: In basal conditions, there was a significant delay in conduction from RA to PVs, not influenced by vagus_stim, and the PV ERPs were shorter than those measured in LA and LAA, but without significant differences compared to RA and RAA. During vagus_stim, conduction times between RA and LA increased from 16+8 ms to 27+6 ms (p 10 s in 45.4% of rabbits during vagus_stim, and ceased after vagus_stim in 4 out of these 5 cases. In 3 animals, PV tachycardia, with fibrillatory conduction, induced with 50 Hz PV pacing during vagus_stim. CONCLUSIONS: Vagus_stim reduces interatrial conduction velocity and significantly shortens atrial ERP, contributing to the induction and duration of AF episodes in the in vivo rabbit heart. This model may be useful for the assessment of autonomic influence on the pathophysiology of AF