66 resultados para Aggressive incidents


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This paper investigates the contribution of monetary policy to the changes in outputgrowth and inflation dynamics in the US. We identify a policy shock and a policy rule ina time-varying coefficients VAR using robust sign restrictions. The transmission of policyshocks has been relatively stable. The variance of the policy shock has decreased over time,but policy shocks account for a small fraction of the level and of the variations in inflationand output growth volatility and persistence. We find little evidence of a significant increasein the long run response of the interest rate to inflation. A more aggressive inflation policyin the 1970s would have produced large output growth costs.

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Previous covering models for emergency service consider all the calls to be of the sameimportance and impose the same waiting time constraints independently of the service's priority.This type of constraint is clearly inappropriate in many contexts. For example, in urban medicalemergency services, calls that involve danger to human life deserve higher priority over calls formore routine incidents. A realistic model in such a context should allow prioritizing the calls forservice.In this paper a covering model which considers different priority levels is formulated andsolved. The model heritages its formulation from previous research on Maximum CoverageModels and incorporates results from Queuing Theory, in particular Priority Queuing. Theadditional complexity incorporated in the model justifies the use of a heuristic procedure.

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We study financial markets in which both rational and overconfident agents coexist and make endogenous information acquisition decisions. We demonstrate the following irrelevance result: when a positive fraction of rational agents (endogeneously) decides to become informed in equilibrium, prices are set as if all investors were rational, and as a consequence the overconfidence bias does not aect informational efficiency, price volatility, rational traders expected profits or their welfare. Intuitively, as overconfidence goes up, so does price infornativeness, which makes rational agents cut their information acquisition activities, effectively undoing the standard effect of more aggressive trading by the overconfident.

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The chemical resistance of ceramic tiles is the subject of the European Standard UNE-EN ISO 10545-13. In order to evaluate the effect of aqueous solutions of several chemicals agents on the aspect of the tile surface, this standard establishes a series of tests at room temperature followed by visual inspection. According to this standard the tiles of this study are classified as being of maximum resistance (UHA). However operating conditions can be more aggressive than those detailed in the standard. So, a systematic study has been undertaken. In the present work, the effect of aqueous solutions of several organic and inorganic acids on the tile surface is evaluated. Samples immersed in different solutions are subjected to the following conditions: T= 60º C; pH=2 and to agitation processes. Visual analysis, as well as optical microscopy and scanning electron microscopy (SEM) were performed in order to determine the possible variation of the superficial aspect of tiles. Moreover, atomic absorption spectrophotometry has been used in order to obtain quantitative information concerning the solubility of system M (III)-L (M= Fe; L= H2O or L= ligand). The results obtained show, in all cases, a progressive dissolution of iron oxide precipitates presents in the ceramic body

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Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DQ antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cw1, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigenic frequencies were observed in patients having peripheral arthritis and patients with only axial involvement. Seven out of nine patients (78%) with an erosive peripheral arthritis were DR7 positive, suggesting that DR7 or genes closely linked could be related with a more aggressive peripheral joint involvement in patients with AS.

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bolism. Surgery was needed in 51% of cases and mortality was 42%. Prosthetic valve endocarditis (nine of 60, 13%) predominated in the aortic position and was associated with abscess formation, required surgery, and high mortality (78%). Pacemaker lead IE (seven of 69, 10%) is associated with a better prognosis when antibiotic treatment is combined with surgery. Conclusions:S lugdunensis IE is an uncommon cause of IE, involving mainly native left sided valves, and it is characterised by an aggressive clinical course. Mortality in left sided native valve IE is high but the prognosis has improved in recent years. Surgery has improved survival in left sided IE and, therefore, early surgery should always be considered. Prosthetic valve S lugdunensis IE carries an ominous prognosis.

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Quantificar les variables temporal, les accions tècniques i els desplaçaments dels jugador al llarg de la competició proporciona una informació excel·lent per deduir les càrregues físiques i fisiològiques a les que estan sotmesos. Per aquest estudi es van visualitzar 4 partits de la Copa del Rei 2012. Es va enregistrà sistemàticament les dades en fulls de registre. Les principals dades analitzades van ser: temps total, temps real, temps de pausa, temps d’acció i relació entre el temps d’acció i el temps de pausa (densitat de treball). També es va analitzar: les incidències reglamentaries, les accions tècniques del jugador i els desplaçaments del jugador. El 45% de les accions es van produir entre 0 i 30s, i el promig d’interval de participació va ser 19:29s ±2:09. Més del 50% de les pauses es van produir entre 11s i 30s, i el promig d’interval de pausa va ser de 24:57s. Aquest va determinar que la densitat de treball era 1:1.3. Aproximadament el 70% de les incidències reglamentàries van ser faltes d’equip I tècniques. Van haver-hi 56 conduccions, 10 driblins, 12 remats, (3 xuts, 2 punxades/escopides, 5 remats de primeres i 2 arrossegades) i 80 passades. Finalment, en un partit el 42,23% dels desplaçaments van ser a baixa intensitat, el 27,02% van ser a intensitat mitjana i el 30,75% van ser a alta intensitat. A més a més, el 81,90% dels desplaçaments a alta intensitat van durar de 0s a 5s, el 54,56% a intensitat mitjana van durar de 6 a 10 s. I el 49,32% a intensitat baixa també van durar 6s a 10s. L’hoquei sobre patins és un esport en el que hi predominen els esforços intermitents a gran intensitat i de curta durada amb una important sol·licitació de la via anaeròbica alàctica. Analitzar la dimensió temporal, les accions tècniques i els desplaçaments dels jugador durant la competició permet estimar les exigències físiques i requeriments energètics, i aquest faciliten l’elaboració d’entrenaments més específics.

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Este trabajo final de carrera se basa en la redacción de un proyecto de ejecución de una zona lúdica situada en el interior del recinto de un camping, la cual estará formada por una piscina de grandes dimensiones formada por tres vasos de tipo desbordante, una piscina de tipo infantil, un jacuzzi y finalmente un edificio de servicios complementarios (bar, aseos y enfermería). La piscina grande estará formada por tres vasos donde el agua va deslizándose de uno a otro hasta ser recogida por un depósito de compensación desde donde se realizará la filtración y tratamiento antes de ser devuelta al piscina de nuevo. La instalación está también preparada para ser utilizado cada vaso como una piscina individual, recogiendo el agua por los rebosaderos laterales y conduciéndola al mismo vaso de compensación. El tratamiento del agua se realizará de forma física a través de la filtración mediante filtros de arena y de forma química analizando la cantidad de cloro residual y el nivel de PH y posteriormente añadiendo de forma automática las cantidades de cloro y corrector de PH adecuados mediante bombas dosificadoras de precisión. La piscina infantil es de pequeñas dimensiones y esta preparada para ser utilizada por niños de muy corta edad. Se diferencia de la piscina grande en el sistema de recirculación de agua (en este casos e utilizarán skimmers) y en el tratamiento posterior, ya que se utilizará el sistema de hidrólisis salina para su desinfección en lugar de añadir directamente cloro. Este sistema de tratamiento del agua no es tan agresivo como el tradicional, siendo cada vez mas utilizado en piscinas de mediano y pequeño tamaño. El jacuzzi es de grandes dimensiones, disponiendo de su propio sistema de tratamiento de agua, utilizando el sistema de hidrólisis salina como en el caso de la piscina infantil. El edificio de servicios dispone de zonas de bar, enfermería y aseos. Se ha descrito desde la estructura a las instalaciones, justificando las conclusiones a través de los cálculos correspondientes, bien de forma manual, bien utilizando diverso software especializado.

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About 85% of multiple sclerosis (MS) cases start as clinically isolated syndrome (CIS).When patients present with a CIS, clinicians face with many questions, most of themrelated with prognosis and treatment. Thereby, patients with CIS have been focus ofresearch. Several studies have demonstrated a relationship between positive IgM lipidspecific oligoclonal band pattern in CSF and higher lesion load on MRI brain scan, higher number of relapses and greater disability, even at the first stages of the disease. On the other hand, no studies have used this previous evidence to treat with more aggressive disease modifying therapy in initial stages of disease course to prevent the earlier axonal damage. The aim of this study is to assess the most effective approved treatment for MS and current therapy for CIS patients presenting high risk to develop CDMS and with biomarkers of poor prognosis. Among this group of patients any disease activity will eventually lead to disability. Therefore, the earlier the treatment is initiated, the more effective to prevent disability will be. It is considered that “time lost is brain lost” and since once damage is established, there is no therapy to be regained later on. In this phase III clinical trial, 172 patients will be randomized 1:1 to receive Interferon β-1b or natalizumab over 96 weeks. Time to develop clinical definitive multiple sclerosis (CDMS) will be included as primary endpoint. Other secondary endpoints will include clinical data, magnetic resonance imaging (MRI) measurements and quality of life tests

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About 85% of multiple sclerosis (MS) cases start as clinically isolated syndrome (CIS).When patients present with a CIS, clinicians face with many questions, most of themrelated with prognosis and treatment. Thereby, patients with CIS have been focus ofresearch. Several studies have demonstrated a relationship between positive IgM lipidspecific oligoclonal band pattern in CSF and higher lesion load on MRI brain scan, higher number of relapses and greater disability, even at the first stages of the disease. On the other hand, no studies have used this previous evidence to treat with more aggressive disease modifying therapy in initial stages of disease course to prevent the earlier axonal damage. The aim of this study is to assess the most effective approved treatment for MS and current therapy for CIS patients presenting high risk to develop CDMS and with biomarkers of poor prognosis. Among this group of patients any disease activity will eventually lead to disability. Therefore, the earlier the treatment is initiated, the more effective to prevent disability will be. It is considered that “time lost is brain lost” and since once damage is established, there is no therapy to be regained later on. In this phase III clinical trial, 172 patients will be randomized 1:1 to receive Interferon β-1b or natalizumab over 96 weeks. Time to develop clinical definitive multiple sclerosis (CDMS) will be included as primary endpoint. Other secondary endpoints will include clinical data, magnetic resonance imaging (MRI) measurements and quality of life tests

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Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. METHODS: Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. RESULTS: To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. CONCLUSION: So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.

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Background: In longitudinal studies where subjects experience recurrent incidents over a period of time, such as respiratory infections, fever or diarrhea, statistical methods are required to take into account the within-subject correlation. Methods: For repeated events data with censored failure, the independent increment (AG), marginal (WLW) and conditional (PWP) models are three multiple failure models that generalize Cox"s proportional hazard model. In this paper, we revise the efficiency, accuracy and robustness of all three models under simulated scenarios with varying degrees of within-subject correlation, censoring levels, maximum number of possible recurrences and sample size. We also study the methods performance on a real dataset from a cohort study with bronchial obstruction. Results: We find substantial differences between methods and there is not an optimal method. AG and PWP seem to be preferable to WLW for low correlation levels but the situation reverts for high correlations. Conclusions: All methods are stable in front of censoring, worsen with increasing recurrence levels and share a bias problem which, among other consequences, makes asymptotic normal confidence intervals not fully reliable, although they are well developed theoretically.

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HDM, Help Desk Manager és una aplicació android que permet crear i gestionar les incidències que es presenten en una empresa.

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Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. METHODS: Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. RESULTS: To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. CONCLUSION: So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.

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Molecular characterization of radical prostatectomy specimens after systemic therapy may identify a gene expression profile for resistance to therapy. This study assessed tumor cells from patients with prostate cancer participating in a phase II neoadjuvant docetaxel and androgen deprivation trial to identify mediators of resistance. Transcriptional level of 93 genes from a docetaxel-resistant prostate cancer cell lines microarray study was analyzed by TaqMan low-density arrays in tumors from patients with high-risk localized prostate cancer (36 surgically treated, 28 with neoadjuvant docetaxel þ androgen deprivation). Gene expression was compared between groups and correlated with clinical outcome. VIM, AR and RELA were validated by immunohistochemistry. CD44 and ZEB1 expression was tested by immunofluorescence in cells and tumor samples. Parental and docetaxel-resistant castration-resistant prostate cancer cell lines were tested for epithelial-to-mesenchymal transition (EMT) markers before and after docetaxel exposure. Reversion of EMT phenotype was investigated as a docetaxel resistance reversion strategy. Expression of 63 (67.7%) genes differed between groups (P < 0.05), including genes related to androgen receptor, NF-k B transcription factor, and EMT. Increased expression of EMT markers correlated with radiologic relapse. Docetaxel-resistant cells had increased EMT and stem-like cell markers expression. ZEB1 siRNA transfection reverted docetaxel resistance and reduced CD44 expression in DU-145R and PC-3R. Before docetaxel exposure, a selected CD44 þ subpopulation of PC-3 cells exhibited EMT phenotype and intrinsic docetaxel resistance; ZEB1/CD44 þ subpopulations were found in tumor cell lines and primary tumors; this correlated with aggressive clinical behavior. This study identifies genes potentially related to chemotherapy resistance and supports evi-dence of the EMT role in docetaxel resistance and adverse clinical behavior in early prostate cancer.