The success of local climate governance in Europe depends not only on leading cities but also on the dynamics between leaders, followers, and laggards. Upscaling local experiments helps to close the ...gap between these actors. This process is driven by the increasing embeddedness of cities and their networks in EU multilevel governance. Embedded upscaling combines horizontal upscaling between leading cities with vertical upscaling between leaders and followers that is mediated by higher levels of government, and hierarchical upscaling that even reaches the laggards. Various types of upscaling, their combinations, and their impacts are analyzed. Networks have become denser and networking has intensified. City networks and their member cities have become embedded in national and EU governance, lost authority and depend more and more on regional, national, and European authorities.
La adopción de tecnologías complejas para el diagnóstico médico, exige el análisis de sus ventajas económicas y técnicas. Se compararon dos inyectores de doble cabezal en términos de costos, tiempos ...y volumen de medio de contraste durante la tomografía computarizada, en un análisis prospectivo de 103 procedimientos. Dos observadores registraron consumibles e indicadores de desempaño durante el uso de (OptiVantage®) y (Medrad® Stellant combinado con el uso de Medrad Stellant Multi-Patient Kit; se determinaron los costos asociados al uso habitual y el uso recomendado en una institución de tercer nivel de atención en Colombia. Se evidenció un tiempo de preparación mayor de 23.3 segundos (p < 0.000) con OptiVantage® (52.2 segundos, IC95% 46.7 – 56.7) respecto del grupo del inyector Medrad® Stellant (28.9 segundos, IC95% 21.8 – 39.5). El volumen de medio de contraste inyectado fue mayor por 8.7 ml (p < 0.005) con OptiVantage® (68.4 ml, IC95% 63.4 – 73.3) versus el inyector Medrad® Stellant (59.7 ml, IC95% 56.7 – 62.7). El costo total por el uso de Medrad® Stellant es 8% más bajo en la modalidad habitual de uso. El Medrad® Stellant CT Injection System combinado con el uso del Medrad Stellant Multi-Patient Kit es más eficiente, ofrece seguridad y un menor costo total por procedimiento realizado.
In order to effectively reduce the psychological anxiety of subway passengers in the fire state and improve the effect of fire emergency management, the fire anxiety status of passengers of different ...genders was counted, based on the fire state-trait anxiety questionnaire. The questionnaire and mathematical statistics were used to discuss the influence of different time periods after the intervention of on-site drills on the psychological anxiety level of passengers. Results: Before the field exercise, the overall fire anxiety level of the sample was in the normal range ; After on-site exercise, female fire anxiety level decreased, but still did not eliminate anxiety, and the effect of male education is not obvious ; After one hour of on-site training, the overall scores of fire anxiety of the samples were reduced; One day after the on-site exercise, women’s psychological anxiety scores began to improve, and men’s psychological anxiety continued to improve. Conclusion: On the whole, on-site drills are effective. After one day of on-site drills, the intervention effect basically disappears. However, on-site drills have a significant effect on eliminating the tension in the face of subway fires, and there are significant differences in these aspects of characteristics between people of different genders in the face of subway fires.
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