Remifentanil versus dexmedtomidine for posterior spinal fusion surgery

Background: Controlling the hemodynamic situation of patients who have spinal operation is of prime importance, and maintaining the heart rate and blood pressure in normal or low- normal levels in these patients can reduce their bleeding loss. One of the commonly used drugs for this purpose is remifentanil. Another sedative-hypnotic-analgesic drug, with acceptable effects is dexmedetomidine. The aim of this study was to compare the effect of dexmedetomidine with remifentanil in spinal operation. Methods: In a double blind randomized clinical trial, using random sampling method, 60 patients with the age range of 15-65 years who were candidates for posterior spinal fusion operation were included. Induction of anesthesia was performed, and both groups received isoflurane 1 during the surgery. Remifentanil was injected via infusion pump in one group. The patients in the trial group received dexmedetomidine. As trial outcomes, heart rate and blood pressure were measured before, after induction and during the operation. Pain score, sedation score and the need to analgesic therapy were recorded in the recovery room and the ward. Independent sample t-test and chi-square were used for statistical analysis. Results: Dexmedetomidine had a significant lowering impact on intraoperative blood pressure and heart rate compared to remifentanil (p<0.001). The mean of sedation scores after extubation in patients who received dexmedetomidine was significantly higher than the sedation scores in patients who received remifentanil (p<0.001). The mean of post-extubation and recovery pain score in patients taking remifentanil was significantly higher than patients taking dexmedetomidine (p<0.05). Conclusion: Dexmedetomidine in patients with spinal operation is associated with lower postoperative pain score and intraoperative bleeding. Hemodynamic effects are significantly better in patients received dexmedetomidine

Maximizing resource utilization by slicing of superscalar architecture

Superscalar architectural techniques increase instruction throughput from one instruction per cycle to more than one instruction per cycle. Modern processors make use of several processing resources to achieve this kind of throughput. Control units perform various functions to minimize stalls and to ensure a continuous feed of instructions to execution units. It is vital to ensure that instructions ready for execution do not encounter a bottleneck in the execution stage; This thesis work proposes a dynamic scheme to increase efficiency of execution stage by a methodology called block slicing. Implementing this concept in a wide, superscalar pipelined architecture introduces minimal additional hardware and delay in the pipeline. The hardware required for the implementation of the proposed scheme is designed and assessed in terms of cost and delay. Performance measures of speed-up, throughput and efficiency have been evaluated for the resulting pipeline and analyzed

Contributions to chatbots and digital analytics in industry

Diese kumulative Dissertation umfasst zehn wissenschaftliche Artikel, die zur Forschung digitaler Analytik, Messung von Technologieakzeptanz und Chatbots beitragen. Ziel der Artikel ist es, die Entwicklung, Implementierung und Verwaltung von Technologien zu vereinfachen und zu unterstützen. Modelle werden entwickelt, welche die wichtigsten Schritte beschreiben und unter anderem relevante damit zusammenhängende Fragen auflisten, die zu beteiligenden Interessengruppen benennen und geeignete Tools vorstellen, welche berücksichtigt werden sollten. Es werden Chatbot Taxonomien entwickelt und vorgestellt, welche die Bandbreite der derzeit bestehenden Gestaltungsmöglichkeiten aufzeigen, während identifizierte Archetypen zu beobachtende Kombinationen aufzeigen. Die Identifizierung der häufigsten Gründe für Misserfolge und die Entwicklung kritischer Erfolgsfaktoren tragen ebenfalls zu dem Ziel bei, den Entwicklungs- und Managementprozess zu erleichtern. Da die Endnutzer über die Akzeptanz und Nutzung und damit über den Erfolg einer Technologie entscheiden, werden Ansätze genutzt, wie die Nutzerakzeptanz von Technologien gemessen werden kann und wie Nutzer frühzeitig in den Entwicklungsprozess eingebunden werden können

Threats to auditor independence: Evidence from Iran

This paper aims to examine threats to auditor independence in Iran. A mixed questionnaire, including both quantitative closed-ended questions and an open-ended qualitative question, is developed to investigate threats to auditor independence. Moreover, thematic analysis is used to triangulate the results against financial media articles throughout 1994 – 2014. Findings suggest that while bribery, non-audit services, and economic condition are key threats to auditor independence in Iran, gifts and presents do not compromise independence given the Iranian culture. This study contributes to a better understanding of auditor independence in Iran, which may apply to other regional settings. Moreover, it provides some suggestions to improve the current Iranian Audit Organisation’s auditor independence framework. (JEL M32)N/

Promoting healthy weight for all young children: a mixed methods study of child and family health nurses' perceptions of barriers and how to overcome them.

Background:Childhood obesity is a global health concern. Early intervention to help parents adopt best practice for infant feeding and physical activity is critical for maintaining healthy weight. Australian governments provide universal free primary healthcare from child and family health nurses (CFHNs) to support families with children aged up to five years and to provide evidence-based advice to parents. This paper aims to examine factors influencing the child obesity prevention practices of CFHNs and to identify opportunities to support them in promoting healthy infant growth. Methods:This mixed methods study used a survey (n = 90) and semi-structured interviews (n = 20) with CFHNs working in two local health districts in Sydney, Australia. Survey data were analysed descriptively; interview transcripts were coded and analysed iteratively. Survey and interview questions examined how CFHNs addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behaviour during routine consultations; factors influencing such practices; and how CFHNs could be best supported. Results:CFHNs frequently advised parents on breastfeeding, introducing solid foods, and techniques for settling infants. They spent less time providing advice on evidence-based formula feeding practices or encouraging physical activity in young children. Although nurses frequently weighed and measured children, they did not always use growth charts to identify those at risk of becoming overweight or obese. Nurses identified several barriers to promoting healthy weight gain in infants and young children, including limited parental recognition of overweight in their children or motivation to change diet or lifestyle; socioeconomic factors (such as the cost of healthy food); and beliefs and attitudes about infant weight and the importance of breastfeeding and physical activity amongst parents and family members. Conclusions:CFHNs require further education and support for their role in promoting optimal child growth and development, especially training in behaviour change techniques to increase parents' understanding of healthy infant weight gain. Parent information resources should be accessible and address cultural diversity. Resources should highlight the health effects of childhood overweight and obesity and emphasise the benefits of breastfeeding, appropriate formula feeding, suitable first foods, responsiveness to infant feeding cues, active play and limiting screen time

Risk Factors Associated with the Arrest for Adolescent to Parent Abuse

This study explored risk factors associated with the arrest for adolescent to parent abuse (ATPA) when compared to arrest for a similar violent misdemeanor against a non-parent. The phenomenon of ATPA is widely under-researched and there is little in terms of prevention policy or treatment. Using 18,548 risk assessment screens performed with adolescents (12-17) arrested in Florida for a violent misdemeanor, and guided by previous literature and social ecological and social bond theories, this analysis explored the relationship between risk factors (categorized as individual characteristics, beliefs, behavior, commitment and involvement and attachment) and arrest for ATPA versus arrest for a violent misdemeanor against a non-parent. Of the 17 hypothesized risk factors, 9 risk factors were found to be significant risk factors associated with the arrest for ATPA versus the arrest for a violent misdemeanor against a non-parent. Age and ethnicity/race were both found to be associated with ATPA arrests. Risk factors found to increase the likelihood of being arrested for ATPA included a history of mental health problems, the adolescent witnessing domestic violence, the adolescent being a victim of abuse, and adolescents\u27 normative beliefs in resolving conflict. The findings of this study add to the current body of literature and can be used to inform the creation of new policies and interventions in the realm of ATPA and family violence

Implications of Structured Programming for Machine Architecture

Based on an empirical study of more than 10,000 lines of program text written in a GOTO-less language, a machine architecture specifically designed for structured programs is proposed. Since assignment, CALL, RETURN, and IF statements together account for 93 percent of all executable statements, special care is given to ensure that these statements can be implemented efficiently. A highly compact instruction encoding scheme is presented, which can reduce program size by a factor of 3. Unlike a Huffman code, which utilizes variable length fields, this method uses only fixed length (1-byte) opcode and address fields. The most frequent instructions consist of a single 1-byte field. As a consequence, instruction decoding time is minimized, and the machine is efficient with respect to both space and time. © 1978, ACM. All rights reserved

Code Review Practices for Refactoring Changes: An Empirical Study on OpenStack

Modern code review is a widely used technique employed in both industrial and open-source projects to improve software quality, share knowledge, and ensure adherence to coding standards and guidelines. During code review, developers may discuss refactoring activities before merging code changes in the code base. To date, code review has been extensively studied to explore its general challenges, best practices and outcomes, and socio-technical aspects. However, little is known about how refactoring is being reviewed and what developers care about when they review refactored code. Hence, in this work, we present a quantitative and qualitative study to understand what are the main criteria developers rely on to develop a decision about accepting or rejecting a submitted refactored code, and what makes this process challenging. Through a case study of 11,010 refactoring and non-refactoring reviews spread across OpenStack open-source projects, we find that refactoring-related code reviews take significantly longer to be resolved in terms of code review efforts. Moreover, upon performing a thematic analysis on a significant sample of the refactoring code review discussions, we built a comprehensive taxonomy consisting of 28 refactoring review criteria. We envision our findings reaffirming the necessity of developing accurate and efficient tools and techniques that can assist developers in the review process in the presence of refactorings

Living with and without an intestinal stoma: Factors that promote psychological well-being and self-care: A cross sectional study.:Psychological well-being and stoma

Abstract Aims This study compared those living with and without an intestinal stoma in relation to physical and psychological health, stress and coping, quality of life and resilience. Also, identifying factors that could be used to promote better self‐care in stoma patients in the future. Design A cross‐sectional and comparative study design was employed. Methods Participants were recruited via email and social media (Facebook and Twitter) between August 2018 and March 2019, to complete an online survey. The data were analysed using analysis of variance to examine group difference and a series of hierarchical linear regression analyses determining predictors of psychological well‐being. Results Of 278 participants aged 18–68 years who completed the survey, 129 (46%) had a stoma and reported significantly poorer physical health. Approximately one‐fifth experienced problems with stoma management. Psychological well‐being was mediated by the duration of living with a stoma (under 3 years) and frequency of leaks (weekly and monthly)