Paulo S. A. Sousa

Omniview-SisPorto 3.5 - a central fetal monitoring station with online alerts based on computerized cardiotocogram+ST event analysis.

Visual analysis of cardiotocograms is poorly reproducible and is currently recognized as the main weakness of the STAN methodology. The Omniview-SisPorto 3.5 program is the most recent version of a central monitoring system that provides visual and sound alerts, based on computer analysis of cardiotocographic and ST event features. This paper describes the programs main characteristics and provides an overview of the systems online alerts. Omniview-SisPorto 3.5 is the first central monitoring system to incorporate computerized analysis of cardiotocographic and ST event features, providing health professionals with online alerts for minor and major changes in monitored signals. The system is currently undergoing extensive clinical evaluation.

A Genetic Algorithm for Lot Size and Scheduling under Capacity Constraints and Allowing Backorders

This article addresses the problem of scheduling economic lots in a multi-product single-machine environment. A mixed integer non-linear programming formulation is developed, which finds the optimal sequence and economic lots. The model takes explicit account of initial inventories, setup times, allows setups to be scheduled at arbitrary epochs in continuous time and models backorders. To solve the problem we develop a hybrid approach, combining a genetic algorithm and linear programming. The approach is tested on a set of instances taken from the literature and compared with other approaches. The experimental results validate the quality of the solutions and the effectiveness of the proposed approach.

Humanized robot dancing: humanoid motion retargeting based in a metrical representation of human dance styles

Expressiveness and naturalness in robotic motions and behaviors can be replicated with the usage of captured human movements. Considering dance as a complex and expressive type of motion, in this paper we propose a method for generating humanoid dance motions transferred from human motion capture (MoCap) data. Motion data of samba dance was synchronized to samba music, manually annotated by experts, in order to build a spatiotemporal representation of the dance movement with variability, in relation to the respective musical temporal structure (musical meter). This enabled the determination and generation of variable dance key-poses according to the captured human body model. In order to retarget these key-poses from the original human model into the considered humanoid morphology, we propose methods for resizing and adapting the original trajectories to the robot joints, overcoming its varied kinematic constraints. Finally, a method for generating the angles for each robot joint is presented, enabling the reproduction of the desired poses in a simulated humanoid robot NAO. The achieved results validated our approach, suggesting that our method can generate poses from motion capture and reproduce them on a humanoid robot with a good degree of similarity.

Factors Influencing the Internationalization of Services Firms: The Case of Design, Engineering and Architecture Consulting Firms

Globalization has created countless opportunities for the internationalization of a wide range of services. Recent technological innovations associated with the reduction or elimination of trade barriers, resulted in an exponential expansion of service firms. This paper analyzes the internal and external factors that influence the decision to operate internationally. The hypotheses are empirically examined through a survey sent to 322 firms from the design, architecture and engineering sector. Multivariate analysis is used to ascertain the main determinants of internationalization in these firms.

SisPorto 4.0 – computer analysis following the 2015 FIGO Guidelines for intrapartum fetal monitoring

Abstract SisPorto 4.0 is the most recent version of a program for the computer analysis of cardiotocographic (CTG) signals and ST events, which has been adapted to the 2015 International Federation of Gynaecology and Obstetrics (FIGO) guidelines for intrapartum foetal monitoring. This paper provides a detailed description of the analysis performed by the system, including the signal-processing algorithms involved in identification of basic CTG features and the resulting real-time alerts.

Audit of a fetal central monitoring station in a clinical setting.

Abstract Objective. To conduct an audit of the Omniview-SisPorto® central monitoring station (CMS) and determine the effect of the measures undertaken to correct identified problems. Methods. All cardiotocograms (CTGs) recorded in randomly selected days of 2006 and 2009, both in the outpatient clinic and labor ward, were reviewed to assess the following parameters: tracing identification, duration, signal quality, signal loss, acquisition method, and time elapsed between tracing-end and birth. A random sample of cases was compared with original paper recordings and 25% of CTGs were re-retrieved for comparison with first retrieval. Results. Antepartum tracings were identified in 92% of cases. Mean signal quality rose from 96.4% in 2006 to 97.1% in 2009 (p = 0.009). Mean signal loss fell from 7.4% to 5.8% (p = 0.012). Intrapartum CTGs were identified in 44% of cases in 2006 and in 69% in 2009 (p < 0.001). Mean interval between tracing-end and birth decreased from 12.0 to 8.4 min (p < 0.001). Coincidence of variables in tracings retrieved twice increased between 2006 and 2009. All retrieved tracings matched the original paper recordings. Several technical problems identified in 2006 were not found in 2009. Conclusions. The Omniview-SisPorto® system showed reliable recording, storage, and retrieval of CTGs. Auditing of fetal CMSs allows improvement of their performance and use.

Central Fetal Monitoring With and Without Computer Analysis: A Randomized Controlled Trial.

OBJECTIVE To evaluate whether intrapartum fetal monitoring with computer analysis and real-time alerts decreases the rate of newborn metabolic acidosis or obstetric intervention when compared with visual analysis. METHODS A randomized clinical trial carried out in five hospitals in the United Kingdom evaluated women with singleton, vertex fetuses of 36 weeks of gestation or greater during labor. Continuous central fetal monitoring by computer analysis and online alerts (experimental arm) was compared with visual analysis (control arm). Fetal blood sampling and electrocardiographic ST waveform analysis were available in both arms. The primary outcome was incidence of newborn metabolic acidosis (pH less than 7.05 and base deficit greater than 12 mmol/L). Prespecified secondary outcomes included operative delivery, use of fetal blood sampling, low 5-minute Apgar score, neonatal intensive care unit admission, hypoxic-ischemic encephalopathy, and perinatal death. A sample size of 3,660 per group (N=7,320) was planned to be able to detect a reduction in the rate of metabolic acidosis from 2.8% to 1.8% (two-tailed α of 0.05 with 80% power). RESULTS From August 2011 through July 2014, 32,306 women were assessed for eligibility and 7,730 were randomized: 3,961 to computer analysis and online alerts, and 3,769 to visual analysis. Baseline characteristics were similar in both groups. Metabolic acidosis occurred in 16 participants (0.40%) in the experimental arm and 22 participants (0.58%) in the control arm (relative risk 0.69 [0.36-1.31]). No statistically significant differences were found in the incidence of secondary outcomes. CONCLUSION Compared with visual analysis, computer analysis of fetal monitoring signals with real-time alerts did not significantly reduce the rate of metabolic acidosis or obstetric intervention. A lower-than-expected rate of newborn metabolic acidosis was observed in both arms of the trial. CLINICAL TRIAL REGISTRATION ISRCTN Registry, http://www.isrctn.com, ISRCTN42314164.

A parameterizable spatiotemporal representation of popular dance styles for humanoid dancing characters

Dance movements are a complex class of human behavior which convey forms of non-verbal and subjective communication that are performed as cultural vocabularies in all human cultures. The singularity of dance forms imposes fascinating challenges to computer animation and robotics, which in turn presents outstanding opportunities to deepen our understanding about the phenomenon of dance by means of developing models, analyses and syntheses of motion patterns. In this article, we formalize a model for the analysis and representation of popular dance styles of repetitive gestures by specifying the parameters and validation procedures necessary to describe the spatiotemporal elements of the dance movement in relation to its music temporal structure (musical meter). Our representation model is able to precisely describe the structure of dance gestures according to the structure of musical meter, at different temporal resolutions, and is flexible enough to convey the variability of the spatiotemporal relation between music structure and movement in space. It results in a compact and discrete mid-level representation of the dance that can be further applied to algorithms for the generation of movements in different humanoid dancing characters. The validation of our representation model relies upon two hypotheses: (i) the impact of metric resolution and (ii) the impact of variability towards fully and naturally representing a particular dance style of repetitive gestures. We numerically and subjectively assess these hypotheses by analyzing solo dance sequences of Afro-Brazilian samba and American Charleston, captured with a MoCap (Motion Capture) system. From these analyses, we build a set of dance representations modeled with different parameters, and re-synthesize motion sequence variations of the represented dance styles. For specifically assessing the metric hypothesis, we compare the captured dance sequences with repetitive sequences of a fixed dance motion pattern, synthesized at different metric resolutions for both dance styles. In order to evaluate the hypothesis of variability, we compare the same repetitive sequences with others synthesized with variability, by generating and concatenating stochastic variations of the represented dance pattern. The observed results validate the proposition that different dance styles of repetitive gestures might require a minimum and sufficient metric resolution to be fully represented by the proposed representation model. Yet, these also suggest that additional information may be required to synthesize variability in the dance sequences while assuring the naturalness of the performance. Nevertheless, we found evidence that supports the use of the proposed dance representation for flexibly modeling and synthesizing dance sequences from different popular dance styles, with potential developments for the generation of expressive and natural movement profiles onto humanoid dancing characters.

Theory of Constraints in the Service Sector: Characterization for Banking and Analysis of the Factors Involved in Its Adoption

In this research we represent the major elements of the Theory of Constraints (TOC) in a services environment, specifically for the banking sector, and we analyze the factors involved in the decision to adopt the TOC by companies in this sector.

Does innovation influence the performance of healthcare organizations

Abstract Innovation is a widely studied field. It is extremely important for any organization wishing to achieve and maintain a competitive advantage in the market, even though assessing the impacts of innovation represents a challenge due to the difficulty of isolating and measuring it. Furthermore, healthcare institutions are facing an increasing need for innovation in order to become competitive and offer new treatments for patients. Surprisingly, little is known about the nature of innovativeness in healthcare organizations and its relationship with performance. The aim of this research is to analyze whether the several types of innovation influence the relevant measures of performance in healthcare institutions, researching empirically the innovativeness–performance relationship. The study is based on a quantitative analysis on 34 Portuguese hospitals, collecting detailed information about the innovation portfolio of each one. Factor analysis and hypothesis testing were applied. Moreover, the hospitals were classified by type of property and geographical region they belong to, and statistical comparative tests were performed to test the existence of statistical differences. It was found that organizational innovation is correlated with process innovation and service innovation. Furthermore, service and process innovations influence operational performance. However, we cannot conclude that innovation in healthcare units has an overall impact on their financial performance. The results of this study may help hospital administrators to make better decisions with regard to their innovation policy design.