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Guzmán, Calderon Edson, Teves Pedro Montes, and Salgado Eduardo Monge. "BISAP-O: obesidad incluida en el score BISAP para mejorar la predicción de severidad en pancreatitis aguda." Sociedad de Gastroenterología del Perú (SGP), 2014. http://hdl.handle.net/10757/324690.
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INTRODUCCION: La mayoría de los pacientes con pancreatitis aguda exhibe una evolución clínica autolimitante y relativamente libre de complicaciones mayores. Varios scores han sido creados con la intensión de lograr predecir adecuada y precozmente la gravedad de la pancreatitis para así poder disminuir esta mortalidad. El score BISAP fue validado en el 2008 como predictor de mortalidad para pancreatitis aguda, mientras que la obesidad es un factor de riesgo independiente que incrementa el riesgo de severidad en pacientes que presentan pancreatitis aguda.
El objetivo del presente estudio es determinar si la obesidad añadida a un score BISAP mejora la predicción de severidad en pacientes con pancreatitis aguda
MATERIAL Y METODOS: El presente estudio fue realizado en el Hospital Nacional Daniel Alcides Carrión, provincia del Callao, departamento de Lima, Perú. Los datos de los pacientes fueron recolectados en el servicio de emergencia de dicho nosocomio, se trató de un estudio retrospectivo transversal, realizado entre enero del 2009 y junio del 2010.
RESULTADOS: Se evaluaron un total de 99 pacientes con diagnóstico de pancreatitis aguda. La etiología de las 99 pancreatitis fueron catalogadas como biliares. Solo 2 terminaron en defunción (2%). La mayoría de casos se presentaron en pacientes del sexo femenino 77 (77,8%). Dieciséis de los 99 pacientes (16%), fueron considerados como pancreatitis aguda grave. El 90% de los pacientes (89 /99), tuvieron un BISAP < 3, 10% un BISAP ≥ 3, quince de los 99 pacientes tuvieron un BISAP-O > 3, de ellos 12 fueron realmente considerados como una pancreatitis severa. De 16 pacientes con pancreatitis severa, 14 pacientes tuvieron un IMC > 25. (p = 0,03; OR = 4,39). BISAP-O tiene una sensibilidad, especificidad, Valor predictivo positivo VPP y Valor predictivo negativo VPN de 75%; 96,4%; 80% y 95,2% respectivamente con una exactitud de 92,3%. El área bajo la curva para el BISAP-O fue 0,94 (IC 95%: 0,89 a 0,99). No hubo diferencias cuando se comparó con los otros scores estudiados (p=0,45).
CONCLUSIONES: El score de BISAP es un método sencillo y rápido que puede ser utilizado para predecir la gravedad de los pacientes con pancreatitis aguda al momento del ingreso a un servicio de emergencia. BISAP asociado a Obesidad (BISAP-O) otorga una mayor sensibilidad y exactitud diagnóstica al score BISAP y puede servir como un parámetro de ayuda para predecir la severidad en los pacientes con pancreatitis aguda. No fue posible evaluar el score de BISAP-O como predictor de mortalidad para los pacientes con pancreatitis aguda, debido a la baja tasa de mortalidad en el presente estudio. Se requieren más estudios para poder validar el score BISAP asociado a la Obesidad para predecir severidad.INTRODUCTION: Most patients with acute pancreatitis exhibits a self-limiting clinical course and relatively free of major complications. Several scores have been created with the intention of achieving adequate and early predict the severity of pancreatitis in order to reduce this mortality. BISAP score was validated in 2008 as a predictor of mortality for acute pancreatitis, obesity is an independent risk factor that increases the risk of severity in patients with acute pancreatitis. The aim of this study is to determine whether obesity BISAP added a score improves prediction of severity in patients with acute pancreatitis MATERIAL AND METHODS: This study was conducted in Daniel Alcides Carrión Hospital, Lima, Peru. The patient data were collected in the Emergency Service, it was a cross-sectional retrospective study, between January 2009 and June 2010. RESULTS: We evaluated a total of 99 patients with acute pancreatitis. Etiology of the 99 were biliary pancreatitis. Only 2 ended in death (2%). Most cases occurred in female patients 77/22 (77.8%). Sixteen of the 99 patients (16%) were considered severe acute pancreatitis. 90% (89/99) had a BISAP <3, 10% a BISAP ≥ 3, fifteen of the 99 patients had a BISAP-O> 3, of them 12 were actually considered a severe pancreatitis. Of 16 patients with severe pancreatitis, 14 patients had a BMI> 25. (P = 0.03, OR = 4.39). BISAP-O has a sensitivity, specificity, PPV and NPV of 75%, 96.4%, 80% and 95.2% respectively, with an accuracy of 92.3%. The area under the curve for BISAP-O was 0.94 (95% CI 0.89 to 0.99). There was no difference when compared with the other studied scores (p = 0.45). CONCLUSIONS: BISAP The score is a simple method that can be used to predict the severity of acute pancreatitis. Obesity associated BISAP (BISAP-O) provides higher sensitivity and diagnostic accuracy to score BISAP and can serve as a parameter to help predict severity in patients with acute pancreatitis. It was not possible to assess the BISAP-O score as a predictor of mortality for patients with acute pancreatitis, due to the low mortality rate in the present study. Further studies are required to validate the score BISAP associated with obesity in predicting severity.
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Alvarado, Gutierrez Franz Osmider. "Utilidad de los puntajes BISAP y APACHE II como predictores de severidad de pancreatitis aguda en pacientes del Hospital Nacional Dos de Mayo - 2016." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2017. https://hdl.handle.net/20.500.12672/6125.
Full textAbstract:
Establece la utilidad de los puntajes BISAP y APACHE II como predictores de severidad de pancreatitis aguda (PA) en pacientes del Hospital Nacional Dos de Mayo. Se realiza un estudio analítico, retrospectivo y transversal entre enero y diciembre de 2016 de pacientes con diagnóstico de PA según la nueva clasificación Atlanta 2012 y se define severidad como falla orgánica persistente mediante puntaje Marshall modificado ≥ 2 a las
48 horas. Selecciona puntos de corte apropiados con los que se calcula la sensibilidad, especificidad, VPP y VPN; y confecciona la curva ROC para los puntajes BISAP y APACHE-II.Tesis
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Maravi, Coronado Julio Cesar. "Comparación del índice neutrófilo/linfocito, APACHE II y BISAP como predictores de severidad en pancreatitis aguda durante el periodo 2011-2013 en el Hospital Nacional Daniel Alcides Carrión." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/12059.
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El documento digital no refieres asesor.Compara el índice neutrófilo/linfocito con el APACHE II y BISAP como predictores de severidad en pacientes con pancreatitis aguda. El presente estudio fue realizado en el Hospital Nacional Daniel Alcides Carrión- Callao durante el periodo de enero del 2011 a diciembre del 2013, donde se recolectaron los datos de todos los pacientes hospitalizados en el Servicio de Gastroenterología, UCIN y UCI con diagnóstico de pancreatitis aguda. Se trató de un estudio observacional, retrospectivo y analítico. Se evaluaron un total de 201 pacientes, la edad promedio fue 42,09 ± 16.87, el sexo predominante fue el femenino 143 (71.14 %) y la etiología más frecuente fue la biliar 178 (88.55 %). Con respecto a la severidad 178 (88.5 %) fueron leves y 23 (11.5 %) fueron severas; 19 (9.45 %) pacientes presentaron falla orgánica y solamente 10 (4.97 %) presentaron necrosis pancreática. El score de BISAP tuvo una sensibilidad de 13,2%, especificidad de 93,6%, VPP de 27,7% y VPN de 86,6%. El score de APACHE una sensibilidad de 19,7%, especificidad de 85,1%, VPP de 17,2% y VPN de 86,9% y el índice neutrófilo/linfocito una sensibilidad de 34,5%, especificidad de 60,6%, VPP de 10,3% y VPN de 86,4%. Las áreas bajo la curva ROC fueron 81.4 % para BISAP, 55% para APACHE II y 49% para el índice neutrófilo/linfocito. Se concluye que el índice neutrófilo/linfocito no es mejor predictor de severidad que el APACHE II y BISAP en los pacientes con pancreatitis aguda, además de no tener una adecuada capacidad discriminatoria diagnóstica.
Trabajo académico
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BERGAMI, L. M. "O trançar de uma trajetória: o feminino em "Bisa Bia, Bisa Bel"." Universidade Federal do Espírito Santo, 2015. http://repositorio.ufes.br/handle/10/3309.
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Previous issue date: 2015-05-28A presente dissertação objetivou investigar como a escritora Ana Maria Machado (1941) aborda questões relacionadas ao feminino por meio de sua literatura. Para tanto, tomou-se como corpus para esta pesquisa a obra Bisa Bia, Bisa Bel, publicada pela primeira vez em 1982. A partir dela, buscou-se evidenciar a representação cultural do feminino, em dado momento histórico e, consequentemente, as nuanças transformadoras da mulher, vincada em uma sociedade androcêntrica. Em nível temático, essa narrativa desnuda sinais da altivez de figuras femininas que romperam com as convenções impostas pela sociedade patriarcalista. Possibilitando e estabelecendo um diálogo entre três gerações de mulheres Bisa Bia, Isabel e Neta Beta , o universo ficcional dessa literatura infanto-juvenil apresenta-se como campo fértil para questionamentos acerca da realidade patriarcal. Tendo-se isso em vista, buscou-se como arcabouço teórico, para fundamentar esta análise, os ensinamentos de Pierre Bourdieu, de Michelle Perrot, de Simone de Beauvoir, de Mikhail Bakhtin, de Antonio Candido, dentre outros.
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COSTALONGA, S. J. D. S. "A trajetória temporal da representação feminina em Bisa Bia, Bisa Bel de Ana Maria Machado." Universidade Federal do Espírito Santo, 2016. http://repositorio.ufes.br/handle/10/9193.
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Previous issue date: 2016-08-23Tendo como corpus de investigação a obra Bisa Bia, Bisa Bel, de Ana Maria Machado, tem-se o propósito de empreender uma reflexão crítico-analítica, considerando a trajetória temporal do feminino que transita por três gerações: Isabel (Bel), personagem narradora que empreende um percurso rumo ao autoconhecimento e à liberdade, partindo do apego às convenções sociais representadas por Bisa Bia até a conquista de autonomia na figura de Neta Beta. O objeto de estudo perpassa as personagens Bisa Bia, cuja percepção de vida remonta ao século XIX, e Isabel, protagonista de uma sociedade de final do século XX, ponderando, sobretudo, o tempo da escritura e a marca pessoal da autora nessa obra literária. Tendo isso em vista, analisou-se a referida obra como resultado das escolhas pessoais do escritor cujo repertório a sociedade e o tempo oferecem sob o prisma da adversidade de vozes da protagonista com ênfase à discussão de gênero, constituindo, assim, mote para discussões críticas sobre os fatos e a repercussão desses nas relações que permeiam o público feminino. Palavras-chave: Bisa Bel; Autoconhecimento; Autonomia; Feminino.
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Jahjah, Mohamad. "BINAP électroniquement modifié : évaluation en catalyse asymétrique." Lyon 1, 2007. http://www.theses.fr/2007LYO10015.
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L’objectif de cette thèse repose sur la synthèse de dérivés du 2,2’-bis(diphénylphosphino)-1,1’-binaphtyle (BINAP) électroniquement enrichis et l’étude de leurs propriétés catalytiques pour les réactions d’hydrogénation asymétrique. De manière à mieux comprendre les phénomènes qui gouvernent la catalyse hétérogène, la recherche d’un ligand amphiphile dont les propriétés ont été étudiées en couche de Langmuir a conduit à la mise au point d’une méthodologie de synthèse d’un BINAP amphiphile et à la préparation des complexes organométalliques correspondants. Dans une deuxième approche, l’influence des propriétés et électroniques des substituants sur la position para du phényle des diphosphines atropoisomères dérivées du BINAP a été étudiée en hydrogénation asymétrique des (α-acylamino)-acryliques esters, d’α-cétoesters et d’hétérocycles. Une corrélation linéaire entre l’excès énantiomérique et les cœfficient de Hammett des substituants a été montrée dans le cadre de la thèse de M. Alamé effectuée au Laboratoire de Génie des Procédés Catalytiques (UMR 2214). La recherche d’analogues du BINAP à phosphore chiral a aboutit à l’obtention de monophosphines de ce type qui ont été étudiées dans les réactions de réduction de cétones aromatiques. Enfin, une nouvelle approche de synthèse du BINAP, basée sur une réaction de couplage de type Ullmann, a aboutit à la préparation du BINAPO et d’un analogue phosphonate du BINAPThis thesis describes the synthesis of electronically enriched 2,2’-bis(diphénylphosphino)-1,1’-binaphtyle (BINAP) derivatives and the study of their properties as ligands in asymmetric hydrogenation. Firstly, we have set up a new synthetic methodology of an amphiphilic BINAP, followed by the preparation of the corresponding organometallic complexes. Their properties were studied as Langmuir layers and contributed to a better knowledge of heterogeneous catalysis phenomenons. Secondly, the influence of electronical properties of para-subtituted phenyl phosphines of BINAP was studied in asymmetric hydrogenation of various substrates. A linear correlation between the enantiomeric excess of the product and the Hammett cœfficient of the substitutants was assessed by M. Alamé during his thesis in the Laboratoire de Génie des Procédés Catalytiques (UMR 2214). The synthesis of monophophosphines bearing a chiral phosphorous atom was also investigated and applied in the reduction of aromatic ketones. At last, a new synthetic approach of BINAP, based on an Ullmann type coupling reaction, was envisioned
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Bergami, Lucinei Maria. "O trançar de uma trajetória : o feminino em Bisa Bia, Bisa Bel, de Ana Maria Machado." reponame:Repositório Institucional da UFES, 2015. http://repositorio.ufes.br/handle/10/1987.
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A presente dissertação objetivou investigar como a escritora Ana Maria Machado (1941) aborda questões relacionadas ao feminino por meio de sua literatura. Para tanto, tomou-se como corpus para esta pesquisa a obra Bisa Bia, Bisa Bel, publicada pela primeira vez em 1982. A partir dela, buscou-se evidenciar a representação cultural do feminino, em dado momento histórico e, consequentemente, as nuanças transformadoras da mulher, vincada em uma sociedade androcêntrica. Em nível temático, essa narrativa desnuda sinais da altivez de figuras femininas que romperam com as convenções impostas pela sociedade patriarcalista. Possibilitando e estabelecendo um diálogo entre três gerações de mulheres – Bisa Bia, Isabel e Neta Beta –, o universo ficcional dessa literatura infanto-juvenil apresenta-se como campo fértil para questionamentos acerca da realidade patriarcal. Tendo-se isso em vista, buscou-se como arcabouço teórico, para fundamentar esta análise, os ensinamentos de Pierre Bourdieu, de Michelle Perrot, de Simone de Beauvoir, de Mikhail Bakhtin, de Antonio Candido, dentre outros.
This work aimed at investigating how the writer Ana Maria Machado (1941) addresses some issues related to women in her literature. For that, we have analyzed her work “Bisa Bia, Bisa Bel”, which was first published in 1982. From this analysis, we have tried to identify the cultural representation of “the feminine” in a given historical context and, as a result, some women's transformative aspects inlaid in an androcentric society. From the thematic perspective, the “Bisa Bia, Bisa Bel”'s narrative presents signs of haughtiness of the female characters, which break with the conventions imposed by patriarchal society. By establishing a dialogue between three generations of women - Bisa Bia, Isabel and granddaughter Beta - the fictional universe of this children's literature presents as a fertile ground for questioning about the patriarchal reality. For supporting this research, we have used, as theoretical foundation, works of the following authors: Pierre Bourdieu, Michelle Perrot, Simone de Beauvoir, Mikhail Bakhtin, and Antonio Candido, among others.
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Berthod, Mikaël. "Nouveaux dérivés du Binap pour la catalyse asymétrique." Lyon 1, 2004. http://www.theses.fr/2004LYO10193.
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Ce travail a consisté à synthétiser des dérivés du 2,2'-bis(diphénylphosphino)-1,1'-binaphtyle (BINAP) qui est un des ligands les plus connus et efficaces en catalyse homogène. Par une nouvelle stratégie de synthèse, de nouveaux dérivés du BINAP substitués en positions 4,4' et 5,5' ont été obtenus par des réactions très efficaces et applicables à grande échelle. Après préparation des complexes organométalliques catalytiquement actifs correspondants, les nouveaux catalyseurs homogènes ou hétérogènes synthétisés ont été testés en hydrogénation dans des conditions réactionnelles classiques ou peu usuelles. Ainsi les(R) et (S)- 4,4' et 5,5'-diaminomethylBINAP ont été synthétisés en 5 étapes depuis le BINAP optiquement pur lui-même, avec des rendements de l'ordre de 64%. Les catalyseurs hydrosolubles correspondants ont montré une grande efficacité dans la réduction de ß-ceto esters en milieu biphasique eau/solvant organique. Une étude de l'hydrogénation du trifluoroacétoacétate d'éthyle a été réalisée en utilisant ces nouveaux catalyseurs en milieu biphasique eau acide/solvant organique. Ces mêmes catalyseurs ont été testés pour l'hydrogénation de ß-cétoesters en milieu biphasique liquide ionique/solvant organique avec une bonne conversion et une très bonne sélectivité. Les 4,4' et 5,5'-perfluoroalkylBINAP ont été synthétisés puis complexés au ruthénium et ont été testés pour l'hydrogénations du 2-méthyl acétamidoacrylate en milieu CO2 supercritique. Enfin, les polyadditions avec le 2,6-diisocyanatotoluène sur les 4,4' et 5,5'-diamBINAP ont conduit au 4,4' et 5,5'-polyNAP. Ces ligands complexés au ruthénium ont montré leur efficacité en hydrogénation asymétrique hétérogène de ß-cétoesters
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Chua, Samuel D. "Speech enhancement during BiPAP use for persons living with ALS." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/43611.
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Speech from behind a face mask while on Bilevel Positive Air Pressure (BiPAP) ventilation is extremely difficult for persons living with Amyotrophic Lateral Sclerosis (ALS). The inability to verbally communicate while on ventilation causes frustration and feelings of isolation from loved ones and decreases quality of life.
A system that integrates with face masks, captures speech, removes ventilator wind noise and outputs and recognizes de-noised speech is proposed, implemented and tested. The system is tested with a dataset consisting of digitally added noise as well as a single patient with ALS. Automated machine recognition of the words is then performed and results analyzed. A subjective listening test is conducted with individuals listening to the noisy and filtered speech samples and the results are also analyzed.
Although intelligibility does not seem to improve for human listeners, there appears to be some improvement in machine recognition scores. In addition, feedback from the ALS community reports an improvement in the quality of life simply because patients are able to use their own voice and be heard by loved ones.
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Lamouille, Thierry. "Nouveaux catalyseurs hétérogènes dérivés du BINAP : applications en catalyse biphasique." Lyon 1, 2001. http://www.theses.fr/2001LYO10165.
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Le BINAP, l'un des ligands les plus efficaces pour l'hydrogénation catalytique asymétrique de nombreux substrats prochiraux, reste cependant peu employé industriellement à cause des difficultés de séparation puis de réutilisation du catalyseur. Pour pallier cet inconvénient, nous avons envisagé la synthèse d'un dérivé : le diam-BINAP possédant deux fonctions amine primaire permettant l'introduction de divers groupements qui induiront des propriétés physico-chimiques variées. Notre travail a consisté, dans un premier temps, à optimiser la synthèse du diam-BINAP. La fonctionnalisation de celui-ci a ensuite été réalisée pour former des ligands utilisables soit en catalyse solide-liquide, liquide-liquide ou bien en milieu CO2 supercritique. Pour la catalyse solide-liquide, des ligands de type urée ont été obtenus par addition d'isocyanates sur le diam-BINAP et un ligand de type amide par condensation du chlorure de téréphtaloyle sur le même composé. Complexés au ruthénium, ces ligands ont montré leur recyclabilité. Le greffage sur silice du diam-BINAP a également été mis en œuvre. La réduction de l'acétoacétate de méthyle avec le complexe de ruthénium correspondant s'est avérée très efficace et le complexe recyclable. Deux ligands hydrosolubles ont été synthétisés l'un par greffage de chaînes polyéthylène glycol, l'autre par formation du bromhydrate d'ammonium du diam-BINAP. Ces ligands complexés au ruthénium ont permis de réaliser des réactions d'hydrogénation en milieu biphasique liquide-liquide avec une très bonne efficacité. Le complexe formé avec le bromhydrate d'ammonium est recyclable quatre fois. Enfin, la catalyse en milieu CO2 supercritique met en jeu un ligand possédant deux chaînes perfluorées coordonné au ruthénium qui conduit à des résultats encore modestes, mais encourageants pour la réduction catalytique à l'acide itaconique. Ces différents systèmes catalytiques non optimisés ont permis aux complexes d'être recyclés soit par filtration soit par extraction.
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Aumann, Sonia Maria. "Avaliação da técnica BIPAP no auxílio ao diagnóstico da doença coronariana." Centro Federal de Educação Tecnológico do Paraná, 2005. http://repositorio.utfpr.edu.br/jspui/handle/1/82.
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O teste ergométrico é um dos exames mais utilizados para diagnosticar a doença coronariana, e como tal apresenta uma grande dificuldade para concluí-lo, pois os indivíduos fadigam antes mesmo de atingir a FC (freqüência cardíaca) preconizada. No trabalho desenvolvido, propõese a aplicação da técnica BiPAP para aumentar a capacidade de permanência do voluntário durante o teste ergométrico e avalia-se sua potencialidade como ferramenta auxiliar ao
diagnóstico coronariano. Como forma de adaptação ao uso incentivador respiratório,
implementou-se a caminhada de 12 min antes do teste ergométrico. Empregou-se uma
amostra de 31 voluntários para a caminhada de 12 min e 30 voluntários para o teste
ergométrico, sendo todos coronarianos do sexo masculino, entre 49 a 68 anos. Os voluntários foram submetidos a um protocolo que consistia de duas etapas: na primeira, sem a aplicação do incentivador respiratório e na segunda, utilizando o equipamento de BiPAP. Para a
caminhada de 12 min, compararam-se as variações de distância percorrida e de freqüência
cardíaca alcançada entre as duas etapas. No teste ergométrico, verificaram-se as variações
cardio-respiratórias pressão arterial, freqüência cardíaca, equivalente metabólico, duplo
produto, consumo de oxigênio, saturação de oxigênio e ácido láctico, nas duas etapas. Com a
aplicação do protocolo experimental, procurou-se suscitar o surgimento de exaustão e fadiga
tardiamente, a fim de se obter um resultado significativo no diagnóstico coronariano e
alcançar a freqüência cardíaca máxima (Fcmáx). Os resultados foram analisados comparando
estatisticamente os parâmetros medidos nas duas etapas, tanto para a caminhada como para o
teste ergométrico. Neste, aplicando a técnica BiPAP, os resultados mostraram um pior
desempenho físico dos voluntários, os quais não atingiram a freqüência cardíaca máxima
(FCM) e entraram em fadiga respiratória precocemente. Para a caminhada de 12 min, os
voluntários superaram a distância percorrida com relação à caminhada sem o uso do
incentivador. Concluiu-se que a técnica BiPAP: (1) durante caminhada em esforço moderado,
proporciona ganhos no rendimento físico, tanto em termos de distância quanto de FC,
superando a caminhada sem o uso do incentivador; (2) no teste ergométrico, não promove
incrementos metabólicos e fisiológicos que venham a melhorar o diagnóstico da doença
coronariana, tendo em vista que ocorreu redução do trabalho respiratório e da saturação de
oxigênio, levando à dispnéia e provocando precocemente a fadiga respiratória,
respectivamenteThe ergometric test is one of the most important medical examinations in order to diagnose coronary disease. However, it shows a great limitation, because individuals get tired even before they have reached a predefined cardiac frequency (CF). In the developed research, it is proposed the application of BiPAP technique during the ergometric test as a means of prolonging the period of testing and improving its performance for the coronary disease diagnostic. As a volunteer adaptation to the breathing booster device, the 12 min walking test before the ergometric one was performed. A group of 31 male coronary patients, 50 up to 68 years old, participated of the walking test and 30 patients, of the ergometric one. The volunteers were submitted to an experimental protocol consisted of 2 stages: in the first one, without the breathing booster device, and in the second one, using it. For the 12 min walking test, it was compared the variations of the coursed distance and the cardiac frequency achieved between the 2 stages. Along the ergometric test, it was measured and compared the cardio-respiratory parameters: arterial pressure, cardiac frequency, metabolic equivalent, double product, oxygen consumption, oxygen saturation and lactic acid. With the application of the clinical protocol, we tried to reach the maximum cardiac frequency (CFM), and to provoke the appearing of late exhaustion and fatigue, which influence the coronary disease diagnostic. For the ergometric test, using the BiPAP technique, the results had shown volunteers wickedly physical performance, reaching no CFM and moreover initiating the process of breathing fatigue precociously. On the walk test, with moderated effort, the volunteers overcame the walked distance in relation to the walking without the use of the breathing booster device, indicating, on this way, that the BiPAP technique can promote an increase of the distance and of FC. For the ergometric test, however, we concluded that the BiPAP technique does not increase metabolic and physiologic parameters which can improve the sensitivity and precision of the coronary disease diagnostic, considering that it had produced a reduction of breathing work and oxygen saturation, bringing to dyspnea and to respiratory fatigue precociously, respectively.
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Ramos, Disney Leite. "O impacto da rede multibanco (rede Dobra24) na rentabilidade do Banco Internacional de São Tomé e Prìncipe." Master's thesis, Universidade de Évora, 2019. http://hdl.handle.net/10174/25255.
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A introdução de novas tecnologias no sector Bancário alterou a forma de comunicação e de relacionamento com os clientes, provocando um forte impacto neste setor, permitindo maior acessibilidade e comodidade aos seus clientes e aumentando a produtividade com a consequente redução de custos. A Banca inseriu as tecnologias emergentes como forma de diferenciação num mercado cada vez mais competitivo. O objetivo deste estudo foi de perceber como a inovação proporcionada pela rede Dobra24 disponibilizado pelo Banco Internacional de São Tomé e Príncipe, trouxe uma mais-valia em termos financeiros; The impact of the Dobra24 network on the profitability of Banco Internacional de São Tomé and Príncipe
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The introduction of new technologies in the Banking sector has changed the way relationship with customers, provoking a strong impact in this sector, allowing greater accessibility and convenience to its customers and increasing the productivity with the consequent reduction of costs. Banking introduced the technologies as a means of differentiation in an increasingly competitive market. The objective of this study was to understand how the innovation provided by Multibanco provided by the São Tomé and Príncipe International Bank, brought a surplus value in financial and non financial terms.
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Nobre, Joana Filipa de Gandarinho e. "Ventilação não-invasiva em pacientes com Esclerose Lateral Amiotrófica." Bachelor's thesis, [s.n.], 2012. http://hdl.handle.net/10284/3437.
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Wiles, Jason Allan. "Mechanistic studies of an enantioselective hydrogenation catalyzed by a ruthenium-BINAP complex." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0009/NQ60039.pdf.
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Lenox, Joseph Daniel. "PARALLEL DELAY FAULT GRADING HEURISTIC AND TESTING APPROACHES TO TROJAN IC DETECTION." OpenSIUC, 2016. https://opensiuc.lib.siu.edu/dissertations/1315.
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A method to perform implicit path delay fault grading on GPGPU architectures is presented. Experimentally it is shown that it is over 1200x faster than a single-core implicit path delay fault grading method previously in the literature for higher accuracy and can be shown to scale to multiple GPGPUs. A post-silicon test pattern generation strategy to maximize the efficiency of broadside tests applied to a sequential design for a limited test budget is presented. Arguments are made for this approach for detecting embedded Trojan ICs in the next-state functions of a sequential system; they are based on a model where long sequences of inputs that are applied to the system in the functional mode can detect if Trojan hardware is triggered with high probability. An efficient and scalable input generation algorithm for broadside tests is introduced and its performance on ISCAS'89 and ITC'99 benchmark circuits is evaluated. A design-for-authentication strategy is presented for the insertion of cells to efficiently partition the combinational core of a circuit to detect inserted Trojan ICs. It is shown that the approach, combined with pseudo-exhaustive test pattern generation, guarantees detection in certain circumstances.
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ALFANDARY, DIDIER. "Bipap ou cpap dans le traitement des patients porteurs d'un syndrome de recouvrement (sas + bpco) : resultats de 55 polysomnographies en air ambiant, cpap, cpap + 02, bipap ; controle chez 11 patients." Amiens, 1994. http://www.theses.fr/1994AMIEM052.
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Abelairas, Edesa Manuel F. "Primary phosphine analogues of BINAP, QUINAP, and [2.2] PHANEPHOS : their stability and reactivity." Thesis, University of Newcastle upon Tyne, 2015. http://hdl.handle.net/10443/3029.
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Primary phosphines have a notorious reputation for being highly air–sensitive and sometimes pyrophoric. They can undergo thermal decomposition, possess a pungent odour and are often toxic. They are however highly useful for preparing phosphorus–containing motifs, allowing access to compounds which are difficult to synthesise through different methodologies. We recently reported the successful isolation of air–stable, chiral monodentate primary phosphines, which were used as precursors in the synthesis of ligands for use in asymmetric catalysis. The stability of these primary phosphines is thought to be a result of extended π–conjugation in their binaphthyl backbone. A number of important catalytic processes require bidentate phosphine ligands. We therefore sought to build upon our previous work, and have prepared a range of enantiopure bidentate primary phosphines, to be used as precursors in the synthesis of novel ligand libraries. In Chapter 2, we introduce methodologies to access a diphosphonate ester–containing 1,1'-binaphthyl framework in both its racemic and chiral forms. For this, copper–catalysed Ullmann C–C homocouplings, Suzuki–Miyaura C–C cross–couplings, and organotin–mediated aryl radical trapping methods were evaluated. Subsequently, the chiral diprimary phosphine, BINAPH2, was synthesised and air–stability studies were performed. Functionalisation of the two –PH2 groups allowed us to access a range of bidentate phosphine ligands with different stereoelectronic properties. Rhodium(I) complexes of the ligands were tested in asymmetric catalytic hydrogenation and hydroformylation reactions of benchmark prochiral substrates. Following on from our work with bidentate P,P–ligands, Chapter 3 describes our efforts to synthesise the novel, heterofunctionalised QUINAP–based primary phosphine QUINAPH2. P,N–chelating ligands were subsequently made and the solid and solution state stabilities of the primary phosphine were studied. Finally, in Chapter 4 we report the synthesis of mono– and bidentate [2.2]paracyclophane– based phosphine ligands, derived from their primary phosphine precursors. Monodentate [2.2]paracyclophanyl primary phosphines possessing varying degrees of conjugation in the backbone were synthesised and their air–stabilities compared to those predicted by our DFT model. The pseudo-ortho substituted bidentate primary phosphine, [2.2]PHANEPH2, was also synthesised, and used to access a series of ligands. These were tested in rhodium(I)–catalysed hydrogenation reactions of prochiral alkenes.
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Vanhoudt, Bettie. "Description du bisa de Zabré: langue mandé du groupe Sud-Est." Doctoral thesis, Universite Libre de Bruxelles, 1992. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/212949.
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Daykin, Margot M. "Ecosystem management, the institutional challenge : an analysis of the Burrard Inlet Environmental Action Program (BIEAP)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0027/MQ51329.pdf.
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Alves, Marcelo Mendes. "Ventilação não-invasiva com pressão positiva (BIPAP) em cães da raça Golden Retriever afetados pela distrofia muscular." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/10/10132/tde-14072011-164329/.
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A Distrofia Muscular dos cães Golden Retriever (GRMD) é uma miopatia degenerativa causada pela ausência da proteína distrofina na superfície da membrana da célula muscular. É geneticamente homóloga à distrofia muscular de Duchenne (DMD) que acomete os humanos, portanto, estes cães são considerados modelos experimentais para estudos que buscam tratamentos para pacientes vitimados pela doença. A maior causa de morte na DMD é a insuficiência respiratória ou infecção pulmonar que ocorre em cerca de 75% dos casos. Os músculos respiratórios são sempre afetados e, juntamente com as cifoescolioses e deformidades torácicas, diminuem marcadamente a função respiratória. O padrão respiratório é de respiração rápida e superficial, com volume corrente diminuído, e está associado com a presença de alterações nas pressões parciais dos gases sanguíneos. A complacência pulmonar diminui, resultante de microatelectasias. Os músculos intercostais internos e abdominais, que auxiliam a expiração, também são acometidos, reduzindo a efetividade da tosse e dificultando a eliminação de secreções. Na fase préterminal da doença, nota-se uma redução na pressão parcial de oxigênio arterial associada com a retenção do gás carbônico, podendo observar-se um quadro de cianose, papiloedema e falhas respiratórias. A ventilação nãoinvasiva com pressão positiva (VNIPP) consiste em um método de assistência ventilatória em que uma pressão positiva é aplicada à via aérea do paciente através de máscaras ou outras interfaces sem a utilização da intubação traqueal. Este estudo teve como escopo avaliar possibilidades de terapia respiratória em cães afetados pela GRMD submetidos à VNIPP, identificar os fatores associados ao sucesso ou ao insucesso da VNIPP; caracterizar os padrões de resposta a VNIPP e complicações associadas. Os conhecimentos específicos das modalidades ventilatórias a serem usadas, assim como dos parâmetros ventilatórios a serem empregados na terapia foram fundamentais para a realização deste trabalho. A monitorização das concentrações dos gases sangüíneos, e da saturação de oxigênio, são essenciais para que possam ser estabelecidos parâmetros ventilatórios seguros e confortáveis aos animais e, assim, viabilizar a terapia. No experimento proposto foram estudados cães Golden Retriever, afetados pela distrofia muscular, submetidos à ventilação mecânica não-invasiva com pressão positiva. Para tanto foi consideradas na avaliação respiratória, a gasometria arterial e a oximetria. Apesar do desconforto respiratório e sinais de hipoventilação, clinicamente observado nos animais, não houve confirmação de Insuficiência Respiratória. Portanto concluímos que o suporte ventilatório não-invasivo (Bipap) falhou em demonstrar melhora nas funções respiratórias dos cães da raça Golden Retriever afetados pela distrofia muscular quando usado sob a forma profilática.The Muscular Dystrophy Golden Retriever dogs (GRMD) is a degenerative myopathy caused by the absence of dystrophin protein on the surface of the membrane of muscle cells. It is genetically counterpart to Duchenne muscular dystrophy (DMD) which affects humans, so these dogs are considered experimental models for studies that seek treatments for patients affected by the disease. The biggest cause of death in DMD is respiratory failure or lung infection that occurs in about 75% of cases. The respiratory muscles are always affected and, together with the cifoescolioses and chest deformities, the markedly reduced respiratory function. The breathing pattern is rapid and superficial, with tidal volume decreased, and is associated with the presence of changes in the partial pressure of blood gases. The lung compliance decreases, resulting from microatelectasias. The intercostal muscles and internal abdominal, which help the expiration, are also affected, reducing the effectiveness of cough and hampering the removal of secretions. In the preterminal disease, there is a reduction in the partial pressure of oxygen blood associated with the retention of carbon dioxide, with a framework of cyanosis, papilloedema and respiratory failure. The non-invasive ventilation with positive pressure (VNIPP) is a method of ventilatory assistance at a positive pressure that is applied to air the patient through masks or other interfaces without the use of intubation. This study was to objective evaluate the potential of respiratory therapy in dogs affected by GRMD submitted to VNIPP, identify the factors associated with the success or failure of VNIPP; characterize the patterns of response to VNIPP and associated complications. The specific knowledge of how to use ventilation and the ventilatory parameters to be used in therapy were fundamental for this work. The monitoring of blood concentrations of the gases, and the saturation of oxygen, are essential in order to be established ventilatory parameters safe and comfortable for animals and thereby facilitate the therapy. In the proposed experiment studied dog Golden Retriever, affected by muscular dystrophy, submitted to non-invasive mechanical ventilation with positive pressure. To do so was considered in assessing breathing, blood gases and oximetry. Despite the signs of respiratory discomfort and hypoventilation, clinically observed in animals, there was no confirmation of respiratory failure. So we find that the non-invasive ventilatory support (Bipap) failed to show improvement in respiratory functions of the breed dogs Golden Retriever affected by muscular dystrophy when used in the form prophylactic.
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Baxter, D. "Blast Injury Outcome Study in Armed forces Personnel (BIOSAP) and Blast Injury In Pigs study (BIIPs)." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/1546198/.
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Aldrin, Philippe. "La BiPAP, et son application dans le traitement des décompensations respiratoires aiguës des insuffisants respiratoires chroniques." Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M180.
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Ter, Halle Rob. "Nouveaux catalyseurs hétérogènes asymétriques." Lyon 1, 1999. http://www.theses.fr/1999LYO10194.
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Ce travail a consiste a synthetiser des derives polymerisables de ligands connus et efficaces en catalyse homogene. Par polymerisation de ces monomeres, des ligands polymeriques insolubles sont obtenus. Apres preparation des complexes organometalliques catalytiquement actifs correspondants, les nouveaux catalyseurs heterogenes synthetises sont testes dans differentes reactions. Nous avons ainsi heterogeneise le ligand, n-(toluene-p-sulfonyl)-1,2-diphenyl ethylene diamine, par synthese d'un derive comportant un groupement vinylique. La copolymerisation de ce monomere en presence de styrene avec differentes quantites d'agent de reticulation, a permis l'obtention de trois polymeres. La preparation des complexes d'iridium et de ruthenium correspondants, a conduit a des catalyseurs qui ont ete testes dans la reduction de l'acetophenone par transfert d'hydrure. L'utilisation de l'iridium a permis d'obtenir 92% d'exces enantiomerique, cependant ce catalyseur heterogene n'a pas pu etre reutilise dans de bonnes conditions. Nous avons egalement synthetise le diam-binap, c'est a dire le binap fonctionnalise avec deux groupements methyle amino en position 6,6. La polyaddition avec le 2,6-diisocyanato toluene a conduit au poly-nap, une polyuree avec un degre de polymerisation de l'ordre de 8. Les complexes de ruthenium du poly-nap ont ete testes pour l'hydrogenation de differents substrats. Les -ceto-esters, les olefines et les cetones non fonctionnalisees ont ete reduites avec des enantioselectivites identiques a celles obtenues avec le binap. Les -ceto-esters et les dehydro aminoacides sont reduits en revanche avec des enantioselectivites legerement plus faibles. Ces catalyseurs peuvent etre reutilises apres la reaction par simple filtration. La partie insoluble est remise en reaction avec le solvant et le substrat. Quatre recyclages ont ete realises sans que l'on observe de perte d'activite ou d'enantioselectivite.
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Alame, Mohamad. "Tentative de corrélation structure-énantiosélectivité et effet de pression en hydrogénation asymétrique." Lyon 1, 2007. http://www.theses.fr/2007LYO10016.
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L’énantiosélectivité des réactions d’hydrogénation catalytique asymétrique peut être largement influencée par la concentration en hydrogène dans la phase liquide catalytique, avec généralement un impact néfaste sur l’excès énantiomérique (ee). Dans cette thèse, nous avons démontré, sur une large base de diphosphines chirales (56) et trois substrats prochiraux de type esters d’acylaminoacrylate, représentant une diversité chimique appréciable, que la conclusion d’un effet néfaste de la pression d’hydrogène généralement admis dans la bibliographie est fausse. En effet, sur la base des 168 systèmes catalytiques étudiés (diphosphine/substrat), quasiment autant d’effets néfastes (28%) et bénéfiques (29%) sont observés. D’autre part, les effets électroniques ont également été aussi étudiés sur une famille restreinte de diphosphines de type BINAP par substitution sur le groupe binaphtyle en positions 5,5’ et 4,4’ ou en position para des groupes phényles portés par le phosphore. La plupart de ces dérivés du BINAP ont dû être synthétisés. En particulier de nouvelles méthodes de synthèse des dérivés 5,5’ (Me, COOH, Ph) ont été mises au point et une nouvelle stratégie de synthèse en milieu liquide ionique a été conçue pour la préparation du synthon de base pour les dérivés 4,4’. Dans le cas des dérivés en position para, une corrélation nette entre l’excès énantiomérique et la constante de HAMMETT des substituants (Me, H, NH2, +NMe3, OMe, OH, O-) est obtenue. L’énantiosélectivité peut ainsi être « pilotée », de +57 à –34 %The enantioselectivity of catalytic asymmetric hydrogenations can be largely influenced by the hydrogen concentration in the catalytic liquid phase, with generally, a negative impact on enantiomeric excess (ee). In this thesis, we showed, on a large number of chiral diphosphine (56) and three prochiral substrates of acylaminoacrylate ester, that the conclusion of a negative effect of the hydrogen pressure generally admitted in the bibliography is wrong. Indeed, on the basis of 168 studied catalytic systems (diphosphine/substrate), an equivalent distribution of negative effects (28%) and beneficial effects (29%) is observed. In addition, the electronic effects were also studied on a restricted family of diphosphines of the BINAP type by substitution on the binaphtyl group in 5,5' and 4,4' position or para of the phenyls groups carried by phosphorus. The majority of these derivatives of the BINAP had to be synthesized. In particular a new method for the synthesis of derived 5,5' (Me, COOH, Ph) was developed and a new strategy of synthesis in ionic liquid medium was designed for the preparation of the 4,4'derivatives. In the case of para derivatives position, a clear correlation between enantiomeric excess and the HAMMETT constant for all the substituents (Me, H, NH2, +NMe3, OMe, OH, O-) is obtained. The enantioselectivity can thus be tuned, from +57 to -34 %
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Figueiredo, Paulo Henrique. "Apóstolo, “bispa” e seus rituais mágicos: observações antropológicas sobre a Igreja Apostólica Plenitude do Trono de Deus (IAPTD)." Universidade Presbiteriana Mackenzie, 2018. http://tede.mackenzie.br/jspui/handle/tede/3637.
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Igreja Presbiteriana do Brasil
The present research shows that there is an interaction process between religion and sorcery in Pentecostal churches recently founded in Brazil. This study was based on antropological perspectives by James George Frazer and Emile Durkheim, in which, both dealt with sorcery and religion as distinct practices. However, it was Marcel Mauss, followed by other theoreticals, who admitted a possible interaction. The present religious entities perform rituals where religion and sorcery are blended, and as mentioned before Antropology has treated these two things as being distinct. Bibliography analisys of the theme was used as methodology; participative observation of the service, as well as TV and radio programmes of Apostololica Plenitude do Trono de Deus Church, founded in 2006 by Agenor Duque and his wife Ingrid Duque.
A presente pesquisa demonstra que há um processo de interação entre religião e magia nas igrejas pentecostais fundadas recentemente no Brasil. O estudo foi baseado nas perspectivas antropológicas de James George Frazer e Émile Durkheim no qual ambos trataram magia e religião como práticas distintas. No entanto foi Marcel Mauss e, seguidamente outros teóricos, que admitiram uma possível interação. Essas atuais entidades religiosas praticam rituais em que há a mistura de práticas mágicas e religiosas, o que a Antropologia clássica em sua grande parte tratou como duas áreas distintas. Como metodologia foi empregada análise bibliográfica do tema; observação participativa dos cultos, assim como da análise de programas televisivos e radiofônicos da Igreja Apostólica Plenitude do Trono de Deus, fundada em São Paulo em 2006 pelo pastor Agenor Duque e sua esposa Ingrid Duque.
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MEURIOT, SABINE. "Traitement palliatif par bicap des cancers obstructifs de l'oesophage et du cardia, evaluation clinique preliminaire chez 19 malades." Lille 2, 1988. http://www.theses.fr/1988LIL2M125.
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Caldeira, Maria de Castro e. Almeida e. Paiva. "Princípios de sustentabilidade aplicados ao projecto de zonas verdes em cobertura. Caso prático dos terraços da BISA." Master's thesis, ISA/UL, 2015. http://hdl.handle.net/10400.5/11159.
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Mestrado em Arquitectura Paisagista - Instituto Superior de AgronomiaThe aim of this work is to study and analyse the benefits Green Roofs can bring to the environment, society and economy in terms of sustainability The goal of addressing these spaces from this perspective, relates to the fact that these issues are considered crucial parts in the ecological crisis we are experiencing today. Coating roofs with vegetation represents a safe, eco-friendly and natural way of softening the impact caused by urbanization and population density. The result of this study is a proposal for a roof top garden at Institute of Agronomy’s Library, going over a detailed analysis of the intervention space and a proposal to enhance the terrace, giving it a new character, taking into account the principles of sustainability studied throughout the work, making it a useful space, functional and beneficial to the building.
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Gautheron-Chapoulaud, Valérie. "Etude de la métallation du cycle benzénique de benzodiazines. Synthèse de composés aux propriétés électro-optiques. Synthèse d'un aza-BINAP." Rouen, 1998. http://www.theses.fr/1998ROUES082.
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Nous avons réalisé et mis au point la première fonctionnalisation via la réaction de lithiation du cycle benzénique de quinazolines, de quinoxalines et de phtalazines. Nous avons pu mettre en évidence une régiosélectivité quasi totale de cette réaction en position péri d'un atome d'azote cyclique. Grâce à la réaction de l'espèce lithiée avec une grande variété d'électrophiles, nous avons pu obtenir de nombreux nouveaux dérivés de benzodiazines difficilement accessibles, voire impossibles à préparer, par les méthodes traditionnelles. Nous avons appliqué cette méthode à la synthèse de diverses benzodiazines présentant des propriétés biologiquement actives potentielles, comme les analogues de la 4-(3-bromoanilino)-6, 7-diméthoxyquinazoline (inhibiteur de la tyrosine kinase). Dans une deuxième partie, nous avons mis au point la synthèse d'un nouveau aza-analogue du BINAP : la 4-(2'-diphénylphosphino-1'-naphtyl)-2-phénylquinazoline. Nous avons, dans une troisième partie, valorisé l'intéressante régiosélectivité de la lithiation en péri d'azote cyclique de benzodiazines en l'associant à la réaction de couplage pour la synthèse de 4,8- et 4,5-di(hétéro)arylbenzodiazines, susceptibles de présenter des propriétés optiques non linéaires.
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Fornasetti, Pietro. "Maisons en voyage : les migrations transnationales au prisme des réseaux matrimoniaux (Sinikiéré, Burkina Faso)." Thesis, Paris, EHESS, 2020. http://www.theses.fr/2020EHES0176.
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À travers l’ethnographie du village burkinabè de Sinikiéré, cette thèse montre que les migrations transnationales participent à la structuration d’un espace social local. Cette idée, qui constitue le fil conducteur de ma recherche, va être démontrée de manière originale : non pas, comme nous ont invité à le faire les études transnationales et post-modernes, en utilisant les mobilités pour déconstruire l’objectivité des territoires nationaux mais, à l’inverse, en montrant qu’une localité peut être produite par les mobilités. Cela revient à dé-singulariser ou banaliser la migration, au profit d’une organisation sociale fondée sur le mouvement. En interagissant avec d’autres catégories, issues de l’espace domestique et de la parenté, le mouvement devient ainsi l’un des opérateurs qui construisent et reconfigurent l’espace social villageois.Cette perspective analytique s’est trouvée fortement stimulée par la méthodologie employée lors de mes recherches. L’analyse des réseaux et le traitement informatique de la parenté m’ont en effet conduit à expérimenter plusieurs techniques : échantillonnage visant l’exhaustivité, constitution et analyse d’une base de données relationnelles, couplage d’analyses quantitatives et qualitatives. Ces techniques permettent notamment de saisir la nature réticulaire de l’espace social de Sinikiéré et fournissent un contrepoint constant à une ethnographie plus classique.Prendre conscience du rapport étroit entre le mouvement et l’organisation sociale m’a conduit à aborder plusieurs objets classiques de l’anthropologie avec de nouveaux yeux : les cadres villageois et ethniques (Chapitre 1), la maison (Chapitre 2), l’idéologie de l’« entente » (Chapitre 3), les âges de la vie (Chapitre 4) et le voyage (Chapitre 5)Through the ethnography of the Burkinabe village of Sinikiéré, this thesis shows that transnational migrations contribute to the structuring of a local social space. This idea, which constitutes the main theme of my research, will be demonstrated in an original way: not, as transnational and post-modern studies have invited us to do, by using mobilities to deconstruct the objectivity of national territories, but instead by showing that a village can be produced by mobilities. This amounts to rendering the notion of migration less unique or banalising it, in favour of a social organisation based on movement. By interacting with other categories deriving from domestic space and kinship, movement thus becomes one of the drivers that constructs and reconfigures the village social space.This analytical perspective was strongly stimulated by the methodology used during my research. The analysis of networks and digital treatment of kinship led me to experiment with several techniques: sampling that aimed to be exhaustive, constitution and analysis of relational databases, and pairing of quantitative and qualitative analyses. These techniques notably allow the reticular nature of the social space of Sinikiéré to be captured and provide a constant counterpoint to more traditional ethnography.Being aware of the narrow relationship between movement and social organisation led me to broach several traditional subjects in anthropology with fresh eyes: village and ethnic frameworks (Chapter 1), the home (Chapter 2), ideology and ‘understanding’ (Chapter 3), ages of life (Chapter 4), and travel (Chapter 5)
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Schreiber, Henning. "Eine historische Phonologie der Niger-Volta-Sprachen ein Beitrag zur Erforschung der Sprachgeschichte der östlichen Ost-Mandesprachen." Köln Köppe, 2008. http://d-nb.info/989058913/04.
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Faure, Armelle. "L'appropriation de l'espace foncier : une étude d'anthropologie sociale en région Bissa (Burkina Faso)." Paris, EHESS, 1990. http://www.theses.fr/1990EHES0019.
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La these comporte trois volets : une introduction historique, qui situe les bissa et leur passe dans l'evolution generale de la region; une monographie du pays bissa; la troisieme partie est consacree aux enjeux fonciers. L'analyse ethnographique, de type classique, s'articule autour des representations de l'espace, de l'organisation politique et sociale des bissa, et des questions de definition et de gestion des terroirs. La perspective de cette etude est de presenter en termes socio-anthropologiques les problemes d'amenagement et de developpement de la region centre-est du burkina faso. Les enjeux fonciers font intervenir des acteurs motives par des logiques variees ; la description d'evenements observes pendant la periode dite "revolutionnaire" (depuis 1983) met en lumiere les crises sociales engendrees par la question agraire : introduction de nouvelles techniques, arrivee de cultivateurs et d'eleveurs migrants, tentative de monetarisation de la terre par les commercants. Le processus de resolution des crises villageoises montre l'importance de l'ideologie du "monde des genies" dans cette societe autochtone : les "maitres des genies" jouent un role politique et social non negligeable, que l'on peut evaluer a partir d'enquetes aupres des chasseurs et pecheurs, des forgerons et des devins.
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Brewer, Paul J. "Allocation and computation in rail networks : a binary conflicts ascending price mechanism (BICAP) for the decentralized allocation of the right to use railroad tracks." Diss., Pasadena, Calif. : California Institute of Technology, 1995. http://resolver.caltech.edu/CaltechETD:etd-09172007-152133.
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Kleman, Angela M. "Asymmetric Hydroformylation of Styrene in Supercritical Carbon Dioxide." University of Toledo / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1116292003.
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Hazard, Benoit. "L' aventure des Bisa dans les ghettos de "l'Or rouge" (Burkina Faso-Italie) : trajectoire historique et recomposition des réseaux migratoires burkinabe dans la région des Pouilles." Paris, EHESS, 2007. http://www.theses.fr/2007EHES0296.
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Cette thèse décrit l'organisation de réseaux migratoires reliant la province du Boulgou (Burkina Faso) à l'Italie et s'attache à cerner une "culture migrante" en discutant, tour à tour, le cadre des études transnationales et les méthodes d'analyse des réseaux. A partir d'une enquête multi-située, elle révèle le redéploiement inédit d'une migration circulaire dans le cadre d'une transmigration initiée depuis la Côte d'Ivoire et dessine la trajectoire d'une société locale dans le champ migratoire burkinabé en Italie. Pour approcher les espaces sociaux de cette circulation, l'accent est mis sur les campements de journaliers agricoles liés à la récolte de tomates et situés dans la région des Pouilles. Figurant les emplacements d'une diaspora africaine forgée sur une communauté d'expérience, ces "ghettos" s'organisent autour de solidarités intermédiaires, comme celle des "caponeri", qui interrogent la capacité des immigrants à produire du lien social dans un contexte maffieuxThis thesis describes the organization of migratory networks connecting the province of Boulgou (Burkina Faso) to Italy. Regarding the interactions between a local context, "bisaku", and the social group of "the sons of Italy", it questions a "travelling culture" by discussing, alternately, a framework proposed by the transnational studies and the network's analysis. Anchored on a multi-sited ethnography, it brings to light the redeployment of a circular migration within the frame of a transmigration operated from Ivory Coast towards Italy. This process leads to describe a local society through its multiple locations and more precisely through places representing an African Diaspora that the Burkinabé name as "ghetto". Altough Bisa perceives these camps of agricultural labourers as "etnoscape", the Mafia practices observed in the fields of tomatoes of the region of Pouilles, as that of the "caponeri" show that the agency of African do not resist to the orders of the local context
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Nilsson, Jonas, and Åsa Schyberg. "Musikens (rock´n) roll i skolan – egenvärde, mervärde eller bara en bisak? Uppfattningar om musikens roll i skolan bland elever och lärare i skolår 5, 7 och 9." Thesis, Kristianstad University College, Department of Teacher Education, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-3388.
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Studien visar hur några lärare och elever i skolår 5, 7 och 9 i intervjuer beskriver musikens roll i skolan och vad den kan ha för betydelse för lärandet. Litteraturgenomgången behandlar musikens roll i utbildningen genom historien och i de senaste läroplanerna, olika musikpedagogiska idéer samt forskning om musik och lärande. Teoretiska utgångspunkter är resonemang av Säljö, Marton och Booth och teorin om habitus. Resultaten från intervjuerna pekar på att musik kan ha många olika roller i skolan i olika sammanhang. Rollerna kan ses i termer av egenvärde och mervärde. Musikens egenvärde är att man tränar förmågor man inte tränar annars. Musikens mervärde är att den ofta tjänar som medel för att uppnå något annat. Musikundervisningens roll anses viktig för att alla ska få lära sig sjunga och spela lite och få kännedom om andras musik. Bakgrundsmusik spelar en roll genom att verka koncentrationshöjande och stimulera till lugn eller aktivitet, beroende på behov för situationen. Bakgrundsmusikens inverkan på lärandet anses av respondenterna olika från person till person. Musik som kan påverka positivt är musik man tycker om, företrädesvis lugn musik. Musik har en viktig roll genom att skapa glädje och avkoppling, vilket anses gynnsamt för lärandet.
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Marano, Alexis. "Non-invasive positive pressure ventilation (nppv) its uses, complications, & implications within nursing practice in acute care settings." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/580.
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The use of noninvasive positive pressure ventilation (NPPV) in acute care settings has drastically increased within the past 20 years. Research has indicated that NPPV is equally as effective as traditional mechanical ventilation(MV) in treating acute exacerbations of chronic pulmonary obstructive disease (COPD) and cardiogenic pulmonary edema. Furthermore, the risk of complication from NPPV is much lower than MV, in terms of ventilator-associated pneumonia and sepsis. It is imperative for the nurse to understand the various indications, interfaces, and potential complications associated with NPPV use. In addition to treating acute exacerbations of COPD and cardiogenic pulmonary edema, NPPV has been used for prevention of reintubation, palliative care, and status asthmaticus. Furthermore, NPPV could be delivered through various interfaces, such as nasal, facial, and helmet. Each of these interfaces could eventually cause complications for the patient, such as skin ulceration and sepsis. However, there is limited amount of research available discussing the role of the nurse in caring for the patient with NPPV. There are no standardized guidelines established to assist the nurse in this care, in terms of interface selection, prevention of complications, and staffing patterns. Several recommendations are presented at the end of this thesis to guide future nursing research, education, and clinical practice, such as exploring the role of oral care and education for NPPV patients.B.S.N.
Bachelors
Nursing
Nursing
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Lehovec, Jakub. "Synchronizace javascript objektu mezi klienty a serverem." Master's thesis, Vysoká škola ekonomická v Praze, 2014. http://www.nusl.cz/ntk/nusl-193341.
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The thesis deals with methods of real-time data synchronization among multiple clients. The thesis focuses on methods in collaborative RIA systems running on the Internet This methods solve data transfer and conflict resolution caused by competitive clients work on one document. The introduction describes two methods: an established Operational transformation method and the new Differential synchronization method. The thesis describes the principles of both methods and their advantages and disadvantages. The aim of the work is implementing and comparison of Differential Synchronization method with Operational transformation method. These methods are compared in Node.js environment of JavaScript programming language and it is compared their performance in terms of response time and resource requirements. It's identified a problems associated with the method implementations in Node.js and it is described solutions of this problems. In the practical part thesis focus on the describing of performance data and behave of methods during measurement and refuted or confirmed the premises of methods definition assumptions. The Differential Synchronization method is extended by some parts based on the author often criticized issues of method.
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Zaake-Hertling, Haldor. "Poröse Koordinationspolymere mit Linkern auf Basis Polycyclischer Aromatischer Kohlenwasserstoffe." Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-210415.
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Zusammenfassung In der vorliegenden Promotionsschrift werden Strategien zur Erzeugung von Linkermolekülen beschrieben, die geeignet sind, um als Bauelemente für sogenannte \"Metal-Organic rameworks\" (MOF) eingesetzt zu werden. Diese Stoffe bestehen aus einem organischen \"Linker\"-Teil, welcher die Metalleinheiten (\"Sekundäre Baueinheit\", SBU) miteinander verbindet, und dadurch die Entstehung von dreidimensionalen porösen Netzwerken ermöglicht. Dieses Projekt wurde an der Universität Leipzig in der Arbeitsgruppe von Prof. Dr. rer. nat. Dr. h.c. Evamarie Hey-Hawkins am Institut für Anorganische Chemie durchgeführt. Seit den frühen neunziger Jahren genießen MOFs großes Interesse aufgrund ihrer besonderen Eigenschaften als Festkörper mit wohldefinierter und permanenter Porosität. In der Einleitung dieser Promotionsschrift werden das Anwendungspotential oder bereits existierende Anwendungen für MOFs und verwandte poröse Feststoffe näher beschrieben. Mögliche Anwendungsgebiete sind unter anderem Gasspeicherung, Trennverfahren, zur Katalyse, in der Medizin und für Detektoren in der analytischen Chemie. Die Auswahl der organischen Baueinheiten für die Synthese von MOFs richtet sich nach Kriterien wie z.B. thermischer Stabilität, Geometrie der koordinierenden Einheiten, Rigidität des Linkermoleküls. Weiterhin können potentielle sekundäre Effekte berücksichtigt werden, z.B. Eignung für katalytische Prozesse, Ladungspufferung oder Lichtsammelvermögen. Alle Linker enthalten aromatische Einheiten; es werden Anthracen, Binaphthyl (verkörpert durch chirale BINAPO-Einheiten), Biphenyl, Pyren und Perylen als Mittelstück des Linkers eingesetzt. Die Promotionsschrift beleuchtet auch in einem Streifblick die Geschichte, das Vorkommen, mögliche Anwendungen und Giftigkeit von Molekülen mit polycyclischen aromatischen Kohlenwasserstoffgruppen. Die Synthese der Linker wurde mittels der folgenden Route realisiert: Bromierung der aromatischen Bestandteile und Anfügen von Endstücken (\"capper\") - welche die koordinierenden Einheiten enthalten - durch die Suzuki-Miyaura-Kupplung. Die Syntheserouten für den bromierten aromatischen Mittelteil des Linkers, die Boronsäuren und die vollständigen Linker, werden im experimentellen Teil beschrieben, und die erhaltenen Linker werden charakterisiert. Für den anorganischen Teil des MOF wurden außerdem ausgewählte komplexe Einheiten erzeugt, die als Startmaterialien für den sogenannten \"controlled SBU approach\" (CSA) dienen. Bei dieser Methode wird eine Baueinheit erzeugt, die der gewünschten eigentlichen Baueinheit im fertiggestellten MOF ähnlich ist und dann als Präkursor in der Synthese eingesetzt wird. Verschiedene Ansätze zur Erzeugung von MOFs wurden ausgeführt: Langsame Diffusion in Flüssigkeiten oder Gelen und vor allem Tempern der organischen und anorganischen Baueinheiten oder Startmaterialien in einem Lösungsmittel, teilweise unter solvothermalen Bedingungen. Mehrere Polymere wurden in einer zur Röntgenstrukturbestimmung geeigneten kristallinen Form erhalten. Die Strukturen werden in der vorliegenden Arbeit präsentiert und diskutiert. Ein Ausblick auf weiterführende Untersuchungen an diesen Verbindungen wird ebenfalls gegebenAbstract This thesis describes approaches to obtain linker molecules that are suitable to build a so-called \"metal-organic framework\", MOF (or porous coordination polymer, PCP). These materials consist of an organic linker part that connects the metal units, \"secondary building units\" (SBU), with each other to form threedimensional, hollow networks. This project was performed at the University of Leipzig in the multinational workgroup of Prof. Dr. rer. nat. Dr. h.c. Evamarie Hey-Hawkins, at the Faculty for Inorganic Chemistry. These MOF materials have gained a lot of interest since the early 1990s for their special properties as solid materials with a well-defined, permanent porosity. The introductory part of this thesis elaborates potential or already current usage of MOF materials and related porous solids, such as gas storage, separation processes, catalysis, medical use and use in analytic detection. The choice of organic building blocks for the synthesis of MOFs followed certain criteria, such as thermal stability, geometry of coordinating units, rigidity of the linker molecule, and potential secondary effects such as suitability for catalytic purposes, charge buffering or light harvesting. All linkers feature aromatic units, and among the cores are moieties like anthracene, binaphthyl (represented by the chiral BINAP), biphenyl, pyrene and perylene. A glance is thrown on the history, occurrence, possible use and potential toxicity of molecules with polycyclic aromatic hydrocarbon moieties. Synthesis of the linkers is implemented by use of brominations of the aromatic core units and attaching capper units - carrying the coordinating units - by means of Suzuki-Miyaura-coupling. The synthesis routes to these molecules, brominated aromatic core, boronic acids and finished linkers, are described in the experimental part. The obtained linkers are characterised and described. Furthermore, selected complex units for the inorganic part of a potential MOF were created as starting materials for a so-called \"controlled SBU approach\" (CSA); wherein a building block, very similar to the desired unit in the final framework, is prepared and then used as a precursor in the synthesis. Various attempts at the generation of MOFs were conducted: Slow diffusion in liquids or gels, and, especially, reactions by tempering the organic and inorganic building blocks or starting materials in a solvent - partially also under solvothermal conditions. Several polymers were obtained in crystalline form, suitable for structure determination by X-ray crystallography. These structures are presented and discussed in this work, as well as the further research on these solids and the results being achieved
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Silva, Ana Sofia Maciel Campos da. "Comparison of HAPS, BISAP and NLR as predictors of morbidity and mortality in acute pancreatitis." Master's thesis, 2018. http://hdl.handle.net/10451/41837.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018Objetivos: Comparar a capacidade preditiva do BISAP, NLR e HAPS, na mortalidade e morbilidade em doentes com Pancreatite Aguda (PA) associada a Litíase. Métodos: Foram analisados retrospetivamente, os dados necessários ao cálculo do BISAP, NLR e HAPS à admissão no Serviço de Urgência. Os doentes foram classificados em PA ligeira, moderada e grave, segundo os critérios de Atlanta revistos em 2012. Foram calculadas Receiver-operating characteristic (ROC) Curve e respetiva area under the curve (AUC) dos 3 índices para determinar a sua acuidade. Foi calculado um ponto de corte ótimo para o NLR. Foram documentados os casos de mortalidade e morbilidade (complicações ou falência orgânica) associados e foi feita uma análise comparativa para cada um dos out-comes, para cada um dos índices. Resultados: O BISAP apresentou melhor capacidade preditiva de mortalidade que o NLR (AUC de 0.86 e 0.78, respetivamente), que por sua vez apresentou um melhor resultado que o HAPS (0.64). Em relação à morbilidade, o BISAP (AUC de 0.82) demonstrou ser superior ao HAPS e NLR , que se assemelham (0.68). Conclusão: BISAP ≥ 3 apresenta uma elevada acuidade preditiva e é o mais específico nos dois out-comes estudados. NLR apresenta uma razoável acuidade preditiva. É a ferramenta mais sensível na previsão de mortalidade (sensibilidade de 84.6%).O HAPS é o índice mais sensível na deteção de morbilidade (sensibilidade de 76.6%). As 3 ferramentas, além de fáceis e rápidas de calcular, são úteis como testes de exclusão, com destaque do BISAP.
Objectives: To compare the predictive capacity of BISAP, NLR and HAPS in morbidity and mortality in patients with acute pancreatitis associated with biliary lithiasis. Methods: In a retrospectively way, it was analysed the necessary data regarding BISAP, NLR and HAPS index calculus, gathered in the Emergency Room admission. The patients were classified as mild Acute Pancreatitis (AP), moderate AP or severe AP, according to 2012 revised Atlanta classification. The Receiver-operating characteristic (ROC) curve and Area under the curve (AUC) for each index were calculated to determine its accuracy. It was also calculated a optimal cut-off point for NLR. Mortality and morbidity cases (complications or organic failure) were documented and it was made a comparative analysis of each outcomes, for each index. Results: BISAP showed better mortality predictive capacity than NLR (AUC 0.86 and 0.78, respectively), with the latter showing better results than HAPS (0.64). Regarding morbidity predictive capacity, BISAP (AUC de 0.82) showed better results than HAPS and NLR (0.68), which resembled. Conclusion: BISAP ≥ 3 presents an elevated predictive accuracy and it is the most specific in both studied outcomes. NLR presents a reasonable predictive accuracy, being the most sensible index in predicting mortality (sensibility 84.6%).. HAPS is the most sensible index predicting morbidity (sensibility 76.6%).. All 3 indexes are easily and readly calculated, also being useful as exclusion tests, mostly BISAP.
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Chen, Zhi-Qiang, and 陳志強. "Novel catalytic reaction involving BINAP ancillary ligand." Thesis, 1994. http://ndltd.ncl.edu.tw/handle/45082710584354824398.
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Chen, Chih Chiang, and 陳志強. "Novel Catalytic Reaction Involving BINAP Ancillary Ligand." Thesis, 1994. http://ndltd.ncl.edu.tw/handle/59744799180009326868.
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碩士國立臺灣大學
化學學系
82
Among the various Ru(BINAP) complexes reported in the literature, Ru(BINAP)(OAc)2 has attracted most attention owing to its high enantioselectivity in the asymmetric hydrogenation of prochiral olefin. We describe a simple and high yield syn- thesis of Ru(BINAP)(OAc)2 from [Ru(COD)Cl2]n. The mechanism of the Ru(BINAP)-catalyted hydrogenation of 2-substituate-acrylic acid has been investigated via detailed deuterium labelling studies. In the thiesis we wish to report a very high yield system for the reductive ammination of .alpha.-ketocarboxylic acids. One of the most difficult parts in the study of the asymmetric hydro- genation of prochiral imines is the geometric isomerism of imines. Opposite optical isomers are expected from the asymmetric hydrogenation of syn and anti imines. To prove this proposal, we synthesize the corresponding oximes which can be isolated and studied separately.
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Esteves, D'Javana Suely Neto Alves. "Relatório de estágio: capital intelectual - um estudo no BISTP." Master's thesis, 2015. http://hdl.handle.net/10400.26/11472.
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O presente relatório é o resultado final de um estágio curricular realizado no âmbito do mestrado em Auditoria Empresarial e Pública do Instituto Superior de Contabilidade e Administração de Coimbra (ISCAC), no Banco Internacional de São Tomé e Príncipe (BISTP). O estágio teve como objetivo proporcionar a inserção da estagiária no mercado de trabalho e adquirir conhecimentos e competências essenciais para o seu desenvolvimento pessoal e profissional.
Nas últimas décadas a globalização da economia mundial e o desenvolvimento contínuo das novas tecnologias de comunicação e de informação conduziram as organizações a procurarem novas fontes de riqueza e de vantagens competitivas para garantirem a sua sustentabilidade e sobrevivência a longo prazo. Como consequência, os ativos intangíveis destacam-se como fatores críticos de crescimento sustentável e o capital intelectual tornou-se o principal recurso das organizações. O capital intelectual é constituído pelo capital humano, capital estrutural e capital relacional, considerando-se que o capital humano compreende o conhecimento e a experiência dos colaboradores da organização, o capital estrutural engloba o conjunto de conhecimentos codificados que são propriedades da organização e o capital relacional compreende as relações com a envolvente externa. Essa nova realidade intangível no meio empresarial tem constituído um desafio para a contabilidade no que toca ao reconhecimento, à mensuração e à divulgação do valor gerado por este recurso, apesar do crescente reconhecimento da sua importância estratégica.
Na elaboração deste trabalho, além da descrição da entidade acolhedora e atividades realizadas durante o estágio, procede-se à revisão dos principais conceitos e literatura relativamente aos ativos intangíveis e, em particular, ao capital intelectual. De seguida, apresenta-se o estudo de caso que foi realizado com o objetivo de averiguar a importância e a situação dos indicadores de capital intelectual no BISTP. Para o efeito foi utilizado um questionário baseado na proposta do Modelo Intelect, dirigido aos gerentes das doze agências.
O estudo permite concluir que o capital intelectual é importante e valorizado na empresa, pois os indicadores selecionados obtiveram um resultado satisfatório na avaliação efetuada pelos gerentes das agências, permitindo identificar os pontos fortes e os pontos fracos que podem ser melhorados para proporcionar à empresa um melhor desempenho.
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Dai, Chih-Chung, and 戴志忠. "Modifed BINAP Ligands and their Application in Asymmetric Catalysis." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/16899121361139516388.
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Dai, Zhi-Zhong, and 戴志忠. "Modified BINAP Ligands and their Application in Asymetric Catalysis." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/37332066072160366469.
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Lu, Hui-Chun, and 呂蕙君. "Rapid growth waves off the Bisa Fishing Harbor." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/07598647927245644957.
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碩士國立臺灣海洋大學
海洋環境資訊學系
95
Rapid growth waves may be dangerous for small crafts in the coastal water or fishermen fishing at the coast. Wave data measured outside the Baudoutz fishing harbor, located near Keelung, were examined to find events with significant wave height increased two folds in six hours. These events were defined as rapid growth waves. It was found that these rapid growth events mostly occurred in the winter and they often grew to more than 3m. For the winter events, the growth rates ranged from 0.24 – 0.46 m/hr. From the meteorological data, one can see that the winter rapid growth wave started to grow close to the time of the lowest atmospheric pressure. The time of the lowest pressure was obviously the passage of a low pressure front, which preceded the winter cold air mass with strong northerly wind. In the rapid growth events, the wave height increased with the locally measured wind speed. By examining the significant wave period and spectral peakedness parameter, one can surmise that the waves in these winter events in large part were due to swells propagated from the north, not the locally generated waves. The rapid growth wave events occurred in the summer, while these events have growth rate in the range of 0.3 – 0.57 m/hr, the highest significant wave height in the events only reached 1.5m. These events were associated with meteorological front. After the passage of the front, the wave height diminished rapidly. Obviously, the summer rapid growth wave posed less danger than those occurred in the winter.
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Ávila, Daniel Martinez. "DDC-BISAC switching as a new case of reader-interest classification." Doctoral thesis, 2018. http://hdl.handle.net/10316/81131.
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Horn, Joachim [Verfasser]. "Synthese eines perfluorierten BINAP-Liganden und dessen Anwendung in fluorigen-organischen Zweiphasensystemen / vorgelegt von Joachim Horn." 2007. http://d-nb.info/983155682/34.
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Fu-Ju, Hung, and 洪富如. "Exploring the adjusting process of adult patients who use bi-level positive airway pressure（BiPAP）ventilator." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/34807896148464457158.
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Fang, Chiang Mei, and 江美芳. "A Study on the Performance Evaluation of BISP and ASP Strategic Alliance in Taiwan." Thesis, 2002. http://ndltd.ncl.edu.tw/handle/90558916158821829137.
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碩士銘傳大學
傳播管理研究所
91
The purpose of this paper is to propose an algorithm for performance evaluation of BISP and ASP strategic alliance in Taiwan under fuzzy environment. The fundamental concepts we have adopted include the factor analysis, eigenvector method, fuzzy Delphi method, fuzzy set theory and multi-criteria decision-making method. We use factor analysis to condense twenty three performance sub-criteria into five criteria to construct the hierarchical structure of performance evaluation of BISP and ASP strategic alliance. The fuzzy Delphi method is integrated with the eigenvector method to form a set of pooled weights of the extracted criteria. The concepts of triangular fuzzy number and linguistic variables are used to assess the preference ratings of linguistic variable, ‘importance’ and ‘appropriateness’. Through the hierarchy integration, we obtain the final scores of performance evaluation of BIS and ASP strategic alliance. Then we use a revised Chang and Chen’s ranking method to rank the final scores of performance for understanding the best ASP.
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Chou, Hsiang-Lin, and 周湘玲. "Patient-ventilator Interaction during APRV/BIPAP Modes among Three Ventilators in ARDS Patients: a Model Lung Study." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/4238wj.
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碩士臺北醫學大學
醫學檢驗暨生物技術學系所
102
Airway pressure release ventilation (APRV) and biphasic positive airway pressure (BIPAP) modes increase mean airway pressure and functional residual capacity by increasing inspiratory time, and allow spontaneous breathing without limitation during high and low airway pressure periods. Many studies confirmed that these two modes can effectively improve ventilation/perfusion and oxygenation in patients with acute respiratory distress syndrome (ARDS). However, APRV/BIPAP modes are not widely used clinically. Several questions have been raised, i.e., why frequent asynchrony occurs between patients and ventilator? Whether augmented spontaneous breathing (ASB) should be used during spontaneous breathing or not? Which kind of ASB is the most effective to decrease the patient’s work of breathing? How do the changes of inspiration/expiration ratio affect the patient-ventilator synchrony and the work of breathing? The APRV/BIPAP mode with inspiratory pressure high/expiratory pressure low settings were 20/8 cmH2O in PB840, G5 and Servo-i. Three different ASB: non, pressure support 16 cmH2O and 100% automatic tube compensation (ATC), combined with five different inspiration/expiration time: 1:5, 2:4, 3:3, 4:2 and 5:1 to formulate 15 test conditions were set on each ventilator. The ASL5000 was used to simulate the lungs of ARDS patients. The computer was connected to the ASL 5000 to collect and analyzed data gained after 10 minutes run of each test conditions according to the settings mentioned above. The purpose of the study was to find the most suitable settings for the three different ventilators, PB840, G5 and Servo-i, with APRV/BIPAP mode and which ventilator has good performance. The results showed that in G5 and Servo-i APRV/BIPAP modes with different ASB, the best patient-ventilator interaction was with pressure support, represented as smallest values of inspiratory time delay (TI delay) and inspiratory trigger pressure (Ptrig). Work of breathing was the least with pressure support, represented as trigger work (WOBtrig) and pressure time product (PTP). In the contrast, the worst and highest of each respectively was with non. However in PB840, we found the highest Ptrig and largest PTP with ATC but the lowest with pressure support. In different inspiration/expiration settings, we found increased WOBtrig, PTP, Ptrig and TI delay with increased inspiration time, possibly due to the spontaneous breathing occurred at high pressure period. The respiratory waveform analysis of 3 ventilators demonstrated that there is no expiratory asynchrony in PB840, probably due to it could automatically shorten its inspiration/expiration time to cooperate the patients breathing cycle. Therefore, PB840 has the best interaction with the simulated lung. Waveform of Servo-i showed irregularity, frequent asynchrony and it could not automatically adjust its inspiration/expiration time to cooperate with the simulated lung. Servo-i has the worst interaction with the simulated lung. In conclusion, expiratory asynchrony occurred in Servo-i and G5. PB840 has longer synchronized interval and it is able to adjust inspiration/expiration time, resulting in better interaction. In the same ventilator we found that without ASB and increased inspiration time would cause poorer patient-ventilator interaction, and increased trigger work. Using pressure support as ASB provides the best interaction and cause the least trigger work.