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In the year 2000 lung cancer was operated in 349 patients in Norway, in 2010 the number was 461. In the first period fatal surgical hemorrhage occurred in eight patients, in four of them peroperatively. Postoperative hemorrhage occurred in four patients in the year 2000 and in two in 2010. Ten patients died intra- or postoperatively in the two periods which is a mortality rate within 30 days after surgery of 4.3% in the first and 1.1% in the second period. Pneumonectomy was performed in 34 patients in 2000 and eight in 2010, respectively. Altogether 19 patients died within six months after surgery without having experienced surgical complications. Pneumonectomy should not be performed in elderly and debilitated persons.
In recent years,
increased attention has been given to guidelines for cost-effectiveness
analysis of medical interventions, and some of these guidelines (such as NICE
) have become rather influential. In the paper, we present a model of
retrieving and processing information to be used for the study of guidelines
and their use. Our main result, which relies on a version of the theorem of
Blackwell , shows that in cases where there are sufficiently many decisions
to be made on the basis of the information obtained, there can be no other
objective ranking of methods than the trivial one ranking more information is
higher than less information. In our context, this means that guidelines may
have administrative advantages but cannot be considered as a scientifically
based approach to better decision making.
The study displays the existence of a gravitational singularity
in the universe generating synchronized and extremely low frequency plane TEM (transverse
electromagnetic) waves. It is proposed that atomic intrinsic electromagnetic fields
create resonance with these plane TEM waves, causing atoms to receive and to re-emit
synchronized plane TEM waves. The energy flow of synchronized plane TEM waves, travelling in opposite
directions between e.g. two atoms, creates mutual force of attraction, i.e. gravity. Consequently, gravity is not
an intrinsic atomic feature; however, the result of passive atoms exposed to electromagnetic
energy. The study describes how plane TEM waves emitted by the gravitational singularity
were measured. The study also displays how gravity from the earth, moon, sun and
the gravitational singularity was measured and how gravity was simulated using an
electronic device. The present electromagnetic law of gravity is compared with Newtonian
geometric law of gravity.
The dynamics and challenges of managing geographically dispersed project teams is examined in a field investigation of 72 multinational product developments, observed and studied between 2008 and 2012. The findings provide insight into the business processes and leadership style most conducive to cross-functional collaboration and effective project integration throughout the enterprise and its partners. The results show that many of the problems that surface on the technical side can be traced to social, psychological and organizational issues. In fact, people issues have the strongest impact on project performance. People are an intricate part of the work process. Issues affecting people, eventually impact the broader enterprise. On the positive side, the study shows that certain conditions, such as personal interest, pride and satisfaction with the work, professional work challenge, accomplishments and recognition, serve as catalysts toward unifying culturally diverse project teams and their work processes. These conditions act as bridging mechanisms between organizational goals and personal interests, between central control and local management norms, and between following a project plan and adaptive problem solving. However, working seamless across borders and cultures requires more than just issuing work orders, project summary plans or management guidelines. Emphasis must be on common values and goals to focus and unify the team. By recognizing the greater autonomy of all international partners as well as their cultural differences, management can build a true partnership among all the contributing organizations with strong linkages for communication, decision making and technology transfer that is sustainable over the project lifecycle. The paper suggests a framework for managerial actions and leadership for building high-performance multinational project teams.