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An epidemic of Coronavirus disease 2019 (COVID-19) outbroke in December 2019 in China, Wuhan, which is becoming a Public Health Emergency of International Concern. As this entity has become one of the worst infectious disease outbreaks of recent times, with mortality estimates in general population ranging from 1.4% to 8%, it is crucial to better understand the prognostic factors which can be associated to the outcome of this disease. However, as the pandemic is still unfortunately under progression, there are limited data with regard to the prognostic factors. Hence, this review seeks to gather and provide the existing data of the literature of all the prognosis factors of COVID-19 infection such as older age, obesity, comorbidities, lymphocytopenia, d-dimers elevation, thrombocytopenia, elevated levels of high-sensitivity cardiac troponin, C-reactive protein elevation and imaging features of COVID-19.

Background People living with HIV (PLHIV) are at increased risk of atherosclerotic cardiovascular disease (ASCVD) and prone to statin-related adverse events from drug-drug interactions with certain antiretroviral regimens. Objectives This study sought to evaluate the efficacy and safety of evolocumab in dyslipidemic PLHIV. Methods BEIJERINCK is a randomized, double-blind, multinational trial comparing monthly subcutaneous evolocumab 420 mg with placebo in PLHIV with hypercholesterolemia/mixed dyslipidemia taking maximally-tolerated statin therapy. The primary endpoint was the percent change (baseline to week 24) in low-density lipoprotein cholesterol (LDL-C); secondary endpoints included achievement of LDL-C Results A total of 464 patients were analyzed (mean age of 56.4 years, 82.5% male, mean duration with HIV of 17.4 years). ASCVD was documented in 35.6% of patients, and statin intolerance/contraindications to statin use were present in 20.7% of patients. Evolocumab reduced LDL-C by 56.9% (95% CI: 61.6%, 52.3%) from baseline to week 24 versus placebo. An LDL-C level of Conclusions Evolocumab was safe and significantly reduced lipid levels in dyslipidemic PLHIV on maximally-tolerated statin therapy. Evolocumab is an effective therapy for lowering atherogenic lipoproteins in PLHIV with high cardiovascular risk.

Cancer patients have higher risk of Covid-19 infection and may develop severe disease with increased mortality. Thoracic CancERs International CoVid-19 COLlaboraTion Registry (Teravolt) is a global consortium that assesses outcomes in this group of patients. -Describe TERAVOLT results in a portuguese tertiary care hospital. -Descriptive study. Patients diagnosed with COVID-19 at Centro Hospitalar Vila Nova de Gaia Thoracic Tumors Unit between march 2020 and january 2021 were included. Demographic, clinical, pathological and radiological data were collected. -31 patients: 71% males, mean age 65,2. 74,2% had non small cell lung carcinoma. Most patients had ECOG PS 1. Disease stage was diverse (IV-63%; III-18,5%; II-3,7%; I-14,8%). 77,4% presented comorbidities. 59,1% were not receiving treatment at time of COVID-19 diagnosis. Fatigue and dyspnea were the most common symptoms; 29% were asymptomatic. 41,9% were hospitalized, none was admitted to the intensive care unit. Pneumonia was the most frequent complication. Death rate was 16,1%. -Compared to TERAVOLT published results, there is a lower death rate in our population (16,1% vs. 32%). All deaths occurred in stage IV patients with ECOG PS 2-3, who were diagnosed with COVID-19 during hospitalization. The percentage of asymptomatic patients may be explained by mandatory SARS-CoV-2 PCR screening tests performed before treatments and invasive procedures. Telephonic visits, less frequent immunotherapy dosing schedules and tyrosine kinase inhibitors given for a 2-month period were implemented measures to prevent unnecessary hospital visits. Protocols regarding infection control measures and treatment options in this group of patients should be created.

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase 3 randomized trials. The EXPosurE Registry RiociguaT in patients with pulmonary hypertension (EXPERT) study was designed to monitor the long-term safety of riociguat in clinical practice. Methods: EXPERT was an international, multicenter, prospective, uncontrolled, non-interventional cohort study of patients treated with riociguat. Patients were followed for at least 1 year and up to 4 years from enrollment or until 30 days after stopping riociguat treatment. Primary safety outcomes were adverse events (AEs) and serious adverse events (SAEs) coded using Medical Dictionary for Regulatory Activities preferred terms and System Organ Classes version 21.0, collected during routine clinic visits and collated via case report forms. Results: In total, 956 patients with CTEPH were included in the analysis. The most common AEs in these patients were peripheral edema/edema (11.7%), dizziness (7.5%), right ventricular (RV)/cardiac failure (7.7%), and pneumonia (5.0%). The most common SAEs were RV/cardiac failure (7.4%), pneumonia (4.1%), dyspnea (3.6%), and syncope (2.5%). Exposure-adjusted rates of hemoptysis/pulmonary hemorrhage and hypotension were low and comparable to those in the long-term extension study of riociguat (Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase–Stimulator Trial [CHEST-2]). Conclusion: Data from EXPERT show that in patients with CTEPH, the safety of riociguat in routine practice was consistent with the known safety profile of the drug, and no new safety concerns were identified. © 2020 The Authors Eli Lilly and Company; Pfizer; Bayer; GlaxoSmithKline; Merck; Actelion Pharmaceuticals; Meso Scale Diagnostics; United Therapeutics Corporation; Novartis Pharma; Merck Sharp and Dohme; GlaxoSmithKline Australia; Deutsche Forschungsgemeinschaft; Grupo Ferrer Internacional, S.A The EXPERT registry was funded by Bayer AG (Berlin, Germany) and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc., Kenilworth, NJ, USA. The authors acknowledge the database administration by Torsten Tille, Dresden, and the project administration of Mrs Romy Hoppenz and Mrs Linda Kottke at GWT-TUD GmbH, Dresden. Medical writing services provided by Richard Murphy PhD of Adelphi Communications Ltd, Macclesfield, UK were funded by Bayer AG in accordance with Good Publication Practice (GPP3) guidelines. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Prof Marius M. Hoeper reports personal fees from Bayer AG, during the conduct of the study; personal fees from Actelion, personal fees from Acceleron, personal fees from MSD, personal fees from Jansen, personal fees from Pfizer, outside the submitted work. Dr Hans Klose reports speaker and consultancy fees from Actelion, Bayer AG, GSK, Novartis, Pfizer, and United Therapeutics and research support from Actelion, Bayer AG, GSK, Pfizer, and MSD. Dr Michael Halank reports personal fees and non-financial support from Actelion, AstraZeneca, Bayer AG, Berlin-Chemie, GSK, OMT, MSD, and Novartis. Dr George Giannakoulas reports speaker and consultancy fees from Actelion, Bayer, ELPEN Pharmaceuticals, GSK, Pfizer, Lilly, and United Therapeutics, and research support from GSK, ELPEN Pharmaceuticals, and Galenica. Dr Henning Gall has received honoraria and/or other support from Actelion, AstraZeneca, Bayer, BMS, GSK, Janssen-Cilag, Lilly, MSD, Novartis, OMT, Pfizer, and United Therapeutics. Dr Pavel Jansa reports consultancy and speaker fees from MSD, AOP Orphan, and Actelion. Prof Ekkehard Grünig reports research grants and speaker honoraria/consultancy fees from Actelion and Bayer/MSD, research grants from GSK, United Therapeutics, Bellerophon, OMT GmbH, Pfizer, Reata, and Novartis, and speaker honoraria from Bial, Medscape, and OrPha Swiss GmbH. Prof David Pittrow reports personal fees from Actelion, Bayer AG, Aspen, Boehringer Ingelheim, Sanofi, Biogen, Shire, and MSD outside the submitted work. Silvia Ulrich reports research grants and personal fees from Actelion, Bayer, MSD, and Orpha Swiss. Tobias J. Lange has received personal fees from Actelion, MSD, Pfizer, and OMT orphan. Dr Iraklis Tsangaris reports speaker and consultancy fees from Actelion, Bayer AG, ELPEN, GSK, MSD, Pfizer, and United Therapeutics. Stephan Rosenkranz reports remunerations for lectures and/or consultancy from Abbott, Actelion, Arena, Bayer, Ferrer, GSK, MSD, Novartis, Pfizer, and United Therapeutics; and research support to his institution from Actelion, Bayer, Novartis, Pfizer, and United Therapeutics. Repke J. Snijder reports grants from Pfizer and Actelion Pharmaceuticals. Prof Iveta Šimková reports consultancy and speaker fees from MSD, AOP Orphan, and Actelion. Dr Marc Humbert reports grants and personal fees from Bayer and GSK, and personal fees from Actelion, Merck, and United Therapeutics. Marion Delcroix has received investigator, speaker, consultant, and steering committee member fees from Actelion, Bayer AG, Bellerophon, Eli Lilly, GlaxoSmithKline, MSD, Pfizer, and Reata, and research grants from Actelion. Joan A. Barberà reports receipt of honoraria for consultation or speaker fees from Actelion and Merck; and research support through his institution from Actelion, Merck, GlaxoSmithKline, and Ferrer. Joanna Pepke-Zaba reports research grants and speaker honoraria/consultancy fees from Actelion, Bayer/MSD, and GSK. Jean-Luc Vachiéry reports ongoing consultancies to Actelion, Sonnivie, Arena Pharma, Bial Portela, and Respira Therapeutics, past consultancies to AstraZeneca, BayerShering, CardioMEMS, GlaxoSmithKline, Pfizer, Merck, and United Therapeutics, and current membership of an advisory board or similar group for Actelion and GlaxoSmithKline. Jean-Luc Vachiéry's institution receives funding from Actelion Pharmaceuticals for performing clinical studies. Regina Steringer-Mascherbauer, Jens Klotsche, and Miguel-Angel Gomez Sanchez have no conflicts of interest relevant to the EXPERT study. Hossein-Ardeschir Ghofrani reports personal fees for advisory board work, and payment for lectures including service on speaker bureaus, from Actelion, Bayer, GSK, Novartis, and Pfizer; consultancy fees from Actelion, Bayer, Bellerophon Pulse Technologies, GSK, MSD, Novartis, and Pfizer; and grants from Deutsche Forschungsgemeinschaft (DFG). Pilar Escribano Subias reports personal fees from Actelion, Bayer AG, GlaxoSmithKline, and Merck Sharp & Dohme, and grants from Actelion, Bayer AG, GlaxoSmithKline, and Ferrer, outside the submitted work. Gérald Simonneau reports personal fees and non-financial support from Actelion, personal fees and non-financial support from Bayer, personal fees and non-financial support from MSD, outside the submitted work. Douglas S. Helmersen reports industry-sponsored research with Bayer AG, United Therapeutics, and Gilead Sciences, Inc., and advisory board/speaker fees from Bayer AG and Actelion. David Langleben reports honoraria, consultation fees, research support, and/or travel expenses from Actelion, Arena, Bayer AG, Northern Therapeutics, PhaseBio, Acceleron, Janssen, and United Therapeutics. Anco Boonstra reports consultancy fees from Pfizer BV and hospitality from Teva Nederland. Lisa M. Mielniczuk reports speaker fees and honoraria from Bayer AG, and speaker fees, consultancy fees, and travel fees from Actelion. Evgenia Williams and Christian Meier are employees of Bayer AG.

A encefalopatia/encefalite ligeira com lesão reversível do corpo caloso é uma entidade clínico-radiológica benigna rara, caracterizada por sintomas neurológicos inespecíficos associados a achados imagiológicos, em ressonância magnética, e lesão do corpo caloso. De etiopatogénese desconhecida, têm sido sugeridos vários desencadeadores (infeções, alterações metabólicas, fármacos, entre outros). Apresenta-se o caso de um homem de 44 anos, previamente saudável, admitido na urgência com quadro súbito de cefaleias, ataxia, mioclonias da face e disartria, em contexto de síndrome gripal. Após diagnóstico presuntivo de encefalite vírica iniciou aciclovir empiricamente, suspenso após ressonância magnética revelando lesões no corpo caloso. O doente evoluiu favoravelmente sem terapêutica dirigida, com resolução clínica em menos de uma semana e controlo imagiológico, aos dois meses, normal. Esta entidade, que exige diagnóstico diferencial entre condições benignas e outras, de pior prognóstico, é habitualmente diagnosticada por exclusão, não exige terapêutica dirigida e apresenta, quase universalmente, um desfecho favorável.

The pull-based development model is widely used in source-code environments like GitHub. In this model, developers actively communicate and share their knowledge or opinions through the exchange of comments. Their goal is to improve the change under development, including its positive impact on design structure. In this context, two central social aspects may contribute to combating or adversely amplifying design decay. First, design decay may be avoided, reduced or accelerated depending whether the communication dynamics among developers - who play specific roles - is fluent and consistent along a change. Second, the discussion content itself may be decisive to either improve or deteriorate the structural design of a system. Unfortunately, there is no study on the the role that key social aspects play on avoiding or amplifying design decay. Previous work either investigates technical aspects of design decay or confirms the high frequency of design discussions in pull-based software development. This paper reports a retrospective study aimed at understanding the role of communication dynamics and discussion content on design decay. We focused our analysis on 11 social metrics related to these two aspects as well as 4 control technical metrics typically used as indicators of design decay. We analyzed more than 11k pull request discussions mined from five large open-source software systems. Our findings reveal that many social metrics can be used to discriminate between design impactful and unimpactful pull requests. Second, various factors of communication dynamics are related to design decay. However, temporal factors of communication dynamics outperformed the participant roles' factors as indicators of design decay. Finally, we noticed certain social metrics tend to be indicators of design decay when analyzing both aspects together.

This work studies the estimation of internal states and voltages in a battery pack composed by lithium-ion cells subject to limited voltage and temperature measurements. A reduced-order electrochemical model for each cell is used. The considered cells are heterogeneous. They are electrically interconnected in series and thermally coupled. The resulting model is linearized and reformulated as a descriptor system. Such a model provides a unified modeling framework accounting for both battery cell dynamics and algebraic states arising from standard Kirchhoff’s laws. An observability study is exploited to design an observable descriptor system that requires the measurement of the surface temperature of one cell together with the total voltage. We resort to Lyapunov theory and the algebraic relationship between the descriptor system states and the measurements to derive a state observer that meets the following conditions. The error system is input-to-state stable and the effect of cell-to-cell variations on a specified performance variable is minimized. The state observer is obtained by solving a set of LMIs. The proposed scheme is able to estimate the state of each individual cell, including state of charge and inner temperature, as well as the unmeasured voltages. The effectiveness of the approach is tested in simulation.

Introduction: The NELSON study included patients between 50-74 years old(y), smokers or ex-smokers for less than 10 years and had a follow-up of 6 years. Objective: Evaluate the number of patients with LC that could have been diagnosed earlier by NELSON screening and to identify the characteristics of patients without screening criteria. Methods: Retrospective observational cohort study of patients diagnosed with LC in the Pneumology-Oncology consult in 2017/2018. Results: 356 patients were included, 251(70.5%) were male,average age of 67+-11y. Most were smokers(n=142;39.9%) or ex-smokers(n=122;34.3%). Of the patients,158(44.4%) had screening criteria at the time of diagnosis and 166(46.6%) would have had screening criteria 6 years before diagnosis. In patients without criteria for screening at diagnosis,the most frequent reasons were being non-smokers(n=94;47.2%), age>74y(n=88;44.2%) and being ex-smokers for>10y(n=67;33.7%). Conclusion: Even if the Nelson screening was already implemented, most patients would not have been included but they were diagnosed in earlier stages.Although one of the objectives of a screening is cost-effectiveness, these results lead us to question whether the criteria for screening should be widened.

Background: After the FLAURA trial, it has been widely discussed which is the best treatment sequencing in EGFR+ NSCLC: start osimertinib as 1st line treatment versus initiate 1st/2nd generation tirosine-kinase inhibitor(1/2G TKI) and use osimertinib for the ones who progress with T790M+. Our aim was to identify the percentage of patients that initiated 1/2G TKI and had clinical conditions to search for the T790M mutation and to initiate osimertinib as 2nd line treatment. Methods: Retrospective study of NSCLC EGFR+ diagnosed between january/2017 and october/2019. Clinical, pathological and molecular data were analyzed. Results: Were identified 88 patients and 29 had initiated 1/2G TKI, which were mainly female (n=20-69.0%), with a median age of 70 years (40-92) and non-smoker (n=22-75.9%). From this group, 5 patients (17.2%) still maintained 1/2G TKI. Considering patients with progression (n=24), 5 patients (20.8%) did not performed the search for the T790M: best supportive care/death (n=4) and lost follow-up (n=1). The T790M was searched in nineteen patients (79.2%) (liquid biopsy and/or tumor): positive in 52.6%(n=10) and insufficient sample in 5.3%(n=1). Regarding the T790M+, 9 patients began osimertinib as 2nd line treatment. One patient had a functional status deterioration while waiting for T790M results. Conclusion: Most patients that progressed after 1/2G TKI presented clinical conditions to search for the T790M mutation. However, only 37,5% of patients had conditions/criteria to initiate osimertinib as 2nd line treatment. Therefore, these results reinforce the importance of finding predictors of T790M+, in order to identify those patients that will benefit from 1/2G TKI->T790M+>osimertinib strategy.

Tracheoesophageal fistulas (TEF) in adults can be managed either surgically or endoscopically, depending on their etiology, size, anatomy and patient comorbidities. A 68-year-old female was admitted to the ER due to dysphagia and a cough. The patient had a medical history of TEF resulting from a tracheostomy and prolonged mechanical ventilation. Previous endoscopic treatment had failed, namely 3-attempts of closure with an over-the-scope clip (OTSC®). The patient refused surgery. After a multidisciplinary discussion (Gastroenterology, Pneumology, Surgery and Interventional-Cardiology), we decided to attempt Amplatzer-Occluder® placement. An 8mm Amplatzer-Occluder® was placed from the tracheal side, with sequential opening of the esophageal and tracheal strands (under endoscopic, bronchofibroscopic and fluoroscopic visualization). Nevertheless, migration of the device occurred 8-weeks later. Percutaneous endoscopic gastrostomy (PEG) was placed and the patient was referred to surgery. When there is extensive fibrosis that is not amendable to the application of clips, atrial septal defect occluder devices can be considered to manage TEF. Nevertheless, there is a need to develop strategies to minimize migration risk.

Program refactoring consists of code changes applied to improve the internal structure of a program and, as a consequence, its comprehensibility. Recent studies indicate that developers often perform composite refactorings, i.e., a set of two or more interrelated single refactorings. Recent studies also recommend certain patterns of composite refactorings to fully remove poor code structures, i.e, code smells, thus further improving the program comprehension. However, other recent studies report that composite refactorings often fail to fully remove code smells. Given their failure to achieve this purpose, these composite refactorings are considered incomplete, i.e, they are not able to entirely remove a smelly structure. Unfortunately, there is no study providing an in-depth analysis of the incompleteness nature of many composites and their possibly partial impact on improving, maybe decreasing, internal quality attributes. This paper identifies the most common forms of incomplete composites, and their effect on quality attributes, such as coupling and cohesion, which are known to have an impact on program comprehension. We analyzed 353 incomplete composite refactorings in 5 software projects, two common code smells (Feature Envy and God Class), and four internal quality attributes. Our results reveal that incomplete composite refactorings with at least one Extract Method are often (71%) applied without Move Methods on smelly classes. We have also found that most incomplete composite refactorings (58%) tended to at least maintain the internal structural quality of smelly classes, thereby not causing more harm to program comprehension. We also discuss the implications of our findings to the research and practice of composite refactoring.

Background Syphilis remains a major challenge and a complex diagnosis. We aim to evaluate the role of polymerase chain reaction (PCR) in Treponema pallidum (Tp) detection in various types of biological samples in the diagnosis of early syphilis. Methods We conducted a cross-sectional study including all attendees of the STI clinic with clinical suspicion of early syphilis. One or more specimens for the detection of Tp by PCR testing were collected. Results The overall sensitivity of Tp PCR test was 82.61% (95% CI: 68.6-92.2%). Tp PCR test had sensitivity of 84.6% (95% CI: 54.6-98.1%) in primary syphilis cases and 81.8% (95% CI: 64.5-93%) in secondary syphilis cases. PCR test performance was independent of HIV status. Conclusion Tp PCR test is a fast and reliable method for the detection of Tp in skin lesions of early syphilis, and it is a powerful tool in clinical settings.

While most loads on wind turbines are originated from wind speed fluctuations, they show a periodic nature with a time-varying frequency proportional to the turbine rotation. This paper exploits this relation and proposes a modified Resonant Controller able to attenuate these frequency-varying periodic disturbances. The resulting controller is designed for both partial and full load wind speed conditions, therefore, it is able to reject periodic loads even when the wind turbine system is subject to changes in the operating rotation speed. Furthermore, a novel piecewise linear representation of the system is presented allowing a systematic design procedure, based on Linear Matrix Inequalities, in order to compute the control parameters. Simulation results in a 2 . 5 MW large scale three-bladed wind turbine illustrate the proposed method, which is able to reduce the root mean value of blade load up to 12 times when compared to a traditional LPV controller.

Background: Tuberculosis (TB) is a multisystemic disease and a leading cause of infectious disease-related mortality worldwide. Objectives: This study aims to characterize patients with TB in a portuguese cohort. Methods: Retrospective analysis of files pertaining inpatients with TB admitted between 1/2005 - 12/2014. Data were analysed using χ2 or Fisher exact test (p 65 (p=0.005, OR=3.34) were associated with ETB. 48 patients were HIV-infected, with median CD4 count of 74.5 cells/μL (13-136), most cases occurring in the setting of new HIV diagnosis. HIV infection was statistically associated with disseminated (OR=12.64), pleural (OR=8.50), meningeal (OR=2.96) and lymphatic TB (OR=2.38). HIV negativity was associated with pulmonary (OR=4.08) and osteoarticular disease (OR=5.42). PTB was confirmed mainly by culture or PCR test plus smear (81.3%). ETB diagnosis was more complex. Clinical outcome was favourable (PTB 98.4%; ETB 94.0%). Eight patients died. Conclusions: TB remains an important healthcare issue in Portugal. Contact with TB-infected person and smoking (PTB) and HIV infection and age > 65 (ETB), were significant risk factors. HIV infection was associated with disseminated, pleural, meningeal and lymphatic disease.

With the raising concerns for the environment, interest in monitoring air quality is likely to increase in the near future. However, most data comes from a limited number of government-owned sensors, which can only capture a small fraction of reality. Improving data coverage thus involves reducing the cost of sensors and make data widely available. For this, we will use a very high number of low-cost sensors as the basis for an air quality monitoring platform, capable of collecting, aggregating, storing and displaying data. This platform will use stream-based technologies capable of scaling for large numbers of sensors and users. The resulting NanoSen-AQM platform will provide vast amounts of air quality data to the public, with the aim of improving public health.

Introduction: Immunotherapy (IO) has improved the outcome of advanced non small cell lung cancer (NSCLC). Recent studies suggested that antibiotics use during IO can adversely affect outcomes. Methods: Retrospective review of patients with advanced NSCLC treated with IO in our department in 2018. We considered the use of antibiotics 3 months before initiation and during IO treatment. Results: 58 patients were included, mainly men (n=50; 86,2%) with a median age of 66 years. Most patients had adenocarcinoma (n=38; 65,5%) and squamous cell carcinoma (n=16; 27,6%), with stage IV at diagnosis (n=36; 62,1%) and a mean PD-L1 expression of 45%. Median number of previous lines of systemic therapies was 1. Patients were treated with pembrolizumab (33;56,9%), nivolumab (24;41,3%) and atezolizumb (1; 1,7%). Antibiotics were used in the 3 months before IO in 12 patients (20,7%) and during IO in 16 (27,6%), mainly due to respiratory infections. No statistically significant difference was found regarding best overall response to IO between patients who received antibiotics and those who did not. However, antibiotic treatment in the 3 months before IO was associated with a lower overall survival (24,9 months vs 16,6 months, p=0,006). Conclusion: These data suggests that antibiotics may reduce effectiveness of IO in lung cancer patients when prescribed up to three months before initiation of treatment. The authors intend to underscore the importance of prescribing antibiotics in lung cancer patients only when strictly necessary, especially if IO is a therapeutic option.

Introduction: We hypothesise that management of tracheal stenosis (TS) following intubation due to cardiogenic shock is particularly difficult. Methods: Retrospective study of patients with TS and history of intubation submitted to bronchoscopic procedures in a Bronchoscopy Unit, from 2014 to 2018. Patients were divided in 2 groups: I – intubation due to cardiogenic shock; II – intubation due to other causes. Clinical data was reviewed. Results: From a total of 55 patients with benign TS, 48 (87.3%) had history of intubation. Three were excluded due to missing cause of intubation. Out of 45 included patients (27 men, median age 58 years, 18 with smoking history), 13 (28.9%) matched group I and 32 (71.1%) group II. Patients’ characteristics and procedures are shown in Table 1. Group I was submitted to significantly more rigid bronchoscopies (6 vs 2, p 0.031) and mechanical dilations (5 vs 2, p 0.031) compared to group II. Discussion: Almost 30% of patients with TS were intubated due to cardiogenic shock. These patients required a higher number of endoscopic procedures, reflecting a more complex management. It would be important to identify risk factors and implement preventive strategies of tracheal injury in these at risk patients. Data: median (IQR), no. of patients (%) or no. of procedures

Introduction: Eosinophilia has been described as a related adverse effect of immunotherapy (IO) in lung cancer treatment and may be predictive of therapeutic response. Methods: Retrospective review of lung cancer patients under IO seen at Multidisciplinary Department of Thoracic Tumors of our hospital through 2018. Patients were divided in two groups depending on whether or not eosinofilia during IO. Clinically significant eosinophilia was defined by blood eosinophil count > 500/mm3. Results: From a total of 58 patients, 19 (32,8%) experienced eosinophilia during treament. 5 patients had an increase of eosinophil count before the initiation of IO that persisted during treatment. The increase of eosinophil count began, on average, after 3,4 months with a mean peak of 810/mm3. Although median OS has not yet been reached in Kaplan-Meier curves for both groups, mortality at 24 months tended to higher in patients who did not present eosinophilia (30,8% vs 21,1%, p=0,437). Conclusion: Eosinophilia during IO was associated with a better response to treatment in lung cancer patients.

The advent of open source has changed the way developers reuse software. The availability of libraries and their corresponding source code in public software repositories enables new forms of analyzing project aspects that can provide clues on their stability and maintainability. However, the literature lacks studies aiming to identify and understand whether and which repository features may correlate with the likeliness of usage of a library. In this sense, we present a factorial experiment using three different regression models - Multiple Linear Regression, Random Forest, and Neural Networks -, aiming at analyzing whether there is a correlation between library usage and a set of features extracted from release management and version control repositories. The results allowed to map features with positive learning impact, such as the number of stars, pull requests, and number of downloads, as well as features that contributed much less to the models (e.g., the repository size). Although the impact level of each feature varied from model to model, we also noticed from the analysis of regression results that the models were capable of achieving higher accuracy when considering only a subset of features. Paper category: Experimental; Language: English

Documentar o raciocínio sobre decisões arquiteturais e de implementação em mensagens de commit não é incomum. Tais mensagens são escritas em formato não-estruturado conforme o projeto é atualizado. Poder classificá-las e utilizá-las para melhorar a compreensão da arquitetura de um projeto pode trazer melhorias ao desenvolvimento. Este trabalho apresenta uma versão multiagente de um trabalho existente e propõe um modelo para um sistema autônomo de extração e classificação de commits baseada em palavras-chave de projetos definidas pelo usuário.

When creating their programs, developers usually have a preferred or standardized style of their own to write code, known as coding style. Such code is usually stored in a version control repository, through which collaborative work usually takes place. However, in such a setting, isolated attempts of standardization can lead to several coding styles coexisting in the same project, causing the opposite effect to that intended. Besides increasing the effort required to understand code, coding style conflicts may also clutter repository history as developers change existing styles to their usual preferences. To overcome this problem, we propose an approach to support the definition of a repository coding style while allowing developers to use their preferred coding style. To illustrate our approach, we built the RECoSt tool and applied it using real excerpts of a popular open source project. Our proposed approach intends to help developers keep their projects' coding style standardized without having to abandon the style they are familiar with.

The interest in the quality of air is likely to increase, as the public concern for health and environmental issues is on the rise. So far, most data available comes from a small numbers of government-owned sensors, lacking a wide coverage of the entire reality. Improving the amount of data available thus involves reducing the cost of sensors and make their readings accessible to the public. The NanoSen-AQM project aims to do precisely that. Create and use vast numbers of low-cost nano-sensors, to make their data accessible for the public. To achieve such an ambitious goal, the project will use state-of-the-art techniques from Machine Learning and mobile and web development frameworks. As a result, the NanoSen-AQM platform should provide free access to the public and low-cost of entry for sensor owners willing to share their data.

In this paper, a methodology for the synthesis of repetitive controllers to ensure periodic reference tracking and harmonic disturbance rejection is cast in a robust control framework. Specifically, the Lyapunov–Krasovskii theory is applied to derive LMI-based conditions for designing a state feedback control law with guaranteed stability and performance properties for system parameter variations. Practical experiments in commercial uninterruptible power supplies – UPS are considered to illustrate and discuss some practical implementation aspects of the proposed method.

Introduction: There is no current evidence to recommend electronic cigarettes as a smoking cessation aid. Data regarding knowledge and use of e-cigarettes among smokers seeking to quit is scarce. Methods: Between August and December 2017, current smokers attending a Smoking Cessation Outpatient Clinic completed a self-administered questionnaire about their knowledge and use of e-cigarettes. Results: A total of 116 smokers [mean (SD) 51.9 (11.6) years; 57.8% men] were included in the analysis and all had heard of e-cigarettes. Overall, 37.1% had tried e-cigarettes, and among these, 9.3% had used e-cigarettes in the past thirty days. The majority (71.3%) reported that they would not use e-cigarettes in the future to quit smoking, and 20.9% had never thought about this possibility. Tobacco was considered a constituent of e-cigarettes by 37.9%. Most (56.0%) referred that e-cigarettes contain nicotine, and only 6.9% thought that e-cigarettes may or may not contain nicotine. Less than a half (44.8%) believed that e-cigarettes could cause dependence. Among 78 (67.2%) smokers who considered that e-cigarettes might have harmful health effects, 32.9% thought that they are less harmful than conventional cigarettes. The opinion of 44.8% was that e-cigarettes could help to decrease cigarette consumption, but only 16.4% considered that they could aid to quit smoking. Discussion: In our cohort, more than a third of smokers had tried e-cigarettes, but misconceptions about these products were common. Screening for the use of e-cigarettes and discussing their potential risks and benefits might be important in intensive smoking cessation intervention programmes.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequently isolated pathogenic microorganism in hospitals in many parts of the world, including Portugal. Our hospital has started in 2015 a screening protocol for MRSA. Objectives: To identify factors that can be useful in predicting the MRSA infection. Methods: We analyzed retrospectively the data of patients hospitalized during one year in the department of Pulmonology. Regression models were conducted. Results: A total of 396 patients were enrolled in this study, including 14 (3.54%) with MRSA infection. The average patient age was 66.5±14.1 years. Multivariate analysis identified frequent hospitalizations (adjusted odds ratio [aOR]: 3.66; 95% confidence interval [CI]: 1.12-11.91) and length of hospital stay (aOR: 1.055; 95% CI: 1.02-1.09) to be independently associated to MRSA infection. Conclusions: The predictors of MRSA infection were frequent hospitalizations and length of hospital stay. Therefore, it is important to implement measures that reduce these risk factors whenever possible and reinforce hospital infection control policies.

Introduction: Urgent airways are life-threatening situations. The availability of a team with expertise in urgent airway management can be life-saving. Our hospital has a team for urgent bronchoscopic interventions outside the normal working hours of the Bronchology Unit. The team alternates every 15 days with another hospital and is on call on week days (5pm-8am) and weekend (24h). It is the referral hospital for the north of Portugal. Aims & methods: Describe the features of urgent bronchoscopic procedures performed by our team (2013-2017). Results: The team was called 178 times, corresponding to 163 patients (table1). Table1-Urgent bronchoscopic interventions9 features Conclusions: Suspected foreign body aspiration was the main indication in children. The 1st technique in most cases was FB and less than a third were converted to RB. More than a third of children required no intervention. The main indications in adults were tracheal stenosis, haemoptysis and foreign body aspiration. The large majority performed RB and only 12% required no intervention.

Introduction: Active screening for MRSA has been used in several hospitals around the world and some studies have demonstrated its impact in reducing the rate of infection by this agent. Our hospital has started in 2015 a screening protocol for MRSA. Objectives: Descriptive analysis of patients hospitalized during one year and submitted to the MRSA screening protocol. Methods: We analyzed retrospectively the data regarding the MRSA screening protocol of the patients hospitalized during one year in the department of Pulmonology. MRSA screening protocol was performed in patients with at least 1 of the following risk factors: hospitalization in high-risk units, reentry within 30 days of discharge, antibiotic therapy in the last 6 months, frequent hospitalizations, each 7 days of hospitalization, presence of invasive medical devices, presence of scaly / exudative dermatological pathology, wounds or chronic ulcers and residents of nursing homes. Results: A total of 316 patients were enrolled in this study. The mean age was 64.1±15.6 years and 179 (56.6%) were males. 170 (53.8%) patients had criteria for the admission screening test and 225 (71.2%) patients had criteria to the screening test due to a hospitalization greater than 7 days. 6 (3.5%) patients had positive screening test for MRSA at admission and 7 (4.1%) had a positive screening test during their hospital stay. In 42 (24.7%) the protocol was not performed due to a fail in protocol. 13 (4.1%) patients were submitted to decolonization. Conclusions: The MRSA screening and descolonization protocols can be useful in hospitals. However, it is necessary to make all the hospital staff aware of the strict compliance of protocols.

The advanced control of microalgal cultures usually requires the knowledge of several component concentrations, which are however not always measurable on-line. In this context, state estimation plays an important role, and software sensors should be robust to model uncertainties and measurement noise. In this study, two software sensors are designed in the form of extended Luenberger observers, using Lyapunov arguments and linear matrix inequalities (LMI). These observers are based on Droop model and a few available on-line sensors. The first observer design estimates the intracellular quota and substrate concentrations considering a linear differential inclusion modeling technique and a constant observer gain. On the other hand, the second one estimates only the intracellular quota concentration assuming uncertainties in the model parameters and a quasi-Linear Parameter Varying (quasi-LPV) representation of the nonlinear system. The results are presented considering simulated and experimental data from Dunaliella tertiolecta culture.

Metastatic lesions in the large bowel are rare. A case of single symptomatic colonic metastasis as first presentation of pulmonary mucoepidermoid carcinoma (MEC) is described. A 62-year-old male was admitted with constipation and rectal bleeding. Colonoscopy revealed extrinsic compression at sigmoid colon, and microscopy suggested a secondary origin. Subsequent chest computed tomography confirmed a right perihilar mass invading posterior mediastinum, carina and esophagus, and also a second consolidation on right lower lobe and ipsilateral mediastinal and subcarinal lymph nodes. After pathologic evaluation of a transthoracic biopsy specimen, the diagnosis of pulmonary high-grade MEC, stage IV (T4, N3, M1b - 7th ed. TNM), was established. Chemotherapy with carboplatin and paclitaxel was initiated, and disease progression occurred after two cycles with increasing colonic mass. Palliative surgery was rejected because of advanced stage, and the patient was submitted to palliative pelvic radiotherapy. Second-line chemotherapy with gemcitabine was initiated, but clinical status worsened and the patient died because of severe lung failure. Clinical, pathological and therapeutic aspects of this uncommon site of extrathoracic metastatic disease are discussed, emphasizing the important contribution of special stains and immunohistochemistry to the diagnosis.

This paper presents a framework for the multivariable robust control of perfusion animal cell cultures. It consists of a cascade control structure and an estimation algorithm, which provides the unmeasurable variables needed in the design of the control law, and ensures the regulation of the cell and glucose concentrations at imposed levels by manipulating the bleed and the dilution rates. The cascade control structure uses a feedback linearizing controller in the inner loop and linear (PI) controllers in the outer loops, and requires the measurement of the cell concentration and the glucose concentration in the bioreactor. Two approaches are provided: the first one assumes the availability of an approximate model of the process kinetics and uses an extended Kalman filter (EKF) to estimate the system states; the second approach does not require the prior knowledge of the process kinetics. These are estimated from the available measurements using sliding mode observers (SMO). A receding horizon optimization algorithm is employed to (periodically) tune the gains of the outer loop controllers. The proposed framework is easy to implement and tune, and may be applied to a general class of perfusion cell culture systems. Its effectiveness and robustness are illustrated by means of simulation results.

Alternating current (ac) active electronic loads (AELs) based on pulsewidth modulation (PWM) converters, capable of emulating nonlinear loads, require effective current control techniques and power stages. These two aspects of an AEL are interdependent mainly due to the presence of electromagnetic compatibility filters to reduce electromagnetic emissions. However, the filter components affect the dynamics of the system. In this context, this paper proposes a digitally implemented control strategy comprising the state feedback, robust observer, phase-locked loop, and linear current controller to cope with ac AEL applications. The control-oriented modeling and the control system design are presented. Experimental results obtained from a 10-kW three-phase three-level PWM converter prototype illustrate and demonstrate the feasibility of the proposed AEL control strategy.

This paper deals with the synthesis problem of multiple resonant controllers for uninterruptible-power-supply systems in a robust control framework. The controller parameters aiming the tracking of sinusoidal reference signals (with zero steady-state error) and the rejection of harmonic components of the output voltage (when supplying energy to time-varying nonlinear loads) are determined by means of a convex optimization problem subject to a set of linear-matrix-inequality constraints. Results from a 5.0-kVA experimental setup are considered to illustrate and validate the proposed approach.

Introdução: A tuberculose pulmonar pode cursar com diversas complicações. As fístulas bronco-pleuro-cutâneas consistem em comunicações anormais entre o brônquio, o espaço pleural e a pele.Caso Clínico: Apresentamos o caso de um homem, 47 anos, esquizofrénico, enviado ao Serviço de Urgência por toracalgia esquerda, tosse produtiva e emagrecimento. Apresentava-se caquético, sendo evidente um orifício cutâneo torácico latero-anterior esquerdo com drenagem purulenta, na qual o exame direto revelou bacilos ácido-álcool resistentes. A radiografia torácica evidenciava infiltrado heterogéneo bilateral. Foi internado com o diagnóstico de tuberculose pulmonar fistulizada. Na expetoração, a pesquisa de bacilos ácido-álcool resistentes foi igualmente positiva, sendo evidenciado Mycobacterium tuberculosis por reação de polimerase em cadeia e exame cultural. Iniciou terapêutica antituberculosa quádrupla apresentando evolução clínica favorável.Conclusões: A formação de fístulas bronco-pleuro-cutâneas é atualmente e em países desenvolvidos, uma complicação rara de tuberculose pulmonar. Assim, apesar da tuberculose ser frequente em Portugal, a raridade deste tipo de complicações torna pertinente a apresentação deste caso clínico.

This paper proposes a new control topology based on the simultaneous implementation of repetitive and resonant controllers to be applied to uninterruptible power supplies. The integration of the controllers is motivated by performance criteria: a good dynamic response with asymptotic tracking is provided by the resonant controller while disturbance rejection is achieved by the repetitive controller. Both strategies are based on the internal model principle, which is the underlying theoretical basis that provides performance criteria for the system. An augmented state-space representation that includes not only the plant but also the controllers is presented so that the control design may be cast in terms of linear matrix inequalities. Robust stability and performance criteria are achieved through a Lyapunov–Krasovskii funcitonal. Simulation results that illustrate the effectiveness of the proposed design are presented.

This study proposes a multiple-input/multiple-output robust approach to the control of bioprocesses based on a cascaded-loop strategy. The internal loop is a classical input-to-output feedback linearising controller which is obtained from the nominal dynamics of the bioprocess. Then, the outer loop is designed based on the internal model principle to obtain zero steady-state tracking error (and disturbance rejection) for constant signals while ensuring the robust stability of the overall closed-loop system. In addition, a robust Luenberger-like observer is proposed to estimate unmeasured state variables for the feedback linearising control law. The approach is applied to the simultaneous control of biomass and substrate concentrations in a perfusion/chemostat bioreactor, where the simulation results demonstrate the effectiveness of the proposed control strategy.

In this study, a multivariable control structure is developed to simultaneously control the concentrations of cells and of one of the nutrients in an animal cell cultivation system operated in perfusion. A cascade control structure is considered consisting of (i) an inner loop with a partially linearizing feedback controller, tuned so as to ensure robustness with respect to parameter uncertainties and non-canceled nonlinearities; and (ii) an outer loop involving two linear predictive controllers. The resulting control strategy shows robustness and performance properties similar to more computationally demanding strategies (such as a multivariable nonlinear MPC strategy), while requiring less measurements and involving an easier implementation.

In this paper, a new model for droop-controlled single-phase voltage-source inverters (VSI) is presented. This model is based on dynamic phasors and includes load, line and filters dynamics, leading to an accurate model for static and transient behavior. Moreover, a controller design method based on linear matrix inequality (LMI) constraints is proposed ensuring not only stability, but also the system performance. Simulation results are provided to demonstrate the model validity and the effectiveness of the design methodology.

Introduction: Studies reveal that among psychiatric patients the number of smokers is the double of the general population. Despite the enormous burden associated with smoking, its evaluation in these patients continues to be neglected. Aim/Methods: Evaluate outcome of an intensive smoking cessation counselling programme on psychiatric patients and its relationship with different smoking and psychiatric related variables. Observational study where all patients with psychiatric disease consecutively enrolled in our programme (January 2013-March 2015) were included. Collected data: socio-demographic variables, type of psychiatric disorder, HADS, Richmond/Fagerstrom test, smoking profile and smoking status at 6-month and 1-year follow-up. Results: 53 patients were included (mean age 52 years). Most prevalent psychiatric pathology was depression (79%) with psychopathologic stability present in 66% of patients. After 6-months and 1-year, 22 (41.5%) and 25 (47.2%) patients, respectively, abandoned the programme. Continuous abstinence was recorded in 12 (22.6%) and 15 (28.3%) patients; with other 10 (18.9%) and 5 (9.4%) reaching 50% reduction of daily cigarette consumption at 6-month and 1-year follow-up, respectively. Lack of psychopathologic stability was related with programme drop-outs at 1-year follow-up (p=0.037). No other significant relationship with our programme outcomes was found. Conclusion: Poorer outcomes among psychiatric patients may have been expected. Nevertheless, as previously reported, our 6-month and 1-year quit rates appear to be in line with those for nonpsychiatric samples. Lack of psychopathologic stability appears to be an important factor for smoking cessation success.

Uma metodologia para o projeto de controladores robustos foi desenvolvida para bioreatores operando em modo descontínuo com alimentação. Inicialmente, apresenta-se um modelo geral que descreve a dinâmica do crescimento da bactéria Escherichia Coli e da levedura Saccharomyces Cerevisiae que são atualmente os dois microorganismos mais utilizados na indústria biotecnológica. A partir do modelo dinâmico da cultura de microorganismos, busca-se projetar uma lei de controle que mantenha a concentração do produto secundário em níveis próximos a zero visando, desta forma, maximizar a produção de biomassa. Com este objetivo, a dinâmica não linear é descrita em termos de parâmetros variantes no tempo (abordagem quasi-LPV) possibilitando a utilização da formulação por desigualdades matriciais lineares para o projeto da dinâmica livre resultante da aplicação de uma lei de controle do tipo linearizante parcial. As condições propostas permitem garantir a estabilidade robusta do sistema em malha fechada frente a incertezas paramétricas, além de assegurar um certo desempenho com relação a perturbações. Para verificar o comportamento da metodologia proposta, vários testes por simulação são realizados para avaliar o comportamento da estratégia proposta em relação a trabalhos disponíveis na literatura especializada A methodology for the robust control design of a class of bioreactors operating in fed-batch mode is proposed. Firstly, a general model is presented to describe the growing dynamics of the bacteria Escherichia Coli and the yeast Saccharomyces Cerevisiae cultures, which are the most employed microorganisms applied in biotechnological industry. From this model, the paper proposes a control law that regulates the by-product concentration in small levels (i.e., close to zero) aiming to maximize the biomass concentration. To this end, the nonlinear dynamics of the bioreactor is rewritten in terms of time-varying parameters (quasi-LPV approach) in order to apply the linear matrix inequality framework for designing the free dynamics resulting from a partial feedback linearizing strategy. The proposed design conditions provide the robust stability of the closed-loop system while ensuring some performance w.r.t. disturbance signals. To verify the behavior of the closed-loop system, several simulation based tests are carried out to evaluate the controller performance against some recent strategies proposed in the specialized literature

This paper proposes a convex optimization approach for the design of robust observers applied to the control of five phase induction machines subject to rotor resistance variation and load disturbance. Based on the first and third harmonic dynamic models of the multi-phase machine, two robust observers are proposed to estimate the rotor flux components. The two observers are applied to the direct field oriented control of a five phase induction machine, where simulation results have demonstrated a high dynamic performance and robustness to parametric variations of the proposed setup.