986 resultados para Centre hospitalier universitaire


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The paper focuses on the role that can be played by urban consolidation centres (UCCs) in reducing freight traffic and its environmental impacts in towns and cities. It is based on the before and after evaluation of a trial led by a major stationery and office supplies company in which urban freight deliveries in central London made from a depot in the suburbs using diesel vehicles were replaced with the use of an urban micro-consolidation centre located in the delivery area together with the use of electrically-assisted cargo tricycles and electric vans. The results show that the total distance travelled and the CO2eq emissions per parcel delivered fell by 20% and 54% respectively as a result of this delivery system. However, the evaluation has also indicated that the distance travelled per parcel rose substantially in the City of London delivery area as a result of the electric vehicles having far smaller load limits in both weight and volume compared with diesel vans. But, at the same time, the trial system was able to virtually eliminate CO2eq emissions per parcel delivered in the City of London. The trial proved successful from the company's perspective in transport, environmental and financial terms. The company therefore decided to continue the operation beyond the end of the trial with it being officially launched during 2010.

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A novel resonator-based bandpass Σ-Δ modulator with an in-built variable centre frequency feature is presented. This structure is designed by analytically determining and subsequently verifying through behavioural level simulations the necessary compensation hardware to be placed in the feedback to ensure stability and good dynamic range performance.

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This paper presents a novel technique for the design of narrow-band sigma-delta modulators with an embedded tunable centre frequency mechanism. This method demonstrates that the use of sum filters combined with a fractional delayer provide the flexibility of tuning the noise shaping band for any desired variable centre frequency input signal.

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This paper presents the design analysis of novel tunable narrow-band bandpass sigma-delta modulators, that can achieve concurrent multiple noise-shaping for multi-tone input signals. This approach utilises conventional comb filters in conjunction with FIR, or allpass IIR fractional delay filters, to deliver the desired nulls for the quantisation noise transfer function. Detailed simulation results show that FIR fractional delay comb filter based sigma-delta modulators tune accurately to most centre frequencies, but suffer from degraded resolution at frequencies close to Nyquist. However, superior accuracies are obtained from their allpass IIR fractional delay counterpart at the expense of a slight shift in noise-shaping bands at very high frequencies.

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This paper presents a methodology for the design of oversampled narrow-band single-loop and multi-stage resonator-based bandpass Σ-Δ modulators that can accommodate different passband centre to sampling frequency ratios. These tunable bandpass configurations are designed by analytically determining the required compensation hardware to deliver good resolution. Thorough simulations demonstrate that comparatively superior in-band signal-to-noise ratios (SNRs) and dynamic ranges (DRs) are attributed to the inclusion of appropriate feedforward and feedback compensators within these structures.

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Dissertação de Natureza Científica para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

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OBJECTIVES: This study aimed at investigating whether data from medical teleconsultations may contribute to influenza surveillance. METHODS: International Classification of Primary Care 2nd Edition (ICPC-2) codes were used to analyse the proportion of teleconsultations due to influenza-related symptoms. Results were compared with the weekly Swiss Sentinel reports. RESULTS: When using the ICPC-2 code for fever we could reproduce the seasonal influenza peaks of the winter seasons 07/08, 08/09 and 09/10 as depicted by the Sentinel data. For the pandemic influenza 09/10, we detected a much higher first peak in summer 2009 which correlated with a potential underreporting in the Sentinel system. CONCLUSIONS: ICPC-2 data from medical teleconsultations allows influenza surveillance in real time and correlates very well with the Swiss Sentinel system.

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La cigarette électronique (E-cigarette) est un phénomène relativement récent qui est en train de prendre une ampleur inattendue, surtout chez les jeunes. La littérature scientifique à ce sujet est encore relativement rare et surtout centrée sur les taux de prévalence. Bien que théoriquement conçues pour les adultes qui voudraient arrêter de fumer, les adolescents sont devenus un public cible pour ces produits, dont beaucoup n'ayant jamais fumé de cigarettes traditionnelles. Du point de vue de la santé publique, une des préoccupations majeures correspond au possible effet indésirable des cigarettes électroniques d'inciter les jeunes au tabagisme. Beaucoup de questions restent sans réponse quant à l'impact des cigarettes électroniques sur la santé publique. Par exemple, il n'est pas clair si les cigarettes électroniques sont juste une nouveauté que les jeunes n'essayent qu'une fois ou si elles ont le potentiel de concurrencer les cigarettes traditionnelles. Même si les cigarettes électroniques sont disponibles en Suisse depuis près de 10 ans, peu de données existent quant aux motifs de consommation des jeunes, les modalités de consommation, les effets recherchés et la perception de leur nocivité.

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Comme d'autres institutions académiques européennes, les universités suisses connaissent des changements importants et « l'excellence académique » est devenu un critère central lors de la sélection des dossiers pour les postes de rang professoral. Dans cet article, nous analyserons les critères d'excellence tels qu'ils apparaissent dans le programme Professeur.e.s boursiers.ières du FNS et les confronterons aux résultats d'une recherche sur les trajectoires de la relève académique que nous avons menée à l'Université de Lausanne. Nous montrerons comment la définition de l'excellence académique obéit à des logiques genrées qui rendent l'accession à un poste professoral plus difficile pour les femmes que pour les hommes. Nous verrons pourquoi les critères d'évaluation des sciences dures, qui sont peu à peu transférés vers les sciences humaines, renforcent les mécanismes d'exclusions des femmes des mondes académiques.

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Interest groups advocate centre-specific outcome data as a useful tool for patients in choosing a hospital for their treatment and for decision-making by politicians and the insurance industry. Haematopoietic stem cell transplantation (HSCT) requires significant infrastructure and represents a cost-intensive procedure. It therefore qualifies as a prime target for such a policy. We made use of the comprehensive database of the Swiss Blood Stem Cells Transplant Group (SBST) to evaluate potential use of mortality rates. Nine institutions reported a total of 4717 HSCT - 1427 allogeneic (30.3%), 3290 autologous (69.7%) - in 3808 patients between the years 1997 and 2008. Data were analysed for survival- and transplantation-related mortality (TRM) at day 100 and at 5 years. The data showed marked and significant differences between centres in unadjusted analyses. These differences were absent or marginal when the results were adjusted for disease, year of transplant and the EBMT risk score (a score incorporating patient age, disease stage, time interval between diagnosis and transplantation, and, for allogeneic transplants, donor type and donor-recipient gender combination) in a multivariable analysis. These data indicate comparable quality among centres in Switzerland. They show that comparison of crude centre-specific outcome data without adjustment for the patient mix may be misleading. Mandatory data collection and systematic review of all cases within a comprehensive quality management system might, in contrast, serve as a model to ascertain the quality of other cost-intensive therapies in Switzerland.