Abstract
This article presents tools used in the Theory of Inventive Problem Solving (TRIZ) which are useful when assessing the evolution direction of technical systems. The following matters are ...discussed: the S-shaped curve, laws (trends and lines) of the evolution of technical systems, multi-screen diagrams, as well as analysis of evolutionary potential. Inventive laws formulated by Gienrich Altshuller as well as laws previously formulated by a Polish writer and promoter of knowledge, Aleksander Głowacki, writing under the pen name Bolesław Prus, have been presented. Finally the innovation roadmaps have been shown. The use of individual tools has been supported by practical examples taken from research performed by the authors, and the usefulness of individual methods was evaluated. All methods have been compared and evaluated.
Perkembangan dan kemajuan teknologi serta ilmu pengetahuan telah mendorong pelaksanaan pelayanan kesehatan yang lebih efektif dan lebih ekonomis dibanding dengan cara yang lazim dikerjakan. Telah ...dilakukan penelitian terhadap 32 pasien operasi laparotomi ginekologis yang dibagi menjadi dua kelompok. Kelompok Tramadol (n=16) diberikan tramadol 2 mg/kgBB (pengenceran akuabides sampai 10 mL) lewat jalur infus selama satu menit, sedangkan pada kelompok Fentanil (n=16) diberikan fentanil 2 µg/kgBB dengan cara yang sama. Lima menit kemudian diberikan propofol 2 mg/kgBB, atrakurium 0,5 mg/kgBB, enfluran 2 volume %, N2O:O2=2 L/menit:2 L/menit. Setelah tiga menit dilakukan laringoskopi intubasi. Pasien diventilasi kendali dengan mode ventilator IPPV. Operasi dilaksanakan bila kedalaman anestesi tercapai berdasar atas skor PRST (P=systolic arterial pressure, R=heart rate, S=sweat, dan T=tears) 2 sampai dengan 4. Analgetik pertolongan 50 µg fentanil diberikan bila skor PRST lebih dari 4. Analgetik postoperatif 30 mg ketorolak dan antimuntah 10 mg metoklopramid diberikan saat jahit kulit. Pencatatan tekanan darah, laju nadi, saturasi O2, dan skor PRST dilakukan sebagai berikut: T0 = penderita tiba di kamar operasi, T1= preintubasi, T2= satu menit setelah intubasi, T3= satu menit setelah insisi, T4 dan seterusnya diukur tiap 15 menit sampai selesai operasi. Pasien diekstubasi setelah pernapasan adekuat. Skala sedasi dan muntah dinilai setiap 15 menit setelah ekstubasi selama dua jam. Dari hasil penelitian didapatkan skor PRST mulai T1 sampai T12 secara statistis tidak berbeda bermakna antara kelompok tramadol dan fentanil (p>0,05). Kedua kelompok mengalami peningkatan skor PRST satu menit setelah intubasi. Skor PRST dipertahankan antara 0 sampai 2. Pada kelompok tramadol dan fentanil masing-masing satu orang mendapatkan analgetik pertolongan fentanil 50 µg karena skor PRST 5. Tidak ditemukan perbedaan skala sedasi dan muntah antara dua kelompok perlakuan. Penelitian ini menunjukkan tramadol 2 mg/kgBB dibanding dengan fentanil 2 µg/kgBB sebagai analgetik intraoperatif pada operasi laparotomi ginekologis memberikan pengaruh yang sama terhadap skor PRST. Kata kunci: Analgetik intraoperatif, fentanil, laparotomi ginekologis, skor PRST, tramadol Comparison of Intravenous Tramadol 2 mg kgBW-1 and Fentanyl 2 mg.kgbw-1 As Intraoperative Analgetic for Gynecologic Laparotomy; Its Effects on PRST Score The development and improvement of technology and sciences influence the effectivity and economic of health care. This study was done on 32 patients who undergoing gynecologic laparotomy. The sample was divided into 2 groups, consisted of 16 patients each group. The tramadol group was given 2 mg.kgbw-1 tramadol (diluted to 10 mL) via infuse line over one minute whereas the fentanyl group was given 2 µg.kgbw-1 fentanyl by the same procedure as tramadol. Inductions was done five minutes later with 2 mg.kgbw-1 propofol, 0.5 mg.kgbw-1 atracurium, and maintenance anesthesia with 2 vol.% enflurane, 50% O2 and 50% N2O at flow rate 4 L/minutes. After three minutes the patient was intubated and ventilated by using control mode. Surgery had performing when depth of anesthesia achieved with PRST (P=systolic arterial pressure, R=heart rate, S=sweat, and T=tears) scored 2 to 4. Rescue analgetic with 50 mcf fentanyl if the PRST score more than 4. Analgetic postoperative 30 mg ketorolac and antiemetic 10 mg metoclopramide were given intravenously during skin closure. Blood pressure, heart rate, oxygen saturation and PRST score were recorded at T0=patient on arrival in theatre, T1=preintubation, T2=one minute after intubation, T3=one minute after incision, T4 and so on were recorded every fifteen minutes until the end of surgery. Extubation was done when patient breath adequately. Sedation scale and incidence of vomiting were evaluated every fifteen minutes for two hours after extubation. The result showed that PRST scores from T1 to T12 were statistically not significant in tramadol group and fentanyl group (p>0.05), but the PRST scores increasing significantly one minute after intubation in both groups. The PRST scores were between 0 to 2. Rescue analgetic was given to one patient in tramadol group and fentanyl group with PRST scored 5. Sedation scale and incidence of vomiting were statistically not significant in both groups. This study concluded that 2 mg.kgbw-1 tramadol and 2 µg.kgBB-1 fentanyl as an intraoperative analgetic during gynecologic laparotomy have the same PRST scores. Key words: Fentanyl, gynecologic, intraoperative analgetic, laparotomy, PRST score, tramadol
Perkembangan dan kemajuan teknologi serta ilmu pengetahuan telah mendorong pelaksanaan pelayanan kesehatan yang lebih efektif dan lebih ekonomis dibanding dengan cara yang lazim dikerjakan. Telah ...dilakukan penelitian terhadap 32 pasien operasi laparotomi ginekologis yang dibagi menjadi dua kelompok. Kelompok Tramadol (n=16) diberikan tramadol 2 mg/kgBB (pengenceran akuabides sampai 10 mL) lewat jalur infus selama satu menit, sedangkan pada kelompok Fentanil (n=16) diberikan fentanil 2 µg/kgBB dengan cara yang sama. Lima menit kemudian diberikan propofol 2 mg/kgBB, atrakurium 0,5 mg/kgBB, enfluran 2 volume %, N2O:O2=2 L/menit:2 L/menit. Setelah tiga menit dilakukan laringoskopi intubasi. Pasien diventilasi kendali dengan mode ventilator IPPV. Operasi dilaksanakan bila kedalaman anestesi tercapai berdasar atas skor PRST (P=systolic arterial pressure, R=heart rate, S=sweat, dan T=tears) 2 sampai dengan 4. Analgetik pertolongan 50 µg fentanil diberikan bila skor PRST lebih dari 4. Analgetik postoperatif 30 mg ketorolak dan antimuntah 10 mg metoklopramid diberikan saat jahit kulit. Pencatatan tekanan darah, laju nadi, saturasi O2, dan skor PRST dilakukan sebagai berikut: T0 = penderita tiba di kamar operasi, T1= preintubasi, T2= satu menit setelah intubasi, T3= satu menit setelah insisi, T4 dan seterusnya diukur tiap 15 menit sampai selesai operasi. Pasien diekstubasi setelah pernapasan adekuat. Skala sedasi dan muntah dinilai setiap 15 menit setelah ekstubasi selama dua jam. Dari hasil penelitian didapatkan skor PRST mulai T1 sampai T12 secara statistis tidak berbeda bermakna antara kelompok tramadol dan fentanil (p>0,05). Kedua kelompok mengalami peningkatan skor PRST satu menit setelah intubasi. Skor PRST dipertahankan antara 0 sampai 2. Pada kelompok tramadol dan fentanil masing-masing satu orang mendapatkan analgetik pertolongan fentanil 50 µg karena skor PRST 5. Tidak ditemukan perbedaan skala sedasi dan muntah antara dua kelompok perlakuan. Penelitian ini menunjukkan tramadol 2 mg/kgBB dibanding dengan fentanil 2 µg/kgBB sebagai analgetik intraoperatif pada operasi laparotomi ginekologis memberikan pengaruh yang sama terhadap skor PRST.
Škljocavi palac u djece Pavljak, Lucija; Bulić, Krešimir; Antabak, Anko
Liječnički vjesnik,
05/2019, Letnik:
141, Številka:
3-4
Journal Article
Recenzirano
Odprti dostop
Prirodan tijek bolesti kod škljocavog palca u djece još je predmet neslaganja, a sukladno tomu i preporuke za liječenje znatno se razlikuju te ne postoje jasne i široko prihvaćene smjernice. Ovim ...radom pokušali smo dati trenutačni literaturni pregled spoznaja o tijeku bolesti te dijagnostičkim i terapijskim mogućnostima s naglaskom
na konačnom ishodu liječenja. Škljocavi palac jedna je od najčešćih anomalija dječje šake i uglavnom se vidi u djece predškolske dobi. Karakteristično je otežano klizanje tetive fleksora policisa longusa kroz njezinu ovojnicu, što je posljedica anatomskog nesklada njihovih veličina. Tipičan klinički nalaz jest palac fiksiran u fleksijskoj kontrakturi, na razini interfalangealnog zgloba. Prvi opis dao je Notta, čije ime i danas nosi palpabilna masa tetive fleksora policisa longusa u području A1 pulleya. Dijagnoza se obično postavlja temeljem anamneze i fizikalnog pregleda, uz ultrazvuk kao korisno rano dijagnostičko sredstvo. Škljocavi palac dijagnostički treba razlučiti od dislokacije,
frakture ili anomalije poznate kao deformacija palca u dlanu. Klinička istraživanja poboljšala su razumijevanje i benignost prirodnog tijeka bolesti. Terapijski postupak ovisi o izboru roditelja i liječnika. On može biti konzervativan, s pomoću udlage i izvođenjem vježba pasivne ekstenzije, ili kirurški, presijecanjem A1 pulleya, što pouzdano vraća pokretljivost interfalangealnog zgloba palca. Spontani oporavak može trajati godinama, no on pruža obiteljima voljnim čekanja mogućnost izbjegavanja stresa hospitalizacije i operacijskog liječenja.
Skrb za natančno in bogato izrazoslovje, tako poljudno in predvsem strokovno, je nujen in pomemben prispevek k razvoju in pestrosti materinega jezika. Pri rabi strokovnih izrazov se pogosto soočamo z ...različnimi interpretacijami in nepotrebno pestrostjo izrazov. To praviloma ne prispeva h kakovosti jezika in prej kaže na premalo skrbno izrazoslovje, na pomanjkljive oz. strokovno neustrezne opredelitve in/ali spregledan izvorni pomen posameznih izrazov. Strokovni izrazi morajo biti nedvoumni in ne smejo dovoljevati različne interpretacije, pomena. Raba in uvajanje poljudnih izrazov v strokovno izrazoslovje je prisotno tudi v izobraževanju. Primer takih zadreg v pedologiji je tudi raba besed 'tla' in 'prst'. Na prvi pogled sicer obrobna tematika ima širšo in pomembnejšo dimenzijo. Zmeda v strokovnem jeziku se namreč pojavlja tudi v prevodih evropske zakonodaje. Tako slovenske verzije nekaterih EU dokumentov mestoma zaradi neustreznih in pomensko dvoumnih oz. zgrešenih prevodov ne odražajo pravega pomena izvornih besedil. To predstavlja zadrego, ki jo je potrebno urediti. Prispevek predstavlja terminološke nedoslednosti v pedološkem izrazoslovju, pojasnjuje in utemeljuje razloge za rabo osnovnih izrazov s področja tal, osvetljuje ljudski pomen besed 'prst' in 'zemlja', primerja s stanjem v drugih jezikih ter nakazuje ustrezno rabo nekaterih ključnih izrazov v strokovnih/znanstvenih besedilih, za potrebe prevajanja in pedagoškega procesa.
Correct and rich professional and scientific terminology is an important contribution to the development and richness of the national languages. Within the scientific and professional terminology we ...can often find incorrect, missed or misinterpreted use of professional terms. In general, such ‘diversity’ of terms does not contribute to the quality and the development of the professional terminology. On the contrary, it demonstrates the lack of precision in scientific terminology, presence of definitions without scientific background and/or overlooked original etymology of individual terms. We are witnessing the attempts of replacement of terms and changes in professional terminology without scientifically sound arguments. Moreover, even at the university level the inappropriate use of technical / professional terms can be detected. An example of such embarrassments in Slovenian language is the use of the words' tla' and 'prst' in professional language. Terminological dispute can be considered as peripheral theme, even unnecessary, however it has a much broader and more important dimension. Namely, confusion in the technical language is also appearing in translations of the European legislation. The Slovenian versions of some EU legal documents are semantically ambiguous and inadequate and, thus do not reflect the correct meaning of source texts due to missed translations. The latter can evolve in a problem and has to be adjusted. The paper presents the soil science terminological inconsistencies, explains and arguments the reasons for use of selected basic soil science terms in Slovenian language. Additionally, it recalls the etymology of the popular terms ‘prst’ and ‘zemlja’, compares the situation in number of European languages and, most importantly, suggests the appropriate use of terms in professional/scientific language, in education and for translation purposes.
DoS(Denial of Service) or DDoS(Distributed DoS) attack is a major threaten and the most difficult problem to solve among many attacks. Moreover, it is very difficult to find a real origin of ...attackers because DoS/DDoS attacker uses spoofed IP addresses. To solve this problem, we propose a probabilistic route selection traceback algorithm, namely PRST, to trace the attacker’s real origin. This algorithm uses two types of packets such as an agent packet and a reply agent packet. The agent packet is in use to find the attacker’s real origin and the reply agent packet is in use to notify to a victim that the agent packet is reached the edge router of the attacker. After attacks occur, the victim generates the agent packet and sends it to a victim’s edge router. The attacker’s edge router received the agent packet generates the reply agent packet and send it to the victim. The agent packet and the reply agent packet is forwarded refer to probabilistic packet forwarding table (PPFT) by routers. The PRST algorithm runs on the distributed routers and PPFT is stored and managed by routers. We validate PRST algorithm by using mathematical approach based on Poisson distribution.
Eleven independent, recessive, N-ethyl-N-nitrosourea-induced mutations that map to a ≈1- to 2-cM region of mouse chromosome (Chr) 7 homologous to human Chr 11p14-p15 were recovered from a screen of ...1,218 gametes. These mutations were initially identified in a hemizygous state opposite a large p-locus deletion and subsequently were mapped to finer genomic intervals by crosses to a panel of smaller p deletions. The 11 mutations also were classified into seven complementation groups by pairwise crosses. Four complementation groups were defined by seven prenatally lethal mutations, including a group (17R3) comprised of two alleles of obvious differing severity. Two allelic mutations (at the psrt locus) result in a severe seizure and runting syndrome, but one mutation (at the fit2 locus) results in a more benign runting phenotype. This experiment has added seven loci, defined by phenotypes of presumed point mutations, to the genetic map of a small (1-2 cM) region of mouse Chr 7 and will facilitate the task of functional annotation of DNA sequence and transcription maps both in the mouse and the corresponding human 11p14-p15 homology region.
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