952 resultados para General Surgery.


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In this paper, we viewed the diel vertical migration (DVM) of copepod in the context of the animal's immediate behaviors of everyday concerns and constructed an instantaneous behavioral criterion effective for DVM and non-DVM behaviors. This criterion employed the function of 'venturous revenue' (VR), which is the product of the food intake and probability of the survival, to evaluate the gains and losses of the behaviors that the copepod could trade-off. The optimal behaviors are to find the optimal habitats to maximize VR. Two types of VRs are formulated and tested by the theoretical analysis and simulations. The sensed VR, monitoring the real-time changes of trade-offs and thereby determining the optimum habitat, is validated to be the effective objective function for the optimization of the behavior; whereas, the realized VR, quantifying the actual profit obtained by an optimal copepod in the sensed-VR-determined habitat, defines the life history of a specific age cohort. The achievement of a robust copepod overwintering stock through integrating the dynamics of the constituent age cohorts subjected to the instantaneous behavioral criterion for DVM clearly exemplified a possible way bridging the immediate pursuit of an individual and the end success of the population. (c) 2005 Published by Elsevier Ltd.

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Garbage collector performance in LISP systems on custom hardware has been substantially improved by the adoption of lifetime-based garbage collection techniques. To date, however, successful lifetime-based garbage collectors have required special-purpose hardware, or at least privileged access to data structures maintained by the virtual memory system. I present here a lifetime-based garbage collector requiring no special-purpose hardware or virtual memory system support, and discuss its performance.

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Background: Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. the beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. the aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period.Methods: Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term(approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5.Results: Both groups demonstrated a reduction in HRV following surgery. the CR programme promoted improvements in HRV indices at discharge for both groups. the OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function.Conclusion: Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG.

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An investigation in innovation management and entrepreneurial management is conducted in this thesis. The aim of the research is to explore changes of innovation styles in the transformation process from a start-up company to a more mature phase of business, to predict in a second step future sustainability and the probability of success. As businesses grow in revenue, corporate size and functional complexity, various triggers, supporters and drivers affect innovation and company's success. In a comprehensive study more than 200 innovative and technology driven companies have been examined and compared to identify patterns in different performance levels. All of them have been founded under the same formal requirements of the Munich Business Plan Competition -a research approach which allowed a unique snapshot that only long-term studies would be able to provide. The general objective was to identify the correlation between different factors, as well as different dimensions, to incremental and radical innovations realised. The 12 hypothesis were formed to prove have been derived from a comprehensive literature review. The relevant academic and practitioner literature on entrepreneurial, innovation, and knowledge management as well as social network theory revealed that the concept of innovation has evolved significantly over the last decade. A review of over 15 innovation models/frameworks contributed to understand what innovation in context means and what the dimensions are. It appears that the complex theories of innovation can be described by the increasing extent of social ingredients in the explanation of innovativeness. Originally based on tangible forms of capital, and on the necessity of pull and technology push, innovation management is today integrated in a larger system. Therefore, two research instruments have been developed to explore the changes in innovations styles. The Innovation Management Audits (IMA Start-up and IMA Mature) provided statements related to product/service development, innovativeness in various typologies, resources for innovations, innovation capabilities in conjunction to knowledge and management, social networks as well as the measurement of outcomes to generate high-quality data for further exploration. In obtaining results the mature companies have been clustered in the performance level low, average and high, while the start-up companies have been kept as one cluster. Firstly, the analysis exposed that knowledge, the process of acquiring knowledge, interorganisational networks and resources for innovations are the most important driving factors for innovation and success. Secondly, the actual change of the innovation style provides new insights about the importance of focusing on sustaining success and innovation ii 16 key areas. Thirdly, a detailed overview of triggers, supporters and drivers for innovation and success for each dimension support decision makers in putting their company in the right direction. Fourthly, a critical review of contemporary strategic management in conjunction to the findings provides recommendation of how to apply well-known management tools. Last but not least, the Munich cluster is analysed providing an estimation of the success probability of the different performance cluster and start-up companies. For the analysis of the probability of success of the newly developed as well as statistically and qualitative validated ICP Model (Innovativeness, Capabilities & Potential) has been developed and applied. While the model was primarily developed to evaluate the probability of success of companies; it has equal application in the situation to measure innovativeness to identify the impact of various strategic initiatives within small or large enterprises. The main findings of the model are that competitor, and customer orientation and acquiring knowledge important for incremental and radical innovation. Formal and interorganisation networks are important to foster innovation but informal networks appear to be detrimental to innovation. The testing of the ICP model h the long term is recommended as one subject of further research. Another is to investigate some of the more intangible aspects of innovation management such as attitude and motivation of mangers. IV

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Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality.

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Pritchard, L., Corne, D., Kell, D.B., Rowland, J. & Winson, M. (2005) A general model of error-prone PCR. Journal of Theoretical Biology 234, 497-509.

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De acuerdo a la normativa de TFEs el repositorio no puede dar acceso a este trabajo. Para consultarlo póngase en contacto con el tutor del trabajo. Puede acceder al resumen del mismo pinchando en el pdf adjunto.

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Este Trabajo Fin de Máster (TFM) propone la elaboración de una memoria proyecto de la unidad de hospitalización A de un centro monográfico de Cirugía Ortopédica y Traumatología (COT) integrado en un hospital general de nivel terciario. Se trata de una memoria con carácter retrospectivo que abarca desde Enero de 2013 hasta Diciembre de 2015. Una memoria que recoge un análisis de la situación junto con todos los aspectos de la nueva organización de la unidad y con propuestas de mejora futuras. Se realiza un análisis externo del modelo organizativo del sistema sanitario regional, del hospital general, de su centro monográfico de COT y de la unidad la cual está integrada en el mismo. El análisis interno ha supuesto una descripción pormenorizada de la unidad, tanto de espacio físico y recursos materiales como de recursos humanos y actividad asistencial junto con los cambios realizados en este periodo y las necesidades que se objetivan para los próximos años y que formarán el eje principal de la parte del proyecto de la presente memoria. Tras ambos análisis se realiza una matriz DAFO, método de ordenación de la información en cuatro categorías básicas: Debilidad, Amenaza, Fortaleza y Oportunidad, a partir del cual se iniciará un proceso de identificación de propuestas de mejora de cara a plantear acciones que se deberían poner en marcha para aprovechar las oportunidades detectadas y permitieran prepararse contra las amenazas teniendo conciencia de las debilidades y fortalezas.

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En este trabajo se analizan los efectos de una disminución de los tipos de las cotizaciones sociales, compensada con un incremento en los tipos del impuesto sobre el valor añadido, como la que tuvo lugar en España en 1995. Para ello se utiliza un modelo de equilibrio general aplicado a la economía española, que se presenta en dos versiones: una donde los sectores productivos se modelizan en competencia perfecta, y otra donde los mismos sectores se modelizan como oligopolistas a la Cournot, lo cual nos permite analizar la influencia del supuesto de competencia imperfecta sobre los resultados. Se ha realizado asimismo una simulación adicional aplicando un supuesto de equal yield por el que el déficit público y el nivel de bienestar del sector público se mantienen constantes tras la aplicación de la nueva política, con objeto de aislar los efectos secundarios que se podrían derivar de un cambio en el comportamiento del sector público.

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[Vá esta impression cotejada con el original del Autor, y corregida de los innumerables errores que padecen las otras].

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Colofón en v.1, v.2, v.5, v.6, y v.7.

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária