996 resultados para 378.01


Relevância:

30.00% 30.00%

Publicador:

Relevância:

20.00% 20.00%

Publicador:

Resumo:

We read the excellent review of telemonitoring in chronic heart failure (CHF)1 with interest and commend the authors on the proposed classification of telemedical remote management systems according to the type of data transfer, decision ability and level of integration. However, several points require clarification in relation to our Cochrane review of telemonitoring and structured telephone support2. We included a study by Kielblock3. We corresponded directly with this study team specifically to find out whether or not this was a randomised study and were informed that it was a randomised trial, albeit by date of birth. We note in our review2 that this randomisation method carries a high risk of bias. Post-hoc metaanalyses without these data demonstrate no substantial change to the effect estimates for all cause mortality (original risk ratio (RR) 0·66 [95% CI 0·54, 0·81], p<0·0001; revised RR 0·72 [95% CI 0·57, 0·92], p=0·008), all-cause hospitalisation (original RR 0·91 [95% CI 0·84, 0·99] p=0·02; revised RR 0.92 [95% CI 0·84, 1·02], p=0·10 ) or CHF-related hospitalisation (original RR 0·79 [95% CI 0·67, 0·94] p=0·008; revised RR 0·75 [95% CI 0·60, 0·94] p=0·01). Secondly, we would classify the Tele-HF study4, 5 as structured telephone support, rather than telemonitoring. Again, inclusion of these data alters the point-estimate but not the overall result of the meta-analyses4. Finally, our review2 does not include invasive telemonitoring as the search strategy was not designed to capture these studies. Therefore direct comparison of our review findings with recent studies of these interventions is not recommended.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Purpose: Young novice drivers continue to be overrepresented in fatalities and injuries arising from crashes even with the introduction of countermeasures such as graduated driver licensing (GDL). Enhancing countermeasures requires a better understanding of the variables influencing risky driving. One of the most common risky behaviours performed by drivers of all ages is speeding, which is particularly risky for young novice drivers who, due to their driving inexperience, have difficulty in identifying and responding appropriately to road hazards. Psychosocial theory can improve our understanding of contributors to speeding, thereby informing countermeasure development and evaluation. This paper reports an application of Akers’ social learning theory (SLT), augmented by Gerrard and Gibbons’ prototype/willingness model (PWM), in addition to personal characteristics of age, gender, car ownership, and psychological traits/states of anxiety, depression, sensation seeking propensity and reward sensitivity, to examine the influences on self-reported speeding of young novice drivers with a Provisional (intermediate) licence in Queensland, Australia. Method: Young drivers (n = 378) recruited in 2010 for longitudinal research completed two surveys containing the Behaviour of Young Novice Drivers Scale, and reported their attitudes and behaviours as pre-Licence/Learner (Survey 1) and Provisional (Survey 2) drivers and their sociodemographic characteristics. Results: An Akers’ measurement model was created. Hierarchical multiple regressions revealed that (1) personal characteristics (PC) explained 20.3%; (2) the combination of PC and SLT explained 41.1%; and (3) the combination of PC, SLT and PWM explained 53.7% of variance in self-reported speeding. Whilst there appeared to be considerable shared variance, the significant predictors in the final model included gender, car ownership, reward sensitivity, depression, personal attitudes, and Learner speeding. Conclusions: These results highlight the capacity for psychosocial theory to improve our understanding of speeding by young novice drivers, revealing relationships between previous behaviour, attitudes, psychosocial characteristics and speeding. The findings suggest multi-faceted countermeasures should target the risky behaviour of Learners, and Learner supervisors should be encouraged to monitor their Learners’ driving speed. Novice drivers should be discouraged from developing risky attitudes towards speeding.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

We consider the problem of maximizing the secure connectivity in wireless ad hoc networks, and analyze complexity of the post-deployment key establishment process constrained by physical layer properties such as connectivity, energy consumption and interference. Two approaches, based on graph augmentation problems with nonlinear edge costs, are formulated. The first one is based on establishing a secret key using only the links that are already secured by shared keys. This problem is in NP-hard and does not accept polynomial time approximation scheme PTAS since minimum cutsets to be augmented do not admit constant costs. The second one extends the first problem by increasing the power level between a pair of nodes that has a secret key to enable them physically connect. This problem can be formulated as the optimal key establishment problem with interference constraints with bi-objectives: (i) maximizing the concurrent key establishment flow, (ii) minimizing the cost. We prove that both problems are NP-hard and MAX-SNP with a reduction to MAX3SAT problem.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

An oriented graphitic nanostructured carbon film has been employed as a conductometric hydrogen gas sensor. The carbon film was energetically deposited using a filtered cathodic vacuum arc with a -75 V bias applied to a stainless steel grid placed 1cm from the surface of the Si substrate. The substrate was heated to 400°C prior to deposition. Electron microscopy showed evidence that the film consisted largely of vertically oriented graphitic sheets and had a density of 2.06 g/cm3. 76% of the atoms were bonded in sp2 or graphitic configurations. A change in the device resistance of >; 1.5% was exhibited upon exposure to 1 % hydrogen gas (in synthetic, zero humidity air) at 100°C. The time for the sensor resistance to increase by 1.5 % under these conditions was approximately 60 s and the baseline (zero hydrogen exposure) resistance remained constant to within 0.01% during and after the hydrogen exposures.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Antimetropia, a sub-classification of anisometropia, is a rare refractive condition in which one eye is myopic and the fellow eye is hyperopic. This case report describes the ocular characteristics and atypical refractive progression in an adult male with a moderate degree of non-amblyopic antimetropia over a 20-year period. The potential mechanisms underlying unilateral axial elongation, anisometropia and myopia progression in adulthood are discussed.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The primary purpose of spermatozoa is to deliver the paternal DNA to the oocyte at fertilization. During the complex events of fertilization, if the spermatozoon penetrating the oocyte contains compromised or damaged sperm chromatin, the subsequent progression of embryogenesis and foetal development may be affected. Variation in sperm DNA damage and protamine content in ejaculated spermatozoa was reported in the cattle, with potential consequences to bull fertility. Protamines are sperm-specific nuclear proteins that are essential to packaging of the condensed paternal genome in spermatozoa. Sperm DNA damage is thought to be repaired during the process of protamination. This study investigates the potential correlation between sperm protamine content, sperm DNA damage and the subsequent relationships between sperm chromatin and commonly measured reproductive phenotypes. Bos indicus sperm samples (n = 133) were assessed by two flow cytometric methods: the sperm chromatin structure assay (SCSA) and an optimized sperm protamine deficiency assay (SPDA). To verify the SPDA assay for bovine sperm protamine content, samples collected from testis, caput and cauda epididymidis were analyzed. As expected, mature spermatozoa in the cauda epididymidis had higher protamine content when compared with sperm samples from testis and caput epididymidis (p < 0.01). The DNA fragmentation index (DFI), determined by SCSA, was positively correlated (r = 0.33 ± 0.08, p < 0.05) with the percentage of spermatozoa that showed low protamine content using SPDA. Also, DFI was negatively correlated (r = -0.21 ± 0.09, p < 0.05) with the percentage of spermatozoa with high protamine content. Larger scrotal circumference contributes to higher sperm protamine content and lower content of sperm DNA damage (p < 0.05). In conclusion, sperm protamine content and sperm DNA damage are closely associated. Protamine deficiency is likely to be one of the contributing factors to DNA instability and damage, which can affect bull fertility. © 2014 American Society of Andrology and European Academy of Andrology.