228 resultados para Guidance for all
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A single-step lateral flow immunoassay was developed and validated to detect okadaic acid (OA) and dinophysis toxins (DTXs), which cause diarrhetic shellfish poisoning. The performance characteristics of the test were investigated, in comparison to reference methods (liquid chromatography tandem mass spectrometry and/or bioassay), using both spiked and naturally contaminated shellfish. A portable reader was used to generate a qualitative result, indicating the absence or presence of OA-group toxins, at concentrations relevant to the maximum permitted level (MPL). Sample homogenates could be screened in 20 min (including extraction and assay time) for the presence of free toxins (OA, DTX1, DTX2). DTX3 detection could be included with the addition of a hydrolysis procedure. No matrix effects were observed from the species evaluated (mussels, scallops, oysters, and clams). Results from naturally contaminated samples (n = 72) indicated no false compliant results and no false noncompliant results at <50% MPL. Thus, the development of a new low-cost but highly effective tool for monitoring a range of important phycotoxins has been demonstrated.
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Commentary on: Ramasamy Venkatasalu M, Whiting D, Cairnduff K. Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end-of-life care. J Adv Nurs 2015;71:2108–18.
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OBJECTIVES: To improve understanding about the potential underlying biological mechanisms in the link between depression and all-cause mortality and to investigate the role that inflammatory and other cardiovascular risk factors may play in the relationship between depressive symptoms and mortality.
METHODS: Depression and blood-based biological markers were assessed in the Belfast PRIME prospective cohort study (N = 2389 men, aged 50-59 years) in which participants were followed up for 18 years. Depression was measured using the 10-item Welsh Pure Depression Inventory. Inflammation markers (C-reactive protein [CRP], neopterin, interleukin [IL]-1 receptor antagonist [IL-1Ra], and IL-18) and cardiovascular-specific risk factors (N-terminal pro-b-type natriuretic peptide, midregion pro-atrial natriuretic peptide, midregion pro-adrenomedullin, C-terminal pro-endothelin-1 [CT-proET]) were obtained at baseline. We used Cox proportional hazards modeling to examine the association between depression and biological measures in relation to all-cause mortality and explore the mediating effects.
RESULTS: During follow-up, 418 participants died. Higher levels of depressive symptoms were associated with higher levels of CRP, IL-1Ra, and CT-proET. After adjustment for socioeconomic and life-style risk factors, depressive symptoms were significantly associated with all-cause mortality (hazard ratio = 1.10 per scale unit, 95% confidence interval = 1.04-1.16). This association was partly explained by CRP (7.3%) suggesting a minimal mediation effect. IL-1Ra, N-terminal pro-b-type natriuretic peptide, midregion pro-atrial natriuretic peptide, midregion pro-adrenomedullin, and CT-proET contributed marginally to the association between depression and subsequent mortality.
CONCLUSIONS: Inflammatory and cardiovascular risk markers are associated with depression and with increased mortality. However, depression and biological measures show additive effects rather than a pattern of meditation of biological factors in the association between depression and mortality.
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Molecular testing is becoming an important part of the diagnosis of any patient with cancer. The challenge to laboratories is to meet this need, using reliable methods and processes to ensure that patients receive a timely and accurate report on which their treatment will be based. The aim of this paper is to provide minimum requirements for the management of molecular pathology laboratories. This general guidance should be augmented by the specific guidance available for different tumour types and tests. Preanalytical considerations are important, and careful consideration of the way in which specimens are obtained and reach the laboratory is necessary. Sample receipt and handling follow standard operating procedures, but some alterations may be necessary if molecular testing is to be performed, for instance to control tissue fixation. DNA and RNA extraction can be standardised and should be checked for quality and quantity of output on a regular basis. The choice of analytical method(s) depends on clinical requirements, desired turnaround time, and expertise available. Internal quality control, regular internal audit of the whole testing process, laboratory accreditation, and continual participation in external quality assessment schemes are prerequisites for delivery of a reliable service. A molecular pathology report should accurately convey the information the clinician needs to treat the patient with sufficient information to allow for correct interpretation of the result. Molecular pathology is developing rapidly, and further detailed evidence-based recommendations are required for many of the topics covered here.
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The recent explosion of genetic and clinical data generated from tumor genome analysis presents an unparalleled opportunity to enhance our understanding of cancer, but this opportunity is compromised by the reluctance of many in the scientific community to share datasets and the lack of interoperability between different data platforms. The Global Alliance for Genomics and Health is addressing these barriers and challenges through a cooperative framework that encourages "team science" and responsible data sharing, complemented by the development of a series of application program interfaces that link different data platforms, thus breaking down traditional silos and liberating the data to enable new discoveries and ultimately benefit patients.
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Most studies examining the relationship between social cleavages and party system fragmentation maintain that higher levels of social diversity lead to greater party system fragmentation. However, most aggregate-level studies focus on one type of social cleavage:ethnic diversity. In order to develop a better understanding of how different cleavages impact electoral competition, this paper considers another type of social cleavage: religious diversity.Contrary to previous literature, higher levels of religious diversity provide incentives for cross-religious cooperation, which in turn reduces party system fragmentation. Using a cross national data set of elections from 1946-2011, the results show that, in contrast to most studies examining the effects of social cleavage diversity on the number of parties, higher religious diversity is associated with lower levels of party system fragmentation.
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The time-dependent close-coupling method is used to calculate electron-impact excitation cross sections for the Li(2s)--{\textgreater}Li(nl) and Li(2p)--{\textgreater}Li(nl) transitions at incident energies just above the ionization threshold. The implementation of the time-dependent close-coupling method on a nonuniform lattice allows the study of continuum-coupling effects in excitations to high principal quantum number, i.e., n{\textless}=10. Good agreement is found with R-matrix with pseudostates calculations, which also include continuum-coupling effects, for excitations to low principal quantum number, i.e., n{\textless}=4. Poor agreement is found with standard distorted-wave calculations for excitations to all principal quantum numbers, with differences still at the 50% level for n=10. We are able to give guidance as to the accuracy expected in the n3 extrapolation of nonperturbative close-coupling calculations of low n cross sections and rate coefficients.
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Organizing and managing channels of distribution is an important marketing task. Due to the emergence of electronic commerce on the Internet, e-channel distribution systems have been adopted by many manufacturers. However, academic and anecdotal evidence both point to the pressures arising from this new e-channel manufacturing environment. Questions marks therefore remain on how the addition of this e-channel affects the traditional marketing strategies of leasing and selling. We set up several two-period dual-channel models in which a manufacturer sells a durable product through both a manufacturer-owned e-channel and an independent reseller (leaser) who adopts selling (leasing) to consumers. Our main results indicate that, direct selling cost aside, product durability plays an important role in shaping the strategies of all members. With either marketing strategy, the additional expansion of an e-channel territory may secure Pareto gains, in which all members benefit.
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BACKGROUND: Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits.
PURPOSE: These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality.
METHODS: Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support.
RESULTS: Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption.
CONCLUSIONS: These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.
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Microneedles (MNs) are minimally invasive devices consisting of numerous micron-sized projections amassed on a baseplate, designed to enhance transdermal drug delivery. When applied to the skin, the needles puncture the outermost layer, the stratum corneum, forming aqueous conduits through which drugs can diffuse to the dermal microcirculation. With an average length of 50-900 μm, MNs are short enough to avoid stimulation of dermal nerves and do not induce bleeding, yet gain access to the skin's rich microcirculation for drug delivery. MNs have been extensively investigated for drug and vaccine delivery, demonstrating their efficacy at increasing the number of compounds amenable to delivery through the skin. This chapter discusses the materials and fabrication methods involved in MN production, alongside the different types of MN arrays and their delivery capabilities. The field has expanded to consider novel applications of MNs including minimally invasive patient monitoring, ocular delivery and enhanced administration of cosmeceuticals. Patient usage and effects on the skin are also considered in terms of safety, efficacy and acceptability. The next steps in MN development are to focus on the scale-up of manufacturing processes, a challenge considering the number of small-scale methods detailed in the literature. Regulatory guidance is awaited to direct this, alongside provision of clearer patient instruction for safe and effective use of MN devices. MNs have tremendous potential to yield real benefits for patients and industry and with continued research in the key areas highlighted, this will begin to be realised over the next number of years.
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γ-Ray sources are among the most fundamental experimental tools currently available to modern physics. As well as the obvious benefits to fundamental research, an ultra-bright source of γ-rays could form the foundation of scanning of shipping containers for special nuclear materials and provide the bases for new types of cancer therapy.
However, for these applications to prove viable, γ-ray sources must become compact and relatively cheap to manufacture. In recent years, advances in laser technology have formed the cornerstone of optical sources of high energy electrons which already have been used to generate synchrotron radiation on a compact scale. Exploiting the scattering induced by a second laser, one can further enhance the energy and number of photons produced provided the problems of synchronisation and compact γ-ray detection are solved.
Here, we report on the work that has been done in developing an all-optical and hence, compact non-linear Thomson scattering source, including the new methods of synchronisation and compact γ-ray detection. We present evidence of the generation of multi-MeV (maximum 16–18 MeV) and ultra-high brilliance (exceeding 1020 photons s−1mm−2mrad−2 0.1% BW at 15 MeV) γ-ray beams. These characteristics are appealing for the paramount practical applications mentioned above.
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Large-scale commercial exploitation of wave energy is certain to require the deployment of wave energy converters (WECs) in arrays, creating ‘WEC farms’. An understanding of the hydrodynamic interactions in such arrays is essential for determining optimum layouts of WECs, as well as calculating the area of ocean that the farms will require. It is equally important to consider the potential impact of wave farms on the local and distal wave climates and coastal processes; a poor understanding of the resulting environmental impact may hamper progress, as it would make planning consents more difficult to obtain. It is therefore clear that an understanding the interactions between WECs within a farm is vital for the continued development of the wave energy industry.To support WEC farm design, a range of different numerical models have been developed, with both wave phase-resolving and wave phase-averaging models now available. Phase-resolving methods are primarily based on potential flow models and include semi-analytical techniques, boundary element methods and methods involving the mild-slope equations. Phase-averaging methods are all based around spectral wave models, with supra-grid and sub-grid wave farm models available as alternative implementations.The aims, underlying principles, strengths, weaknesses and obtained results of the main numerical methods currently used for modelling wave energy converter arrays are described in this paper, using a common framework. This allows a qualitative comparative analysis of the different methods to be performed at the end of the paper. This includes consideration of the conditions under which the models may be applied, the output of the models and the relationship between array size and computational effort. Guidance for developers is also presented on the most suitable numerical method to use for given aspects of WEC farm design. For instance, certain models are more suitable for studying near-field effects, whilst others are preferable for investigating far-field effects of the WEC farms. Furthermore, the analysis presented in this paper identifies areas in which the numerical modelling of WEC arrays is relatively weak and thus highlights those in which future developments are required.