988 resultados para INTERNATIONAL NORMALIZED RATIO


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Heterodyne receivers at millimeter and submillimeter wavelength are widely used for radiometric spectral line observations for atmospheric remote sensing or radio astronomy. The quantitative analysis of such observations requires an accurate knowledge of the mixers's sideband ratio. In addition, its potential sensitivity to spurious harmonics needs to be well understood. In this paper, we discuss a measurement technique for these receiver characteristics, which is based on a scanning Martin Puplett Interferometer used in conjunction with a wide band digital autocorrelation spectrometer for the analysis of the intermediate frequency band. We present measurement results of different double sideband and sideband separating mixers, which were developed for the proposed 340GHz multi-beam limb sounder STEAMR.

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Background: There is limited evidence about the impact of treatment for subclinical hypothyroidism, especially among older people. Aim: To investigate the variation in GP treatment strategies for older patients with subclinical hypothyroidism depending on country and patient characteristics. Design and setting: Case-based survey of GPs in the Netherlands, Germany, England, Ireland, Switzerland, and New Zealand. Method: The treatment strategy of GPs (treatment yes/no, starting-dose thyroxine) was assessed for eight cases presenting a woman with subclinical hypothyroidism. The cases differed in the patient characteristics of age (70 versus 85 years), vitality status (vital versus vulnerable), and thyroid-stimulating hormone (TSH) concentration (6 versus 15 mU/L). Results: A total of 526 GPs participated (the Netherlands n = 129, Germany n = 61, England n = 22, Ireland n = 21, Switzerland n = 262, New Zealand n = 31; overall response 19%). Across countries, differences in treatment strategy were observed. GPs from the Netherlands (mean treatment percentage 34%), England (40%), and New Zealand (39%) were less inclined to start treatment than GPs in Germany (73%), Ireland (62%), and Switzerland (52%) (P = 0.05). Overall, GPs were less inclined to start treatment in 85-year-old than in 70-year-old females (pooled odds ratio [OR] 0.74 [95% confidence interval [CI] = 0.63 to 0.87]). Females with a TSH of 15 mU/L were more likely to get treated than those with a TSH of 6 mU/L (pooled OR 9.49 [95% CI = 5.81 to 15.5]). Conclusion: GP treatment strategies of older people with subclinical hypothyroidism vary largely by country and patient characteristics. This variation underlines the need for a new generation of international guidelines based on the outcomes of randomised clinical trials set within primary care

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PURPOSE: Exercise-related sudden cardiac deaths (SCD) occur with a striking male predominance. A higher sympathetic tone in men has been suggested as risk factor for SCD. Elite athletes have the highest risk for exercise-related SCD. We aimed to analyze the autonomic nervous system of elite cross-country skiers from Norway, Russia and Switzerland in supine position and after orthostatic challenge in various training periods (TP). METHOD: Measurements of heart rate variability (HRV) were performed on a weekly basis over 1 year using an orthostatic challenge test with controlled breathing. Main outcome parameters were the high-frequency power in supine position (HFsupine) as marker of cardiac parasympathetic activity and the low-frequency/high-frequency power ratio after orthostatic challenge (LF/HFstand) as marker of cardiac sympathetic activation. Training intensity and duration were recorded daily and expressed as training strain. The training year was divided into three TPs. An average of weekly HRV measurements was calculated for each TP. RESULT: Female (n = 19, VO2max 62.0 +/- 4.6 ml kg(-1) min(-1), age 25.8 +/- 4.3 years) and male (n = 16, VO2max 74.3 +/- 6.3 ml kg(-1) min(-1), age 24.4 +/- 4.2 years) athletes were included. Training strain was comparable between sexes (all p > 0.05) and changed between TPs (all p < 0.05) while no HRV parameters changed over time. There were no sex differences in HFsupine while the LF/HFstand was significantly higher in male athletes in all TPs. CONCLUSION: For a comparable amount of training, male athletes showed constantly higher markers of sympathetic activity after a provocation maneuver. This may explain part of the male predominance in sports-related SCD.

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BACKGROUND Management of tuberculosis in patients with HIV in eastern Europe is complicated by the high prevalence of multidrug-resistant tuberculosis, low rates of drug susceptibility testing, and poor access to antiretroviral therapy (ART). We report 1 year mortality estimates from a multiregional (eastern Europe, western Europe, and Latin America) prospective cohort study: the TB:HIV study. METHODS Consecutive HIV-positive patients aged 16 years or older with a diagnosis of tuberculosis between Jan 1, 2011, and Dec 31, 2013, were enrolled from 62 HIV and tuberculosis clinics in 19 countries in eastern Europe, western Europe, and Latin America. The primary endpoint was death within 12 months after starting tuberculosis treatment; all deaths were classified according to whether or not they were tuberculosis related. Follow-up was either until death, the final visit, or 12 months after baseline, whichever occurred first. Risk factors for all-cause and tuberculosis-related deaths were assessed using Kaplan-Meier estimates and Cox models. FINDINGS Of 1406 patients (834 in eastern Europe, 317 in western Europe, and 255 in Latin America), 264 (19%) died within 12 months. 188 (71%) of these deaths were tuberculosis related. The probability of all-cause death was 29% (95% CI 26-32) in eastern Europe, 4% (3-7) in western Europe, and 11% (8-16) in Latin America (p<0·0001) and the corresponding probabilities of tuberculosis-related death were 23% (20-26), 1% (0-3), and 4% (2-8), respectively (p<0·0001). Patients receiving care outside eastern Europe had a 77% decreased risk of death: adjusted hazard ratio (aHR) 0·23 (95% CI 0·16-0·31). In eastern Europe, compared with patients who started a regimen with at least three active antituberculosis drugs, those who started fewer than three active antituberculosis drugs were at a higher risk of tuberculosis-related death (aHR 3·17; 95% CI 1·83-5·49) as were those who did not have baseline drug-susceptibility tests (2·24; 1·31-3·83). Other prognostic factors for increased tuberculosis-related mortality were disseminated tuberculosis and a low CD4 cell count. 18% of patients were receiving ART at tuberculosis diagnosis in eastern Europe compared with 44% in western Europe and 39% in Latin America (p<0·0001); 12 months later the proportions were 67% in eastern Europe, 92% in western Europe, and 85% in Latin America (p<0·0001). INTERPRETATION Patients with HIV and tuberculosis in eastern Europe have a risk of death nearly four-times higher than that in patients from western Europe and Latin America. This increased mortality rate is associated with modifiable risk factors such as lack of drug susceptibility testing and suboptimal initial antituberculosis treatment in settings with a high prevalence of drug resistance. Urgent action is needed to improve tuberculosis care for patients living with HIV in eastern Europe. FUNDING EU Seventh Framework Programme.

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CFC-11 (CCl3F), CFC-12 (CCl2F2), HF, and SF6 products from limb-viewing satellite instruments are provided in the form of monthly zonal mean time series obtained from HALOE, MIPAS, ACE-FTS, and HIRDLS within the time period 1991-2010. The data products are made available as part of the Stratosphere-troposphere Processes And their Role in Climate (SPARC) Data Initiative. The trace gas time series extend from the mid-troposphere to as high as the mesosphere. The zonal monthly mean time series are calculated on the SPARC Data Initiative climatology grid using 5° latitude bins and 28 pressure levels. The zonal monthly mean volume mixing ratio (VMR) and the standard deviation along with the number of averaged data values are given for each month, latitude bin, and pressure level. Furthermore, the mean, minimum, and maximum local solar time, the average latitude, and the average day of the month within each bin for one selected pressure level are provided. The time series of all variables are saved in a consistent netcdf format.

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Extreme winter warming events in the sub-Arctic have caused considerable vegetation damage due to rapid changes in temperature and loss of snow cover. The frequency of extreme weather is expected to increase due to climate change thereby increasing the potential for recurring vegetation damage in Arctic regions. Here we present data on vegetation recovery from one such natural event and multiple experimental simulations in the sub-Arctic using remote sensing, handheld passive proximal sensors and ground surveys. Normalized difference vegetation index (NDVI) recovered fast (2 years), from the 26% decline following one natural extreme winter warming event. Recovery was associated with declines in dead Empetrum nigrum (dominant dwarf shrub) from ground surveys. However, E. nigrum healthy leaf NDVI was also reduced (16%) following this winter warming event in experimental plots (both control and treatments), suggesting that non-obvious plant damage (i.e., physiological stress) had occurred in addition to the dead E. nigrum shoots that was considered responsible for the regional 26% NDVI decline. Plot and leaf level NDVI provided useful additional information that could not be obtained from vegetation surveys and regional remote sensing (MODIS) alone. The major damage of an extreme winter warming event appears to be relatively transitory. However, potential knock-on effects on higher trophic levels (e.g., rodents, reindeer, and bear) could be unpredictable and large. Repeated warming events year after year, which can be expected under winter climate warming, could result in damage that may take much longer to recover.

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Sediment core logs from six sediment cores in the Labrador Sea show millennial-scale climate variability during the last glacial by recording all Heinrich events and several major Dansgaard-Oeschger cycles. The same millennial-scale climate change is documented for surface-water d18O records of Neogloboquadrina pachyderma (left coiled); hence the surface-water d18O record can be derived from sediment core logging by means of multiple linear regression, providing a paleoclimate proxy record at very high temporal resolution (70 yrs). For the Labrador Sea, sediment core logs contain important information about deep-water current velocities and also reflect the variable input of IRD from different sources as inferred from grain-size analysis, benthic d18O, the relation of density and p-wave velocity, and magnetic susceptibility. For the last glacial, faster deep-water currents which correspond to highs in sediment physical properties, occurred during iceberg discharge and lasted for a several centuries to a few millennia. Those enhanced currents might have contributed to increased production of intermediate waters during times of reduced production of North Atlantic Deep Water. Hudson Strait might have acted as a major supplier of detrital carbonate only during lowered sea level (greater ice extent). During coldest atmospheric temperatures over Greenland, deep-water currents increased during iceberg discharge in the Labrador Sea, then surface water freshened shortly after, while the abrupt atmospheric temperature rise happened after a larger time lag of >=1 kyr. The correlation implies a strong link and common forcing for atmosphere, sea surface, and deep water during the last glacial at millennial time scales but decoupling at orbital time scales.

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During summer 2008, as part of the Circumpolar Flaw Lead system study, we measured phytoplankton photosynthetic parameters to understand regional patterns in primary productivity, including the degree and timescale of photoacclimation and how variability in environmental conditions influences this response. Photosynthesis-irradiance measurements were taken at 15 sites primarily from the depth of the subsurface chlorophyll a (Chl a) maximum (SCM) within the Beaufort Sea flaw lead polynya. The physiological response of phytoplankton to a range of light levels was used to assess maximum rates of carbon (C) fixation (P*m), photosynthetic efficiency (alpha*), photoacclimation (Ek), and photoinhibition (beta*). SCM samples taken along a transect from under ice into open water exhibited a >3-fold increase in alpha* and P*m, showing these parameters can vary substantially over relatively small spatial scales, primarily in response to changes in the ambient light field. Algae were able to maintain relatively high rates of C fixation despite low light at the SCM, particularly in the large (>5 µm) size fraction at open water sites. This may substantially impact biogenic C drawdown if species composition shifts in response to future climate change. Our results suggest that phytoplankton in this region are well acclimated to existing environmental conditions, including sea ice cover, low light, and nutrient pulses. Furthermore, this photoacclimatory response can be rapid and keep pace with a developing SCM, as phytoplankton maintain photosynthetic rates and efficiencies in a narrow ''shade-acclimated'' range.

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A comprehensive (mineralogical, geochronological, and geochemical) study of zircons from an eclogitized gabbronorite dike was carried out in order to identify reliable indicators (mineralogical and geochronological) of genesis of the zircons in their various populations and, correspondingly, ages of certain geological events (magmatic crystallization of the gabbroids, their eclogitization, and overprinted retrograde metamorphism). Three populations of zircons separated from two rock samples comprised xenogenic, magmatic (gabbroic), and metamorphic zircons, with the latter found exclusively in the sample of retrograded eclogitized gabbroids. Group I zircons are xenogenic and have a Meso- to Neoarchean age. Mineral inclusions in them (quartz, apatite, biotite, and chlorite) are atypical of gabbroids, and geochemistry of these zircons is very diverse. Group II zircons contain mineral inclusions of ortho- and clinopyroxene and are distinguished for their very high U, Th, Pb, and REE concentrations and Th/U ratios. These zircons formed during the late magmatic crystallization of the gabbroids at temperatures of 1150-1160°C, and their U-Pb age 2389±25 Ma corresponds to this process. Eclogite mineral assemblages crystallized shortly after the magmatic process, as follows from the fact that marginal portions of prismatic zircons contain clinopyroxene inclusions with elevated contents of the jadeite end-member. Group III zircons contain rare amphibole and biotite inclusions and have low Ti, Y, and REE concentrations, low Th/U ratios, high Hf concentrations, contain more HREE than LREE, and have U-Pb age 1911±9.5 Ma, which corresponds to age of overprinted amphibolite-facies metamorphism.

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Little is known concerning the effect of CO2 on phytoplankton ecophysiological processes under nutrient and trace element-limited conditions, because most CO2 manipulation experiments have been conducted under elements-replete conditions. To investigate the effects of CO2 and iron availability on phytoplankton ecophysiology, we conducted an experiment in September 2009 using a phytoplankton community in the iron limited, high-nutrient, low-chlorophyll (HNLC) region of the Bering Sea basin . Carbonate chemistry was controlled by the bubbling of the several levels of CO2 concentration (180, 380, 600, and 1000 ppm) controlled air, and two iron conditions were established, one with and one without the addition of inorganic iron. We demonstrated that in the iron-limited control conditions, the specific growth rate and the maximum photochemical quantum efficiency (Fv/Fm) of photosystem (PS) II decreased with increasing CO2 levels, suggesting a further decrease in iron bioavailability under the high-CO2 conditions. In addition, biogenic silica to particulate nitrogen and biogenic silica to particulate organic carbon ratios increased from 2.65 to 3.75 and 0.39 to 0.50, respectively, with an increase in the CO2 level in the iron-limited controls. By contrast, the specific growth rate, Fv/Fm values and elemental compositions in the iron-added treatments did not change in response to the CO2 variations, indicating that the addition of iron canceled out the effect of the modulation of iron bioavailability due to the change in carbonate chemistry. Our results suggest that high-CO2 conditions can alter the biogeochemical cycling of nutrients through decreasing iron bioavailability in the iron-limited HNLC regions in the future.

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Geological, petrochemical, and geochemical data are reported for volcanic rocks of a Cretaceous pull-apart basin in the Tan Lu strike-slip system, Asian continental margin. A comparison of these volcanic rocks with magmatic rocks from typical Cenozoic transform margins in the western North America and rift zones of Korea made it possible to distinguish some indicator features of transform-margin volcanic rocks. Magmatic rocks from strike-slip extension zones bear island-arc, intraplate, and occasionally depleted MORB geochemical signatures. In addition to calc-alkaline rocks there are bimodal volcanic series. The rocks are characterized by high K2O, MgO, and TiO2 contents. They show variable enrichment in LILE relative to HFSE, which is typical of island-arc magmas. At the same time they are rich in compatible transition elements, which is a characteristic of intraplate magmas. Trace element distribution patterns normalized to MORB or primitive mantle usually show a negative Ta-Nb anomaly typical of suprasubduction settings. Their Ta/Nb ratio is lower, whereas Ba/Nb, Ba/La, and La/Yb ratios are higher than those of some MORB and OIB. In terms of trace element systematics, for example, Ta-Th-Hf, Ba/La-(Ba/La)_n, (La/Sm)_n-La/Hf, and others, they fall within the area of mixing of magmas from several sources (island arc, intraplate, and depleted reservoirs). Magmatic rocks of transform settings show a sigmoidal chondrite-normalized REE distribution pattern with a negative slope of LREE, depletion in MREE, and an enriched or flat HREE pattern. Magmas with mixed geochemical characteristics presumably originated in a transform margin setting in local extension zones under influence of mantle diapirs, which caused metasomatism and melting of the lithosphere at different levels, and mixing of melts from different sources in variable proportions.

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Paleomagnetic inclination, declination and relative paleointensity were reconstructed from the sediments of Laguna Potrok Aike in the framework of the International Continental scientific Drilling Program (ICDP) Potrok Aike maar lake Sediment Archive Drilling prOject (PASADO). Here we present the u-channel-based full vector paleomagnetic field reconstruction since 51.2 ka cal BP. The relative paleointensity proxy (RPI) was built by normalising the natural remanent magnetisation with the anhysteretic remanent magnetisation using the average ratio at 4 demagnetisation steps part of the ChRM interval (NRM/ARM10e40 mT). A grain size influence on the RPI was removed using a correction based on the linear relationship between the RPI and the median destructive field of the natural remanent magnetisation (MDFNRM). The new record is compared with other lacustrine and marine records and stacks from the mid- to high-latitudes of the Southern Hemisphere, revealing consistent millennial-scale variability, the identification of the Laschamp and possibly the Mono Lake geomagnetic excursions, and a direction swing possibly associated to the Hilina Pali excursion at 20 ka cal BP. Nonetheless, a global-scale comparison with other high-resolution records located on the opposite side of the Earth and with various dipole field references hint at a different behaviour of the geomagnetic field around southern South America at 46 ka cal BP.