85 research outputs found
Recommended from our members
Transversus abdominis-plane block versus local anesthetic wound infiltration in lower abdominal surgery: a systematic review and meta-analysis of randomized controlled trials
Background: Postoperative pain management is of great importance in perioperative anesthetic care. Transversus abdominis plane (TAP) block has been described as an effective technique to reduce postoperative pain and morphine consumption after open lower abdominal operations. Meanwhile, local anesthetic infiltration (LAI) is also commonly used as a traditional method. However, the effectiveness of these two methods has not been compared before. Methods: A meta-analysis of all relevant randomized controlled trials (RCTs) was conducted to compare the efficacy of single shot TAP block with that of single shot LAI for postoperative analgesia in adults. Major medical databases and trial registries were searched for published and unpublished RCTs. The endpoints include postoperative visual analog scale (VAS) pain score, morphine requirement, and rate of postoperative nausea and vomiting (PONV). For continuous data, weighted mean differences (WMDs) were formulated; for dichotomous data, risk ratios (RR) were calculated. Results were derived using a random-/fixed-effects model with 95% confidence interval (CI). Results: Four RCTs, encompassing 96 TAP-block and 100 LAI patients, were included in the final analysis. Patients in the TAP-block group had lower VAS pain scores 24 hours postoperatively compared with the LAI group, both at rest (WMD [95% CI] = -0.67 [p < 0.01] and with movement (WMD = -0.89, p < 0.01). There were no significant between-group differences in 24-hour postoperative morphine requirements, the rates if PONV or VAS pain scores at 2 and 4 h postoperatively. Conclusion: TAP block and LAI provide comparable short-term postoperative analgesia, but TAP block has better long-lasting effect. Electronic supplementary material The online version of this article (doi:10.1186/1471-2253-14-121) contains supplementary material, which is available to authorized users
Antithrombotic Prophylaxis in the Middle East
Several factors have been proposed to explain the persistence of a high incidence of venous thromboembolism worldwide with its associated morbidity and mortality. Underutilization of anticoagulants and failure of adherence to thromboprophylaxis guidelines are emerging global health concerns. We herein review this alarming observation with special emphasis on the Middle East region. We also discuss strategies that could help control this increasingly reported problem
A review of tertiary BIM education for advanced engineering communication with visualization
SPECT with Tc-99m-labeled agents is better able to detect viability after nitrate administration. Nitrates induce vasoclilation and may increase blood flow to severely hypoperfused but viable myocardium, thereby enhancing tracer delivery and improving the detection of viability. Quantitative data on the changes in blood flow are lacking in SPECT but can be provided by PET. The aim of the present study was to use PET to evaluate whether nitrate administration increases blood flow to chronically dysfunctional but viable myocardium. Methods: N-13-Ammonia PET was used to quantitatively assess blood flow, and F-18-FDG PET was used as the gold standard to detect viable myocardium. Twenty-five patients with chronic ischemic left ventricular dysfunction underwent N-13-ammonia PET at rest and after nitrate administration. Results: A significant increase in nitrate-enhanced blood flow was observed in viable segments (from 0.55 +/- 0.15 to 0.68 +/- 0.24 mL/min/g, P <0.05). No statistically significant change in blood flow was observed in nonviable segments (0.60 +/- 0.20 vs. 0.55 +/- 0.18 mL/min/g). A ratio of at least 1.1 for nitrate-enhanced flow to resting flow allowed optimal detection of viable myocardium, yielding a sensitivity of 82% with a specificity of 100%. Conclusion: N-13-Ammonia PET showed a significant increase in nitrate-enhanced blood flow in viable myocardium, whereas blood flow remained unchanged after nitrate administration in nonviable myocardium. Nitrate use during myocardial perfusion imaging will lead to improved assessment of myocardial viability
Building information modelling – A novel parametric modeling approach based on 3D surveys of historic architecture
Building Information Modelling (BIM) appears to be the best answer to simplify the traditional process of design, construction, management and maintenance. On the other hand, the intricate reality of the built heritage and the growing need to represent the actual geometry using 3D models collide with the new paradigms of complexity and accuracy, opening a novel operative perspective for restoration and conservation. The management of complexity through BIM requires a new management approach focused on the development of improve the environmental impact cost, reduction and increase in productivity and efficiency the Architecture, Engineering and Construction (AEC) Industry. This structure is quantifiable in morphological and typical terms by establishing levels of development and detail (LoDs) and changes of direction (ReversLoDs) to support the different stages of life cycle (LCM). Starting from different experiences in the field of HBIM, this research work proposes a dynamic parametric modeling approach that involves the use of laser scanning, photogrammetric data and advanced modelling for HBIM
Digital Transformation Strategy Framework
This chapter presents the construction of a Strategic Digital Transformation operational framework, necessary and adaptable to any type of company and sector of activity. Therefore, the strategic framework suggested includes the patterns, actions, approaches and several measures as follows: a pattern for preparing Internal Training Plan adapted to Digital Strategy, a Tool for diagnosing the level of digital maturity and a Scorecard tool for the assessment and actions associated with the scope of the optimum degree of digital maturity), a Digital Transformation Strategic Framework (elements and phases), a Digital Transformation Strategy Plan (phases and actions) and a Digital Transformation Strategy’s Balance Scorecard.2019-2
national bim digital platform for construction innovance project
INNOVance represents the first digital platform in the construction sector with BIM methodology on a national level. It's also a BIM library, a Common Data Environment (CDE) of BIM projects in a contract, for sharing work information, and a data exchange platform for the entire construction sector. The platform operates in accordance with the UNI 11337: 2009 standard and it is the origin of the UNI 11337: 2017 standard group. The project was formed within the research relating to the Competitive Call: Energy Efficiency, Industry 2015, promoted by the Ministry of Economic Development (MISE)
A Semiotic Approach for Guiding the Visualizing of Time and Space in Enterprise Models
Part 2: Organizational Semiotics and ApplicationsInternational audienceEven if geographical aspects such as location are included already in the Zachman framework (as the where-perspective), it is not common to have detailed geographical aspects included in enterprise models. Cartography is the science of visualizing geographical information in maps. Traditionally the field has not included conceptual relationships that you find in enterprise models. Both cartography and enterprise modelling have developed guidelines for obtaining high quality visualizations. SEQUAL is a quality framework developed for understanding quality of models and modelling languages based on semiotic theory. In cartography such frameworks are not common. An adaptation of SEQUAL in the context of cartographic maps called MAPQUAL has been presented earlier. Differences between quality of maps and quality of conceptual models, pointing to guidelines for combined representations have been performed, and we try in this paper to investigate the utility of these guidelines in a simple trial. The result of the trial is presented, indicating that it is possible to represent conceptual, temporal, and spatial aspects in the same models in many ways, but that the choice of main perspective should depend on participant appropriateness
Propuesta guía para una planeación y ejecución en proyectos de vivienda unifamiliar con enfoque Lean Construction
Trabajo de investigaciónEste trabajo contempla el desarrollo de una matriz enfocada en la metodología Lean Construction para la planeación y ejecución en proyectos de vivienda unifamiliar. Así mismo se evidencia un análisis de manera cuantitativa y cualitativamente en la adopción de la filosofía Lean Construction en procesos de la gestión de la planeación y ejecución de proyectos, que permite establecer un orden de actividades y sub actividades que componen las fases de un proyecto de vivienda unifamiliar en la relación del alcance exitoso en productividad y rendimiento.INTRODUCCIÓN
1. GENERALIDADES
2. METODOLOGÍAS EN EL MARCO DE LA PLANEACIÓN Y EJECUCIÓN DE PROYECTOS
3. LEAN CONSTRUCTION EN ACTIVIDADES DE CONSTRUCCIÓN
4. IMPLEMENTACIÓN DE LA MATRIZ EN CASO DE ESTUDIO
5. CONCLUSIONES
6. RECOMENDACIONES BIBLIOGRAFÍA
ANEXOSPregradoIngeniero Civi
- …