967 resultados para 1995_03151107 TM-2 4500202


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Objectives To investigate the effect of Nintendo Wii (TM)-based motor cognitive training versus balance exercise therapy on activities of daily living in patients with Parkinson's disease. Design Parallel, prospective, single-blind, randomised clinical trial. Setting Brazilian Parkinson Association. Participants Thirty-two patients with Parkinson's disease (Hoehn and Yahr stages 1 and 2). Interventions Fourteen training sessions consisting of 30 minutes of stretching, strengthening and axial mobility exercises, plus 30 minutes of balance training. The control group performed balance exercises without feedback or cognitive stimulation, and the experimental group performed 10 Wii Fit (TM) games. Main outcome measure Section II of the Unified Parkinson's Disease Rating Scale (UPDRS-II). Randomisation Participants were randomised into a control group (n = 16) and an experimental group (n = 16) through blinded drawing of names. Statistical analysis Repeated-measures analysis of variance (RM-ANOVA). Results Both groups showed improvement in the UPDRS-II with assessment effect (RM-ANOVA P < 0.001, observed power = 0.999). There was no difference between the control group and the experimental group before training {8.9 [standard deviation (SD) 2.9] vs 10.1 (SD 3.8)}, after training [7.6 (SD 2.9) vs 8.1 (SD 3.5)] or 60 days after training [8.1 (SD 3.2) vs 8.3 (SD 3.6)]. The mean difference of the whole group between before training and after training was -0.9 (SD 2.3, 95% confidence interval -1.7 to -0.6). Conclusion Patients with Parkinson's disease showed improved performance in activities of daily living after 14 sessions of balance training, with no additional advantages associated with the Wii-based motor and cognitive training. Registered on http://www.clinicaltrials.gov (identifier: NCT01580787). (C) 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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The National Institute for Clinical Excellence (NICE) guidelines recommend the use of bare-metal stents (BMS) in non-complex lesions with a low risk of restenosis (diameter a parts per thousand yen3 mm and lesion length a parts per thousand currency sign15 mm) and the use of drug-eluting stents (DES) in more complex lesions with a high risk of restenosis (diameter < 3.0 mm or lesion length > 15 mm). However, the guidelines were created based on studies evaluating BMS and DES only. We performed an analysis of patients undergoing non-urgent percutaneous coronary intervention with the novel endothelial cell capturing stent (ECS). The ECS is coated with CD34(+) antibodies that attract circulating endothelial progenitor cells to the stent surface, thereby accelerating the endothelialization of the stented area. We analyzed all patients enrolled in the worldwide e-HEALING registry that met the NICE criteria for either low-risk or high-risk lesions and were treated with a parts per thousand yen1 ECS. The main study outcome was target vessel failure (TVF) at 12-month follow-up, defined as the composite of cardiac death or MI and target vessel revascularization (TVR). A total of 4,241 patients were assessed in the current analysis. At 12-month follow-up, TVF occurred in 7.0% of the patients with low-risk lesions and in 8.8% of the patients with high-risk lesions (p = 0.045). When evaluating the diabetic patients versus the non-diabetic patients per risk group, no significant differences were found in TVF, MI or TVR in either risk group. The ECS shows good clinical outcomes in lesions carrying either a high or a low risk of restenosis according to the NICE guidelines with comparable rates of cardiac death, myocardial infarction, and stent thrombosis. The TVF rate with ECS was slightly higher in patients with high-risk lesions, driven by higher clinically driven TLR. The risk of restenosis with ECS in patients carrying high-risk lesions needs to be carefully considered relative to other risks associated with DES. Furthermore, the presence of diabetes mellitus did not influence the incidence of TVF in either risk group.

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INTRODUÇÃO: Os estudos com stents farmacológicos têm avaliado predominantemente populações masculinas de descendência europeia. O estudo de braço único SPIRIT Women avalia o stent eluidor de everolimus XIENCE TM V em lesões de novo complexas em uma população feminina do mundo real, incluindo pacientes latino-americanas. Esta análise permite compreender como essa população responde ao implante de stent, comparativamente a pacientes não-latino-americanas. MÉTODOS: Das 1.572 pacientes matriculadas em 73 locais fora dos Estados Unidos, 138 (9%) foram recrutadas na Argentina, no Brasil e na Venezuela. RESULTADOS: As lesões-alvo tinham diâmetro de referência do vaso entre 2,25 mm e 4 mm e extensão da lesão ≤ 28 mm. As características basais foram semelhantes entre os grupos, com exceção de maior prevalência de hipertensão arterial, infarto do miocárdio (IM) de parede anterior e história familiar de doença arterial coronária na coorte latino-americana. As lesões tendiam a ser mais complexas em mulheres latino-americanas, com menor diâmetro de referência do vaso-alvo, maior extensão da lesão, maior excentricidade e angulação e mais lesões tipo B2/C. Os eventos foram adjudicados de acordo com as definições do Academic Research Consortium. Em um ano, o desfecho combinado de morte por todas as causas, IM e revascularização do vaso-alvo (RVA) foi de 12,1% na população não-latino-americana e de 10,1% na população latino-americana (P = 0,58). CONCLUSÕES: Em um ano, os baixos índices de eventos cardíacos adversos, incluindo trombose do stent, falha da lesão-alvo, morte cardíaca, IM e RVA nas mulheres latino-americanas foram comparáveis aos das mulheres não-latino-americanas, apesar da maior complexidade das lesões. Esses resultados demonstram a segurança e a eficácia do stent XIENCE TM V nessa pequena coorte de pacientes latino-americanas, à semelhança do que é observado com populações maiores e mais variadas.

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Auf einer drei Anbauperioden umfassenden Ground Truth Datenbasis wird der Informationsgehalt multitemporaler ERS-1/-2 Synthetic Aperture Radar (SAR) Daten zur Erfassung der Arteninventare und des Zustandes landwirtschaftlich genutzter Böden und Vegetation in Agrarregionen Bayerns evaluiert.Dazu wird ein für Radardaten angepaßtes, multitemporales, auf landwirtschaftlichen Schlägen beruhendes Klassifizierungsverfahren ausgearbeitet, das auf bildstatistischen Parametern der ERS-Zeitreihen beruht. Als überwachte Klassifizierungsverfahren wird vergleichend der Maximum-Likelihood-Klassifikator und ein Neuronales-Backpropagation-Netz eingesetzt. Die auf Radarbildkanälen beruhenden Gesamtgenauigkeiten variieren zwischen 75 und 85%. Darüber hinaus wird gezeigt, daß die interferometrische Kohärenz und die Kombination mit Bildkanälen optischer Sensoren (Landsat-TM, SPOT-PAN und IRS-1C-PAN) zur Verbesserung der Klassifizierung beitragen. Gleichermaßen können die Klassifizierungsergebnisse durch eine vorgeschaltete Grobsegmentierung des Untersuchungsgebietes in naturräumlich homogene Raumeinheiten verbessert werden. Über die Landnutzungsklassifizierung hinaus, werden weitere bio- und bodenphysikalische Parameter aus den SAR-Daten anhand von Regressionsmodellen abgeleitet. Im Mittelpunkt stehen die Paramter oberflächennahen Bodenfeuchte vegetationsfreier/-armer Flächen sowie die Biomasse landwirtschaftlicher Kulturen. Die Ergebnisse zeigen, daß mit ERS-1/-2 SAR-Daten eine Messung der Bodenfeuchte möglich ist, wenn Informationen zur Bodenrauhigkeit vorliegen. Hinsichtlich der biophysikalischen Parameter sind signifikante Zusammenhänge zwischen der Frisch- bzw. Trockenmasse des Vegetationsbestandes verschiedener Getreide und dem Radarsignal nachweisbar. Die Biomasse-Informationen können zur Korrektur von Wachstumsmodellen genutzt werden und dazu beitragen, die Genauigkeit von Ertragsschätzungen zu steigern.

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Sulfate aerosol plays an important but uncertain role in cloud formation and radiative forcing of the climate, and is also important for acid deposition and human health. The oxidation of SO2 to sulfate is a key reaction in determining the impact of sulfate in the environment through its effect on aerosol size distribution and composition. This thesis presents a laboratory investigation of sulfur isotope fractionation during SO2 oxidation by the most important gas-phase and heterogeneous pathways occurring in the atmosphere. The fractionation factors are then used to examine the role of sulfate formation in cloud processing of aerosol particles during the HCCT campaign in Thuringia, central Germany. The fractionation factor for the oxidation of SO2 by ·OH radicals was measured by reacting SO2 gas, with a known initial isotopic composition, with ·OH radicals generated from the photolysis of water at -25, 0, 19 and 40°C (Chapter 2). The product sulfate and the residual SO2 were collected as BaSO4 and the sulfur isotopic compositions measured with the Cameca NanoSIMS 50. The measured fractionation factor for 34S/32S during gas phase oxidation is αOH = (1.0089 ± 0.0007) − ((4 ± 5) × 10−5 )T (°C). Fractionation during oxidation by major aqueous pathways was measured by bubbling the SO2 gas through a solution of H2 O2

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e-Manufacturing™, das ist die schnelle, flexible und kostengünstige Fertigung von Produkten, Formen/Werkzeugen oder Modellen direkt aus elektronischen Daten. e-Manufacturing™ schließt Rapid Prototyping, Rapid Tooling oder Rapid Manufacturing ein, geht aber zugleich weit über den Gedanken der schnellen Verfügbarkeit hinaus. Zwar wird auch in Zukunft die schnelle Produktentwicklung eine immer wichtigere Rolle spielen, bei der e-Manufacturing™ für ein verkürztes Time to Market sorgt, Entwicklungskosten verringert und zur Risikominimierung beiträgt. Darüber hinaus entstehen aber auch neue Geschäftsmodelle, da Kleinserienproduktion, steigende Variantenvielfalt und eine individualisierte Produktion (Mass Customization) plötzlich möglich und wirtschaftlich sind und sich neue Logistikkonzepte wie (Spare) parts on demand entwickeln. Die neue Konstruktionsfreiheit des Laser-Sinterns ermöglicht neue Produktkonzepte. Minimale Einschränkungen durch das Fertigungsverfahren erlauben funktionelle Integration und die Fertigung des „Unmöglichen“, da kreisförmige und lineare Werkzeugbewegungen das Produktdesign nicht mehr beeinflussen bzw. limitieren. Auch die Fertigungskonzepte unterliegen einem Wandel und werden deutlich flexibler. Werkzeuglose Produktion, losgrößenangepasste Fertigung und dezentrale Fertigung on demand sind die Schlagworte der Zukunft. Der vorliegende Beitrag zeigt Beispiele für den erfolgreichen kommerziellen Einsatz von Laser-Sintern in allen Phasen des Produktlebenszyklus. Der Schwerpunkt liegt dabei auf der direkten Herstellung von Funktionsteilen in der Serienfertigung. Die entscheidenden Faktoren für eine erfolgreiche Einführung und Anwendung von e-Manufacturing™ werden diskutiert. Der Beitrag zeigt auf, wie die neuesten technologischen Innovationen im Laser-Sintern, speziell zur Produktivitätssteigerung, das Spektrum der Anwendungsfelder erweitern, in denen dieses Fertigungsverfahren kostengünstige Lösungen bietet.

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10.1002/hlca.200390311.abs A series of oligonucleotides containing (5′S)-5′-C-butyl- and (5′S)-5′-C-isopentyl-substituted 2′-deoxyribonucleosides were designed, prepared, and characterized with the intention to explore alkyl-zipper formation between opposing alkyl chains across the minor groove of oligonucleotide duplexes as a means to modulate DNA-duplex stability. From four possible arrangements of the alkyl groups that differ in the density of packing of the alkyl chains across the minor groove, three (duplex types I–III, Fig. 2) could experimentally be realized and their duplex-forming properties analyzed by UV-melting curves, CD spectroscopy, and isothermal titration calorimetry (ITC), as well as by molecular modeling. The results show that all arrangements of alkyl residues within the minor groove of DNA are thermally destabilizing by 1.5–3°/modification in Tm. We found that, within the proposed duplexes with more loosely packed alkyl groups (type-III duplexes), accommodation of alkyl residues without extended distorsion of the helical parameters of B-DNA is possible but does not lead to higher thermodynamic stability. The more densely packed and more unevenly distributed arrangement (type-II duplexes) seems to suffer from ecliptic positioning of opposite alkyl groups, which might account for a systematic negative contribution to stability due to steric interactions. The decreased stability in the type-III duplexes described here may be due either to missing hydrophobic interactions of the alkyl groups (not bulky enough to make close contacts), or to an overcompensation of favorable alkyl-zipper formation presumably by loss of structured H2O in the minor groove.

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