Marinha Portuguesa

Until there is an effective implementation of COVID-19 vaccination program, a robust testing strategy, along with prevention measures, will continue to be the most viable way to control disease spread. Such a strategy should rely on disparate diagnostic tests to prevent a slowdown in testing due to lack of materials and reagents imposed by supply chain problems, which happened at the beginning of the pandemic. In this study, we have established a single-tube test based on RT-LAMP that enables the visual detection of less than 100 viral genome copies of SARS-CoV-2 within 30 min. We benchmarked the assay against the gold standard test for COVID-19 diagnosis, RT-PCR, using 177 nasopharyngeal RNA samples. For viral loads above 100 copies, the RT-LAMP assay had a sensitivity of 100% and a specificity of 96.1%. Additionally, we set up a RNA extraction-free RT-LAMP test capable of detecting SARS-CoV-2 directly from saliva samples, albeit with lower sensitivity. The saliva was self-collected and the collection tube remained closed until inactivation, thereby ensuring the protection of the testing personnel. As expected, RNA extraction from saliva samples increased the sensitivity of the test. To lower the costs associated with RNA extraction, we performed this step using an alternative protocol that uses plasmid DNA extraction columns. We also produced the enzymes needed for the assay and established an in-house-made RT-LAMP test independent of specific distribution channels. Finally, we developed a new colorimetric method that allowed the detection of LAMP products by the visualization of an evident color shift, regardless of the reaction pH.

Automated environmental monitoring in marine environments is currently carried out either by small-scale robotic systems, composed of one or few robots, or static sensor networks. In this paper, we propose the use of swarm robotics systems to carry out marine environmental monitoring missions. In swarm robotics systems, each individual unit is relatively simple and inexpensive. The robots rely on decentralized control and local communication, allowing the swarm to scale to hundreds of units and to cover large areas. We study the application of a swarm of aquatic robots to environmental monitoring tasks. In the first part of the study, we synthesize swarm control for a temperature monitoring mission and validate our results with a real swarm robotics system. Then, we conduct a simulation-based evaluation of the robots' performance over large areas and with large swarm sizes, and demonstrate the swarm's robustness to faults. Our results show that swarm robotics systems are suited for environmental monitoring tasks by efficiently covering a target area, allowing for redundancy in the data collection process, and tolerating individual robot faults.

Over the last decades, several therapeutic options were considered in the treatment of the osteoradionecrosis (ORN) of the mandible, including supportive measures, ultrasound therapy, corticosteroids, hyperbaric oxygen, surgical resection with reconstruction, and, more recently, drugs capable of reversing the fibroatrophic process. Once established, the ORN does not spontaneously disappear and a standard treatment has not yet been defined. The clear clinical effectiveness of hyperbaric oxygen therapy (HBOT) varies according to the literature and there are some economic/logistic issues to be considered; the triplet tocopherol/pentoxifylline/clodronate demands greater evidence from randomized clinical trials and also resilience from the patient, given the long treatment duration and its possible side effects. Controversy around the ideal treatment of the initial stage ORN of the mandible persists. More rigorous randomized prospective trials are essential. The purpose of this article was to review the relevant literature on the physiopathology of ORN of the mandible and discuss the new perspectives of its conservative treatment. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.

The sea as a very extensive area, renders difficult a pre-emptive and long-lasting search for shipwreck survivors. The operational cost for deploying manned teams with such proactive strategy is high and, thus, these teams are only reactively deployed when a disaster like a shipwreck has been communicated. To reduce the involved financial costs, unmanned robotic systems could be used instead as background surveillance teams patrolling the seas. In this sense, a robotic team for search and rescue (SAR) operations at sea is presented in this work. Composed of an Unmanned Surface Vehicle (USV) piggybacking a watertight Unmanned Aerial Vehicle (UAV) with vertical take-off and landing capabilities, the proposed cooperative system is capable of search, track and provide basic life support while reporting the position of human survivors to better prepared manned rescue teams. The USV provides long-range transportation of the UAV and basic survival kits for victims. The UAV assures an augmented perception of the environment due to its high vantage point.

OBJECTIVES: To analyze the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. METHODS: Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. RESULTS: From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. CONCLUSIONS: Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.

The spectral content of time-varying signals is examined using a modified version of the instantaneous power spectrum (IPS). The short duration periodogram and the pseudo Wigner-Ville distribution (PWD) have been used extensively to display the time-varying spectral information. A disadvantage of the periodogram is its inherently poor resolution, due to the requirement of matching the resolution width to the spectral dynamics of the signal. Potential problems associated with PWD are spectral cross terms and an inability to resolve spectral components at the endpoints of the analysis segment. A modified version of IPS is shown to be less sensitive to these types of problems. In addition, IPS can work with real-valued signals sampled at the traditional Nyquist rate.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

Unmanned Aerial Vehicles (UAVs) can be an important resource when performing Search and Rescue (SAR) operations at sea, as this technology is fairly inexpensive when compared to traditional SAR approaches that use significant human resources and expensive air and naval assets, thus enabling the deployment of several UAVs simultaneously in these missions to perform rescue targets search in maritime environments.In order to maximize the usefulness of these UAVs in such operations, we propose a method which utilizes a state-of-the-art object detection network to perform real-time rescue target detection on-board the UAV, using standard RGB cameras, with minimal human intervention, thus enabling an increased vehicle autonomy and search range. Additionally, since the UAVs only relay the candidate images and locations that contain possible rescue targets, given by the onboard detector, it is possible to have several UAVs working in parallel that report back to a single human operator.We have selected the YOLOv4-tiny detection network, pretrained in the COCO dataset, and retrained it to detect rescue targets at sea. For this purpose some datasets were recorded and annotated to simulate the presence of maritime rescue targets. The proposed approach has been validated on an independent test dataset, showing that it has good detection capabilities and thus providing convincing results regarding the use of UAVs with automatic target detection capabilities in SAR missions.

The paper describes the seventh edition of Rapid Environmental Picture Atlantic exercise (REP16-Atlantic) which took place in July 2016 along the coast of Sesimbra and Troia, Portugal. The intent was to demonstrate coordinated operations of unmanned underwater, surface, and air vehicles contributed by participants coming from different European institutions from both research and industry fields. The REP-Atlantic is a yearly demonstration exercise targeted at advancing the state of art in networked vehicle systems through large scale experimentation in real-life operational scenarios. The exercise allows for the collaboration between manned and unmanned assets with a focus on exploring technological levels of operational readiness on all layers of the autonomous systems' system breakdown structure.

The pose (3D position and orientation) of an Unmanned Aerial Vehicle (UAV) during the landing process aboard a ship can be estimated using a 3D model-based vision system approach. The developed vision system is based on a standard Red, Green and Blue (RGB) camera using one workstation for processing data located on the ship's deck. A ground-based vision system allows the use of small size and weight UAV, due to the low computer requirements onboard. The proposed architecture is based on a Particle Filter (PF) scheme and has three stages: importance sampling, importance weighting and resampling. In the importance sampling, we detect bounding box candidates and apply an appearance-based pose sampler to retrieve the most likely poses. After this, we fuse information from the current frame with information from the previous time step using an Unscented Kalman Filter (UKF) for the translational motion filtering and an Unscented Bingham Filter (UBiF) for the rotational motion filtering. In the importance weighting stage, we use a color based likelihood metric to deal with the expected real sky background filled with clouds. In the resampling stage, we eliminate particles with low importance weights and replicate high weight ones. Results show that performance is compatible with the automatic landing system requirements.

•This was an international, multicenter analysis including 691 patients with metastatic TNBC.•The frequency of HER2-low was 32.0% (95% CI 28.5% to 35.5%).•Similar frequencies were seen in metastases (29.8%) and primary tumors (33.4%; P = 0.324).•There was no statistically different OS between HER2-low and HER2-0 TNBC (HR 1.00; P = 0.969).•There was no significant impact of HER2-low on OS in multivariable analysis (HR 0.95; P = 0.545). BackgroundTriple-negative breast cancer (TNBC) is associated with poor prognosis, and new treatment options are urgently needed. About 34%-39% of primary TNBCs show a low expression of human epidermal growth factor receptor 2 (HER2-low), which is a target for new anti-HER2 drugs. However, little is known about the frequency and the prognostic value of HER2-low in metastatic TNBC.Patients and methodsWe retrospectively included patients with TNBC from five European countries for this international, multicenter analysis. Triple-negativity had to be shown in a metastatic site or in the primary breast tumor diagnosed simultaneously or within 3 years before metastatic disease. HER2-low was defined as immunohistochemically (IHC) 1+ or 2+ without ERBB2 gene amplification. Survival probabilities were calculated by the Kaplan–Meier method, and multivariable hazard ratios (HRs) were estimated by Cox regression models.ResultsIn total, 691 patients, diagnosed between January 2006 and February 2021, were assessable. The incidence of HER2-low was 32.0% [95% confidence interval (CI) 28.5% to 35.5%], with similar proportions in metastases (n = 265; 29.8%) and primary tumors (n = 425; 33.4%; P = 0.324). The median overall survival (OS) in HER2-low and HER2-0 TNBC was 18.6 and 16.1 months, respectively (HR 1.00; 95% CI 0.83-1.19; P = 0.969). Similarly, in multivariable analysis, HER2-low had no significant impact on OS (HR 0.95; 95% CI 0.79-1.13; P = 0.545). No difference in prognosis was observed between HER2 IHC 0/1+ and IHC 2+ tumors (HR 0.89; 95% CI 0.69-1.17; P = 0.414).ConclusionsIn this large international dataset of metastatic TNBC, the frequency of HER2-low was 32.0%. Neither in univariable nor in multivariable analysis HER2-low showed any influence on OS. Triple-negative breast cancer (TNBC) is associated with poor prognosis, and new treatment options are urgently needed. About 34%-39% of primary TNBCs show a low expression of human epidermal growth factor receptor 2 (HER2-low), which is a target for new anti-HER2 drugs. However, little is known about the frequency and the prognostic value of HER2-low in metastatic TNBC. We retrospectively included patients with TNBC from five European countries for this international, multicenter analysis. Triple-negativity had to be shown in a metastatic site or in the primary breast tumor diagnosed simultaneously or within 3 years before metastatic disease. HER2-low was defined as immunohistochemically (IHC) 1+ or 2+ without ERBB2 gene amplification. Survival probabilities were calculated by the Kaplan–Meier method, and multivariable hazard ratios (HRs) were estimated by Cox regression models. In total, 691 patients, diagnosed between January 2006 and February 2021, were assessable. The incidence of HER2-low was 32.0% [95% confidence interval (CI) 28.5% to 35.5%], with similar proportions in metastases (n = 265; 29.8%) and primary tumors (n = 425; 33.4%; P = 0.324). The median overall survival (OS) in HER2-low and HER2-0 TNBC was 18.6 and 16.1 months, respectively (HR 1.00; 95% CI 0.83-1.19; P = 0.969). Similarly, in multivariable analysis, HER2-low had no significant impact on OS (HR 0.95; 95% CI 0.79-1.13; P = 0.545). No difference in prognosis was observed between HER2 IHC 0/1+ and IHC 2+ tumors (HR 0.89; 95% CI 0.69-1.17; P = 0.414). In this large international dataset of metastatic TNBC, the frequency of HER2-low was 32.0%. Neither in univariable nor in multivariable analysis HER2-low showed any influence on OS.

The paper describes the sixth edition of Rapid Environmental Picture Atlantic exercise (REPIS-Atlantic) which took place in July 2015 off the Portuguese islands of Azores to demonstrate coordinated operations of unmanned underwater, surface, and air vehicles contributed by participants coming from Europe and the United States of America. REP-Atlantic is a yearly demonstration exercise targeted at advancing the state of art in networked vehicle systems through large scale experimentation in real-life operational scenarios.

Pneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cysts within gastrointestinal tract wall from esophagus to rectum, with preferential involvement of large and small intestine. PCI is rare with an estimated incidence of 0.03 to 0–2% in general population. PCI can be distinguished into idiopathic (15%) or secondary (85%) and the clinical picture ranges from completely asymptomatic to life-threatening intraabdominal complications. Although etiology of PCI appears to be multifactorial, the exact pathophysiology is poorly understood and two main theories have been proposed (mechanical and bacterial). Over the last decades, an enormous therapeutic armamentarium was considered in PCI's management, including hyperbaric oxygen therapy (HBOT). Treatment comprises conservative treatment in mild cases to surgery in highly symptomatic and complicated PCI. In the late 70s, HBOT started to be used in selected cases of PCI not responding to conservative measures. Since then, several case reports, case series, and reviews have been published in the literature with variable outcomes. The overall response rate and complete response were 92.1% ( n = 82/89) and 65.2% ( n = 58/89), respectively, with a median follow-up of 7 months. Furthermore, HBOT is extremely safe, with few reported complications in the literature when used for PCI. Nevertheless, a randomized, controlled, and double-blind clinical trial is unlikely to occur given the rarity of PCI, logistical issues of HBOT, and methodological considerations related to adequate blinding with a sham-controlled group. HBOT in combination with personalized diet and antibiotics may be beneficial for moderate to severe PCI in patients with no indication for emergency exploratory laparotomy. The purpose of this article is to synthesize the existing data, analyse results of previous studies, identify gaps in knowledge, and discuss PCI' management, including the proposal of an algorithm, with a special focus on HBOT.

Propeller cavitation is a significant contributor to vessel underwater radiated noise (URN). It is often assumed to be the major contributor for large vessels at higher speeds, but very little work is available in the literature on the role of cavitation on small boat propellers. In this work, data from two trials are presented to show how cavitation develops on small boats and how this contributes to the overall sound levels. Camera footage is combined with hydrophone measurements to determine the cavitation inception speed and this shows that tip vortex cavitation can appear at 5 knots. The emergence of cavitation is accompanied by a sharp rise in the URN levels. Cavitation due to gas bubbles being pulled close to the propeller blades is observed at speeds as low as 4 knots, leading to either bubble collapse close to the blades or the tip vortex cavitating downstream of the propeller. Wavelet analysis is used to investigate the makeup of the high frequency noise, providing insights into the types of cavitation that are present and how they scale with speed. This shows that high frequency noise from cloud cavitation increases far more substantially with speed than for tip vortex cavitation. • Camera footage shows the cavitation pattern on an outboard propeller. • The cavitation inception speed on all three boats is no more than 6 knots. • Tip vortex cavitation predominates on both outboard-powered vessels. • High frequency noise scales weakly with speed when tip vortex cavitation predominates. • High frequency noise scales strongly with speed when cloud cavitation predominates.

The REP10 AUV experiment, which took place in Portugal, is described together with the lessons learned with this deployment. The REP10 AUV experiment was organized by the Portuguese Navy in cooperation with the Naval Undersea Warfare Center - Newport (US), Porto University (PO), the Naval Research Laboratory (US) and the NATO Undersea Research Centre (IT). The experiment was focused on the demonstration of heterogeneous autonomous vehicles in mine-warfare and Rapid Environmental Assessment missions. Nine autonomous submarines of 4 different types (Gavia, Iver2, LAUV SeaCon and Isurus) were deployed together with the autonomous catamaran Swordfish from the Bacamarte ship from the Portuguese Navy. Spatial and temporal segregation principles simplified the deployment of multiple vehicles from different institutions. Inter-operated wireless and acoustic networks were used to demonstrate the feasibility of real-time task re-planning and situational awareness. The surface autonomous vehicle proved key to the deployment of additional sonars and communication gateways. Remote servers were used for data assimilation and forecasting for daily planning.

The success of current and future military operations not only depends significantly on the explicit, technical, and tactical knowledge of the military personnel who execute them but also on their attitudes and behavior, such as courage, commitment, and high levels of readiness. Thus, using a sample of 336 military personnel exclusively from the operational component of the Portuguese Navy (PON) force system, the first aim of this study was to analyze the relationship between the perception of HPWS and the three dimensions of organizational commitment (OC), i.e., affective (AC), normative (NC) and continuance commitment (CC). The second aim was to analyze the mediating role of the three dimensions of commitment in the relationship between HPWS and performance, i.e., task performance (TP), contextual performance (CP), and counterproductive performance (CPP). The results obtained through the analysis of structural equation models made it possible to support a positive and significant relationship between the HPWS and each of the dimensions of commitment. The results also indicated that the AC has a mediating effect on the relationship between HPWS and performance, fully in the case of CP and partially in TP. In CPP, we observed that there is an indirect effect of HPWS and this dimension of performance. The theoretical and practical implications of these results are discussed.

Sumario 1. Definicao, Epidemiologia e Classificacao das Emergencias Hipertensivas 738 2. Aspectos Fisiopatologicos da Emergencia Hipertensiva 739 […] Posicionamento Luso-Brasileiro de Emergencias Hipertensivas – 2020

Abstract The use of the finite element concept in the time domain has resulted in a reinterpretation of many previously recorded recurrence formulae and the discovery of new ones. An important new feature common to all such schemes is the fact that a weighted forcing term is used. This precludes the application of unrealistic forcing terms resulting in a direct finite difference derivation and ‘smooths’ oscillation due to sudden changes of boundary condition. This problem is discussed in the context of various two‐ and three‐level time schemes.

Today, in our landscape perception exists a gap that needs to be fulfilled. It's important to increase the coverage, temporal and spatial resolution in order to cover this gap, as well as reduce costs with human resources that usually take this kind of tasks. Unmanned Autonomous vehicles with their inherent autonomy and reduced needs of human and communication resources, can provide additional capabilities and a new innovative solution to this problem This paper presents and describes the participation of ICARUS Team at euRathlon 2015 and the importance of this type of events performed with multiple unnamed systems.

It is presented a vision system based on a standard RGB digital camera to track an unmanned aerial vehicle (UAV) during the landing process aboard a ship. The developed vision system is located on the ship's deck and is used to track the UAV during all the landing process. A Ground-based vision system makes it possible to use an UAV with small size and weight, since the UAV will have less computer requirements. The proposed method uses a particle filter (PF) for pose estimation and an unscented Kalman filter (UKF) approach for filtering. This combination provides an adapted filtering framework for tracking. The implemented particle filter is inspired in the evolution strategies present in genetic algorithms with modifications in the mutation and crossover operators to avoid sample impoverishment. Results show that position and angular estimates precision is compatible with the automatic landing system requirements.

Background Wayfinding has been adopted in several intense evacuation and navigation simulations; however, the use of biometric measurements for characterizing physiological outcomes has been somewhat overlooked and applied only under limited laboratory conditions. Methods Twenty-four participants took part in a virtual reality (VR) experiment using a wayfinding installation with the Oculus Rift S head-mounted display (HMD). They were immersed in a simulation of a burning underground parking lot and tasked to navigate to the exit. The purpose of this research was to investigate the high-level effect of wayfinding assistive lights on behavioral, physiological, and psychological outcomes. Participants were split into two groups: the control group was exposed to a scene without assistive lights, and the experimental group was exposed to the same scene with assistive lights. Results Results indicate there was no statistically significant difference between the groups in traveled distance, pauses, turns, or game completion time. Curiously, differences between the two groups in heart rate (HR) outcomes were found to be statistically significant, with subjects in the control group displaying an increasing HR trend during simulation. Conclusions This finding, in accordance with previous studies that have shown the efficacy of landmarks and wayfinding affordances in reducing cognitive demands, suggests that assistive lights might contribute to improved brain wiring connectivity during the game. We discuss these findings in the context of a rich wayfinding affordances literature.