162 research outputs found

    Extrinsic and intrinsic motivation for experience grounded tacit knowledge sharing in Chinese software organisations

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    Purpose – The purpose of this study is to identify and explain the role of individuals’ awareness and motivation in facilitating knowledge sharing (KS) in the real world of practice, as well as to establish areas of convergence between theory and practice that can be of use to both academics and practitioners involved in knowledge intensive organisations. Design/methodology/approach – This study used Grounded Theory (GT) as an inductive methodology to collect, analyse and interpret data from multiple case-studies. 44 participants from Chinese software organisations were selected on the basis of their role in SW design and development and were interviewed using a semi-structured interview script. The data analysis followed a Straussian approach to coding, which consists of open coding, axial coding and selective coding. The analysis focused on the impact of individuals’ awareness and motivation to share knowledge. Findings – The findings of this research show that the motivation for KS – a time consuming and demanding activity – is indeed related to awareness by managers and developers of the benefits of KS in their professional practice. Practitioners shared their experiences and tacit knowledge with others, partly because it was required by their companies, but also because they have a sound awareness of the need to share knowledge both inside and outside their organisations. Research limitations/implications – As a typical social science inductive study, this research is bounded by the context in which the theory proposed emerged from. Further research should be conducted into a richer variety of organisational and national contexts, as suggested by good theoretical sampling practice, which could provide further insights or contrasts. Originality/value – Despite a number of theoretical propositions found in the literature, there is a clear lack of implementation strategies and models that explain the role of awareness and motivation in facilitating KS in the world of practice. This issue of applicability of theoretical propositions is now recognised as one of the fundamental key issues in KS. This study provides new and practice grounded insights in this area and is of interest to both practitioners and theoreticians as it explains and bridges the individuals’ awareness and motivation for tacit KS

    Co-combustion of residual forest biomass and sludge in a pilot-scale bubbling fluidized bed

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    In this work, the co-combustion of residual forest biomass from eucalyptus and its blend with different amounts of primary and secondary sludge from the pulp and paper industry was studied in a pilot-scale bubbling fluidized bed reactor. The main objective was the determination of sludge addition influence on the overall process and on the composition of the exhaust gases, with emphasis on chlorine emissions, namely present in the solid phase (fly ashes) and in the gaseous phase (hydrogen chloride), and nitrogen oxides emissions. The co-combustion process of residual forest biomass with primary sludge (up to 5% in mass) and secondary sludge (up to 10% in mass) was successfully demonstrated as a valid energy valorization option. Except specific cases, no significant emissions increase of nitrogen oxides, carbon monoxide or hydrogen chloride were found with the addition of sludge. In fact, hydrogen chloride emissions decreased, potentially due to an increase in the chlorine retention in ashes caused by the high inorganic content present in the sludge. This high inorganic content can also lead to a significant increase in ash production during the combustion process. Thus, consequently, without proper maintenance, significant ash accumulation along the combustion system may occur, which can decrease the process efficiency and cause equipment damage.publishe

    Mesotelioma Maligno Primário do Peritoneu Associado a Carcinoma de Células Renais. Revisão Concisa

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    O Mesotelioma peritoneal maligno é um tumor maligno relacionado frequentemente com exposição prolongada a fibras de amianto, de mau prognóstico, de diagnóstico geralmente tardio, face à pouca expressão clínica na fase inicial da doença. Como o mesotelioma evolui geralmente só na cavidade peritoneal, doentes seleccionados poderão ter maior sobrevivência se for possível a peritonectomia extensa e quimioterapia hipertérmica intraperitoneal intraoperatória. Os autores referem a sincronicidade ainda não descrita, de mesotelioma peritoneal maligno primário e carcinoma de Grawitz. São revistos concisamente: a clínica destes tumores, síndromes paraneoplásicos (disfunção bioquímica hepática, emagrecimento extremo); etiopatogenia da acção cancerígena das fibras de amianto; mecanismos de disseminação intraperitoneal; avaliação tomodensitométrica; importância da imunohistoquímica no diagnóstico histopatológico; estadiamento; importância do tratamento multidisciplinar destes tumores

    Mechanical Thrombectomy in Stroke in Nonagenarians: Useful or Futile?

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    Background: Mechanical thrombectomy is the standard treatment in acute ischemic stroke due to large vessel occlusion, but there is limited evidence about its efficacy in very old patients. We sought to analyse safety and effectiveness of mechanical thrombectomy in nonagenarian versus octagenarian patients. Methods: We included consecutive patients with acute ischemic stroke due to large vessel occlusion subjected to mechanical thrombectomy, during 29 months in a tertiary center. Patients were divided into two sub-groups, according to age: 80-89 and >90 years old. Recanalization, complications, functional outcome and mortality at discharge and at 3 months were compared. Multivariable analysis was performed to identify independent predictors of functional outcome at 3 months of follow-up, assessed by the modified Rankin Scale. Results: A total of 128 octogenarians (88.9%) and 16 nonagenarians (11.1%) met the inclusion criteria. Successful revascularization was achieved in 87.5% of octagenarians and in 81.3% of nonagenarians (p = 0.486). Symptomatic hemorrhage occurred in 3.1% and 6.3% of younger and older patients, respectively (p = 0.520). Cerebral edema occured in 35.2% of octagenarians versus 25.0% of nonagenarians (p = 0.419). Functional independence (mRS ≤ 2) at 3 months was achieved in 28 (22.6%) and 5 (31.3%) of octagenarians and nonagenarians, respectively (p = 0.445). Mortality at 3 months was not significantly higher in nonagenarians (37.5%) versus octagenarians (33.9%, p = 0.773). Conclusions: No significant diferences were found in functional outcome, mortality, recanalization and complication rates between octagenarians and nonagenarians submitted to mechanical thrombectomy, underlining that patients should not be excluded from mechanical thrombectomy based on age alone.info:eu-repo/semantics/publishedVersio

    Acute Treatment of Isolated Posterior Cerebral Artery Occlusion: Single Center Experience

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    Background and objectives: Randomized trials for mechanical thrombectomy (MT) excluded patients with ischemic strokes due to isolated posterior cerebral artery occlusion (IPCAO), and there is no evidence for best acute treatment strategy in these patients. We aimed to assess the effectiveness and safety of MT in acute IPCAO. Methods: We retrospectively analyzed consecutive patients with acute stroke due to IPCAO submitted to MT and/or intravenous thrombolysis (IVT), between 2015-2019. Effectiveness outcomes (recanalization rate, first-pass effect, NIHSS 24h improvement and 3-month Modified Ranking Scale - mRS) and safety outcomes (complications, symptomatic intracranial hemorrhage (SICH) and 3-month mortality) were described and compared between groups. Results: A total of 38 patients were included, 25 underwent MT and 13 had IVT alone. Successful and complete recanalization were achieved in 68% and 52% of MT patients, respectively. NIHSS improvement at 24h was found in 56% of MT patients versus 30.8% of patients submitted to IVT alone (OR [95% CI]=2.86 [0.69-11.82]) and excellent functional outcome at 3 months (mRS≤1) was achieved in 54.2% of MT patients versus 38.5% in the IVT group (OR [95% CI]=1.60 [0.41-6.32]). Complications occurred in 3 (12%) procedures and there were no SICH. Mortality at 3 months was 20% in the MT group and 15.4% in patients submitted to IVT alone. Conclusions: Our results reflect a real-world scenario in a single center and seem to support the recently growing literature showing that MT is a feasible and safe treatment in IPCAO, with favorable effectiveness.info:eu-repo/semantics/publishedVersio

    Endovascular Treatment of Pediatric Ischemic Stroke: a Single Center Experience and Review of the Literature

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    Introduction: Mechanical thrombectomy is standard treatment for large vessel occlusion (LVO) in adults. There are no randomized controlled trials for the pediatric population. We report our single-center experience with thrombectomy of LVO in a series of pediatric patients, and perform a review of the literature. Methods: Retrospective review of consecutive pediatric thrombectomy cases between 2011 and 2018. Demographic variables, imaging data, technical aspects and clinical outcome were recorded. Results: In a period of 7 years, 7 children were treated for LVO at our center. Median age was 13 (2-17), and median Ped-NIHSS was 15 (3-24), and the median ASPECTS was 8 (2-10). Five patients had cardiac disease, and 2 of them were under external cardiac assistance. Median time from onset of symptoms to beginning of treatment was 7h06m (2h58m-21h38m). Five patients had middle cerebral artery occlusions. Thrombectomy was performed using a stentriever in 3 patients, aspiration in 3 patients, and combined technique in 1 patient. Six patients had good recanalization (TICI 2 b/3). There were no immediate periprocedural complications. At 3 months, 4 patients (57%) were independent (mRS score <3). Two patients died, one after haemorrhagic transformation of an extensive MCA infarct, and one due to extensive brainstem ischemia in the setting of varicella vasculitis. Discussion: Selected pediatric patients with LVO may be treated with mechanical thrombectomy safely. In patients under external cardiac assistance and under anticoagulation, thrombectomy is the only alternative for treatment of LVO. A multidisciplinary approach in specialized pediatric stroke centers with trained neurointerventionalists are essential for good results.info:eu-repo/semantics/publishedVersio

    Collateral pial circulation relates to the degree of brain edema on CT 24 hours after ischemic stroke

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    Background Cerebral edema is frequent in patients with acute ischemic stroke (AIS) who undergo reperfusion therapy and is associated with high mortality. The impact of collateral pial circulation (CPC) status on the development of edema has not yet been determined. Methods We studied consecutive patients with AIS and documented M1-middle cerebral artery (MCA) and/or distal internal carotid artery (ICA) occlusion who underwent reperfusion treatment. Edema was graded on the 24-hour non-contrast computed tomography (NCCT) scan. CPC was evaluated at the acute phase (≤6 hours) by transcranial color-coded Doppler, angiography and/or CT angiography. We performed an ordinal regression model for the effect of CPC on cerebral edema, adjusting for age, baseline National Institutes of Health Stroke Scale, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on admission, NCCT, parenchymal hemorrhagic transformation at 24 hours and complete recanalization at six hours. Results Among the 108 patients included, 49.1% were male and mean age was 74.2 ± 11.6 years. Multivariable analysis showed a significant association between cerebral edema and CPC status (OR 0.22, 95% CI 0.08-0.59, p = 0.003), initial ASPECTS (OR 0.72, 95% CI 0.57-0.92, p = 0.007) and parenchymal hemorrhagic transformation (OR 23.67, 95% CI 4.56-122.8, p < 0.001). Conclusions Poor CPC is independently associated with greater cerebral edema 24 hours after AIS in patients who undergo reperfusion treatment.info:eu-repo/semantics/publishedVersio
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