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Littérature scientifique sur le sujet « Stoke units »

Auteur : Grafiati
Publié le 4 juin 2021
Mis à jour le 11 février 2022

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Articles de revues sur le sujet "Stoke units"

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Yahya, Nurul, et Derrett Watts. « Patient experience survey for community drug and alcohol service users in hospitals ». BJPsych Open 7, S1 (juin 2021) : S229. http://dx.doi.org/10.1192/bjo.2021.611.

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AimsTo explore and monitor experience of hospital care provided to patients of Stoke Community Drug and Alcohol Services (CDAS) and Edward Myers Unit (EMU; detox inpatient based unit).MethodThe sample was collected from patients who attended face-face clinics at CDAS and patients living in Stoke-On-Trent who were admitted to the Edward Myers Unit. The survey pertains to four locations, which include Royal Stoke Hospital, A + E, Harplands Hospital (Mental Health Unit), and EMU.We collected data of over two months from September–November 2020. The cohort of patients from CDAS included new presentations or restart Opioid Substitution Treatment (OST) clinics and people known to the alcohol team at CDAS.We delivered a survey pertaining to experience of hospital care in the last 12 months. This includes treatment at A&E Royal Stoke Hopital, any of the wards at Royal Stoke Hospital, Harplands Hospital and Edward Myers Unit.ResultThe uptake for the survey was 53/83 (64%) at CDAS clinic and 23/44 (52%) at Edward Myers Unit. The sample comprised more men than women. The majority were aged 31–40 years. Most common substances used were alcohol.Majority of patients has been admitted to the general hospital, either in the ward or seen at A + E. Most people were very satisfied with their treatment in all four locations. This include withdrawal symptoms, pain, mental health, and discharge plan. There were diverse reasons given of the satisfactory scores. EMU seems to have the best overall scores comparatively to the other units, with Harplands Hospital seems to be doing worse.The free text comments revealed that the staffs' courtesy, respect, careful listening and easy access of care was particularly the strongest driver of overall patient satisfaction. Patients look for supportive relationships, to be involved in treatment decisions, effective approaches to care, easy treatment access and a non-judgemental treatment environment. In some aspects, patients were dissatisfied with pain management, longer waiting times and inability to treat them as equal to non drug/alcohol users.ConclusionOn objective measures, patients were satisfied with treatment received, however, some has point out their dissatisfaction, particularly in the mental health setting. This project calls for greater attention and support for addiction service provision in emergency departments and hospital wards. Although these findings do not represent the views of all patients in SUD treatment, findings give insight into the ways treatment providers, service managers and policy makers might enhance the patient experience to improve patient treatment prognosis and outcomes
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Cashion, Catelyn, Yash Gawarikar et Ronak Patel. « 081 Description of a stroke unit mimic admissions ». Journal of Neurology, Neurosurgery & ; Psychiatry 89, no 6 (24 mai 2018) : A33.1—A33. http://dx.doi.org/10.1136/jnnp-2018-anzan.80.

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IntroductionThere is evidence to support both clinically and economically that stroke units improve stroke outcomes, but this is offset by high stroke mimics rates, which account for up to quarter of stroke unit admissions. There is no Australian data looking at stroke mimic rates and the time of day when they are admitted.MethodsWe conducted a retrospective cross-sectional study at Calvary Public Hospital, Bruce from May 2014 to May 2017 looking at stroke unit admission rates and mimic types. We collected data on the times of stroke unit admission, business hours Monday to Friday 0800–1630 hours and after-hours Monday to Friday 1630–0800 hours, weekends 0800–0800 hours. Stroke mimics length of stay (LOS) was compared with TIA mild strokes (NIHSS <5) LOS.ResultsOut of 1017 stoke unit admissions, 257 (25.3%) were stroke mimics. The most common mimic diagnoses were migraine and headaches (18.3%), peripheral vestibulopathy (14.0%), and functional neurology (13.2%). Data on admission times were available for 240 of 257 (93.4%) mimics of which more than 2/3 s of mimics were admitted after-hours; Bayes factor 0.912 demonstrating this is unlikely to be a significant difference. 3.5% of stroke mimics were thrombolysed with 2/3 s occurring after-hours. The average LOS was 2.3 days for mimics, compared to 4.0 days for TIA and minor strokes (p=0.00017).ConclusionOur study shows similar stroke mimic rates as previously described in literature with a higher proportion of these patients were admitted after-hours. However, there is little evidence that this difference is significant. The LOS for stroke mimics was less than TIAs and minor strokes. Our study highlights the need for better recognition of stroke mimics in order to prevent unnecessary utilisation of a valuable resource such as the stroke unit.
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BARALIAKOS, XENOFON, JOACHIM LISTING, ANNA von der RECKE et JURGEN BRAUN. « The Natural Course of Radiographic Progression in Ankylosing Spondylitis — Evidence for Major Individual Variations in a Large Proportion of Patients ». Journal of Rheumatology 36, no 5 (30 mars 2009) : 997–1002. http://dx.doi.org/10.3899/jrheum.080871.

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Objective.To describe the natural course of radiographic progression and to differentiate rates of progression in patients with ankylosing spondylitis (AS).Methods.Overall, 146 patients with AS who had never received anti-tumor necrosis factor therapy were analyzed in this retrospective cohort study. The main inclusion criterion was the availability of complete sets of cervical and lumbar radiographs from at least 2 timepoints within 6 years. Using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), we quantified the structural changes and assessed different rates of radiographic progression based on development of new syndesmophytes/year.Results.The mean followup time was 3.8 ± 1.7 years (range 1–6) and the mean number of consecutive radiographs was 2.7 (range 2–6) per patient. The mean mSASSS change/year was 1.3 ± 2.5 units. Radiographic progression showed much variability, since 43% of patients showed a 4-fold greater rate of progression than the mean, and 23% had no progression. The data-based definition for “fast progression” was calculated as a change > 5 mSASSS units or > 2 new syndesmophytes; for “moderate progression” as change of 2.0–5.0 mSASSS units or < 2 new syndesmophytes; and for “slow progression” as change of < 2 mSASSS units or no more than 1 new syndesmophyte within 2 years. The only factor to predict future radiographic progression was the number of syndesmophytes at baseline.Conclusion.Radiographic progression in AS is rather variable and many patients show high rates of progression. On the basis of this retrospective dataset we propose to differentiate patients on an individual level according to their progression rates: patients with fast, moderate, and slow radiographic progression, assessed by counting new syndesmophytes. Predicting radiographic progression remains difficult; only the prevalence of syndesmophytes at baseline is predictive of future damage.
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van der Heijde, Désirée, Pedro Machado, Jürgen Braun, Kay-Geert A. Hermann, Xenofon Baraliakos, Benjamin Hsu, Daniel Baker et Robert Landewé. « MRI inflammation at the vertebral unit only marginally predicts new syndesmophyte formation : a multilevel analysis in patients with ankylosing spondylitis ». Annals of the Rheumatic Diseases 71, no 3 (6 octobre 2011) : 369–73. http://dx.doi.org/10.1136/annrheumdis-2011-200208.

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ObjectiveTo investigate the relationship between MRI inflammation at the vertebral unit and the formation and growth of syndesmophytes at the same vertebral unit.MethodsAn 80% random sample of the ASSERT database was analysed. MRI were scored using the ankylosing spondylitis (AS) spinal MRI activity score (at baseline, 24 and 102 weeks) and spinal x-rays were scored using the modified Stoke AS spine score (at baseline and 102 weeks). Data were analysed at the patient level and the vertebral unit level using a multilevel approach to adjust for within-patient correlation.ResultsThere was a slightly increased probability of developing syndesmophytes in vertebral units with MRI activity, which was maintained after adjustment for within-patient correlation (per vertebral unit level) and treatment, and after further adjustment for potential confounders, resulting in significant OR ranging from 1.51 to 2.26. Growth of existing syndesmophytes at the vertebral unit level was not associated with MRI activity. At the patient level only a trend for an association was observed.ConclusionMRI inflammation in a vertebral unit slightly increases the propensity to form a new syndesmophyte in the same vertebral unit, but does not predict the growth of already existing syndesmophytes. Despite this association, the large majority of new syndesmophytes developed in vertebral units without inflammation. The subtle association at the vertebral unit level did not translate into an association at the patient level.
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Ramiro, Sofia, Carmen Stolwijk, Astrid van Tubergen, Désirée van der Heijde, Maxime Dougados, Filip van den Bosch et Robert Landewé. « Evolution of radiographic damage in ankylosing spondylitis : a 12 year prospective follow-up of the OASIS study ». Annals of the Rheumatic Diseases 74, no 1 (16 août 2013) : 52–59. http://dx.doi.org/10.1136/annrheumdis-2013-204055.

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ObjectivesTo describe the evolution of radiographic abnormalities of the spine in patients with ankylosing spondylitis (AS).MethodsPatients with AS were followed prospectively with 2 yearly radiographs for 12 years. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was scored by two readers (R1 and R2). New syndesmophytes at uninvolved vertebral corners were computed. Radiographic progression was investigated using generalised estimating equations.Results809 radiographs (presenting 520 at 2 yearly intervals) from 186 patients (70% men, mean age 43 (SD 12) years, mean 20 (SD 12) years since symptom onset and 83% HLA-B27 positive) were included. Mean mSASSS at baseline was 11.6 (16.2). While the course of progression in individual patients was highly variable, and still occurred in patients with decades of symptom duration, mean 2 year progression was 2.0 (3.5) mSASSS units. Over the entire follow-up, at least one new syndesmophyte was found in 55% (R1) and 63% (R2) of patients (38% (R1) and 39% (R2) of all intervals). In 24% of patients (39% of intervals), there was no progression. A progression ≥5 mSASSS units occurred in 22% of patients (or in 12% of intervals). At the group level, a linear time course model fitted the data best, with a constant rate over the entire 12 year interval of 0.98 mSASSS units/year. Radiographic progression occurred significantly faster in men, in HLA-B27 positive patients and in patients with a baseline mSASSS≥10.ConclusionsLong term radiographic progression in AS is highly variable in the individual patient, more severe in HLA-B27 positive men and still occurs after decades of disease. At the group level, however, progression in AS follows an approximately linear course.
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Molnar, Christoph, Almut Scherer, Xenofon Baraliakos, Manouk de Hooge, Raphael Micheroli, Pascale Exer, Rudolf O. Kissling et al. « TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity : results from the Swiss Clinical Quality Management cohort ». Annals of the Rheumatic Diseases 77, no 1 (22 septembre 2017) : 63–69. http://dx.doi.org/10.1136/annrheumdis-2017-211544.

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ObjectivesTo analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS).MethodsPatients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis.ResultsA total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97).ConclusionTNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity.
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Hebeisen, M., R. Micheroli, A. Scherer, X. Baraliakos, M. De Hooge, D. Van der Heijde, R. B. M. Landewé et al. « OP0075 SPINAL RADIOGRAPHIC PROGRESSION IN AXIAL SPONDYLOARTHRITIS AND THE IMPACT OF CLASSIFICATION AS NONRADIOGRAPHIC VERSUS RADIOGRAPHIC DISEASE ». Annals of the Rheumatic Diseases 79, Suppl 1 (juin 2020) : 50–51. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3576.

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Background:Data on spinal radiographic progression is more limited in nonradiographic axial spondyloarthritis (nr-axSpA) than in the radiographic disease state (r-axSpA). It remains unclear, whether radiographic sacroiliitis is by itself associated with progression of spinal structural damage.Objectives:To investigate whether spinal radiographic progression relates to structural damage at the sacroiliac level in axSpA by means of statistical mediation analyses in a large prospective real-life cohort of patients with axSpA.Methods:Patients from the Swiss Clinical Quality Management cohort were included if they fulfilled the ASAS classification criteria and could be classified as nr-axSpA or r-axSpA after central scoring of pelvis radiographs. Spinal radiographs performed every 2 years were scored according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The relationship between classification status and spinal progression over 2 years was investigated using binomial generalized estimating equations models with adjustment for sex, ankylosing spondylitis disease activity score (ASDAS) and tumor necrosis factor inhibitor treatment. Baseline spinal damage was considered an intermediate variable and included in sensitivity analyses, as were additional variables potentially influencing radiographic progression.Results:In total, 88 nr-axSpA and 418 r-axSpA patients contributed to data for 725 radiographic intervals (Table 1). Mean (SD) mSASSS change over 2 years was 0.16 (0.62) units in nr-axSpA and 0.92 (2.78) units in r-axSpA, p=0.01. Nr-axSpA was associated with a significantly lower progression over 2 years (defined as an increase in ≥2 mSASSS units) in adjusted analyses (OR 0.33, 95%CI 0.13; 0.83), confirmed with progression defined as the formation of ≥1 syndesmophyte. Mediation analyses revealed that sacroiliitis exerted its effect on spinal progression indirectly by being associated with the appearance of a first syndesmophyte (OR 0.09, 95%CI 0.02; 0.36 for nr-axSpA vs r-axSpA) (Fig. 1 and 2). Baseline syndesmophytes were predictors of further progression.Table 1.Baseline characteristics at first radiograph.ParameterN506nr-axSpAN = 88r-axSpAN = 418PFemale sex, %50654.533.7<0.001Age, y50639.5±11.140.4±11.00.52Symptom duration, y49810.0±9.914.0±9.8<0.001HLA-B27 positive, %45271.680.70.09BASDAI4274.6±2.04.2±2.30.26ASDAS4082.8±0.92.8±1.10.74Elevated CRP, %42230.640.60.14BASFI4332.8±2.23.1±2.50.71BASMI4351.1±1.42.2±2.0<0.001mSASSS5060.9±1.56.8±12.7<0.001Syndesmophytes, %5069.135.2<0.001On TNFi, %50619.336.40.002Fig. 1.Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) for individual patients plotted as a function of duration since symptom onset.Fig. 2.Two-year mSASSS progression depicted in a cumulative probability plot. Progression was defined as an increase in mSASSS of at least 2 units (dotted line) in 2 years.Conclusion:Spinal structural damage is mainly restricted to patients with r-axSpA, leading to relevant prognostic and therapeutic implications.Disclosure of Interests:Monika Hebeisen: None declared, Raphael Micheroli: None declared, Almut Scherer: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Manouk de Hooge: None declared, Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead Sciences, Inc., Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma; Director of Imaging Rheumatology BV, Robert B.M. Landewé Consultant of: AbbVie; AstraZeneca; Bristol-Myers Squibb; Eli Lilly & Co.; Galapagos NV; Novartis; Pfizer; UCB Pharma, Kristina Buerki: None declared, Michael Nissen Grant/research support from: Abbvie, Consultant of: Novartis, Lilly, Abbvie, Celgene and Pfizer, Speakers bureau: Novartis, Lilly, Abbvie, Celgene and Pfizer, Burkhard Moeller: None declared, Pascal Zufferey: None declared, Pascale Exer: None declared, Adrian Ciurea Consultant of: Consulting and/or speaking fees from AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Merck Sharp & Dohme, Novartis and Pfizer.
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Lee, Jung-Sun, Eun-Ju Lee, Jae-Hyun Lee, Seok-Chan Hong, Chang-Keun Lee, Bin Yoo, Ji-Seon Oh et al. « Autoantibodies against Protein Phosphatase Magnesium-Dependent 1A as a Biomarker for Predicting Radiographic Progression in Ankylosing Spondylitis Treated with Anti-Tumor Necrosis Factor Agents ». Journal of Clinical Medicine 9, no 12 (7 décembre 2020) : 3968. http://dx.doi.org/10.3390/jcm9123968.

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Background: Patients with ankylosing spondylitis (AS) have increased levels of protein phosphatase magnesium-dependent 1A (PPM1A) and autoantibodies. We evaluated the usefulness of serum anti-PPM1A antibodies as a biomarker for AS. Methods: Serum samples from 58 AS patients were obtained from a multicenter registry prior to the initiation of anti-TNF agents. The serum levels of anti-PPM1A antibodies were measured using ELISA. Spinal radiographic progression was defined as an increase in the modified stoke ankylosing spondylitis spinal score (mSASSS) by ≥2 units or a newly developed syndesmophyte. The role of exogenous PPM1A on bone mineralization was evaluated using primary osteoprogenitors acquired from patients with AS and non-inflammatory controls. Results: The baseline levels of anti-PPM1A antibodies and mSASSS were higher in the radiographic progression group than in the non-progression group. In logistic regression analysis, baseline mSASSS and serum anti-PPM1A antibodies were associated with a higher risk of progression. The level of anti-PPM1A antibodies for predicting progression had an AUC of 0.716 (cut-off value: 43.77 ng/mL). PPM1A stimulation increased matrix mineralization in AS-osteoprogenitors but not in controls. Conclusion: Along with mSASSS, the serum levels of anti-PPM1A antibodies might be useful as a predictor of radiographic progression after treatment with anti-TNF agents.
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Babikian, Viken L., et Jens J. Schwarze. « Stroke units ». Journal of Stroke and Cerebrovascular Diseases 4, no 3 (janvier 1994) : 183–87. http://dx.doi.org/10.1016/s1052-3057(10)80184-3.

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Babikian, Viken L., et Jens J. Schwarze. « Stroke units ». Journal of Stroke and Cerebrovascular Diseases 4 (janvier 1994) : S104—S108. http://dx.doi.org/10.1016/s1052-3057(10)80273-3.

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Thèses sur le sujet "Stoke units"

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Wood, Victorine Alexandra. « A critical appraisal of post-acute stroke management in NHS hospitals ». Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299734.

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Taylor, Elizabeth Rose. « Therapy on stroke units : an ethnographic study ». Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/therapy-on-stroke-units(5f47840f-0913-4dcd-911d-6367e8540b39).html.

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Background: Guidelines and audit have been widely adopted as quality improvement strategies in healthcare. A recent stroke guideline states that 45 minutes of each relevant therapy, 5 days per week, should be provided to patients deemed appropriate. National audit data suggest variation across teams in the proportion of patients deemed appropriate, and the quantity and frequency of therapy provided. Reasons for these variations are unknown. Aim: To investigate the ways in which policy, professional judgement and patient need influence the delivery of therapies in stroke units (SUs) in the era of the 45 minute guideline. Method: An ethnographic study, including participant observation and interviews, was conducted in three SUs. Results: Drawing on theoretical concepts of audit society and street level bureaucracy, the study found that the 45 minute guideline was limited in its ability to influence delivery of therapies. The attempt to standardise therapy time was undermined by variation in the roles and remits of SUs and therapists, and varied understandings of ‘what counts’ as therapy. Thus they had different approaches to assessing therapy needs, and adopted different audit reporting practices. In line with the claims of street level bureaucracy, therapists developed routines of practice to simplify and manage their caseloads. In one example, the audit had become a way of categorising patients’ need for therapy and justifying resource allocation. The thesis identifies the role of ‘Street Level Leaders’ in guiding therapists’ attitudes and practices. The thesis provides empirical data to support the theoretical concept of audit society, showing how changes to therapy standards and practice took place in a wider economic and social context. Conclusions: The 45 minute guideline was one of many factors influencing delivery of therapy and was diversely interpreted and implemented. The study’s findings suggest that, in the context of the quasi-marketisation of healthcare, audit may become a tool of commissioner-centred, rather than patient-centred care. Ongoing engagement between strategic leaders, patients and clinicians is needed, to ensure that quality of care does not become secondary to ‘playing the numbers game’.
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Kubik, Sebastian [Verfasser]. « Charakteristik der zertifizierten Stroke Units in Deutschland / Sebastian Kubik ». Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2016. http://d-nb.info/1113592982/34.

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Dahllöf, Oliver, Oliver Dahllöf, Felix Hofwimmer et Felix Hofwimmer. « Optimal placement of a Mobile Stroke Unit (MSU) to achieve improved stroke care ». Thesis, Malmö universitet, Fakulteten för teknik och samhälle (TS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-20525.

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Tid till behandling är livsviktigt för människor som får en stroke. På olika platser i världen har man därför sett värdet i att införskaffa en specialambulans för stroke (stroke-ambulans) som har specialutrustning och specialpersonal som kan utföra intravenös behandling (trombolys). Då det är uppenbart att dess involvering i vården skulle hjälpa åtminstone en viss andel patienter används ofta ingen utvecklad metod eller analys av var och hur denna stroke-ambulans ska placeras. Genom att noggrant undersöka läget i Skåne län om hur denna placeringen kan gå till, är vårt mål att genom vår metod, som bygger på optimering av förväntade transporttider, upplysa beslutstagare om olika perspektiv man bör ta hänsyn till. Vår metod kan användas över olika geografiska områden.Vi föreslår en optimeringsmetod som utgår från två olika perspektiv: effektivitet och jämlikhet. Metoden visar att beroende på vilket perspektiv man väljer, kan den optimala placeringen för ett givet område variera kraftigt. Det är därför viktigt att beslutstagare av placering för stroke-ambulanser har tydliga och väl genomtänkta mål. Dessa mål bör även innefatta de lokala sjukhusens mål när det kommer till förbättring av behandlingstiden för strokepatienter, s.k. door-to-needle-time (DTN) då dessa i vissa fall kan göra större förbättringar än vad en införskaffning av en stroke-ambulans skulle göra.
Tid till behandling är livsviktigt för människor som får en stroke. På olika platser i världen har man därför sett värdet i att införskaffa en specialambulans för stroke (stroke-ambulans) som har specialutrustning och specialpersonal som kan utföra intravenös behandling (trombolys). Då det är uppenbart att dess involvering i vården skulle hjälpa åtminstone en viss andel patienter används ofta ingen utvecklad metod eller analys av var och hur denna stroke-ambulans ska placeras. Genom att noggrant undersöka läget i Skåne län om hur denna placeringen kan gå till, är vårt mål att genom vår metod, som bygger på optimering av förväntade transporttider, upplysa beslutstagare om olika perspektiv man bör ta hänsyn till. Vår metod kan användas över olika geografiska områden.Vi föreslår en optimeringsmetod som utgår från två olika perspektiv: effektivitet och jämlikhet. Metoden visar att beroende på vilket perspektiv man väljer, kan den optimala placeringen för ett givet område variera kraftigt. Det är därför viktigt att beslutstagare av placering för stroke-ambulanser har tydliga och väl genomtänkta mål. Dessa mål bör även innefatta de lokala sjukhusens mål när det kommer till förbättring av behandlingstiden för strokepatienter, s.k. door-to-needle-time (DTN) då dessa i vissa fall kan göra större förbättringar än vad en införskaffning av en stroke-ambulans skulle göra.
The time to treatment is vital for people who suffer from a stroke. Therefore, in different places in the world, the value of acquiring a specially developed ambulance for a stroke (i.e., a Mobile Stroke Unit, MSU) with special equipment and specialists who can perform intravenous treatment (thrombolysis) has been identified. Since it is clear that an MSU’s involvement in health care would aid at least a certain proportion of the patients, the MSU is often purchased and placed without any developed method or analysis of where and how this MSU is to be placed. By carefully examining the situation in Skåne Municipality of how this placement could be performed, we will inform decision makers about different perspectives that should be taken into consideration, including other areas than Skåne.Our optimization method showed that depending on what perspective you are investing, efficiency or equality, the optimal placement for any given area can vary greatly. It is therefore importantthat decision-makersofMSUpurchaseshaveclearandwell-thought-outgoals.These goals should also include the goals of the local hospitals when it comes to improving the treatment time for stroke patients, door-to-needle (DTN), as the DTN may in some cases make greater improvements than a purchase of an MSU would.
The time to treatment is vital for people who suffer from a stroke. Therefore, in different places in the world, the value of acquiring a specially developed ambulance for a stroke (i.e., a Mobile Stroke Unit, MSU) with special equipment and specialists who can perform intravenous treatment (thrombolysis) has been identified. Since it is clear that an MSU’s involvement in health care would aid at least a certain proportion of the patients, the MSU is often purchased and placed without any developed method or analysis of where and how this MSU is to be placed. By carefully examining the situation in Skåne Municipality of how this placement could be performed, we will inform decision makers about different perspectives that should be taken into consideration, including other areas than Skåne.Our optimization method showed that depending on what perspective you are investing, efficiency or equality, the optimal placement for any given area can vary greatly. It is therefore importantthat decision-makersofMSUpurchaseshaveclearandwell-thought-outgoals.These goals should also include the goals of the local hospitals when it comes to improving the treatment time for stroke patients, door-to-needle (DTN), as the DTN may in some cases make greater improvements than a purchase of an MSU would.
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Strand, Tage. « Stroke : patient characteristics, efficacy of a stroke unit and evaluation of hemodilution therapy ». Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 1986. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-141049.

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Stroke is a major health problem in all developed countries. These studies, performed in a stroke unit at a medical department, were designed to characterize essential clinical features of the different cerebrovascular disorders on admission to hospital, to evaluate the efficacy of admitting unselected stroke patients to a stroke unit and, to evaluate hemodilution as a therapeutical regime in patients with cerebral infarction. A prospective registry included 409 patients admitted to the stroke unit over a five-year period. Modern diagnostic equipment (CT scan and CSF analyses) and strict diagnostic criteria revealed a diagnostic distribution of 11% hemorrhagic, 76% ischemic cerebrovascular lesions and 13% TIAs. Mean age varied between 65.8 and 77.5 years in the various diagnostic groups with the highest in patients with embolic cerebral infarctions. Concomitant disorders affecting the cardiovascular system were highly prevalent and only 14% was free of such diseases prior to the stroke. In a comparative prospective study, over 16 months, no differences were found between patients treated in the stroke unit (n = 110) and the general medical wards (n = 183) regarding prognostic indicators on admission such as age, concomitant disorders and neurological symptoms. The stroke patients treated in the stroke unit had a statistically significant better prognosis regarding functional outcome and the need for long-term hospitalization was reduced up to one year after the stroke when compared to patients treated in general medical wards. All stroke patients seemed to benefit with the possible exception of patients in coma on admission. These results were achieved within the same or shorter length of initial hospital stay for patients in the stroke unit. Neither overall mortality, nor mortality in subgroups of prognostic importance was significantly affected by the stroke unit regime. Rapid hemodilution in the early phase of cerebral infarction by the combination of venesection and administration of dextran 40 was evaluated in a prospective controlled trial. After randomization 52 hemodi- luted and 50 control patients were comparable in prognostic variables. Signs of blood-brain-barrier breakdown and hemorrhagic admixture to the cerebrospinal fluid in the acute phase were less frequent in hemodiluted subjects. The hemodi luted patients showed a significantly higher degree of early improvement and fewer progressions. Neurological and functional disability in survivors and need for long-term hospitalization was significantly reduced at 3 months and at one year after the stroke compared to controls. Mortality was not affected.
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O'Connor, Stephen Edward. « An investigation to determine the nature of nursing care in stroke units ». Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242688.

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Parekh, Ishita. « Factors influencing functional outcome of stroke patients admitted to a tertiary hospital ». University of the Western Cape, 2011. http://hdl.handle.net/11394/5292.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Stroke is a leading cause of death and disability worldwide. Individuals with stroke often face functional limitations. There are several factors that are associated with functional outcome post stroke. Treatment in a stroke unit with a multidisciplinary approach reduces the likelihood of dependency after stroke. The aim of the present study is to identify factors influencing functional outcome of stroke patients admitted to a South African tertiary hospital. A descriptive, observational, longitudinal quantitative study design was used to obtain the data. Convenience non-probability sampling method was used. The research instruments used to collect the data were National Institute of Health Stroke Scale (NIHSS), Hospital Anxiety and Depression Scale (HADS), Barthel Index and a socio-demographic and medical profile data form. All the instruments were used at admission and discharge while at two months only Barthel Index was used for data collection. The data analysis was done using SPSS v 18 and SAS v 9. Mean, standard deviation, range and percentages were used for descriptive purposes and Tobit analysis was used to determine the association between independent and dependent variables. The descriptive results showed that the mean age was 59.83 years with number of females slightly more than males and hypertension being the most common risk factor. The results of the quantitative analysis revealed four factors that influence functional outcome at either discharge or at two months: age, severity of stroke, functional level at admission. Age and severity of stroke influenced the functional outcome at both the stages. The necessary ethical clearance was obtained in prior to commencement of the study. The outcomes of the study could contribute to enhance rehabilitation of stroke patients at an inpatient settings and awareness among population.
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Yazdi, Hamid R. « The finishing stroke, Edgar Allan Poe's aesthetics of unity ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ62356.pdf.

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Glader, Eva-Lotta. « Stroke care in Sweden : Hospital care and patient follow-up based on Riks-Stroke, the National Quality Register for Stroke Care ». Doctoral thesis, Umeå universitet, Medicin, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-94114.

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Stobbart, Lynne. « Conducting randomised controlled trials in an acute stroke unit ». Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/1944.

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Stroke is a major cause of death and disability in the UK. Few treatments exist and those that do, such as thrombolysis (‘clot-busting’ treatment) must be given urgently and are not risk-free. Large scale randomised controlled trials are crucial for the development of safe, effective, acute interventions, but progress has been limited, ostensibly due to ethical and regulatory difficulties. Theoretical work in this area has focussed primarily upon the requirement for prospective informed consent, but has also considered potential conflicts of interests inherent in the dual role of clinicianresearchers, and the notion that research and clinical practice are, can be, and should be conducted separately. Empirical evidence on this topic is lacking. By providing such evidence, this study examines claims made in the literature regarding the difficulties encountered or perceived in conducting emergency research. It also explores whether, how, and to what effect, the distinction between research and clinical activity advocated in the bioethical literature is maintained. Methods Ethnographic methods were employed, including participant observation, semistructured interviews, and audio-recording of research consent interactions in an acute stroke unit. Data were analysed drawing upon constant comparative and framework methods. Results and conclusion Whilst providing empirical evidence supporting some of the theoretical and conceptual literature, the data also furnish a detailed account of pragmatic issues encountered and managed daily by healthcare professionals in the acute stroke environment. Whilst attempts were made at the study site to separate, at least in part, clinical and research activity, it was observed that absolute separation of clinical activities is neither attainable, sustainable, nor desirable. Placement of research nurses within the clinical environment may promote transparency and greater understanding of their role, whilst simultaneously demystifying research concepts. Ultimately this may promote closer working relationships, contributing to enhanced recruitment, retention and management of research participants.
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Livres sur le sujet "Stoke units"

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Langhorne, Peter, et Martin Dennis, dir. Stroke Units. Tavistock Square, UK : BMJ Books, 1998. http://dx.doi.org/10.1002/9780470760215.

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Fiedler, Christine, Martin Köhrmann et Rainer Kollmar, dir. Pflegewissen Stroke Unit. Berlin, Heidelberg : Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-29995-7.

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Fiedler, Christine, Martin Köhrmann et Rainer Kollmar, dir. Pflegewissen Stroke Unit. Berlin, Heidelberg : Springer Berlin Heidelberg, 2017. http://dx.doi.org/10.1007/978-3-662-53625-4.

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Martin, Dennis, dir. Stroke units : An evidence based approach. London : BMJ Books, 1998.

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The Stone Court. Santa Barbara : ABC-CLIO, 2008.

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Hutchinson, Ron. Heat exchanger design for mass store hot water units. Leicester : De Montfort University, 1999.

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Massachusetts. Executive Office of Consumer Affairs and Business Regulation. Massachusetts food store item pricing law. Boston, Mass : The Office, 1990.

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McMillan, Dana. Pet store : A complete theme unit including learning centers. Carthage, IL : Teaching & Learning Co., 2000.

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McMillan, Dana. Pet store : A complete theme unit including learning centers. Carthage, IL : Teaching & Learning Co., 2000.

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dure, Opificio delle pietre, Galleria d'arte moderna (Florence, Italy) et Palazzo Pitti, dir. Dagli splendori di corte al lusso borghese : L'Opificio delle pietre dure nell'Italia unita. Livorno : Sillabe, 2011.

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Chapitres de livres sur le sujet "Stoke units"

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Brainin, Michael, Claudia Tatschl et Yvonne Teuschl. « Stroke Units ». Dans Stroke, 93–104. Basel : KARGER, 2009. http://dx.doi.org/10.1159/000210275.

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Leimbach, Judy, Kathy Leimbach et Mary Lou Johnson. « School Store ». Dans Math Extension Units, 31. New York : Routledge, 2021. http://dx.doi.org/10.4324/9781003236474-27.

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Leimbach, Judy, Kathy Leimbach et Mary Lou Johnson. « Class Store ». Dans Math Extension Units, 14. New York : Routledge, 2021. http://dx.doi.org/10.4324/9781003236481-10.

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Leimbach, Judy, Kathy Leimbach et Mary Lou Johnson. « Book Store Sale ». Dans Math Extension Units, 28. New York : Routledge, 2021. http://dx.doi.org/10.4324/9781003236474-24.

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Rha, Joung-Ho. « Stroke Unit ». Dans Stroke Revisited : Diagnosis and Treatment of Ischemic Stroke, 13–18. Singapore : Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-1424-6_2.

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Marquardt, Lars. « Epidemiologie und Bedeutung der Stroke Unit ». Dans Pflegewissen Stroke Unit, 3–11. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29995-7_1.

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Bäuerlein, Sabine, et Nicole Lunz. « Pflegerische Überwachung ». Dans Pflegewissen Stroke Unit, 119–29. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29995-7_10.

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Lorenz, Mario. « Ganzheitlich rehabilitierende Prozesspflege nach den AEDL ». Dans Pflegewissen Stroke Unit, 131–39. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29995-7_11.

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Lorenz, Mario, et Nicole Lunz. « Bobath – Lagerung und Transfer ». Dans Pflegewissen Stroke Unit, 141–48. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29995-7_12.

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Joa-Lausen, Caroline. « Basale Stimulation – Orientierung und Wahrnehmung ». Dans Pflegewissen Stroke Unit, 149–58. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29995-7_13.

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Actes de conférences sur le sujet "Stoke units"

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Wiltse, D. J. « Long Stroke Pumping Units ». Dans Annual Technical Meeting. Petroleum Society of Canada, 1995. http://dx.doi.org/10.2118/95-28.

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Borchardt, Ralf. « Transport of the Reactor Pressure Vessels in the Greifswald Nuclear Power Plant ». Dans ASME 2009 12th International Conference on Environmental Remediation and Radioactive Waste Management. ASMEDC, 2009. http://dx.doi.org/10.1115/icem2009-16012.

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Five WWER-440 reactors are being dismantled on the Greifswald Nuclear Power Plant (KGR) site. The strategy for the dismantling of the reactor units 1 to 4 (operation time 12–17 years) was to cut and pack the components remotely. For this purpose dry and wet cutting areas were installed. The remote cutting and packing of the reactor pressure vessel and its internals was successfully tested with non-activated original reactor components of units 7 and 8 from October 1999 until July 2003. From August 2004 until July 2007 the internals from reactor units 1 and 2 were cut, packed and transported to the on-site Interim Store North (ISN). For the reactor 5 it was planned to transport the RPV in one piece and the reactor internals in shielding and transport containers to the interim store for decay storage. In December 2003 the RPV of unit 5 was lifted and transported to the interim store. From April 2006 up to July 2006 the reactor internals of unit 5 were packed and transported to the interim store. After the evaluation of the experience made during the transport and the radiological measurements and samplings taken from the RPV unit 1, the strategy for the dismantling of the reactors was changed. The reactor pressure vessels of the units 1 to 4 and the reactor internals of the units 3 and 4 should be removed as complete parts and stored as shielded large components in the ISN. In summer 2005 EWN applied for the new strategy at the responsible licensing authority and in August 2007 this license was granted. In November 2007 the reactor pressure vessels of the units 1 and 2 were transported into the ISN. The transport of the reactor pressure vessels and the internals from units 3 and 4 is planned in the period from March till September 2009. These transports of the reactor pressure vessels and internals show that the dismantling of the reactors with dismantling and interim storage of large components could not only be an alternative for cutting but could also be favored from the economical and radiological point of view.
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Tudruj, M. S. « A customized control store design in microprogrammed control units ». Dans the 18th annual workshop. New York, New York, USA : ACM Press, 1985. http://dx.doi.org/10.1145/18927.18926.

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Brandvik, Tobias, et Graham Pullan. « An Accelerated 3D Navier-Stokes Solver for Flows in Turbomachines ». Dans ASME Turbo Expo 2009 : Power for Land, Sea, and Air. ASMEDC, 2009. http://dx.doi.org/10.1115/gt2009-60052.

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A new three-dimensional Navier-Stokes solver for flows in turbomachines has been developed. The new solver is based on the latest version of the Denton codes, but has been implemented to run on Graphics Processing Units (GPUs) instead of the traditional Central Processing Unit (CPU). The change in processor enables an order-of-magnitude reduction in run-time due to the higher performance of the GPU. Scaling results for a 16 node GPU cluster are also presented, showing almost linear scaling for typical turbomachinery cases. For validation purposes, a test case consisting of a three-stage turbine with complete hub and casing leakage paths is described. Good agreement is obtained with previously published experimental results. The simulation runs in less than 10 minutes on a cluster with four GPUs.
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« Hybrid Simulation Approach for Prospective Assessment of Mobile Stroke Units ». Dans 2nd International Conference on Simulation and Modeling Methodologies, Technologies and Applications. SciTePress - Science and and Technology Publications, 2012. http://dx.doi.org/10.5220/0004029603570366.

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Dorgan, Andrew J., Eric Loth, Todd L. Bocksell et P. K. Yeung. « Boundary Layer Dispersion of Near-Wall Injected Particles of Various Inertias ». Dans ASME/JSME 2003 4th Joint Fluids Summer Engineering Conference. ASMEDC, 2003. http://dx.doi.org/10.1115/fedsm2003-45492.

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A direct numerical simulation approach was employed along with a Lagrangian particle tracking technique to investigate particle motion and dispersion in a turbulent boundary layer. The present study investigated a range of particle inertias corresponding to outer Stokes numbers varying from 10−4 to 1. In all cases, the ratio of particle terminal velocity to fluid friction velocity was held constant at 10−2 such that the effects of particle inertia would be isolated and dominant with respect to particle dispersion. The particles were injected near the wall at a height of four wall units (with elastic wall collision specified at one wall unit) and their locations recorded at several streamwise planes. Particles having an outer Stokes number much less than unity reach a similar outer flow distribution profile by the time they pass a collection plane located at eight boundary layer thicknesses downstream of injection. Moderately larger particles tended to yield increased wall collisions and increased near-wall concentrations. The increased concentration in the near-wall region (or reduced diffusion away from the wall) is attributed to a coupling of inertia effects and turbulent structures for the non-homogeneous flow (sometimes referred to as turbophoresis). The highest Stokes number particles yield the highest near-wall concentration, but resulted in a decrease in wall collisions in the first few collision bins as it tends to be unaffected by the near-wall structures.
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Vassiliadis, Stamatis, Filipa Duarte et Stephan Wong. « A Load/Store Unit for a Memcpy Hardware Accelerator ». Dans 2007 International Conference on Field Programmable Logic and Applications. IEEE, 2007. http://dx.doi.org/10.1109/fpl.2007.4380711.

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Wang, D. F., X. M. Cui, G. Y. Gao, Z. Z. Huang et B. Z. Hu. « A New Long Stroke Pumping Unit with High Speed ». Dans SPE Production Operations Symposium. Society of Petroleum Engineers, 1995. http://dx.doi.org/10.2118/29532-ms.

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Turk, George F., et Jeffrey A. Melby. « SAMOA STONE : An Architectural and Functional Concrete Armor Unit ». Dans Coastal Structures 2003. Reston, VA : American Society of Civil Engineers, 2004. http://dx.doi.org/10.1061/40733(147)83.

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Sakhnovskiy, M. Y., et B. M. Timochko. « Certification method of Stokes polarimeter and its optical units using magneto-optical modulation ». Dans International Conference on Correlation Optics, sous la direction de Oleg V. Angelsky. SPIE, 1999. http://dx.doi.org/10.1117/12.370412.

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Rapports d'organisations sur le sujet "Stoke units"

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Eighteen-year-old sporting goods retail store worker dies in a fall from a shelving unit - Pennsylvania. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, septembre 2001. http://dx.doi.org/10.26616/nioshface200106.

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Final environmental impact statement for the construction and operation of an independent spent fuel storage installation to store the Three Mile Island Unit 2 spent fuel at the Idaho National Engineering and Environmental Laboratory. Docket Number 72-20. Office of Scientific and Technical Information (OSTI), mars 1998. http://dx.doi.org/10.2172/573193.

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