236 resultados para stages of anesthesia
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Immigrant entrepreneurs tend to start businesses within their ethnic enclave (EE), as it is an integral part of their social and cultural context and the location where ethnic resources reside (Logan, Alba, & Stults, 2003). Ethnic enclaves can be seen as a form of geographic cluster, China Towns are exemplar EEs, easily identified by the clustering of Chinese restaurants and other ethnic businesses in one central location. Studies on EE thus far have neglected the life cycles stages of EE and its impact on the business experiences of the entrepreneurs. In this paper, we track the formation, growth and decline of an EE. We argue that EE is a special industrial cluster and as such it follows the growth conditions proposed by the cluster life cycle theory (Menzel & Fornahl, 2009). We report a mixed method study of Chinese Restaurants in South East Queensland. Based on multiple sources of data, we concluded that changes in government policies leading to a sharp increase of immigrant numbers from a distinctive culture group can lead to the initiation and growth of the EE. Continuous incoming of new immigrants and increase competition within the cluster mark the mature stage of the EE, making the growth condition more favourable “inside” the cluster. A decline in new immigrants from the same ethnic group and the increased competition within the EE may eventually lead to the decline of such an industrial cluster, thus providing more favorable condition for growth of business outside the cluster.
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Use of the hand is vital in working life due to the grabbing and pinching it performs. Spherical grip is the most commonly used, due to similarity to the gripping of a computer mouse. Knowledge of its execution and the involved elements is essential. Analysis of this exertion with surface electromyography devices (to register muscular activity) and accelerometer devices (to register movement values ) can provide multiple variables. Six subjects performed ball gripping and registered real-time electromyography (thenar region, hypothenar region, first dorsal interosseous, flexors of the wrist, flexor carpi ulnaris and extensors of the wrist muscles) and accelerometer (thumb, index, middle, ring, pinky and palm) values. The obtained data was resampled “R software” and processed “Matlab Script” based on an automatic numerical sequence recognition program. Electromyography values were normalized on the basis of maximum voluntary contraction, whilst modular values were calculated for the acceleration vector. After processing and analysing the obtained data and signal, it was possible to identify five stages of movement in accordance with the module vector from the palm. The statistical analysis of the variables was descriptive: average and standard deviations. The outcome variables focus on the variations of the modules of the vector (between the maximum and minimum values of each module and phase) and the maximum values of the standardized electromyography of each muscle. Analysis of movement through accelerometer and electromyography variables can give us an insight into the operation of spherical grip. The protocol and treatment data can be used as a system to complement existing assessments in the hand.
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Background Chronic kidney disease is a global public health problem of increasing prevalence. There are five stages of kidney disease, with Stage 5 indicating end stage kidney disease (ESKD) requiring dialysis or death will eventually occur. Over the last two decades there have been increasing numbers of people commencing dialysis. A majority of this increase has occurred in the population of people who are 65 years and over. With the older population it is difficult to determine at times whether dialysis will provide any benefit over non-dialysis management. The poor prognosis for the population over 65 years raises issues around management of ESKD in this population. It is therefore important to review any research that has been undertaken in this area which compares outcomes of the older ESKD population who have commenced dialysis with those who have received non-dialysis management. Objective The primary objective was to assess the effect of dialysis compared with non-dialysis management for the population of 65 years and over with ESKD. Inclusion criteria Types of participants This review considered studies that included participants who were 65 years and older. These participants needed to have been diagnosed with ESKD for greater than three months and also be either receiving renal replacement therapy (RRT) (hemodialysis [HD] or peritoneal dialysis [PD]) or non-dialysis management. The settings for the studies included the home, self-care centre, satellite centre, hospital, hospice or nursing home. Types of intervention(s)/phenomena of interest This review considered studies where the intervention was RRT (HD or PD) for the participants with ESKD. There was no restriction on frequency of RRT or length of time the participant received RRT. The comparator was participants who were not undergoing RRT. Types of studies This review considered both experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case control studies and analytical cross sectional studies. This review also considered descriptive epidemiological study designs including case series, individual case reports and descriptive cross sectional studies for inclusion. This review included any of the following primary and secondary outcome measures: •Primary outcome – survival measures •Secondary outcomes – functional performance score (e.g. Karnofsky Performance score) •Symptoms and severity of end stage kidney disease •Hospital admissions •Health related quality of life (e.g. KDQOL, SF36 and HRQOL) •Comorbidities (e.g. Charlson Comorbidity index).
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The rate at which people move and resettle around the world is unprecedented. Mobility and resettlement is now greatly assisted by the use of inexpensive internet communication technologies (ICTs) for a wide variety of functions: to communicate locally and across territories, for localised information seeking, geo – locational mapping and for forging new social connections in host countries and cities. This article is based on a qualitative study of newly arrived migrants and mobile people from non English speaking backgrounds (NESB) to the city of Brisbane, Australia and investigates how the internet is used to assist the initial period of settling into the city. As increasing amounts of essential information is placed online, the study asks how people from NESB communities manage to negotiate the types of information they require during the early stages of resettlement, given varying levels of access to ICTs, digital and language literacy. The study finds that the internet is widely used for specific location information seeking (such as accommodation and job-seeking), but this is often supplemented with other non-mediated sources of information. The study identified implications for social policy in regard to the resourcing and access of information. While findings are specific to the study location, it is feasible that the patterns of internet use for resettlement have relevance in a broader context.
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Head and neck squamous cell carcinoma (HNSCC) accounts for a bulk of the oral and laryngeal cancers, the majority (70%) of which are associated with smoking and excessive drinking, major known risk factors for the development of HNSCC. In contrast to reports that suggest an inverse relationship between smoking and global DNA CpG methylation, hypermethylation of promoters of a number of genes was detected in saliva collected from patients with HNSCC. Using a sensitive methylation-specific polymerase chain reaction (MSP) assay to determine specific methylation events in the promoters of RASSF1A, DAPK1, and p16 genes, we demonstrate that we can detect tumor presence with an overall accuracy of 81% in the DNA isolated from saliva of patients with HNSCC (n = 143) when compared with the DNA isolated from the saliva of healthy nonsmoker controls (n = 31). The specificity for this MSP panel was 87% and the sensitivity was 80%(with a Fisher exact test P < .0001). In addition, the test panel performed extremely well in the detection of the early stages of HNSCCs, with a sensitivity of 94% and a specificity of 87%, and a high. concordance value of 0.8, indicating an excellent overall agreement between the presence of HNSCC and a positive MSP panel result. In conclusion, we demonstrate that the promoter methylation of RASSF1A, DAPK1, and p16 MSP panel is useful in detecting hypermethylation events in a noninvasive manner in patients with HNSCC.
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Hedonic pricing techniques can be used to generate quantitative information useful to the project appraiser at various stages of the project cycle, most notably project formulation and investment appraisal. To illustrate, a hedonic pricing model is applied to marina berthing charges in England and Wales. The technique determines the relevant marina facilities that are reflected in marina rental price. The contribution of the key marina facilities is expressed in monetary terms as the contribution to cost per overall rental price per foot.
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PURPOSE The purpose of this study was to demonstrate the potential of near infrared (NIR) spectroscopy for characterizing the health and degenerative state of articular cartilage based on the components of the Mankin score. METHODS Three models of osteoarthritic degeneration induced in laboratory rats by anterior cruciate ligament (ACL) transection, meniscectomy (MSX), and intra-articular injection of monoiodoacetate (1 mg) (MIA) were used in this study. Degeneration was induced in the right knee joint; each model group consisted of 12 rats (N = 36). After 8 weeks, the animals were euthanized and knee joints were collected. A custom-made diffuse reflectance NIR probe of 5-mm diameter was placed on the tibial and femoral surfaces, and spectral data were acquired from each specimen in the wave number range of 4,000 to 12,500 cm(-1). After spectral data acquisition, the specimens were fixed and safranin O staining (SOS) was performed to assess disease severity based on the Mankin scoring system. Using multivariate statistical analysis, with spectral preprocessing and wavelength selection technique, the spectral data were then correlated to the structural integrity (SI), cellularity (CEL), and matrix staining (SOS) components of the Mankin score for all the samples tested. RESULTS ACL models showed mild cartilage degeneration, MSX models had moderate degeneration, and MIA models showed severe cartilage degenerative changes both morphologically and histologically. Our results reveal significant linear correlations between the NIR absorption spectra and SI (R(2) = 94.78%), CEL (R(2) = 88.03%), and SOS (R(2) = 96.39%) parameters of all samples in the models. In addition, clustering of the samples according to their level of degeneration, with respect to the Mankin components, was also observed. CONCLUSIONS NIR spectroscopic probing of articular cartilage can potentially provide critical information about the health of articular cartilage matrix in early and advanced stages of osteoarthritis (OA). CLINICAL RELEVANCE This rapid nondestructive method can facilitate clinical appraisal of articular cartilage integrity during arthroscopic surgery.
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The successful establishment and growth of mixed-species forest plantations requires that complementary or facilitatory species be identified. This can be difficult in many tropical areas because the growth characteristics of endemic species are often unknown, particularly when grown at potentially higher densities in plantations than in natural forests. Here, we investigate whether wood density is a useful and readily accessible trait for choosing complementary species for mixed species plantations. Wood density represents the carbon investment per unit volume of stem with a trade-off generally found between fast (low wood density) and slow (high wood density) growing species. To do this, we use data collected from 18 highly diverse mixed species plantations (4–23 mostly native species) aged from 6 to 11 years at the time of data collection located on Leyte Island, Philippines. We found significant negative correlations between wood densities and the height of the most abundant species, as well as with measures of overall stand growth and tree diameter size distribution. Not only do species with denser woods have slower growth rates, but also mixed-species plantations with higher average wood density and higher stem density were also less productive, at least in these young plantations. Similarly, stands with a high diversity in wood densities were less productive. There is growing interest in making greater use of native multi-species mixtures in smallholder and community planting programs in the tropics, and our results show databases of wood density values may help improve their design. In the early development stages of plantations, canopy closure and rapid height growth are usually key silvicultural targets, and wood density values can predict the rapid height development of species. If plantations are being grown for the livelihood of small landholders then the best target is to choose some species with different wood densities. This allows an early harvest of low-wood density species for early income, and will also reduce competition for slower growing trees with higher wood densities for later income generation.
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It is well established that the traditional taxonomy and nomenclature of Chironomidae relies on adult males whose usually characteristic genitalia provide evidence of species distinction. In the early days some names were based on female adults of variable distinctiveness – but females are difficult to identify (Ekrem et al. 2010) and many of these names remain dubious. In Russia especially, a system based on larval morphology grew in parallel to the conventional adult-based system. The systems became reconciled with the studies that underlay the production of the Holarctic generic keys to Chironomidae, commencing notably with the larval volume (Wiederholm, 1983). Ever since Thienemann’s pioneering studies, it has been evident that the pupa, notably the cast skins (exuviae) provide a wealth of features that can aid in identification (e.g. Wiederholm, 1986). Furthermore, the pupae can be readily associated with name-bearing adults when a pharate (‘cloaked’) adult stage is visible within the pupa. Association of larvae with the name-bearing later stages has been much more difficult, time-consuming and fraught with risk of failure. Yet it is identification of the larval stage that is needed by most applied researchers due to the value of the immature stages of the family in aquatic monitoring for water quality, although the pupal stage also has advocates (reviewed by Sinclair & Gresens, 2008). Few use the adult stage for such purposes as their provenance and association with the water body can be verified only by emergence trapping, and sampling of adults lies outside regular aquatic monitoring protocols.
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Self-regulation is a coping strategy that allows older drivers to drive safely for longer. Self-regulation depends largely on the ability of drivers to evaluate their own driving. Therefore the success of self-regulation, in terms of driving safety, is influenced by the ability of older drivers to have insight into their declining driving performance. In addition, previous studies suggest that providing feedback to older adults regarding their driving skills may lead them to change their driving behaviour. However, little is currently known about the impact of feedback on older drivers’ self-awareness and their subsequent driving regulatory behaviour. This study explored the process of self-regulation and driving cessation among older drivers using the PAPM as a framework. It also investigated older adults’ perceptions and opinions about receiving feedback in regards to their driving abilities. Qualitative focus groups with 27 participants aged 70 years or more were conducted. Thematic analysis resulted in the development of five main themes; the meaning of driving, changes in driving pattern, feedback, the planning process, and solutions. The analysis also resulted in an initial model of driving self-regulation among older drivers that is informed by the current research and the Precaution Adoption Process Model as the theoretical framework. It identifies a number of social, personal, and environmental factors that can either facilitate or hinder people’s transition between stages of change. The findings from this study suggest that further elaboration of the PAPM is needed to take into account the role of insight and feedback on the process of self-regulation among older drivers.
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The transcriptome response of Atlantic salmon (Salmo salar) displaying advanced stages of amoebic gill disease (AGD) was investigated. Naïve smolt were challenged with AGD for 19 days, at which time all fish were euthanized and their severity of infection quantified through histopathological scoring. Gene expression profiles were compared between heavily infected and naïve individuals using a 17 K Atlantic salmon cDNA microarray with real-time quantitative RT-PCR (qPCR) verification. Expression profiles were examined in the gill, anterior kidney, and liver. Twenty-seven transcripts were significantly differentially expressed within the gill; 20 of these transcripts were down-regulated in the AGD-affected individuals compared with naïve individuals. In contrast, only nine transcripts were significantly differentially expressed within the anterior kidney and five within the liver. Again the majority of these transcripts were down-regulated within the diseased individuals. A down-regulation of transcripts involved in apoptosis (procathepsin L, cathepsin H precursor, and cystatin B) was observed in AGD-affected Atlantic salmon. Four transcripts encoding genes with antioxidant properties also were down-regulated in AGD-affected gill tissue according to qPCR analysis. The most up-regulated transcript within the gill was an unknown expressed sequence tag (EST) whose expression was 218-fold (± SE 66) higher within the AGD affected gill tissue. Our results suggest that Atlantic salmon experiencing advanced stages of AGD demonstrate general down-regulation of gene expression, which is most pronounced within the gill. We propose that this general gene suppression is parasite-mediated, thus allowing the parasite to withstand or ameliorate the host response. © 2008 Springer Science+Business Media, LLC.
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The Sydney rock oyster (Saccostrea glomerata) (SRO) is an oyster species that only occurs in estuaries along Australia's east coast. The SRO industry evolved from commercial gathering of oyster in the 1790s to a high production volume aquaculture industry in the 1970s. However, since the late 1970s the SRO industry has experienced a significant and continuous decline in production quantities and the industry's future commercial viably appears to be uncertain. The aim of this study was to review the history and the status of the SRO industry and to discuss the potential future prospects of this industry. This study summarised findings of the existing literature about the industry and defined development stages of the industry. Particular focus was put on the more recent development within the industry (1980s-present) which has not been covered adequately in the existing literature. The finding from this study revealed that major issues of the industry are linked to the management of prevailing diseases, the handling of water quality impairments from increasing coastal development, increasing competition from Australia's Pacific oyster (Crassostrea gigas) industry and the current socio-economic profile of the industry. The study also found that policy makers are currently confronted by the dilemma of saving a "dying art". Findings from this industry review may be vital for current and future fisheries managers and stakeholders as a basis for reviewing industry management and development strategies. This review may also be of interest for other aquaculture industries and fisheries who are dealing with similar challenges as the SRO industry.
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In the current regulatory climate, there is increasing expectation that law schools will be able to demonstrate students’ acquisition of learning outcomes regarding collaboration skills. We argue that this is best achieved through a stepped and structured whole-of-curriculum approach to small group learning. ‘Group work’ provides deep learning and opportunities to develop professional skills, but these benefits are not always realised for law students. An issue is that what is meant by ‘group work’ is not always clear, resulting in a learning regime that may not support the attainment of desired outcomes. This paper describes different types of ‘group work', each associated with distinct learning outcomes. It suggests that ‘group work’ as an umbrella term to describe these types is confusing, as it provides little indication to students and teachers of the type of learning that is valued and is expected to take place. ‘Small group learning’ is a preferable general descriptor. Identifying different types of small group learning allows law schools to develop and demonstrate a scaffolded, sequential and incremental approach to fostering law students’ collaboration skills. To support learning and the acquisition of higherorder skills, different types of small group learning are more appropriate at certain stages of the program. This structured approach is consistent with social cognitive theory, which suggests that with the guidance of a supportive teacher, students can develop skills and confidence in one type of activity which then enhances motivation to participate in another.
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Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket-related discomfort leading to a significant decrease in quality of life. Bone-anchored prostheses are increasingly acknowledged as viable alternative method of attachment of artificial limb. In this case, the prosthesis is attached directly to the residual skeleton through a percutaneous fixation. To date, a few osseointegration fixations are commercially available. Several devices are at different stages of development particularly in Europe and the US. [1-15] Clearly, surgical procedures are currently blooming worldwide. Indeed, Australia and Queensland, in particular, have one of the fastest growing populations. Previous studies involving either screw-type implants or press-fit fixations for bone-anchorage have focused on biomechanics aspects as well as the clinical benefits and safety of the procedure. [16-25] In principle, bone-anchored prostheses should eliminate lifetime expenses associated with sockets and, consequently, potentially alleviate the financial burden of amputation for governmental organizations. Sadly, publications focusing on cost-effectiveness are sparse. In fact, only one study published by Haggstrom et al (2012), reported that “despite significantly fewer visits for prosthetic service the annual mean costs for osseointegrated prostheses were comparable with socket-suspended prostheses”.[26] Consequently, governmental organizations such as Queensland Artificial Limb Services (QALS) are facing a number of challenges while adjusting financial assistance schemes that should be fair and equitable to their clients fitted with bone-anchored prostheses. Clearly, more scientific evidence extracted from governmental databases is needed to further consolidate the analyses of financial burden associated with both methods of attachment (i.e., conventional sockets prostheses, bone-anchored prostheses). The purposes of the presentation will be: 1. To outline methodological avenues to assess the cost-effectiveness of bone-anchored prostheses compared to conventional sockets prostheses, 2. To highlight the potential obstacles and limitations in cost-effectiveness analyses of bone-anchored prostheses, 3. To present preliminary results of a cost-comparison analysis focusing on the comparison of the costs expressed in dollars over QALS funding cycles for both methods of attachment.
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IgA is an important mucosal antibody that can neutralize mucosal pathogens by either preventing attachment to epithelia (immune exclusion) or alternatively inhibit intraepithelial replication following transcytosis by the polymeric immunoglobulin receptor (pIgR). Chlamydia trachomatis is a major human pathogen that initially targets the endocervical or urethral epithelium in women and men, respectively. As both tissues contain abundant SIgA we assessed the protection afforded by IgA targeting different chlamydial antigens expressed during the extra and intraepithelial stages of infection. We developed an in vitro model utilizing polarizing cells expressing the murine pIgR together with antigen-specific mouse IgA, and an in vivo model utilizing pIgR-/- mice. SIgA targeting the extraepithelial chlamydial antigen, the major outer membrane protein (MOMP), significantly reduced infection in vitro by 24 % and in vivo by 44 %. Conversely, pIgR-mediated delivery of IgA targeting the intraepithelial inclusion membrane protein A (IncA) bound to the inclusion but did not reduce infection in vitro or in vivo. Similarly, intraepithelial IgA targeting the secreted protease Chlamydia protease-like activity factor (CPAF) also failed to reduce infection. Together, these data suggest the importance of pIgR-mediated delivery of IgA targeting extra but not intraepithelial chlamydial antigens for protection against a genital tract infection.