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Most studies concerning intraoperative temporary arterial occlusion overlook the period between and after clip placement.To analyze the brain tissue oxygen tension through the process by which anterograde arterial blood flow is re-established after temporary clipping (TR).In this prospective observational study, patients who presented to surgery for middle cerebral artery aneurysms were continuously monitored with ICM+, to obtain temporal (downstream) PbtO2 levels while M1 segment temporary clips were applied and removed. PbtO2 changes were analyzed and compared with the clipping phase, and measures of exposure to hypoxia were defined and assessed during both phases and used in a model to test the impact of extending them.Eighty-six TRs (20 patients) were recorded. The mean acquired amount of time per clip release (CR) event was 336.7 seconds. Temporary clip removal produced specifically shaped, highly individual PbtO2 curves that correlated with their corresponding clipping phase events but developing slower and less consistently. The CR phase was responsible for greater cumulative exposure to hypoxia than the clip application phase through the first and second minutes of each. In our model, the duration of the TR phase was mostly responsible for the total exposure to hypoxia, and longer CR phases reduced the mean exposure to hypoxia.During the clip removal phase, the brain tissue is still exposed to oxygen levels that are significantly below the baseline, reverting through a singular, dynamic process. Therefore, it must be regarded by surgeons with the same degree of attention as its counterpart.

Emerging economies are in an almost winless situation: they would benefit from improving the extremely poor economic situation, making them self-reliant and economically productive. However, the poor fight for daily survival and, therefore, cannot afford to improve themselves. This article describes the state of the &ldquo, Grande Hotel&rdquo, in the city of Beira, Mozambique, built-in Portuguese colonial times, a real vertical shanty building that is occupied by approximately 1000 inhabitants trapped in poverty. To carry out any constructive intervention in a building or an urban complex, it is necessary to carry out a rehabilitation project that is developed based on a diagnosis of the building understudy, its main deteriorations, the causes, mechanisms of action, evolution, and possible treatments to be used for its repair. Analysis methods are necessary for the conservation of buildings since trying to stop, or correct buildings&rsquo, deterioration without a diagnosis of their problems or a prognosis on their evolution is a risky procedure with a high percentage of failure chances. The use of an appropriate methodology for diagnosing the damage present in the &ldquo, and its prediction of evolution and development should directly impact a better quality of rehabilitation projects in the neighborhood where the building is located.

Submitted by Ana Teresa Vaz Ferreira (vaz.ferreira@ipcb.pt) on 2022-01-31T16:20:01Z No. of bitstreams: 1 Abstract.pdf: 222601 bytes, checksum: 71e1bb5ac3ff7c8e43ddf35c86edcb7b (MD5) Approved for entry into archive by Carla Nabais (carlanabais@ipcb.pt) on 2022-01-31T16:33:35Z (GMT) No. of bitstreams: 1 Abstract.pdf: 222601 bytes, checksum: 71e1bb5ac3ff7c8e43ddf35c86edcb7b (MD5) Made available in DSpace on 2022-01-31T16:33:35Z (GMT). No. of bitstreams: 1 Abstract.pdf: 222601 bytes, checksum: 71e1bb5ac3ff7c8e43ddf35c86edcb7b (MD5) Previous issue date: 2022-01 info:eu-repo/semantics/publishedVersion

Improving the thermal performance of the historic building stock has the potential to revitalise these buildings and reduce the operational energy share. To achieve that, the first requirement should be to identify and clearly characterise the building stock. However, currently, there is a lack of knowledge regarding the thermal behaviour of traditional wall solutions, and, consequently, energy auditors often use assumptions and simplifications to predict it. Wrong estimations or excessive simplifications may have a severe impact on the thermal behaviour assessment and consequently on the effectiveness of the retrofitting measures. In the scope of buildings thermal comfort and energy efficiency, the thermal resistance of both the external and internal envelope is one of the most relevant parameters for the characterisation of building elements. This work investigates the in situ thermal resistance of a traditional wall solution (“tabique” wall) of a historic building located in the north region of Portugal. The Simple Hot Box - Heat Flow Meter Method (SHB-HFM), based on the procedure described in the standard ISO 9869, is considered in the present study and its applicability to heterogeneous traditional wall solutions is discussed. The importance of controlling the radiative part of the heat transfer onto the measuring sensors is highlighted, and new development to the method is proposed in this paper via the introduction of a baffle inside the SHB. Furthermore, a finite element computer model of the case study was developed in order to ensure that some important premises allowing improving the accuracy of the final results were achieved during the measurement period as well as to enhance the robustness of the obtained conclusions. The achieved results contribute to explore the applicability of the SHB-HFM to highly heterogeneous constructive solutions present in historic buildings, where the traditional HFM method may not be applicable. In addition, this research also aims to better understand the thermal behaviour of “tabique” walls, upon which the available information is scarce. The experimental measurements and numerical simulation results present a good agreement, and an R-value of 0.56 m2 °C W−1 is measured and computed.

ResumoIntrodução e objetivosA metformina é um agente amplamente usado no tratamento oral da diabetes mellitus tipo 2, considerada como terapêutica de primeira linha e usada em monoterapia ou em associação com outros fármacos antidiabéticos e com a insulina. Pela sua excreção exclusivamente renal, existem dúvidas quanto à segurança de seu uso em diabéticos com comprometimento da função renal. Esta revisão baseada na evidência pretende esclarecer a existência de valores de TFG, a partir dos quais o uso de metformina deve ser reduzido e/ou suspenso.MétodosPesquisa de normas de orientação clínica, revisões sistemáticas e estudos originais publicados em português ou inglês entre 1 de janeiro de 2000 e 31 de março de 2014 com os termos MeSH “metformin”, “glomerular filtration rate” e “chronic kidney disease”. Foi usada a Strenght of Recomendation Taxonomy (Sort) da American Family Physician para atribuição dos níveis de evidência e forças de recomendação.Resultados e conclusõesOito artigos cumpriam os critérios de inclusão (cinco normas de orientação clínica, duas revisões sistemáticas e um artigo original). Constatou‐se maior consenso quanto aos valores a partir dos quais se deve suspender a metformina em relação aos indicativos para a redução da sua dose. As guidelines internacionais e as revisões sistemáticas indicam a suspensão da metformina quando a TFG é inferior a 30ml/min (Sort A). Quanto à necessidade de ajuste da dose, em revisão sistemática, essa deve ser reduzida quando ocorre diminuição da TFG para valores inferiores a 60ml/min e a função renal monitorada a cada três meses e não se deve iniciar terapêutica de novo com metformina nesse estágio (Sort A).AbstractIntroduction and objectivesMetformin is widely used for the oral treatment of type 2 diabetes, considered first‐line therapy and used as monotherapy or in combination with other antidiabetic drugs or insulin. Because of its exclusive renal excretion, there are doubts about the safety of its use in diabetic patients with impaired renal function. This evidence‐based review aims to clarify the existence of values of GFR, from which the use of metformin should be reduced and/or suspended.MethodsSearch for clinical guidelines, systematic reviews and original studies published in English or Portuguese, between January 1, 2000 and March 31, 2014 using the MeSH terms “metformin”, “glomerular filtration rate” and “chronic kidney disease”. The Strength of Recommendation Taxonomy (Sort) by the American Academy of Family Physicians was used to assign levels of evidence and strength of recommendation.Results and conclusionsEight articles met the inclusion criteria (five clinical guidelines, two systematic reviews and one original article). There was a higher consensus about the values from which to suspend metformin compared to those from which to reduce the dosage. International guidelines and systematic reviews indicate the suspension of metformin when GFR is less than 30ml/min/m2 (Sort A). The need to adjust the dosage, in a systematic review, is indicated when GFR is decreased to less than 60ml/min/m2. The renal function should be monitored every 3 months, and therapy with metformin should not be started at this stage (Sort A).