Ergebnisse der minimal-invasiven direkten koronaren Bypassoperation (MIDCAB) bei über 80-jährigen Patienten

Ziel der vorliegenden Arbeit ist die Evaluation der Ergebnisse von über 80-jährigen Patienten nach einer MIDCAB-Operation. Die präoperativen und frühpostoperativen Ergebnisse wurden mit denen jüngerer MIDCAB-Patienten desselben Operationszentrums verglichen. Darüber hinaus wurden die Langzeitergebnisse der über 80-Jährigen erfasst und mit den Literaturergebnissen nach konventioneller Bypassoperation oder Koronarintervention in diesem Alterssegment verglichen. Die über 80-Jährigen (logistischer EuroSCORE 9,2%) hatten in den ersten 30 postoperativen Tagen eine Sterblichkeit von 6,0%. Relevante kardiale oder zerebrale Komplikationen (MACCE) traten mit einer Häufigkeit von 8,0% auf. Die Follow-up-Zeit lag im Mittel bei 40,4 Monaten, hierbei gaben 60,7% der Patienten keine Angina pectoris mehr an. Von einer besseren postoperativen Leistungsfähigkeit berichteten 55,2% der Befragten und 48,3% verspürten nur eine leichte Einschränkung der körperlichen Leistungsfähigkeit. Nach Kaplan-Meier betrug die geschätzte mittlere Überlebenszeit 102,1 Monate (95%-CI: 84,7-119,4) und die geschätzte mittlere MACCE-freie Überlebenszeit 84 Monate (95%-CI: 55,1-112,9). Die körperliche Summenskala lag im Mittel bei 37,2 und die psychische bei 48,0.   Die vorliegende Arbeit zeigt, dass bei über 80-Jährigen, oft multimorbiden Patienten, die MIDCAB-Operation gute Ergebnisse hinsichtlich Überlebenszeiten, MACCE und Lebensqualität ermöglicht. Besonders bei Hochrisikopatienten sollte dieses Verfahren erwogen werden, da die Patienten weder mit einer Sternotomie noch durch eine Herz-Lungen-Maschine belastet werden. Das operative Trauma ist somit gegenüber der konventionellen Bypasschirurgie reduziert und bedingt eine raschere postoperative Rekonvaleszenz. Im Vergleich zu Literaturangaben zur Koronarintervention zeigte sich eine niedrigere Rate an erneuten Revaskularisationen des Zielgefäßes

Entre risas y llanto se aprende a vivir

Para Papalia, Feldman y Martorell el desarrollo humano se da en ocho etapas. ¿Qué han vivido los estudiantes universitarios? El objetivo conocer los eventos que han vivido. La orientación metodológica es cuanlitativa y Estudio de caso cualitativo. Técnica: autobiografía. La población fue 21 estudiantes de la Facultad de Pedagogía de la Universidad Veracruzan que reconocen que lo vivido les ha servido de aprendizaje, las adversidades los han hecho fuertes, son capaces de enfrentar los retos de la vida, han aprendido a valorar a las personas, tienen: el deseo de formar una familia, la convicción que van a lograr la meta en su vida, se sienten contentos de estudiar y descubrieron que servir a los demás los llena de felicidad.  

A Utilização do Design Thinking pelo Designer Instrucional na Produção de Materiais Educacionais Destinados à Educação a Distância

This research investigated how the adoption of the Design Thinking method can assist the instructional designer in the production of educational materials aimed at distance education. It started from the principle that the adoption of the Design Thinking method in the context of distance education can be as successful, agile and efficient, as it is presented in other contexts, such as on-site education, for example. This research used a case about the production of an audiovisual resource that ended in failure, but that could have a different result if the Design Thinking method were used. The problem that guided this research started from the question: how can the application of the Design Thinking method contribute to the work of the instructional designer, working in distance education? The objective that motivated this research was to present the Design Thinking method and discuss how its adoption can contribute to the work of the instructional designer who works in the field of distance education, especially in the production of educational resources. It was concluded that Design Thinking has the ability to be used in the context of distance education and that professionals with different expertise can benefit from using this method, including the instructional designer. Future research could investigate the application of the Design Thinking method in the production of more complex solutions, such as an educational project. Still, they could investigate the use of Design Thinking by the teacher, as an aid in the production of activities aimed at collaboration and experimentation by students. Keywords: Design thinking. Instructional design. Distance education. Education. Design.A presente pesquisa investigou como a adoção do método Design Thinking pode auxiliar o designer instrucional na produção de materiais educacionais voltados à Educação a distância. Partiu do princípio de que a adoção do método Design Thinking no contexto da Educação a distância pode ser tão exitosa, ágil e eficiente, tal como se apresenta em outros contextos, como na Educação Presencial, por exemplo. Esta pesquisa utilizou um caso sobre a produção de um recurso audiovisual que terminou em fracasso, mas que poderia ter um resultado diferente se o método Design Thinking fosse utilizado. O problema que norteou esta pesquisa partiu do questionamento: como a aplicação do método Design Thinking pode contribuir junto ao trabalho do designer instrucional, atuante na Educação a distância? O objetivo que motivou a realização desta pesquisa foi o de apresentar o método Design Thinking e discutir como sua adoção pode contribuir junto ao trabalho do designer instrucional que atua no âmbito da Educação a distância, especialmente na produção de recurso educativo. Concluiu-se que o Design Thinking tem capacidade de ser utilizado no contexto da Educação a distância e que profissionais com diferentes expertises podem se beneficiar da utilização de tal método, inclusive o designer instrucional. As pesquisas futuras poderiam investigar a aplicação do método Design Thinking na produção de soluções mais complexas, tais como um projeto educacional. Ainda, poderiam investigar a utilização do Design Thinking pelo professor, como auxílio na produção de atividades que visem a colaboração e a experimentação por parte dos alunos. Palavras-chave: Design thinking. Design instrucional. Educação a distância. Educação. Design

Zum Selbstbild von Bergjungarbeitern im Steinkohlenbergbau an der Ruhr

Copy held by FIZ Karlsruhe; available from UB/TIB Hannover / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

HC-SCR: NOx Reduction using Mn and Cu Catalysts Impregnated on Coconut Shell-based and Palm Kernel Shell-based Activated Carbon

A need of economical and tenable resources for Selective Catalytic Reduction (SCR) metallic catalyst production, the characteristics of catalysts and the coconut shells (CS) and palm kernel shells (PKS) activated carbon were determined as potential precursors for the catalyst used in the system of flue gas denitrification at low temperature. Hydrocarbon Selective Catalytic Reduction (HC-SCR) has been a promising method to be an alternative approach for reduction of NOx emissions because it consumes inherent hydrocarbon and is operated at low temperature. Therefore, the aim of this research is to investigate the potential of selective catalytic reduction activity towards NOx reduction along with the factors that influence the efficiency of catalysts performance. In this reserach, adsorption and reduction phenomenon are believed to happen simultaneously. Therefore, activated carbon CS and PKS were studied for its adsorption capability, thermodynamic as well as adsorption isotherms (i.e Langmuir and Freundlich). For catalytic activity, activated carbon (AC) was impregnated with Manganese (Mn) and Copper (Cu) metals prior undergoing low temperature treatment of calcination process for their NOx reduction potential. The potential of impregnated of CS and PKS with manganese and copper, respectively, with different concentration (8%, 10% and 12%) have been studied in the catalytic studies utilizing fixed-bed catalytic reactor was used to investigate the activities of catalysts in order to compare the NOx gas reduction performance by varying temperature ranging from 150 °C-250 °C. Both raw ACs and the metallic catalysts were further characterized using BET, SEM, XRF, H2-TPR, and XRD to support the findings obtained from the activities of the NOx reduction catalysts. Better performance of adsorption was observed in CSAC compared to PKSAC under different temperature conditions which was recorded 27.32% while PKSAC, 21.95%. This was due to the size of pores of CS was slightly bigger than PKS in BET analysis. For isotherm studies, the value of R2 of Langmuir isotherm plot was very near to the most fitting value of R2 = 1, meanwhile, for Freundlich isotherms with R2 > 0.98, it was noticed that it fitted less with the NO sorption by CS and PKS. NO sorption result at different NO initial concentration versus capacity of sorption shows both ACs were favorable for adsorption since both of the R-squared were near to 1. The error difference between the experiment and predicted data was less than 4% and 5% respectively for CS and PKS indicates that the isotherm model exhibit excellent reproduction of the experimental data at the whole concentration range for the component adsorption of NO from flue gas. As for thermodynamic study, both CS and PKS adsorption of NOx was found increase with increase in temperature. Results show a negative value for Gibb’s free energy at all temperature ranges and ∆G⁰ increases with increase in temperature. These negative values represent spontaneous nature as well as feasibility of adsorption reaction. Decrease in ∆G with the increase in temperature reflects better sorption at elevated temperature. The positive value for change in entalphy is due to endothermic nature of adsorption of NOx. For catalytic study, the highest NOx reduction percentage of NOx conversion can be seen at 200 °C for both CS-Cu8 and CS-Cu10, respectively recorded 70.02% and 76.83% due to the advantage of having better potential in redox reaction in SCR system for the selectivity of NOx proven by H2-TPR analysis. Overall, CS-Cu10 has demonstrated the potential of the metallic catalyst for NOx reduction; however improvisation on the synthesis technique is required to combat generation of impurities during the combustion may clog the pore structure of the catalyst supports at higher temperature than 200 °C

HC-SCR: NOx Reduction using Mn and Cu Catalysts Impregnated in Coconut and Palm Kernel Shell Activated Carbon

The characteristics of catalysts impregnated in coconut shell (CS) and palm kernel shell (PKS) activated carbon were determined as potential precursors of catalysts used in a flue gas denitrification system at low temperature. In this study, Manganese (Mn) and Copper (Cu) with metal loading of 8% were impregnated in the activated carbon (AC) before undergoing low temperature calcination process. The morphological properties of samples was analysed using Scanning Electron Microscopy (SEM) and Brunauer, Emmett and Teller (BET) was used to determine the surface area and pore size of samples. The exhaust gas from a diesel engine at a constant flow rate of 4L/min was passed through in a fixed-bed catalytic reactor containing the catalyst, and the concentration of NOx was measured for temperatures ranging from 150°C to 250°C. It was found that the CS catalysts (CS-Mn and CS-Cu) and PKS catalysts (PKS-Mn and PKS-Cu) have the potential to reduce NOx concentration, and results showed that the metal loading of 8% resulted NOx reduction ranging from ~48% to 64%

HC-SCR: NO

The characteristics of catalysts impregnated in coconut shell (CS) and palm kernel shell (PKS) activated carbon were determined as potential precursors of catalysts used in a flue gas denitrification system at low temperature. In this study, Manganese (Mn) and Copper (Cu) with metal loading of 8% were impregnated in the activated carbon (AC) before undergoing low temperature calcination process. The morphological properties of samples was analysed using Scanning Electron Microscopy (SEM) and Brunauer, Emmett and Teller (BET) was used to determine the surface area and pore size of samples. The exhaust gas from a diesel engine at a constant flow rate of 4L/min was passed through in a fixed-bed catalytic reactor containing the catalyst, and the concentration of NOx was measured for temperatures ranging from 150°C to 250°C. It was found that the CS catalysts (CS-Mn and CS-Cu) and PKS catalysts (PKS-Mn and PKS-Cu) have the potential to reduce NOx concentration, and results showed that the metal loading of 8% resulted NOx reduction ranging from ~48% to 64%

HC-SCR: NOx Reduction using Mn and Cu Catalysts Impregnated in Coconut and Palm Kernel Shell Activated Carbon

The characteristics of catalysts impregnated in coconut shell (CS) and palm kernel shell (PKS) activated carbon were determined as potential precursors of catalysts used in a flue gas denitrification system at low temperature. In this study, Manganese (Mn) and Copper (Cu) with metal loading of 8% were impregnated in the activated carbon (AC) before undergoing low temperature calcination process. The morphological properties of samples was analysed using Scanning Electron Microscopy (SEM) and Brunauer, Emmett and Teller (BET) was used to determine the surface area and pore size of samples. The exhaust gas from a diesel engine at a constant flow rate of 4L/min was passed through in a fixed-bed catalytic reactor containing the catalyst, and the concentration of NOx was measured for temperatures ranging from 150°C to 250°C. It was found that the CS catalysts (CS-Mn and CS-Cu) and PKS catalysts (PKS-Mn and PKS-Cu) have the potential to reduce NOx concentration, and results showed that the metal loading of 8% resulted NOx reduction ranging from ~48% to 64%