京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第17826号 / 医博第3824号 / 新制||医||999(附属図書館) / 30641 / 京都大学大学院医学研究科医学専攻 / (主査)教授 渡邉 大, 教授 村井 俊哉, 教授 柳田 素子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

This thesis is an examination of Bertrand Russell's realist "bundle theory of particulars". In Russell's earlier work, the need to explain the unity and individuality of objects compelled him to accept particulars as well as universals as ultimate kinds of reality. Nevertheless, in carrying out his efforts to economize his ontology, he discovered he could not reduce properties to particulars, because there are some relations that resist nominalistic explanation, but particulars could be reduced to bundles of qualities. In this thesis, I show that the realist 'bundle theory' not only reduces the kinds of ultimate reality to one, i.e., to universal qualities, but also serves all of the purposes for which bare particulars were originally required. Specifically. I examine what I take to be the major criticisms leveled against the realist 'bundle theory': the problem of individuation, the problem of necessity, and the problem of analyticity. I defend the strength and consistency of Russell's theory and argue that it can answer to the objections. / Thesis / Doctor of Philosophy (PhD)

This is Part A. / <p> Effects in 19 element CANDU fuel bundles containing ThO2 and UO2, located in thermonuclear reactor blankets, have been examined for a variety of blanket designs. The buildup in time of nuclides derived from Th232 by neutron capture was studied. The essential CTR (Controlled Thermonuclear Reactor) blanket features that were examined were tritium breeding in the blanket (the fusion reaction of interest was the DT reaction resulting in the production of a 14.1 MeV neutron and a 3.5 MeV alpha particle), neutron multiplication in the blanket and the U233 production. Means of optimizing these features were also examined. Some conclusions concerning the use and influence of the CANDU bundle are made.</p> <p> It is of interest to study the details of the buildup of U233 in the bundles with the view of perhaps transferring bundles directly from the CTR blanket into a core of a fission power reactor. As such, it would be necessary to convert approximately 3% of the initial thorium present to U233 before transferral. This report examines time steps over which this could be achieved and looks at the performance of the blanket as a whole when such changes occur. The production of unwanted radioactive isotopes is looked at with suggestions of how to minimize this production without harming the rest of the blanket's basic functions.</p> <p> Procedures outlined in the preliminary report "Bench-Mark Neutronic Calculations for Fusion Reactor Designs" by S.A. Kushneriuk and P.Y. Wong form a basis for all of the calculations made in this report. Based on the findings of that report, it is expected that values presented here do reflect, to a fair degree of accuracy, conditions encountered in the CTR blankets studied.</p> / Thesis / Master of Engineering (MEngr)

No description available.

This thesis studies the construction of noncompact Einstein manifolds of cohomogeneity one on some vector bundles. Cohomogeneity one vector bundle whose isotropy representation of the principal orbit G/K has two inequivalent irreducible summands has been studied in [Böh99][Win17]. However, the method applied does not cover all cases. This thesis provides an alternative construction with a weaker assumption of G/K admits at least one invariant Einstein metric. Some new Einstein metrics of Taub-NUT type are also constructed. This thesis also provides construction of cohomogeneity one Einstein metrics for cases where G/K is a Wallach space. Specifically, two continuous families of complete smooth Einstein metrics are constructed on vector bundles over CP2, HP2 and OP2 with respective principal orbits the Wallach spaces SU(3)/T2, Sp(3)/(Sp(1)Sp(1)Sp(1)) and F4/Spin(8). The first family is a 1-parameter family of Ricci-flat metrics. All the Ricci- flat metrics constructed have asymptotically conical limits given by the metric cone over a suitable multiple of the normal Einstein metric. All the Ricci-flat metrics constructed have generic holonomy except that the complete metric with G2 holonomy discovered in [BS89][GPP90] lies in the interior of the 1-parameter family on manifold in the first case. The second family is a 2-parameter family of Poincaré–Einstein metrics. / Thesis / Doctor of Philosophy (PhD)

Computational fluid dynamics and finite element analysis were employed to study vestibular hair cell bundle mechanics under physiologic stimulus conditions. CFD was performed using ANSYS CFX and FEA utilized a custom MATLAB model. Nine varieties of hair cell bundles were modeled using tip-forcing only (commonly used experimentally), fluid-flow only (physiologic for free-standing bundles), and combined loading (physiologic for bundles with tip attachments) conditions to determine how the bundles behaved in each case. The bundles differed in the heights of their components, their length and width, and their number of steriocilia. Tip links were modeled to determine ion-channel opening behavior. Results show that positive pressures, negative pressures, and shear stresses on the exterior of the bundles are of comparable magnitude. Under combined loading, some bundles experienced very high suction pressures on their interior. The bundles with tall steriocilia are hindered by the endolymph while those with short steriocilia and much taller kinocilia are assisted by the fluid flow. Each bundle type has a different range over which it is most sensitive so that the bundles cumulatively cover a very large range of stimuli; the order in which bundles respond from smallest stimulus magnitude to largest is free-standing extrastriolar bundles, attached striolar bundles, attached extrastriolar bundles, and free-standing extrastriolar bundles. A short examination of off-axis loading shows that the prevailing theory suggesting that bundle response is proportional to the cosine of the angle between the stimulus direction and the bundle's direction of maximum excitation is incorrect. / Ph. D.

Yes / IMPORTANCE Patients undergoing emergency laparotomy have high mortality, but few studies exist to improve outcomes for these patients. OBJECTIVE To assess whether a collaborative approach to implement a 6-point care bundle is associated with reduction in mortality and length of stay and improvement in the delivery of standards of care across a group of hospitals. DESIGN, SETTING, AND PARTICIPANTS The Emergency Laparotomy Collaborative (ELC) was a UK-based prospective quality improvement study of the implementation of a care bundle provided to patients requiring emergency laparotomy between October 1, 2015, and September 30, 2017. Participants were 28 National Health Service hospitals and emergency surgical patients who were treated at these hospitals and whose data were entered into the National Emergency Laparotomy Audit (NELA) database. Post-ELC implementation outcomes were compared with baseline data from July 1, 2014, to September 30, 2015. Data entry and collection were performed through the NELA. INTERVENTIONS A 6-point, evidence-based care bundle was used. The bundle included prompt measurement of blood lactate levels, early review and treatment for sepsis, transfer to the operating room within defined time goals after the decision to operate, use of goal-directed fluid therapy, postoperative admission to an intensive care unit, and multidisciplinary involvement of senior clinicians in the decision and delivery of perioperative care. Change management and leadership coaching were provided to ELC leadership teams. MAIN OUTCOME AND MEASURES Primary outcomes were in-hospital mortality, both crude and Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P-POSSUM) risk-adjusted, and length of stay. Secondary outcomes were the changes after implementation of the separate metrics in the care bundle. RESULTS A total of 28 hospitals participated in the ELC and completed the project. The baseline group included 5562 patients (2937 female [52.8%] and a mean [range] age of 65.3 [18.0-114.0] years), whereas the post-ELC group had 9247 patients (4911 female [53.1%] and a mean [range] age of 65.0 [18.0-99.0] years). Unadjusted mortality rate decreased from 9.8% at baseline to 8.3% in year 2 of the project, and so did risk-adjusted mortality from a baseline of 5.3% to 4.5% post-ELC. Mean length of stay decreased from 20.1 days during year 1 to 18.9 days during year 2. Significant changes in 5 of the 6 metrics in the care bundle were achieved. CONCLUSIONS AND RELEVANCE A collaborative approach using a quality improvement methodology and a care bundle appeared to be effective in reducing mortality and length of stay in emergency laparotomy, suggesting that hospitals should adopt such an approach to see better patient outcomes and care delivery performance. / This study was funded by The Health Foundation, United Kingdom, as part of a Scaling Up Award.

Approved for public release; distribution is unlimited / The construction of an apparatus for the condensation performance testing of a horizontal bundle of four tubes with various refrigerants was completed. The apparatus was instrumented, and data reduction software was developed to provide bundle and single tube condensation data. Two tube bundles were tested, smooth copper tubes and low integral-fin copper-nickel tubes, with two refrigerants, R-114 and R-113. An enhancement ratio of about 2.0 for the overall heat transfer coefficient was demonstrated for the finned tubes over the smooth tubes. Internal contamination, possibly due to a breakdown of the refrigerant molecules when subjected to high temperatures in the boiling chamber, inhibited further meaningful data collection. Recommendations for improvement of the test apparatus are made. / http://archive.org/details/condensationofre00mabr / Lieutenant, United States Navy

The Centers for Medicare and Medicaid Services (CMS) report thousands of falls in hospitals each year. The CMS does not reimburse hospitals for fall related injuries, costing the hospital system organization for which this DNP project was designed millions of dollars each year. Framed within the Iowa model of evidence-based practice and using a team approach, the purpose of this project was to develop an evidence-based (EB) fall safety bundle for use by nursing staff and a curriculum to educate staff on prevention strategies. The components of the EB fall bundle kit were approved by the stakeholder committee. Evaluation of the curriculum and the pretest/posttest items was completed by three content experts. The curriculum was evaluated related to the objectives using a 'met' (2) and a 'not met' (1) response. All responses were 'met' for an average score of 2 showing the content met the objectives. Validation of the pretest/post items was conducted using a 10-item, Likert scale, ranging from 1- 'is not relevant' to 4- 'is highly relevant'. The content validation index was 1.0, showing that the test items met the objectives and content of the course. Recommendations included providing a consistent methodology to disseminate the fall safety bundle and educational curriculum across the entire healthcare system as well as adding the fall safety bundle tool kit to the hospital's intranet page for ease of access for all staff. Social change will be achieved by facilitating prevention of fall related injuries and avoiding the financial impact on the facility.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.