849 resultados para teaching out-of-field


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A pacemaker, regularly emitting chemical waves, is created out of noise when an excitable photosensitive Belousov-Zhabotinsky medium, strictly unable to autonomously initiate autowaves, is forced with a spatiotemporal patterned random illumination. These experimental observations are also reproduced numerically by using a set of reaction-diffusion equations for an activator-inhibitor model, and further analytically interpreted in terms of genuine coupling effects arising from parametric fluctuations. Within the same framework we also address situations of noise-sustained propagation in subexcitable media.

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Experimental observations of self-organized behavior arising out of noise are also described, and details on the numerical algorithms needed in the computer simulation of these problems are given.

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This report presents the results of work zone field data analyzed on interstate highways in Missouri to determine the mean breakdown and queue-discharge flow rates as measures of capacity. Several days of traffic data collected at a work zone near Pacific, Missouri with a speed limit of 50 mph were analyzed in both the eastbound and westbound directions. As a result, a total of eleven breakdown events were identified using average speed profiles. The traffic flows prior to and after the onset of congestion were studied. Breakdown flow rates ranged between 1194 to 1404 vphpl, with an average of 1295 vphpl, and a mean queue discharge rate of 1072 vphpl was determined. Mean queue discharge, as used by the Highway Capacity Manual 2000 (HCM), in terms of pcphpl was found to be 1199, well below the HCM’s average capacity of 1600 pcphpl. This reduced capacity found at the site is attributable mainly to narrower lane width and higher percentage of heavy vehicles, around 25%, in the traffic stream. The difference found between mean breakdown flow (1295 vphpl) and queue-discharge flow (1072 vphpl) has been observed widely, and is due to reduced traffic flow once traffic breaks down and queues start to form. The Missouri DOT currently uses a spreadsheet for work zone planning applications that assumes the same values of breakdown and mean queue discharge flow rates. This study proposes that breakdown flow rates should be used to forecast the onset of congestion, whereas mean queue discharge flow rates should be used to estimate delays under congested conditions. Hence, it is recommended that the spreadsheet be refined accordingly.

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OBJECTIVE: To evaluate whether early mobilization after acute ischaemic stroke is better than delayed mobilization with regard to medical complications and if it is safe in relation to neurological function and cerebral blood flow. DESIGN: Randomized controlled pilot trial of early versus delayed mobilization out of bed with incidence of severe complications as the primary outcome. SETTING: Acute stroke unit in the neurology department of a University Hospital. PARTICIPANTS: Fifty patients after ischaemic stroke with a National Institutes of Health Stroke Scale (NIHSS) score >6 were recruited. INTERVENTION: All patients were treated with physiotherapy immediately after their admission. In the early protocol patients were mobilized out of bed after 52 hours, in the delayed protocol after seven days. RESULTS: Eight out of 50 randomized patients were excluded from the per-protocol analysis because of early transfer to other hospitals. There were 2 (8%) severe complications in the 25 early mobilization patients and 8 (47%) in the 17 delayed mobilization patients (P < 0.006). There were no differences in the total number of complications or in clinical outcome. In the 26 patients (62%) who underwent serial transcranial Doppler ultrasonography, no blood flow differences were found. CONCLUSION: We found an apparent reduction in severe complications and no increase in total complications with an early mobilization protocol after acute ischaemic stroke. No influence on neurological three-month outcomes or on cerebral blood flow was seen. These results justify larger trials comparing mobilization protocols with possibly even faster mobilization out of bed than explored here.

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OBJECTIVES: To measure the proportion of adult non-traumatic cardiac or respiratory arrest among calls for seizure to an emergency medical dispatch centre and to record whether known epileptic patients present cardiac or respiratory arrest together with seizure. METHODS: This 2-year prospective observational investigation involved the collection of tape recordings of all incoming calls to the emergency medical dispatch centre, in which an out-of-hospital non-traumatic seizure was the chief complaint in patients >18 years, in addition to the paramedics' records of all patients who presented with respiratory or cardiac arrest. The authors also recorded whether the bystander spontaneously mentioned to the dispatcher that the victim was known to have epilepsy. RESULTS: During the 24-month period, the call centre received 561 incoming calls for an out-of-hospital non-traumatic seizure in an adult. Twelve cases were classified as cardiac or respiratory arrest by paramedics. In one case, the caller spontaneously mentioned that the victim had a history of epilepsy. The proportion of cardiac or respiratory arrest among calls for seizure was 2.1%. CONCLUSION: Although these cases are rare, dispatchers should closely monitor seizure patients with the help of bystanders to exclude an out-of-hospital cardiac or respiratory arrest, in which case the dispatcher can offer telephone cardiopulmonary resuscitation advice until the paramedics arrive. Whenever the activity of the centre allows it and no new incoming call is on hold, this can be achieved by staying on the line with the caller or by calling back. A history of epilepsy should not modify the type of monitoring performed by the dispatcher as those patients may also have an arrest together with seizure.

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Appendix: List of species found in boundaries