Challenger J Hockey Prosthesis Final Design Report

The content of this report is withheld as confidential. QL+ is the owner of the intellectual property created throughout the duration of this project. Dr. Tom Mase (mechanical engineering) maintains a full copy of the report and intends to disseminate it upon completion of the necessary intellectual property protection measures

Propuesta de mejora del servicio de mantenimiento preventivo de motocicletas para incrementar la productividad en la empresa Tecnimoto Cix E. I. R. L.

La empresa Tecnimoto Cix E.I.R.L. se dedica a brindar servicios de mantenimiento de motocicletas en la ciudad de Chiclayo. Esta investigación tuvo como objetivo general proponer la implementación del servicio de mantenimiento preventivo en las motocicletas para incrementar la productividad en Tecnimoto Cix E.I.R.L. Se realizó el diagnóstico de la situación actual de la empresa, se mapeó los procesos del servicio de mantenimiento preventivo de las motocicletas y sus actividades respectivas, en donde se identificó que en el año 2019 se dejó de percibir 74 795,00 soles debido a que no se atendió a los clientes debido a la demora en los procesos. Para mejorar la problemática de la baja productividad, se propuso implementar la metodología SMED, luego realizar las mejoras en las técnicas de trabajo de la limpieza del carburador, siendo este proceso el cuello de botella; después aplicar la estandarización de procesos en base a los lineamientos de la Organización Internacional de Trabajo (OIT). Teniendo en cuenta los tiempos estándar, se realizó un balance de línea y también se efectuó la distribución de planta con celdas de trabajo. Con las mejoras propuestas se logró incrementar la productividad total en 29,2%. Las propuestas de implementación del proceso productivo de la empresa Tecnimoto Cix E.I.R.L. es económicamente viable, esto se debe a que se obtuvo un Valor Actual Neto de 26 715,94 soles, una Tasa Interna de Retorno de 39,46%, un beneficio costo de 1,26 y una tasa de recuperación de 2 años con 8 meses y 26 días

Librarians Assemble! Creating Comics Studies Communities

Presented at ACRL 2021. Comics Studies is an emerging field of study that brings scholarly attention to graphic narratives in a variety of published forms. While libraries have long recognized that comics are important materials to include in collections, collection development is only the first step in fostering a Comics Studies community. Librarians have a unique role to play in supporting innovative use of libraries’ collections of comics materials through outreach, education, and programming.This panel features scholar librarians who research, collect, and promote comics in their libraries, describing their experiences with creating comics studies communities at the campus, regional, and international levels.Ope

Anticipation: beyond synthetic biology and cognitive robotics

The aim of this paper is to propose that current robotic technologies cannot have intentional states any more than is feasible within the sensorimotor variant of embodied cognition. It argues that anticipation is an emerging concept that can provide a bridge between both the deepest philosophical theories about the nature of life and cognition and the empirical biological and cognitive sciences steeped in reductionist and Newtonian conceptions of causality. The paper advocates that in order to move forward, cognitive robotics needs to embrace new platforms and a conceptual framework that will enable it to pursue, in a meaningful way, questions about autonomy and purposeful behaviour. We suggest that hybrid systems, part robotic and part cultures of neurones, offer experimental platforms where different dimensions of enactivism (sensorimotor, constitutive foundations of biological autonomy, including anticipation), and their relative contributions to cognition, can be investigated in an integrated way. A careful progression, mindful to the deep philosophical concerns but also respecting empirical evidence, will ultimately lead towards unifying theoretical and empirical biological sciences and may offer advancement where reductionist sciences have been so far faltering

Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey.Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD.Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting

Contribution of brain or biological reserve and cognitive or neural reserve to outcome after TBI: a meta-analysis (prior to 2015)

Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve. The evidence for genetic sources of reserve was limited and often contrary to prediction. APOE ∈4 status has been studied most, but did not have a consistent or sizeable impact on outcomes. The majority of studies found that younger age was associated with better outcomes, however most failed to adjust for normal age-related changes in cognitive performance that are independent of a TBI. This finding was reversed (older adults had better outcomes) in the small number of studies that provided age-adjusted scores; although it remains unclear whether differences in the cause and severity of injuries that are sustained by younger and older adults contributed to this finding. Despite being more likely to sustain a TBI, males have comparable outcomes to females. Overall, as is the case in the general population, higher levels of education and pre-morbid IQ are both associated with better outcomes.Jane L. Mathias, Patricia Wheato

Serologic Reactivity Reflects Clinical Expression of Ulcerative Colitis in Children

Background In contrast to pediatric Crohn's disease (CD), little is known in pediatric ulcerative colitis (UC) about the relationship between disease phenotype and serologic reactivity to microbial and other antigens. Aim The aim of this study was to examine disease phenotype and serology in a well-characterized inception cohort of children newly diagnosed with UC during the PROTECT Study (Predicting Response to Standardized Pediatric Colitis Therapy). Methods Patients were recruited from 29 participating centers. Demographic, clinical, laboratory, and serologic (pANCA, ASCA IgA/IgG, Anti-CBir1, and Anti-OmpC) data were obtained from children 4-17 years old with UC. Results Sixty-five percent of the patients had positive serology for pANCA, with 62% less than 12 years old and 66% 12 years old or older. Perinuclear anti-neutrophil cytoplasmic antibodies did not correspond to a specific phenotype though pANCA ò100, found in 19%, was strongly associated with pancolitis (P = 0.003). Anti-CBir1 was positive in 19% and more common in younger children with 32% less than 12 years old as compared with 14% 12 years old or older (P < 0.001). No association was found in any age group between pANCA and Anti-CBir1. Relative rectal sparing was more common in +CBir1, 16% versus 7% (P = 0.02). Calprotectin was lower in Anti-CBir1+ (Median [IQR] 1495 mcg/g [973-3333] vs 2648 mcg/g [1343-4038]; P = 0.04). Vitamin D 25-OH sufficiency was associated with Anti-CBir1+ (P = 0.0009). Conclusions The frequency of pANCA in children was consistent with adult observations. High titer pANCA was associated with more extensive disease, supporting the idea that the magnitude of immune reactivity may reflect disease severity. Anti-CBir1+ was more common in younger ages, suggesting host-microbial interactions may differ by patient age

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Dynamic routing system to optimize patient care times for the level iii-1 hospital outpatient service using decision trees

El Perú cuenta con un sistema de atención sanitaria descentralizado, administrado por cinco entidades: el Ministerio de Salud (MINSA), que ofrece servicios de salud para el 60% de la población; EsSalud con 30% de la población; FFAA, PNP, el sector privado al 10% restante. Considerando la información se desarrolla una propuesta de solución web con soporte en microservicios para optimizar los tiempos de atención de salud del hospital. En el capítulo 1, describe el proyecto y objeto en estudio, el planteamiento del problema y objetivos, asimismo, los indicadores de éxito del proyecto. El capítulo 2, se incorporan los 7 student outcomes donde se evidencia la aplicación por parte de los integrantes. El capítulo 3, describe el marco teórico para el desarrollo, planeamiento estratégico, arquitectura empresarial, marco de trabajo de Zachman, TOGAF, arquitectura de software y la Guía de los Fundamentos para la Dirección de Proyectos (Guía PMBOK®) El capítulo 4, describe el análisis de negocio bajo el marco de trabajo de Zachman, además, de realizar la ingeniería de procesos tomando el 2do nivel de Zachman. El capítulo 5, resultado del proyecto de acuerdo con el análisis de requerimientos, el modelado y diseño de la arquitectura de software usando la técnica de notación C4 basado en descomposición estructural del sistema y del prototipo. El capítulo 6, enfocamos la gestión y el ciclo de vida del proyecto. Finalmente, el capítulo 7, se realiza las conclusiones para el desarrollo del proyecto.Peru has a decentralized health care system administered by five entities: the Ministry of Health (MINSA), which offers health services for 60% of the population; ESSALUD with 30% of the population; Armed Forces, the Police Department, and the private sector representing the remaining 10%. Regarding this information, it is necessary to develop a proposal for a web solution with support in microservices in order to optimize assistance times in external consulting services in the organization. Chapter 1 describes the project and object under study, the problem statement and objectives as well as the project's success indicators. Chapter 2 incorporates the 7 student outcomes where the application done by the members is evidenced. Chapter 3 describes the theoretical framework for development, strategic planning, enterprise architecture, Zachman framework, TOGAF, software architecture and the Guide to the Fundamentals for Project Management (PMBOK® Guide) Chapter 4 describes the business analysis under the Zachman framework, in addition to performing the process engineering taking Zachman's 2nd level. Chapter 5, result of the project according to the requirements analysis, modeling and design of the software architecture using the C4 notation technique based on the structural decomposition of the system and the prototype. Chapter 6 describes Project Management where the PMBOK® good practice guide is used. Finally, chapter 7, the conclusions of the project are shown.Tesi