204 resultados para balanced anesthesia


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FROM KCWS 2011 CHAIRS AND SUMMIT PROCEEDING EDITORS In recent years, with the impact of global knowledge economy, a more comprehensive development approach has gained significant popularity. This new development approach, so called ‘knowledgebased development’, is different from its traditional predecessor. With a much more balanced focus on all of the four key development domains – economic, enviro-urban, institutional, and sociocultural – this contemporary approach, aims to bring economic prosperity, environmental sustainability and local institutional competence with a just socio-spatial order to our cities and regions. The ultimate goal of knowledge-based development is to produce a city purposefully designed to encourage the continuous production, circulation and commercialisation of social and scientific knowledge – this will in turn establish a ‘knowledge city’. A city following the ‘knowledge city’ concept embarks on a strategic mission to firmly encourage and nurture locally focussed innovation, science and creativity within the context of an expanding knowledge economy and society. In this regard a ‘knowledge city’ can be seen as an integrated city, which physically and institutionally combines the functions of a science and technology park with civic and residential functions and urban amenities. It also offers one of the effective paradigms for the sustainable cities of our time. This fourth edition of KCWS – The 4th Knowledge Cities World Summit 2011 – makes an important reminder that the 'knowledge city' concept is a key notion in the 21st Century development. Considering this notion, the Summit sheds light on the multi-faceted dimensions and various scales of building a ‘knowledge city’ via 'knowledge-based development' paradigm by particularly focusing on the overall Summit theme of ‘Knowledge Cities for Future Generations’. At this summit, the theoretical and practical maturing of knowledge-based development paradigms are advanced through the interplay between the world’s leading academics’ theories and the practical models and strategies of practitioners’ and policy makers’ drawn from around the world. This summit proceeding is compiled in order to disseminate the knowledge generated and shared in KCWS 2011 with the wider research, governance, and practice communities the knowledge cocreated in this summit. All papers of this proceeding have gone through a double-blind peer review process and been reviewed by our summit editorial review and advisory board members. We, organisers of the summit, cordially thank the members of the Summit Proceeding Editorial Review and Advisory Board for their diligent work in the review of the papers. We hope the papers in this proceeding will inspire and make a significant contribution to the research, governance, and practice circles.

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This study determined the current trends in supply, demand, and equilibrium (ie, the level of employment where supply equals demand) in the market for Certified Registered Nurse Anesthetists (CRNAs). It also forecasts future needs for CRNAs given different possible scenarios. The impact of the current availability of CRNAs, projected retirements, and changes in the demand for surgeries are considered in relation to CRNAs needed for the future. The study used data from many sources to estimate models associated with the supply and demand for CRNAs and the relationship to relevant community and policy characteristics such as per capita income of the community and managed care. These models were used to forecast changes in surgeries and in the supply of CRNAs in the future. The supply of CRNAs has increased in recent years, stimulated by shortages of CRNAs and subsequent increases in the number of CRNAs trained. However, the increases have not offset the number of retiring CRNAs to maintain a constant age in the CRNA population. The average age will continue to increase for CRNAs in the near future despite increases in CRNAs trained. The supply of CRNAs in relation to surgeries will increase in the near future.

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This article introduces a deterministic approach to using low-temperature, thermally non-equilibrium plasmas to synthesize delicate low-dimensional nanostructures of a small number of atoms on plasma exposed surfaces. This approach is based on a set of plasma-related strategies to control elementary surface processes, an area traditionally covered by surface science. Major issues related to balanced delivery and consumption of building units, appropriate choice of process conditions, and account of plasma-related electric fields, electric charges and polarization effects are identified and discussed in the quantum dot nanoarray context. Examples of a suitable plasma-aided nanofabrication facility and specific effects of a plasma-based environment on self-organized growth of size- and position-uniform nanodot arrays are shown. These results suggest a very positive outlook for using low-temperature plasma-based nanotools in high-precision nanofabrication of self-assembled nanostructures and elements of nanodevices, one of the areas of continuously rising demand from academia and industry.

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This paper presents the design of a dual Z-source inverter that can be used with either a single dc source or two isolated dc sources. Unlike traditional inverters, the integration of a properly designed Z-source network and semiconductor switches to the proposed dual inverter allows buck-boost power conversion to be performed over a wide modulation range with three-level output waveforms generated. The connection of an additional transformer to the inverter ac output also allows all generic wye- or delta-connected loads with three-wire or four-wire configuration to be supplied by the inverter. Modulation-wise, the dual inverter can be controlled using a carefully designed carrier-based pulse-width modulation (PWM) scheme that always will ensure balanced voltage boosting of the Z-source network, while simultaneously achieving reduced common-mode switching. Because of the omission of dead-time delays in the dual inverter PWM scheme, its switched common-mode voltage can be completely eliminated, unlike in traditional inverters where narrow common-mode spikes are still generated. Under semiconductor failure conditions, the presented PWM schemes can easily be modified to allow the inverter to operate without interruption and for cases where two isolated sources are used, zero common-mode voltage can still be ensured. These theoretical findings together with the inverter practicality have been confirmed both in simulations using PSIM with Matlab/Simulink coupler and experimentally using a laboratory implemented inverter prototype.

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This paper presents the design of a dual Z-source inverter that can be used with either a single dc source or two isolated dc sources. Unlike traditional inverters, the integration of a properly designed Z-source network and semiconductor switches to the proposed dual inverter allows buck-boost power conversion to be performed over a wide modulation range, with three-level output waveforms generated. The connection of an additional transformer to the inverter ac output also allows all generic wye-or delta-connected loads with three-wire or four-wire configuration to be supplied by the inverter. Modulationwise, the dual inverter can be controlled using a carefully designed carrier-based pulsewidth-modulation (PWM) scheme that will always ensure balanced voltage boosting of the Z-source network while simultaneously achieving reduced common-mode switching. Because of the omission of dead-time delays in the dual-inverter PWM scheme, its switched common-mode voltage can be completely eliminated, unlike in traditional inverters, where narrow common-mode spikes are still generated. Under semiconductor failure conditions, the presented PWM schemes can easily be modified to allow the inverter to operate without interruption, and for cases where two isolated sources are used, zero common-mode voltage can still be ensured. These theoretical findings, together with the inverter practicality, have been confirmed in simulations both using PSIM with Matlab/Simulink coupler and experimentally using a laboratory-implemented inverter prototype.

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The paper investigates the design of secret sharing that is immune against cheating (as defined by the Tompa-Woll attack). We examine secret sharing with binary shares and secrets. Bounds on the probability of successful cheating are given for two cases. The first case relates to secret sharing based on bent functions and results in a non-perfect scheme. The second case considers perfect secret sharing built on highly nonlinear balanced Boolean functions.

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In 1972, the United Nations (UN) Conference on the Human Environment expressed a growing realization that economic and social progress needed to be balanced with a concern for the environment and the stewardship of natural resources. The hard-to-grasp concept of "sustainable development" was first defined as "development that meets the needs of the present without compromising the ability of future generations to meet their needs" (World Commission on Environment and Development [WESDJ, 1987, p. 43). This definition contains two concepts: first, "human needs," with priority given to the world's poor, and, second, the environment's limits for meeting the state of technological and social organization (WESD, 1987, p. 43). At the 2002 World Summit on Sustainable Development (UN, 2002a), the focus on environmental protection broadened to encompass social justice and the fight against poverty as key principles of development that is sustainable. Three interdependent and mutually reinforcing "pillars" were recognized: economic development, social development, and environmental protection. These pillars must be established at local, national, and global levels. The complexity and interrelationship of critical issues such as poverty, wasteful consumption, urban decay, population growth, gender inequality, health, conflict, and the violation of human rights are addressed in all three pillars (Pigozzi, 2003, p. 3). Following the concept of sustainable development, we argue that the challenge for developing countries in contemporary society is to meet the very real need for economic development and opportunities for income generation, while avoiding the unintended and unwanted consequences of economic development and globalization. These consequences include social exclusion, loss of cultural heritage, and environmental and ecological problems.

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Solution processable diketopyrrolopyrrole (DPP)-bithiophene polymers (PDBT) with long branched alkyl side chains on the DPP unit are synthesized. These polymers have favourable highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) energy levels for the injection and transport of both holes and electrons. Organic thin film transistors (OTFTs) using these polymers as semiconductors and gold as source/drain electrodes show typical ambipolar characteristics with very well balanced high hole and electron mobilities (μ h = 0.024 cm 2 V -1 s -1 and μ e = 0.056 cm 2 V -1 s -1). These simple and high-performing polymers are promising materials for ambipolar organic thin film transistors for low-cost CMOS-like logic circuits.

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We describe and discuss the unique electrical characteristics of an organic field-effect transistor in which the active layer consists of a type II lateral heterojunction located approximately midway between the source and drain. The two active semiconductors on either side of the junction transport only one carrier type each, with the other becoming trapped, which leads to devices that operate in only the steady state when there is balanced electron and hole injections from the drain and source. We describe the unique transfer characteristics of such devices in two material systems.

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A new, solution-processable, low-bandgap, diketopyrrolopyrrole- benzothiadiazole-based, donor-acceptor polymer semiconductor (PDPP-TBT) is reported. This polymer exhibits ambipolar charge transport when used as a single component active semiconductor in OTFTs with balanced hole and electron mobilities of 0.35 cm2 V-1s-1 and 0.40 cm 2 V-1s-1, respectively. This polymer has the potential for ambipolar transistor-based complementary circuits in printed electronics.

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This paper evaluates the suitability of sequence classification techniques for analyzing deviant business process executions based on event logs. Deviant process executions are those that deviate in a negative or positive way with respect to normative or desirable outcomes, such as non-compliant executions or executions that undershoot or exceed performance targets. We evaluate a range of feature types and classification methods in terms of their ability to accurately discriminate between normal and deviant executions both when deviances are infrequent (unbalanced) and when deviances are as frequent as normal executions (balanced). We also analyze the ability of the discovered rules to explain potential causes and contributing factors of observed deviances. The evaluation results show that feature types extracted using pattern mining techniques only slightly outperform those based on individual activity frequency. The results also suggest that more complex feature types ought to be explored to achieve higher levels of accuracy.

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The current ‘holy grail’ for our health and well-being centres around the search for, and establishment of, a work/life balance. For many individuals, this appears to be an ever-elusive goal – forever slipping from our grasp as we juggle the day-to-day battle for our attention and time from an array of sources. When we add the word ‘Women’ to this mix, often the number of sources related to these demands multiplies in alignment with the number of roles we fill. To take this to even another level, consider the addition of the words ‘Sport’ or ‘Elite Athlete’ to ‘Women’ and ‘Work/Life Balance’, and the search for the ‘holy grail’ becomes more literal! Many sportswomen at the elite level face significant challenges in balancing working to support themselves and/or their families, studying to lay the foundations of a post-sport career, (often) spending the equivalent of full-time hours training towards their sporting goals, and additionally investing in the things that are important for them outside of these two areas – the ‘Life’ component. Getting the work/life balance ‘balanced’ has been suggested to be a key component of investing in our health and well-being. The same is applicable to sportswomen, with the added suggestion that if the balance between work/sport/life is achieved, this can positively impact upon sporting performance itself. These ideas and observations will be explored via experience within the Australian elite sporting environment from a psychologist’s perspective, with questions and invitations for further discussion.

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Purpose We examined the age-dependent alterations and longitudinal course of subbasal nerve plexus (SNP) morphology in healthy individuals. Methods Laser-scanning corneal confocal microscopy, ocular screening, and health and metabolic assessment were performed on 64 healthy participants at baseline and at 12-month intervals for 3 years. At each annual visit, eight central corneal images of the SNP were selected and analyzed using a fully-automated analysis system to quantify corneal nerve fiber length (CNFL). Two linear mixed model approaches were fitted to examine the relationship between age and CNFL, and the longitudinal changes of CNFL over three years. Results At baseline, mean age was 51.9 ± 14.7 years. The cohort was sex balanced (χ2 = 0.56, P = 0.45). Age (t = 1.6, P = 0.12) and CNFL (t = -0.50, P = 0.62) did not differ between sexes. A total of 52 participants completed the 36-month visit and 49 participants completed all visits. Age had a significant effect on CNFL (F1,33 = 5.67, P = 0.02) with a linear decrease of 0.05 mm/mm2 in CNFL per one year increase in age. No significant change in CNFL was observed over the 36-month period (F1,55 = 0.69, P = 0.41). Conclusions The CNFL showed a stable course over a 36-month period in healthy individuals, although there was a slight linear reduction in CNFL with age. The findings of this study have implications for understanding the time-course of the effect of pathology and surgical or therapeutic interventions on the morphology of the SNP, and serves to confirm the suitability of CNFL as a screening/monitoring marker for peripheral neuropathies.

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Customer Relationship Management (CRM) packaged software has become a key contributor to attempts at aligning business and IT strategies in recent years. Throughout the 1990s there was, in many organisations strategies, a shift from the need to manage transactions and toward relationship management. Where Enterprise Resource Planning packages dominated the management of transactions era, CRM packages lead in regard to relationships. At present, balanced views of CRM packages are scantly presented instead relying on vendor rhetoric. This paper uses case study research to analyse some of the issues associated with CRM packages. These issues include the limitations of CRM packages, the need for a relationship orientation and the problems of a dominant management perspective of CRM. It is suggested that these issues could be more readily accommodated by organisational detachment from beliefs in IT as utopia, consideration of prior IS theory and practice and a more informed approach to CRM package selection.

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The direct costs of managing adverse outcomes from Australian health care are estimated to be $2 billion. The audit cycle is considered an important tool to assist in the preventive management of adverse outcomes.Australian guidelines for audit cycle design allow for comparison of data sets derived from similar surgical specialities. However a lack of data set standardisation inhibits meaningful comparisons of foot and ankle surgical audits. This research will assist development of a best practice model for auditing foot and ankle surgery. Data derived from this model will improve the safety and quality of foot and ankle surgery. The preliminary phase of this process is to identify and understand the attitudes and behaviours of how and why surgeons participate in the audit cycle. A descriptive embedded multiple case study research design is planned to provide an intense focus on a single phenomenon (the audit cycle) within its real life context (clinical governance). The measures to be included in the case study have been identified by the Balanced Patient Safety Measurement Framework. These include: audit and peer review activity, provider attitudes to patient safety, safety learning, action and performance. A purposive sample of 6 to 8 surgeons (units of analysis) from 3 to 4 specialities (cases) will undergo semi-structured interview. This will investigate: current audit tools and processes; attitudes; and behaviours of surgeons to the audit cycle. Similarities in and differences between the units of analysis will indicate which identified measures function as barriers or enablers of the audit cycle. Reliability and validity (external and construct) will be assessed using established methods for case studies. The descriptive embedded multiple case study will reveal how and why foot and ankle surgeons participate in the audit cycle. This will inform further research to improve the outcomes of foot and ankle surgery through development of an audit tool.