Kohti leikkaussalin tuloksellista toiminnanohjausta

Background: The aging population is placing increasing demands on surgical services, simultaneously with a decreasing supply of professional labor and a worsening economic situation. Under growing financial constraints, successful operating room management will be one of the key issues in the struggle for technical efficiency. This study focused on several issues affecting operating room efficiency. Materials and methods: The current formal operating room management in Finland and the use of performance metrics and information systems used to support this management were explored using a postal survey. We also studied the feasibility of a wireless patient tracking system as a tool for managing the process. The reliability of the system as well as the accuracy and precision of its automatically recorded time stamps were analyzed. The benefits of a separate anesthesia induction room in a prospective setting were compared with the traditional way of working, where anesthesia is induced in the operating room. Using computer simulation, several models of parallel processing for the operating room were compared with the traditional model with respect to cost-efficiency. Moreover, international differences in operating room times for two common procedures, laparoscopic cholecystectomy and open lung lobectomy, were investigated. Results: The managerial structure of Finnish operating units was not clearly defined. Operating room management information systems were found to be out-of-date, offering little support to online evaluation of the care process. Only about half of the information systems provided information in real time. Operating room performance was most often measured by the number of procedures in a time unit, operating room utilization, and turnover time. The wireless patient tracking system was found to be feasible for hospital use. Automatic documentation of the system facilitated patient flow management by increasing process transparency via more available and accurate data, while lessening work for staff. Any parallel work flow model was more cost-efficient than the traditional way of performing anesthesia induction in the operating room. Mean operating times for two common procedures differed by 50% among eight hospitals in different countries. Conclusions: The structure of daily operative management of an operating room warrants redefinition. Performance measures as well as information systems require updating. Parallel work flows are more cost-efficient than the traditional induction-in-room model.

An 8-to-1 bit 1-MS/s SAR ADC With VGA and Integrated Data Compression for Neural Recording

Low power consumption per channel and data rate minimization are two key challenges which need to be addressed in future generations of neural recording systems (NRS). Power consumption can be reduced by avoiding unnecessary processing whereas data rate is greatly decreased by sending spike time-stamps along with spike features as opposed to raw digitized data. Dynamic range in NRS can vary with time due to change in electrode-neuron distance or background noise, which demands adaptability. An analog-to-digital converter (ADC) is one of the most important blocks in a NRS. This paper presents an 8-bit SAR ADC in 0.13-mu m CMOS technology along with input and reference buffer. A novel energy efficient digital-to-analog converter switching scheme is proposed, which consumes 37% less energy than the present state-of-the-art. The use of a ping-pong input sampling scheme is emphasized for multichannel input to alleviate the bandwidth requirement of the input buffer. To reduce the data rate, the A/D process is only enabled through the in-built background noise rejection logic to ensure that the noise is not processed. The ADC resolution can be adjusted from 8 to 1 bit in 1-bit step based on the input dynamic range. The ADC consumes 8.8 mu W from 1 V supply at 1 MS/s speed. It achieves effective number of bits of 7.7 bits and FoM of 42.3 fJ/conversion-step.

Current kinematics and dynamics of Africa and the East African Rift System

Although the East African Rift System (EARS) is an archetype continental rift, the forces driving its evolution remain debated. Some contend buoyancy forces arising from gravitational potential energy (GPE) gradients within the lithosphere drive rifting. Others argue for a major role of the diverging mantle flow associated with the African Superplume. Here we quantify the forces driving present-day continental rifting in East Africa by (1) solving the depth averaged 3-D force balance equations for 3-D deviatoric stress associated with GPE, (2) inverting for a stress field boundary condition that we interpret as originating from large-scale mantle tractions, (3) calculating dynamic velocities due to lithospheric buoyancy forces, lateral viscosity variations, and velocity boundary conditions, and (4) calculating dynamic velocities that result from the stress response of horizontal mantle tractions acting on a viscous lithosphere in Africa and surroundings. We find deviatoric stress associated with lithospheric GPE gradients are similar to 8-20 MPa in EARS, and the minimum deviatoric stress resulting from basal shear is similar to 1.6 MPa along the EARS. Our dynamic velocity calculations confirm that a force contribution from GPE gradients alone is sufficient to drive Nubia-Somalia divergence and that additional forcing from horizontal mantle tractions overestimates surface kinematics. Stresses from GPE gradients appear sufficient to sustain present-day rifting in East Africa; however, they are lower than the vertically integrated strength of the lithosphere along most of the EARS. This indicates additional processes are required to initiate rupture of continental lithosphere, but once it is initiated, lithospheric buoyancy forces are enough to maintain rifting.

Lmlk seal impressions once again : a second rejoinder to Oded Lipschits

Abstract: This article deals in the main with claims made by Lipschits et al. that the lmlk stamps were partly manufactured after Sennacherib’s campaign in 701 BCE. It forms specifically a rejoinder to Lipschits’ claims published recently. Finally, in the epilogue, are presented the data dealing with the suggestions of Lipschits, which have already been published by Stern, Grena and Van der Veen.

Procedures to prevent the occurrence of potentially dangerous situations during the operation of the Mackereth 1-metre mini or short sediment corer

During the 1950s and 1960s, F.J.H. Mackereth developed and published plans for a series of pneumatic samplers for lake sediments. Unfortunately, as the equipment was continually evolving during ensuing research, no user manuals, beyond the original publication, had been produced. Over the last few years there have been a few potentially very serious accidents with the 1-metre corer, which has prompted the authors to carry out a risk assessment. This highlighted two weaknesses in the design and its later developments. They can be corrected simply by checking for screw threads that may have been added to the exhaust port on the mini-corer, and by changing the operating procedure. An A4 nine-page user manual is now available from the authors. A small charge ( pound sterling 10 in 1998) will be made to cover handling costs and postage.

Different colloids self-assembly in micromolding

Micromolding in capillaries (MIMIC) and non-conformal contact micromolding (NCCM) were employed to pattern the silica microspheres by the use of capillary forces. Three types of silica microspheres aggregations, small dot, ring and grid patterns, from the same prepatterned poly(dimethylsiloxane) (PDMS) stamps, were created by tuning the contact mode between the PDMS mold and the substrate and the concentration of silica microspheres suspension during the micromolding. The formation mechanisms of different patterns were discussed.

MIT SchMUSE: Class-Based Remote Delegation in a Capricious Distributed Environment

MIT SchMUSE (pronounced "shmooz") is a concurrent, distributed, delegation-based object-oriented interactive environment with persistent storage. It is designed to run in a "capricious" network environment, where servers can migrate from site to site and can regularly become unavailable. Our design introduces a new form of unique identifiers called "globally unique tickets" that provide globally unique time/space stamps for objects and classes without being location specific. Object location is achieved by a distributed hierarchical lazy lookup mechanism that we call "realm resolution." We also introduce a novel mechanism called "message deferral" for enhanced reliability in the face of remote delegation. We conclude with a comparison to related work and a projection of future work on MIT SchMUSE.

Ochrona i konserwacja zasobu w archiwach państwowych w Polsce

Wydział Historyczny

Annotation of Case C-272/94, Criminal proceedings against Michel Guiot and Climatec SA, ECR 1996 I-1905

Employer's contributions - Loyalty stamps - Bad-weather stamps - Freedom to provide services - Posted Workers

New identifications for blue objects towards the Galactic center: post-AGE stars, Be/disk stars and others

As part of a programme to investigate spatial variations in the Galactic chemical composition, we have been searching for normal B-type stars and A-type supergiants near the Galactic center. During this search we have found eleven peculiar stars, and in some cases performed detailed abundance analyses of them which suggest that they may be at a post-AGB evolutionary stage.

Magnetic Characteristics of a High-layer-number NiFe/FeMn Multilayer

We report the static & dynamic magnetic characteristics of a high-layer-number NiFe/FeMn multilayer test structure with potential applications in broadband absorber and filter devices. To allow fine control over the absorption linewidths and to understand the mechanisms governing the resonances in a tailored structure similar to that expected to be used in real world applications, the multilayer was intentionally designed to have layer thickness and interface roughness variations. Magnetometry measurements show the sample has complex hysteresis loops with features consistent with single ferromagnetic film reversals. Structural characterisation by transmission electron microscopy allows us to correlate the magnetic properties with structural features. Analysis of resonance frequencies from broadband ferromagnetic resonance measurements as a function of field magnitude and orientation provide values of the local exchange bias, rotatable anisotropy, and uniaxial anisotropy fields for specific layers in the stack and explain the observed mode softening. The linewidths of the multilayer are adjustable around the bias field, approaching twice that seen at larger fields, allowing control over the bandwidth of devices formed from the structure.

1916-2016. The 1916 Easter Rising

Commissioned by An Post to commemorate the centenary of the Easter Rising, this illustrated book draws on eye-witness accounts to assess this key turning-point in modern Irish history. Leading historian Fearghal McGarry explores the impact of events at the General Post Office, as well as setting the rebellion in its wider historical context. His account concludes with an assessment of the Rising's commemoration since 1916 and a commentary on the definitive stamps issued by An Post to mark the formative event in the emergence of an independent Irish nation.

Land cover mapping analysis and urban growth modeling using remote sensing techniques

The rapid growth of big cities has been noticed since 1950s when the majority of world population turned to live in urban areas rather than villages, seeking better job opportunities and higher quality of services and lifestyle circumstances. This demographic transition from rural to urban is expected to have a continuous increase. Governments, especially in less developed countries, are going to face more challenges in different sectors, raising the essence of understanding the spatial pattern of the growth for an effective urban planning. The study aimed to detect, analyse and model the urban growth in Greater Cairo Region (GCR) as one of the fast growing mega cities in the world using remote sensing data. Knowing the current and estimated urbanization situation in GCR will help decision makers in Egypt to adjust their plans and develop new ones. These plans should focus on resources reallocation to overcome the problems arising in the future and to achieve a sustainable development of urban areas, especially after the high percentage of illegal settlements which took place in the last decades. The study focused on a period of 30 years; from 1984 to 2014, and the major transitions to urban were modelled to predict the future scenarios in 2025. Three satellite images of different time stamps (1984, 2003 and 2014) were classified using Support Vector Machines (SVM) classifier, then the land cover changes were detected by applying a high level mapping technique. Later the results were analyzed for higher accurate estimations of the urban growth in the future in 2025 using Land Change Modeler (LCM) embedded in IDRISI software. Moreover, the spatial and temporal urban growth patterns were analyzed using statistical metrics developed in FRAGSTATS software. The study resulted in an overall classification accuracy of 96%, 97.3% and 96.3% for 1984, 2003 and 2014’s map, respectively. Between 1984 and 2003, 19 179 hectares of vegetation and 21 417 hectares of desert changed to urban, while from 2003 to 2014, the transitions to urban from both land cover classes were found to be 16 486 and 31 045 hectares, respectively. The model results indicated that 14% of the vegetation and 4% of the desert in 2014 will turn into urban in 2025, representing 16 512 and 24 687 hectares, respectively.

Commerative Stamp Presentation

Pictured here from left to right are James Hogan, Librarian, and President James Gibson with a set of stamps commerating Sir Isaac Brock that were issued from the Bailiwick of Guernsey in October of 1969.