316 resultados para Mitchell, Wiliam
Resumo:
This book draws on interview material with more than 100 evangelicals. We ask why do people born into the same religious community turn out so differently? We tell the stories of pro-life DUP picketers, liberal peace-campaigning ministers, housewives afraid of the devil, students deconstructing their faith and atheists mortified by their religious past. We explore why people have chosen to go in one religious direction or another, and how their religious journeys have unfolded.
Resumo:
PURPOSE: To evaluate the permanent prostate brachytherapy (PPB) learning curve using postimplant multisector dosimetric analysis and to assess the correlation between sector -specific dosimetry and patient-reported outcome measures (PROMs).
METHODS AND METHODS: First 200 patients treated with (125)I PPB monotherapy (145 Gy) at a single institution were assessed. Postimplant dosimetry (PID) using CT was evaluated for whole prostate (global) and 12 sectors, assessing minimum dose to 90% of prostate (D90) and dose to 0.1 cm(3) of rectum (D0.1cc). Global and sector PID results were evaluated to investigate changes in D90 with case number. Urinary and bowel PROMs were assessed using the International Prostate Symptom Score and the Expanded Prostate Cancer Index Composite questionnaire. The correlation between global and individual sector PID and urinary/bowel PROMs was also evaluated.
RESULTS: Linear regression confirmed a significant improvement in global D90 with case number (r(2) = 0.20; p = 0.001) at a rate of 0.11 Gy/case. Postimplant D90 of base sectors increased at a rate of 0.11-0.15 Gy/case (p = 0.0001) and matched global improvement. The regression lines of midgland and apex sectors were significantly different from global D90 (p = 0.01). Posterior midgland sectors showed a significant reduction in D90 with case number at a rate of 0.13-0.19 Gy/case (p = 0.01). Dose to posterior midgland sectors correlated with rectal D0.1cc dose but not bowel PROMs. Dose to posterior midgland sectors correlated with urinary International Prostate Symptom Score change, which was not apparent when global D90 alone was considered.
CONCLUSIONS: Sector analysis provided increased spatial information regarding the PPB learning curve. Furthermore, sector analysis correlated with urinary PROMs and rectal dose.
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Reproductive disorders that are common/increasing in prevalence in human males may arise because of deficient androgen production/action during a fetal 'masculinization programming window'. We identify a potentially important role for Chicken Ovalbumin Upstream Promoter-Transcription Factor II (COUP-TFII) in Leydig cell (LC) steroidogenesis that may partly explain this. In rats, fetal LC size and intratesticular testosterone (ITT) increased ~3-fold between e15.5-e21.5 which associated with a progressive decrease in the percentage of LC expressing COUP-TFII. Exposure of fetuses to dibutyl phthalate (DBP), which induces masculinization disorders, dose-dependently prevented the age-related decrease in LC COUP-TFII expression and the normal increases in LC size and ITT. We show that nuclear COUP-TFII expression in fetal rat LC relates inversely to LC expression of steroidogenic factor-1 (SF-1)-dependent genes (StAR, Cyp11a1, Cyp17a1) with overlapping binding sites for SF-1 and COUP-TFII in their promoter regions, but does not affect an SF-1 dependent LC gene (3β-HSD) without overlapping sites. We also show that once COUP-TFII expression in LC has switched off, it is re-induced by DBP exposure, coincident with suppression of ITT. Furthermore, other treatments that reduce fetal ITT in rats (dexamethasone, diethylstilbestrol (DES)) also maintain/induce LC nuclear expression of COUP-TFII. In contrast to rats, in mice DBP neither causes persistence of fetal LC COUP-TFII nor reduces ITT, whereas DES-exposure of mice maintains COUP-TFII expression in fetal LC and decreases ITT, as in rats. These findings suggest that lifting of repression by COUP-TFII may be an important mechanism that promotes increased testosterone production by fetal LC to drive masculinization. As we also show an age-related decline in expression of COUP-TFII in human fetal LC, this mechanism may also be functional in humans, and its susceptibility to disruption by environmental chemicals, stress and pregnancy hormones could explain the origin of some human male reproductive disorders.
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Relative strengths of surface interaction for individual carbon atoms in acyclic and cyclic hydrocarbons adsorbed on alumina surfaces are determined using chemically resolved 13C nuclear magnetic resonance (NMR) T1 relaxation times. The ratio of relaxation times for the adsorbed atoms T1,ads to the bulk liquid relaxation time T1,bulk provides an indication of the mobility of the atom. Hence a low T1,ads/T1,bulk ratio indicates a stronger surface interaction. The carbon atoms associated with unsaturated bonds in the molecules are seen to exhibit a larger reduction in T1 on adsorption relative to the aliphatic carbons, consistent with adsorption occurring through the carbon-carbon multiple bonds. The relaxation data are interpreted in terms of proximity of individual carbon atoms to the alumina surface and adsorption conformations are inferred. Furthermore, variations of interaction strength and molecular configuration have been explored as a function of adsorbate coverage, temperature, surface pre-treatment, and in the presence of co-adsorbates. This relaxation time analysis is appropriate for studying the behaviour of hydrocarbons adsorbed on a wide range of catalyst support and supported-metal catalyst surfaces, and offers the potential to explore such systems under realistic operating conditions when multiple chemical components are present at the surface.
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The garment we now recognise as the Aran jumper emerged as an international symbol of Ireland from the twin twentieth century transatlantic flows of migration and tourism. Its power as a heritage object derives from: 1) the myth commonly associated with the object, in which the corpse of a drowned fisherman is identified and claimed by his family due to the stitch patterns of his jumper (Pádraig Ó Síochain 1962; Annette Lynch and Mitchell Strauss 2014); 2) the meanings attached to those stitch patterns, which have been read, for example, as genealogical records, representations of the natural landscape and references to Christian and pre-Christian ‘Celtic’ religion (Heinz Kiewe 1967; Catherine Nash 1996); and 3) booming popular interest in textile heritage on both sides of the Atlantic, fed by the reframing of domestic crafts such as knitting as privileged leisure pursuits (Rachel Maines 2009; Jo Turney 2009). The myth of the drowned fisherman plays into transatlantic migration narratives of loss and reclamation, promising a shared heritage that needs only to be decoded. The idea of the garment’s surface acting as text (or map) situates it within a preliterate idyll of romantic primitivism, while obscuring the circumstances of its manufacture. The contemporary resurgence in home textile production as recreation, mediated through transnational online networks, creates new markets for heritage textile products while attracting critical attention to the processes through which such objects, and mythologies, are produced. The Aran jumper’s associations with kinship, domesticity and national character make it a powerful tool in the promotion of ancestral (or genealogical) tourism, through marketing efforts such as The Gathering 2013. Nash’s (2010; 2014) work demonstrates the potential for such touristic encounters to disrupt and enrich public conceptions of heritage, belonging and relatedness. While the Aran jumper has been used to commodify a simplistic sense of mutuality between Ireland and north America, it carries complex transatlantic messages in both directions.
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This paper presents multilevel models that utilize the Coxian phase-type distribution in order to be able to include a survival component in the model. The approach is demonstrated by modeling patient length of stay and in-hospital mortality in geriatric wards in Italy. The multilevel model is used to provide a means of controlling for the existence of possible intra-ward correlations, which may make patients within a hospital more alike in terms of experienced outcome than patients coming from different hospitals, everything else being equal. Within this multilevel model we introduce the use of the Coxian phase-type distribution to create a covariate that represents patient length of stay or stage (of hospital care). Results demonstrate that the use of the multilevel model for representing the in-patient mortality is successful and further enhanced by the inclusion of the Coxian phase-type distribution variable (stage covariate).
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Quality of care is an important aspect of healthcare monitoring, which is used to ensure that the healthcare system is delivering care of the highest standard. With populations growing older there is an increased urgency in making sure that the healthcare delivered is of the highest standard. Healthcare providers are under increased pressure to ensure that this is the case with public and government demand expecting a healthcare system of the highest quality. Modelling quality of care is difficult to measure due to the many ways of defining it. This paper introduces a potential model which could be used to take quality of care into account when modelling length of stay. The Coxian phase-type distribution is used to model length of stay and the associated quality of care incorporated into the Coxian using a Hidden Markov model. Covariates are also introduced to determine their impact on the hidden level to find out what potentially can affect quality of care. This model is applied to geriatic patient data from the Lombardy region of Italy. The results obtained highlighted that bed numbers and the type of hospital (public or private) can have an effect on the quality of care delivered.
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In this extended introductory essay, Catherine Gander and Sarah Garland suggest new ways of looking at the correspondences between visual and verbal practices to consider their material and conceptual connections in a specifically American set of histories, contexts and interpretive traditions. Tracing a lineage of experiential philosophy that is grounded in the overturning of a Cartesian mind/body split, the authors argue for pluralistic perspectives on intermedial innovations that situate embodied and imaginative reader-viewer response as vital to the life of the artwork. Gander and Garland chart two main strands to this approach: the pragmatist strain of American aesthetics and social politics, rooted in the essays of transcendentalist Ralph Waldo Emerson and emanating from the writings of John Dewey and William James; and the conceptualist strain of French-American Marcel Duchamp, whose ground-breaking ideas both positioned the artwork as a phenomenological construction and liberated the artist from established methods of practice and discourse. The ‘imagetext’ (after W. J. T. Mitchell) is therefore, argue Gander and Garland, a site consisting of far more than word and image – but a living assemblage of language, idea, thing, cognition, affect and shared experience.