Escola Superior de Tecnologia e Gestão
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Browsing Escola Superior de Tecnologia e Gestão by Field of Science and Technology (FOS) "Ciências Médicas::Outras Ciências Médicas"
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- Commingled and disarticulated human remains related to 1755 Lisbon earthquake: Height estimation from incomplete and complete femoral bonesPublication . Matos, Sofia; Flamino, Carolina Barroso; Borges, Guilherme; Francisco, Inês; Tropa, Madalena; Cruz, Tiago; Bento, Beatriz; Santos, Rui; Pereira, Cristiana PalmelaIntroduction: In Forensic Medicine, the estimation of the stature often has a crucial role in the reconstruction phase of disjointed populations. The femur, being the longest bone in the human body, is usually the most reliable source in height estimation. However, in these populations, intact femurs are hardly ever found, making it necessary to use femur fragments for the same purpose. Aim: This investigation aims to estimate the stature of the catastrophic population concerning the earthquake that occurred in Lisbon, in 1755. Materials and Methods: The study was conducted on 8 whole femurs and 21 fragments, which were measured and weighted. These measurements were applied in a regression formula, obtained from the gathered research, in order to estimate the stature of the population. Results: The results showed that, for the whole femur, the corresponding height varies between 147.96 cm and 168.82 cm. For the fragments, the obtained estimates vary between 151.96 cm and 174.96 cm. Conclusion: The methods used proved to be reliable in estimating the length of the femur, as well as in deducting the height of individuals through this bone, allowing the study of these parameter's evolution in generations.
- Dermoscopic skin lesion image segmentation based on Local Binary Pattern Clustering: Comparative studyPublication . Pereira, Pedro M. M.; Fonseca-Pinto, Rui; Paiva, Rui Pedro; Assuncao, Pedro A. A.; Tavora, Luis M. N.; Thomaz, Lucas A.; Faria, Sergio M. M.Accurate skin lesion segmentation is important for identification and classification through computational methods. However, when performed by dermatologists, the results of clinical segmentation are affected by a certain margin of inaccuracy (which exists since dermatologist do not delineate lesions for segmentation but for extraction) and also significant inter- and intra-individual variability, such segmentation is not sufficiently accurate for segmentation studies. This work addresses these limitations to enable detailed analysis of lesions’ geometry along with extraction of non-linear characteristics of region-of-interest border lines. A comprehensive review of 39 segmentation methods is carried out and a contribution to improve dermoscopic image segmentation is presented to determine the regions-of-interest of skin lesions, through accurate border lines with fine geometric details. This approach resorts to Local Binary Patterns and k-means clustering for precise identification of lesions boundaries, particularly the melanocytic. A comparative evaluation study is carried out using three different datasets and reviewed algorithms are grouped according to their approach. Results show that algorithms from the same group tend to perform similarly. Nevertheless, their performance does not depend uniquely on the algorithm itself but also on the underlying dataset characteristics. Throughout several evaluations, the proposed Local Binary Patterns method presents, consistently, better average performance than the current state-of-the-art techniques across the three different datasets without the need of training or supervised learning steps. Overall, apart from presenting a new segmentation method capable of outperforming the current state-of-the-art, this paper provides insightful information about the behaviour and performance of different image segmentation algorithms.
- Lichen planus and its therapeutic management: a retrospective studyPublication . Rebelo, Mariana Rodrigues; Pereira, Cristina Palmela; Santos, Rui Sousa; Soares-de-Almeida, Luís; Filipe, PauloObjectives: To study the epidemiological distribution of the disease lichen planus and its therapeutic management. Methods: A total of 174 patients with a lichen planus diagnosis between 2008 and 2017 at a Portuguese public hospital were included in this retrospective study. The following data were collected from clinical records: gender, age, topographic distribution of lesions, prescribed therapy (active substance, route, and scheme of administration), mean duration of illness, and episodes of cure and relapse. Statistical analysis was performed using IBM® SPSS® Statistics software, version 25. Results: In this population, lichen planus affected both genders with the same probability (p=0.820), and was more prevalent in the 4th-5th decades of age. The lesions appeared in the skin (75.9% of the patients), mucous membranes (5.2%), or both (19.0%). The most prescribed drugs were corticosteroids, followed by antihistamines and immunosuppressants. Topical corticosteroids were the most common ones, namely clobetasol propionate (37.4%). Within the systemic corticosteroids, prednisolone was the most prescribed drug (12.3%). The average duration of lesions and symptoms was approximately 6.5 months. For the relapsing population (12%), the mean period of symptoms’ remission was 513 days. Conclusions: The epidemiological parameters of lichen planus in these Portuguese patients bear similarities with other described populations. No evidence-based therapeutic has proven to be effective for lichen planus treatment, but topical corticosteroids continue to be the first-line therapy for this pathology.
- Osteometric and osteomorphological sex estimation from the Os Coxa in an archaelogical population related to the 1755 earthquake of LisbonPublication . Flamino, Carolina Barroso; Oliveira, Daniel; Ferreira, Leonor; Martins, Matilde; Santos, Renata; Laureano, Rita; Nunes, Tânia; Bento, Beatriz; Santos, Rui; Pereira, Cristiana PalmelaIntroduction: The ability to determine sex from unknown skeletal remains vital, and methods to do it on various bones of the human skeleton have been researched extensively. The present work consists in the analysis of coxal bones belonging to the victims of the 1755 Lisbon's Earthquake. Aims: This project aims the characterization of the population whose skeletal remains were found in the Cloister's South Wing of Academia das Ciencias de Lisboa in 2004. Materials and Methods: In order to achieve the final objective, six measurements were taken, in anatomic position, and seven indices were calculated. Furthermore, morphological characteristics were observed through four different methods. These procedures were applied to a total number of 129 coxal bones. Results: From measurements and indices, the best results found were 16 females and 5 males, but the overall results were not reliable, since there was no consensus between the different measurements and so the majority of the coxal bone were classified as ambiguous. However, the Phenice's Method in the study of the coxal morphology showed to be very specific-through this procedure 18 females and 9 males were estimated. Conclusions: It was noticed that the measurements and the calculation of indices are less reliable than the morphological observations. Moreover, Phenice's Method seemed to be the most precise, once it evaluates three parameters simultaneously, instead of just one, allowing to obtain more accurate results for sexual discrimination.
- Profiling IT Security and Interoperability in Brazilian Health Organisations From a Business PerspectivePublication . Rijo, Rui; Martinho, Ricardo; Oliveira, Adicinéia Aparecida; Alves, Domingos; Reis, Zilma Silveira Nogueira; Santos-Pereira, Cátia; Correia, Manuel E.; Antunes, Luís Filipe; Cruz-Correia, Ricardo JoãoThe proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades has resulted in a considerable fragmentation within health information technology (IT), with a strong political interference. The problem regarding this issue became twofold: 1) there are considerable flaws regarding interoperability and security involving patient data; and 2) it is difficult even for an experienced company to enter the Brazilian health IT market. In this article, the authors aim to assess the current state of IT interoperability and security in hospitals in Brazil and evaluate the best business strategy for an IT company to enter this difficult but very promising health IT market. A face-to-face questionnaire was conducted among 11 hospital units to assess their current status regarding IT interoperability and security aspects. Global Brazilian socio-economic data was also collected, and helped to not only identify areas of investment regarding health IT security and interoperability, but also to derive a business strategy, composed out of recommendations listed in the paper.
- The reference method influence on the sensitivity of the Clostridium difficile enzyme immunoassays: A meta analysisPublication . Martins, João Paulo; Felgueiras, Miguel; Santos, RuiThe use of enzyme immunoassays to screen for toxins A and B produced by Clostridium difficile is a common procedure in algorithms designed for its detection. Moreover, the absence of a unique test capable of providing reliable results at low cost motivates a great discussion about which algorithm is the best. Thus, several studies have evaluated the performance of these enzyme immunoassays. However, all fail to provide sufficient explanations for the different behaviours observed in different studies that evaluate the same index test against a common reference method. Our main goal was to find out which factors affect the sensitivity of these assays, since the specificity is very close to 1. In this research, we verified that sensitivity increases with the prevalence rate and with the proportion of reported cases of onset diarrhea. Therefore, its use is advisable for high prevalence rates (e.g. in an epidemic setting). As far as reference methods are concerned, nucleic acid amplification tests can be used as a reference method, with a performance similar to the well-accepted toxigenic culture. The method chosen for toxigenicity screening in a toxigenic culture also seems to affect the evaluation performance of tests and should be better studied in the future.
- The role of beliefs, expectations and values in decision-making favoring climate change adaptation - Implications for communications with European forest professionalsPublication . Blennow, K.; Persson, J.; Gonçalves, Luísa M.S.; Borys, A.; Dutcă, I.; Hynynen, J.; Janeczko, E.; Lyubenova, M.; Merganič, J.; Merganičová, K.; Peltoniemi, M.; Petr, M.; Reboredo, F.; Vacchiano, G.; Reyer, C. P. O.Beliefs, expectations and values are often assumed to drive decisions about climate change adaptation. We tested hypotheses based on this assumption using survey responses from 508 European forest professionals in ten countries. We used the survey results to identify communication needs and the decision strategies at play, and to develop guidelines on adequate communications about climate change adaptation. We observed polarization in the positive and negative values associated with climate change impacts accepted by survey respondents. We identified a mechanism creating the polarization that we call the 'blocked belief' effect. We found that polarized values did not correlate with decisions about climate change adaptation. Strong belief in the local impacts of climate change on the forest was, however, a prerequisite of decision-making favoring adaptation. Decision-making in favor of adaptation to climate change also correlated with net values of expected specific impacts on the forest and generally increased with the absolute value of these in the absence of 'tipping point' behavior. Tipping point behavior occurs when adaptation is not pursued in spite of the strongly negative or positive net value of expected climate change impacts. We observed negative and positive tipping point behavior, mainly in SW Europe and N-NE Europe, respectively. In addition we found that advice on effective adaptation may inhibit adaptation when the receiver is aware of effective adaptation measures unless it is balanced with information explaining how climate change leads to negative impacts. Forest professionals with weak expectations of impacts require communications on climate change and its impacts on forests before any advice on adaptation measures can be effective. We develop evidence-based guidelines on communications using a new methodology which includes Bayesian machine learning modeling of the equivalent of an expected utility function for the adaptation decision problem.
- Skin lesion classification enhancement using border-line features – The melanoma vs nevus problemPublication . Pereira, Pedro M. M.; Fonseca-Pinto, Rui; Paiva, Rui Pedro; Assuncao, Pedro A. A.; Tavora, Luis M. N.; Thomaz, Lucas A.; Faria, Sergio M. M.Machine learning algorithms are progressively assuming an important role as a computational tool to support clinical diagnosis, namely in the classification of pigmented skin lesions. The current classification methods commonly rely on features derived from shape, colour, or texture, obtained after image segmentation, but these do not always guarantee the best results. To improve the classification accuracy, this work proposes to further exploit the border-line characteristics of the lesion segmentation mask, by combining gradients with local binary patterns (LBP). In the proposed method, these border-line features are used together with the conventional ones to enhance the performance of skin lesion classification algorithms. When the new features are combined with the classical ones, the experimental results show higher accuracy, which impacts positively the overall performance of the classification algorithms. As the medical image datasets usually present large class imbalance, which results in low sensitivity for the classifiers, the border-line features have a positive impact on this classification metric, as evidenced by the experimental results. Both the features’ usefulness and their impact are assessed in regard to the classification results, which in turn are statistically tested for completeness, using three different classifiers and two medical image datasets.
- Statistical Modeling of Lower Limb Kinetics During Deep Squat and Forward LungePublication . Roeck, Joris De; Houcke, J. Van; Almeida, D.; Galibarov, P.; Roeck, L. De; Audenaert, Emmanuel A.Purpose: Modern statistics and higher computational power have opened novel possibilities to complex data analysis. While gait has been the utmost described motion in quantitative human motion analysis, descriptions of more challenging movements like the squat or lunge are currently lacking in the literature. The hip and knee joints are exposed to high forces and cause high morbidity and costs. Pre-surgical kinetic data acquisition on a patient-specific anatomy is also scarce in the literature. Studying the normal inter-patient kinetic variability may lead to other comparable studies to initiate more personalized therapies within the orthopedics. Methods: Trials are performed by 50 healthy young males who were not overweight and approximately of the same age and activity level. Spatial marker trajectories and ground reaction force registrations are imported into the Anybody Modeling System based on subject-specific geometry and the state-of-the-art TLEM 2.0 dataset. Hip and knee joint reaction forces were obtained by a simulation with an inverse dynamics approach. With these forces, a statistical model that accounts for inter-subject variability was created. For this, we applied a principal component analysis in order to enable variance decomposition. This way, noise can be rejected and we still contemplate all waveform data, instead of using deduced spatiotemporal parameters like peak flexion or stride length as done in many gait analyses. In addition, this current paper is, to the authors’ knowledge, the first to investigate the generalization of a kinetic model data toward the population. Results: Average knee reaction forces range up to 7.16 times body weight for the forwarded leg during lunge. Conversely, during squat, the load is evenly distributed. For both motions, a reliable and compact statistical model was created. In the lunge model, the first 12 modes accounts for 95.26% of inter-individual population variance. For the maximal-depth squat, this was 95.69% for the first 14 modes. Model accuracies will increase when including more principal components. Conclusion: Our model design was proved to be compact, accurate, and reliable. For models aimed at populations covering descriptive studies, the sample size must be at least 50.