Ventilación controlada por volumen vs. ventilación controlada por presión en pacientes sometidos a ventilación de un solo pulmón

El establecimiento de la ventilación de un solo pulmón (OLV) tiene varios inconvenientes como el incremento de las presiones de la vía aérea y aumento del shunt. Estos cambios pueden estar influenciados por el modo ventilatorio escogido. La ventilación controlada por presión (VCP) es un modo alternativo ampliamente usado en pacientes con falla respiratoria por sus características de aporte de flujo y presión. En este estudio la VCP fue usada en los pacientes que requerían OLV y sus efectos sobre las presiones en la vía aérea, oxigenación y estado hemodinámico fueron comparados con la ventilación controlado por volumen (VCV). Nosotros estudiamos 41 pacientes que requerian OLV. Después de ventilar los dos pulmones con volumen los pacientes fueron aleatorizados a uno de dos grupos. En el primer grupo (n=19) OLV fue iniciada con VCV y luego de transcurrido 30 minutos los pacientes fueron cambiados a VCP, donde se mantuvo la ventilación por el mismo tiempo. En el otro grupo (n=21) los pacientes iniciaron en VCP 30 minutos y luego fueron cambiados a VCV con una duración similar. Las presiones en la vía aérea, gases arteriales y variables hemodinámicas fueron medidos durante OLV en cada modo ventilatorio previo al cambio. Nosotros observamos que el inicio de OLV genera un incremento de la presión inspiratoria pico (PIP) (p=0.0002) y presión plateau (p=0.005). Este aumento es mayor en el grupo que fue VCV (p=0.008) que en el grupo que fue VCP (p=0.003). No hubo diferencia estadísticamente significativa en las otras varibles estudiadas entre los grupos. Nosotros concluimos que la VCP puede ser una alternativa a VCV en pacientes que requieren OLV porque disminuye las presiones en la vía aérea y aunque no mejora la oxigenación si puede minimizar el desarrollo de lesiones pulmonares inducidas por la ventilación en una población que es de alto riesgo para el desarrollo de la misma.

El Outsourcing en la dinámica de sistemas hacia mercados extranjeros

Este trabajo recopila literatura académica relevante sobre estrategias de entrada y metodologías para la toma de decisión sobre la contratación de servicios de Outsourcing para el caso de empresas que planean expandirse hacia mercados extranjeros. La manera en que una empresa planifica su entrada a un mercado extranjero, y realiza la consideración y evaluación de información relevante y el diseño de la estrategia, determina el éxito o no de la misma. De otro lado, las metodologías consideradas se concentran en el nivel estratégico de la pirámide organizacional. Se parte de métodos simples para llegar a aquellos basados en la Teoría de Decisión Multicriterio, tanto individuales como híbridos. Finalmente, se presenta la Dinámica de Sistemas como herramienta valiosa en el proceso, por cuanto puede combinarse con métodos multicriterio.

Influencia de la relación estratégica comunitaria y el marketing en la salud financiera de las organizaciones en mercados internacionales

La globalización de mercados ha generado una serie de cambios en la estructura del comercio internacional, como el surgimiento de áreas de libre comercio, que son el resultado de las integraciones económicas, las cuales han facilitado los flujos de capital, recursos y personas. La internacionalización no solamente se ha convertido en una estrategia para aprovechar las oportunidades que se dan en los mercados internacionales, sino también en un medio de diversificación del riesgo para reducir la dependencia del mercado doméstico. Sin embargo, para emprender un proceso de internacionalización, es necesario conocer muy bien el contexto dentro del cual se desarrollan los clientes, puesto que la falta de conocimiento del entorno puede perjudicar la salud financiera de la empresa. De ahí la importancia de utilizar una definición de comunidad y unas estrategias comunitarias con las cuales se identifiquen las necesidades, objetivos e intereses de la comunidad, para establecer un relación a largo plazo que procure el desarrollo de ambas partes. La relación estratégica comunitaria y el marketing impactan positivamente la salud financiera de la empresa, en la medida en que este desarrollo mutuo, tanto de la comunidad como de la empresa, no solamente incrementa el interés y el compromiso por seguir interactuando; también crea vínculos afectivos entre ambas partes, lo cual consolida aún más la perdurabilidad de la relación, logrando así una fidelización de los clientes y por ende aumentando la rentabilidad de la empresa.

International entry modes in Brazil and the CAGE distances effects

The international entry mode choices have a relevant importance for the impact they have on successful internationalization strategies. Many theories have been developed to describe which entry mode may be better than another according to the particular situation. The CAGE Distances Framework developed by Ghemawat to identify which dimensions companies should look when develop an internationalization strategy, may be useful to identify also how those dimensions impact on the international entry mode decision. The aim of this thesis is to study which kind of relationship exists between Cultural, Administrative, Geographic and Economic Distances and international entry mode choice. It analyzes a sample of companies that have been entered in Brazil through a logistic regression. According to this analysis, a negative and significant relation between Cultural Distance and need of control exists, a positive one exists between Administrative and Geographic, while no significant relationship has been found with the Economic dimension. Those findings are conceivably explainable through the theories found by scholars, but a deeper analysis that may take into account the specificity of every country is highly recommended, like the one developed with Brazil in this thesis.

A contribution for thermoeconomic modelling: A methodology proposal

This work presents a thermoeconomic optimization methodology for the analysis and design of energy systems. This methodology involves economic aspects related to the exergy conception, in order to develop a tool to assist the equipment selection, operation mode choice as well as to optimize the thermal plants design. It also presents the concepts related to exergy in a general scope and in thermoeconomics which combines the thermal sciences principles (thermodynamics, heat transfer, and fluid mechanics) and the economic engineering in order to rationalize energy systems investment decisions, development and operation. Even in this paper, it develops a thermoeconomic methodology through the use of a simple mathematical model, involving thermodynamics parameters and costs evaluation, also defining the objective function as the exergetic production cost. The optimization problem evaluation is developed for two energy systems. First is applied to a steam compression refrigeration system and then to a cogeneration system using backpressure steam turbine. (C) 2010 Elsevier Ltd. All rights reserved.

Modes of Supply for US Exports of Services

We examine the choice of modes of delivery in services based on US data, including both cross-border exports and sales through foreign affiliates. We focus on characteristics of destination markets and how this impacts on mode choice. We find that market size, distance and policy all play a role in where firms establish, and in how many markets firms enter. The importance of sales through affiliates relative to total foreign sales also depends on factors like market size, geographic and economic distance and the policy regime in place. Precisely, how important these factors are depends on the sector in question.

Railway Rapid Transit timetables with variable and elastic demand.

This paper focuses on the design of railway timetables considering a variable elastic demand profile along a whole design day. Timetabling is the third stage in the classical hierarchical railway planning process. Most of previous works on this topic consider a uniform demand behavior for short planning intervals. In this paper, we propose a MINLP model for designing non-periodic timetables on a railway corridor where demand is dependent on waiting times. In the elastic demand case, long waiting times lead to a loss of passengers, who may select an alternative transportation mode. The mode choice is modeled using two alternative methods. The first one is based on a sigmoid function and can be used in case of absence of information for competitor modes. In the second one, the mode choice probability is obtained using a Logit model that explicitly considers the existence of a main alternative mode. With the purpose of obtaining optimal departure times, in both cases, a minimization of the loss of passengers is used as objective function. Finally, as illustration, the timetabling MINLP model with both mode choice methods is applied to a real case and computational results are shown.

Assessment methodology applied to demand measures to change urban mobility behavior

In order to minimize car-based trips, transport planners have been particularly interested in understanding the factors that explain modal choices. Transport modelling literature has been increasingly aware that socioeconomic attributes and quantitative variables are not sufficient to characterize travelers and forecast their travel behavior. Recent studies have also recognized that users’ social interactions and land use patterns influence travel behavior, especially when changes to transport systems are introduced; but links between international and Spanish perspectives are rarely dealt with. The overall objective of the thesis is to develop a stepped methodology that integrate diverse perspectives to evaluate the willingness to change patterns of urban mobility in Madrid, based on four steps: (1st) analysis of causal relationships between both objective and subjective personal variables, and travel behavior to capture pro-car and pro-public transport intentions; (2nd) exploring the potential influence of individual trip characteristics and social influence variables on transport mode choice; (3rd) identifying built environment dimensions on travel behavior; and (4th) exploring the potential influence on transport mode choice of extrinsic characteristics of individual trip using panel data, land use variables using spatial characteristics and social influence variables. The data used for this thesis have been collected from a two panel smartphone-based survey (n=255 and 190 respondents, respectively) carried out in Madrid. Although the steps above are mainly methodological, the application to the area of Madrid allows deriving important results that can be directly used to forecast travel demand and to evaluate the benefits of specific policies that might be implemented in the area. The results demonstrated, respectively: (1st) transport policy actions are more likely to be effective when pro-car intention has been disrupted first; (2nd) the consideration of “helped” and “voluntary” users as tested here could have a positive and negative impact, respectively, on the use of public transport; (3rd) the importance of density, design, diversity and accessibility underlying dimensions responsible for land use variables; and (4th) there are clearly different types of combinations of social interactions, land use and time frame on travel behavior studies. Finally, with the objective to study the impact of demand measures to change urban mobility behavior, those previous results have been considered in a unique way, a hybrid discrete choice model has been used on a 5th step. Then it can be concluded that urban mobility behavior is not only ruled by the maximum utility criterion, but also by a strong psychological-environment concept, developed without the mediation of cognitive processes during choice, i.e., many people using public transport on their way to work do not do it for utilitarian reasons, but because no other choice is available. Regarding built environment dimensions, the more diversity place of residence, the more difficult the use of public transport or walking.

Research and development opportunities for improved transportation energy usage. Summary technical report.

Transportation Department, Washington, D.C.

Transportation services, utilization and needs of the elderly in non-urban areas: patterns in two Kentucky communities. Final report.

Federal Transit Administration, Washington, D.C.

ITS Institutional and Legal Issues Program. Review of the SaFIRES operational test. Final report.

Transportation Department, Joint Program Office for Intelligent Transportation Systems, Washington, D.C.

Trading off among the needs of motor vehicle users, pedestrians, and bicyclists. Case study no. 10.

Federal Highway Administration, Washington, D.C.

Special reports on trip and vehicle attributes: based on data from 1990 Nationwide Personal Transportation Survey (NPTS).

Federal Highway Administration, Washington, D.C.

Transit-supportive development in the United States: experiences and prospects. Final report.

Federal Transit Administration, Washington, D.C.