991 resultados para 445


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BACKGROUND: New generation transcatheter heart valves (THV) may improve clinical outcomes of transcatheter aortic valve implantation. METHODS AND RESULTS: In a nationwide, prospective, multicenter cohort study (Swiss Transcatheter Aortic Valve Implantation Registry, NCT01368250), outcomes of consecutive transfemoral transcatheter aortic valve implantation patients treated with the Sapien 3 THV (S3) versus the Sapien XT THV (XT) were investigated. An overall of 153 consecutive S3 patients were compared with 445 consecutive XT patients. Postprocedural mean transprosthetic gradient (6.5±3.0 versus 7.8±6.3 mm Hg, P=0.17) did not differ between S3 and XT patients, respectively. The rate of more than mild paravalvular regurgitation (1.3% versus 5.3%, P=0.04) and of vascular (5.3% versus 16.9%, P<0.01) complications were significantly lower in S3 patients. A higher rate of new permanent pacemaker implantations was observed in patients receiving the S3 valve (17.0% versus 11.0%, P=0.01). There were no significant differences for disabling stroke (S3 1.3% versus XT 3.1%, P=0.29) and all-cause mortality (S3 3.3% versus XT 4.5%, P=0.27). CONCLUSIONS: The use of the new generation S3 balloon-expandable THV reduced the risk of more than mild paravalvular regurgitation and vascular complications but was associated with an increased permanent pacemaker rate compared with the XT. Transcatheter aortic valve implantation using the newest generation balloon-expandable THV is associated with a low risk of stroke and favorable clinical outcomes. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01368250.

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INTRODUCTION: Alcohol use is one of the leading modifiable morbidity and mortality risk factors among young adults. STUDY DESIGN: 2 parallel-group randomized controlled trial with follow-up at 1 and 6 months. SETTING/PARTICIPANTS: Internet based study in a general population sample of young men with low-risk drinking, recruited between June 2012 and February 2013. INTERVENTION: Internet-based brief alcohol primary prevention intervention (IBI). The IBI aims at preventing an increase in alcohol use: it consists of normative feedback, feedback on consequences, calorific value alcohol, computed blood alcohol concentration, indication that the reported alcohol use is associated with no or limited risks for health. INTERVENTION group participants received the IBI. Control group (CG) participants completed only an assessment. MAIN OUTCOME MEASURES: Alcohol use (number of drinks per week), binge drinking prevalence. Analyses were conducted in 2014-2015. RESULTS: Of 4365 men invited to participate, 1633 did so; 896 reported low-risk drinking and were randomized (IBI: n = 451; CG: n = 445). At baseline, 1 and 6 months, the mean (SD) number of drinks/week was 2.4(2.2), 2.3(2.6), 2.5(3.0) for IBI, and 2.4(2.3), 2.8(3.7), 2.7(3.9) for CG. Binge drinking, absent at baseline, was reported by 14.4% (IBI) and 19.0% (CG) at 1 month and by 13.3% (IBI) and 13.0% (CG) at 6 months. At 1 month, beneficial intervention effects were observed on the number of drinks/week (p = 0.05). No significant differences were observed at 6 months. CONCLUSION: We found protective short term effects of a primary prevention IBI. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN55991918.

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Kirjallisuutta

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The Gulf of Finland is said to be one of the densest operated sea areas in the world. It is a shallow and economically vulnerable sea area with dense passenger and cargo traffic of which petroleum transports have a share of over 50 %. The winter conditions add to the risks of maritime traffic in the Gulf of Finland. It is widely believed that the growth of maritime transportation will continue also in the future. The Gulf of Finland is surrounded by three very different national economies with, different maritime transportation structures. Finland is a country of high GDP/per capita with a diversified economic structure. The number of ports is large and the maritime transportation consists of many types of cargoes: raw materials, industrial products, consumer goods, coal and petroleum products, and the Russian transit traffic of e.g. new cars and consumer goods. Russia is a large country with huge growth potential; in recent years, the expansion of petroleum exports has lead to a strong economic growth, which is also apparent in the growth of maritime transports. Russia has been expanding its port activities in the Gulf of Finland and it is officially aiming to transport its own imports and exports through the Russian ports in the future; now they are being transported to great extend through the Finnish, Estonian and other Baltic ports. Russia has five ports in the Gulf of Finland. Estonia has also experienced fast economic growth, but the growth has been slowing down already during the past couples of years. The size of its economy is small compared to Russia, which means the transported tonnes cannot be very massive. However, relatively large amounts of the Russian petroleum exports have been transported through the Estonian ports. The future of the Russian transit traffic in Estonia looks nevertheless uncertain and it remains to be seen how it will develop and if Estonia is able to find replacing cargoes if the Russian transit traffic will come to an end in the Estonian ports. Estonia’s own import and export consists of forestry products, metals or other raw materials and consumer goods. Estonia has many ports on the shores of the Gulf of Finland, but the port of Tallinn dominates the cargo volumes. In 2007, 263 M tonnes of cargoes were transported in the maritime traffic in the Gulf of Finland, of which the share of petroleum products was 56 %. 23 % of the cargoes were loaded or unloaded in the Finnish ports, 60 % in the Russian ports and 17 % in the Estonian ports. The largest ports were Primorsk (74.2 M tonnes) St. Petersburg (59.5 M tonnes), Tallinn (35.9 M tonnes), Sköldvik (19.8 M tonnes), Vysotsk (16.5 M tonnes) and Helsinki (13.4 M) tonnes. Approximately 53 600 ship calls were made in the ports of the Gulf of Finland. The densest traffic was found in the ports of St. Petersburg (14 651 ship calls), Helsinki (11 727 ship calls) and Tallinn (10 614 ship calls) in 2007. The transportation scenarios are usually based on the assumption that the amount of transports follows the development of the economy, although also other factors influence the development of transportation, e.g. government policy, environmental aspects, and social and behavioural trends. The relationship between the development of transportation and the economy is usually analyzed in terms of the development of GDP and trade. When the GDP grows to a certain level, especially the international transports increase because countries of high GDP produce, consume and thus transport more. An effective transportation system is also a precondition for the economic development. In this study, the following factors were taken into consideration when formulating the future scenarios: maritime transportation in the Gulf of Finland 2007, economic development, development of key industries, development of infrastructure and environmental aspects in relation to maritime transportation. The basic starting points for the three alternative scenarios were: • the slow growth scenario: economic recession • the average growth scenario: economy will recover quickly from current instability • the strong growth scenario: the most optimistic views on development will realize According to the slow growth scenario, the total tonnes for the maritime transportation in the Gulf of Finland would be 322.4 M tonnes in 2015, which would mean a growth of 23 % compared to 2007. In the average growth scenario, the total tonnes were estimated to be 431.6 M tonnes – a growth of 64 %, and in the strong growth scenario 507.2 M tonnes – a growth of 93%. These tonnes were further divided into petroleum products and other cargoes by country, into export, import and domestic traffic by country, and between the ports. For petroleum products, the share of crude oil and oil products was estimated and the number of tanker calls in 2015 was calculated for each scenario. However, the future development of maritime transportation in the GoF is dependent on so many societal and economic variables that it is not realistic to predict one exact point estimate value for the cargo tonnes for a certain scenario. Plenty of uncertainty is related both to the degree in which the scenario will come true as well as to the cause-effect relations between the different variables. For these reasons, probability distributions for each scenario were formulated by an expert group. As a result, a range for the total tonnes of each scenario was formulated and they are as follows: the slow growth scenario: 280.8 – 363 M tonnes (expectation value 322.4 M tonnes)

  • the average growth scenario: 404.1 – 465.1 M tonnes (expectation value 431.6 M tonnes)
  • the strong growth scenario: 445.4 – 575.4 M tonnes (expectation value 507.2 M tonnes) Three alternatives scenarios were evaluated to realize most likely with the following probability distribution:
  • the slow growth scenario: 35 %
  • the average growth scenario: 50 %
  • the strong growth scenario: 15 %. In other words, expert group evaluated the average growth scenario to be the most likely to realize, second likely was the slow growth scenario, and the strong growth scenario was evaluated to be the most unlikely to realize. In sum, it can be stated that the development of maritime transportation in the Gulf of Finland is dominated by the development of Russia, because Russia dominates the cargo volumes. Maritime transportation in Finland is expected to be more stable and, in any case, such a growth potential cannot be seen in Finland. The development of maritime transportation in Estonia is rather challenging to forecast at the moment but, on the other hand, the transported tonnes in the Estonian ports are relatively small. The shares of export and import of the maritime transportation are not expected to change radically in the reference period. Petroleum products will dominate the transports also in the future and the share of oil products will probably increase compared to the share of crude oil. In regard to the other cargoes, the transports of raw materials and bulk goods will probably be replaced to some extend by cargoes of high-value, which adds especially to the container transports. But in overall, substantial changes are not expected in the commodity groups transported by sea. The growth potential of the ports concentrates on the Russian ports, especially Primorsk and Ust-Luga, if investments will come true as planned. It is likely that the larger ports do better in the competition than the small ones due to the economies of scale and to the concentration of cargo flows. The average ship sizes will probably grow, but the growth potential is rather limited because of geographical conditions and of the maritime transportation structure in the Gulf of Finland. Climate change and other environmental aspects are becoming more central e.g. in transportation politics. These issues can affect the maritime transportation in the Gulf of Finland through, for instance, strict environmental requirements concerning the emissions from shipping, or the port investments. If environmental requirements raise costs, it can affect the demand of transportation. In the near future, the development of the maritime transportation in the Gulf of Finland is mainly dependent on the current economic instability. If it will lead to a longer lasting recession, the growth of the transported tonnes will slow down. But if the instability does not last long, it can be expected that the economic growth will continue and along with it also the growth of transported tonnes.

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    Invocatio: I.N.D.

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    Zn-EDTA degradabilty by catechol-driven Fenton reaction was studied. Response surface methodology central composite design was employed to maximize this complex degradation. Theoretical speciation calculations were in good agreement with the experimental results. Fenton and Fenton type treatments are typically thought to be applicable only in the highly acidic range, representing a major operational constraint. Interestingly, at optimized concentrations, this CAT-driven Fenton reaction at pH 5.5 achieved 100% Zn-EDTA degradation; 60% COD and 17% TOC removals, using tiny amounts of CAT (50 µM), Fe(III) (445 µM) and H2O2 (20 mM) with no evident ferric sludge.

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    Soitinnus: orkesteri.

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    The nutrient load to the Gulf of Finland has started to increase as a result of the strong economic recovery in agriculture and livestock farming in the Leningrad region. Also sludge produced from municipal wastewater treatment plant of the Leningrad region causes the great impact on the environment, but still the main options for its treatment is disposal on the sludge beds or Landfills. The aim of this study was to evaluate the implementation of possible joint treatment methods of manure form livestock and poultry enterprises and sewage sludge produced from municipal wastewater treatment plants in the Leningrad region. The study is based on published data. The most attention was put on the anaerobic digestion and incineration methods. The manure and sewage sludge generation for the whole Leningrad region and energy potential produced from their treatment were estimated. The calculations showed that total amount of sewage sludge generation is 1 348 000 t/a calculated on wet matter and manure generation is 3 445 000 t/a calculated on wet matter. The potential heat release from anaerobic digestion process and incineration process is 4 880 000 GJ/a and 5 950 000 GJ/a, respectively. Furthermore, the work gives the overview of the general Russian and Finnish legislation concerning manure and sewage sludge treatment. In the Gatchina district it was chosen the WWTP and livestock and poultry enterprises for evaluation of the centralized treatment plant implementation based on anaerobic digestion and incineration methods. The electricity and heat power of plant based on biogas combustion process is 4.3 MW and 7.8 MW, respectively. The electricity and heat power of plant based on manure and sewage sludge incineration process is 3.0 MW and 6.1 MW, respectively.

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    Este trabalho descreve a construção e a determinação de parâmetros físico-químicos com um eletrodo de segunda ordem do tipo, Pt|Hg|Hg2(PAB)2|Grafite, sensível ao íon p-aminobenzoato (PAB). O eletrodo é construído facilmente, apresenta um rápido tempo de resposta, é de baixo custo e tem um tempo de vida útil superior a 12 meses. Utilizando o referido eletrodo foi possível estimar os coeficientes de atividade iônica individuais do PAB, a 25ºC, em força iônica ajustada entre 0,700-3,000 mol L-1 com NaClO4, em solução aquosa. O potencial molal padrão do eletrodo determinado a 25ºC é de (445,5 ± 0,5) mV. A constante termodinâmica do produto de solubilidade, T Kps (I=0) do Hg2(PAB)2 determinada com o eletrodo é de (T Kps = 2,50 x 10-12 mol³ L-3 , a 25ºC). Uma característica favorável consiste no fato de que o eletrodo pode ser utilizado para determinar a concentração de íons p-aminobenzoato livres em sistemas complexos de íons metálicos.

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    Analisou-se a produtividade de povoamentos de eucalipto, localizados nas regiões Belo Oriente, Nova Era e Guanhães, situadas na Bacia do Rio Doce, em Minas Gerais. Estudaram-se as precipitações ocorridas nas estações chuvosas e os componentes do balanço hídrico de Thornthwaite e Mather (1955), relativos ao período de janeiro de 1985 a dezembro de 1998, objetivando estudar a influência desses componentes com o ganho de volume médio anual de madeira (m³ ha-1). Para tal, utilizaram-se dados do inventário florestal da Empresa Florestal Celulose Nipo-Brasileira - CENIBRA, relativos à idade de três a sete anos. A produtividade de madeira foi influenciada pelo total precipitado na estação chuvosa (PEC). Os menores valores de incremento periódico mensal (IPM) foram observados nos anos precedidos de estação chuvosa seca (S) ou muito seca (MS), sendo que os maiores valores de IPM ocorreram nos anos precedidos de estações chuvosas, classificadas como chuvosa (C) ou muito chuvosa (MC). Considerando que tal fato foi mais pronunciado em Guanhães e Nova Era, verificou-se a correlação da PEC, finalizada em cada ano, com o IPM nos períodos de aumento (1986 a 1992) e diminuição na PEC (1992 a 1995), sendo que essas correlações atingiram um r² superior a 80%. Para um aumento de 100 mm na PEC de um ano para outro, o aumento no IPM foi, em média, de 0,445 m³ha-1mês-1, enquanto para uma redução de 100 mm a diminuição no IPM foi de 0,64 m³ha-1mês-1, para as duas regiões. Guanhães apresenta o maior índice de local médio, assim como a maior produtividade média, seguindo-se Nova Era e Belo Oriente.

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    1868/07/12 (Numéro 445).

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    Kirjallisuusarvostelu

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    OBJETIVOS: Pacientes com trauma abdominal tratados cirurgicamente são muito suscetíveis ao desenvolvimento de hipertensão intra-abdominal e síndrome do compartimento abdominal, cujo diagnóstico é baseado na medição da pressão intraabdominal associada a parâmetros clínicos. Este estudo teve por objetivos avaliar prospectivamente o comportamento da pressão intra-abdominal de pacientes com trauma abdominal cirurgicamente tratados e identificar se há relação entre tal comportamento e parâmetros clínicos destes pacientes. MÉTODO: A técnica de Kron foi utilizada para medir a pressão intra-abdominal. A casuística foi composta por 17 homens e três mulheres com média de idade de 36,9 anos (D.P. 12,943). O mecanismo de trauma mais freqüente foi contusão abdominal 12 (60%) contra oito (40%) pacientes com ferimentos penetrantes. Os dados foram coletados em 6 e 18 horas de pós-operatório. RESULTADOS: As médias de pressão intra-abdominal foram 10,4 cmH2O (D.P. 3,939) em 6 horas e 10,263 cmH2O (D.P. 3,445) em 18 horas de pós operatório. A análise dos resultados mostrou correlação estatisticamente significante entre o volume de colóides infundidos e a pressão intra-abdominal em 6 e 18 horas pós-operatórias (p = 0,0380 e p = 0,0033 respectivamente). É provável que tal correlação se deva ao edema visceral causado pelo extravasamento capilar de soluções, aumentando a pressão intra-abdominal. CONCLUSÕES: Os achados deste estudo ratificam a idéia de relação entre grandes volumes de infusão venosa, sobretudo colóides, e o aumento da pressão intra-abdominal e destacam a importância da avaliação da pressão intra-abdominal em pacientes com trauma abdominal submetidos a grandes reposições volêmicas, sobretudo as soluções coloidais.

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    In this thesis the dynamics of cold gaseous atoms is studied. Two different atomic species and two different experimental techniques have been used. In the first part of the thesis experiments with Bose-Einstein condensates of Rb-87 are presented. In these experiments the methods of laser cooling and magnetic trapping of atoms were utilized. An atom chip was used as the experimental technique for implementation of magnetic trapping. The atom chip is a small integrated instrument allowing accurate and detailed manipulation of the atoms. The experiments with Rb-87 probed the behaviour of a falling beam of atoms outcoupled from the Bose-Einstein condensate by electromagnetic field induced spin flips. In the experiments a correspondence between the phases of the outcoupling radio frequency field and the falling beam of atoms was found. In the second part of the thesis experiments of spin dynamics in cold atomic hydrogen gas are discussed. The experiments with atomic hydrogen are conducted in a cryostat using a dilution refrigerator as the cooling method. These experiments concentrated on explaining and quantifying modulations in the electron spin resonance spectra of doubly polarized atomic hydrogen. The modifications to the previous experimental setup are described and the observation of electron spin waves is presented. The observed spin wave modes were caused by the identical spin rotation effect. These modes have a strong dependence on the spatial profile of the polarizing magnetic field. We also demonstrated confinement of these modes in regions of strong magnetic field and manipulated their spatial distribution by changing the position of the field maximum.