The purpose of this study was to explore and describe the surgical nurses’ perceptions about the management of post-operative pain and strategies employed in management of pain in patients who have undergone total hip or knee replacement surgery in King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Qualitative, exploratory-descriptive research design was applied. Purposive nonprobability sampling was used and data collected by means of audio-recorded semistructured individual interviews. Data saturation was reached after interviewing twenty surgical nurses. Themes and categories emerged from adopting Creswell’s (2013) “data analysis spiral”. One of the key findings was that patients reportedly experience moderate to severe pain during the first three days after surgery, before it is controlled on mild to moderate levels or before the patient is pain free. Conclusions were drawn, and one of the major ones was that multimodal strategies are employed by the surgical to manage post-operative pain. Recommendations were also made from findings of this study, and one key recommendation was that expatriate nurses to have access to Arabic speakers to overcome language barriers. / Health Studies

Thesis (PhD)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Diabetes mellitus is amongst the leading causes of morbidity and mortality in the world, affecting young, adult and old people. Beta cell replacement therapy for insulin delivery remains the ultimate remedy for diabetes. However, insufficient donor pancreas and the use of immunosuppressive drugs prevent the wide-spread of this therapy. Other avenues of self generated beta cells within the organ itself need to be explored. Therefore, understanding the chronobiology of cellular mechanisms in the lineage of beta cell induced neogenesis is a valuable tool in improving beta cell replacement in patients with diabetes. The aim of this study was to induce recapitulation of the morpho-genetic sequence of endocrine cells development in the pancreas of rats after the pancreatic duct ligation (PDL) procedure. Serial sections of PDL tissues of the pancreas were obtained from 78 Sprague- Dawley rats and were assessed morphologically. The immunofluorescent tissues were statistically analysed using a computerized morphometry technique. The protein expression indices of Caspase3, Insulin, Pdx1, Ngn3, NeuroD and Pax6 were quantified. The efficiency levels of coexpression of these homeodomain proteins separately with insulin were defined by the ratio of the mean value of insulin expression to the mean value of their respective protein expression. The morphological changes were characterized by the appearance of granulated acinar cells at 6 hours post-PDL and the proliferation of endocrine tissues from 84 hours through to 120 hours. The morpho-immunofluorescent evaluation showed the highest immunoreactivity of Caspase3 and Pdx1 at 6 hours, Ngn3 at 36 hours, Pax6 and insulin at 84 hours while NeuroD expression was at 120 hours. The immunohistofluorescent analysis showed that caspase3 and Pdx1 were the first to be expressed at 6 hours while the insulin and NeuroD expression appeared later at 84 hours and 120 hours, respectively. However, Pax6 expression was continuous across time periods post-PDL, while Ngn3 expression showed a peak at 36 hours. The efficiency (highest and earliest expression) of co-expression of all these homeodomain proteins with insulin was restricted between 12 hours and 24 hours. The optimal efficiency was at 12 hours by Ngn3 with insulin. A good efficiency was shown for Pdx1 with insulin, NeuroD with insulin and Pax6 with insulin at 12 hours and 24 hours, respectively. A low efficiency was observed for insulin and caspase3 co-expression at 24 hours. This study suggests that for transplantation, PDL tissues harvested at an early time post-PDL (between 12 and 24 hours) could yield a higher success rate; the study also provides evidence for a connection between morphological changes in the PDL pancreas and the protein synthesis necessary for the lineage of endocrine cell development. / AFRIKAANSE OPSOMMING: Diabetes Mellitus resorteer onder die vernaamste oorsake van morbiditeit en mortaliteit wêreldwyd, en tuister jongmense, volwassenes en bejaardes. Daar bestaan egter ‘n wêreldwye tekort aan skenkerorgane met immuun-onderdrukingsterapie as ondersteuningsbehandeling. Beta-sel vervangingsterapie, vir die voorsiening van insulien, bly daarom die voorkeur behandeling vir die siekte wat noodsaak dat die wetenskap kyk na alternatiewe behandelingsregimens wat meganismes rondom orgaanregenerasie insluit. Begrip van die chronobiologie van die sellulêre meganismes betrokke rondom beta-sel ontwikkeling mag waardevolle lig werp op die neogenese van beta-selle wat gevolglik daartoe mag lei dat beta-sel vervanging as ‘n moontlike behandelingsterapie oorweeg mag word vir pasiënte met suikersiekte. Die oogmerk van hierdie studie is om die rekapitulasie van die morfo-genetiese volgorde van die endokriene pankreas na afbinding van die pankreasbuis te bepaal. Pankreasbuis afbinding is op 78 Sprague-Dawley laboratorium rotte onder algemene narkose uitgevoer, die pankreas is na voorafbepaalde tydsvakke verwyder en in histologiese seriesnitte gesny. Snitte is immunositochemiese gekleur en morfometries assesseer. Die afskeidingsindeks vir selboodskappers vir Caspase3, Insulien, Pdx1, Ngn3, NeuroD en Pax6 is kwantifiseer. Die gelyktydige afskeiding van elk van bogenoemde boodskappers tesame met insulien is omskryf as ‘n verhouding tot mekaar en in terme van dié van insulien. Die morfologiese verandering in die weefsel bespeur is gekenmerk deur die verskyn van gegranuleerde asinêre selle ses (6) ure na buisafbinding en die proliferasie van endokriene weefsel vanaf vier-en-tagtig (84) ure deurlopend tot een-honderd-en-twintig (120) ure. Die morfo-immunofluoresserende evaluering toon dat Caspase3 en Pdx1 by 6 uur die hoogste is, die van Ngn3 by 36 ure, Pax6 en insulien by 84 ure en NeuroD by 120 ure. Verder toon die analise dat Caspase3 en Pdx1 rondom 6 ure hul verskyning gemaak het terwyl dié van insulien en NeuroD eers rondom 84 tot 120 uur verskyn het. Die verskyning van Pax6 het deurlopend regoor al die tydsduurtes verskyn en Ngn3 het rondom 36 uur sy hoogste vlak bereik. Die gelyktydige uitdrukking van homeodomein proteïene tesame met insulien het slegs tussen die tydperke van 12 en 24 ure plaasgevind. Die uitdrukking van Pdx1 met insulien, NeuroD met insulien en Pax6 met insulien het almal tussen 12 en 24 ure plaasgevind. Caspase3 tesame met insulien is slegs by die 24 uur tydsperiode bespeur. Vir die oorplant van pankreas weefsel wat aan buisafbinding onderwerp is suggereer hierdie studie dat die geskikste tyd vir die oes van endokriene weefsel liewer vroeër (12 to 24 ure) as later uitgevoer behoort te word. Verder wil dit voorkom of hierdie tydsperiode ook die hoogste seltelling lewer. Die studie lewer waardevolle inligting oor die verwantskap tussen die morfologiese veranderings wat na buisafbinding plaasvind en die proteïen sintese wat sel-opvolgontwikkeling bevorder.

人力資源是各行政機關、學校的基本要素，也是國家最重要的資產，機關管理的核心。而公務體制中最基層的編制內工友人力管理卻仍未有完整建制，僅依據事務管理規則、勞動基準法及相關行政規定辦理，因此，本研究希望達成的研究目的：1.瞭解事務勞力替代方案、勞動基準法實施前後，工友管理制度的變遷、現況及缺失。2.探討未來工友管理體制因應之道及如何提昇管理工友之行政效能。 本研究透過文獻回顧及管理實務上的問題，以交通部（含所屬各行政機關）的個案分析，對管理者及工友代表進行深度訪談，瞭解工友管理所面臨相關問題與改進建議之看法。 主要之問題為1.工友餉級與薪點問題。2.管理指揮系統紊亂，缺乏有效監督的問題。3.工友名稱問題。4.各類機關工友設置標準仍應全面檢討員額精簡問題。5.工作分配仍有不均，人力仍未充份有效運用等問題。6.工友優惠資遣退休政策推展成效問題。7.勞工退休金制度選擇新制或舊制應注意事項。8.工友建制存廢問題。 我國行政機關工友管理制度之探討經本研究發現，在執行上如從1.技工工友薪資結構改革方案。2.工友管理事項予以統一規範。3.工友名稱4.加強實施員額管制及委託外包。5.改進工作分配。6.鼓勵工友自願退離方案。7.選擇勞工退休金新制舊制注意事項。8.工友建制存廢進行研議。實務面向改善，並針對所發現問題提出研究建議，期使工友管理制度更臻完善。 / Human resources are the fundamental elements of every administrative organization and educational institution, as well as the most essential asset of a country, and the core of organizational management. Under the fundamental organization of public affairs system, the management of maintenance worker is still incomplete, handled only by relevant administrative regulations such as Management Affairs Regulations and Labor Standard Law. Hence, the research expects to achieve the following objectives: 1. Understand Replacement Policy of Affairs Labor, and the transition, current status, and deficiency of maintenance worker management system before and after the execution of Labor Standard Law. 2. To discuss future maintenance worker management system, and ways to enhance the administrative efficiency of maintenance worker management. The research will analyze the case study from the Ministry of Transportation and Communications (including affiliated administrative organizations) through documents and practical management problems. The research will proceeds in-depth interview with the management and maintenance worker representative in order to understand relevant problems encountered in maintenance worker management, and to provide suggestions for improvement. The main problems include: 1. the salary of maintenance worker. 2. Management command chain chaos, lack of efficient supervision. 3. The name of maintenance worker. 4. Overall streamline quota review, and the employing standard of maintenance worker from various organizations. 5. Disproportionate division of labor, inefficient deploy of manpower. 6. The effectiveness of promoting preferential retirement policy of maintenance workers. 7. Notes to consider when selecting new or old Labor Pension Act. 8. The abolishment of maintenance worker system. The research finds that the maintenance worker management system of administrative organizations can be perfected after the improvement from the practical domain, as well as from the suggestions provided for the following problems: 1. Salary structure reform of technician and maintenance worker. 2. Standardized maintenance worker management regulations. 3. The name of maintenance worker. 4. Strengthen quota control and OEM. 5. Improve the division of labor. 6. Encourage maintenance worker to retire voluntarily. 7. Notes to consider when selecting new or old Labor Pension Act. 8. The abolishment of maintenance worker system.

論文摘要: 本研究以現金餘額計劃（Cash Balance Plan）及確定提撥退休金計劃（Defined Contribution Pension Plan）建構出公務人員退撫基金之建議機制，建構之主要目的在於透過第一層現金餘額計劃之利息給付機制降低退休基金利率風險，同時由第二層確定提撥計劃獲取額外退休所得，使雇主與員工在双層式退休金計劃下，同時承擔投資風險，以降低基金利率風險並同時滿足適當退休所得保障。本文在現金餘額計劃不同控管年限及利息給付假設下，模擬超額積蓄（Overfunded）基金與不足額積蓄（Underfunded）基金執行資產負債管理（Asset Liability Management）所需存續期間，同時模擬双層式退休金計劃提供員工之退休所得替代率，研究結果發現： 1、超額積蓄基金及不足額積蓄基金均可以在目前資本市場中找到符合所需存續期間之資產投資。在控管20年限內，超額積蓄基金所需存續期間在-1.71年到0.39年之間；不足額積蓄基金所需存續期間在4.68年到8.31年之間。 2、退休基金越接近超額狀態越有利於資產負債管理。當基金積蓄狀態越接近超額積蓄時，基金負債與資產的比例較不足額積蓄基金低，故資產負債管理所需存續期間較短，對於基金能夠控管的年限也越長。 3、雇主可透過現金餘額計劃利息給付機制執行百分之百免疫策略。雇主可利用現金餘額計劃利息給付依據外部債券利率為參考依據的特性，鎖定債券利率，達到資產負債管理百分之百免疫效果。 4、現金餘額計劃執行百分之百免疫策略情況下，45歲以下公務人員採行自動選擇投資基金（Default Fund）為高風險投資基金，自動選擇提撥率（Default Rate）為每月薪資5.08﹪，可使員工達到適當所得替代率保障水準。 / Abstract This thesis proposes an new alternative two-tier pension composed of Cash Balance Plan (CBP ) and defined contribution pension plan to the traditional defined benefit pension plan of Taiwan Public Employee Retirement System(TPERS). In order to decrease the interest-rate risk of the pension fund and to provide additional retirement income protection, we utilize the credit rate mechanism of CBP and supplement CBP with additional defined contribution plan. We investigate the Asset-Liability Management (ALM) for TPERS and calculate the liability duration under different time horizons, interest credits of CBP. We also simulate the replacement rate of the two-tier pension plan under different contribution rates, and investment returns. The results are as follows: 1、Given the twenty-year time horizons, the asset duration of overfunded plan ranges between –1.71 years and 0.39 years, whereas that of underfunded plan varies from 4.68 years to 8.31 years. In this case, the requirements of asset duration can be satisfied in the Taiwan Capital Market. 2、The overfunded pension plan has higher probabilities to meet the requirements of asset duration. Therefore, we suggest that the fund manager can increase the asset allocation percentage of external fund management in order to improve the long-term returns. 3、Perfect matching of pension fund can be achieved by matching the yield of securities to interest credit under CBP . In addition, we suggest that the interest credit of the new labor contracts should take the trend of the current interest rate into consideration. 4、Replacement rates provided by CBP for woman range from 19.05﹪ to 45.70﹪and from 20.86﹪to 50.05﹪for man assuming the interest credit rate is 5.2%. To increase the retirement income, the defined contribution plan provide additional replacement rate between 13.56﹪and 162.96﹪for woman and between 14.85﹪and 178.42﹪for man assuming the employee can contribute 3.08 percent to 13.37 percent of regular salaries and investment returns are from 4 percent to 8 percent .

為使台灣公部門能利用確定提撥的概念及妥善運用投資資源，以期在減少政府負擔的情況下獲得足夠的退休所得，故本研究以所得替代率、金錢價值比及平均數-變異數比等指標來針對公務人員退撫基金附加節約儲蓄制度採行之可能與投資策略彼此運用之模擬結果加以分析，結果如下： 1. 各情境下以BH策略所得出之期末個人帳戶平均累積值表現最佳，然其具相當大的波動變異程度，投資人需承受相當大的風險。而TIPP策略之表現則與前述完全相反。 2. 若投資者採用BH策略或是採用CPPI與TIPP策略(CM策略)且欲追求較高的所得替代率，則建議採用Lifecycle(平衡型)的投資比例配置方式，加計DB制下之給付則平均可提供男(女)性約70.204%-75.204% (65.49%-70.49%)的所得替代率，而金錢價值比則為2.399(2.95)。 3. 無論投資者採用何種策略進行投資，若欲追求最小的可能變異風險，則建議採取平衡型的投資比例配置方式，加計確定給付制下之給付則平均可提供男(女)性約67.924%-72.924%(65.318%-70.318%)的所得替代率，金錢價值比則為2.6835。 本文模擬結果所得出之所得替代率平均維持於70%上下，代表若政府將可藉此制度減輕政府負擔外亦可使員工擁有一定水平的退休生活，故可採用。至於投資策略與配置方式如何取捨須依不同的投資者而定。 　 關鍵詞：公務人員退撫基金、確定提撥制、所得替代率、金錢價值比、Lifecycle / Abstract Because the improvement of medical technology and the structure of population is aging. It makes human worry about the living in the future. In order to enable the public servants of Taiwan to utilize the system of the Defined Contribution and to relief the pressure of fiscal, so we simulate in this article and analysis the results of simulation by using replacement rate, money’s worth ratio, and mean-variance ratio. The result is as follows: 1.When investor adopt the BH strategy in the process of investment, it will create the best replacement rate and money’s worth ratio under every situation, but it can be anticipated more uncertainty. Investors need to think thrice before they act. The TIPP strategy is opposite. 2.If investors adopt BH strategy or CPPI and TIPP strategy (CM strategy) and wanting to pursue the substituting rate of the higher income , the best selection is proposed adopting the Lifecycle (balanced) scenario, and it can offer replacement ratio about 70.204% - 75.204% (65.49% - 70.49% ) for the man (the woman ) under adding the DB system. Besides, the money’s worth rate is 2.399 (2.95). 3. If the investors want to pursue the least influence in the process of investment whatever investors adopt which strategies, the best scenario is the balanced type, and it can offer replacement ratio about 67.924%-72.924%(65.318%-70.318%) for the man (the woman) under adding the DB system. Besides, the money’s worth rate is 2.6835. The outcome of the simulation in this article is keep the replacement rate maintain about 70% equally, What is the best selection for investor that must be contingent upon different characteristics of investors. Keywords: public servants, Defined Contribution, Replacement rate, The money’s worth ratio, Lifecycle hypothesis.

近年來隨著台灣人口日漸少子化，「養兒防老」的傳統觀念已不符時勢所趨，面對高齡化社會所帶來龐大的財政負擔及老年人口安養等社會問題。過去研究結果提供了一可能的解決方案－「逆向房屋抵押貸款（Reverse Mortgage, RM）」，然而，對於此種新型貸款在台灣推行之完整可行性分析，相關研究尚付之闕如。是故，本研究從承貸雙方角度出發，旨在深入探討未來逆向房屋抵押貸款在台推行之可行性。 首先，對於申貸者而言，本研究以30至60歲且名下擁有不動產之家戶為研究單位，並用問卷調查台灣中年房屋持有者申請逆向房屋抵押貸款之意願程度。針對調查結果，再以「羅吉斯迴歸（Logistic Regression）」分析影響申請意願之顯著因子，據以探討申請意願與受訪者特性兩者之關係。 其次，從承貸者角度建立一貸款定價模型，模擬分析於損益兩平條件下，貸款機構有無貸款保險，以及於不同貸款給付方案中，其可提供逆向房屋抵押貸款之最高可貸款成數（Loan to Value, LTV）。再者，進一步結合台灣各主要都會區房價資料，研究顯示所得替代率（Income Replacement Ratio, IRR-RM）符合多數申貸者之基本需求。 本研究預期「逆向房屋抵押貸款」除了有效解決人口老化所衍生之社會問題外，亦兼具政府「就地老化（Aging in Place）」政策效益，提升了老年生活品質，維護老年人口的尊嚴。 / With the continuously declining fertility rates and the increasing life expectancy, Taiwan has become one of the aging societies in the world. To release the financial strain of the government, a great number of literature has suggested an alternative option, Reverse Mortgage (RM), to improve the retiring life quality of the elders. However, little attention has been given specifically to the feasibility of the application of RM and the pricing model in individual countries. This study thus conducted the questionnaire and collected the data in Taiwan for analysis in order to show the implementation feasibility of RM in aging society for both the aspects of both lenders and borrowers. First of all, to find out the factors affecting the willingness in applying for RM and the characteristic of the middle-aged homeowners, we designed a survey and a quantitative analysis of the questionnaire through Logistic Regression Analysis. Second, under a break-even hypothesis, we analyzed the ratio of Loan to Value (LTV) a reverse mortgage lender would offer through the simulation model. Furthermore, the housing data from different metropolises of Taiwan is integrated into the study in order to determine whether if the Income Replacement Ratio of RM (IRR-RM) could meet the basic needs of Taiwanese. Results found in this paper suggest that RM could satisfy the general need of people in Taiwan. Procedures conducted in this study may also provide precious insight for other aging countries. This paper suggests that reverse mortgage could not only solve the society issues, but also secure the retiring lives of the elders and preserve their living qualities.

<p>Studija se sastojala od dva dela &ndash; eksperimentalnog i kliničkog. Eksperimentalni deo je sproveden na Fakultetu tehničkih nauka u Novom Sadu na Departmanu za mehanizaciju i konstrukciono ma&scaron;instvo. Trideset dve zglobne povr&scaron;ine gornjeg okrajka golenjače sa pripojem prednje ukr&scaron;tene veze je uzeto tokom totalne aloartroplastike kolena kod trideset dva pacijenta kod kojih je preoperativno načinjena AP i profilna radiografija sa standardnim uvećanjem u cilju merenja veličine kolena a uz prethodno potpisanu saglasnost pacijenata. Zatim je načinjeno trodimenzionalno skeniranje prostorne povr&scaron;ine pripoja prednje ukr&scaron;tene veze na golenjači u odnosu na ravan zglobne povr&scaron;ine golenjače heptičkim uređajem &bdquo;Phantom Omni&reg;&ldquo; radi utvrđivanja korelacije između povr&scaron;ine pripoja prednje ukr&scaron;tene veze na golenjači i veličine platoa golenjače. U eksperimentalni deo su bili uključeni pacijenti oba pola metodom slučajnog izbora kod kojih je ugrađivana totalna proteza kolena a koji su prethodno potpisali informisani pristanak pacijenta na operativni zahvat na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Klinički deo studije je bio retrospektivno-prospektivnog karaktera i obuhvatio je ukupno 60 pacijenata izabranih metodom slučajnog izbora od kojih je ispitivanu grupu činilo 30 pacijenata u kojih je do&scaron;lo do ponovne rupture prednje ukr&scaron;tene veze levog ili desnog kolena nakon urađene primarne rekonstrukcije te je načinjena ponovna rekonstrukcija veze, i kontrolnu grupu koju je činilo 30 pacijenata u kojih je zbog rupture prednje ukr&scaron;tene veze načinjena primarna rekonstrukcija nakon koje nije do&scaron;lo do ponovne rupture. Kod svih pacijenata je rekonstrukcija prednje ukr&scaron;tene veze kolena rađena kalemom kost-tetiva-kost. Ishod rekonstrukcije je procenjivan na osnovu Tegner bodovne skale, Lysholm i IKDC bodovne skale za koleno, artrometrijskog merenja Lachman testa, Pivot shift testa, poloţaja kalema i urađeno je poređenje dobijenih rezultata u ispitivanoj (revizionoj) i kontrolnoj grupi. U klinički deo istraţivanja su bili uključeni pacijenti oba pola, ţivotne dobi od 18 do 40 godina koji su operisani na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine u Novom Sadu a koji su dali informisani pristanak za uključivanje. Kriterijumi za isključivanje pacijenata iz kliničkog dela istraživanja su bili životna dob manja od 18 i veća od 40 godina, pojava težih op&scaron;te-hirur&scaron;kih komplikacija i prestanak želje pacijenta da dalje učestvuje u ovom istraživanju. Nakon sveobuhvatne analize dobijenih rezultata istraţivanja, zaključeno je da postoji korelacija između povr&scaron;ine pripoja prednje ukr&scaron;tene veze na golenjači i veličine platoa golenjače. Formula, načinjena matematičko-statističkim metodama za ovo istraživanje, adekvatna je i praktično primenljiva za predikciju povr&scaron;ine pripoja prednje ukr&scaron;tene veze na golenjači u velikom procentu slučajeva a na osnovu samo dva radiografska parametra izmerenih preoperativno &ndash; prednje-zadnjeg i unutra&scaron;nje-spolja&scaron;njeg dijametra platoa golenjače. Kori&scaron;ćenje ove formule može da doprinese pobolj&scaron;anju rezultata hirur&scaron;kog lečenja pacijenata sa pokidanom prednjom ukr&scaron;tenom vezom kolena. Takođe, zaključeno je da je uzrok neuspeha primarne rekonstrukcije multifaktorijalan kao i da nema statistički značajne razlike u ishodu između ispitanika sa dobrom i ispitanika sa lo&scaron;om pozicijom kalema. Potvrđena je pretpostavka da je ishod ponovne rekonstrukcije prednje ukr&scaron;tene veze kolena slabiji u odnosu na ishod primarne.</p> / <p>This study consisted of two parts &ndash; experimental and clinical. Experimental part was conducted at the Department of Mechanization and Design Engineering of The Faculty of Technical Sciences, University of Novi Sad. Thirty two proximal tibial articular surfaces together with the anterior cruciate ligament insertion of thirty two patients were harvested during total knee arthroplasty. All patients had standard preoperative AP and profile radiographs with standard magnification in order to acquire the knee measurements. All patients previously signed the informed consent. The harvested proximal tibial articular surfaces were 3D scanned by a haptic device called &bdquo;Phantom Omni&reg;&ldquo; in order to determine the correlation between the size of the anterior cruciate ligament insertion site and the size of the tibial plateau. Thirty two randomly chosen patients of both sexes which had a knee arthroplasty were included in the experimental part of this study. All of the patients signed the informed consent at The Clinic for Orthopedic Surgery and Traumatology of The Clinical Centre of Vojvodina. The clinical part was a retrospective-prospective study. This part included 60 randomly chosen patients divided into two groups. The test group consisted of 30 patients who had undergone a revision anterior cruciate ligament reconstruction. The control group consisted of 30 patients who had undergone only primary anterior cruciate ligament reconstruction. A bone-tendon-bone graft was used for the reconstruction in all cases. The outcome was assessed by using Tegner activity scale, Lysholm knee scoring scale, IKDC score, arthrometric evaluation, Pivot shift test and the position of the graft. The results were compared between the test group and the control group. The clinical part of the study included 60 patients of both sexes, age 18-40 which were operated at The Clinic for Orthopedic Surgery and Traumatology of The Clinical Centre of Vojvodina. All of the patients signed the informed consent for participation in this study. The exclusion criteria were age under 18 and above 40, occurrence of severe general surgical complications and a patient wish to be excluded from further investigation. After a thorough analysis of the results, we concluded that the correlation between the size of the anterior cruciate ligament tibial insertion site and the size of the tibial plateau exists. Formula which was created for this study by using mathematical and statistical methods, is adequate and practically applicable for the prediction of size of the anterior cruciate ligament tibial insertion site in the majority of cases based on just two preoperative radiographic parameters &ndash; AP and profile diameter of the tibial plateau. The use of this formula may improve the outcome of the anterior cruciate ligament reconstruction. We also concluded that the cause of the primary anterior cruciate ligament reconstruction failure is multifactorial as well as that there is no statistically significant difference between the patients with good and the patients with poor graft position. We confirmed the assumption that the outcome of the revision anterior cruciate ligament reconstruction is poorer than the outcome of the primary anterior cruciate ligament reconstruction.</p>

L’imaginaire social français est aujourd’hui dominé par une peur lancinante. Au début du XXIe siècle, les angoisses démographiques et culturelles entretenues par une partie des intellectuels trouvent de nouvelles assises dans la popularisation de la fantasmatique du « grand remplacement », un scénario conspirationniste qui annonce un changement de population sur le territoire français où une civilisation orientale prend peu à peu la place des « idéaux occidentaux ». La littérature a la particularité de mettre en récit des représentations et des débats précis qui circulent dans l’imaginaire social. Cette étude évalue le travail d’invention spécifique à la littérature produit dans trois romans – L’Épuisant désir de ces choses de Renaud Camus, Petit frère d’Éric Zemmour et Soumission de Michel Houellebecq – qui créent, modifient et reconfigurent cette fantasmatique. Ces textes décrivent et anticipent la fin de la Ve République telle qu’elle est aujourd’hui connue, mais de façons différentes. Pour des raisons ethniques, civiques ou métaphysiques, ils laissent entendre que désormais « la France, c’est les autres! ». / A haunting fear pervades the French social imaginary. In the early twenty-first century the demographic and cultural anxieties of certain intellectuals took root in the popularization of the "great replacement" phantasmatic ; a scenario that announced changes in the populations of French territories, a conspiracy that would lead to Eastern culture eventually replacing "occidental ideals". Literature makes it possible for representations and precise debates circulating in the social imaginary to come alive through storytelling. The present study will evaluate the invention work, specific to literature, that was produced in Renaud Camus's L’Épuisant désir de ces choses, Éric Zemmour's Petit frère and Michel Houellebecq's Soumission. The novels in question create, alter, and reconfigure, albeit in different ways, this phantasmatic, describing and anticipating the end of the Fifth Republic as it is known today. Be it for ethnic, civic, or metaphysical reasons, they suggest that, henceforth, "la France, c'est les autres!".

Mucopolysaccharidosis IIIB (MPS IIIB) is a rare, metabolic disorder that results from a deficiency in the lysosomal hydrolase, α-N-acetylglucosaminidase (Naglu). Naglu is a housekeeping enzyme involved in the degradation pathway of heparan sulfate. A deficiency in active Naglu leads to an accumulation of heparan sulfate within the lysosome, initiating a pathological cascade within the cell. Patients with MPS IIIB experience progressive central nervous system degeneration and die within the first few decades of life. Presently, enzyme replacement therapy, which is a standard of care for other lysosomal storage disorders, is an ineffective treatment for MPS IIIB. This is due to impermeability of the blood-brain barrier (BBB) to exogenous recombinant enzymes. A promising approach to this therapeutic obstacle is protein transduction domains. Protein transduction domains have been shown to facilitate the delivery of active enzyme across the BBB in mice. Previously, our laboratory used Spodoptera frugiperda (Sf9) insect cell system to express human recombinant Naglu fused to a synthetic protein transduction domain (PTD4). The purpose was to use PTD4 to the facilitate the delivery of Naglu across biological membranes, including the blood-brain barrier. However, a missing stop codon following PTD4 limited its transducibility. The stop codon was re-introduced and the improved fusion enzyme, Naglu-PTD4X, was stably expressed in Sf9 cells. The overarching goal of this project is to create a large-scale production of human recombinant Naglu that has the potential to be used to treat the neuropathology of patients with MPS IIIB. This project used a three-step purification system to purify Naglu-PTD4X. Uptake of Naglu-PTD4X was assessed in MPS IIIB fibroblasts using a fluorogenic activity assay, immunoblotting, and immunocytochemistry. Our purification system was successful at purifying Naglu-PTD4X to homogeneity with a 26% yield and specific activity of 84,000 units/mg. An increase in Naglu activity was detected in MPS IIIB fibroblasts following incubation with Naglu-PTD4X. Future directions will focus on optimizing immunodetection and conducting BBB penetration studies in murine models. / Graduate / 2020-06-21

Resultatet av en energikartläggning på tryckeriet VK - Media visade det sig att en stor del av energin gick till den gamla belysningen. Den gamla belysningen med högtrycksnatriumarmaturer och högtrycksnatriumljuskällor byttes då ut mot en ny energieffektiv belysning med två olika LED-armaturer i packsalen på tryckeriet. Det ska nu utföras en utvärdering av belysningsbytet. Utvärderingen av belysningsbytet kommer att baseras på sänkningen i energianvändning, skillnader i belysningsstyrkor och förändring av arbetsmiljön.   Det främsta syftet med belysningsbytet är att sänka energianvändningen och att förbättra arbetsmiljön. Simuleringar på belysningen med högtrycksnatriumljuskällor och LED-armaturer har gjorts i DIALux evo. I DIALux gjordes beräkningar på belysningsstyrkor och energianvändning. Momentana effektmätningar med en multimeter har genomförts på belysningen före och efter bytet. För att sedan beräkna den årliga energianvändningen utifrån de uppmätta effekterna. Belysningsstyrkorna mättes med en luxmeter på plats i packsalen för att sedan beräkna medelbelysningsstyrkan och jämnheten för belysningen för att se om de står sig mot riktvärdena och jämföra dem med värdena från DIALux. Livscykelkostnaden beräknades för belysningen med högtrycksnatriumljuskällor och för belysningen med LED-armaturer. För den nya belysningen beräknades även paybacktiden.   Resultatet av beräkningar på energianvändningen visar att den årliga energianvändningen kommer att sänkas med 70 procent i och med bytet till LED-armaturer. Vid ett belysningsbyte är målet att den årliga energianvändningen ska sänkas med 50 procent. Medelbelysningsstyrkan för den nya LED-belysningen på cirka 680 lx möter kravet för medelbelysningsstyrkan på 300 lx som gäller för packsalen enligt standarden SS-EN 12464-1:2011. Livscykelkostnaden för den gamla belysningen och den nya LED-belysningen beräknades till ungefär 990 000 kronor respektive 330 000 kronor. Den diskonterade paybacktiden för LED-belysningen beräknades till 1,7 år. Gällande arbetsmiljön så har LED-belysningen monterats på en för låg armaturhöjd och kommer att höjas upp för att uppnå en behagligare arbetsmiljö.   Att investera i en ny energieffektiv belysning innebär en stor sänkning av den årliga energianvändningen samtidigt som investeringen har en relativt kort återbetalningstid. Det finns många fördelar med att byta ut den gamla belysningen som en förbättrad arbetsmiljö och sänkta kostnader. Förhoppningsvis kommer fler industrier att byta ut sin gamla belysning till energieffektiv belysning då de står för en stor del av den totala elanvändningen som går till belysning i Sverige. / The result of an energy survey at the printing company VK – Media showed that the energy use of the old lighting was a large part of the total energy use. The old lighting with high-pressure sodium luminaires and high-pressure sodium light sources was then replaced with a new energy-efficient lighting with two different LED luminaires in the packaging room at the printing company. An evaluation of the replacement of the luminaires should now be carried out. The evaluation of the lighting change is based on the reduction of energy use, differences of illuminance and changes in the working environment.   The primary aim of the lighting replacement is to reduce the energy use and to improve the working environment. Simulations on the lighting with high-pressure sodium light sources and LED luminaires have been made in DIALux evo. In DIALux, calculations were made on illuminance and energy use. Momentary power measurements with a multimeter have been carried out on the lighting before and after the replacement. The measured power was then used to calculate the annual energy use for the luminaires. The illuminance were measured with a luxmeter in the packing room and the measured values was then used to calculate the average illuminance and the uniformity of the lighting, to see if they stand against the guideline values and compare them with the values from DIALux. The life cycle cost was calculated for the lighting with high pressure sodium light sources and for the lighting with LED luminaires. The payback time was also calculated for the new lighting with LED luminaires.   The result of the calculations on the energy use showed that the annual energy use will be reduced by 70 per cent with the LED luminaires and the aim with a lighting replacement is to reduce the annual energy use by 50 percent. The average illuminance of the new LED lighting is about 680 lx meets the requirement for the average illuminance of 300 lx that applies to the packing room according to the standard SS-EN 12464-1: 2011. The life cycle cost of the old lighting and the new LED lighting was estimated at approximately 990,000 SEK and 330,000 SEK, respectively. The discounted payback time for the LED lighting was estimated at 1.7 years. Regarding the working environment, the LED lighting has been mounted at a luminaire height that is too low and will be raised to achieve a more comfortable working environment.   Investing in a new energy-efficient lighting means a large reduction in annual energy use, while the investment has a relatively short repayment period. There are many advantages to replacing the old lighting such as an improved work environment and reduced costs for the company. Hopefully, more industries will replace their old lighting for energy-efficient lighting as they account for a large part of the total electricity use when it comes to lighting in Sweden.