928 resultados para Procedures coordination


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Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

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Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2014 through June 30, 2015

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Agreed-upon procedures report on the City of Princeton, Iowa for the period July 1, 2014 through June 30, 2015

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Agreed-upon procedures report on the City of Moravia, Iowa for the period July 1, 2014 through June 30, 2015

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La complexité croissante de la prise en charge des malformations cardiaques congénitales impose des interventions chirurgicales et des cathétérismes cardiaques interventionnels fréquents. Chacune de ces techniques a ces limitations propres. Les interventions hybrides associent les avantages de la chirurgie cardiaque et du cathétérisme interventionnel. Dans notre expérience, les thérapies hybrides permettent de diminuer le temps de circulation extracorporelle, de diminuer la morbidité des interventions chirurgicales, de raccourcir le séjour du patient aux soins intensifs. Pour certaines malformations cardiaques congénitales complexes pour lesquelles il n'existe pas de chirurgie ou de thérapie interventionnelle idéale, les interventions hybrides sont en train de s'imposer comme la prise en charge incontournable. Increasing complexity in management of congenital heart disease imposes more frequent surgeries and interventions. Each technique has its own limitations, which could impair the anticipated result. Hybrid procedures join the advantages of cardiac surgery and interventions, creating a synergy in the management of these patients with cardiac anomalies. In our experience, hybrid procedures shorten cardiopulmonary bypass, reduce morbidity of surgery and reduce duration of stay in the intensive care unit. For some complex congenital heart diseases for which there are no ideal surgical or interventional options, hybrid procedures are becoming increasingly important in their management. Finally hybrid procedures allow surgeons and cardiologist to achieve complex procedures that could not be possible in another way

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Effective coordination is key to many situations that affect the well-being of two or more humans. Social coordination can be studied in coordination games between individuals located on networks of contacts. We study the behavior of humans in the laboratory when they play the Stag Hunt game - a game that has a risky but socially efficient equilibrium and an inefficient but safe equilibrium. We contrast behavior on a cliquish network to behavior on a random network. The cliquish network is highly clustered and resembles more closely to actual social networks than the random network. In contrast to simulations, we find that human players dynamics do not converge to the efficient outcome more often in the cliquish network than in the random network. Subjects do not use pure myopic best-reply as an individual update rule. Numerical simulations agree with laboratory results once we implement the actual individual updating rule that human subjects use in our laboratory experiments.

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Dr. Narakas intended to study a series of 61 cases of shoulder sequelae of obstetric palsy. His vast experience would have enriched our clinical knowledge of this ailment. The authors carry on with that study to clarify his therapeutic approach and share the benefit of his experience.

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Nanotechnology is becoming part of our daily life in a wide range of products such as computers, bicycles, sunscreens or nanomedicines. While these applications already become reality, considerable work awaits scientists, engineers, and policy makers, who want such nanotechnological products to yield a maximum of benefit at a minimum of social, environmental, economic and (occupational) health cost. Considerable efforts for coordination and collaboration in research are needed if one wants to reach these goals in a reasonable time frame and an affordable price tag. This is recognized in Europe by the European Commission which funds not only research projects but also supports the coordination of research efforts. One of these coordination efforts is NanoImpactNet, a researcher-operated network, which started in 2008 promote scientific cross-talk across all disciplines on the health and environmental impact of nanomaterials. Stakeholders contribute to these activities, notably the definition of research and knowledge needs. Initial discussions in this domain focused on finding an agreement on common metrics, and which elements are needed for standardized approaches for hazard and exposure identification. There are many nanomaterial properties that may play a role. Hence, to gain the time needed to study this complex matter full of uncertainties, researchers and stakeholders unanimously called for simple, easy and fast risk assessment tools that can support decision making in this rapidly moving and growing domain. Today, several projects are starting or already running that will develop such assessment tools. At the same time, other projects investigate in depth which factors and material properties can lead to unwanted toxicity or exposure, what mechanisms are involved and how such responses can be predicted and modelled. A vision for the future is that once these factors, properties and mechanisms are understood, they can and will be accounted for in the development of new products and production processes following the idea of "Safety by Design". The promise of all these efforts is a future with nanomaterials where most of their risks are recognized and addressed before they even reach the market.

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The General Assembly Line Balancing Problem with Setups (GALBPS) was recently defined in the literature. It adds sequence-dependent setup time considerations to the classical Simple Assembly Line Balancing Problem (SALBP) as follows: whenever a task is assigned next to another at the same workstation, a setup time must be added to compute the global workstation time, thereby providing the task sequence inside each workstation. This paper proposes over 50 priority-rule-based heuristic procedures to solve GALBPS, many of which are an improvement upon heuristic procedures published to date.

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Abstract: The objective of this work was to define procedures to assess the tolerance of cassava genotypes to postharvest physiological deterioration (PPD) and to microbial deterioration (MD). Roots of six cassava genotypes were evaluated in two experiments, during storage under different environmental conditions: high temperature and low soil moisture; or low temperature and high soil moisture. Roots were treated or not with fungicide (carbendazim) before storage. Genotype reactions to MD and PPD were evaluated at 0, 2, 5, 10, 15, 20, and 30 days after harvest (DAH), in the proximal, medial, and distal parts of the roots. A diagrammatic scale was proposed to evaluate nonperipheral symptoms of PPD. Fungicide treatment and root position did not influence PPD expression; however, all factors had significant effect on MD severity. Genotypes differed as to their tolerance to PPD and MD. Both deterioration types were more pronounced during periods of higher humidity and lower temperatures. The fungicide treatment increased root shelf life by reducing MD severity up to 10 DAH. Whole roots showed low MD severity and high PPD expression up to 10 DAH, which enabled the assessment of PPD without significant interference of MD symptoms during this period.

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OBJECTIVES: This study investigated the relationship between inter-arm coordination and the energy cost of locomotion in front crawl and breaststroke and explored swimmers' flexibility in adapting their motor organization away from their preferred movement pattern. DESIGN: Nine front-crawlers performed three 300-m in front crawl and 8 breaststrokers performed three 200-m in breaststroke at constant submaximal intensity and with 5-min rests. Each trial was performed randomly in a different coordination pattern: freely chosen, 'maximal glide' and 'minimal glide'. Two underwater cameras videotaped frontal and side views to analyze speed, stroke rate, stroke length and inter-limb coordination. METHODS: In front crawl, inter-arm coordination was quantified by the index of coordination (IdC) and the leg beat kicks were counted. In breaststroke, four time gaps quantified the arm to leg coordination (i.e., time between leg and arm propulsions; time between beginning, 90° flexion and end of arm and leg recoveries). The energy cost of locomotion was calculated from gas exchanges and blood lactate concentration. RESULTS: In both front crawl and breaststroke, the freely chosen coordination corresponded to glide pattern and showed the lowest energy cost (12.8 and 17.1Jkg(-1)m(-1), respectively). Both front-crawlers and breaststrokers were able to reach 'maximal glide' condition (respectively, +35% and +28%) but not 'minimal glide' condition for front crawl. CONCLUSIONS: The freely chosen pattern appeared more economic because more trained. When coordination was constrained, the swimmers had higher coordination flexibility in breaststroke than in front crawl, suggesting that breaststroke coordination was easier to regulate by changing glide time.

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INTRODUCTION: Preoperative scores are widely used predictors of complications after major surgery. These scores, however, are not widely used in transurethral procedures. The aim of this study was to assess the value of the Charlson Comorbidity Index (CCI), the age-adjusted CCI, the American Society of Anesthesiologist score (ASA) and the Nutritional Risk Score (NRS) in predicting early morbidity after transurethral urological procedures. METHODS: Consecutive patients undergoing transurethral resection of the bladder or the prostate were prospectively enrolled. The scores were calculated preoperatively; 30-day complications were prospectively recorded according to the Dindo-Clavien classification. Univariate logistic regression was performed to investigate the value of each score and of other factors (i.e., age, sex, body mass index, anemia, smoking habit, type of operation and anaesthesia) as predictors of complications. A multivariate model was then calculated using these predictors. RESULTS: Overall, 197 patients were included. The mean age was 72 (standard deviation ± 10). In total, 26.9% patients had at least 1 complication. Using univariate analysis, we found that each score significantly predicted complications. In multivariate analysis, only the ASA (odds ration [OR] 2.11; 95% confidence interval [CI] 1.01-4.43) and the NRS (OR 2.42; 95% CI 1.56-3.74) remained independent predictors. The best model incorporated ASA, NRS and gender, and predicted morbidity with an area under the curve of 76%. Our study's main limitations are population heterogeneity and limited sample size. CONCLUSION: The ASA and the NRS are important and independent determinants of early morbidity after transurethral procedures. The use of these indices may assist clinicians in the decision-making process to balance the possible benefits of transurethral procedures with the potential risks.