28 research outputs found
Methodology for profiling literature in healthcare simulation
No full textThe publications that relate to the application of simulation to healthcare have steadily increased over the years. These publications are scattered amongst various journals that belong to several subject categories, including Operational Research, Health Economics and Pharmacokinetics. The simulation techniques that are applied to the study of healthcare problems are also varied. The aim of this study is to present
a methodology for profiling literature in
healthcare simulation. In our methodology, we
have considered papers on healthcare that have been published between 1970 and 2007 in
journals with impact factors that belonging to various subject categories reporting on the application of four simulation techniques, namely, Monte Carlo Simulation, Discrete-Event Simulation, System Dynamics and Agent-Based Simulation. The methodology has the following objectives: (a) to categorise the papers under the different simulation techniques and identify the
healthcare problems that each technique is
employed to investigate; (b) to profile, within our dataset, variables such as authors, article citations, etc.; (c) to identify turning point (strategically important) papers and authors through co-citation analysis of references cited
by the papers in our dataset. The focus of the paper is on the literature profiling methodology, and not the results that have been derived through the application of this methodology. The authors hope that the methodology presented here will be used to conduct similar work in not only healthcare but also other research domains
Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study
No full textAbstract Introduction Altered levels of cerebrospinal fluid (CSF) glucose and lactate concentrations are associated with poor outcomes in acute brain injury patients. However, no data on changes in such metabolites consequently to therapeutic interventions are available. The aim of the study was to assess CSF glucose-to-lactate ratio (CGLR) changes related to therapies aimed at reducing intracranial pressure (ICP). Methods A multicentric prospective cohort study was conducted in 12 intensive care units (ICUs) from September 2017 to March 2022. Adult (> 18 years) patients admitted after an acute brain injury were included if an external ventricular drain (EVD) for intracranial pressure (ICP) monitoring was inserted within 24 h of admission. During the first 48–72 h from admission, CGLR was measured before and 2 h after any intervention aiming to reduce ICP (“intervention”). Patients with normal ICP were also sampled at the same time points and served as the “control” group. Results A total of 219 patients were included. In the intervention group (n = 115, 53%), ICP significantly decreased and CPP increased. After 2 h from the intervention, CGLR rose in both the intervention and control groups, although the magnitude was higher in the intervention than in the control group (20.2% vs 1.6%; p = 0.001). In a linear regression model adjusted for several confounders, therapies to manage ICP were independently associated with changes in CGLR. There was a weak inverse correlation between changes in ICP and CGRL in the intervention group. Conclusions In this study, CGLR significantly changed over time, regardless of the study group. However, these effects were more significant in those patients receiving interventions to reduce ICP
Improvement of the logistics system of a chemical company
No full textThe following thesis serves as one of the concluding steps towards the finalization of the Industrial Technologies Engineering bachelor’s degree at ETSEIB, UPC. It is made in collaboration with consulting firm Accenture, where the author has worked during the past two years. As a result, the purpose and scope of this work is on the upcoming improvements made possible due to the implementation of a transportation management system (TMS) by Accenture to a chemicals company referred to as Paintings & Coatings Inc. The work will follow on the explanation of how the TMS works, transportation processes implemented with it, and will focus on two main improvements, Non-Integrated sites incorporation and Data Analysis and Dashboards, made possible thanks to the effort done in a Continuous Improvement team put in place after the TMS rollout. Non-Integrated sites incorporation emphasizes on a visual basic for applications (VBA) tool, facilitated via Microsoft Excel. It was created to diminish the time non-integrated sites users had to dedicate to the manual upload of deliveries inside the TMS. Therefore, it is studied how the manual process works, and how the tool was created through to a set of VBA modules and deep understanding of the different variables that could affect each type of delivery created. As well as the improvements achieved thanks to its application. Data Analysis and Dashboards focuses on key performance indicators definition and report creation process via a business intelligence tool called Tableau. This point value comes at the possibility of studying and understanding large amounts of information compiled since the beginning of the TMS implementation, to understand the current performance of transport, data inconsistencies and future enhancements. At its end, the thesis highlights that although it is not meant to have a great environmental impact, thanks to the Data Analysis and Dashboards created, it is also possible to measure the CO2 emissions and its reduction thanks to the transportation improvements made possible with the TMS. All enhancements hereby presented, are conceivable thanks to the learnings acquired over the course of the career, such as notions on informatics, transportation, environment, and technical problems approach and solution. And thanks to more specific learnings on transportation systems, study case and study company acquired during the work on this project
Improvement of the logistics system of a chemical company
No full textThe following thesis serves as one of the concluding steps towards the finalization of the Industrial Technologies Engineering bachelor’s degree at ETSEIB, UPC. It is made in collaboration with consulting firm Accenture, where the author has worked during the past two years. As a result, the purpose and scope of this work is on the upcoming improvements made possible due to the implementation of a transportation management system (TMS) by Accenture to a chemicals company referred to as Paintings & Coatings Inc. The work will follow on the explanation of how the TMS works, transportation processes implemented with it, and will focus on two main improvements, Non-Integrated sites incorporation and Data Analysis and Dashboards, made possible thanks to the effort done in a Continuous Improvement team put in place after the TMS rollout. Non-Integrated sites incorporation emphasizes on a visual basic for applications (VBA) tool, facilitated via Microsoft Excel. It was created to diminish the time non-integrated sites users had to dedicate to the manual upload of deliveries inside the TMS. Therefore, it is studied how the manual process works, and how the tool was created through to a set of VBA modules and deep understanding of the different variables that could affect each type of delivery created. As well as the improvements achieved thanks to its application. Data Analysis and Dashboards focuses on key performance indicators definition and report creation process via a business intelligence tool called Tableau. This point value comes at the possibility of studying and understanding large amounts of information compiled since the beginning of the TMS implementation, to understand the current performance of transport, data inconsistencies and future enhancements. At its end, the thesis highlights that although it is not meant to have a great environmental impact, thanks to the Data Analysis and Dashboards created, it is also possible to measure the CO2 emissions and its reduction thanks to the transportation improvements made possible with the TMS. All enhancements hereby presented, are conceivable thanks to the learnings acquired over the course of the career, such as notions on informatics, transportation, environment, and technical problems approach and solution. And thanks to more specific learnings on transportation systems, study case and study company acquired during the work on this project
Pure distortion of symmetric box beams with hinged walls
No full text[EN] This paper is concerned with the analysis of the pure torsion and distortion of straight box beams with trapezial cross-sections and hinged walls. A one-dimensional mechanical model for this kind of system subjected to anti-symmetric loads on the end cross-sections and no warping constraints is developed. The distortional stiffness of the system is provided by the torsional rigidity of the wall panels. The cross-sectional kinematic condition for which torsion and distortion are uncoupled has been determined. Novel explicit expressions of the internal and external distortional moments, the distortion constant, and the distortional warping pattern have been deduced; they can be directly translated to the classical distortion theory. Results of representative test cases with different section shapes and loads show excellent agreement with finite element models using shell elements. The model is a first step to analyse bridge decks with a distortionable central cell for wind engineering applications. Finally, an extension of the model, including the distortional stiffness provided by the frame bending stiffness of the cross-section walls, is presented. The extended model is applicable to assess the large-scale torsional¿distortional effects in long beams with closed cross sections.This research was carried out during the stay of C. Lazaro at the Chair of Structural Analysis of the Technical University of Munich. This co-author gratefully acknowledges the support for his stay provided by the Universitat Politecnica de Valencia and the retraining grant of the Spanish Ministry of Universities (RD 289/2021 and UNI/551/2021) funded by the European Union NextGenerationEU program. The authors thank also Salvador Monleon (UPV, Valencia) for the interesting discussions on this work.Lazaro, C.; Martínez-López, G.; Bletzinger, K.; Wüchner, R. (2024). Pure distortion of symmetric box beams with hinged walls. Thin-Walled Structures. 205. https://doi.org/10.1016/j.tws.2024.112356S20
Surface fuel loads following a coastal-transitional fire of unprecedented severity: Boulder Creek fire case study
No full textBritish Columbia experienced three years with notably large and severe wildfires since 2015. Multiple stand-replacing wildfires occurred in coastal-transitional forests, where large fires are typically rare and thus information on post-fire carbon is lacking. Because of their carbon storage potential, coastal-transitional forests are important in the global carbon cycle. We examined differences in surface fuel carbon among fire severity classes in 2016, one year after the Boulder Creek fire, which burned 6 735 ha of coastal-transitional forests in 2015. Using remotely-sensed indices (dNBR) we partitioned the fire area into unburned (control), low-, moderate-, and high-severity classes. Field plots were randomly located in each class. At each plot, surface fuel carbon was quantified by typeâ coarse, small, and fine woody material, duff, and litterâ and carbon mass by fuel type was compared among severity classes. Total surface fuel carbon did not differ significantly between burned and unburned plots, however there was significantly less duff and litter carbon in burned plots. Remotely-sensed severity classes did not properly capture wildfire impacts on surface fuels, especially at lower severities. Pre-fire stand characteristics are also important drivers of surface fuel loads. This case-study provides baseline data for examining post-fire fuel carbon dynamics in coastal-transitional British Columbia.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author
The fantastic in Spain during the late- nineteenth and early-twentieth centuries
No full textThis thesis has as its primary objective the drawing together and subsequent theorisation of diverse texts which can be understood to be examples of Spanish fantastic literature. It demonstrates that from nineteenth-century Realism and Naturalism (exemplified in narratives by Pérez Galdós, Alarcón and Pardo Bazán), through turn-of-the-century modernismo (Valle-Inclán and Zamacois) to twentieth- century proto-existentialism (Unamuno), a significant number of texts were produced which, in spite of the obvious differences between them, refute the widely held idea that 'the fantastic' and Spanish literature share little common ground. The thesis is therefore one more step along the journey of establishing that Spanish fantastic literature is as important and integral to the whole swathe of Spanish cultural production as it is in many other European countries. The critical analyses of the narratives push at the boundaries of previous interpretative strategies both in terms of the fantastic and of the texts themselves. The exception to this interrogation and reinvigoration of earlier interpretations is to be found in the approach to the narratives by Zamacois, which have hitherto received very little critical attention. These detailed readings draw out the complexities and intriguing perspectives which the fantastic in Spain presents to the attentive reader. By means of these textual analyses, the thesis also explores some of the various possibilities presented by the fantastic itself, putting flesh on the theoretical bones of several different critical discourses. Ultimately, this thesis charts a dynamic and coherent corpus of material which represents the process of the psychologisation of the supernatural from Romanticism onwards. Each successive text more starkly expresses the unreal horrors of the fractured human mind, as well as the mutations of the body. As such, the evolutionary history of the fantastic in Spain is shown to be more gripping and relevant than has hitherto been understood to be the case
Neurological outcomes and mortality of hyperoxaemia in patients with acute brain injury: protocol for a systematic review and meta-analysis
No full textIntroduction Oxygen is frequently prescribed in neurocritical care units. Avoiding hypoxaemia is a key objective in patients with acute brain injury (ABI). However, several studies suggest that hyperoxaemia may also be related to higher mortality and poor neurological outcomes in these patients. The evidence in this direction is still controversial due to the limited number of prospective studies, the lack of a common definition for hyperoxaemia, the heterogeneity in experimental designs and the different causes of ABI. To explore the correlation between hyperoxaemia and poor neurological outcomes and mortality in hospitalised adult patients with ABI, we will conduct a systematic review and meta-analysis of observational studies and RCTs.Methods and analysis The systematic review methods have been defined according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and follow the PRISMA-Protocols structure. Studies published until June 2024 will be identified in the electronic databases MEDLINE, Embase, Scopus, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov. Retrieved records will be independently screened by four authors working in pairs, and the selected variables will be extracted from studies reporting data on the effect of ‘hyperoxaemia’ versus ‘no hyperoxaemia on neurological outcomes and mortality in hospitalised patients with ABI. We will use covariate-adjusted ORs as outcome measures when reported since they account for potential cofounders and provide a more accurate estimate of the association between hyperoxaemia and outcomes; when not available, we will use univariate ORs. If the study presents the results as relative risks, it will be considered equivalent to the OR as long as the prevalence of the condition is close to 10%. Pooled estimates of both outcomes will be calculated applying random-effects meta-analysis. Interstudy heterogeneity will be assessed using the I2 statistic; risk of bias will be assessed through Risk Of Bias In Non-Randomised Studies of Interventions, Newcastle-Ottawa or RoB2 tools. Depending on data availability, we plan to conduct subgroup analyses by ABI type (traumatic brain injury, postcardiac arrest, subarachnoid haemorrhage, intracerebral haemorrhage and ischaemic stroke), arterial partial pressure of oxygen values, study quality, study time, neurological scores and other selected clinical variables of interest.Ethics and dissemination Specific ethics approval consent is not required as this is a review of previously published anonymised data. Results of the study will be shared with the scientific community via publication in a peer-reviewed journal and presentation at relevant conferences and workshops. It will also be shared key stakeholders, such as national or international health authorities, healthcare professionals and the general population, via scientific outreach journals and research institutes’ newsletters
Comparison of 5th-and 14th-year Douglas-fir and understory vegetation responses to selective vegetation removal
No full textWOS: 000292428600002The effects of early vegetation management on the survival and growth of Douglas-fir [Pseudotsuga menziesii (Mirb.) Franco] were examined 5 and 15 years after planting in the Oregon Coast Range. Our first objective was to document the effects of vegetation species competition upon key ecosystem properties. The second objective was to document the effects of vegetation removal during early Douglas-fir stand establishment upon long-term tree growth and on biomass production by vegetation components. Seven levels of manual vegetation removal were maintained for the first 5 years after planting: 0%, 25%, 50%, 75%, and 100% shrub removal; and 100% shrub removal combined with 50% or 100% herbaceous vegetation removal. Shrub and herb removal did not affect Douglas-fir survival at year five, but treatments providing less than 75% shrub removal significantly reduced Douglas-fir survival by year 15. Removing shrubs and herbs completely (100S + 100H) during the 5 years following tree planting allowed successful tree establishment, with a 366% increase in biomass accumulation per hectare for Douglas-fir in that treatment at the end of 14 years of growth. At 15 years stand age, even with shrub removal alone, a 304% gain in tree biomass per hectare was obtained compared to no vegetation removal (NVR). By stand age 15 years, any increase in the degree of understory removal beyond 75% did not contribute significantly to additional tree survival and growth. The understory vegetation on NVR treatment plots and the herbaceous vegetation on 100% shrub removal (100S) treatment plots, contained >90% and >80% of aboveground biomass N at 5 years, respectively, indicating possible competition for soil N. Soil moisture was not different among treatments at 5 years. Complete vegetation removal (100S + 100H) for 5 years resulted in a significant increase in soil bulk density (P < 0.05), a significant decrease in total soil C (P < 0.05) and no change in total soil N in the upper 15 cm of the mineral soil. By 14 years, however, only the soil bulk density remained greater (P < 0.05) on the 100S + 100H treatment. We conclude that greater tree survival and growth occurred with at least 75% shrub removal. Our results suggest that managers may have substantial flexibility in maintaining a partial understory component suitable for ecosystem productivity, canopy cover and wildlife habitat, while maintaining forests productive for timber resources. (C) 2011 Elsevier B.V. All rights reserved.Duzce University, TurkeyDuzce University; Oregon State University Forest Science Department; US Forest Service Pacific Northwest Research StationUnited States Department of Agriculture (USDA)United States Forest Service; US Environmental Protection AgencyUnited States Environmental Protection AgencySupport for the senior author was received from Duzce University, Turkey. Research support came from the Oregon State University Forest Science Department, the US Forest Service Pacific Northwest Research Station, and the US Environmental Protection Agency. We gratefully acknowledge the assistance of Robert G. Wagner, who began the original study and shared key data for tree survival and growth from year 5. The following individuals gave helpful advice on research methods and data analysis: Carol Glassman, Jillian Gregg, Erik Hobbie, Marc Kramer, Dave Myrold, Nan Posavatz, and Chris Swanston. Dan Binkley, Elizabeth C. Cole, Douglas A. Maguire, Vicente J. Monleon, John C. Tappeiner, II, and Richard H. Waring provided helpful manuscript suggestions. Angeline S. Cromack and Kevin T. Cromack edited and formatted the final draft of the paper
