Implementation of a perioperative management protocol for patients undergoing orthopedic surgery

OBJECTIVE: To evaluate the initial results after the implementation of perioperative protocol in patients over 60 years of age undergoing surgical treatment for femur fractures.METHODS: We conducted a prospective study of patients older than 60 years who were hospitalized with femur fracture. They were operated under spinal anesthesia and analgesia by lumbar plexus blockade. Data evaluation was performed before arrival in the operating room during surgery, in the post-anesthesia recovery room and in the ward the next morning of the operation.RESULTS: 105 patients underwent various types of surgical corrections of the femur. The hospital stay ranged from three to 86 days. Fasting ranged from 9h15min to 19h30mn. Hypotension occurred in 5.7%. The duration of motor blockade ranged from 1h45min to 5h30imn. Maltodextrin feeding ranged from 50min to 3h45min and the time spent in the post-anesthetic care unit ranged from 50 minutes to 4 hours. Onset of oral intake in the ward ranged from 4hto 8h15min. The duration of anesthesia ranged from 14 to 33 hours. No patient required a urinary catheter, nor was transferred to the ICU. All patients were able to be discharged on the first postoperative day.CONCLUSION: The use of a protocol to accelerate the postoperative period may reduce the fasting time, length of hospital stay and provide faster i discharge n elderly patients with femur fractures.

The Shadow Moiré method using the phase shifting technique and digital image processing: computational implementation and application to the 3D-reconstruction of a buckled plate

The Shadow Moiré fringe patterns are level lines of equal depth generated by interference between a master grid and its shadow projected on the surface. In simplistic approach, the minimum error is about the order of the master grid pitch, that is, always larger than 0,1 mm, resulting in an experimental technique of low precision. The use of a phase shift increases the accuracy of the Shadow Moiré technique. The current work uses the phase shifting method to determine the surfaces three-dimensional shape using isothamic fringe patterns and digital image processing. The current study presents the method and applies it to images obtained by simulation for error evaluation, as well as to a buckled plate, obtaining excellent results. The method hands itself particularly useful to decrease the errors in the interpretation of the Moiré fringes that can adversely affect the calculations of displacements in pieces containing many concave and convex regions in relatively small areas.

Performance evaluation of 3D computer vision techniques

This work presents the implementation and comparison of three different techniques of three-dimensional computer vision as follows: • Stereo vision - correlation between two 2D images • Sensorial fusion - use of different sensors: camera 2D + ultrasound sensor (1D); • Structured light The computer vision techniques herein presented took into consideration the following characteristics: • Computational effort ( elapsed time for obtain the 3D information); • Influence of environmental conditions (noise due to a non uniform lighting, overlighting and shades); • The cost of the infrastructure for each technique; • Analysis of uncertainties, precision and accuracy. The option of using the Matlab software, version 5.1, for algorithm implementation of the three techniques was due to the simplicity of their commands, programming and debugging. Besides, this software is well known and used by the academic community, allowing the results of this work to be obtained and verified. Examples of three-dimensional vision applied to robotic assembling tasks ("pick-and-place") are presented.

Evaluation of pesticide residues in oranges from São Paulo, Brazil

Pesticides in “PERA” orange samples (N = 57) from São Paulo City, Brazil were assessed and the pesticide intake contribution was estimated for chronic risk assessment. Seventy-six pesticides were evaluated by the gas chromatography multi-residue method, including isomers and metabolites (4.332 determinations). The mean recoveries at the limit of quantification level were in the range of 72-115% and the relative standard deviation for five replicate samples was 1-11%. The limits of detection and quantification ranged from 0.005 to 0.4 mg.kg−1 and from 0.01 to 0.8 mg.kg−1, respectively. Pesticides were found in 42.1% of the samples at levels ranging from 0.06 to 2.9 mg.kg−1. Of the contaminated samples, 3.5% contained residues (bifenthrin and clofentezine) above the maximum residue level and 12.3% contained unauthorized pesticides (azinphos-ethyl, parathion, myclobutanil, profenofos, and fenitrothion). The estimated risk characterization for orange intake by adults and children, respectively, ranged from 0.04 to 6.6% and from 0.1 to 26.5% of the acceptable daily intake. The detection of irregular residues emphasizes the need for better implementation of Good Agriculture Practices and greater control of formulated products. Other pesticides surveyed did not pose a health risk due to consumption.

HIDING IN PLAIN SIGHT- Sustainable Physical Activity Program Development and Evaluation for Youth with Special Needs: An Evaluative Case Study

The purpose of my research was to contribute to the improvement and sustainability of the Special Needs Activity Program, and develop program implementation strategies that had practical outcomes. I conducted an evaluative case study of S.N.A.P in order to determine what a quality adapted physical activity (APA) program is, why S.N.A.P is considered a quality APA program, and what institutional policies and practices exist to support it. Data was collected via interviews, questionnaires, and observations. Data analysis involved inductive and deductive methods, and a SWOTAR evaluation. Results indicate that quality APA programs include: ‘people’, ‘environment’, and ‘expectations’; there are benefits of experiential learning; activity stations that promote creativity are valuable; several stakeholders do not know the details about S.N.A.P but recognize its value; the institution values what S.N.A.P provides, yet, there is nothing being done to sustain it. Future research should investigate the feasibility of implementing S.N.A.P in various contexts.

Development and evaluation of a research-based prosthodontic clinical record

Introduction: Bien que l'importance de transférer les données de la recherche à la pratique a été largement démontrée, ce processus est toujours lent et fait face à plusieurs défis tels que la conceptualisation des évidences, la validité interne et externe de la recherche scientifique et les coûts élevés de la collecte de grandes quantités de données axées sur le patient. Les dossiers dentaires des patients contiennent des renseignements valables qui donneraient aux chercheurs cliniques une opportunité d'utiliser un large éventail d'informations quantitatives ou qualitatives. La standardisation du dossier clinique permettrait d’échanger et de réutiliser des données dans différents domaines de recherche. Objectifs: Le but de cette étude était de concevoir un dossier patient axé sur la recherche dans le domaine de la prosthodontie amovible à la clinique de premier cycle de l’Université de Montréal. Méthodes: Cette étude a utilisé des méthodes de recherche-action avec 4 étapes séquentielles : l'identification des problèmes, la collecte et l'interprétation des données, la planification et l’évaluation de l'action. Les participants de l'étude (n=14) incluaient des professeurs, des chercheurs cliniques et des instructeurs cliniques dans le domaine de la prosthodontie amovible. La collecte des données a été menée à l’aide d’une revue de littérature ciblée et complète sur les résultats en prosthodontie ainsi que par le biais de discussions de groupes et d’entrevues. Les données qualitatives ont été analysées en utilisant QDA Miner 3.2.3. Résultats: Les participants de l'étude ont soulevé plusieurs points absents au formulaire actuel de prosthodontie à la clinique de premier cycle. Ils ont partagé leurs idées pour la conception d'un nouveau dossier-patient basé sur 3 objectifs principaux: les objectifs cliniques, éducatifs et de recherche. Les principaux sujets d’intérêt en prosthodontie amovibles, les instruments appropriés ainsi que les paramètres cliniques ont été sélectionnés par le groupe de recherche. Ces résultats ont été intégrés dans un nouveau formulaire basé sur cette consultation. La pertinence du nouveau formulaire a été évaluée par le même groupe d'experts et les modifications requises ont été effectuées. Les participants de l'étude ont convenu que le cycle de recherche-action doit être poursuivi afin d'évaluer la faisabilité d’implémentation de ce dossier modifié dans un cadre universitaire. Conclusion: Cette étude est une première étape pour développer une base de données dans le domaine de la prothodontie amovible. La recherche-action est une méthode de recherche utile dans ce processus, et les éducateurs académiques sont bien placés pour mener ce type de recherche.

Development and Evaluation of Blind Identification Techniques for Nonlinear Systems

Identification and Control of Non‐linear dynamical systems are challenging problems to the control engineers.The topic is equally relevant in communication,weather prediction ,bio medical systems and even in social systems,where nonlinearity is an integral part of the system behavior.Most of the real world systems are nonlinear in nature and wide applications are there for nonlinear system identification/modeling.The basic approach in analyzing the nonlinear systems is to build a model from known behavior manifest in the form of system output.The problem of modeling boils down to computing a suitably parameterized model,representing the process.The parameters of the model are adjusted to optimize a performanace function,based on error between the given process output and identified process/model output.While the linear system identification is well established with many classical approaches,most of those methods cannot be directly applied for nonlinear system identification.The problem becomes more complex if the system is completely unknown but only the output time series is available.Blind recognition problem is the direct consequence of such a situation.The thesis concentrates on such problems.Capability of Artificial Neural Networks to approximate many nonlinear input-output maps makes it predominantly suitable for building a function for the identification of nonlinear systems,where only the time series is available.The literature is rich with a variety of algorithms to train the Neural Network model.A comprehensive study of the computation of the model parameters,using the different algorithms and the comparison among them to choose the best technique is still a demanding requirement from practical system designers,which is not available in a concise form in the literature.The thesis is thus an attempt to develop and evaluate some of the well known algorithms and propose some new techniques,in the context of Blind recognition of nonlinear systems.It also attempts to establish the relative merits and demerits of the different approaches.comprehensiveness is achieved in utilizing the benefits of well known evaluation techniques from statistics. The study concludes by providing the results of implementation of the currently available and modified versions and newly introduced techniques for nonlinear blind system modeling followed by a comparison of their performance.It is expected that,such comprehensive study and the comparison process can be of great relevance in many fields including chemical,electrical,biological,financial and weather data analysis.Further the results reported would be of immense help for practical system designers and analysts in selecting the most appropriate method based on the goodness of the model for the particular context.

Vertikale Integrationsstrukturen kommunaler Verkehrsunternehmen : eine transaktionskostentheoretische Evaluation

Der Markt für öffentlichen Personennahverkehr (ÖPNV) wird liberalisiert, in die gewachsenen Monopolstrukturen werden Marktmechanismen implementiert. Ziel der neuen ordnungspolitischen Rahmenbedingungen ist die Steigerung der Effizienz des defizitären Verkehrsbereichs, der von kommunalen Verkehrsunternehmen dominiert wird. Diese erbringen als Quasi-Monopolisten traditionell die Verkehrsdurchführung, regelmäßig anfallende Defizite werden von der öffentlichen Hand ausgeglichen. Bedingt durch ihre Leistungsstrukturen sind kommunale Verkehrsunternehmen in einem Wettbewerbsmarkt kaum konkurrenzfähig. Charakteristisch für diesen Unternehmenstyp ist der hohe Grad an vertikal integrierten Wertschöpfungsstufen. Im Gegensatz zu anderen Branchen erbringen kommunale Verkehrsunternehmen die wesentlichen Teile der gesamten ÖPNV-Wertschöpfungskette innerhalb der eigenen Unternehmensgrenzen. An dem hohen vertikalen Integrationsgrad setzt die Untersuchung an. Mit dem von Williamson entwickelten Instrumentarium der Transaktionskostentheorie werden die Leistungsbereiche einer transaktionskostentheoretischen Bewertung unterzogen. Als Alternativen zum institutionellen Arrangement der vertikalen Integration – das als Hierarchie bezeichnet wird – stehen die Arrangements Kooperation und Markt zur Verfügung. Die Bewertung zeigt, welche Leistungsbereiche unter transaktionskostentheoretischen Gesichtspunkten hierarchisch institutionalisiert werden sollten und welche alternativ erbracht werden können. Aus den Ergebnissen werden Strategieempfehlungen abgeleitet, die als Arbeitshypothesen einer anschließenden empirischen Überprüfung unterzogen werden. Die befragten ÖPNV-Experten bewerten somit die Marktfähigkeit der Strategieempfehlungen. Die Untersuchungsergebnisse werden für die Erarbeitung eines alternativen Koordinierungsarrangements für kommunale Verkehrsunternehmen herangezogen. Das Modell basiert auf der Grundlage Strategischer Netzwerke. Kommunale Verkehrsunternehmen nehmen in dem Modell die Rolle des Nukleus ein, der eine Vielzahl von Netzwerkpartnern steuert und für die Erbringung der ÖPNV-Leistungen mit diesen kooperiert.

Performance Evaluation of the Scheme 86 and HP Precision Architecture

The Scheme86 and the HP Precision Architectures represent different trends in computer processor design. The former uses wide micro-instructions, parallel hardware, and a low latency memory interface. The latter encourages pipelined implementation and visible interlocks. To compare the merits of these approaches, algorithms frequently encountered in numerical and symbolic computation were hand-coded for each architecture. Timings were done in simulators and the results were evaluated to determine the speed of each design. Based on these measurements, conclusions were drawn as to which aspects of each architecture are suitable for a high- performance computer.

Multicast algorithms evaluation using an adaptative routing in ATM networks

This paper proposes a multicast implementation based on adaptive routing with anticipated calculation. Three different cost measures for a point-to-multipoint connection: bandwidth cost, connection establishment cost and switching cost can be considered. The application of the method based on pre-evaluated routing tables makes possible the reduction of bandwidth cost and connection establishment cost individually

Implementation of global make to inventory strategy at BASF SE

La optimización y armonización son factores clave para tener un buen desempeño en la industria química. BASF ha desarrollado un proyecto llamada acelerador. El objetivo de este proyecto ha sido la armonización y la integración de los procesos de la cadena de suministro a nivel mundial. El proceso básico de manejo de inventarios se quedó fuera del proyecto y debía ser analizado. El departamento de manejo de inventarios en BASF SE ha estado desarrollando su propia estrategia para la definición de procesos globales de manufactura. En este trabajo se presentará un informe de las fases de la formulación de la estrategia y establecer algunas pautas para la fase de implementación que está teniendo lugar en 2012 y 2013.

Improvement of strategies for the management of fire blight (Erwinia amylovora). Evaluation and optimization of physical and chemical control methods, and use of decision support systems

El foc bacterià és una malaltia que afecta a plantes de la família de la rosàcies, causada pel bacteri Erwinia amylovora. El seu rang d'hostes inclou arbres fruiters, com la perera, la pomera o el codonyer, i plantes ornamentals de gran interès comercial i econòmic. Actualment, la malaltia s'ha dispersat i es troba àmpliament distribuïda en totes les zones de clima temperat del món. A Espanya, on la malaltia no és endèmica, el foc bacterià es va detectar per primer cop al 1995 al nord del país (Euskadi) i posteriorment, han aparegut varis focus en altres localitzacions, que han estat convenientment eradicats. El control del foc bacterià, és molt poc efectiu en plantes afectades per la malaltia, de manera que es basa en mesures encaminades a evitar la dispersió del patogen, i la introducció de la malaltia en regions no endèmiques. En aquest treball, la termoteràpia ha estat avaluada com a mètode d'eradicació d'E. amylovora de material vegetal de propagació asimptomàtic. S'ha demostrat que la termoteràpia és un mètode viable d'eradicar E. amylovora de material de propagació. Gairebé totes les espècies i varietats de rosàcies mantingudes en condicions d'humitat sobrevivien 7 hores a 45 ºC i més de 3 hores a 50 ºC, mentre que més d'1 hora d'exposició a 50 ºC amb calor seca produïa danys en el material vegetal i reduïa la brotació. Tractaments de 60 min a 45 ºC o 30 min a 50 ºC van ser suficients per reduir la població epífita d'E. amylovora a nivells no detectables (5 x 102 ufc g-1 p.f.) en branques de perera. Els derivats dels fosfonats i el benzotiadiazol són efectius en el control del foc bacterià en perera i pomera, tant en condicions de laboratori, com d'hivernacle i camp. Els inductors de defensa de les plantes redueixen els nivells de malaltia fins al 40-60%. Els intervals de temps mínims per aconseguir el millor control de la malaltia van ser 5 dies pel fosetil-Al, i 7 dies per l'etefon i el benzotiadiazol, i les dosis òptimes pel fosetil-Al i el benzotiadiazol van ser 3.72 g HPO32- L-1 i 150 mg i.a. L-1, respectivament. Es millora l'eficàcia del fosetil-Al i del benzotiadiazol en el control del foc bacterià, quan es combinen amb els antibiòtics a la meitat de la dosi d'aquests últims. Tot i que l'estratègia de barrejar productes és més pràctica i fàcil de dur a terme a camp, que l'estratègia de combinar productes, el millor nivell de control de la malaltia s'aconsegueix amb l'estratègia de combinar productes. Es va analitzar a nivell histològic i ultrastructural l'efecte del benzotiadiazol i dels fosfonats en la interacció Erwinia amylovora-perera. Ni el benzotiadiazol, ni el fosetil-Al, ni l'etefon van induir canvis estructurals en els teixits de perera 7 dies després de la seva aplicació. No obstant, després de la inoculació d'E. amylovora es va observar en plantes tractades amb fosetil-Al i etefon una desorganització estructural cel·lular, mentre que en les plantes tractades amb benzotiadiazol aquestes alteracions tissulars van ser retardades. S'han avaluat dos models (Maryblyt, Cougarblight) en un camp a Espanya afectat per la malaltia, per determinar la precisió de les prediccions. Es van utilitzar dos models per elaborar el mapa de risc, el BRS-Powell combinat i el BIS95 modificat. Els resultats van mostrar dos zones amb elevat i baix risc de la malaltia. Maryblyt i Cougarblight són dos models de fàcil ús, tot i que la seva implementació en programes de maneig de la malaltia requereix que siguin avaluats i validats per un període de temps més llarg i en àrees on la malaltia hi estigui present.

Enhanced convolution approach for CAC in ATM networks, an analytical study and implementation

The characteristics of service independence and flexibility of ATM networks make the control problems of such networks very critical. One of the main challenges in ATM networks is to design traffic control mechanisms that enable both economically efficient use of the network resources and desired quality of service to higher layer applications. Window flow control mechanisms of traditional packet switched networks are not well suited to real time services, at the speeds envisaged for the future networks. In this work, the utilisation of the Probability of Congestion (PC) as a bandwidth decision parameter is presented. The validity of PC utilisation is compared with QOS parameters in buffer-less environments when only the cell loss ratio (CLR) parameter is relevant. The convolution algorithm is a good solution for CAC in ATM networks with small buffers. If the source characteristics are known, the actual CLR can be very well estimated. Furthermore, this estimation is always conservative, allowing the retention of the network performance guarantees. Several experiments have been carried out and investigated to explain the deviation between the proposed method and the simulation. Time parameters for burst length and different buffer sizes have been considered. Experiments to confine the limits of the burst length with respect to the buffer size conclude that a minimum buffer size is necessary to achieve adequate cell contention. Note that propagation delay is a no dismiss limit for long distance and interactive communications, then small buffer must be used in order to minimise delay. Under previous premises, the convolution approach is the most accurate method used in bandwidth allocation. This method gives enough accuracy in both homogeneous and heterogeneous networks. But, the convolution approach has a considerable computation cost and a high number of accumulated calculations. To overcome this drawbacks, a new method of evaluation is analysed: the Enhanced Convolution Approach (ECA). In ECA, traffic is grouped in classes of identical parameters. By using the multinomial distribution function instead of the formula-based convolution, a partial state corresponding to each class of traffic is obtained. Finally, the global state probabilities are evaluated by multi-convolution of the partial results. This method avoids accumulated calculations and saves storage requirements, specially in complex scenarios. Sorting is the dominant factor for the formula-based convolution, whereas cost evaluation is the dominant factor for the enhanced convolution. A set of cut-off mechanisms are introduced to reduce the complexity of the ECA evaluation. The ECA also computes the CLR for each j-class of traffic (CLRj), an expression for the CLRj evaluation is also presented. We can conclude that by combining the ECA method with cut-off mechanisms, utilisation of ECA in real-time CAC environments as a single level scheme is always possible.

Innovative implementation of iLearn e-Portfolio for Personal Development Planning

iLearn is a Web 2.0 tool developed in Blackboard to help students with Personal Development Planning (PDP). This paper describes a case study on how the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP benefits the students. The e-Portfolio tool benefits students as it enables them to create and share portfolios, record achievements and reflections that support future job applications and promotion. Students find it beneficial because they can make use of iLearn e-Portfolio to keep academic records and achievements, activities and interests, work experience, reflective practice, employer information and some other useful resources, and also to tailor their CV and covering letters including evidence to support their CV, transferable skills and selling points. Useful information for preparing for an interview, reflecting after an event and any thoughts and evaluation can be kept in iLearn e-Portfolio. Keeping assessment and feedback records in iLearn e-Portfolio enables students to know their progress, to identify any gaps they need to fill to develop their study practices and areas for development. The key points from the feedback on the assignments and assessments are beneficial for future improvement. The reflections on the assignments and how students make use of the advice are particularly useful to improve their overall performance. In terms of pedagogical benefits, the “Individual Learner Profile” records and reviews evidence in verbal communication, basic and higher academic skills, time management, numeracy skill and IT skills, students become increasingly aware of their own strengths and any weaker areas that may require development. The e-Portfolio also provides opportunity for students to reflect on the experience and skills they have gained whilst participating in activities outside their studies. As the iLearn e-Portfolio is a reflective practice tool, it is consistent with the principle of Schon's reflective practitioner to reframe problems and to explore the consequences of actions. From the students’ feedback, for those who engage regularly in iLearn, they are better able to set agendas for their Personal Tutorial meetings and provide their Personal Tutor with a unique record of their achievements, skills and attributes which help them writing effective references for them. They make the most of their student experience in general. They also enhance their transferable skills and employability overall. The iLearn e-Portfolio prepares for the workplace and life beyond University including continuing professional development. Students are aware of their transferable skills, evidence of the skills and skill level, including award or accreditation, and their personal reflection on their transferable skills. It is beneficial for students to be aware of their transferable skills, to produce evidence of the skills and skills level such as award and accreditation, and to record their personal reflection on their transferable skills. Finally, the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP will improve their employability.

Implementation of a Bayesian design in a dose-escalation study of an experimental agent in healthy volunteers

Bayesian decision procedures have recently been developed for dose escalation in phase I clinical trials concerning pharmacokinetic responses observed in healthy volunteers. This article describes how that general methodology was extended and evaluated for implementation in a specific phase I trial of a novel compound. At the time of writing, the study is ongoing, and it will be some time before the sponsor will wish to put the results into the public domain. This article is an account of how the study was designed in a way that should prove to be safe, accurate, and efficient whatever the true nature of the compound. The study involves the observation of two pharmacokinetic endpoints relating to the plasma concentration of the compound itself and of a metabolite as well as a safety endpoint relating to the occurrence of adverse events. Construction of the design and its evaluation via simulation are presented.