Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients.

PURPOSE: Unlike in the outpatient setting, delivery of aerosols to critically ill patients may be considered complex, particularly in ventilated patients, and benefits remain to be proven. Many factors influence aerosol delivery and recommendations exist, but little is known about knowledge translation into clinical practice. METHODS: Two-week cross-sectional study to assess the prevalence of aerosol therapy in 81 intensive and intermediate care units in 22 countries. All aerosols delivered to patients breathing spontaneously, ventilated invasively or noninvasively (NIV) were recorded, and drugs, devices, ventilator settings, circuit set-up, humidification and side effects were noted. RESULTS: A total of 9714 aerosols were administered to 678 of the 2808 admitted patients (24 %, CI95 22-26 %), whereas only 271 patients (10 %) were taking inhaled medication before admission. There were large variations among centers, from 0 to 57 %. Among intubated patients 22 % (n = 262) received aerosols, and 50 % (n = 149) of patients undergoing NIV, predominantly (75 %) inbetween NIV sessions. Bronchodilators (n = 7960) and corticosteroids (n = 1233) were the most frequently delivered drugs (88 % overall), predominantly but not exclusively (49 %) administered to patients with chronic airway disease. An anti-infectious drug was aerosolized 509 times (5 % of all aerosols) for nosocomial infections. Jet-nebulizers were the most frequently used device (56 %), followed by metered dose inhalers (23 %). Only 106 (<1 %) mild side effects were observed, despite frequent suboptimal set-ups such as an external gas supply of jet nebulizers for intubated patients. CONCLUSIONS: Aerosol therapy concerns every fourth critically ill patient and one-fifth of ventilated patients.

Straightforward synthesis of cyclic and bicyclic peptides

Cyclic peptide architectures can be easily synthesized from cysteine-containing peptides with appending maleimides, free or protected, through an intramolecular Michael-type reaction. After peptide assembly, the peptide can cyclize either during the trifluoroacetic acid treatment, if the maleimide is not protected, or upon deprotection of the maleimide. The combination of free and protected maleimide moieties and two orthogonally protected cysteines gives access to structurally different bicyclic peptides with isolated or fused cycles.

Estudi de la coautoria de publicacions científiques entre UPC i nou universitats dels Estats Units: Brown University, University of Chicago, Northwestern University, Stanford University, Columbia University, Cornell University, Harvard University, Princeton University i Duke University

S'analitza la coautoria de la UPC amb autors vinculats a institucions acadèmiques dels Estats Units, per totes les àrees temàtiques i sense considerar límits cronològics o documentals.

Estudi de la coautoria de publicacions científiques entre UPC i cinc universitats dels Estats Units : Caltech, Stanford University, UC Davis, UC Irvine i UCLA

S'analitza la coautoria de la UPC amb autors vinculats a institucions acadèmiques dels Estats Units, per totes les àrees temàtiques, de gener de 2009 a juny de 2014.

Developing an Improved System for Allocating Support Unit Costs to Business Units

The objective of this study is to develop an improved support unit cost allocation system for a medium-sized technology company, and to examine which options for overhead cost accounting exist. The study begins with presenting the terminology and methods associated with overhead cost accounting and responsibility accounting. Also the most common challenges and resulting benefits of overhead cost allocation system development are brought up. As one research method two case studies were conducted for benchmarking purposes. These external cases are compared with the principal company’s cost allocation system and reflected against the theoretical background. In the empirical section interviews were used as the primary source of information alongside self studying principal company’s old cost allocation method. Interviews revealed the main weaknesses of the old system and proposals for a new one, which were utilized in setting targets for developing the new system. As a result of the development process an improved support unit cost allocation system was realized for year 2009. The new system is able to handle support unit costs in more detail enhancing the transparency and fairness of resulting cost allocations. Parts of support unit costs are now seen as business units’ own costs rather than group-level overhead. Also recommendations for further development are made after analyzing how well the targets were reached.

Developing co-operation of business units – exploring synergies and a joint business model

The purpose of this study was to develop co-operation between business units of the company operating in graphic industry. The development was done by searching synergy opportunities between these business units. The final aim was to form a business model, which is based on co-operation of these business units.The literature review of this thesis examines synergies and especially the process concerning the search and implementation of synergies. Also the concept of business model and its components are examined. The research was done by using qualitative research method. The main data acquiring method to the empirical part was theme interviews. The data was analyzed using thematisation and content analysis.The results of the study include seven identified possible synergies and a business model, which is based on the co-operation of the business units. The synergy opportunities are evaluated and the implementation order of the synergies is suggested. The presented synergies create the base for the proposed business model.

Of pearls and pigs : a conceptual-semantic Tiernet approach to formal representation of structure and variation of phraseological units

"Helmiä sioille", pärlor för svin, säger man på finska om någonting bra och fint som tas emot av en mottagare som inte vill eller har ingen förmåga att förstå, uppskatta eller utnyttja hela den potential som finns hos det mottagna föremålet, är ointresserad av den eller gillar den inte. För sådana relativt stabila flerordiga uttryck, som är lagrade i språkbrukarnas minnen och som demonstrerar olika slags oregelbundna drag i sin struktur använder man inom lingvistiken bl.a. termerna "idiom" eller "fraseologiska enheter". Som en oregelbundenhet kan man t.ex. beskriva det faktum att betydelsen hos uttrycket inte är densamma som man skulle komma till ifall man betraktade det som en vanlig regelbunden fras. En annan oregelbundenhet, som idiomforskare har observerat, ligger i den begränsade förmågan att varieras i form och betydelse, som många idiom har jämfört med regelbundna fraser. Därför talas det ofta om "grundform" och "grundbetydelse" hos idiom och variationen avses som avvikelse från dessa. Men när man tittar på ett stort antal förekomstexempel av idiom i språkbruk, märker man att många av dem tillåter variation, t.o.m. i sådan utsträckning att gränserna mellan en variant och en "grundform" suddas ut, och istället för ett idiom råkar vi plötsligt på en "familj" av flera besläktade uttryck. Allt detta väcker frågan om hur dessa uttryck egentligen ska vara representerade i språket. I avhandlingen utförs en kritisk granskning av olika tidigare tillvägagångssätt att beskriva fraseologiska enheter i syfte att klargöra vilka svårigheter deras struktur och variation erbjuder för den lingvistiska teorin. Samtidigt presenteras ett alternativt sätt att beskriva dessa uttryck. En systematisk och formell modell som utvecklas i denna avhandling integrerar en beskrivning av idiom på många olika språkliga nivåer och skildrar deras variation i form av ett nätverk och som ett resultat av samspel mellan idiomets struktur och kontexter där det förekommer, samt av interaktion med andra fasta uttryck. Modellen bygger på en fördjupande, språkbrukbaserad analys av det finska idiomet "X HEITTÄÄ HELMIÄ SIOILLE" (X kastar pärlor för svin).

Energetic sustainability of three arabica coffee growing systems used by family farming units in Espírito Santo state

Three growing systems of Arabica coffee were evaluated under the energy perspective, in the state of Espírito Santo in Brazil. The systems are conventional cultivation (CC), cultivation with good agricultural practices (CGP) and organic farming (OF). It was made a comparison of the energy flows within these three systems to show sustainable levels of each one based on production average data of several family-farming units. Therefore, we analyzed crop yield, total energy efficiency reverse (TEER), energy efficiency of ripe coffee (EERC) and non-renewable energy efficiency (NREE). OF system had values for TEER, EERC and NREE of 3.3 4.7 and 7.9 respectively. Yet CC showed values of 1.8, 1.9 and 1.6 for TEER, EERC and NREE respectively. Furthermore, CGP presented values for TEER, EERC and NREE of 0.7, 1.3 and 1.4 respectively. The highest yield was observed in CGP, reaching an amount of 1794 kg ha-1(17,455 MJ); however, this system expends more energy than it converts. Thus, over those points, OF is the most sustainable system.

Comparative study between patients with acute appendicitis treated in primary care units and in emergency hospitals

Objective: To retrospectively analyze the relationship of time of care, combined with possible post-appendectomy complications, with the promptness of transfer of patients seen in Emergency Care Units (UPA) to the emergency hospital.Methods: We analyzed patients with preoperative diagnosis of acute appendicitis undergoing appendectomy from January to July 2012. Patients were divided into two groups according to the site of the first care. Group A included patients who received initial care directly in the emergency department of the Lourenço Jorge County Hospital (HMLJ) and group B consisted of patients seen in the UPA and forwarded to HMLJ to undergo surgical treatment.Results: the average time between initial treatment and surgery in group A was 29 hours (SD = 21.95) and 54 hours in group B (SD = 54.5). Considering the onset of symptoms, the patients in group A were operated on average 67 hours after (SD = 42.55), while group B, 90 hours (SD = 59.58). After the operation, patients in group A were hospitalized, on average, for 94 hours (SD = 73.53) and group B, 129 hours (SD = 193.42).Conclusion: there was no significant difference in the time elapsed between the onset of symptoms, initial treatment and early surgical treatment, or time elapsed between surgery and discharge.