165 resultados para immature stage
Resumo:
The management of the perineum during birth has multiple long-term effects on women and their families. The midwife has a key role to play and often the techniques they employ vary significantly, as does their justification of these practices. This article seeks to examine current evidence to explore what is known to contribute to lower perineal trauma rates and what practices should be avoided to protect childbearing women. The conclusions drawn show that the updating of
practice and antenatal education may be required so that woman are given the information they need to make an informed choice as to what they want for their own body, child and experience.
Resumo:
Aims/hypothesis
The genetic determinants of diabetic nephropathy remain poorly understood. We aimed to identify novel susceptibility genes for diabetic nephropathy.
MethodsWe performed a genome-wide association study using 1000 Genomes-based imputation to compare type 1 diabetic nephropathy cases with proteinuria and with or without renal failure with control patients who have had diabetes for more than 15 years and no evidence of renal disease.
ResultsNone of the single nucleotide polymorphisms (SNPs) tested in a discovery cohort composed of 683 cases and 779 controls reached genome-wide statistical significance. The 46 top hits (p < 10−5) were then sought for first-stage analysis in the Genetics of Kidneys in Diabetes US (US-GoKinD) study, an independent population of 820 cases and 885 controls. Two SNPs in strong linkage disequilibrium with each other and located in the SORBS1 gene were consistently and significantly (p < 10−4) associated with diabetic nephropathy. The minor rs1326934-C allele was less frequent in cases than in controls (0.34 vs 0.43) and was associated with a decreased risk for diabetic nephropathy (OR 0.70; 95% CI 0.60, 0.82). However, this association was not observed in a second stage with two additional diabetic nephropathy cohorts, the All Ireland-Warren 3-Genetics of Kidneys in Diabetes UK and Republic of Ireland (UK-ROI; p = 0.15) and the Finnish Diabetic Nephropathy (FinnDiane; p = 0.44) studies, totalling 2,142 cases and 2,494 controls. Altogether, the random-effect meta-analysed rs1326934-C allele OR for diabetic nephropathy was 0.83 (95% CI 0.72, 0.96; p = 0.009).
Conclusions/interpretationThese data suggest that SORBS1 might be a gene involved in diabetic nephropathy.
Intraoperative radiotherapy in early stage breast cancer: potential indications and evidence to date
Resumo:
Following early results of recent studies of intra-operative radiotherapy (IORT) in the adjuvant treatment of patients with early breast cancer, the clinical utility of IORT is a subject of much recent debate within the breast oncology community. This review describes the intra-operative techniques available, the potential indications, and the evidence to date pertaining to local control and toxicity. We also discuss any implications for current practice and future research.
Resumo:
Renewable energy is high on international and national agendas. Currently, grid-connected photovoltaic (PV) systems are a popular technology to convert solar energy into electricity. Existing PV panels have a relatively low and varying output voltage so that the converter installed between the PVs and the grid should be equipped with high step-up and versatile control capabilities. In addition, the output current of PV systems is rich in harmonics which affect the power quality of the grid. In this paper, a new multi-stage hysteresis control of a step-up DC-DC converter is proposed for integrating PVs into a single-phase power grid. The proposed circuitry and control method is experimentally validated by testing on a 600W prototype converter. The developed technology has significant economic implications and could be applied to many distributed generation (DG) systems, especially for the developing countries which have a large number of small PVs connected to their single-phase distribution network.
Resumo:
Since the rediscovery of Elizabeth Cary’s drama, The Tragedy of Mariam, the play and its author have generated a veritable critical industry. Yet little has been written about performance, a lacuna explained by a reluctance to think about Mariam as a theatrical creation. This article challenges the current consensus by arguing for the play’s theatrical imprint and by analysing two 2013 performances – a site-specific production at Cary’s birthplace, and a production by the Lazarus Theatre Company. Throughout, Mariam is engaged with in terms of casting, costume, lighting, set and movement, issues that have mostly been bypassed in Cary studies.
Resumo:
As the concept of engine downsizing becomes ever more integrated into automotive powertrain development strategies, so too does the pressure on turbocharger manufacturers to deliver improvements in map width and a reduction in the mass flow rate at which compressor surge occurs. A consequence of this development is the increasing importance of recirculating flows, both in the impeller inlet and outlet domains, on stage performance.
The current study seeks to evaluate the impact of the inclusion of impeller inlet recirculation on a meanline centrifugal compressor design tool. Using a combination of extensive test data, single passage CFD predictions, and 1-D analysis it is demonstrated how the addition of inlet recirculation modelling impacts upon stage performance close to the surge line. It is also demonstrated that, in its current configuration, the accuracy of the 1-D model prediction diminishes significantly with increasing blade tip speed.
Having ascertained that the existing model requires further work, an evaluation of the vaneless diffuser modelling method currently employed within the existing 1-D model is undertaken. The comparison of the predicted static pressure recovery coefficient with test data demonstrated the inherent inadequacies in the resulting prediction, in terms of both magnitude and variation with flow rate. A simplified alternative method based on an equivalent friction coefficient is also presented that, with further development, could provide a significantly improved stage performance prediction.