Author response: can vascular function be assessed by the interpretation of retinal vascular diameter changes?

A protocol with repeated stimulation cycles should be analyzed stepwise, in that each stimulation is evaluated, and a reaction pattern is identified. No two subjects will react identically, in that dilation and recovery times can vary; however, this is not reason enough to abandon a multiple stimulation cycle with fixed recovery and stimulation times. Furthermore, it enables us to examine and determine the range in which a normal subject will be placed and can then be compared to different pathophysiological states (i.e., smokers and different diseases). The purpose of our paper was to highlight the importance of evaluating these different cycles and the danger of false interpretation when averaging results. There are many different ways of evaluating dilatory responses and elasticity, but each of them must be carefully evaluated and should not be overaveraged, which can result in a loss of sensitivity and specificity.

A Bayesian neural network algorithm identifies patients in whom post-EVAR surveillance may be unnecessary

Lifelong surveillance is not cost-effective after endovascular aneurysm repair (EVAR), but is required to detect aortic complications which are fatal if untreated (type 1/3 endoleak, sac expansion, device migration). Aneurysm morphology determines the probability of aortic complications and therefore the need for surveillance, but existing analyses have proven incapable of identifying patients at sufficiently low risk to justify abandoning surveillance. This study aimed to improve the prediction of aortic complications, through the application of machine-learning techniques. Patients undergoing EVAR at 2 centres were studied from 2004–2010. Aneurysm morphology had previously been studied to derive the SGVI Score for predicting aortic complications. Bayesian Neural Networks were designed using the same data, to dichotomise patients into groups at low- or high-risk of aortic complications. Network training was performed only on patients treated at centre 1. External validation was performed by assessing network performance independently of network training, on patients treated at centre 2. Discrimination was assessed by Kaplan-Meier analysis to compare aortic complications in predicted low-risk versus predicted high-risk patients. 761 patients aged 75 +/− 7 years underwent EVAR in 2 centres. Mean follow-up was 36+/− 20 months. Neural networks were created incorporating neck angu- lation/length/diameter/volume; AAA diameter/area/volume/length/tortuosity; and common iliac tortuosity/diameter. A 19-feature network predicted aor- tic complications with excellent discrimination and external validation (5-year freedom from aortic complications in predicted low-risk vs predicted high-risk patients: 97.9% vs. 63%; p < 0.0001). A Bayesian Neural-Network algorithm can identify patients in whom it may be safe to abandon surveillance after EVAR. This proposal requires prospective study.

Aranyszabály helyett adósságfék - a német példa = Debt-brake instead of the golden rule - the case of Germany

Az Európai Unió megújuló gazdasági kormányzási rendszerének egyik meghatározó pillére a diszkrecionális gazdaságpolitikával szemben megfogalmazott szabályalapúság lesz. A minden korábbinál erősebb és vélhetően hatékonyabb szabályok bevezetésének legelkötelezettebb híve Németország. Az elmúlt évtizedekben a folyó költségvetési kiadások hiányból történő finanszírozásának tilalmát előíró aranyszabályt inkább kevesebb, mint több sikerrel alkalmazó Németország most arra vállalkozott, hogy nem csak saját hatáskörben vezeti be az ún. adósságféket, hanem követendő példaként állítja azt a többi tagország elé is. Írásunkban az aranyszabály, illetve az adósságfék előnyeit és hátrányait vesszük számba a német tapasztalatok felhasználásával. / === / The need to strengthen rules-based fiscal policy has emerged as a widely shared consensus amongst policy-makers in the recent economic and financial crisis. Germany has become the most devoted advocator of the new regime, where more innovative and effective fiscal rules are supposed to play an even bigger role than before. Germany supports such a move however not only in rhetoric but also in practice. It decided to abandon its several decade old golden rule and to adopt a more sophisticated one, the so-called debt-brake. This article provides a cost-benefit analysis of both the previous and the new fiscal rule.

Gazdasági kormányzás a gazdasági és monetáris unióban - a globális politika lehetetlen szentháromsága szemszögéből (Economic governance in the economic and monetary union – applying the trilemma of global politics)

Az Európai Unió a világgazdaság egyik legfontosabb integrációja. A benne megvalósuló gazdasági integráció szorossága megfelel annak a szintnek, amit Rodrik hiperglobalizációnak nevez. Az elmélet szerint a politika szintjén egyszerre nem megvalósítható a demokratikus politikai döntéshozatal, a teljes világgazdasági integráció, illetve a nemzetállam. A trilemma a globalizáció útjában álló intézményi különbségeken alapszik. Megoldása három módon lehetséges: a demokrácia kiiktatásával a megoldás az arany kényszerzubbony, ahol a piaci mechanizmusok veszik át az állami gazdaságpolitika szerepét; a globális kormányzás megvalósulása esetén a szuverén nemzetállamok tűnnek el a nemzetközi rendszerből; végül a Bretton Woods kompromisszum esetében a globalizáció útjába állítunk akadályokat. Írásunkban a modellt az európai integrációra, egészen pontosan a Gazdasági és Monetáris Unióra alkalmazzuk. Érvelésünk szerint, ha fent kívánjuk tartani az integráció szorosságát, erősíteni kell az integráció szintjén a gazdasági kormányzást, ami pedig csak a tagállami szuverenitás rovására mehet. Ez, mely a GMU esetében leginkább a fiskális föderáció erősítését jelenti ugyanakkor, megnövelve az integráció költségeit, egy többsebességes Európa kialakulása irányába hathat. _____ The European Union with its sophisticated institutional system is the most important regional integration on Earth. This tight form of economic integration converges to the level that Dani Rodrik calls hyperglobalization in his model, the political trilemma of globalisation. In this model Rodrik assumes that from the three desired element of world politics (deep economic integration, the nation state, and democratic politics) only two can be chosen. We can either choose deep integration and the nation state but then we have to abandon democracy; or we can choose deep integration and democracy, but then we have to forfeit the nation state; or we have to circumscribe globalisation to maintain democracy and the nation state. In our paper we develop the mentioned model and then we apply it to the case of the European integration. We argue that if we want to maintain the deep integration among member states in the EU we have to pass more and more functions of the nation states to the federation level. In case of the EMU that means that federal fiscal policy is needed which could lead to multi-speed Europe considering new member states reluctance to give up their specific institutions.

Soviet and Western bloc competition in the less developed world and the collapse of Détente

The purpose of my dissertation was to examine the competition between the U.S.-led Western bloc and the Soviet bloc in the less developed world during Détente. I assessed whether or not the Soviet bloc pushed for strategic gains in the less developed world in the middle-to-late 1970's and whether this contributed to the U.S. decision to abandon Détente in 1979. I made the attempt to test the international relations theory of balance of threat realism (Walt, 1992). I accomplished the test in two ways. First, I measured the foreign aid allocations (military and economic) made by each respective bloc towards the Third World by using a quantitative approach. Second, I examined U.S. archives using the process-tracing/historical method. The U.S. archives gave me the ability to evaluate how U.S. decision-makers and U.S. intelligence agencies interpreted the actions of the Soviet bloc. They also gave me the chance to examine the U.S. response as we evaluated the policies that were pushed by key U.S. decision-makers and intelligence agencies. On the question of whether or not the Soviet bloc was aggressive, the quantitative evidence suggested that it was not. Instead, the evidence found the Western-bloc to have been more aggressive in the less developed world. The U.S. archives also showed Soviet actions to have been defensive. Key U.S. decision-makers and intelligence agencies attested to this. Finally, the archives show that U.S. officials pushed for aggressive actions against the Third World during the final years of Détente. Thus, balance of threat realism produced an incorrect assessment that U.S. aggression in the late 1970's was a response to Soviet aggression during Détente. The evidence suggests structural Marxism and domestic politics can better explain U.S./Western actions. The aggressive foreign aid allocations of the West, coupled with evidence of U.S. decision-makers/agencies vehemently concerned about the long-term prospects of the West, strengthened structural Marxism. Domestic politics can also claim to explain the actions of U.S. decision-makers. I found extensive archival evidence of bureaucratic inter-agency conflict between the State Department and other intelligence agencies in areas of strategic concern to the U.S.

Managing Strategic Change

The essay - Managing Strategic Change – by K. Michael Haywood, Associate Professor, School of Hotel and Food Administration, University of Guelph, is initially characterized by Haywood as: “The ability to manage strategic change is critical for hospitality industry executives today. Executives must be capable of creating a vision of the future and implementing its direction. The author gives avenues for that management process.” “The effective management of strategic change is the major challenge confronting hospitality executives,” says Associate Professor Haywood. “Responding to a rapidly changing business environment and constantly evolving competitive threats and opportunities requires executives who can anticipate and plan for change.” According to Professor Haywood, the management of strategic change is a future imperative for hospitality executives. Implementing those changes will be even more difficult. “Survival and growth for many hospitality firms during the next decade will depend on the development of new strategic visions which can provide significant competitive advantages,” he says. “Strategies for managing costs and technology will be central to this task,” Haywood expands the thought. Haywood suggests two primary types of change hospitality executives should be aware of. First, is change that is anticipated, anticipatory change. Second, is the other more crucial type of change, strategic change in the face of crisis, or simply stated, reactive change. Professor Haywood describes the distinction between the two. In describing the approach that should be implemented in responding to an anticipatory change, Haywood says, “If time permits, and change is to be introduced gradually, pilots and trials should be run to assess the impact of the new strategy on the organization. These trials are used to create pockets of commitment throughout the corporation, build comfort levels with the new approach, and neutralize or win over potential opposition.” There are the obvious advantages to using an approach like the one described above, but there are disadvantages as well. Haywood discusses both. In addressing reactive change, Haywood offers that the process is a more - time is of the essence – condition, and that strong leadership and a firm hand on employee control is imperative. “Personal leadership, tough-mindedness, the willingness to ruthlessly abandon the familiar and the past, and the use of informal strategic levers are the hallmarks of sterling executive performance in such periods,” he says. “All these changes involve substantial technical, financial, and human risks,” Haywood wants you to know. “In order to make them, and still remain competitive, hospitality and travel-related corporations require executives capable of creating a vision of the future, able to sell that vision to their employees, and tough-minded enough to implement strategies to make the vision a reality.”

Acompanhamento do crescimento e desenvolvimento da criança: a participação das mães da área rural

The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

Entre rios e ruas: água, açude e tragédia em uma cidade do agreste potiguar (Santa Cruz, 1º de abril de 1981)

On the evening of April 1, 1981, the city of Santa Cruz was taken by a flood that destroyed the spillway weir Santa Cruz and much of the city, causing the population of the lower areas to abandon their homes. Residences and closest to the dam, the river and the creek Trairi Sin streets were totally affected, and many of the houses and public buildings completely destroyed. Located in the state of Rio Grande do Norte, the city of Santa Cruz is marked by a very hot climate and semi-arid. With an average normal rainfall of 498.7 mm per year, the city is affected by drought since the beginning of its foundation, around the year 1831. For its development had continued, it was necessary that the population actualize various environmental interventions Nature, especially as regards the storage and distribution of water. Considering the process of occupying the space in question, as well as the relationships that human groups have with the natural environment, we aim to analyze how human interventions affect the environment around them, modifying it to meet their needs and interests. Thus, we intend to understand how media coverage enabled the construction of a framework of tragedy. We intend to observe how the occupation of Santa Cruz led to the modification of their surroundings, trying to discuss the effects of human intervention on natural disasters. Among the research sources include newspapers A República, Diário de Natal, Tribuna do Norte, O Poti and Folha de São Paulo, as well as interviews with the then mayor of Santa Cruz, Hildebrando Teixeira de Souza, and with the couple José Henrique de Pontes and Severina Aguida de Pontes, whose house was hit by the flood. We will also take messages from the state government, the minutes of the city council of Santa Cruz and reports produced by DNOCS on the construction of the weir and its survey after the flood.

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

Jogos de negócio : o que leva o docente de cursos da área de Ciências Sociais Aplicadas a adotar a ferramenta de ensino

The Business Games are a growing teaching strategy and alternative to the academic front through the new process of Teaching and Learning. Through literature review and semi-structured interviews, this work addresses the teachers considering their subjectivity in deciding JN as the three profiles suggested by Faria and Wellington (2004): those who use it, those who stopped using and those who do not. The research corpus is limited to contributions of 22 respondents between master and doctors teachers of Applied Social Sciences area courses in colleges of Brasília (DF), Goiânia (GO), Ribeirão Preto (SP) and Uberlandia (MG). The content analysis of the interviews allowed to infer that: (1) join the teaching strategy is a commitment to a complex planning, with constant training and proactivity related to student feedback; (2) abandons the practice is becoming less common, because managers tend to recommend it and there are more and more software available for specific disciplines. Its discussed also other contributions (motivations) given by respondents of the three groups that were not found in the literature. It is hoped that this work will serve (1) incentive to teachers on the use of Business Games as a teaching strategy (2) consultation by managers when they decide about purchasing simulation software. Finally, stands out that the educational success of JN depends not only on the various motivations of teachers, as well as the interest and commitment of the student.

Les prédicteurs psychologiques de la fin prématurée du traitement chez des agresseurs sexuels judiciarisés

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Rythme et sujet : L'infini turbulent d'Henri Michaux

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

"Suffragettes of the Harem": The Evolution of Sympathy and the Afterlives of Sentimentality in American Feminist Orientalism, 1865-1920

This project examines narrative encounters in space identified as “harem,” produced by authors with biographical ties to the vanguard of the American Suffrage Movement. I regard these feminists’ circulations East, to the domestic space of the Other, as a hitherto unstudied, yet critical component of transnationalism in the history of U.S. Suffrage. This literary record also crucially reveals the extent to which sentimentality was plotted as a potential force for the reform of other cultures. An urge to sympathize denied in the space of the harem illustrates the colonial anxieties that subtended sentimentality’s prospective deployment beyond national borders. In five chapters on the work of Anna Leonowens, Susan Elston Wallace, Demetra Vaka Brown, Charlotte Perkins Gilman, and Edith Wharton, I examine how Suffrage-minded authors writing the harem strategically abandon an activist praxis of fellow feeling. Such a reluctance to transform sentimental literature into a colonial literature consequently informs that genre’s postbellum decline. The sentiments that run dry for American feminists in the harem additionally foreground the costly failures of Wilsonian Idealism, a doctrine that appropriated a discourse of sentimentality in order to script the United States’ expanded involvement in global affairs.

Latent Space and Social Psychological Models of Diffusion

The problem of social diffusion has animated sociological thinking on topics ranging from the spread of an idea, an innovation or a disease, to the foundations of collective behavior and political polarization. While network diffusion has been a productive metaphor, the reality of diffusion processes is often muddier. Ideas and innovations diffuse differently from diseases, but, with a few exceptions, the diffusion of ideas and innovations has been modeled under the same assumptions as the diffusion of disease. In this dissertation, I develop two new diffusion models for "socially meaningful" contagions that address two of the most significant problems with current diffusion models: (1) that contagions can only spread along observed ties, and (2) that contagions do not change as they spread between people. I augment insights from these statistical and simulation models with an analysis of an empirical case of diffusion - the use of enterprise collaboration software in a large technology company. I focus the empirical study on when people abandon innovations, a crucial, and understudied aspect of the diffusion of innovations. Using timestamped posts, I analyze when people abandon software to a high degree of detail.

To address the first problem, I suggest a latent space diffusion model. Rather than treating ties as stable conduits for information, the latent space diffusion model treats ties as random draws from an underlying social space, and simulates diffusion over the social space. Theoretically, the social space model integrates both actor ties and attributes simultaneously in a single social plane, while incorporating schemas into diffusion processes gives an explicit form to the reciprocal influences that cognition and social environment have on each other. Practically, the latent space diffusion model produces statistically consistent diffusion estimates where using the network alone does not, and the diffusion with schemas model shows that introducing some cognitive processing into diffusion processes changes the rate and ultimate distribution of the spreading information. To address the second problem, I suggest a diffusion model with schemas. Rather than treating information as though it is spread without changes, the schema diffusion model allows people to modify information they receive to fit an underlying mental model of the information before they pass the information to others. Combining the latent space models with a schema notion for actors improves our models for social diffusion both theoretically and practically.

The empirical case study focuses on how the changing value of an innovation, introduced by the innovations' network externalities, influences when people abandon the innovation. In it, I find that people are least likely to abandon an innovation when other people in their neighborhood currently use the software as well. The effect is particularly pronounced for supervisors' current use and number of supervisory team members who currently use the software. This case study not only points to an important process in the diffusion of innovation, but also suggests a new approach -- computerized collaboration systems -- to collecting and analyzing data on organizational processes.

Les prédicteurs psychologiques de la fin prématurée du traitement chez des agresseurs sexuels judiciarisés

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.