A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.

IDEA MANAGEMENT SYSTEM - AN ESSENTIAL COMPONENT IN THE CONTINUOUS IMPROVEMENT OF QUALITY AND INNOVATION

It is known the power of ideas is tremendous. But there are employees in many companies who have good ideas but not put them into practice. On the other hand, there are many others who have good ideas and are encouraged to contribute their ideas for innovation in the company. This study attempts to identify factors that contribute to success in managing ideas and consequent business innovation. The method used was the case study applied to two companies. During the investigation, factors considered essential for the success of an idea management program were identified, of which we highlight, among others, evidences the results, involvement of the top management, establishment of goals and objectives; recognition; dissemination of good results. Companies with these implemented systems, capture the best ideas from their collaborators and apply them internally. This study intends to contribute to business innovation in enterprises through creation and idea management, mainly through collecting the best ideas of their own employees. The results of this study can be used to help improving deployed suggestions systems, as well as, all managers who wish to implement suggestions systems/ideas management systems.

Gradual correction of phosphorus availability in the no-tillage system

ABSTRACT In areas cultivated under no-tillage system, the availability of phosphorus (P) can be raised by means of the gradual corrective fertilization, applying phosphorus into sowing furrows at doses higher than those required by the crops. The objective of this work was to establish the amount of P to be applied in soybean crop to increase content of P to pre-established values at the depth of 0.0 to 0.10 m. An experiment was carried out on a clayey Haplorthox soil with a randomized block experimental design distributed in split-split plot, with four replications. Two soybean crop systems (single or intercropped with Panicum maximum Jaca cv. Aruana) were evaluated in the plots. In addition, it was evaluated four P levels (0, 60, 120 and 180 kg ha-1 P2O5) applied in the first year in the split plots; and four P levels (0, 30, 60 and 90 kg ha-1 P2O5) applied in the two subsequent crops in the split-split plot. Contents of P were extracted by Mehlich-1 and Anion Exchange Resin methods from soil samples collected in the split-split plot. It was found that it is necessary to apply 19.4 or 11.1 kg ha-1 of P2O5, via triple superphosphate as source, to increase 1 mg dm-3 of P extracted by Mehlich-1 or Resin, respectively, in the 0.0 to 0.10 m layer of depth. The soil drain P character decreases as the amount of this nutrient supplied in the previous crops is increased.

Financial strategies for minimizing corporate income taxes under Brazil's new global tax system

In 1996, Brazil adopted a worldwide income tax system for corporations. This system represents a fundamental change in how the Brazílian government treats multinational transactions and the tax minimizing strategies relevant to businesses. In this article, we describe the conceptual basis for worldwide tax systems and the problem of double taxation that they create. Responses to double taxation by both the governments and the priva te sector are considered. Namely, the imperfect mechanisms developed by Brazil and other countries for mitigating double taxation are analyzed. We ultimately focus on the strategies that companies utilize in order not only to avoid double texetion, but also to take advantage of tax havens.

Mudanças estratégicas em organizações hospitalares: uma abordagem contextual e processual

O objetivo central do artigo consiste em verificar como ocorreu o processo de mudança estratégica em uma organização hospitalar. Analisam-se, de forma empírica, as mudanças estratégicas ocorridas nos últimos 20 anos no Hospital CBS. São identificadas as condições objetivas do setor - ambiente real, arena cognitiva - como ambiente percebido e a rede de colaboradores que dão suporte às atividades do hospital. O período de mais transformações foi o de 1991 a 1995, e as principais mudanças foram na cultura do hospital, na filosofia de trabalho dos médicos e funcionários, na forma de treinamento dos funcionários, na estrutura organizacional, nos processos e na tecnologia. Detectou-se que a coalizão dominante do hospital sofre apenas influência externa em razão das mudanças tecnológicas e que, internamente, o corpo clínico tem controle sobre o processo de tomada de decisões.

Organização e trabalho em transição: da lógica "sistêmico-controladora" à lógica "processual-relacional"

Para pesquisadores e gestores, é útil identificar duas formas alternativas de caracterizar discursivamente as atividades organizacionais e gerenciais: uma forma sistêmico-controladora e outra processual-relacional. A primeira é proveniente de aspirações modernistas e universalistas acerca da maximização do controle nas questões humanas, operacionalizando-se por meio da idéia de que as organizações são grandes sistemas controláveis, mecânicos e orientados para resultados. Em vez disso, é mais útil caracterizar a realidade organizacional pelo foco em processos emergentes dos padrões das relações entre as pessoas, as organizações e o ambiente social que as cerca. Se os gestores compreenderem o modo como seu trabalho contribui para a formação de tais processos, podem promover a evolução do aprendizado e de competências gerenciais por meio da construção de significados, negociações e barganhas, e do exercício do poder.

Ambivalent implications of health care information systems: a study in the Brazilian public health care system

This article evaluates social implications of the "SIGA" Health Care Information System (HIS) in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

A System Dynamics-Based Simulation Experiment for Testing Mental Model and Performance Effects of Using the Balanced Scorecard

This study develops a theoretical model that explains the effectiveness of the balanced scorecard approach by means of a system dynamics and feedback learning perspective. Presumably, the balanced scorecard leads to a better understanding of context, allowing managers to externalize and improve their mental models. We present a set of hypotheses about the influence of the balanced scorecard approach on mental models and performance. A test based on a simulation experiment that uses a system dynamics model is performed. The experiment included three types of parameters: financial indicators; balanced scorecard indicators; and balanced scorecard indicators with the aid of a strategy map review. Two out of the three hypotheses were confirmed. It was concluded that a strategy map review positively influences mental model similarity, and mental model similarity positively influences performance.

A system dynamics-based simulation

This study develops a theoretical model that explains the effectiveness of the balanced scorecard approach by means of a system dynamics and feedback learning perspective. Presumably, the balanced scorecard leads to a better understanding of context, allowing managers to externalize and improve their mental models. We present a set of hypotheses about the influence of the balanced scorecard approach on mental models and performance. A test based on a simulation experiment that uses a system dynamics model is performed. The experiment included three types of parameters: financial indicators; balanced scorecard indicators; and balanced scorecard indicators with the aid of a strategy map review. Two out of the three hypotheses were confirmed. It was concluded that a strategy map review positively influences mental model similarity, and mental model similarity positively influences performance.