955 resultados para 650 Gestione e servizi ausiliari
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http://www.archive.org/details/ethicsofwarbyalh00kamauoft
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BACKGROUND: Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown. OBJECTIVE: To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthcare worker during patient care. DESIGN: Two models were created to simulate sequential patient contacts by a hand hygiene-noncompliant healthcare worker. Model 1 involved encounters with patients of unknown MRSA status. Model 2 involved an encounter with an MRSA-colonized patient followed by an encounter with a patient of unknown MRSA status. The probability of new MRSA infection for the second patient was calculated using published data. A simulation of 1 million noncompliant events was performed. Total costs of resulting infections were aggregated and amortized over all events. SETTING: Duke University Medical Center, a 750-bed tertiary medical center in Durham, North Carolina. RESULTS: Model 1 was associated with 42 MRSA infections (infection rate, 0.0042%). Mean infection cost was $47,092 (95% confidence interval [CI], $26,040-$68,146); mean cost per noncompliant event was $1.98 (95% CI, $0.91-$3.04). Model 2 was associated with 980 MRSA infections (0.098%). Mean infection cost was $53,598 (95% CI, $50,098-$57,097); mean cost per noncompliant event was $52.53 (95% CI, $47.73-$57.32). A 200-bed hospital incurs $1,779,283 in annual MRSA infection-related expenses attributable to hand hygiene noncompliance. A 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital. CONCLUSIONS: Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.
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BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of complicated skin and skin-structure infection (cSSSI). Increasing antimicrobial resistance in cSSSI has led to a need for new safe and effective therapies. Ceftaroline was evaluated as treatment for cSSSI in 2 identical phase 3 clinical trials, the pooled analysis of which is presented here. The primary objective of each trial was to determine the noninferiority of the clinical cure rate achieved with ceftaroline monotherapy, compared with that achieved with vancomycin plus aztreonam combination therapy, in the clinically evaluable (CE) and modified intent-to-treat (MITT) patient populations. METHODS: Adult patients with cSSSI requiring intravenous therapy received ceftaroline (600 mg every 12 h) or vancomycin plus aztreonam (1 g each every 12 h) for 5-14 days. RESULTS: Of 1378 patients enrolled in both trials, 693 received ceftaroline and 685 received vancomycin plus aztreonam. Baseline characteristics of the treatment groups were comparable. Clinical cure rates were similar for ceftaroline and vancomycin plus aztreonam in the CE (91.6% vs 92.7%) and MITT (85.9% vs 85.5%) populations, respectively, as well as in patients infected with MRSA (93.4% vs 94.3%). The rates of adverse events, discontinuations because of an adverse event, serious adverse events, and death also were similar between treatment groups. CONCLUSIONS: Ceftaroline achieved high clinical cure rates, was efficacious against cSSSI caused by MRSA and other common cSSSI pathogens, and was well tolerated, with a safety profile consistent with the cephalosporin class. Ceftaroline has the potential to provide a monotherapy alternative for the treatment of cSSSI. TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT00424190 for CANVAS 1 and NCT00423657 for CANVAS 2.
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Dentro del contexto del Cambio Global ha surgido el interés en conocer y entender la dinámica de los ecosistemas. La técnica Eddy Covariance (EC) es utilizada a nivel global para el registro continuo de los intercambios turbulentos de masa y energía en una diversidad de ecosistemas, con sensores montados en torres micrometeorológicas y en plataformas móviles. Así mismo, el empleo de modelos atmosféricos de mesoescala suma un aporte a la compresión de los procesos de intercambio suelo-atmósfera dentro de la Capa Límite Atmosférica. Lo enunciado anteriormente motivó la elaboración de la presente tesis en la cual se planteó caracterizar los intercambios turbulentos, estudiando su variabilidad sobre un bosque seco nativo y uno implantado en Argentina y evaluar el desempeño del modelo BRAMS-4.2 en alta resolución en reproducir estos intercambios. A partir de los valores observados, se encontró que la concentración media diaria y los flujos de CO2 presentaron un marcado ciclo diurno. El valor medio de las concentraciones en el bosque implantado fue igual a 736.2 más o menos 42.4 mg/m3 y en el bosque nativo igual a 641.9 más o menos 22.4 mg/m3. Los flujos de CO2 presentaron una amplitud media mayor en verano igual a 1.42 mg/m2s (0.27 mg/m2s) en el bosque implantado (bosque nativo). Los flujos de calor latente registrados en el bosque implantado fueron mayores a los registrados en el bosque nativo. La implementación del sistema de sensores instalados a bordo del avión Sky Arrow 650 ERA permitió realizar mediciones en los primeros metros de la atmósfera. El modelo BRAMS-4.2 supo reproducir razonablemente bien distintas variables meteorológicas así como también los flujos de masa y energía. Los resultados obtenidos en esta tesis son un aporte para ampliar el conocimiento sobre los intercambios turbulentos entre la vegetación y las capas bajas de la atmósfera en distintos ecosistemas de Argentina.
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p.263-274
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p.111-115
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Dentro del contexto del Cambio Global ha surgido el interés en conocer y entender la dinámica de los ecosistemas. La técnica Eddy Covariance (EC)es utilizada a nivel global para el registro continuo de los intercambios turbulentos de masa y energía en una diversidad de ecosistemas, con sensores montados en torres micrometeorológicas y en plataformas móviles. Así mismo, el empleo de modelos atmosféricos de mesoescala suma un aporte a la compresión de los procesos de intercambio suelo-atmósfera dentro de la Capa Límite Atmosférica. Lo enunciado anteriormente motivó la elaboración de la presente tesis en la cual se planteó caracterizar los intercambios turbulentos, estudiando su variabilidad sobre un bosque seco nativo y uno implantado en Argentina y evaluar el desempeño del modelo BRAMS-4.2 en alta resolución en reproducir estos intercambios. A partir de los valores observados, se encontró que la concentración media diaria y los flujos de CO2 presentaron un marcado ciclo diurno. El valor medio de las concentraciones en el bosque implantado fue igual a 736.2 ± 42.4 mg/m3 y en el bosque nativo igual a 641.9 ± 22.4 mg/m3. Los flujos de CO2 presentaron una amplitud media mayor en verano igual a 1.42 mg/m2s (0.27 mg/m2s)en el bosque implantado (bosque nativo). Los flujos de calor latente registrados en el bosque implantado fueron mayores a los registrados en el bosque nativo. La implementación del sistema de sensores instalados a bordo del avión Sky Arrow 650 ERA permitió realizar mediciones en los primeros metros de la atmósfera. El modelo BRAMS-4.2 supo reproducir razonablemente bien distintas variables meteorológicas así como también los flujos de masa y energía. Los resultados obtenidos en esta tesis son un aporte para ampliar el conocimiento sobre los intercambios turbulentos entre la vegetación y las capas bajas de la atmósfera en distintos ecosistemas de Argentina.
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p.185-190
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Con este trabajo se da cuenta de los aprendizajes que logran los estudiantes del nivel bachillerato al trabajar con un problema de una situación real de movimiento empleando tecnología como son los sensores (dispositivos transductores) y calculadora graficadora. La aproximación socioepistemológica sirvió de sustento para realizar un análisis previo, el cual nos permitió identificar tres usos de las gráficas: construcción de gráficas utilizando la regla de correspondencia entre dos variables, gráficas por operaciones gráficas y la graficación por medio de la simulación de un fenómeno físico empleando tecnología. El trabajo con estudiantes nos permitió caracterizar el uso de las gráficas a partir de las actividades de modelación con las características del Comportamiento Tendencial de las Funciones.
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Se pone de manifiesto la necesidad de que el profesor gestione la construcción de significado en el aula y lo haga a partir de las interpretaciones que pueda inferir de los aportes verbales de los estudiantes durante el proceso. Se muestra que la construcción de significado de una definición que un profesor podría despachar muy rápidamente (señalando un error, repitiendo la definición y pidiendo a los estudiantes que se fijen bien en ella para reformular la representación de la situación en la que el objeto definido se pone en juego), está lejos de ser un asunto baladí. En el segundo ejemplo que se presenta es posible ver cómo la gestión del profesor en pro de la construcción de significado de un objeto geométrico (en este caso, el enunciado del Teorema Localización de Puntos), no se agota en el momento en que se enuncia y demuestra el Teorema sino que se requiere también en momentos en que se usa en el marco de la resolución de un nuevo problema.
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In this paper a mixed Eulerian-Lagrangian approach for the modelling metal extrusion processes is presented. The approach involves the solution of non-Newtonian fluid flow equations in an Eulerian context, using a free-surface algorithm to track the behaviour of the workpiece and its extrusion. The solid mechanics equations associated with the tools are solved in Lagangrian context. Thermal interactions between the workpiece are modelled and a fluid-structure interaction technique is employed to model the effect of the fluid traction load imposed by the workpiece on the tools. Two extrusion test cases are investigated and the results obtained show the potential of the model with regard to representing the physics of the process and the simulation time.
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The growth of computer power allows the solution of complex problems related to compressible flow, which is an important class of problems in modern day CFD. Over the last 15 years or so, many review works on CFD have been published. This book concerns both mathematical and numerical methods for compressible flow. In particular, it provides a clear cut introduction as well as in depth treatment of modern numerical methods in CFD. This book is organised in two parts. The first part consists of Chapters 1 and 2, and is mainly devoted to theoretical discussions and results. Chapter 1 concerns fundamental physical concepts and theoretical results in gas dynamics. Chapter 2 describes the basic mathematical theory of compressible flow using the inviscid Euler equations and the viscous Navier–Stokes equations. Existence and uniqueness results are also included. The second part consists of modern numerical methods for the Euler and Navier–Stokes equations. Chapter 3 is devoted entirely to the finite volume method for the numerical solution of the Euler equations and covers fundamental concepts such as order of numerical schemes, stability and high-order schemes. The finite volume method is illustrated for 1-D as well as multidimensional Euler equations. Chapter 4 covers the theory of the finite element method and its application to compressible flow. A section is devoted to the combined finite volume–finite element method, and its background theory is also included. Throughout the book numerous examples have been included to demonstrate the numerical methods. The book provides a good insight into the numerical schemes, theoretical analysis, and validation of test problems. It is a very useful reference for applied mathematicians, numerical analysts, and practice engineers. It is also an important reference for postgraduate researchers in the field of scientific computing and CFD.
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The aim of the current study was to evaluate the impact of chitosan derivatives, namely N-octyl-chitosan and N-octyl-O-sulfate chitosan, incorporated in calcium phosphate implants to the release profiles of model drugs. The rate and extent of calcein (on M.W. 650 Da) ED, and FITC-dextran (M.W. 40 kDa) on in vitro release were monitored by fluorescence spectroscopy. Results show that calcein release is affected by the type of chitosan derivative used. A higher percentage of model drug was released when the hydrophilic polymer N-octyl-sulfated chitosan was present in the tablets compared with the tablets containing the hydrophobic polymer N-octyl-chitosan. The release profiles of calcein or FD from tablets containing N-octyl-O-sulfate revealed a complete release for FD after 120 h compared with calcein where 20% of the drug was released over the same time period. These results suggest that the difference in the release profiles observed from the implants is dependent on the molecular weight of the model drugs. These data indicate the potential of chitosan derivatives in controlling the release profile of active compounds from calcium phosphate implants. (C) 2009 Elsevier Ltd. All rights reserved.
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Epilobium parviflorum Schreb. (Onagraceae) is used for the treatment of benign prostatic hyperplasia (BPH), which is regarded as an endocrine disorder caused by age-related hormone imbalance and increased oxidative damage [1,2,3]. Epilobium can moderate the obstructive and the irritative symptoms of BPH [1] but its biological action is not entirely identified. E. parviflorum is rich in phytosterols, flavonoids (myricetin, quercetin, kaempferol and their glycosides), phenolic acids, catechins, ellagi- and gallotannins [4]. The potential biological effects of Epilobium parviflorum Schreb. have been investigated, in respect to its antioxidant, anti-inflammatory, enzyme-inhibitory and anti-androgenic effect. The whole-plant water extract showed higher antioxidant effect (IC50=1.65±0.05µg/mL) in DPPH assay than Trolox or ascorbic acid and inhibited the lipid peroxidation examined in TBA assay (IC50=2.31±0.18mg/mL). In concentrations 0.20-15.00µg/mL the extract possessed a protective effect comparable to catalase enzyme (2500 IU/mL), against oxidative damage generated on fibroblast cells. The examination of the COX-inhibitory effect showed that E. parviflorum had an anti-inflammatory effect (IC50=1.38±0.08µg/mL). Investigation of steroid receptor binding ability and the aromatase enzyme-inhibition showed negative results in the concentration range examined.