Phenomenological material models such as Johnson-Cook plasticity are often used in finite element simulations of large deformation processes at different strain rates and temperatures. Since the material constants that appear in such models depend on the material, experimental data, fitting method, as well as the mathematical representation of strain rate and temperature effects, the predicted material behavior is subject to uncertainty. In this dissertation, evidence theory is used for modeling uncertainty in the material constants, which is represented by separate belief structures that are combined into a joint belief structure and propagated using impact loading simulation of structures. Yager’s rule is used for combining evidence obtained from more than one source. Uncertainty is quantified using belief, plausibility, and plausibility-decision functions. An evidence-based design optimization (EBDO) approach is presented where the nondeterministic response functions are expressed using evidential reasoning. The EBDO approach accommodates field material uncertainty in addition to the embedded uncertainty in the material constants. This approach is applied to EBDO of an externally stiffened circular tube under axial impact load with and without consideration of material field uncertainty caused by spatial variation of material uncertainties due to manufacturing effects. Surrogate models are developed for approximation of structural response functions and uncertainty propagation. The EBDO example problem is solved using genetic algorithms. The uncertainty modeling and EBDO results are presented and discussed.

Vid långt gången nedsättning av njurfunktionen uppstår ett förgiftningsliknande symtom vilket innebär att kroppen inte kan göra sig av med dess slaggprodukter i vanlig omfattning. För att behandla tillståndet är dialysbehandling ett alternativ. Peritonealdialys är en av de dialysformer som allmänsjuksköterskan mer sällan kommer i kontakt på grund av att behandlingen inte är bunden till sjukhusmiljö och därför vanligtvis utförs av patienten själv i hemmiljö. Byte av dialysvätska sker flera gånger under dygnet med ett antal timmar emellan bytena. Syftet var att undersöka peritonealdialys inverkan på patientens sömn. Metoden som valdes var en litteraturstudie där materialinhämtning skedde via veteskapliga databaser. Resultat tio artiklar valdes ut och bearbetades. Under bearbetningen kom det fram fyra övergripande teman. Patienter med peritonealdialys och sömnpåverkan har följande problem: Uppvaknande under sömn, försämrad sömn, insomningsbesvär och sömnapné. / At long time advanced renal dysfunction occurs a poisoning symptom which means that the body can´t eliminate it´s waste products. One option for treating the condition are dialysis. Peritonealdialysis is one of the forms of dialysis a general nurse less frequently are in contact with. The treatment is not bound to a hospital and therefore normally preformed by the patient at home. The exchanges of dialysis fluid takes place several times throughout the day with a number of hours between the exchanges. The aim was to investigate peritonealdialysis effects on the patient's sleep. The method chosen was a literature study with materials from scientific databases. The Results of ten articles were selected and processed. During the process, four broad themes came up. Patients with peritoneal dialysis and sleep impact has the following problems: Awakening during sleep, impaired sleep, insomnia and sleep apnea.

No description available.

京都大学 / 新制・課程博士 / 博士(経済学) / 甲第24381号 / 経博第668号 / 新制||経||303(附属図書館) / 京都大学大学院経済学研究科経済学専攻 / (主査)教授 関口 格, 教授 原 千秋, 教授 NEWTON Jonathan Charles Scott / 学位規則第4条第1項該当 / Doctor of Economics / Kyoto University / DGAM

Background Vancomycin dosing strategies targeting trough concentrations of 15–20 mg/L are no longer supported due to lack of efficacy evidence and increased risk of nephrotoxicity. Area-under-the-curve (AUC24) nomograms have demonstrated adequate attainment of AUC24 goals ≥ 400 mg h/L with more conservative troughs (10–15 mg/L). Objective The purpose of this study is to clinically validate a vancomycin AUC24 dosing nomogram compared to conventional dosing methods with regards to therapeutic failure and rates of acute kidney injury. Setting This study was conducted at a tertiary, community, teaching hospital in the United States. Method This retrospective, cohort study compared the rates of therapeutic failures between AUC24-extrapolated dosing and conventional dosing methods. Main outcome measure Primary outcome was treatment failure, defined as all-cause mortality within 30 days, persistent positive methicillin-resistant Staphylococcus aureus blood culture, or clinical failure. Rates of acute kidney injury in non-dialysis patients was a secondary endpoint. Results There were 96 participants in the extrapolated-AUC24 cohort and 60 participants in the conventional cohort. Baseline characteristics were similar between cohorts. Failure rates were 11.5% (11/96) in the extrapolated-AUC24 group compared to 18.3% (11/60) in the conventional group (p = 0.245). Reasons for failure were 6 deaths and 5 clinical failures in the extrapolated-AUC24 cohort and 10 deaths and 1 clinical failure in the conventional group. Acute kidney injury rates were 2.7% (2/73) and 16.4% (9/55) in the extrapolated-AUC24 and conventional cohorts, respectively (p = 0.009). Conclusion Extrapolated-AUC24 dosing was associated with less nephrotoxicity without an increase in treatment failures for bloodstream infections compared to conventional dosing. Further investigation is warranted to determine the relationship between extrapolated-AUC24 dosing and clinical failures.

No description available.

Bakgrund: På vägen från novis till kompetent sjuksköterska finns det många faktorer som påverkartransitionen. Detta beror på att det finns ett tydligt glapp mellan teori och praktik förnyutexaminerade sjuksköterskor, vilket leder till att känslan av att vara redo inför denprofessionella yrkesrollen saknas när det efter examen är dags att börja arbeta somsjuksköterska. Genom att stötta de nyutexaminerade sjuksköterskorna under transitionenfrån novis till kompetent kan man förutom att ge de novisa sjuksköterskorna bättreförutsättningar för att lyckas i yrkesrollen, även främja patientsäkerheten. Syfte: Syftet var att beskriva vad som påverkar den nyutexaminerade sjuksköterskans transitionfrån novis till kompetent i sjukhusmiljö. Metod: Arbetets metod var en icke-systematisk litteraturöversikt. Datainsamlingen utfördes genomdatabassökningar i CINAHL och PubMed och totalt 15 vetenskapliga artiklar inkluderadesi resultatet. Samtliga inkluderade artiklar granskades utifrån Sophiahemmet högskolasbedömningsunderlag för vetenskaplig klassificering avseende studier med kvantitativ ochkvalitativ metodansats. Dataanalysen skedde genom en integrerad analysmetod där deinkluderade artiklarnas resultatdel jämfördes och kategorier togs fram. Resultat: Resultatet visade att det fanns fyra huvudkategorier vilka beskriver hur man kundeunderlätta transitionen från novis till kompetent sjuksköterska i sjukhusmiljö. Kategoriernavar utvecklande och hämmande faktorer, simulationsövningar, kliniska stödprogram ochhandledning. Slutsats: Utvecklande och hämmande faktorer påverkade transitionen till kompetent sjuksköterska.Kliniska stödprogram visade sig vara en stor tillgång för de nyutexamineradesjuksköterskorna. Det kan vara rimligt att öka antalet platser på dessa program som finns ilandet för att alla ska få de bästa förutsättningarna att utvecklas inom yrkesrollen. Ävensimulationsövningar hade en positiv inverkan på de novisa sjuksköterskornaskompetensutveckling. Handledning är också en tillgång men kan däremot behövautvecklas för att uppnå sin fulla potential som stöd i de novisa sjuksköterskornaskompetensutveckling. / Background Many factors affect the transition from novice to competent nurse. This is because there isa gap between theory and practice which leads to a feeling of being unprepared for theprofessional role. By supporting newly graduated nurses during their transition fromnovice to competent nurse, it is possible to give them better conditions to develop theirskills and promote patient safety. Aim The aim was to describe what affects the newly graduated nurse's transition from novice tocompetent in a hospital environment. Method This was a non-systematic literature review. Data collection was performed throughdatabase searches in CINAHL and PubMed. A total of 15 scientific articles were includedin the results. Included articles were reviewed on the basis of Sophiahemmet University'sassessment for scientific classification for quantitative and qualitative method approaches.An integrated data analysis was used where the results part of the included articles wascompared to form categories. Results Four main categories described how to facilitate the transition from novice to competentnurse in a hospital environment. The categories were: developing and inhibiting factors,simulation practice, clinical support programs and preceptorship. Conclusions Developing and inhibiting factors influenced the transition to a competent nurse. Clinicalsupport programs proved to be a great asset for the newly graduated nurses. It may bereasonable to increase the number of places on these programs available in the country sothat everyone has the best conditions to develop in the professional role. Simulationpractice also had a positive impact on their competence development. Preceptorship is alsoan asset but needs to be developed to achieve its full potential as support in the novicenurses' competence development.

In Dylan Thomas's poetry, he refers to an inexorable, amoral force that exists within the universe. This force exists in all things, yet cannot be manipulated. His first collection, 18 Poems, serves as the premier source for defining and understanding the existence of this force. Two poems in particular, "A Process in the Weather of the Heart" and "The Force that Through the Green Fuse Drives the Flower," provide the most comprehensive examination of the force. However, his idea of the force is not confined to his poetry. During the last years of his life, he completed a play titled Under Mile Wood, which explores the treatment of the force. Within the play Thomas presents life as it exists in the small, seaside town of Llareggub. The town and its inhabitants are subject to the force, which results in the characters' unique eccentricities.

<p>As the economy recovered with the winding down of the pandemic, businesses with complex supply chains could not bring their inventories back to optimal levels as their production was susceptible to disruption due to supply outages. Deriving optimal ordering policies as a way to mitigate the impact of production disruption represents a challenge in multi-stage decision problems given the complexity of the network and the uncertainty in the demand.</p> <p><br></p> <p>In the first part of the thesis, we formulate a stochastic inventory control problem for a general supply network model. Using the Bellman’s recursion and properties of the cost function at each stage, we characterize the optimal request decision as a threshold policy where the threshold computation is based on the marginal cost. Lastly, we validate that the policy developed minimizes the inventory cost and meets an exogenous random demand. However, the policy does not guarantee that the inventory level for each firm satisfies the constraints when a supply disruption occurs in the network.</p> <p><br></p> <p>In the second part of the thesis, we consider a serial network in which firms engage in production subject to disruption risk and they look to maximize their profit. We propose an algorithm to characterize a stationary optimal policy based on the closed-form solutions obtained from a discounted finite horizon problem for profit maximization. Finally, by computing the policy proposed as a function of the tier’s location and its disruption probability, we provide simulation results of the disruption effect in the supply network.</p>

Due to the lack of research on White teacher racial identity development and White graduates of alternative teacher education programs teaching in urban under-resourced schools, this study aimed to: examine how White graduates of alternative teacher education programs perceive race and racism in their urban under-resourced schools, explore the impact of their alternative teacher education programs on their racial identities, and evaluate their abilities to deepen their racial identities in the context of their urban under-resourced schools. Critical examination and analysis of the experiences of White teachers, through the lenses of Critical Race Theory, Critical White Studies, and Howard’s Racial Identity Development Model, provided insights on how quickly expanding alternative teacher education programs across the nation are failing to adequately and critically address White teachers’ racial identity development. Well-intentioned participants recognized a noticeable racial mismatch, did not perceive race or racism in their urban under-resourced schools, lacked exposure to critical coursework, felt unprepared to work with racially dissimilar students, faced difficulties processing their experiences, and showed minimal evidence of having well developed racial identities. Alternative teacher education programs are recommended to prioritize race issues and racial identity development by providing opportunities for White educators to perceive race, adequately preparing and supporting White teachers, and implementing Howard’s (2006) Racial Identity Development Model.