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Efeitos do pneumoperitônio e de uma manobra de recrutamento alveolar seguida por pressão positiva no final da expiração na função cardiopulmonar em ovinos anestesiados com isoflurano e fentanil / Effects of pneumoperitoneum and of an alveolar recruitment maneuver followed positive end-expiratory pressure by on cardiopulmonary function in sheep anesthetized with isoflurane-fentanylRodrigues, Jéssica Corrêa [UNESP] 26 February 2016 (has links)
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Previous issue date: 2016-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A realização da laparoscopia cirúrgica requer a insuflação de gás carbônico (CO2) na cavidade abdominal. O pneumoperitônio formado eleva a pressão intra-abdominal (PIA), deslocando o diafragma em sentido cranial, o que resulta em diminuição da complacência pulmonar e consequentemente formação de áreas atelectásicas. Este estudo objetivou investigar os efeitos do pneumoperitônio e de uma manobra de recrutamento alveolar (MRA) seguida por aplicação de pressão positiva ao final da expiração (PEEP) na função cardiorrespiratória em ovinos. Em um delineamento prospectivo aleatório cruzado, nove ovinos (36–52 kg) foram anestesiados com isoflurano e fentanil e submetidos à ventilação com volume controlado (volume corrente: 12 mL/kg) com o emprego do bloqueador neuromuscular atracúrio. Cada animal recebeu três tratamentos com intervalo de dez dias entre cada experimento: Controle (sem intervenção); Pneumo (pneumoperitônio mantido por 120 minutos sob PIA de 15 mmHg); Pneumo+MRA/PEEP (pneumoperitônio mantido por 120 minutos sob PIA de 15 mmHg e realização de uma MRA aos 60 minutos após insuflação abdominal seguida por 10 cmH2O de PEEP). A MRA consistiu em aumentos progressivos na pressão expiratória a cada minuto até alcançar o valor de 20 cmH2O de PEEP. As variáveis estudadas foram coletadas até 30 minutos após a interrupção do pneumoperitônio. A insuflação abdominal com CO2 diminuiu significativamente (P < 0.05) os valores de PaO2 de 435–462 mmHg (intervalo dos valores médios observados) no tratamento Controle para 377–397 mmHg e 393–413 mmHg nos tratamentos Pneumo e Pneumo+MRA/PEEP, respectivamente. A complacência estática (Cstat, mL/cmH2O/kg) diminuiu significativamente de 0,83–0,86 (Controle) para 0,49–0,52 (Pneumo) e 0,51–0,54 (Pneumo+MRA/PEEP) após a indução do pneumoperitônio. A MRA/PEEP elevou significativamente a PaO2 (429–444 mmHg) e a Cstat (0,68–0,72) quando comparada com o os animais sob pneumoperitônio que não receberam a MRA/PEEP (PaO2: 383–385 mmHg e Cstat: 0,48–0,49). A realização do pneumoperitônio aumentou significativamente a formação de “shunt” intrapulmonar; porém após a aplicação da MRA/PEEP houve uma diminuição significativa nos valores de “shunt”. Trinta minutos após a desinsuflação abdominal, a PaO2 e a Cstat encontravam-se significativamente menores e o “shunt” intrapulmonar significativamente maior no tratamento Pneumo quando comparado ao tratamento Controle. Durante os últimos 60 minutos de pneumoperitônio (Pneumo e Pneumo+MRA/PEEP), os valores médios de índice cardíaco (IC) foram 20–28 % menores (P < 0.05) que os valores observados no tratamento Controle. Após a MRA/PEEP, a pressão média da artéria pulmonar (PMAP) apresentou-se significativamente maior (47-56%) e a pressão arterial média (PAM) apresentou-se significativamente menor (16%) em relação ao tratamento Controle. Concluiu-se que a desinsuflação abdominal não foi suficiente para reverter os impactos negativos na função pulmonar associados à realização do pneumoperitônio e que a realização de uma MRA seguida por PEEP foi capaz de melhorar a complacência do sistema pulmonar e reverter o prejuízo na oxigenação ocasionados pela insuflação abdominal, sem, no entanto, induzir alterações hemodinâmicas inaceitáveis. / Laparoscopic surgical procedures usually require carbon dioxide (CO2) insufflation into the peritoneal cavity. The pneumoperitoneum increases intra-abdominal pressure (IAP) displaces the diaphragm cranially, and decreases respiratory system compliance, leading to the development of atelectasis. This study aimed to investigate the effects of pneumoperitoneum and of an alveolar recruitment maneuver (ARM) followed by positive end-expiratory pressure PEEP on cardiopulmonary function in sheep. In a prospective randomized crossover study, nine sheep (36–52 kg) received 3 treatments with 10-day intervals during isoflurane-fentanyl anesthesia and volume-controlled ventilation (tidal volume: 12 mL/kg): Control (no intervention); Pneumo (120 minutes of CO2 pneumoperitoneum until achieving an intra-abdominal pressure of 15 mmHg); Pneumo+ARM/PEEP (same pneumoperitoneum protocol with an ARM after 60 minutes of abdominal inflation). The ARM consisted of stepwise increases in end-expiratory pressures every minute until 20 cmH2O of PEEP, followed by 10 cmH2O of PEEP. Data were recorded until 30 minutes after abdominal deflation. Abdominal inflation significantly (P < 0.05) decreased PaO2 from 435–462 mmHg (range of recorded mean values) in controls to 377–397 mmHg and 393–413 mmHg in the Pneumo and Pneumo+ARM/PEEP treatments, respectively. Static compliance (Cstat, mL/cmH2O/kg) was significantly decreased from 0.83–0.86 (Control) to 0.49–0.52 (Pneumo), and 0.51–0.54 (Pneumo+ARM/PEEP) after induction of pneumoperitoneum. The ARM/PEEP significantly increased PaO2 [429–444 mmHg and Cstat (0.68–0.72)] from values recorded during pneumoperitoneum alone [PaO2: 383–385 mmHg and Cstat: 0.48–0.49]. Pneumoperitoneum significantly increased intrapulmonary Shunt; while the ARM/PEEP significantly decreased the Shunt. Thirty minutes after abdominal deflation (Pneumo), PaO2 and Cstat were significantly lower and the Shunt was higher than in controls. During the last 60 minutes of pneumoperitoneum (Pneumo and Pneumo+ARM/PEEP), cardiac index values were 20–28 % lower than in controls. After the ARM/PEEP, mean pulmonary artery pressure was significantly higher (47-56%) and mean systemic arterial pressure was significantly lower (16%) than controls. It was concluded that abdominal deflation is not enough to reverse the impairment in pulmonary function associated with pneumoperitoneum and the ARM/PEEP may improve respiratory system compliance and reverse the oxygenation impairment induced by pneumoperitoneum with clinically acceptable hemodynamic changes.
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The road to FMFM 1: the United States Marine Corps and maneuver warfare doctrine, 1979-1989Damian, Fideleon II January 1900 (has links)
Master of Arts / Department of History / Michael A. Ramsay / In 1989, the United States Marine Corps published the document Fleet Marine Force Manual 1, Warfighting. Its appearance signaled the official adoption of maneuver warfare as the Corps's organizational philosophy and the basis of its doctrine for preparing and conducting operations. The decade of debate and experimentation that preceded the publication of Warfighting has not received detailed examination, but merits such for the insights it can provide to understanding intellectual change and military reform.
Beginning in 1979, Marine Corps officers engaged in an intraservice debate over the issue of maneuver warfare, a new concept that began to circulate among military reformers in the latter half of the 1970s. A group of Marine officers known as "maneuverists" began meeting in unofficial seminars to study, refine, and promote the idea. Maneuverists believed that maneuver warfare was a more fluid and dynamic way of fighting because it stressed flexibility, creativity, and a focus on enemy behavior. They also thought the new idea offered a more effective alternative for fighting war than contemporary practices, which they thought focused too much on rigid application of standardized procedures and methods of existing manuals. The intellectual transformation of the Marine Corps involved three main mechanisms. The first was a theoretical mechanism centered on public debate in the pages of Marine Corps Gazette to introduce and defend maneuver warfare to Marine audience. The second was a functional/practical mechanism that involved educational and training initiatives at the Amphibious Warfare School and Camp Lejeune, North Carolina. The third mechanism was the use of institutional authority made possible with the appointment of General Alfred M. Gray, a senior and vocal maneuver warfare champion, to the position Commandant of the Marine Corps. Using the authority of his office, Gray directed the writing of a doctrinal manual encapsulating the ideas of maneuver warfare to provide the Corps organizational focus and direction. The resulting manual FMFM 1, Warfighting, officially adopted maneuver warfare as service doctrine and organizational warfighting philosophy.
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Měření jízdních manévrů vozidel hromadné přepravy osob, pro stanovení komfortní a bezpečné jízdy / Measuring the Manoeuvres of Public Transport Vehicles to Determine a Comfortable and Safe RideHlavová, Vendula January 2017 (has links)
The comfort perceived by passengers during transport in public transport plays a vital role, and its improvement can lead to attracting more customers. For this reason, there is a constant effort to improve the comfort of the passenger. This thesis deals with the objective measurement of the maneuvers of MHD in Brno (tram, trolleybus, bus) with the XL Meter and together with the subjective evaluation of the standing and sitting figurant, determines the limit values of longitudinal and transverse acceleration for comfortable ride and dangerous ride, which can lead to accidents to passengers.
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Experimentální stanovení zatížení letounu / Experimental load definitionDratva, Jakub January 2018 (has links)
The thesis is focused on experimental load definition of an aircraft. Especially is measured bending moment is measured on wing during the flight. The thesis includes theoretical basis for strain gauge measurements and procedure of statistic evaluation. For each of flight maneuvers, there are theoretical wing loads calculated and then the values are compared. The end of the thesis shows proposals for improvement of used method of flight possible repeated measurement.
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Vztah aerobní zdatnosti a silové vytrvalosti seniorek k vybraným antropometrickým parametrům / Relationship between aerobic endurance and static strength of elderly female athletes to selected anthropometric parametersToman Hrušková, Zdeňka January 2018 (has links)
Title: Relation between aerobic endurance and static strength of elderly female athletes to selected anthropometric parameters. Objectives: The purpose of this study is to analyse an aerobic endurance, tested by 2 km walk test and static strength tested by prone bridge maneuver and to investigate any existing association to selected anthropometric parameters. These tests were undertaken by elderly female athletes studying U3A at the UK FTVS. Methods: 48 elderly female athletes (age 66,1±2,35, body height 1,67±0,064cm, body weight 69,80±10,42kg, waist circumference 88,82±10,64cm, body mass index (BMI) 25,10±3,62), studying U3V of UK FTVS at the time of taking the part in the research. The original sample of elderly athletes accounted for 86, but elderly athletes over age of 70 and athletes under heart - rate medication were excluded. Male athletes were also excluded for greater group compatibility. Measurement of aerobic endurance was realized by a 2 km walk test at the athletic stadium of UK FTVS according to Mr. Stejskal. Time and heart rate were scanned by sporttesters (PolarS610i). Static strength was measured by isometric method of prone bridge maneuver. Selected anthropometric parameters to the aerobic endurance and prone bridge maneuver were investigated. All data was processed using the...
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När föräldrar begär hem sitt barn : En kvalitativ studie om socialsekreterares handlingsutrymme och barnets anknytning vid en hemtagningsbegäran / When Parents Request Their Child Back Home : A Qualitative Study of the Social Workers Room for Maneuver in the Case of Home Return Request and Children'S AttachmentHussein, Sara, El Dakkak, Sara January 2022 (has links)
The aim of this study is to examine how different factors affect the social worker's room for maneuver in relation to the case of home return request and the LVU process. Furthermore, the purpose is to examine how the social workers experience that the children are affected during home returns and what kind of effects it has on the children's attachment. The questions that have permeated our work are: What does the social worker's room for maneuver look like in relation to the case of home return request? and which factors do social workers believe affect the children's attachment to a home return request? The questions have been answered with the help of semi - structured interviews with five social workers from family home care. The results of the study have been analyzed with the help of previous research, Lipsky's theory, “Street level Bureaucracy” and Bowlby's attachment theory. The conclusion of the study has shown that the social workers' room of maneuver are complex but that the social workers have to some extent freedom of action. The room for maneuver is made possible and hindered by laws, guidelines and frameworks that exist in the organization. Furthermore, the conclusion showed that children's development can be affected when a home request becomes relevant, as the child both has a connection to the family home and their biological family. These attachment patterns that the child creates in turn create whether the child will develop healthily or not.
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Skolkuratorns handlingsutrymme : En kvalitativ studie om skolkuratorers upplevelser av handlingsutrymme, samverkan och legitimitet i skolmiljön / The school counselors room for maneuver : A qualitative study of school counselors' experiences of room for maneuver, cooperation and legitimacy in the school environmentFransson, Josefine, Gränsmark, Malin January 2021 (has links)
The aim of this study has been to get a better understanding of school counselors experience of their room for maneuver in a pedagogical environment. Consequently, examine the meaning of legitimacy and cooperation with other professions within the school. Our study emanates from six semi-structured qualitative interviews with school counselors that have been analyzed from a thematic analysis. The study consists mainly of three key concepts room for maneuver, cooperation and legitimacy. The result shows that there is a duality around their perception of these key concepts. School counselors find both strengths and difficulties in their profession and role at the school. Our conclusion is that school counselors need a clearer job description and support from mainly principals to enable the work more health-promoting and preventive in school. The school counselors described a desire for a central manager with an educational background more similar to theirs in order to make it easier for them to find their role at the school. ,
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Handlingsutrymmets motstridighet : En kvalitativ studie om vad det är som påverkar biståndshandläggares beslutsfattande / The contradiction of the space of action : A qualitative study of what´s affects the care managers decision making?Jogren, Mariana, Axelsson, Felicia January 2022 (has links)
Sauer and Ahnlund (2021) believe that the care manager who works in social work is described as complex because the role involves having an approach to various individual needs that the individuals have. The difficulty is to assemble politics, profession and organizational choices as they, based on this, must take a stand in situations of ethical sensitivity. Previous research shows that guidelines, knowledge and interaction affect the care managers room for maneuver, where it is described that these can provide security and benefits. However, it appears that difficulties may arise in these parts of the decision-making process that the care managers as a profession has the task of implementing (Olaison, Torres & Forssell 2018; Janlöv, Hallberg & Petersson 2011). The purpose of the study is to investigate how the care managers in elderly care describe their role and how guidelines, knowledge and interaction affect the care managers in their decision-making. Semistructured interviews were conducted with seven care managers in elderly care. The study is alalyzed based on Lipsky´s (2010) theory of grassroots bureaucrats. The results show that the care managers are based on the individual´s needs at the center. However, the study shows that they describe guidelines, knowledge and interaction in different ways in relation to the decision-making process because they create different spaces for action. Our study shows that the role of care managers is contradictory which means that the elderly's need for help is treated in different ways, depending on which care manager they meet. / Sauer och Ahnlund (2021) menar att biståndshandläggare som arbetar inom det sociala arbetet beskrivs som en komplex roll då rollen innebär att ha ett förhållningssätt till olika individuella behov som individer har. Svårigheten är att knyta samman politik, profession samt organisatoriska val då de utifrån detta skall ta ställning kring situationer av etisk känslighet. Tidigare forskning visar att riktlinjer, kunskap och interaktion påverkar biståndshandläggares handlingsutrymme då det beskrivs att dessa kan ge trygghet och fördelar. Dock framkommer det att svårigheter kan uppstå inom dessa delar i beslutsprocessen som biståndshandläggare som profession har som uppgift att genomföra (Olaison, Torres & Forssell 2018; Janlöv, Hallberg & Petersson 2011). Syftet med studien är att undersöka hur biståndshandläggare inom äldreomsorgen beskriver sin roll samt hur riktlinjer, kunskap och interaktion med klienterna och klienternas anhöriga påverkar biståndshandläggare i deras beslutsfattande. Semistrukturerade intervjuer har genomförts med sju biståndshandläggare inom äldreomsorgen. Studien analyseras utifrån Lipskys (2010) teori om gräsrotsbyråkrater. Resultatet visar att biståndshandläggarna utgår från den enskildes behov i centrum. Dock visar studien att de beskriver riktlinjer, kunskap och interaktion på olika sätt i förhållande till beslutsprocessen på grund av att de skapar olika handlingsutrymmen. Vår studie visar att rollen som biståndshandläggare är motstridig och innebär att äldres hjälpbehov behandlas på olika sätt, beroende på vilken biståndshandläggare de möter.
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Motion Planning for Aggressive Flights of an Unmanned Aerial VehicleMedén, Alexander, Warberg, Erik January 2021 (has links)
Autonomous Unmanned Aerial Vehicles (UAV) havegreat potential in executing various complex tasks due to theirflexibility and relatively small size. The aim of this paper is todevelop a motion planner capable of generating a trajectory withaggressive maneuvers through narrow spaces without collision.The approach utilizes a framework using an optimized variantof the Rapidly-exploring Random Tree (RRT) algorithm, calledRRT*, with a Control Barrier Functions (CBF) based obstacleavoidance algorithm as well as a motion primitive generator. If amotion primitive collides with an obstacle, the obstacle avoidancealgorithm will attempt to reach the end state of a motion primitivein a collision free manner while complying with the actuationconstraints. From the collision free trajectories an optimal path iscontinuously searched for by RRT* by minimizing a cost in jerk.The performance of RRT* and the obstacle avoidance are testedin simulations independently and jointly, in several differentscenarios. The resulting motion planner successfully finds ahigh-level trajectory for the different scenarios. Limitations ofthe method as well as possible areas of improvements are alsodiscussed at the end of this paper. / Autonoma UAV har goda möjligheter för att utföra flera olika komplexa uppgifter tack vare deras flexibilitet och storlek. Denna rapport redogör för en rörelseplaneringsalgoritm som kombinerar manövrerbarheten hos en UAV för att skapa en kollisionsfri bana som innehåller aggressiva manövreringar genom trånga utrymmen. Tillvägagångssättet innefattar att kombinera Rapidly-exploring Random Tree (RRT*) med en algoritm för att undvika hinder baserad på Control Barrier Functions (CBF), samt att låta banan delas upp i segment, så kallade motion primitives, som genereras var för sig. Om en motion primitive kolliderar kommer den hinderundvikande algoritmen göra ett försök att nå dess målposition medan kollision undviks och manövreringsbegränsningarna uppfylls. Med en samling genomförbara motion primitives söker RRT* efter en kontinuerlig bana optimerad med hänsyn till en kostnad i ryck. Prestandan för RRT* och den hinderundvikande algoritmen simuleras både separat och tillsammans. Den resulterande rörelseplaneraren lyckas hitta en genomförbar bana för vardera scenario. Begränsningar av metoden samt potentiella förbättringsområden diskuteras i slutet av denna rapport. / Kandidatexjobb i elektroteknik 2021, KTH, Stockholm
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Space Rider System: GNC and System Model Improvements / Space Rider System: GNC- och systemmodellförbättringarVial, Simon January 2022 (has links)
As part of a continuous trend of the space sector for obtaining higher performance space science and Earth observations, there is an increasing demand for higher requirements in pointing accuracy and disturbance prediction. The Space Rider System (SRS) is a Low Earth Orbit (LEO) reusable vehicle that aims at answering to that demand. It is a real science platform for short orbital missions, and its service module is being developed for European Space Agency (ESA) by Italian company AVIO S.p.A. The module possesses several rotating parts such as the solar arrays and the reaction wheels, that both create vibration disturbances that might jeopardize the Micro-Gravity (MG) requirements set on the project. At the same time, these reaction wheels were found to be failing to complete certain slew maneuvers, although they are the preferred actuator for most attitude controls. In a perspective to studying these aspects and exploring possible enhancements, this study develops two generic models to simulate the vibration disturbances from Solar Array (SA) and Reaction Wheel (RW). Furthermore, the optimization routine of a different guidance approach using a quaternion shape method is developed to tackle the Reaction Wheels Assembly (RWA) saturation. Through extensive validation work coupled with research and simulations, the developed models were found to enable a good estimation of the vibrations on the spacecraft, and enhance the ability of the company to validate requirements in a more agile way. Furthermore, an optimization algorithm was developed and has shown great performance in desaturating all the problematic maneuvers using reaction wheels during orbital phases, with low computational requirements. / Som en del av rymdsektorns kontinuerliga strävan att uppnå högre prestanda inom rymdvetenskap och jordobservationer ökar kraven på högre precision i riktningen och störningsförutsägelser. Space Rider System (SRS) är en återanvändbar farkost för låg jordbana (LEO) som syftar till att uppfylla dessa krav. SRS är en vetenskapsplattform för korta rymduppdrag i omloppsbana, och dess servicemodul utvecklas för ESA av det italienska företaget AVIO S.p.A. Modulen har flera roterande delar, t.ex. solpanelerna och reaktionshjulen, som båda skapar vibrationsstörningar som kan äventyra de krav på mikrovibrationer som ställs på projektet. Samtidigt konstaterades det att reaktionshjulen inte klarar av att genomföra vissa svängningsmanövrar, trots att de är det föredragna manöverdonet för de flesta attitydkontroller. För att studera dessa aspekter och utforska möjliga förbättringar utvecklas i denna studie två generiska modeller för att simulera vibrationsstörningar från solpanelerna och reaktionshjulen. Dessutom utvecklas optimeringsrutinen för en annan styrningsmetod med hjälp av en kvaternion-formmetod för att hantera mättnaden av reaktionshjulen. Genom ett omfattande valideringsarbete med forskning och simuleringar visade sig de utvecklade modellerna möjliggöra en god uppskattning av vibrationerna på rymdfarkosten och förbättra företagets förmåga att validera krav på ett smidigare sätt. Vidare utvecklades en optimeringsalgoritm som har visat stor prestanda när det gäller att avmätta alla problematiska manövrar med hjälp av reaktionshjul under omloppsfaserna, med låga beräkningskrav.
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