Severity score system for progressive myelopathy: development and validation of a new clinical scale

Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

The electromyographic threshold in children: Differences in neuromuscular activation during progressive exercise between boys and men

The electromyographic threshold (EMGTh), defined as an upward inflexion in the rising EMG signal during progressive exercise, is thought to reflect the onset of increased type-II MU recruitment. The study’s objective was to compare the relative exercise intensity at which the EMGTh occurs in boys vs. men. Participants included 21 men (23.4±4.1 yrs) and 23 boys (11.1±1.1 yrs). Ramped cycle-ergometry was conducted to volitional exhaustion with surface EMG recorded from the vastus lateralis muscles. The EMGTh was mathematically determined using a composite of both legs. EMGTh was detected in 95.2% of the men and in 78.3% of the boys (χ2(1, n=44) =2.69, p =.10). The boys’ EMGTh was significantly higher than the men’s (86.4±9.6 vs. 79.7±10.0% of peak power-output at exhaustion; p <.05). These findings suggest that boys activate their type-II MUs to a lesser extent than men during progressive exercise and support the hypothesis of differential child–adult MU activation.

Progressive French Reader First year

UANL

Modulation de l’expression du gène CFTR par le produit du gène FIC1 responsable de la cholestase familiale intra-hépatique progressive de type 1 : Identification des mécanismes moléculaires impliqués

Réalisé en cotutelle avec l'Université de Cergy-Pontoise

On the optimality of progressive income redistribution

We compute the optimal non-linear tax policy for a dynastic economy with uninsurable risk, where generations are linked by dynastic wealth accumulation and correlated incomes. Unlike earlier studies, we find that the optimal long-run tax policy is moderately regressive. Regressive taxes lead to higher output and consumption, at the expense of larger after-tax income inequality. Nevertheless, equilibrium effects and the availability of self-insurance via bequests mitigate the impact of regressive taxes on consumption inequality, resulting in improved average welfare overall. We also consider the optimal once-and-for-all change in the tax system, taking into account the transition dynamics. Starting at the U.S. status quo, the optimal tax reform is slightly more progressive than the current system.

Analytical Investigations 0n Collapse of Cylindrical Submarine Shells

Submarine hull structure is a watertight envelope, under hydrostatic pressure when in operation. Stiffened cylindrical shells constitute the major portion of these submarine hulls and these thin shells under compression are susceptible to buckling failure. Normally loss of stability occurs at the limit point rather than at the bifurcation point and the stability analysis has to consider the change in geometry at each load step. Hence geometric nonlinear analysis of the shell forms becomes. a necessity. External hydrostatic pressure will follow the deformed configuration of the shell and hence follower force effect has to be accounted for. Computer codes have been developed based on all-cubic axisymmetric cylindrical shell finite element and discrete ring stiffener element for linear elastic, linear buckling and geometric nonIinear analysis of stiffened cylindrical shells. These analysis programs have the capability to treat hydrostatic pressure as a radial load and as a follower force. Analytical investigations are carried out on two attack submarine cylindrical hull models besides standard benchmark problems. In each case, the analysis has been carried out for interstiffener, interdeepframe and interbulkhead configurations. The shell stiffener attachment in each of this configuration has been represented by the simply supported-simply supported, clamped-clamped and fixed-fixed boundary conditions in this study. The results of the analytical investigations have been discussed and the observations and conclusions are described. Rotation restraint at the ends is influential for interstiffener and interbulkhead configurations and the significance of axial restraint becomes predominant in the interbulkhead configuration. The follower force effect of hydrostatic pressure is not significant in interstiffener and interdeepframe configurations where as it has very high detrimental effect on buckling pressure on interbulkhead configuration. The geometric nonlinear interbulkhead analysis incorporating follower force effect gives the critical value of buckling pressure and this analysis is recommended for the determination of collapse pressure of stiffened cylindrical submarine shells.

Análisis de la transformación de las relaciones militares entre Turquía e Israel a partir de la ruptura de la alianza bilateral generada por el ataque a la Flotilla de Gaza. Período 2008 a 2011

Amenazas como Siria, Irán y el PKK fueron relevantes al momento de forjar una alianza entre Turquía e Israel a mediados de los noventa. Con la firma de varios acuerdos en el ámbito militar se fortaleció la relación bilateral en materia de seguridad. Sin embargo, la llegada de un nuevo gobierno a Turquía en 2002 generó un cambio en materia de política exterior, especialmente con Israel. La monografía sustentada bajo los postulados de la Teoría del Balance de las Amenazas concluye que la ruptura de la alianza se dio por el cambio en la política exterior de seguridad turca, el bloqueo a Gaza por parte de Israel en 2008 y el ataque a la Flotilla de Gaza en 2010, conduciendo a una transformación en los acuerdos militares pactados para la seguridad y estabilidad de ambos países en la región de Medio Oriente.

Edexcel AS History: The Collapse of the Liberal State and the Triumph of Fascism in Italy, 1896-1943.

Esta guía ha sido escrita por un examinador y explica los requisitos de cada unidad, resume el contenido relevante de cada unidad e incluye una serie de preguntas y respuestas. Cumple los requisitos establecidos para aprobar el examen de historia del nivel Edexcel AS que pertenece al segundo ciclo de enseñanza secundaria. El tema principal del libro es el colapso del estado liberal y el triunfo del fascismo en Italia, 1896-1943, los temas secundarios son: Italia en 1896, el impacto de la Primera Guerra Mundial en Italia, la crisis económica y política de la posguerra, el aumento del fascismo en 1922, la creación del estado fascista, la política de Mussolini, y el impacto de la Segunda Guerra Mundial en Italia.