Miniaturization and Integration of Optoelectronics for Contact Lens Embedded Display and Wireless Communication

Thesis (Ph.D.)--University of Washington, 2013

The river solofrana bicycle network: a project of green mobility

The article presents the “LungoSolofrana” project, carried out during the course “Urban and Mobility” in the academic year 2009/2010, held during the bachelor in Environmental Engineering at the University of Naples “Federico II”. The work has also been chosen as a finalist at the “UrbanPromo 2010” contest, the urban and territorial marketing event sponsored by the National Institute of Urban Planning and Urbit which was held in Venice in 2010. The project consists in a green mobility proposal, developed with an approach based on the integration of the environmental redevelopment of a portion of river Solofrana, located in the Salerno Province, and of the renewal of seven local stations of the railway line Mercato San Severino – Nocera Inferiore, including the realization of a cycle-path network for the natural environment fruition. Furthermore the work drew attention to the local and regional administration. The main intent of the project is to integrate sustainable mobility themes with the environment recovery in a territory affected by high environmental troubles. The area includes the municipalities of Nocera Inferiore, Nocera Superiore, Mercato San Severino, Castel San Giorgio and Roccapiemonte, situated in Salerno’s province, with a total population about 114.000 (font Demo ISTAT 2010). The area extension is about 84,30 sqkm and it is crossed by river Solofrana that is the central point of the project idea. The intervention strategy is defined in two kinds of actions: internal and external rail station interventions. The external rail station interventions regard the construction of pedestrian-cycle paths with the scope of increasing the spaces dedicated to cyclists and to pedestrians along the river Solofrana sides and to connect the urban areas with the railway station. In this way, it’s also possible to achieve an urban requalification of the interested area. On the other side, the interventions inside the station , according to Transit Oriented Development principles, aim at redeveloping common spaces with the insertion of new activities and at realizing new automatic cycle parks covered by photovoltaic panels. The project proposal consists of the urban regeneration of small railway stations along the route-Nocera-Codola Mercato San Severino in the province of Salerno, through interventions aimed at improving pedestrian accessibility. The project involves in particular the construction of pedestrian paths protected access to the station and connecting with neighboring towns and installation of innovative bike parking stations in elevation, covering surfaces coated with solar panels and spaces information. The project is aimed to propose a new model of sustainable transport for small and medium shifts as an alternative to private transportation

Influence of entrepreneurial orientation in export performance

This study aims at investigating the influence that entrepreneurial orientation has on export performance of Portuguese footwear small and mediumenterprises (SMEs). Therefore, a quantitative methodological approach was used, conducting a descriptive, exploratory and transversal empirical study, having applied a questionnaire to a sample of Portuguese companies exporting footwear. The research results suggest that entrepreneurial orientation enhances export performance in the analysed SMEs, particularly innovation and proactiveness, through the amount of funds invested, human resources dedicated to this activity, number of new products or services introduced in the market and frequent change in product lines or services and materialization of a long-term perspective, which is accompanied by innovative activities or new businesses. Therefore, the findings sustain the necessity to invest in entrepreneurial orientation as a strategic determinant, which contributes to the growth of small firms in foreignmarkets. Finally, the main limitation of this study is related to the sample size, since it was difficult to find companies willing to collaborate with this kind of research.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

Prise en charge des troubles oculomoteurs après effraction iatrogène de l'orbite au cours d'interventions sinusiennes endoscopiques [Management of motility disorders secondary to iatrogenic orbital fracture during endoscopic sinus surgery.]

PURPOSE: Orbital wall fracture may occur during endoscopic sinus surgery, resulting in oculomotor disorders. We report the management of four cases presenting with this surgical complication. METHODS: A non-comparative observational retrospective study was carried out on four patients presenting with diplopia after endoscopic ethmoidal sinus surgery. All patients underwent full ophthalmologic and orthoptic examination as well as orbital imaging. RESULTS: All four patients presented with diplopia secondary to a medial rectus lesion confirmed by orbital imaging. A large horizontal deviation as well as limitation of adduction was present in all cases. Surgical management consisted of conventional recession-resection procedures in three cases and muscle transposition in one patient. A useful field of binocular single vision was restored in two of the four patients. CONCLUSION: Orbital injury may occur during endoscopic sinus surgery and cause diplopia, usually secondary to medial rectus involvement due to the proximity of this muscle to the lamina papyracea of the ethmoid bone. Surgical management is based on orbital imaging, duration of the lesion, evaluation of anterior segment vasculature, results of forced duction testing and intraoperative findings. In most cases, treatment is aimed at the symptoms rather than the cause, and the functional prognosis remains guarded.

Limiting rights, Canadian style : the Supreme Court of Canada, American jurisprudence and section 1 of the Charter /

The addition of the Charter of Rights and Freedoms represented a fundamental shift in Canadian governance. Many saw the tabling of such a document as a further, even fmal, step towards the Americanization of the Canadian polity. While the Charter's presence has significantly altered the relationship between citizens, government and the courts, it has done so by maintaining the traditional values and experiences that has been the hallmarks of Canadian constitutionalism. This is in contrast to the fears harboured by critics suggesting that the Charter was a further Americanization of the Canadian Polity, notwithstanding the very different natures of the American Bill of Rights and the Canadian Charter. Analyzing American Supreme Court precedent use by the Canadian Supreme Court has demonstrated that such an Americanization has not, in fact, occurred. In the present analysis of American precedent use in section 1 limitation of rights cases, the citation of these precedents are at best episodic, at least on the quantitative level. Qualitatively, the Canadian Supreme Court generally uses American jurisprudence to further support broad definitions of 'great rights' . As for the more intricate details of rights limitations and the process involved in detennining how Charter rights are limited, one would be hard pressed to find even cursory references to American case law.

Educating for love of wisdom : John Dewey and Simone Weil

The writings of John Dewey (1859-1952) and Simone Weil (1909-1943) were analyzed with a view to answering 3 main questions: What is wisdom? How is wisdom connected to experience? How does one educate for a love of wisdom? Using a dialectical method whereby Dewey (a pragmatist) was critiqued by Weil (a Christian Platonist) and vice versa, commonalities and differences were identified and clarified. For both, wisdom involved the application of thought to specific, concrete problems in order to secure a better way of life. For Weil, wisdom was centered on a love of truth that involved a certain way of applying one's attention to a concrete or theoretical problem. Weil believed that nature was subject to a divine wisdom and that a truly democratic society had supernatural roots. Dewey believed that any attempt to move beyond nature would stunt the growth of wisdom. For him, wisdom could be nourished only by natural streams-even if some ofthem were given a divine designation. For both, wisdom emerged through the discipline of work understood as intelligent activity, a coherent relationship between thinking and acting. Although Weil and Dewey differed on how they distinguished these 2 activities, they both advocated a type of education which involved practical experience and confronted concrete problems. Whereas Dewey viewed each problem optimistically with the hope of solving it, Weil saw wisdom in, contemplating insoluble contradictions. For both, educating for a love of wisdom meant cultivating a student's desire to keep thinking in line with acting-wanting to test ideas in action and striving to make sense of actions observed.

Synthesis of Chiral Benzimidazolylidenes from 1,10-Phenathrolines and 1,10-Phenathroline-2,9-dione /

A^-heterocyclic carbenes (NHCs) have become the focus of much interest as ancillary ligands for transition metal catalysts in recent years. Their structural variability and strong cy-donation properties have led to the preparation of demonstrably useful organometallic catalysts. Among the three general structural types of NHCs (imidazolylidenes, imidazolinylidenes, and benzimidazolylidenes), benzimidazolylidenes are the least investigated because of the limitation of current synthetic approaches. The preparation of chiral analogues is even more challenging. Previously, our group has demonstrated an alternative approach to synthesizing benzimidazolylidenes with a tetracyclic framework in three steps from 1,10-phenanthroline. This thesis is focused on approaches to chiral benzimidazolylidenes derived from substituted 1,10-phenanthrolines. A key step in the preparation of these ligands involves a reduction of the pyridyl rings in 1,10-phenanthrolines. Chirality can be introduced to phenanthrolines before, during, or after the reduction as illustrated by three approaches: 1) de novo construction of the phenanthroline from chiral ketones with endo and exo faces to provide a degree of diastereoselectivity during subsequent reduction; 2) introduction of substituents into the 2- and 2,9- position of phenanthroline by nucleophilic aromatic substitution, followed by a reduction-resolution sequence; and 3) use of the protected octahydrophenanthroline as a substrate for chiral induction a to nitrogen.

THE USE OF COGNITIVE INTERVIEWS TO EVALUATE THE LIVING CONDITIONS SURVEY

Cognitive interviews were used to evaluate two draft versions of a financial survey in Jamaica. The qualitative version used a few open-ended questions, and the quantitative version used numerous close-ended questions. A secondary analysis based on the cognitive interview literature was used to guide a content analysis of the aggregate data of both surveys. The cognitive interview analysis found that the long survey had fewer respondent errors than the open-ended questions on the short survey. A grounded theory analysis then examined the aggregate cognitive data, showing that the respondents attached complex meanings to their financial information. The main limitation of this study was that the standard assessments of quantitative and qualitative reliability and validity were not utilized. Further research should utilize statistical methods to compare and contrast aggregated cognitive interview probe responses on open and close ended surveys.

A Narrative Study of Patient Encounter Accounts of Physicians, Nurses, and Medical Receptionists after Two Decades of a Paradigm of Patient-Centered Care

Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.

Explaining the Persistence of Commodity Prices

This paper extends the Competitive Storage Model by incorporating prominent features of the production process and financial markets. A major limitation of this basic model is that it cannot successfully explain the degree of serial correlation observed in actual data. The proposed extensions build on the observation that in order to generate a high degree of price persistence, a model must incorporate features such that agents are willing to hold stocks more often than predicted by the basic model. We therefore allow unique characteristics of the production and trading mechanisms to provide the required incentives. Specifically, the proposed models introduce (i) gestation lags in production with heteroskedastic supply shocks, (ii) multiperiod forward contracts, and (iii) a convenience return to inventory holding. The rational expectations solutions for twelve commodities are numerically solved. Simulations are then employed to assess the effects of the above extensions on the time series properties of commodity prices. Results indicate that each of the features above partially account for the persistence and occasional spikes observed in actual data. Evidence is presented that the precautionary demand for stocks might play a substantial role in the dynamics of commodity prices.

La limitation de responsabilité dans le transport multimodal

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de L.L.M. en droit des affaires"

Growing up expectations. Better understanding the expectations of community partners in participatory action research projects

This paper challenges the assumption that youth and youth agencies are in a condition of equality when entering a participatory action research (PAR). By asserting that it is not a state of equality that practitioners nor youth should assume nor be immediately striving for, but a consistently equitable process, this article draws from and reflects on the relationship between young people and researchers who have used a PAR methodology in action oriented projects. Using the UNESCO Growing up in Cities Canada project as a case example, this review extrapolates from and reflects on challenges faced by the project as a whole. Using semi-structured interviews to explore the roles of adults and youth, a number of strategies are highlighted as the techniques used to overcome these challenges. The discussion concludes with further reflection on the complexities of equality and equity, recommending a number of actions that have the potential to create an equitable environment in PAR projects similar to the one examined.

An Epistemic Argument in Support of Liberal Neutrality

My aim in the present paper is to develop a new kind of argument in support of the ideal of liberal neutrality. This argument combines some basic moral principles with a thesis about the relationship between the correct standards of justification for a belief/action and certain contextual factors. The idea is that the level of importance of what is at stake in a specific context of action determines how demanding the correct standards to justify an action based on a specific set of beliefs ought to be. In certain exceptional contexts –where the seriousness of harm in case of mistake and the level of an agent’s responsibility for the outcome of his action are specially high– a very small probability of making a mistake should be recognized as a good reason to avoid to act based on beliefs that we nonetheless affirm with a high degree of confidence and that actually justify our action in other contexts. The further steps of the argument consist in probing 1) that the fundamental state’s policies are such a case of exceptional context, 2) that perfectionist policies are the type of actions we should avoid, and 3) that policies that satisfy neutral standards of justification are not affected by the reasons which lead to reject perfectionist policies.

Les causes de déchéance du droit à limitation de responsabilité du transporteur maritime international de marchandises sous connaissement

La présente étude examine les causes de déchéance du droit à limitation de responsabilité du transporteur maritime de marchandises. En règle générale, les plafonds d’indemnisation fixés par les conventions internationales écartent la réparation intégrale du préjudice causé par le transporteur maritime de marchandises. Cependant, il est également prévu un certain nombre de causes de déchéance de ce droit à limitation, pour lesquelles les conditions d’application diffèrent d’une convention internationale à l’autre (Règles de La Haye, Règles de La Haye-Visby, Règles de Hambourg et Règles de Rotterdam). Parallèlement, les tribunaux nationaux, par le recours à des notions propres de leurs systèmes juridiques, modifient l’étendue des causes de déchéance de ce droit. En somme, la déchéance du droit à limitation de responsabilité variera selon la convention internationale appliquée et selon la juridiction compétente. Ce qui, en définitive, porte atteinte à la structuration rationnelle du régime de responsabilité du transporteur maritime dans sa globalité et à l’objectif d’uniformisation poursuivi jusqu’ici.