Sistema de informação de apoio à gestão da manutenção de uma frota de autocarros

Dissertação de mestrado em Engenharia Industrial (área de especialização em Gestão Industrial)A manutenção é uma actividade transversal e importante e tem uma expressão muito significativa dentro das organizações. Os recursos gastos em manutenção têm uma dimensão pouco explicitada e percebida, no entanto a sua influência nos restantes processos é essencial e decisiva. O presente trabalho incide sobre uma organização que se dedica ao transporte colectivo de passageiros, mais especificamente no seu sistema de gestão da manutenção. No actual sistema de manutenção, as decisões a nível de gestão apenas se baseiam na experiência dos seus colaboradores, privilegiando por norma soluções de curto prazo que se apresentam menos dispendiosas, mas que mais tarde se vem a revelar não terem sido as mais correctas. Torna-se perceptível a existência de uma oportunidade de melhoria e tendo em conta que esta é uma organização que tem como filosofia a melhoria contínua, o que se pretende com este projecto é que de futuro a gestão também seja fundamentada em informação proveniente da recolha e tratamento de dados, potenciando uma maior eficiência de recursos. Este documento pretende relacionar a redução de perdas na área da manutenção, com as boas práticas de gestão, tendo como recurso a informação. Neste âmbito é desenvolvido um sistema de informação de suporte à gestão da manutenção da frota de autocarros existente, baseado nas especificações do actual sistema, e na revisão bibliográfica realizada em torno das grandes temáticas que envolvem este tipo de projecto. O sistema de informação desenvolvido tem como objectivo aumentar a eficiência do sistema de manutenção, através de uma gestão suportada por informação que vai de encontro ao que são os objectivos definidos para o departamento a nível organizacional.Maintenance is an important activity that crosses all areas, having an important impact within organizations. The resources spent on maintenance has a high dimension but little explicit and perceived, and its influence on other processes is essential and decisive. The presented work refers to a study about the maintenance management system of an organization dedicated to public passenger transport. In the current maintenance system, the decisions at management level are based on experience of its employees, privileged short-term solutions that are less expensive, but reveal themselves be the least accurate. It becomes apparent that there is an opportunity for improvement and taking into account that this is an organization that has a philosophy of continuous improvement, the intended with this project is that in the future, management is based on information from the collection and data processing, increasing the efficiency of resources. This document is intended to establish a bridge between the minimization of losses related to management practices in the area of maintenance, with the use of information. Within this scope was developed an information system to support the maintenance management of the bus fleet, based on the specifications of the current system and in the literature review was a great support to this type of project. The information system developed aims to increase the efficiency of the maintenance system, through a management supported by information that goes against what are the department goals at the organizational level

Microbial consortium increases maize productivity and reduces grain phosphorus concentration under field conditions

Background:The use of microbes that improve plant phosphorus (P) use efficiency is an avenue to boostcrop yields while alleviating environmental impacts. We tested three microbial inoculants (Rhizoglomusirregularealone – designated AMF;Pseudomonas putidaalone – designated PSB; andR. irregulareandP. putidain consortium – designated AMF+PSB), combined with chemical fertilizers, in an intensive maizeagricultural system.Results:As hypothesized: (i) despite the native soil microbial community and the application of P fertil-izer, the microbial inoculants enhanced plant P uptake from the soil by 14–60%, and consequentlyimproved P acquisition efficiency; (ii) PSB and AMF+PSB plants produced ±50% more biomass per unitof P taken up, and consequently enhanced plant internal P use efficiency (i.e. the biomass producedper unit of P); and (iii) the combined inoculation of AMF and PSB provided the best results in terms ofproductivity and P use efficiency. Further, the microbial inoculants altered P allocation within the plant,reducing grain P concentration.Conclusion:By testing the microbial inoculants under field conditions, our study clearly shows that themicrobial consortium (AMF+PSB) increased maize productivity, and at the same time improved P use effi-ciency. Further, the use of these microbial inoculants was shown to be compatible with conventionalagricultural management practices.info:eu-repo/semantics/publishedVersio

Mobile video annotations: a case study on supporting rehabilitation exercises

Annotations enable us to highlight key points or add information to content presented, for instance, on paper or digital media. Even though smartphones and tablets facilitate video capturing, currently only few applications allow limited video annotations using the mobile device itself. Given that video annotations can assist many tasks that depend or can be enhanced by video capturing, in previous work we have contributed with a tool for allowing multimodal video annotation using mobile devices. Upon experimenting with the tool, we identified that reviewing rehabilitation exercise videos can be especially enhanced with video annotations. Professionals in the field of physiotherapy and occupational therapy can add relevant annotations for their patients to improve performance of their exercises. After an evaluation with a specialist in occupational therapy, we identified new requirements associated with the monitoring of patients. We then identified the opportunity to develop a monitoring system with the collaboration of two rehabilitation specialists. Since these two specialists work with mirror therapy, we defined requirements that are relevant for this type of therapy. The system was developed to support the monitoring of exercises combined with video recording and annotation capabilities. The system aims to support rehabilitation therapy by distance: therapists can monitor patients as they record videos that are sent for evaluation. We identified requirements that may be applied in many scenarios, however mirror therapy demanded many specific requirements related to the recording of videos.Coordination for the Improvement of Higher Education Personnel (CAPES)São Paulo Research Foundation (FAPESP, grant #2011/17040-0)National Council for Scientific and Technological Development (CNPq

7th Drug hypersensitivity meeting: part two

No abstract availabl

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Support system for neuromotor rehabilitation: remote monitoring model for mirror therapy

A terapia do espelho, técnica utilizada no tratamento de pacientes em reabilitação neurológica, tem mostrado bons resultados a um custo relativamente baixo. Nessa terapia, um espelho é colocado ao longo do plano sagital mediano do paciente entre os dois membros, superiores ou inferiores, com o intuito de transmitir estímulos visuais para o cérebro para induzir a ilusão dos membros em questão estarem se deslocando de forma síncrona. Considerando a simplicidade, os resultados obtidos e o baixo custo da terapia do espelho, neste trabalho exploramos recursos tipicamente disponíveis em dispositivos móveis do tipo tablet e smartphones para propor um modelo de acompanhamento remoto baseado na gravação e no compartilhamento de vídeos de sessões de terapia do espelho considerando dois tipos de usuários: terapeutas e pacientes. O modelo é apresentado na forma de um protótipo de um sistema de acompanhamento remoto de pacientes que utilizam a terapia do espelho em sua reabilitação. Especialistas avaliaram que o sistema apresenta grande potencial no auxilio à reabilitação de membros superiores, podendo ser utilizado por qualquer paciente em reabilitação pela terapia do espelho devido à sua facilidade de uso. Entre os trabalhos futuros viabilizados pela versão atual do sistema estão testes com pacientes em tratamento para verificação das implicações resultantes de sua utilização.The mirror therapy technique used in the treatment of patients in neurological rehabilitation has shown good results in a relatively low cost. In this therapy, a mirror is placed along the median sagittal plane of the patient between the two limbs, higher or lower, in order to transmit visual stimuli to the brain to induce the illusion of the limbs are moving synchronously. Considering the simplicity, the results obtained and the low cost of mirror therapy in this work we explore resources available on mobile devices like tablet and smartphones to propose a remote monitoring model based on recording and sharing videos of mirror therapy sessions considering two types of users: therapists and patients. The model is presented as a prototype of a remote monitoring system of patients that use mirror therapy in their rehabilitation. Experts evaluated that the system presents great potential to aid in the rehabilitation of the upper limbs and may be used by any patient due to its ease of use. Among the future work made possible by the current version of the system are the patients tests verifying the implications of the system in the therapy

Structural and functional differences in the brain of elderly with depressed MCI and non-depressed MCI and its relationship to Alzheimer\'s disease: a study by magnetic resonance

A doença de Alzheimer (DA) e a depressão tardia (DT) têm uma relação complexa e indeterminada. Nos estágios pré-demência, os pacientes com comprometimento cognitivo leve (CCL) apresentam sintomas relacionados à depressão com relativa frequência, e essa combinação aumenta a chance de progressão para DA. Trabalhos anteriores levantaram a possibilidade de que DT poderia ser um fator de risco para a DA ou o CCL deprimido (CCLD) poderia ser até mesmo um estágio prodrômico da DA. Neste trabalho, nosso objetivo foi usar a ressonância magnética para explorar as diferenças funcionais e estruturais no cérebro de pacientes com CCL com e sem depressão. Sessenta e cinco indivíduos foram divididos em quatro grupos: Cognitivamente Normal (CN), Comprometimento Cognitivo Leve Não Deprimido (CCLnD), CCLD e DA. Espessura cortical, volumes cerebrais e integridade da substância branca foram comparados entre os grupos a partir de dados estruturais de ressonância magnética. Também usamos dados de imagens de ressonância magnética funcional para avaliar as mudanças na conectividade funcional. Na comparação principal considerando os grupos CCLnD e CCLD em relação ao grupo CN: 1- Os pacientes com CCLD mostraram atrofia mais pronunciada nas estruturas do lobo temporal medial (hipocampo, amígdala e córtex entorrinal), e CCLnD apresentou maior perda geral de volume cortical. 2- O grupo CCLD apresentou assimetria significativa com maior dano estrutural no hemisfério direito. 3- O giro lingual e outras regiões mediais posteriores permaneceram estruturalmente preservado no grupo CCLD, porém, o giro lingual apresentou maior conectividade funcional com o hipocampo do que outros grupos, inclusive o grupo CN. Nossos resultados sugerem que o grupo CCLD mostra mudanças específicas no cérebro que não correspondem totalmente ao esperado para um estágio avançado de MCI nem um pródromo de AD, mas um subtipo de CCL que pode ser diferenciado usando neuroimagem.Alzheimer\'s disease (AD) and Late-life depression (LLD) have a complex and undetermined relationship. In pre-dementia stages, patients with mild cognitive impairment have depression-related symptoms with relative frequency, and this combination increases the chance of progression to AD. Previous work raised the possibility that LLD could be a risk factor for AD or depressed-MCI (DMCI) could even be a prodromal stage of AD. In this work, we aimed to use magnetic resonance imaging (MRI) to explore functional and structural differences in the brain of patients with MCI with and without depression. Sixty-five subjects were divided in four groups: Cognitively Normal (CN), Non-Depressed Mild Cognitive Impairment (nDMCI), Depressed-MCI, and AD. Cortical thickness, brain volumes and white matter integrity were compared among the groups from structural MRI data. We also used functional MRI data to assess changes in functional connectivity. In the main comparison considering nDMCI and DMCI groups related to CN: 1- DMCI patients showed more pronounced atrophy in medial temporal lobe structures (hippocampus, amygdala, and entorhinal cortex), and nDMCI showed more overall loss of cortical volume. 2- DMCI showed significant asymmetry with higher structural damage right hemisphere. 3- Lingual gyrus, and other medial posterior areas, remained structurally preserved in the DMCI group, however, the lingual gyrus showed higher functional connectivity with the hippocampus than other groups, including CN. Our findings suggest that DMCI shows specific changes in the brain that don\'t fully match the expected for an advanced stage of MCI neither a prodrome of AD, but an MCI subtype that can be differentiated using neuroimaging

Relationship between the Somatosensory Cortex Morphology, Cutaneous Allodynia, and Clinical Features of Patients with Migraine

Recent studies have demonstrated the presence of brain alterations in patients with migraine. Functional and vascular changes in the brain are related to the presence and severity of cutaneous allodynia. However, the association between brain structural changes and cutaneous allodynia has not been yet investigated in patients with migraine. Thus, the purpose of this study was to evaluate the correlation between the severity of cutaneous allodynia, migraine features, and the thickness and volume of the somatosensory cortex. Forty-five patients with migraine, with and without aura and chronic migraine, were included. Volunteers filled out the Allodynia Symptom Questionnaire (ASC-12/Brazil) and were evaluated via magnetic resonance imaging (MRI). The images were inspected by a blinded neuroradiologist and analyzed with Freesurfer software. Correlation tests and a linear regression model were used to evaluate the relationship among the outcomes. The somatosensory cortex thickness and volume were not different among migraine subgroups (p > 0.05). There was no significant correlation between the somatosensory thickness and volume with the ASC-12/Brazil, migraine frequency, intensity, migraine onset or aura frequency. The ASC-12/Brazil score variability cannot be predicted by the somatosensory cortex thickness or volume. The results show that the somatosensory cortex morphology is neither associated with cutaneous allodynia nor with migraine features among migraineurs