986 resultados para A1B scenario
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Abstract
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BACKGROUND: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation. METHODS/DESIGN: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq?, A. P. Advance?, King Vision?) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC?, GlideScope?, McGrath?) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt. DISCUSSION: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway. TRIAL REGISTRATION: NCT01692535.
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Crops and forests are already responding to rising atmospheric carbon dioxide and air temperatures. Increasing atmospheric CO2 concentrations are expected to enhance plant photosynthesis. Nevertheless, after long-term exposure, plants acclimate and show a reduction in photosynthetic activity (i.e. down-regulation). If in the future the Earth"s temperature is allowed to rise further, plant ecosystems and food security will both face significant threats. The scientific community has recognized that an increase in global temperatures should remain below 2°C in order to combat climate change. All this evidence suggests that, in parallel with reductions in CO2 emissions, a more direct approach to mitigate global warming should be considered. We propose here that global warming could be partially mitigated directly through local bio-geoengineering approaches. For example, this could be done through the management of solar radiation at surface level, i.e. by increasing global albedo. Such an effect has been documented in the south-eastern part of Spain, where a significant surface air temperature trend of -0.3°C per decade has been observed due to a dramatic expansion of greenhouse horticulture.
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Tutkimuksen tavoitteena on ennakoida liiketoimintaprosessien sähköistymisen kehittymistä käyttämällä skenaariomenetelmää, yhtä laajimmin käytetyistä tulevaisuuden tutkimisen menetelmistä. Tarkastelun kohteena ovat erityisesti tulevaisuuden e-business -ratkaisut metsäteollisuudessa. Tutkimuksessa selvitetään skenaariomenetelmän ominaisuuksia, skenaariosuunnittelun periaatteita sekä menetelmän sopivuutta teknologian ja toimialan muutosten tarkasteluun. Tutkimuksen teoriaosassa selvitetään teknologian muutoksen vaikutusta toimialojen kehitykseen. Todettiin, että teknologisella muutoksella on vahva vaikutus toimialojen muutoksiin, ja että jokainen toimiala seuraa tietynlaista kehitystrajektoria. Yritysten tulee olla tietoisia teknologisen muutoksen nopeudesta ja suunnasta, ja seurata toimialansa kehityksen sääntöjä. Metsäteollisuudessa muutosten radikaali luonne sekä ICT-teknologian nopea kehitys asettavat haasteita liiketoimintaprosessien sähköistämisen kentässä. Empiriaosuudessa luotiin kolme erilaista skenaariota e-busineksen tulevaisuudesta metsäteollisuudessa. Skenaariot perustuvat pääosin aiheen asiantuntijoiden tämän hetkisiin näkemyksiin, joita koottiin skenaariotyöpajassa. Skenaarioiden muodostamisessa yhdistettiin kvalitatiivisia ja kvantitatiivisia elementtejä. Muodostetut kolme skenaariota osoittavat, että e-busineksen vaikutukset tulevaisuudessa nähdään pääosin positiivisina, ja että yritysten tulee kehittyä aktiivisesti ja joustavasti pystyäkseen hyödyntämään sähköisiä ratkaisuja tehokkaasti liiketoiminnassaan.
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This thesis attempts to find whether scenario planning supports the organizational strategy as a method for addressing uncertainty. The main issues are why, what and how scenario planning fits in organizational strategy and how the process could be supported to make it more effective. The study follows the constructive approach. It starts with examination of competitive advantage and the way that an organization develops strategy and how it addresses the uncertainty in its operational environment. Based on the conducted literature review, scenario methods would seem to provide versatile platform for addressing future uncertainties. The construction is formed by examining the scenario methods and presenting suitable support methods, which results in forming of the theoretical proposition for supporter scenario process. The theoretical framework is tested in laboratory conditions, and the results from the test sessions are used a basis for scenario stories. The process of forming the scenarios and the results are illustrated and presented for scrutiny
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Epävarmuus ei ole outoa enää julkishallinon alueellakaan. Globalisaation,tietotalous ja muut yksityissektoria ravistelleet ilmiöt ovat lisänneet mielenkiintoa erilaisiin tekniikoihin joilla voidaan lievittää epävarmuudesta aiheutuvia ongelmia. Tämä raportti kuvailee skenaariosuunnittelun käyttöä eräänä mahdollisuutena epävarmuuden hallintaan julkishallinnossa ja yksityissektorilla. Raportti sijoittuu samaan skenaariotutkimuksen jatkumoon edellisten LTY:ssä toteutettujen skenaariotutkimusten kanssa. tutkimus valottaa tutkimuksen ja käytännön työn nykytilaa helposti hyödynnettävässä muodossa. Rapostin kontribuutio on kuvata tutkimukseen perustuva tuettu skenaarioprosessi ja syntyneet skenaariot, keskittyen prosessin tukemiseen eri menetelmin.
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The markets of biomass for energy are developing rapidly and becoming more international. A remarkable increase in the use of biomass for energy needs parallel and positive development in several areas, and there will be plenty of challenges to overcome. The main objective of the study was to clarify the alternative future scenarios for the international biomass market until the year 2020, and based on the scenario process, to identify underlying steps needed towards the vital working and sustainable biomass market for energy purposes. Two scenario processes were conducted for this study. The first was carried out with a group of Finnish experts and thesecond involved an international group. A heuristic, semi-structured approach, including the use of preliminary questionnaires as well as manual and computerised group support systems (GSS), was applied in the scenario processes.The scenario processes reinforced the picture of the future of international biomass and bioenergy markets as a complex and multi-layer subject. The scenarios estimated that the biomass market will develop and grow rapidly as well as diversify in the future. The results of the scenario process also opened up new discussion and provided new information and collective views of experts for the purposes of policy makers. An overall view resulting from this scenario analysis are the enormous opportunities relating to the utilisation of biomass as a resource for global energy use in the coming decades. The scenario analysis shows the key issues in the field: global economic growth including the growing need for energy, environmental forces in the global evolution, possibilities of technological development to solve global problems, capabilities of the international community to find solutions for global issues and the complex interdependencies of all these driving forces. The results of the scenario processes provide a starting point for further research analysing the technological and commercial aspects related the scenarios and foreseeing the scales and directions of biomass streams.
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A common belief is that further quantum corrections near the singularity of a large black hole should not substantially modify the semiclassical picture of black hole evaporation; in particular, the outgoing spectrum of radiation should be very close to the thermal spectrum predicted by Hawking. In this paper we explore a possible counterexample: in the context of dilaton gravity, we find that nonperturbative quantum corrections which are important in strong-coupling regions may completely alter the semiclassical picture, to the extent that the presumptive spacelike boundary becomes timelike, changing in this way the causal structure of the semiclassical geometry. As a result, only a small fraction of the total energy is radiated outside the fake event horizon; most of the energy comes in fact at later retarded times and there is no problem of information loss. This may constitute a general characteristic of quantum black holes, that is, quantum gravity might be such as to prevent the formation of global event horizons.
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The Mediterranean basin is a particularly vulnerable region to climate change, partly due to its quite unique character that results both from physiographic conditions and societal development. The region features indeed a near-closed sea surrounded by very urbanised littorals and mountains from which numerous rivers originate. This results in a lot of interactions and feedbacks between oceanic-atmospheric-hydrological processes that play a predominant role on climate and extreme events that frequently cause heavy dam- ages and human losses in the Mediterranean ...
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Tutkimuksen tavoitteena oli selvittää millaisia ympäristöskenaarioita tietoliikenteelle toimialana voidaan rakentaa ja mitkä näistä skenaarioista suosivat Bluetoothin diffuusiota ja kehittymistä nykyisten tuote- ja palvelunäkemysten valossa. Lisäksi pyrittiin arvioimaan, mitkä ympäristötekijät ja suuntaukset saattavat vaikuttaa Bluetoothin diffuusioon. Tutkimus rajoittui eurooppalaisen tietoliikenneympäristön tarkasteluun viiden vuoden aikana. Tietoliikennetoimialan nykytilaa ja tulevaisuutta koskevan kirjallisuuden pohjalta luotiin kolme alustavaa skenaariorunkoa. Näitä runkoja arvioitiin asiantuntijahaastattelujen avulla, jotta skenaarioista saataisiin monipuolisempia ja niiden johdonmukaisuutta voitaisiin parantaa. Lopullisia skenaarioita verrattiin Bluetoothin käyttökohteista esitettyihin näkemyksiin. Skenaarioiden teemat olivat “Fokusoidut bisnessovellukset”, “Viihdettä massoille” sekä “Tietoa kaikille”. Havaittiin, että Bluetoothin omaksumiseen vaikuttavat eniten seuraavat tekijät: teknologian sosiaalinen hyväksyntä, toimialan halukkuus teknologian edistämiseen sekä Bluetoothin ja sen kilpailijoiden kehittyminen jatkossa.