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The differential diagnosis of true aneurysms and pseudoaneurysms is challenging, and multimodality cardiac imaging is often necessary. We report a case in which the limitations of these techniques are exposed, showing that post-operative evaluation of tissue layers remains the gold standard in establishing this diagnosis. (Level of Difficulty: Beginner.), Graphical abstract

Introduction Clinical approach of cardiac aneurysms and pseudoaneurysms is significantly distinct. Therefore, it is crucial to accurately differentiate these two entities, which could be a real challenge. Case report We describe a case of a 55-year-old woman, with hypertension and previous smoking habits. She was admitted in our Cardiology Department with the diagnosis of anterior acute myocardial infarction, and was submitted to emergent coronariography, unveiling an occlusion of the middle segment of the anterior descending artery. She underwent successful primary percutaneous coronary intervention (PCI) 1h45 after the chest pain onset. Transthoracic echocardiogram (TTE) revealed depressed left ventricle ejection fraction (LVEF 30%), with akinesia of anterior and septal walls and all apical segments. She evolved in Killip-Kimbal class 2 and was discharged clinically stable. One week later, the patient performed a control TTE that showed an apical thrombus, with a small pericardial effusion, and she initiated warfarin. Three weeks later, a reevaluation TTE demonstrated a severe increase of the left ventricle dimensions, with LVEF 32%, and a small pericardial effusion. In apical 4-chambers incidence, it was visualized a linear structure (42 mm x 5 mm) attached to the endocardial border of the anterolateral apical segment and to the apical segment of the interventricular septum, of undefined nature. The apical segments were dyskinetic and had a very thin wall, which could correspond to aneurysm versus pseudoaneurysm. To clarify these findings, the patient performed a cardiac magnetic resonance revealing a large anterior myocardial infarction complicated with extensive myocardial necrosis, severe depression of LV systolic function (LVEF 25%) and septum rupture distal to the right ventricle apex (without connecting with it), compatible with a large apical pseudoaneurysm. The clinical case was discussed in the Heart Team and it was decided to perform cardiac surgery. However, surgical findings showed integrity of septal and free walls, and she underwent an aneurysmectomy, without further complications. Histological examination confirmed the presence of a thin myocardial wall with marked fibrosis and, consequently, the diagnosis of ventricular aneurysm. She was discharged clinically stable and maintains follow-up in Cardiology consultation of our Hospital. Conclusion In this patient, initially admitted with an anterior myocardial infarction submitted to primary PCI, follow-up with advanced imaging modalities pointed to the diagnosis of pseudoaneurysm. Despite the preoperative diagnosis, surgical findings were compatible with a giant left ventricular aneurysm. Even with high spatial resolution exams, postoperative evaluation of tissue layers remains the gold standard for this differential diagnosis. Abstract P871 Figure. Apical pseudoaneurysm vs aneurysm

In modern economic society, organizations competitiveness relies heavily on their ability to leverage and manage knowledge rather than in physical assets, some authors refer even though the concepts of knowledge management (KM) are being well implemented in the industrial sector, the construction segment, however, appears to have some difficulties in adopting the practices and strategies offered by KM. It is known that the construction sector (CS) is experiencing a time of instability and recession, and one of the causes of this may involve the lack of adaptation to knowledge era. Therefore, this paper, based on literature review, gives an overview of inhibitor and the facilitator factors of knowledge sharing (KS) with the objective to answer two questions: which of the KS inhibitors and facilitators characterize the CS? has the CS its specifics KS inhibitors and facilitators? Its presented a framework in order to verify the existence of exclusive factors of the sector. At this point it is possible to suggest that CS has mainly organizational factors as inhibitors and the facilitators factors are almost individual. The facilitating factors might be the consequence of an effective and successful KS strategy and can be seen as guidelines to improve the construction industry organizational performance.

Bad decisions in public procurement processes have two negative effects: price increase of public goods and services with an impact on public expenditure, and adversely effects on competition, with the negative result of loss of efficiency and social welfare. Electronic public procurement (EPP) has been considered an important tool for promoting competition, simplifying and ensuring transparency in decision-making processes, thus ensuring significant time and money gains. In Portugal, EPP replaced paper-based pre-contractual procedures for communication and processing based on information technologies and systems. Interested in this phenomenon, the authors of this paper structured the TrivPlat project, a tool of free access for monitoring, managing and evaluating electronic public procurement. This paper aims to present the TrivPlat project and its contributions to the discussion about additional efforts needed to be implemented in order to efficiently promote a more transparent and accountable governance, in the defense of public interest., This work is funded by FEDER funds through the Operational Program for Competitiveness Factors -COMPETE and National Funds through FCT -Foundation for Science and Technology under the Project: FCOMP-01-0124-FEDER-022674 and PEst-OE/CJP/UI0758/2013-14

A research work focused on studying earth render for tabique application purposes is presented. Initially, a brief description of the tabique building technique is provided. The relevance of the application of this traditional building technique is also highlighted. Different compositions of earth render are experimentally analysed and the respective performance is evaluated. Flexural and compressive strengths, workability, drying shrinkage cracking and water resistance are the material properties assessed. A simple earth render is selected as being adequate for tabique building applications and it is applied on the manufacturing of a tabique wall sample. This wall sample is monitored in terms of thermal insulation ability and its thermal transmission coefficient is estimated. Taking into account that there is still a lack of published technical information related to this topic, this paper may contribute to solve this limitation and to give some guidance in future repairing processes of tabique construction. The technological benefit of adding lime or cement with earth is researched. Real tabique timber structure samples are applied in order to validate the obtained experimental results., info:eu-repo/semantics/publishedVersion

Tabique is a traditional Portuguese building technique using timber and earth and was intensively applied until the 20th century. There is an impressive tabique heritage that requires maintenance and rehabilitation interventions. Taking into account the facts that technical and scientific publications related to this particular technique are lacking and that the technique is also applied worldwide, this research work is a very relevant one. This study aims at studying the thermal insulation behaviour of tabique walls and in particular, tabique walls coated using metal corrugated sheets and thermally reinforced with an insulation material. This type of building component is initially characterized and some building details concerning the metal corrugated sheet coating are described. An experimental work was conducted to determine the thermal transmission coefficient of the tabique wall samples. It was concluded that providing the tabique wall coated with metal corrugated sheets with a 3 cm extruded polystyrene board results in a thermal insulation improvement of 61%. These results revealed that the thermal insulation reinforcement of tabique walls is possible and it may be a straightforward building procedure because it can be achieved using the thermal insulation building materials that are currently being used. Therefore, the thermal insulation reinforcement of tabique walls seems feasible. Furthermore, the thermal insulation parameters obtained in this study are similar to the ones obtained for currently applied walls solutions in new buildings. This technical fact may provide guidance for the possibility of using solutions used in old buildings to meet the thermal comfort requirements expected in today’s times. The knowledge gained will also be useful to support future proposals of energy rehabilitation solutions. Practical implications: In this article, tabique construction and its relevance worldwide are discussed. This article highlights the building details concerning the use of metal corrugated sheet coating on tabique walls and evaluates the thermal insulation behaviour of this wall system. The outcomes indicate that it is possible to improve the thermal insulation of a tabique wall. The data obtained in this study may be valuable for repairing tabique walls and may also inspire innovative building solutions in modern industrial practice.

Literature has highlighted the potential of information and communication technology (ICT) in building new models of public governance that promote fairness and accountability, which are key requirements in the fight against corruption. In this context, it is worth mentioning the sector of public procurement, since it is one of the most sensitive concerning any corruption risk. There have been a number of investments by governments towards the implementation of public e-procurement. Portugal is referenced by the European Commission as a good example in this regard. The question that arises is whether this would have an impact on the degree of trust between the citizens and governance, i.e. regarding perception of corruption. This paper explores the theme "ICT governance and transparency in the fight against corruption - the case of public e-procurement in Portugal." Thus, the aim is to discuss the abovementioned issue with a view in developing future investigations.

Methods: Sixty one patients (57.4% men, mean age 62.7 ± 14 years) were evaluated with CU and TEE with an interval inferior to one month. CIM was measured at the common carotid artery (CCA); CP was defined as a localizaed protrusion in the arterial lumen larger than 1.5 mm, in the CCA or the internal carotid, without uniform wall involvement. AIM was measured at the aortic arch; AP was defined as a hyperechogenic area with >2 mm of thickness.

Public procurement represents the largest part of public expenditures and, for that reason, is one of the most sensitive areas regarding the risk of corruption. There are several governmental investments in this area to accomplish the principle of integrity and to achieve more transparecy. In Portugal, in the e-government context, the strategy was the adoption of electronic platforms for procurement, as the main reinforcement measure of transparency in public procurement. However, this article, through a exploratory literature review, based on OCDE recommendations and European Union official reports, this paper aims at contributing to the discussion on the use of information and communication technology, specifically electronic platforms, in Portuguese public procurement. While the gains are potentially significant, it should be noted that the implementation of the principle of integrity implies articulated measures of technological and political dimension as well as organizational culture.