763 resultados para Chu gokugo Kaiwa.


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Acknowledgements We thank Philippe Bolifraud (INRA, France), Krawiec Angele, Sandra Grange, Laurence Puillet-Anselme (CHU Grenoble, France) and Margaret Fraser (Aberdeen, UK) for their expert technical assistance. The authors also thank the staff of the sheep sheds of Jouy-en-Josas (INRA, France). The authors would also like to thank the anonymous reviewers for their close examination of this article and their useful comments.

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Funding: This work was partially supported by grants from National Basic Research Program of China (2013CB530605; 2014CB942803), from National Natural Science Foundation of China 1230046; 31071252; 81101182) and from Chinese Academy of Sciences (KSCX2-EW-R-05, KJZD-EW-L08). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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This paper uses empirical evidence to examine the operational dynamics and paradoxical nature of risk management systems in the banking sector. It demonstrates how a core paradox of market versus regulatory demands and an accompanying variety of performance, learning and belonging paradoxes underlie evident tensions in the interaction between front and back office staff in banks. Organisational responses to such paradoxes are found to range from passive to proactive, reflecting differing organisational, departmental and individual risk culture(s), and performance management systems. Nonetheless, a common feature of regulatory initiatives designed to secure a more structurally independent risk management function is that they have failed to rectify a critical imbalance of power - with the back office control functions continuing to be dominated by front office trading and investment functions. Ultimately, viewing the 'core' of risk management systems as a series of connected paradoxes rather than a set of assured, robust practices, requires a fundamental switch in emphasis away from a normative, standards-based approach to risk management to one which gives greater recognition to its behavioural dimensions.

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The surface properties of InP electrodes were examined following anodization in (NH4)2S and KOH electrolytes. In both solutions, the observation of current peaks in the cyclic voltammetric curves was attributed to selective etching of the substrate and a film formation process. AFM images of samples anodized in the sulfide solution, revealed surface pitting and TEM micrographs revealed the porous nature of the film formed on top of the pitted substrate. After anodization in the KOH electrolyte, TEM images revealed that a porous layer extending 500 nm into the substrate had been formed. Analysis of the composition of the anodic products indicates the presence of In2S3 in films grown in (NH4)2S and an In2O3 phase within the porous network formed in KOH.

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RATIONALE: Limitations in methods for the rapid diagnosis of hospital-acquired infections often delay initiation of effective antimicrobial therapy. New diagnostic approaches offer potential clinical and cost-related improvements in the management of these infections. OBJECTIVES: We developed a decision modeling framework to assess the potential cost-effectiveness of a rapid biomarker assay to identify hospital-acquired infection in high-risk patients earlier than standard diagnostic testing. METHODS: The framework includes parameters representing rates of infection, rates of delayed appropriate therapy, and impact of delayed therapy on mortality, along with assumptions about diagnostic test characteristics and their impact on delayed therapy and length of stay. Parameter estimates were based on contemporary, published studies and supplemented with data from a four-site, observational, clinical study. Extensive sensitivity analyses were performed. The base-case analysis assumed 17.6% of ventilated patients and 11.2% of nonventilated patients develop hospital-acquired infection and that 28.7% of patients with hospital-acquired infection experience delays in appropriate antibiotic therapy with standard care. We assumed this percentage decreased by 50% (to 14.4%) among patients with true-positive results and increased by 50% (to 43.1%) among patients with false-negative results using a hypothetical biomarker assay. Cost of testing was set at $110/d. MEASUREMENTS AND MAIN RESULTS: In the base-case analysis, among ventilated patients, daily diagnostic testing starting on admission reduced inpatient mortality from 12.3 to 11.9% and increased mean costs by $1,640 per patient, resulting in an incremental cost-effectiveness ratio of $21,389 per life-year saved. Among nonventilated patients, inpatient mortality decreased from 7.3 to 7.1% and costs increased by $1,381 with diagnostic testing. The resulting incremental cost-effectiveness ratio was $42,325 per life-year saved. Threshold analyses revealed the probabilities of developing hospital-acquired infection in ventilated and nonventilated patients could be as low as 8.4 and 9.8%, respectively, to maintain incremental cost-effectiveness ratios less than $50,000 per life-year saved. CONCLUSIONS: Development and use of serial diagnostic testing that reduces the proportion of patients with delays in appropriate antibiotic therapy for hospital-acquired infections could reduce inpatient mortality. The model presented here offers a cost-effectiveness framework for future test development.

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Le développement professionnel (DP) des infirmières est essentiel et déterminant dans lâobtention dâune meilleure qualité de soins. Pour se réaliser, le développement professionnel nécessite un engagement individuel des infirmières elles-mêmes. Or, une disparité est observée en centre hospitalier universitaire (CHU) entre la volonté exprimée par les infirmières de poursuivre leur DP et leur assiduité dans les activités de développement offertes par les organisations. Lâobjectif de cette étude qualitative est de décrire la perception des infirmières Åuvrant en CHU (n=8) en regard des facteurs organisationnels susceptibles de favoriser leur engagement à poursuivre leur développement professionnel. Cette analyse a été effectuée à partir de huit entrevues individuelles semi-dirigées réalisées auprès dâinfirmières Åuvrant dans le secteur de chirurgie du CHU Sainte-Justine. Les résultats démontrent que de nombreux facteurs organisationnels et individuels. Les principaux facteurs influant sur lâengagement des infirmières sont : a) un environnement favorable au DP; b) lâaccessibilité au DP et; c) des modalités de DP variées. Les modalités les plus favorables sont celles favorisant leur autonomie et incitant leur implication. En conclusion, pour obtenir un maximum dâengagement des infirmières, les organisations doivent présenter une offre de DP variée et structurée, répondant aux besoins professionnels des infirmières, tout en mitigeant lâimpact des contraintes liées à leur fonction et à leur vie personnelle.

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The present study investigated the concentrations and patterns of PBDEs and hydroxylated (OH) PBDE analogues in two ringed seal populations: less contaminated Svalbard and more contaminated Baltic Sea. Mean concentration of hepatic sum-PBDE, which was dominated by BDE47, was six times higher in the ringed seals from the Baltic Sea compared to the seals from Svalbard. BDE47/sum-PBDE was higher in the seals from Svalbard compared to that for Baltic seals, while the trend was opposite for BDE153 and 154. The geographical difference in contaminant pattern of PBDEs in ringed seals could be explained by biotransformation via oxidative metabolism and/or by dietary differences. OH-PBDEs were detectable in the majority of plasma samples from both locations, and dominated by bioaccumulation of naturally occurring congeners. Low levels of 3-OH-BDE47 and 4'-OH-BDE49 in the Baltic ringed seals suggested minor oxidative biotransformation of BDE47. In the Baltic seals, BDE153/sum-PBDEs and BDE154/sum-PBDEs increased and BDE28/sum-PBDE decreased with increasing sum-POP concentration, which suggests BDE153 and 154 are more persistent than BDE28. Contrasting diets of the ringed seals in these two locations may influence the PBDE congener pattern due to selective long-range transport and direct effluent emissions to Svalbard and the Baltic, respectively.

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Based on an original and comprehensive database of all feature fiction films produced in Mercosur between 2004 and 2012, the paper analyses whether the Mercosur film industry has evolved towards an integrated and culturally more diverse market. It provides a summary of policy opportunities in terms of integration and diversity, emphasizing the limiter role played by regional policies. It then shows that although the Mercosur film industry remains rather disintegrated, it tends to become more integrated and culturally more diverse. From a methodological point of view, the combination of Social Network Analysis and the Stirling Model opens up interesting research tracks to analyse creative industries in terms of their market integration and their cultural diversity.

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This paper presents a numerical study of a linear compressor cascade to investigate the effective end wall profiling rules for highly-loaded axial compressors. The first step in the research applies a correlation analysis for the different flow field parameters by a data mining over 600 profiling samples to quantify how variations of loss, secondary flow and passage vortex interact with each other under the influence of a profiled end wall. The result identifies the dominant role of corner separation for control of total pressure loss, providing a principle that only in the flow field with serious corner separation does the does the profiled end wall change total pressure loss, secondary flow and passage vortex in the same direction. Then in the second step, a multi-objective optimization of a profiled end wall is performed to reduce loss at design point and near stall point. The development of effective end wall profiling rules is based on the manner of secondary flow control rather than the geometry features of the end wall. Using the optimum end wall cases from the Pareto front, a quantitative tool for analyzing secondary flow control is employed. The driving force induced by a profiled end wall on different regions of end wall flow are subjected to a detailed analysis and identified for their positive/negative influences in relieving corner separation, from which the effective profiling rules are further confirmed. It is found that the profiling rules on a cascade show distinct differences at design point and near stall point, thus loss control of different operating points is generally independent.

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We study a multiuser multicarrier downlink communication system in which the base station (BS) employs a large number of antennas. By assuming frequency-division duplex operation, we provide a beam domain channel model as the number of BS antennas grows asymptotically large. With this model, we first derive a closed-form upper bound on the achievable ergodic sum-rate before developing necessary conditions to asymptotically maximize the upper bound, with only statistical channel state information at the BS. Inspired by these conditions, we propose a beam division multiple access (BDMA) transmission scheme, where the BS communicates with users via different beams. For BDMA transmission, we design user scheduling to select users within non-overlapping beams, work out an optimal pilot design under a minimum mean square error criterion, and provide optimal pilot sequences by utilizing the Zadoff-Chu sequences. The proposed BDMA scheme reduces significantly the pilot overhead, as well as, the processing complexity at transceivers. Simulations demonstrate the high spectral efficiency of BDMA transmission and the advantages in the bit error rate performance of the proposed pilot sequences.

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Thèse réalisée dans le cadre d'un Ph.D.interdisciplinaire en Psychologie, en création littéraire et en orthopédagogie. L'impact de la création littéraire a été étudié chez des adolescents atteints d'une maladie chronique au CHU Sainte-Justine de Montréal. Cette recherche est exploratoire car la création littéraire n'a jamais été étudiée dans cette perspective. Elle a été réalisée sous la direction de Catherine Mavrikakis, professeure et écrivain à la Faculté des arts et sciences au Département des littératures francophones de l'Université de Montréal et de Jean-François Saucier, psychiatre et anthropologue à la Faculté de médecine au Département de psychiatrie de l'Université de Montréal et chercheur au CHU Sainte-Justine. Interdisciplinary Study.