986 resultados para Anesthethic techniques, regional: Epidural
Resumo:
The globalization and development of an information society promptly change shape of the modern world. Cities and especially megacities including Saint-Petersburg are in the center of occuring changes. As a result of these changes the economic activities connected to reception and processing of the information now play very important role in economy of megacities what allows to characterize them as "information". Despite of wide experience in decision of information questions Russia, and in particular Saint-Petersburg, lag behind in development of information systems from the advanced European countries. The given master's thesis is devoted to development of an information system (data transmission network) on the basis of wireless technology in territory of Saint-Petersburg region within the framework of FTOP "Electronic Russia" and RTOP "Electronic Saint-Petersburg" programs. Logically the master's thesis can be divided into 3 parts: 1. The problems, purposes, expected results, terms and implementation of the "Electronic Russia" program. 2. Discussion about wireless data transmission networks (description of technology, substantiation of choice, description of signal's transmission techniques and types of network topology). 3. Fulfillment of the network (organization of central network node, regional centers, access lines, description of used equipment, network's capabilities), financial provision of the project, possible network management models.
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This paper presents a bibliometric analysis of the contributions that have been presented to the 30 Spanish Regional Studies Meetings which have been hold since 1973. Firstly, the paper displays rankings of the authors and institutions that have participated more actively in the Meetings. Secondly, the paper analyses the main changes in the objectives, topics and research techniques of the contributions, as well as in the scientific specialisation of their authors. This analysis allows drawing some conclusions on the evolution of Regional Science in Spain throughout the last 30 years.
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We present a detailed evaluation of the seasonal performance of the Community Multiscale Air Quality (CMAQ) modelling system and the PSU/NCAR meteorological model coupled to a new Numerical Emission Model for Air Quality (MNEQA). The combined system simulates air quality at a fine resolution (3 km as horizontal resolution and 1 h as temporal resolution) in north-eastern Spain, where problems of ozone pollution are frequent. An extensive database compiled over two periods, from May to September 2009 and 2010, is used to evaluate meteorological simulations and chemical outputs. Our results indicate that the model accurately reproduces hourly and 1-h and 8-h maximum ozone surface concentrations measured at the air quality stations, as statistical values fall within the EPA and EU recommendations. However, to further improve forecast accuracy, three simple bias-adjustment techniques mean subtraction (MS), ratio adjustment (RA), and hybrid forecast (HF) based on 10 days of available comparisons are applied. The results show that the MS technique performed better than RA or HF, although all the bias-adjustment techniques significantly reduce the systematic errors in ozone forecasts.
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This paper analyses the differential impact of human capital, in terms of different levels of schooling, on regional productivity and convergence. The potential existence of geographical spillovers of human capital is also considered by applying spatial panel data techniques. The empirical analysis of Spanish provinces between 1980 and 2007 confirms the positive impact of human capital on regional productivity and convergence, but reveals no evidence of any positive geographical spillovers of human capital. In fact, in some specifications the spatial lag presented by tertiary studies has a negative effect on the variables under consideration.
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The aim of this study was to group temporal profiles of 10-day composites NDVI product by similarity, which was obtained by the SPOT Vegetation sensor, for municipalities with high soybean production in the state of Paraná, Brazil, in the 2005/2006 cropping season. Data mining is a valuable tool that allows extracting knowledge from a database, identifying valid, new, potentially useful and understandable patterns. Therefore, it was used the methods for clusters generation by means of the algorithms K-Means, MAXVER and DBSCAN, implemented in the WEKA software package. Clusters were created based on the average temporal profiles of NDVI of the 277 municipalities with high soybean production in the state and the best results were found with the K-Means algorithm, grouping the municipalities into six clusters, considering the period from the beginning of October until the end of March, which is equivalent to the crop vegetative cycle. Half of the generated clusters presented spectro-temporal pattern, a characteristic of soybeans and were mostly under the soybean belt in the state of Paraná, which shows good results that were obtained with the proposed methodology as for identification of homogeneous areas. These results will be useful for the creation of regional soybean "masks" to estimate the planted area for this crop.
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The use of intensity-modulated radiotherapy (IMRT) has increased extensively in the modern radiotherapy (RT) treatments over the past two decades. Radiation dose distributions can be delivered with higher conformality with IMRT when compared to the conventional 3D-conformal radiotherapy (3D-CRT). Higher conformality and target coverage increases the probability of tumour control and decreases the normal tissue complications. The primary goal of this work is to improve and evaluate the accuracy, efficiency and delivery techniques of RT treatments by using IMRT. This study evaluated the dosimetric limitations and possibilities of IMRT in small (treatments of head-and-neck, prostate and lung cancer) and large volumes (primitive neuroectodermal tumours). The dose coverage of target volumes and the sparing of critical organs were increased with IMRT when compared to 3D-CRT. The developed split field IMRT technique was found to be safe and accurate method in craniospinal irradiations. By using IMRT in simultaneous integrated boosting of biologically defined target volumes of localized prostate cancer high doses were achievable with only small increase in the treatment complexity. Biological plan optimization increased the probability of uncomplicated control on average by 28% when compared to standard IMRT delivery. Unfortunately IMRT carries also some drawbacks. In IMRT the beam modulation is realized by splitting a large radiation field to small apertures. The smaller the beam apertures are the larger the rebuild-up and rebuild-down effects are at the tissue interfaces. The limitations to use IMRT with small apertures in the treatments of small lung tumours were investigated with dosimetric film measurements. The results confirmed that the peripheral doses of the small lung tumours were decreased as the effective field size was decreased. The studied calculation algorithms were not able to model the dose deficiency of the tumours accurately. The use of small sliding window apertures of 2 mm and 4 mm decreased the tumour peripheral dose by 6% when compared to 3D-CRT treatment plan. A direct aperture based optimization (DABO) technique was examined as a solution to decrease the treatment complexity. The DABO IMRT technique was able to achieve treatment plans equivalent with the conventional IMRT fluence based optimization techniques in the concave head-and-neck target volumes. With DABO the effective field sizes were increased and the number of MUs was reduced with a factor of two. The optimality of a treatment plan and the therapeutic ratio can be further enhanced by using dose painting based on regional radiosensitivities imaged with functional imaging methods.
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Acid sulfate (a.s.) soils constitute a major environmental issue. Severe ecological damage results from the considerable amounts of acidity and metals leached by these soils in the recipient watercourses. As even small hot spots may affect large areas of coastal waters, mapping represents a fundamental step in the management and mitigation of a.s. soil environmental risks (i.e. to target strategic areas). Traditional mapping in the field is time-consuming and therefore expensive. Additional more cost-effective techniques have, thus, to be developed in order to narrow down and define in detail the areas of interest. The primary aim of this thesis was to assess different spatial modeling techniques for a.s. soil mapping, and the characterization of soil properties relevant for a.s. soil environmental risk management, using all available data: soil and water samples, as well as datalayers (e.g. geological and geophysical). Different spatial modeling techniques were applied at catchment or regional scale. Two artificial neural networks were assessed on the Sirppujoki River catchment (c. 440 km2) located in southwestern Finland, while fuzzy logic was assessed on several areas along the Finnish coast. Quaternary geology, aerogeophysics and slope data (derived from a digital elevation model) were utilized as evidential datalayers. The methods also required the use of point datasets (i.e. soil profiles corresponding to known a.s. or non-a.s. soil occurrences) for training and/or validation within the modeling processes. Applying these methods, various maps were generated: probability maps for a.s. soil occurrence, as well as predictive maps for different soil properties (sulfur content, organic matter content and critical sulfide depth). The two assessed artificial neural networks (ANNs) demonstrated good classification abilities for a.s. soil probability mapping at catchment scale. Slightly better results were achieved using a Radial Basis Function (RBF) -based ANN than a Radial Basis Functional Link Net (RBFLN) method, narrowing down more accurately the most probable areas for a.s. soil occurrence and defining more properly the least probable areas. The RBF-based ANN also demonstrated promising results for the characterization of different soil properties in the most probable a.s. soil areas at catchment scale. Since a.s. soil areas constitute highly productive lands for agricultural purpose, the combination of a probability map with more specific soil property predictive maps offers a valuable toolset to more precisely target strategic areas for subsequent environmental risk management. Notably, the use of laser scanning (i.e. Light Detection And Ranging, LiDAR) data enabled a more precise definition of a.s. soil probability areas, as well as the soil property modeling classes for sulfur content and the critical sulfide depth. Given suitable training/validation points, ANNs can be trained to yield a more precise modeling of the occurrence of a.s. soils and their properties. By contrast, fuzzy logic represents a simple, fast and objective alternative to carry out preliminary surveys, at catchment or regional scale, in areas offering a limited amount of data. This method enables delimiting and prioritizing the most probable areas for a.s soil occurrence, which can be particularly useful in the field. Being easily transferable from area to area, fuzzy logic modeling can be carried out at regional scale. Mapping at this scale would be extremely time-consuming through manual assessment. The use of spatial modeling techniques enables the creation of valid and comparable maps, which represents an important development within the a.s. soil mapping process. The a.s. soil mapping was also assessed using water chemistry data for 24 different catchments along the Finnish coast (in all, covering c. 21,300 km2) which were mapped with different methods (i.e. conventional mapping, fuzzy logic and an artificial neural network). Two a.s. soil related indicators measured in the river water (sulfate content and sulfate/chloride ratio) were compared to the extent of the most probable areas for a.s. soils in the surveyed catchments. High sulfate contents and sulfate/chloride ratios measured in most of the rivers demonstrated the presence of a.s. soils in the corresponding catchments. The calculated extent of the most probable a.s. soil areas is supported by independent data on water chemistry, suggesting that the a.s. soil probability maps created with different methods are reliable and comparable.
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Metodología: se realizó un estudio descriptivo para evaluar las ventajas de la técnica regional sobre la técnica general en mujeres ASA 1 y 2 en Hospital Occidente de Kennedy. Se evaluaron los signos vitales, tiempo de recuperación, analgesia postoperatoria y efectos colaterales. Resultados: se incluyeron un total de 177 pacientes, 79 con anestesia regional y 98 pacientes con anestesia general. Los resultados en el postoperatorio mostraron que no hay diferencias estadísticamente significativas en cuanto a manejo de dolor, efectos colaterales, variación en signos vitales. Se encontró una diferencia significativa en el tiempo de recuperación p=0,02 siendo la técnica espinal 20 minutos en promedio más prolongada. Discusión: ambas técnicas suponen una buena opción como técnica anestésica para pacientes llevadas a legrado obstétrico, a pesar que el tiempo de recuperación fue mayor en el grupo de técnica espinal, se obtuvo un mejor manejo del dolor, sin el requerimiento de otros analgésicos durante el postoperatorio.
Resumo:
Por sus múltiples causas y su sintomatología inespecífica, el síndrome doloroso regional complejo es una de las situaciones clínicas que mayor dificultad genera en el tratamiento fisioterapéutico. Este síndrome se define como una disfunción vasomotora, mediada por el sistema simpático en donde su manifestación primaria es un dolor que aumenta y permanece en el tiempo y que no tolera las diferentes modalidades y técnicas utilizadas por los Fisioterapeutas como herramientas de intervención. A través del tiempo el Fisioterapeuta ha tenido una acción relevante en el manejo del usuario con dolor, sin importar la causa o consecuencia del mismo. Por esta razón con esta revisión se quiere, integrar acciones terapéuticas como la carga de peso, la desensibilización y la relajación, que han dado excelentes resultados, a las prácticas tradicionales (medios físicos, ultrasonido, masaje sedativo y diferentes tipos de corrientes) aplicables a quienes padecen dolor secundario, traumático o visceral que compromete el sistema simpático en forma refleja.
Resumo:
Introducción: La simpatectomía es el tratamiento de la hiperhidrosis palmar y consiste en denervación simpática de miembros superiores que produce un efecto en el flujo sanguíneo al impactar la respuesta vasoconstrictora. El cambio en el flujo sanguíneo se puede evaluar a través de la onda fotopletismográfica. Metodología: Se realizaron 2 sesiones (presimpatectomía y postsimpatectomía) de 10 minutos en cada miembro superior en 28 pacientes obteniendo 79 señales fotopletismográficas distribuidas así: 37 presimpatectomía y 42 señales postsimpatectomía. De cada señal se analizó 1.5 minutos donde se tienen 80 ondas de fotopletismografía y se miden 6 variables: 1. Componente AC (componente pulsátil), 2. Componente DC (componente no pulsátil), 3. Relación entre AC/DC (índice de perfusión), 4. Area bajo la curva (AUC), 5. Tiempo entre el inicio de la onda y pico sistólico (T_DA) y 6. Tiempo entre cada onda de pulso (T_DD). Resultados: Aumentó 120% el componente AC y disminuyó 78% en DC del miembro superior derecho (MSD) con 99% de confiabilidad (p<0.001) entre presimpatectomía (n=18) y postsimpatectomía (n=21). AC/DC aumentó 55% con 95% de confiabilidad entre presimpatectomía (n=19) y postsimpatectomía (n=21) en el miembro superior izquierdo (p<0.05). No se encontró diferencia para T_DA, T_DD ni AUC. Discusión y Conclusión: La simpatectomía en pacientes con hiperhidrosis palmar produce un cambio en el flujo sanguíneo de los miembros superiores evidenciado por los cambios en el componente no pulsátil (DC) y pulsátil (AC) que es secundario a la vasodilatación consecuencia del bloqueo simpático por la denervación quirúrgica de los ganglios simpáticos torácicos.
Comparación de la anestesia espinal con anestesia general endovenosa para legrado uterino obstétrico
Resumo:
Introducción: La elección de la técnica anestésica para cualquier procedimiento quirúrgico debe estar basada en su seguridad, la rapidez para su aplicación, la recuperación óptima para el paciente y minimización de los efectos secundarios, la anestesia raquídea es una técnica anestésica que puede ser utilizada con buenos resultados clínicos y minimas complicaciones . Materiales y métodos: Se realizó un estudio observacional con recolección prospectiva en mujeres clasificadas como ASA I - II y que posteriormente fueron llevadas a la realización de legrado uterino obstétrico por embarazo no viable durante las primeras 12 semanas de gestación, las técnicas anestésicas fueron anestesia espinal o anestesia general endovenosa dependiendo de la elección hecha por el anestesiólogo previo al procedimiento. Se midieron variables hemodinámicas, control del dolor postoperatorio, tiempo de recuperación y complicaciones perioperatorias con el fin de determinar si se presentaban diferencias significativas entre estas dos técnicas anestésicas. Resultados: Se incluyeron un total de 110 pacientes, 63.6% (n=70) con anestesia general y 36.4% (n40) con anestesia espinal. Ambas poblaciones fueron comparables. Se presentaron menos efectos secundarios con la técnica espinal, hay una diferencia estadísticamente significativa en cuanto al dolor a favor de la anestesia espinal (p0,000) Discusión: La anestesia raquídea es una opción viable, sencilla , fácil y eficaz para la realización de legrados obstétricos, se puede realizar con monitorización básica y las complicaciones son mínimas. Se requieren estudios más amplios para determinar el papel de cual es la mejor técnica. Palabras claves: legrado uterino instrumentado, anestesia espinal, anestesia general endovenosa
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Species rich semi-natural grasslands are an important but threatened habitat throughout Europe and much of the former area has been lost since the 1950s. However, in some countries large areas have been preserved and the demand for meadow recreation by sowing seed mixtures is increasing. In the White Carpathians Protected Landscape Area (Czech Republic) the use of commercial seed mixtures is undesirable and the use of regional mixtures has been investigated. The costs for seeding large areas are high and lower cost techniques are needed. In 1999 a field experiment was set up to investigate the establishment of hay meadow vegetation comparing sowing a regional mixture all over a plot with sowing narrow 2.5 In strips of regional seed mixtures into a matrix of a commercial grass mixture or into natural regeneration. The results after five seasons showed good establishment of the sown species in the meadow treatment. Spread of sown species from the sown strips into the surrounding matrix occurred but the cover of species was lower in the commercial grass matrix compared with the natural regeneration matrix. Colonisation of some plots by unsown desirable grassland species from adjacent grassland habitats also occurred, but more species colonised the natural regeneration matrix than the commercial grasses or the sown meadow matrix itself. Overall, the results indicate that, in appropriate situations, sown strips can provide a lower cost but slower and longer-term alternative to field scale sowing of regional seed mixtures for recreation of hay meadow vegetation. (C) 2007 Elsevier Ltd. All rights reserved.
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[1] High-elevation forests represent a large fraction of potential carbon uptake in North America, but this uptake is not well constrained by observations. Additionally, forests in the Rocky Mountains have recently been severely damaged by drought, fire, and insect outbreaks, which have been quantified at local scales but not assessed in terms of carbon uptake at regional scales. The Airborne Carbon in the Mountains Experiment was carried out in 2007 partly to assess carbon uptake in western U.S. mountain ecosystems. The magnitude and seasonal change of carbon uptake were quantified by (1) paired upwind-downwind airborne CO2 observations applied in a boundary layer budget, (2) a spatially explicit ecosystem model constrained using remote sensing and flux tower observations, and (3) a downscaled global tracer transport inversion. Top-down approaches had mean carbon uptake equivalent to flux tower observations at a subalpine forest, while the ecosystem model showed less. The techniques disagreed on temporal evolution. Regional carbon uptake was greatest in the early summer immediately following snowmelt and tended to lessen as the region experienced dry summer conditions. This reduction was more pronounced in the airborne budget and inversion than in flux tower or upscaling, possibly related to lower snow water availability in forests sampled by the aircraft, which were lower in elevation than the tower site. Changes in vegetative greenness associated with insect outbreaks were detected using satellite reflectance observations, but impacts on regional carbon cycling were unclear, highlighting the need to better quantify this emerging disturbance effect on montane forest carbon cycling.
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As wind generation increases, system impact studies rely on predictions of future generation and effective representation of wind variability. A well-established approach to investigate the impact of wind variability is to simulate generation using observations from 10 m meteorological mast-data. However, there are problems with relying purely on historical wind-speed records or generation histories: mast-data is often incomplete, not sited at a relevant wind generation sites, and recorded at the wrong altitude above ground (usually 10 m), each of which may distort the generation profile. A possible complimentary approach is to use reanalysis data, where data assimilation techniques are combined with state-of-the-art weather forecast models to produce complete gridded wind time-series over an area. Previous investigations of reanalysis datasets have placed an emphasis on comparing reanalysis to meteorological site records whereas this paper compares wind generation simulated using reanalysis data directly against historic wind generation records. Importantly, this comparison is conducted using raw reanalysis data (typical resolution ∼50 km), without relying on a computationally expensive “dynamical downscaling” for a particular target region. Although the raw reanalysis data cannot, by nature of its construction, represent the site-specific effects of sub-gridscale topography, it is nevertheless shown to be comparable to or better than the mast-based simulation in the region considered and it is therefore argued that raw reanalysis data may offer a number of significant advantages as a data source.
Conditioning model output statistics of regional climate model precipitation on circulation patterns
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Dynamical downscaling of Global Climate Models (GCMs) through regional climate models (RCMs) potentially improves the usability of the output for hydrological impact studies. However, a further downscaling or interpolation of precipitation from RCMs is often needed to match the precipitation characteristics at the local scale. This study analysed three Model Output Statistics (MOS) techniques to adjust RCM precipitation; (1) a simple direct method (DM), (2) quantile-quantile mapping (QM) and (3) a distribution-based scaling (DBS) approach. The modelled precipitation was daily means from 16 RCMs driven by ERA40 reanalysis data over the 1961–2000 provided by the ENSEMBLES (ENSEMBLE-based Predictions of Climate Changes and their Impacts) project over a small catchment located in the Midlands, UK. All methods were conditioned on the entire time series, separate months and using an objective classification of Lamb's weather types. The performance of the MOS techniques were assessed regarding temporal and spatial characteristics of the precipitation fields, as well as modelled runoff using the HBV rainfall-runoff model. The results indicate that the DBS conditioned on classification patterns performed better than the other methods, however an ensemble approach in terms of both climate models and downscaling methods is recommended to account for uncertainties in the MOS methods.