38 resultados para Bernard, of Clairvaux, Saint, 1090 or 1091-1153.


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This study addresses one of the shortcomings apparent in previous research on expatriate job-transfers, namely the lack of exploratory, empirical groundwork into the motives of expatriates to seek or accept international assignments. The relocatee population of a large German MNC was surveyed for their motives to seek or accept their transfer, using an open-response format. Responses were content analysed in order to arrive at an empirically grounded set of motives. The findings provide a very detailed picture of employees' motives to seek or accept international assignments and thus an important interim result that, when used as input in subsequent investigations, promises highly relevant results due to established content validity.

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The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ. We found that overall antioxidant index, a measure of the combined intake of vitamin C, vitamin E, total carotenoids, and selenium, was associated with a reduced risk of EAC [odds ratio (OR) = 0.57; 95% CI = 0.33-0.98], but not BE (OR = 0.95; 95% CI = 0.53-1.71) or RE (OR = 1.60; 95% CI = 0.86-2.98), for those in the highest compared with lowest category of intake. Those in the highest category of vitamin C intake had a lower risk of EAC (OR = 0.37; 95% CI = 0.21-0.66; P-trend = 0.001) and RE (OR = 0.46; 95% CI = 0.24-0.90; P-trend = 0.03) compared with those in the lowest category. Vitamin C intake was not associated with BE, and intake of vitamin E, total carotenoids, zinc, copper, or selenium was not associated with EAC, BE, or RE. In conclusion, the overall antioxidant index was associated with a reduced risk of EAC. Higher dietary intake of vitamin C was associated with a reduced risk of EAC and RE. These results suggest that antioxidants may play a role in the pathogenesis of RE and EAC and may be more important in terms of progression rather than initiation of the disease process.

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Studies demonstrate the active and passive capability of lichens to inhibit or retard the weathering of calcareous surfaces. Lichen coverage may actively protect a surface through shielding by the thallus and the binding and waterproofing of the rock surface and subsurface by fungal hyphae. Passive protection of rock surfaces may be induced by the formation of an insoluble encrustation, such as calcium oxalate, at the lichen-rock interface. Recent research suggests that the decay of hyphae, induced by changes in microenvironmental conditions, necrosis, parasitism or the natural physiological traits of particular lichen species, may expose a chemically and physically weakened substrate to dissolution triggering relatively rapid weathering-related surface lowering. Consequently, certain epilithic crustose and endolithic lichens may induce a period of surface stability throughout the course of their lifespan, followed by a phase of instability and rapid episodic microtopographical evolution after death and decay. A series of conceptual models is proposed to illustrate this idea over short (single lichen lifespan) and long (multiple lichen lifespans) timescales. The models suggest that the microscale biogeomorphological system of lichen-rock interaction is underpinned by nonlinear dynamical system theory as it exhibits dynamical instability and is consequently difficult to predict over a long timescale. Dominance by biodeterioration or bioprotection may be altered by changes in lichen species or in environmental conditions over time.

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It has long been accepted that thermal and moisture regimes within stonework exert a major influence upon patterns of salt movement and, subsequently, the type and severity of salt-induced decay. For example, it is suggested that slow drying is more likely to bring dissolved salts to the surface, whereas rapid drying could result in the retention of some salt at or near the frequent wetting depth. In reality however, patterns of heating, cooling and surface wetting regimes that drive them – are complex and inconsistent responses to a wide range of environmental controls. As a first step to understanding the complexity of these relationships, this paper reports a series of experiments within a climatic cabinet designed to replicate the effects of short-term temperature fluctuations on the surface and sub-surface temperature regimes of a porous Jurassic limestone, and how they are influenced by surface wetting, ambient temperature and surface airflow. Preliminary results confirm the significance of very steep temperature/stress gradients within the outer centimetre or less of exposed stone under short-duration cycles of heating and cooling. This is important because this is the zone in which many stone decay processes, particularly salt weathering, operate, these processes invariably respond to temperature and moisture fluctuations, and short-term interruptions to insolation could, for example,
trigger these fluctuations on numerous occasions over a day. The data also indicate that there are complex patterns of temperature reversal with depth that are influenced in their intensity and location by surface wetting and moisture penetration, airflow across the surface and ambient air temperature. The presence of multiple temperature reversals and their variation over the course of heating and cooling phases belies previous assumtions of smooth, exponential increases and decreases in subsurface temperatures in response, for example to diurnal patterns of heating and cooling

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The fluorescence of molecules 1-3 is enhanced by factors of up to 67 in the presence of magnesium and calcium ions in neutral water which allows the selective monitoring of magnesium ions under simulated physiological conditions and permits the construction of truth tables with OR logic when these molecules are viewed as ion input-photon output molecuIar devices.

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Gait disturbances are a common feature of Parkinson’s disease, one of the most severe being freezing of gait. Sensory cueing is a common method used to facilitate stepping in people with Parkinson’s. Recent work has shown that, compared to walking to a metronome, Parkinson’s patients without freezing of gait (nFOG) showed reduced gait variability when imitating recorded sounds of footsteps made on gravel. However, it is not known if these benefits are realised through the continuity of the acoustic information or the action-relevance. Furthermore, no study has examined if these benefits extend to PD with freezing of gait. We prepared four different auditory cues (varying in action-relevance and acoustic continuity) and asked 19 Parkinson’s patients (10 nFOG, 9 with freezing of gait (FOG)) to step in place to each cue. Results showed a superiority of action-relevant cues (regardless of cue-continuity) for inducing reductions in Step coefficient of variation (CV). Acoustic continuity was associated with a significant reduction in Swing CV. Neither cue-continuity nor action-relevance was independently sufficient to increase the time spent stepping before freezing. However, combining both attributes in the same cue did yield significant improvements. This study demonstrates the potential of using action-sounds as sensory cues for Parkinson’s patients with freezing of gait. We suggest that the improvements shown might be considered audio-motor ‘priming’ (i.e., listening to the sounds of footsteps will engage sensorimotor circuitry relevant to the production of that same action, thus effectively bypassing the defective basal ganglia).

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Background

It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients.

Purpose

To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness.

Methods

We searched Medline, EMBASE and the Cochrane central register of controlled trials from 1980 to June 2016, and manually reviewed relevant conference proceedings from 2009 to the present. Two reviewers independently assessed search results for inclusion and undertook data extraction and quality appraisal. We included randomised trials comparing fluid regimens with differing fluid balances between groups, and observational studies investigating the relationship between fluid balance and clinical outcomes.

Results

Forty-nine studies met the inclusion criteria. Marked clinical heterogeneity was evident. In a meta-analysis of 11 randomised trials (2051 patients) using a random-effects model, we found no significant difference in mortality with conservative or deresuscitative strategies compared with a liberal strategy or usual care [pooled risk ratio (RR) 0.92, 95 % confidence interval (CI) 0.82–1.02, I2 = 0 %]. A conservative or deresuscitative strategy resulted in increased ventilator-free days (mean difference 1.82 days, 95 % CI 0.53–3.10, I2 = 9 %) and reduced length of ICU stay (mean difference −1.88 days, 95 % CI −0.12 to −3.64, I2 = 75 %) compared with a liberal strategy or standard care.

Conclusions

In adults and children with ARDS, sepsis or SIRS, a conservative or deresuscitative fluid strategy results in an increased number of ventilator-free days and a decreased length of ICU stay compared with a liberal strategy or standard care. The effect on mortality remains uncertain. Large randomised trials are needed to determine optimal fluid strategies in critical illness.