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Integration der Ganzkörper-Computertomographie in einen modernen Schockraumalgorithmus - Auswirkung auf den Zeitpunkt der frühen operativen Versorgung und das klinische Outcome polytraumatisierter Patienten / Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple traumaQuaisser, Constanze January 2010 (has links) (PDF)
Ein Zeitgewinn in der frühen klinischen Versorgung polytraumatisierter Patienten ist nach wie vor eines der vorrangigen Ziele moderner Schockraumalgorithmen. Insbesondere Patienten, die unmittelbar im Anschluss an die primäre klinische Versorgung operativ versorgt werden müssen, könnten von einer verkürzten Zeit bis zum Beginn des operativen Eingriffes profitieren. Die Primärdiagnostik mittels Ganzkörper-MSCT hat in den letzten Jahren zunehmend an Bedeutung in der Schockraumversorgung polytraumatisierter Patienten gewonnen. Ihr entscheidender Vorteil könnte insbesondere die Zeitersparnis durch den schnelleren diagnostischen Arbeitsablauf im Rahmen eines MSCT-gestützten Schockraumalgorithmus sein. Bisherige Studien berichteten über deutliche Zeitgewinne im Vergleich zur konventionellen Röntgendiagnostik. Es wird aber weiterhin diskutiert, welches Verfahren als „golden standard“ gilt, insbesondere welches Verfahren das klinische Outcome polytraumatisierter Patienten verbessern kann. In der vorliegenden Studie wurde daher ein Vergleich zwischen einem konventionellen Schockraumalgorithmus mit konventioneller Röntgendiagnostik, Sonographie und organfokussiertem CT sowie einem modernen Schockraumalgorithmus mit fester Integration der Ganzkörper-MSCT gezogen. Es wurde die Hypothese untersucht, ob die MSCT eine signifikante Zeitersparnis in der Schockraumversorgung polytraumatisierter Patienten bis zum Beginn dringlicher operativer Eingriffe bringt und ob dieser Zeitgewinn eine Verbesserung des klinischen Outcome bedeutet. In der vorliegenden retrospektiven Studie wurden im Zeitraum von 2001-2007 zwei Gruppen von Schockraumpatienten erfasst: In Gruppe I wurden 155 Patienten von 2001-2003 eingeschlossen, die nach dem konventionellen Schockraumalgorithmus behandelt wurden. In Gruppe II wurden von 2004-2007 163 polytraumatisierte Patienten eingeschlossen, die primär im Rahmen eines MSCT-gestützten Schockraumalgorithmus versorgt wurden. Bei allen Patienten wurden die tOR als Zeitintervall zwischen Beginn der Schockraumversorgung und Beginn des operativen Eingriffes sowie demographische und klinische Daten erfasst. Das klinische Outcome wurde mittels der Intensivliegezeit, der Beatmungsdauer und der Mortalität untersucht. Bei dem Vergleich der Gruppen wurde als nicht-parametrischer Test der Man-Whitney-Rank Sum Test verwendet, mit p<0.05 als Signifikanzniveau. Die tOR in Gruppe I war 120 Minuten (Interquartilabstand 90-150 Minuten), während sie in Gruppe II 105 Minuten (85-133 Minuten) betrug (p<0.05). In beiden Gruppen starben insgesamt vierzehn Patienten, davon fünf in den ersten vierundzwanzig Stunden. Die Intensivliegezeit betrug in Gruppe I fünf Tage (Interquartilabstand 1-14), in Gruppe II acht Tage (Interquartilabstand 2-19), p=0,157. In Gruppe I wurden die Patienten drei Tage (Interquartilabstand 1-12) maschinell beatmet, in Gruppe II fünf Tage (Interquartilabstand 1-15). Zusammenfassend kann gesagt werden, dass die Einführung der MSCT als primäre Schockraumdiagnostik die tOR, also das Zeitintervall bis zum Beginn dringlicher operativer Eingriffe verkürzt. Diese Aussage passt zur vorherrschenden Meinung in der aktuellen Literatur. Das Outcome konnte im Gegensatz zu anderen Studien nicht verbessert werden. Es ist davon auszugehen, dass einen Hauptgrund hierfür ein signifikant höherer ISS-Wert in der Gruppe II darstellt. Für eine definitive Aussage über eine mögliche Verbesserung des klinischen Outcome durch die MSCT als Primärdiagnostik im Schockraum sind weitere Untersuchungen an einem größeren Patientenkollektiv über einen längeren Zeitraum erforderlich. / Objectives Whole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome. Methods The authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006. Results tOR in group I (n=155) was 120 (90-150) min (median and IQR) and 105 (85-133) min (median and IQR) in group II (n=163), respectively (p<0.05). Patients of group II had significantly more serious injuries. No difference in outcome data was found. 14 patients died in both groups within the first 30 days; five of these died within the first 24 h. Conclusion A whole-body MSCT-based diagnostic approach to multiple trauma shortens the time interval to start emergency surgery in patients with multiple injuries. Mortality remained unchanged in both groups. Patients of group II were more seriously injured; an improvement of outcome might be assumed.
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Växande geometriska mönster i skolan : En studie om undervisningsmetoder, svårigheter och utveckling. / Growing geometric patterns in school : A study of teaching methods, difficulties and development.Lindeberg, Ludvig January 2019 (has links)
Studien försöker bidra med kunskap om hur lärare, med fokus på årskurs 4-6, arbetar med växande geometriska mönster i skolan. Avsikten med studien är att bidra med kunskap om vilka metoder lärare använder, vilka svårigheter de upplever med undervisningen samt hur de tror att undervisningen kan utvecklas. Då det anses att växande geometriska mönster är en ingång för elever att gå från ett rekursivt till ett algebraiskt tänkande ingår det som en del i kursplanen för matematikämnet. Inom forskningsfältet finns det två skilda teorier om hur undervisning om växande geometriska mönster ska bedrivas, nämligen hierarkisk- eller dynamisk undervisning. Studien undersöker på ett kvalitativt sätt ovan nämnda teorier. Studien använder fenomenologin som teoretisk utgångspunkt för att förstå det komplexa fenomenet undervisning. Semistrukturerade intervjuer har genomförts med fyra grundskolelärare i Västsverige. De data som insamlats från intervjuerna har analyserats ett flertal gånger enligt den hermeneutiska spiralen. Det för att säkerställa att resultatet blir vetenskapligt trovärdigt. Studien fann att lärare föredrar att arbeta praktiskt med växande geometriska mönster, bland annat genom metoden ”mattemaskinen” och genom att skapa egna mönster med praktiskt material. Vidare fann studien att lärare har svårt att undervisa elever om hur de ska skriva en formel till ett givet mönster, då lärarna upplever att elever ofta har svårt att ens förstå hur de ska ta sig an uppgiften. Det framkom även att läromedlet spelar en stor roll för hur mycket tid det matematiska området får i undervisningen. För att undervisningen om växande geometriska mönster ska kunna förbättras menar lärarna att de behöver mer utbildning om hur undervisningen ska bedrivas, framförallt när det kommer till att undervisa om formelskapandet. Lärarna anser att det matematiska området borde uppmuntras mer av Skolverket. / This study investigates how teachers work with growing geometric patterns, with a focus on students aged 10-12 in the west of Sweden. Specifically, it uncovers what methods teachers use and the difficulties they experience when teaching growing geometrical patterns, as well as outlining how they believe teaching in this subject can be developed. Teaching growing geometrical patterns is part of the Swedish curriculum, because it is seen as a pathway to algebra. Current research says that there are two main theories on teaching growing geometrical pattern, hierarchically or dynamically. This study takes a qualitative approach to investigate these theories further. It uses phenomenology as a theoretical framework, as a way to understand the complex phenomenon of teaching. Semi-structured interviews were conducted with four primary school teachers in Sweden. The data gained from these interviews was analysed multiple times using the hermeneutical spiral, to ensure scientific rigour. The findings demonstrate that teachers prefer using hands on methods when teaching growing geometrical patterns to students, such as a method called the “math machine” and using real objects to create patterns. However, they experience difficulties when instructing students how to turn the pattern into a formula, as students often find this progression difficult to grasp. Additionally, the teachers explained that study material has a big impact on how much time teaching growing geometrical patterns is allocated in the classroom, as most of them will only teach this topic if it is covered in the textbook. For the teaching to improve, teachers need more resources regarding how to teach growing geometrical patterns, particularly when it comes to developing formula, and the teaching of the topic needs to be further promoted by the Swedish National Agency for Education.
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Contribuição ao estabelecimento do comprimento desejável da espiral de transição em rodovias rurais e urbanas. / Contribution to the establishment of the desirable length of the spiral transition in highways and streets.Arakawa, Maki 21 November 2012 (has links)
A curva de transição apresenta um raio de curvatura variando de um valor infinito no fim da tangente até um valor igual ao raio da curva circular no final da curva de transição. Nos projetos rodoviários, o tipo de curva mais utilizado é a clotóide, pois esta corresponde à trajetória descrita pelo veículo, com uma velocidade constante e o volante girando com velocidade angular constante. Consequentemente, é uma situação em que não requer esforço do motorista, proporciona uma trajetória mais natural e um aumento/redução da aceleração radial de um veículo de forma gradual. O presente trabalho admite que o comprimento desejável da espiral de transição em rodovias rurais e urbanas, baseado na recomendação da AASHTO (2011), é igual à distância correspondente a um tempo de percurso de 2 segundos ao longo da via à velocidade de projeto. É recomendável que o comprimento considerado como desejável seja suficiente para se realizar a transição da superelevação, e por outro lado, deve ser menor que o comprimento crítico de hidroplanagem, ou seja, comprimento a partir do qual o veículo passa a perder contato do pneu/pavimento em uma pista coberta com lâmina dágua, a uma velocidade crítica. Visto que os manuais brasileiros não introduzem a hidroplanagem como um dos fatores considerados para estabelecer estes comprimentos, pretende-se desenvolver uma ferramenta de trabalho que auxilia na determinação do comprimento desejável da espiral de transição, possibilitando uma análise do risco de ocorrência do fenômeno da hidroplanagem. No estudo de caso, são calculados comprimentos da espiral de transição de três curvas, onde serão feitas também simulações com diferentes parâmetros para analisar as situações críticas de hidroplanagem. Os resultados obtidos demonstram que comprimentos muito longos da espiral de transição, combinado com uma declividade longitudinal muito baixa pode aumentar o risco de hidroplanagem. / The transition curve has a radius of curvature varying from infinity at the end of the tangent to a value equal to the radius of the circular arc at the end of the transition curve. In highway design, clothoid is the most commonly used spiral type because it corresponds to the path described by the vehicle, with a constant speed and the less need for steering. Consequently, it\'s a situation that doesn\'t require driver effort, providing a more natural path and a gradual increase / reduction of the centrifugal force of a vehicle. Based on AASHTO (2011)\'s recommendation, this study establishes that the desired length of the spiral transition in highways and streets is equal to the distance traveled in 2 seconds in the design speed. It\'s recommended that the spiral length considered as desirable is sufficient to perform the superelevation runoff and on the other hand, should be shorter than the critical length of hydroplaning, in other words, it\'s a phenomenon caused by the increase of the water film above the contact pressure of tire and road. Since the manuals do not introduce hydroplaning as one of the criteria considered in establishing these lengths, a tool will be developed to define the desirable spiral length, allowing an analysis of the risk of hydroplaning. In the study, the lengths of three spiral transition curves are calculated; furthermore simulations with different parameters of these three curves are also calculated to analyze critical situations of hydroplaning. The results demonstrate that longer lengths of spiral transition combined with lower grades may increase the risk of hydroplaning.
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Análise temporal da antena espiral equiangular filamentar. / Transient analysis of the thin-wire equiangular spiral antenna.Freitas, Renata Valerio de 19 December 2016 (has links)
Por conta da liberação de uma nova faixa de espectro as aplicações que utilizam transmissão em banda ultralarga se expandiram. Por conta disso, várias formas de transmissão pulsada ganharam destaque. Contudo, o projeto e estudo de antenas até então era majoritariamente feito em banda estreita e regime permanente senoidal. Além disso, para transmissão pulsada, a resposta impulsiva da antena passa a ser mais necessária do que sua resposta em banda estreita. Por isso, o objetivo desse estudo foi explorar o que ocorre com pulsos estreitos se propagando em uma antena de forma a se obter uma aproximação da resposta impulsiva de antenas. Mais especificamente, foi obtido um modelo analítico que explicita a relação entre a geometria e o funcionamento da antena. Através do estudo da espiral equiangular foi possível encontrar o decaimento do pulso de corrente ao longo da linha como também o campo radiado de forma quantitativa. Tal resultado, assim como os procedimentos para sua obtenção, poderá ser utilizado para outras antena filamentares. / The applications for Ultra Wide Band have grown since the new regulation allowed the use of a new large frequency band. Since then, systems for pulsed transmission entered the spotlight. However, the antenna\'s project and study were in big part done in narrowband and sinusoidal steady-state. Besides, the impulse response is of much more interest for these systems than the frequency response. For this reason, the main goal of this work is to explore how current pulses propagate on the antenna to obtain an approximate impulse response. Moreover, an analytical model that unveils the relation between the antenna geometry and its current decay is presented. Through the study of the equiangular spiral it is possible to find the pulse decay as a function of the line length and the radiated field in a quantitative fashion. This result as well as the methods used to obtain it can be used for other antennas.
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Stellar spiral structures in realistic dark matter haloesHu, Shaoran January 2017 (has links)
In this Thesis, I explore the formation and evolution of stellar spiral structures embedded in realistic dark matter haloes with very high resolution simulations. I first study the impact of the shape of the dark matter haloes. I find that non-adiabatic changes to the dark matter halo shape, commonly found in cosmological simulations due to the assembly history of haloes, can trigger strong two-armed grand-design spiral structures extending from the inner disc to the outer region. The nature of the spiral structures is found to be consistent with kinematic density waves based on the study of their power spectra. Such grand-design spiral structures may help the formation of transient multi-armed spiral structures if the self-gravity in disc is strong enough. Evolution of spiral structures is similar when the disc and the halo are misaligned, although warps develop additionally. I further find a strong correlation between the torque strength from the halo and the strength of the corresponding spiral structures. In the second part of my Thesis I then study the influence of subhaloes by including them from realistic cosmological simulations. I identify five different massive subhaloes that hit the central region of the disc, two out of which hit the disc twice. Aside from disc heating, three distinct generations of spiral structures are found in the stellar disc, which can be related to different subhaloes. For each generation, counter-rotating single-armed spiral structures develop first. They wind up very quickly before two-armed spiral structures become prominent. These spiral structures are again identified as kinematic density waves. We find that rather than interacting with the disc through resonances, subhaloes preferentially trigger spiral structures impulsively, due to their relatively short impact time with the disc. The strength of spiral structures can be related to the integrated strength of the torque generated by subhaloes. The correlation between the torque strength exerted by a triaxial dark matter halo and by subhaloes and the spiral strength may provide constraints on the distribution of dark matter.
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Análise temporal da antena espiral equiangular filamentar. / Transient analysis of the thin-wire equiangular spiral antenna.Renata Valerio de Freitas 19 December 2016 (has links)
Por conta da liberação de uma nova faixa de espectro as aplicações que utilizam transmissão em banda ultralarga se expandiram. Por conta disso, várias formas de transmissão pulsada ganharam destaque. Contudo, o projeto e estudo de antenas até então era majoritariamente feito em banda estreita e regime permanente senoidal. Além disso, para transmissão pulsada, a resposta impulsiva da antena passa a ser mais necessária do que sua resposta em banda estreita. Por isso, o objetivo desse estudo foi explorar o que ocorre com pulsos estreitos se propagando em uma antena de forma a se obter uma aproximação da resposta impulsiva de antenas. Mais especificamente, foi obtido um modelo analítico que explicita a relação entre a geometria e o funcionamento da antena. Através do estudo da espiral equiangular foi possível encontrar o decaimento do pulso de corrente ao longo da linha como também o campo radiado de forma quantitativa. Tal resultado, assim como os procedimentos para sua obtenção, poderá ser utilizado para outras antena filamentares. / The applications for Ultra Wide Band have grown since the new regulation allowed the use of a new large frequency band. Since then, systems for pulsed transmission entered the spotlight. However, the antenna\'s project and study were in big part done in narrowband and sinusoidal steady-state. Besides, the impulse response is of much more interest for these systems than the frequency response. For this reason, the main goal of this work is to explore how current pulses propagate on the antenna to obtain an approximate impulse response. Moreover, an analytical model that unveils the relation between the antenna geometry and its current decay is presented. Through the study of the equiangular spiral it is possible to find the pulse decay as a function of the line length and the radiated field in a quantitative fashion. This result as well as the methods used to obtain it can be used for other antennas.
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Corrosion Assessment of Mechanically Formed Aluminized SteelAkhoondan, Mersedeh 01 November 2007 (has links)
Ribbed steel pipes made of Type 2 aluminized steel are commonly used for culvert pipes for highway drainage. Typically aluminized steel pipes have shown good durability and are expected to have long service life, e.g. 75 years; also, they are used in a wide variety of soil and water conditions. However, early corrosion of aluminized steel pipes has been recently observed in some inland locations. Initial observations showed severe corrosion in forms of pits, both along the ribs and at the nearby flat portions of the pipes. It is critical to determine the cause of early deterioration and establish methods of durability prediction. The possibility of unusual environmental conditions is being investigated elsewhere, but this research focuses on possible mechanical factors aggravating corrosion, since it is prevalent near pipe rib deformations. While forming the rib bends in the pipe, the outer bend surface is exposed to extreme tensile stresses which would cause small coating cracks (microfissures) exposing base metal. Those may lead to early corrosion as galvanic protection from the surrounding aluminum may not be sufficient under certain environments.
Electrochemical impedance spectroscopy was used to measure corrosion rate of both formed and flat aluminized steel samples in simulated natural waters. Initial findings show that specimens formed by spherical indentation were susceptible to early corrosion development in moderately aggressive simulated natural water, but not in a more benign, precipitating simulated natural water solution.
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Design And Characterization Of Multi-Layer Coplanar Waveguid Baluns And InductorsObeidat, Khaled 01 July 2003 (has links)
This work examined the design and characterization of multilayer coplanar waveguide baluns and inductors. This work derives a design procedure that helps RF engineers design cost effective multilayer coplanar waveguide (CPW) spiral balun that works in the frequency range 1-8 GHz. The accuracy of the developed procedure has been proven by designing two balun circuits of different dimensions and simulating them using available commercial software, Momentum (MoM) and Empire (FDTD). The simulation results have shown good balun performance over the desired frequency range. Furthermore some of the designed balun circuits have been fabricated and measured and the results agree with the simulations. The smaller balun (2.4 mm x 1.4 mm) with a minimum spacing of 25mm works very good in the frequency range 4-8 GHz with a 4 GHz operational bandwidth (OBW) and 5o phase difference and 0.5 dB amplitude imbalance. The larger balun (5.6mm x 3.0 mm) with minimum spacing of 100mm works well in the frequency range 2-4 GHz with a 2 GHz operational bandwidth (OBW) and 10o phase difference and 0.5 dB amplitude imbalance. Such a large-size balun is suitable for a new fabrication technique called Direct-Write.
This thesis focuses on techniques that can be used to enhance balun performance, it has been shown through this work that adding some capacitance at certain points in the balun circuit will decrease both the phase difference and the amplitude imbalance of the balun. Some of these techniques were discovered through the thesis work and the other techniques were used before, but for different balun structures.
An additional study to the effect of the ground plane on the spiral inductor model is included herein. Formulas for the inductance nominal value in the existing CPW ground plane for some spiral inductors are derived here, in addition to the derivation of an RF spiral inductor model that is independent of the ground plane. The importance of this model lies in its necessity in designing an antenna dipole loaded with lumped elements (in the absence of ground plane) to control the antenna electrical length without changing its physical length.
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The impact of internal and external responses on human rights practices in China: the Chinese government and the spiral modelFleay, Caroline January 2005 (has links)
This thesis assesses the usefulness of the five phase spiral model as an explanation of the changes in the Chinese government's human rights practices from the time of the "antirightist" campaign in 1957-58 to the end of 2003. Thomas Risse, Stephen Ropp and Kathryn Sikkink's spiral model focuses on the constitutive relationship between a target state and international human rights norms by exploring the influence of a transnational network promoting these norms on the human rights practices of the target state. The thesis concludes that the spiral model has provided a valid explanation for many of the changes in the Chinese government's human rights practices, and its responses to its internal and external critics, from 1957 to 2003. Many of the responses of the transnational human rights network and the Chinese government by the end of this period indicate that the latter had progressed to phase three of the model. Some aspects of the Chinese government's practices and relationships with its more powerful state critics can be better explained by the alternative explanations examined here, neorealism and modernisation theories. However, constructivist approaches, and in particular the spiral model, are more effective in explaining the developing pattern of communication about the validity of human rights norms. This thesis also concludes that the spiral model only conceptualises part of the constitutive relationship between the target state and international human rights norms - the influence of these norms on the identities, interests and behaviours of a target state. / It does not conceptualise the influence of a target state on international human rights norms or the transnational human rights network. Therefore, the spiral model cannot explain why the Chinese government has had such a significant influence over the enforcement mechanisms of these norms. An explanation for this is found instead by combining elements of neorealism and constructivism.
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Antennes à très large bande passante et de très faible épaisseur - Application à l'intégration d'antennes dans des structures de porteurs dans la bande 100MHz-1GHzSchreider, Ludovic January 2006 (has links) (PDF)
Un des enjeux majeurs dans l'intégration de nouveaux systèmes de guerre électronique (GE) dans les avions d'armes est notamment la réduction de l'encombrement des antennes. En GE, La bande passante des antennes peut être de l'ordre de la décade et la fréquence basse peut être voisine de la centaine de MHz, ce qui rend l'intégration des antennes difficile voire impossible selon les cas. Les antennes de GE font habituellement appel à des antennes dites "indépendantes de la fréquence" placées au-dessus d'une cavité absorbante. La fabrication des matériaux absorbants est à ce jour encore "artisanale" et donc onéreuse. De plus, ces matériaux sont lourds et ils ne présentent pas les mêmes caractéristiques électriques d'une fabrication à l'autre. Les travaux présentés dans ce manuscrit sont dédiés à la réalisation d'antennes à très large bande passante de très faible épaisseur et sans absorbant. Nous avons proposé et validé une nouvelle structure basée sur les matériaux à bandes interdites électromagnétiques (BIE). Le nouveau dispositif permet de remplacer les matériaux absorbants, de réduire l'épaisseur des antennes large bande et de réduire les coûts de fabrication grâce à un procédé industriel de fabrication. La nouvelle structure présente contrairement à toutes les autres structures BIE l'avantage d'être ultra large bande et compacte (de l'ordre de 1/100ième de longueur d'onde d'épaisseur). Nous avons montré l'intérêt d'utiliser un tel dispositif pour réduire l'épaisseur et améliorer les performances des antennes planaires de forme et de polarisation quelconque.
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