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Vessel tracking systems data, namely the Vessel Monitoring System (VMS), developed for fisheries control, and the Automatic Identification System (AIS), developed to promote safety at sea, when taken in conjunction with e-logbooks and sales notes constitute an important contribute for the knowledge of the spatial activity of the fishing fleets, allowing for an improved management of commercial fisheries. This is even more relevant for fishing activities carried out in large EEZs or at the high seas where available data is insufficient to support evidence-based management measures towards sustainable fisheries. This paper summarizes the results obtained from mapping the spatiotemporal dynamics of two Portuguese commercial fleets targeting highly migratory pelagic species in the Northeast Atlantic between 2012 and 2018. The results show a clearer and more accurate global picture of the seasonal and spatial pressure footprint exerted by these open-sea fisheries.

Background and Aims With the geriatric population increasing, the patients reaching stage 5 chronic kidney disease (CKD) are older, frailer and have multiple comorbidities. Technological advances in renal replacement therapy (RRT) and easier access to dialysis resulted in an expansion on geriatric dialysis population. Conservative management (CM) is an option that should be considered in this population, where is crucial to balance the survival and quality of life. Beside mortality, with this study we aim to evaluated patient-outcomes (hospitalization, falls and functional capacity) in older and frailer stage 5 CKD patients receiving hemodialysis (HD) and in CM. Method We conducted a single center retrospective study in older (≥ 75years), frailer (Clinical Frailty Scale – CFS ≥ 5) and with multiple comorbidities (modified Charlson comorbidity index – mCCI ≥ 5 and) stage 5 CKD patients, admitted in our Nephrology department between January 1, 2014 to December 31, 2020. The eGFR was calculated through Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI) at the time of decision or at the time of starting HD. The comorbidities were stratified using the mCCI and frailty was assessed with CFS at the time of decision in CM group (CMG) and at the start of HD (HDG). We evaluated hospitalizations, falls, CFS one-year later and survival in each group. Survival analysis was performed using the Kaplan–Meier method and was calculated at the beginning of RRT or eGFR ≤ 15ml/min/1.73m2 in CMG. Differences between the two groups were tested with Mann-Whitney U method. Results A total of 76 patients with indication to start RRT were included: 61.8% (n=47) initiated HD and 38.2% (n=29) were in CM. The reasons for CM decision were deterioration of clinical condition (n=11), expected survival less than 6 months (n=8), patient option (n=5) and cognitive impairment (n=5). Clinical characteristics are presented in Table 1. The CMG was older [median, IQR: 88 (85.5-90.5) vs 80 (77.0 – 83.0), p < 0.001] and had a lower BMI [23.44 (21.08 - 25.08) vs 26.23 (23.26 – 29.20), p=0.006]. Both groups did not differ significantly in terms of sex, CKD etiology, comorbidity or frailty. A total of 66 patients died at the end of the study [CMG 100% (n= 29) vs 78.7% HDG (n=37)]. The overall survival has higher on the HDG compared to the CMG with a median survival rate of 503 days (Fig 1). One-year survival rate was 53.5% in HDG vs 24% CMG (p Conclusion In our study, hemodialysis was associated to improved survival in older and frailer stage 5 CKD patients compared to CM. However, this group had more hospitalizations, falls and poor functional status. These outcomes have a crucial impact on quality of life in this population and should be consider at the time of treatment decision. One of the limitations of our study was small sample size in both groups. In the future, we consider that is important to perform multicenter studies focused on patients-outcomes. We also think that it’s important to understand the patient and family perspective in terms of quality of life and symptom burden associated to each treatment option.

Introduction: Chronic kidney disease (CKD) is an independent risk factor for several unfavorable outcomes including cardiovascular disease (CVD), particularly in the elderly, who represent the most rapidly growing segment of the end-stage kidney disease (ESKD) population. Portugal has the highest European unadjusted incidence and prevalence rates of ESKD. In 2012, we started to follow a cohort of elderly CKD patients, we describe their baseline characteristics, risk profile, and cardiovascular disease burden. Methods: All CKD patients aged 65 years and older referred to our department during 2012 were enrolled. Baseline data included: demographic, CKD stage, medication, comorbid conditions. Estimated glomerular filtration rate (eGFR) was calculated by the CKD-EPI formula. Results: A total of 416 patients, 50% referred by primary care physicians, aged 77 ± 7 years, 52% male, with a median eGFR of 32 mL/min/1.73m2 participated in the study. Fifty percent had diabetes (DM), 85% dyslipidemia, 96% hypertension; 26% were current/former smokers, and 24% had a body mass index > 30 kg/m2. The prevalence of CVD was 62% and higher in stage 4-5 patients; in diabetics, it gradually increased with CKD progression (stage 3a < stage 3b < stage 4-5) (39, 58, 82%; p < 0.001). Conclusions: At baseline, our CKD elderly cohort had a higher burden of CVD. The prevalence of CVD was greater than in other European CKD cohorts. Lower level of eGFR was associated with a greater burden of CVD and was more pronounced in diabetics, highlighting the importance of strategically targeting cardiovascular risk reduction in these patients. Introdução: Doença renal crônica (DRC) é fator de risco independente para vários desfechos desfavoráveis, incluindo doença cardiovascular (DCV), particularmente em idosos, o segmento de crescimento mais rápido da população com doença renal terminal (DRT). Portugal tem a maior incidência europeia não-ajustada e a maior prevalência de DRT. Neste artigo caracterizamos uma coorte de idosos com DRC, referenciados para a nefrologia, com particular ênfase para o risco e carga de doença cardiovascular. Métodos: Foram incluídos todos os pacientes com DRC com 65 anos ou mais encaminhados ao nosso departamento em 2012. Os dados basais incluíram: demografia, estágio da DRC, medicação e comorbidades. A taxa de filtração glomerular (TFGe) foi calculada pela fórmula CKD-EPI. Resultados: Metade dos 416 pacientes incluídos foram encaminhados por médicos da atenção primária; sua idade era 77 ± 7 anos; 52% eram homens; a TFGe mediana era de 32 mL /min/1,73 m2. Metade tinha diabetes (DM), 85% dislipidemia, 96% hipertensão; 26% eram fumantes atuais/ antigos; 24% tinham índice de massa corporal > 30 kg/m2. A prevalência de DCV foi de 62%, sendo maior entre pacientes nos estágios 4-5; em diabéticos, aumentou gradualmente com a progressão da DRC (estágio 3a < estágio 3b < estágio 4-5) (39%, 58%, 82%; p < 0,001). Conclusões: A coorte de idosos com DRC apresentava inicialmente maior carga de DCV. A prevalência de DCV foi maior que em outras coortes europeias com DRC. Níveis menores de TFGe foram associados a carga maior de DCV e foram mais pronunciados entre diabéticos, destacando a importância de objetivar estrategicamente a redução do risco cardiovascular nesses pacientes. info:eu-repo/semantics/publishedVersion

Background and Aims Transthyretin (TTR) amyloidosis is a disease characterized by destabilization of the native TTR tetramer. It can be caused by aging or due to pathogenic mutations, and its diagnosis is often missed. Hereditary transthyretin amyloidosis (ATTRv), due to Val50Met mutation, is frequently linked with polyneuropathy but it can cause nephropathy too, causing wide range levels of albuminuria and renal dysfunction. Tafamidis, a TTR tetramer stabilizer, has been associated with significant decrease of albuminuria in ATTRv. However, TTR nephropathy is not an approved indication for its use. Plus, the renal effects of chronic oral administration of this TTR stabilizer are yet to be understood. This study evaluated longitudinal changes of eGFR-EPI within 72 months of therapy with tafamidis and identified factors associated with these changes. Method A retrospective cohort, single centre study was conducted. We have followed consecutive ATTRv Val50Met patients on tafamidis therapy from July 2012 to March 2019. Men and women aged 18-85 years were eligible if they had neuropathy stage I, were anti-amyloid treatment-naïve patients that accomplished at least 60 months of tafamidis therapy and had eGFR over 45 ml/min/1.73m2 with any grade of albuminuria. Exclusion criteria were: pregnancy, malignancies, diabetes and concurrent etiologies for nephropathy. Statistical analyses included Mann-Whitney test and linear mixed models to analyze the longitudinal changes in eGFR of the two groups of patients (albumunuric/ non-albuminuric at baseline), by controlling for variables that could be associated with eGFR EPI Cystatin C course. Results From 366 patients, biopsy-proven ATTR amyloidosis, treated with tafamidis, 122 patients met our criteria (56 males, 66 females) and had a median age of 36 (IQR: 32-46) years old. Twenty-eight had pathological urinary albumin-to-creatinine ratio (ACR), defined by ACR >30 mg/dL, and ACR >300 mg/dL was only found in females. In univariate analysis no significant differences were found between median eGFR decline in albuminuric versus non-albuminuric patients (p=0.330). At all time points, mean eGFR levels were significantly lower in baseline albuminuric patients. According to our estimation, eGFR at baseline was 11.2 mL/min/1.73 m2 lower in baseline albuminuric patients, adjusted for age at the disease onset and time between symptom onset and tafamidis initiation. Baseline albuminuria status (p=0,005), age at the disease onset (p Conclusion This study represents a real-life experience of oral chronic administration of tafamidis and its effects on ATTR nephropathy, concerning albuminuria reduction and renal function decline. Our analysis had shown similar decline rates in eGFR, irrespectively the degree of albuminuria at baseline, differently from what would be expected, since higher grades of albuminuria are related with more rapidly kidney function deterioration. Besides its capacity of stabilizing TTR tetramers, tafamidis could have an enhancing role in the podocyte regeneration process through potential cofactors for amyloid fibrils toxic effect, that could be present in the glomerular basement membrane and mesangium. This nephroprotector effect should be considered when a switch of therapy is demanded by the neuropathy status and a second line treatment is considered. Presence of renal disease may be an indication for tafamidis maintenance and combined therapy.

Introduction: Estimated glomerular filtration rate (eGFR) based on serum cystatin-C (sCys) seems as accurate as when based on serum creatinine (sCr), but sCys seems a better predictor of adverse outcomes. We aimed to study whether sCys could be a reliable tool for the prediction of adverse outcomes in elderly patients with severe chronic kidney disease (CKD). Methods: A group of 348 elderly patients with non-end-stage CKD (stages 1-4, according to eGFR-EPI sCr and/or sCys), referred to our consultation unit during 2016, was retrospectively studied and divided into four exclusive categories: CKD_stage4_neither (eGFR-sCr≥30mL/min; eGFR-sCys≥30mL/min), CKD_stage4_sCr_only (eGFR-sCr

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Patients who are candidates for a second kidney transplant (SKT) frequently have a higher level of panel reactive antibodies (PRA). We assessed the allosensitisation change after a first graft failure (GF), its predictors and impact on retransplantat outcomes. We retrospectively selected 140 adult patients who received a SKT. Recipient and donor characteristics were analyzed. We defined the delta PRA (dPRA) as the difference between peak PRA before the SKT and first one (cohort median value = +10%). Logistic regression analysis was used to determine risk factors for dPRA ≥ 10% and acute rejection (AR) in the SKT. Univariable and multivariable Cox analysis was applied to assess independent predictors of second GF. Risk factors for dPRA ≥ 10% at SKT were AR (OR = 2.57; P = 0.022), first graft survival

Aim: Mortality in end-stage renal disease (ESRD) remains high, particularly among elderly, who represents the most rapidly growing segment of the ESRD population in wealthier countries. We developed and validated a risk score in elderly patients to predict 6-month mortality after dialysis initiation. Methods: We used data from a cohort of 421 patients, aged 65 years and over who started dialysis between 2009 and 2016, in our Nephrology department. The predictive score was developed using a multivariable logistic regression analysis. A bootstrapping technique was used for internal validation. Results: The overall mortality within 6 months was 14.0%. Five independent predictors were identified, and a points system was constructed: age 75 years or older (2 points), coronary artery disease (2), cerebrovascular disease with hemiplegia (2), time of nephrology care before dialysis (Conclusions: We developed a simple prediction score based on readily available clinical and laboratory data that can be a practical and useful tool to assess short-term prognosis in elderly patients starting dialysis. It may help to inform patients and their families about ESRD treatment options and provide a more patient-centered overall approach to care.

Visible-Light Communication (VLC) is the transmission of data using the visible-light spectrum. It uses the rapid response of light devices, such as Light Emitting Diodes (LEDs), to modulate the emitted light in order to transmit information. In this work, we present a novel and simpler modulation technique for VLC. It uses the Pulse Width Modulator (PWM) of a DC/DC converter, which acts as a power source for an LED load. Hence, we apply a split-phase modulation by changing the PWM carrier's phase at each bit transition, causing a transition of the output current ripple. By detecting the ripple, the receiver can decode the data sent by the light source. Additionally, average duty cycle value is not affected by transmission. Transmission data rate is a multiple of the switching frequency. Finally, experimental results using a synchronous buck converter as a driver for a 22.6 W LED load operating with a current ripple of 30% showed successful transmission and detection of a bit stream sequence in a Light-Of-Sight (LOS) configuration for over a distance of 1.5 m. The converter's switching frequency is of 100 kHz, giving a data-rate of 50 kbps.

Acute pancreatitis is a potentially life-threatening disease. If the diagnosis and the treatment are not prompt, it can rapidly evolve to a medical emergency. Severe hypertriglyceridemia, defined as above 1000 mg/dl, is the third most common cause of acute pancreatitis. Conventional management includes fat dietary restriction and pharmacological treatment; however, these measures take time to be effective. Plasmapheresis seems to be an alternative and safe adjunctive therapy because it allows the rapid reduction of the trigger agent in circulation. Its use, especially in severe cases, has been increasingly reported. The authors report three cases of severe hypertriglyceridemia-induced pancreatitis in which early plasmapheresis was successfully used with other supportive clinical management.

This paper presents an electronic ballast for driving high intensity discharge (HID) lamps with low frequency square waveform from a dc supply. From the dc source (e.g., PFC rail), a flyback arrangement is inserted into a switching structure whose output provides low frequency voltage yet avoiding instability issues. Proposal's main advantage is the use of one single choke of simple assembly and only two active switches for current control and inversion. Converter design for DCM is presented in this work, besides an equivalent circuit from a control point of view. Small signal ac model is obtained and a feedback control loop is designed, based upon frequency response stability and performance analysis. HID dynamics is inserted into converter model, with feedback directly implemented. A prototype is presented and described in detail, consisting of a complete power and sensing circuit fully referenced to the switches common ground proposal. For design conformity, experimental and simulation results from Matlab and PSIM are presented, as well as discussions about the converter feasibility.

Dissertação de Mestrado em Enfermagem Médico-Cirúrgica apresentada na Escola Superior de Saúde do Instituto Politécnico de Viana do Castelo Os trabalhadores da área da saúde são dos que maior risco apresentam de sofrer incidentes violentos no trabalho, especialmente os que laboram em áreas como a psiquiatria e a urgência. A falta de medidas de segurança, o contacto físico próximo e a preocupação dos doentes com o estado de saúde predispõem os enfermeiros a sofrerem violência. Este estudo refere-se à violência no trabalho dos enfermeiros nos serviços de urgência médico-cirúrgicos da região norte de Portugal. Trata-se de um estudo de metodologia qualitativa, do tipo exploratório-descritivo e observacional. Com ele pretendemos compreender o fenómeno da violência no trabalho a que os enfermeiros dos serviços de urgência estão expostos. Foram analisados doze relatos de enfermeiros vítimas de violência no local de trabalho, através da técnica de análise de conteúdo. Dos doze participantes, nove são do género feminino e três do género masculino, variando as suas idades entre os 28 e os 58 anos e com uma média de 14 anos de experiência profissional em serviço de urgência. Os dados sugerem que a violência no trabalho dos enfermeiros é uma realidade frequente, ocorrendo independentemente da idade, experiência profissional, caraterísticas pessoais ou profissionais. Verificaram-se agressões psicológicas (6) e físicas (6) em igual proporção e o principal agressor foi o próprio doente, principalmente sob o comportamento de estalos, murros ou insultos. A maioria das vítimas referiu ter sofrido após a agressão consequências psicológicas, com impacto tanto na vida profissional como na pessoal. As consequências psicológicas da agressão identificadas foram perturbação, stress, desgaste emocional, insegurança, receio de agressão física, ansiedade, angústia, tristeza, medo, impaciência, receio pela segurança e nervosismo. A maioria dos participantes referiu porta automática, maior privacidade na triagem (local onde se verificaram mais agressões) e policiamento como possíveis medidas para diminuir a violência. O apoio prestado pela Instituição às vítimas nos casos de agressão foi considerado como insatisfatório e cinco vítimas notificaram a violência de que foram alvo. Conclui-se ser urgente a adoção de medidas para o combate deste problema e a prevenção só será possível através do comprometimento conjunto entre sociedade, Instituições de Saúde, gestores e profissionais de saúde envolvidos, responsabilizando os utentes pelos seus atos e incentivando os profissionais a notificar a violência sofrida. É um dever das Instituições promoverem um ambiente de trabalho seguro para os seus profissionais. Esperamos que este estudo seja mais um contributo para a segurança no trabalho deste grupo profissional no exercício das suas funções nos serviços de urgência, melhorando a satisfação no trabalho e a qualidade dos cuidados prestados ao doente crítico/família. The healthcare workers are those who have higher risk of suffering violent incidents at work, especially those who work in areas such as psychiatry and emergency. The lack of security measures, the close physical contact and the patient’s concern for the health predispose nurses to suffer violence. This study refers to violence at work of nurses in the medical-surgical emergency services in the northern region of Portugal. It is a qualitative methodology study, exploratory-descriptive and observational. With it we aim to understand the phenomenon of violence at work that nurses of the emergency services are exposed. Twelve reports of nurses who were victims of violence were analyzed in the workplace, through the content analysis technique. Of the twelve participants, nine are female and three are male, varying their ages between 28 and 58 years and with an average of 14 years of professional experience in emergency department. The data suggest that violence at work of the nurses is a common reality, occurring regardless of age, professional experience, personal or professional characteristics. There were psychological aggression (6) and physical (6) in the same proportion and the main aggressor was the patient himself, mainly under the popping behavior, punches and insults. The consequences after the aggression that most of the victims said were the psychological consequences that impact both professional and personal life. The psychological consequences of the aggression identified were the disturbance, stress, emotional stress, insecurity, fear of physical aggression, anxiety, anguish, sadness, fear, impatience, fear for the safety and nervousness. Most participants said that automatic door, greater privacy screening (where there have been more attacks) and policing as possible measures to reduce violence. The support provided by the Institution for victims in cases of aggression was considered unsatisfactory and five victims reported the suffered violence. We conclude that it’s urgent to adopt measures to combat this problem and the prevention can only be achieved through the commitment set between society, Health Institutions, health managers and professionals involved by giving users responsibility for their actions and encouraging professionals to report the suffered violence. It is a duty of the Institutions to promote a safe working environment for its employees. We hope this study will be a further contribution to safety at work of this professional group in the performance of their duties in emergency services, enhancing job satisfaction and quality of care to the critically ill patient/family.

This paper presents a compact emergency lamp using light-emitting diodes (LEDs). The goal is to develop a compact and low-cost electronic circuit to drive and control the current of LEDs arranged in a single enclosure. The main advantage of the proposed idea is to use the same equipment in the daily activities, supplied by the ac line, and under a mains failure, supplied by a battery. The proposal also aims to achieve energy saving, higher luminous efficacy, and higher useful life when replacing traditional fluorescent-based emergency lighting systems. The use of the E-27 socket provides the advantage of easy installation, with the simple replacement of the lamp without any change in the electrical wiring. Buck and boost converters were employed in order to supply the LEDs by mains and by battery, respectively. However, the converters are designed in order to work without electrolytic capacitors, which have advantages such as reducing size and cost of the circuit, THD reduction, and increasing the useful life of the driver. The battery can be composed of three rechargeable Ni-MH batteries (1.2 V) or a Li-ion battery (3.6 V). The design complies with the Brazilian and international standards for emergency lighting systems and IEC 61000-3-2. The proposed circuit was implemented, and the experimental results were satisfactory.

This paper proposes some topologies for developing electronic ballasts, supplying high-intensity discharge lamps fed by a pulsewidth-modulation ac-ac converter, implemented with bidirectional switches. The lamp operates directly from the ac mains; thus, operation with low frequency so as to prevent the occurrence of destructive acoustic resonance is provided. The features of the proposed solution are high efficiency, high power factor, low cost, and the absence of electrolytic capacitors. This paper includes the design of passive elements, the transfer function, and the development of the control strategy. The experimental results qualify the viability of the system feasibility.

This work presents a decentralized current sharing control technique for a modular power supply composed of n output parallel-connected DC-DC converters. Each converter is connected to the load through individual line resistance. A phase shifted PWM signal, whose phase is proportional to each converters measured output resistance, is used to control switch state, generating a small power flow at switching frequency between connected units. In order to provide proper load sharing, a voltage reference adjustment for the main control loop is done through the weighted sum of measured reactive power at switching frequency and load current controller output. A distributed power system with three buck converters feeding a 75 W Light Emitting Diode (LED) street lighting fixture is tested with simulations to prove the feasibility of the idea.

This work presents a novel current sharing control technique based on an improved droop control scheme for a modular power supply composed of n output parallel-connected DC-DC converters. Each converter is connected to the load through individual line resistance and modeled as a dependent voltage source. In order to provide proper load sharing, a voltage reference adjustment for the main control loop is done through the load current controller output. A distributed power supply composed by three buck converters with their outputs connected in parallel designed for a 75 W Light Emitting Diode (LED) street lighting fixture is tested through simulations to prove the feasibility of the idea.

Background Studies have investigated the consequences of intrauterine malnutrition on birth weight and overall survival but not on wound healing. This study aims to assess the influence of in utero malnutrition on wound healing of newborn rats. Methods Pregnant Wistar rats were divided into 2 groups. Study rats were given 50% of the food intake of controls throughout pregnancy in a pair-fed manner. The body weight and length of the newborns were measured. Newborns were breast-fed until day 21, when a laparotomy was performed. The effect of the laparotomy was assessed by measure of the wound strength and collagen deposition at postoperative day (POD) 7 (n = 15) and POD 21 (n = 15). Results The body weight and length of newborns of malnourished mothers were significantly smaller at birth compared with controls (respectively, 4.5 +/- 0.1 g vs 5.8 +/- 0.1 g, p = .0003 and 4.6 +/- 0.1 cm vs 5.2 +/- 0.1 cm, p = .0003). Maximum, rupture, and tensile strength of malnourished newborns were smaller than controls on POD 7 (0.281 +/- 0.031 vs 0.470 +/- 0.031, p = .0061, 0.112 +/- 0.06 kgf vs 0.173 +/- 0.08 kgf, p = .0495 and 0.019 +/- 0.002 kgf/mm2 vs 0.024 +/- 0.003 kgf/mm2, p = .050, respectively). On POD 21, only tensile strength remained lower (0.044 +/- 0.003 kgf/mm2 vs 0.058 +/- 0.003 kgf/mm2, p = .0477). Type I collagen deposition of malnourished newborns was similar to controls on POD 7 (57.69 +/- 10.06 vs 48.34 +/- 15.65, p = .3187) and on POD 21 (75.6 +/- 7.21 vs 80.0 +/- 9.92, p = .4212). Conclusions In utero malnutrition decreases the abdominal wound strength of newborn rats but not the collagen deposition, suggesting that breast-feeding nutrition is effective in recovering the collagen deposition but not overall wound strength.

BACKGROUND Recent evidence has suggested that glutamine is one of the primary energy sources of the colon. The aim of this study was to evaluate the effects of oral glutamine supplementation on the healing of colonic anastomoses in rats. METHODS Forty-eight adult male Wistar rats, weighing 174.41 +/- 37.39 g, were housed in individual cages. All rats had free access to water and standard rat chow. The rats were randomized to receive daily, for 7 days before the operation and during the postoperative period, 10% L-glutamine (GLN group) or 10% glycine (GLY group) in isonitrogenous and isovolumetric solutions (1.5 g/kg per day), through an orogastric tube. On the eighth day, rats were anesthetized and subjected to 2 colonic transections, one 6 cm distal from the ileocecal valve and another 5 cm distal from the first transection. Bowel continuity was restored by 2 end-to-end, single layer, everted, anastomoses with 8 interrupted sutures (6-0 nylon). After the operation, the rats were kept in individual cages and had free access to water and rat chow. One-half of the rats in each group were killed either on postoperative day 3 or 8, and the 2 colonic anastomoses of each animal were resected and stored in 0.9% saline and 10% formalin for tensile strength and histologic (hematoxylineosin and collagen densitometry) studies, respectively. Student's t-test and Kruskal Wallis tests were used for statistical analysis. RESULTS Total rupture strength was significantly higher in the GLN group (GLN: 0.068 +/- 0.045 kgf versus GLY: 0.042 +/- 0.027 kgf, p = .04). The mean monocytes infiltrate was significantly smaller in the GLN group (p = .04). The collagen densitometry analysis demonstrated greater percent area of type I (mature) in the GLN group compared with GLY (58.65 +/- 11.70% versus 41.79 +/- 10.54%, p = .0000), respectively. Subgroup analyses according to the day of rat death were still significant: GLN 3: 54.22 +/- 10.02% versus GLY 3: 41.92 +/- 13.31% (p = .04) and GLN 8: 62.63 +/- 12.13% versus GLY 8: 41.67 +/- 7.69% (p = .0004). Type III collagen (immature) percent area was significantly smaller in the GLN group's colonic anastomoses (GLN: p = .0000; GLN 3: p = .04 and GLN 8: p = .0003, respectively). CONCLUSIONS Perioperative oral glutamine supplementation increases total rupture strength and improves the percent area of mature collagen at the anastomoses sites on postoperative days 3 and 8.

Invasive infections caused by fungal species are uncommon. They are usually associated with poor outcomes. They usually occur in immunocompromised patients such as kidney transplant recipients. The identification of fungi in blood or in tissue culture is important to establish the correct diagnosis. Survival is conditioned by the degree of suspicion, early diagnosis and early initiation of appropriate therapy. The authors present a case of an invasive fungal infection by Cunninghamella bertholletiae in a renal transplant recipient.

AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in terms of acute rejection between the two groups (3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eGFR was not significantly different between groups (median 59 mL/min in DSA-Cw group, compared to median 51 mL/min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years (100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection (AMR) incidence was DSA strength (HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively (Log-rank P = 0.005). CONCLUSION: Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA. info:eu-repo/semantics/publishedVersion

This paper presents a converter structure applied to supply high power Light Emitting Diodes (LEDs) from the mains in a street lighting system, based on the Reduced Redundant Power Processing (R2P2) principle. It is used a Buck-Boost operating in Discontinuous Conduction Mode (DCM) as Power Factor Corrector (PFC) to guarantee high power factor and low current harmonic injection to the mains. The second converter of the structure works only to control the current through the LED array. Because LED have a voltage source behaviour, only part of the rated power needs to be processed twice to regulate the output current. The system modelling and control structure are shown in detail. A laboratory prototype, with a rated power of 75W for a rated input voltage of 220V rms , was built to show the feasibility of the idea.

This paper introduces a topology applied to LED systems that unifies high efficiency with the avoidance of electrolytic capacitors. The main idea is to reduce the redundant power processing, making the second converter to process less energy. The capacitor is reduced by increasing the ripple at the output of the power factor correction converter and using the second converter to compensate this ripple. A 75W prototype was built and compared with a single-stage topology and with an integrated two-stage topology.

This paper presents a converter structure applied to supply high power Light Emitting Diodes (LEDs) from the mains in a street lighting system, based on the Reduced Redundant Power Processing (R2P2) principle. To guarantee high power factor and low harmonic injection a buck-boost operating in Discontinuous Conduction Mode (DCM) is employed as Power Factor Corrector (PFC). The second converter of the structure controls the current over the LEDs string, but it does not process all the power. This is done summing the voltage of the first with the second converter. Avoiding the double processing of the power, the efficiency is improved. Besides that, the capacitance value of the first converter is dramatically reduced by increasing the ripple limits, making possible the use of film capacitors to increase the life span of the system. The system project and control structure are showed in details. A laboratory prototype, with a rated power of 75W for a rated input voltage of 220V rms , was built to show the feasibility of the idea.

This paper deals with a topology for an off-line LED electronic driver. The use of electrolytic capacitors in the DC link is avoided, therefore extending lifespan and reliability. Given that the resulting output capacitance of the PFC stage is relatively small, a high LF ripple appears at the DC-link. This work proposes the use of a current-fed bidirectional buck converter as a second stage. With the proposed scheme, this stage processes only the AC power corresponding to this voltage ripple, thus increasing the efficiency with respect to a conventional two stage topology. In this approach, the output converter is connected in series with the LEDs assembly, yielding to low voltage stresses at the stage. With a given current control, this scheme ensures a constant current through the LEDs, and ability for AM and PWM dimming operation. A design procedure is shown, and the theoretical results have been validated in a built prototype for a 65W LEDs lamp.

Dissertação de Mestrado apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Psicologia, especialização em Clínica e da Saúde. A presente investigação tem como objectivo aprofundar o tema do stress parental, averiguando quais são os indutores do mesmo. Segundo Abdin (1992) o stress parental depende de um conjunto de factores, que funcionam como indutores de stress. Este autor considera que estes são compostos pelas características dos pais, das crianças e do meio, e irão determinar o comportamento parental. Mostra-se ainda um possível factor indutor de stress, o stress de vida, vivenciado por cada progenitor. Assim, quanto maior for o stress da vida de cada indivíduo, possivelmente maior será o stress parental (Baltazar, 2009). Tendo em conta o que a literatura refere, decidiu-se relacionar com variáveis, dando origem aos seguintes objectivos: (1) Verificar se o stress parental varia em função do género dos pais (Moreira, 2010); (2) Averiguar se a idade da figura parental tem influência no stress parental (Moreira, 2010); (3) Perceber se quando é verificado um maior stress de vida, também se verifica um maior stress parental (Baltazar, 2009); (4) Avaliar a não variabilidade do stress parental em função da idade da criança (Vrijmoet-Wiersma et al, 2009); (5) Avaliar se o stress parental pode variar conforme o ano de escolaridade em que a criança se encontra. Foi administrado, um Questionário sócio-demográfico e o instrumento Índice de Stress Parental (Abidin & Santos, 2003) a setenta figuras parentais. Foram maioritariamente preenchidos pelas mães (mães – 61, 87% / pais - 9, 13%) com idades compreendidas entre os 23 e os 53 anos de idade (mães: M = 35 DP=5,6 / pais: M=37 DP=6,4).Os resultados indicam que não existe influência do género parental no stress parental (p=0,975). Deste modo, ambas as figuras parentais vivenciam níveis de stress similares. A idade dos progenitores também parece não se revelar um indutor de stress. Verificou-se ainda uma correlação positiva entre o stress de vida e o stress parental (ρ = 1), que revela que estas variáveis se movimentam na mesma direcção. Assim, quando um valor aumenta ou outro também aumenta. Por outro lado, quando um valor diminui o outro também diminui. Conclui-se então que, quanto maior o stress de vida maior será o stress parental. Para terminar, foi ainda possível avaliar que a idade da criança não afecta o stress parental (p =0,675). O ano de escolaridade que a criança frequenta também não influência o stress parental (p =0,589). Estes resultados vêm reforçar o investimento nesta área de estudo, assim como a necessidade de ser valorizada a figura parental masculina. This research aims to deepen the theme of parental stress, checking what its inducers are. According to Abdin (1992) parental stress depends on a number of factors that work as inducers of stress. This author believes that these are made of the characteristics of parents, children and the characteristics of the environment which will determine the parental behaviour. They also show a possible factor inducing stress, the stress of life experienced by each parent. Thus the higher the stress of life of each individual is, the greater parental stress will be (Baltazar, 2009). According to available information, some variables were related, creating the following objectives: (1) Check whether the parental stress varies depending on the gender of the parents (Moreira, 2010), (2) Determine if the age of the parental figure has an influence on parental stress (Moreira, 2010), (3) Understand if a greater stress of life, leads to a greater parental stress (Baltazar, 2009), (4) assess the variability of parental stress as a function of child age (Vrijmoet-Wiersma et al, 2009), (5) Assess whether parental stress may vary according to the school year in the child attends. A socio-demographic questionnaire, and the, Parental Stress Index (Abidin & Santos, 2003), was undertaken by to seventy parental figures, mostly mothers (mothers - 61, 87% / fathers 9, 13%) aged between 23 and 53 years old (mothers: M = 35 SD = 5.6 / fathers: M = 37 SD = 6.4). The results show that there is no influence of gender on parental stress (p = 0.975), thus both parents experience similar stress levels. Moreover, the age of the parents also does not seem to be a stress inducer. There is also a positive correlation between the stress of life and parental stress (ρ = 1), which shows that these variables move in the same direction, so when one value increases the other increases too, and then when a value decreases the other also decreases. In conclusion, the higher the stress of life is, the higher parental stress will become. Finally, it was also possible to assess that the child's age doesn’t seem to affect parental stress (p = 0.675), as well as the school year the child attends (p = 0.589).These results strengthen the investment in this area of study, with the need to value both male and female parental figures. Cette recherche à comme but approfondir le thème du stress parental, vérifiant quels sont les inducteurs de la même. Selon Abdin (1992) le stress parental dépend d'un certain nombre de facteurs, qui fonctionnent comme des inducteurs de stress. Cet auteur croit que ceux-là sont composés par les caractéristiques des parents, des enfants et de l’ambiance, et détermineront le comportement parental. On montre aussi un possible facteur inducteur du stress, le stress de la vie vécue par chaque parent. De cette façon, plus le stress de la vie de chaque individu, probablement plus le stress parental (Baltazar, 2009). Considérant ce que la littérature nous cite, on a décidé de mettre en rapport avec des variables, causant les suivants objectifs : (1) Vérifier si le stress parental varie selon le genre des parents (Moreira, 2010), (2) Enquérir si l'âge de la figure parentale a influence sur le stress parental (Moreira , 2010), (3) Comprendre si quand on constate un plus grand stress de la vie, s’il y a aussi un plus grand stress parental (Baltazar, 2009), (4) Évaluer la l’invariabilité du stress parental en fonction de l'âge des enfants (Vrijmoet-Wiersma et al, 2009), (5) Évaluer si le stress parental peut varier selon l'année scolaire de l'enfant. On a administré un questionnaire socio-démographiques et l'instrument Index de stress parental (Abidin & Santos, 2003), a soixante-dix figures parentales, et la majorités a été remplis par les mères (mères - 61, 87% / pères-9, 13% ) avec l’âgés entre 23 et 53 ans (mères: M = 35 SD = 5,6 / pères: M = 37 SD = 6,4). Les résultats indiquent qu'il n'ya aucune influence du genre parental sur le stress parental (p = 0,975). De cette façon, les figures parentales vivent des niveaux de stress similaires. L'âge des parents semblent aussi ne pas révéler un inducteur de stress. On a vérifié aussi une corrélation positive entre le stress de la vie et du stress parental (ρ = 1), qui montre que ces variables se déplacer dans la même direction. Ainsi, quand une valeur augmente l’autre augmente aussi. D’autre part, quand une valeur diminue l'autre diminue aussi. On conclu que plus le stress de la vie plus le stress parental. Pour conclure, il a été encore possible d'évaluer que l'âge de l'enfant n’affecte pas le stress des parents (p = 0,675). L'année que l'enfant fréquente n’influence pas le stress parentales (p = 0,589). Ces résultats on renforcé l'investissement dans ce domaine d'étude, ainsi comme la nécessité de valoriser la figure parental masculine.

This paper deals with the high pressure lamps feed by direct conversion AC to AC with ZETA converter implemented by bidirectional switches for the lamp operation on the mains frequency. The aim is to prevent the occurrence of destructive acoustic resonance. Also has high efficiency, high power factor and low cost. The approach focused on passive elements design in the circuit, the transfer function and the digital control applied to DSP controller. At the end is shown the prototype system response.

This paper deals with the high pressure lamps fed by SEPIC converter implemented with bidirectional switches with the lamp operation frequency of the main supply so as to prevent the occurrence of destructive acoustic resonance and high efficiency, unitary power factor and low cost. It approached the passive elements design in the circuit, the transfer function and the control equation with its control strategy by DSP controller. At the end is shown the system response.

This paper proposes a circuit for a compact lamp based on high-brightness LEDs. It aims energy savings, high luminous efficacy and high useful life when substituting incandescent or compact fluorescent bulbs for LEDs without any change in the electric system installation. In order to supply the LEDs by mains with a forward current, the Buck converter has been chosen. The load can be composed by 36 to 52 LEDs of 5 mm connected in series, resulting in a converter output voltage between 90 V and 187 V. The advantage of series connection is that all LEDs produce the same brightness since its luminous intensity is proportional to the supplied current. The disadvantage is that the damage of one LED could results in an open-circuit, turning off the entire group. To fix this problem, the proposed idea on this work is the introduction of Diacs connected in parallel with groups of LEDs. So, if one LED burns the breakdown voltage is reached, and the Diac in parallel with this group become a short- circuit guaranteeing the operating of the others groups. To verify the proposed idea, the compact lamp has been implemented and tested.

This paper presents a lamp voltage inversion methodology and output capacitor analysis applied to a bidirectional flyback converter. The converter integrates the power control and the inversion stage, feeding a HPS lamp with a low frequency symmetrical square waveform, avoiding the acoustic resonance phenomenon occurrence. A detailed design of the lamp parallel capacitor is developed with parameters of stability, lamp power high frequency ripple and the lamp voltage inversion time to avoid lamp re-ignition. Experimental results are presented to validate the proposed topology.

This paper presents the integration of power stages in order to supply HPS lamps with a low frequency square waveform. This waveform is chosen to avoid the acoustic resonance phenomenon occurrence. Conventionally, the electronic ballast to supply the lamp in this way should have three power stages: power factor correction (PFC), power control (PC) and inverter. In this work, a methodology to integrate these power stages is defined. Seven different topologies are proposed and their experimental results are obtained in order to compare each one.

This paper presents a warm-up and steady-state control method for a 70 W high-pressure sodium (HPS) lamp fed by electronic ballast, in order to replace the still commonly used electromagnetic ballasts and take better advantage of lamp's useful life and luminous efficacy. Along this work, a reliable electronic ballast topology has been chosen, attending the specified requirements. After, the warm-up and steady-state control algorithms have been developed and a microcontroller has been chosen to perform them. Finally, the circuit has been assembled and experimental results are shown.

This paper presents an electronic ballast based on chopper to supply a 70W high intensity discharge (HID) lamp. The ballast consists on a bipolar buck chopper operating in continuous conduction mode (CCM) and an igniter circuit. It works with a switching frequency of 33 kHz and supplies the lamp in the mains frequency. The igniter circuit provides the necessary high voltage for the lamp's startup initial procedure. The goal is to supply the lamp from 220V plusmn 20% mains with a reduced number of components, decreasing the system final cost [14] without compromising the reliability and the lifetime. It is controlled by an 8 bits microcontroller, thus contributing to reduction in the number of parts. Some experimental results are presented to validate the proposed ballast, and its behavior shows it is a good choice to avoid the effects of acoustic resonance phenomenon.

This paper presents a comparative analysis of electronic ballast topologies that supply high intensity discharge (HID) lamps with a low frequency symmetrical square waveform. The analyzed topologies are based on the same technique of using two bidirectional DC/DC converters connected to the lamp in a differential way. This technique makes possible to obtain a low frequency output voltage, in spite of the high frequency switching operation of each DC/DC converter.

This paper presents the project of a distributed emergency lighting system by using light emitting diodes. The converter applied to supply this network consists of the integration of two flyback converters. The integrated converters are responsible for the battery charge maintenance and LEDs' supplying. Simulation and experimental results are shown in order to validate the proposed idea. The design has been accomplished according to the IEEE STD 446, 1995 and Brazilian standards NBR 10898,1999.