942 resultados para Radial and linear endobronchial ultrasound


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This nested case-control analysis of a Swiss ambulatory cohort of elderly women assessed the discriminatory power of urinary markers of bone resorption and heel quantitative ultrasound for non-vertebral fractures. The tests all discriminated between cases and controls, but combining the two strategies yielded no additional relevant information. INTRODUCTION: Data are limited regarding the combination of bone resorption markers and heel quantitative bone ultrasound (QUS) in the detection of women at risk for fracture. METHODS: In a nested case-control analysis, we studied 368 women (mean age 76.2 +/- 3.2 years), 195 with low-trauma non-vertebral fractures and 173 without, matched for age, BMI, medical center, and follow-up duration, from a prospective study designed to predict fractures. Urinary total pyridinolines (PYD) and deoxypyridinolines (DPD) were measured by high performance liquid chromatography. All women underwent bone evaluations using Achilles+ and Sahara heel QUS. RESULTS: Areas under the receiver operating-characteristic curve (AUC) for discriminative models of the fracture group, with 95% confidence intervals, were 0.62 (0.56-0.68) and 0.59 (0.53-0.65) for PYD and DPD, and 0.64 (0.58-0.69) and 0.65 (0.59-0.71) for Achilles+ and Sahara QUS, respectively. The combination of resorption markers and QUS added no significant discriminatory information to either measurement alone with an AUC of 0.66 (0.60-0.71) for Achilles+ with PYD and 0.68 (0.62-0.73) for Sahara with PYD. CONCLUSIONS: Urinary bone resorption markers and QUS are equally discriminatory between non-vertebral fracture patients and controls. However, the combination of bone resorption markers and QUS is not better than either test used alone.

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This study aimed to develop a hip screening tool that combines relevant clinical risk factors (CRFs) and quantitative ultrasound (QUS) at the heel to determine the 10-yr probability of hip fractures in elderly women. The EPISEM database, comprised of approximately 13,000 women 70 yr of age, was derived from two population-based white European cohorts in France and Switzerland. All women had baseline data on CRFs and a baseline measurement of the stiffness index (SI) derived from QUS at the heel. Women were followed prospectively to identify incident fractures. Multivariate analysis was performed to determine the CRFs that contributed significantly to hip fracture risk, and these were used to generate a CRF score. Gradients of risk (GR; RR/SD change) and areas under receiver operating characteristic curves (AUC) were calculated for the CRF score, SI, and a score combining both. The 10-yr probability of hip fracture was computed for the combined model. Three hundred seven hip fractures were observed over a mean follow-up of 3.2 yr. In addition to SI, significant CRFs for hip fracture were body mass index (BMI), history of fracture, an impaired chair test, history of a recent fall, current cigarette smoking, and diabetes mellitus. The average GR for hip fracture was 2.10 per SD with the combined SI + CRF score compared with a GR of 1.77 with SI alone and of 1.52 with the CRF score alone. Thus, the use of CRFs enhanced the predictive value of SI alone. For example, in a woman 80 yr of age, the presence of two to four CRFs increased the probability of hip fracture from 16.9% to 26.6% and from 52.6% to 70.5% for SI Z-scores of +2 and -3, respectively. The combined use of CRFs and QUS SI is a promising tool to assess hip fracture probability in elderly women, especially when access to DXA is limited.

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Linear programming models are effective tools to support initial or periodic planning of agricultural enterprises, requiring, however, technical coefficients that can be determined using computer simulation models. This paper, presented in two parts, deals with the development, application and tests of a methodology and of a computational modeling tool to support planning of irrigated agriculture activities. Part I aimed at the development and application, including sensitivity analysis, of a multiyear linear programming model to optimize the financial return and water use, at farm level for Jaíba irrigation scheme, Minas Gerais State, Brazil, using data on crop irrigation requirement and yield, obtained from previous simulation with MCID model. The linear programming model outputted a crop pattern to which a maximum total net present value of R$ 372,723.00 for the four years period, was obtained. Constraints on monthly water availability, labor, land and production were critical in the optimal solution. In relation to the water use optimization, it was verified that an expressive reductions on the irrigation requirements may be achieved by small reductions on the maximum total net present value.

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Hydrolysis of D-valyl-L-leucyl-L-arginine p-nitroanilide (7.5-90.0 µM) by human tissue kallikrein (hK1) (4.58-5.27 nM) at pH 9.0 and 37ºC was studied in the absence and in the presence of increasing concentrations of 4-aminobenzamidine (96-576 µM), benzamidine (1.27-7.62 mM), 4-nitroaniline (16.5-66 µM) and aniline (20-50 mM). The kinetic parameters determined in the absence of inhibitors were: Km = 12.0 ± 0.8 µM and k cat = 48.4 ± 1.0 min-1. The data indicate that the inhibition of hK1 by 4-aminobenzamidine and benzamidine is linear competitive, while the inhibition by 4-nitroaniline and aniline is linear mixed, with the inhibitor being able to bind both to the free enzyme with a dissociation constant Ki yielding an EI complex, and to the ES complex with a dissociation constant Ki', yielding an ESI complex. The calculated Ki values for 4-aminobenzamidine, benzamidine, 4-nitroaniline and aniline were 146 ± 10, 1,098 ± 91, 38.6 ± 5.2 and 37,340 ± 5,400 µM, respectively. The calculated Ki' values for 4-nitroaniline and aniline were 289.3 ± 92.8 and 310,500 ± 38,600 µM, respectively. The fact that Ki'>Ki indicates that 4-nitroaniline and aniline bind to a second binding site in the enzyme with lower affinity than they bind to the active site. The data about the inhibition of hK1 by 4-aminobenzamidine and benzamidine help to explain previous observations that esters, anilides or chloromethyl ketone derivatives of Nalpha-substituted arginine are more sensitive substrates or inhibitors of hK1 than the corresponding lysine compounds.

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INTRODUCCIÓN. El ultrasonido es fundamental en la medicina de emergencias, no se conoce cual debería ser la curva de aprendizaje para obtener las competencias técnicas y operativas; ACEP recomienda por cada ventana ecográfica realizar 25 repeticiones. No existe una curva de aprendizaje para ventana de VCI en la población de residentes colombianos. OBJETIVO: Determinar la curva de aprendizaje necesaria para obtener una proporción mayor al 80% de éxitos en la toma de la ventana ecográfica de la VCI, usando la escala de calificación para el aseguramiento de la calidad sugerida por ACEP, en residentes de I a III año de medicina de emergencias. METODOLOGÍA: Estudio experimental no comparativo, que evaluó la proporción de éxito en función del las tomas repetidas de la VCI por ultrasonido, mediciones que se tomaron luego de participar en una capacitación teórica y demostrativa de la técnica propuesta; se calificaron los videos según la escala publicada por ACEP. El análisis estadístico se realizó con un modelo logístico multinivel para la proporción del éxito, agrupado por repetición y agrupado por sujeto. RESULTADOS: Se obtuvo información de 8 residentes, cada uno realizo 25 repeticiones a 3 modelos sanos con asignación aleatoria. Se realizó la curva de aprendizaje obteniendo en 11 repeticiones una proporción de 0.80 (rango 0.54 a 0.92) y en 21 repeticiones una proporción de 0.9 (rango 0.75 a 0.96), datos ajustados por numero de repetición y residente. CONCLUSIÓN: La curva de aprendizaje para la ventana ecográfica de la VCI es de 11 y 21 repeticiones para obtener el 80% y 90% de éxito en residentes de medicina de emergencias de I a III año de la universidad del rosario.

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The primary objective of this study is to determine whether nonlinear frequency compression and linear transposition algorithms provide speech perception benefit in school-aged children.

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The validity of approximating radiative heating rates in the middle atmosphere by a local linear relaxation to a reference temperature state (i.e., ‘‘Newtonian cooling’’) is investigated. Using radiative heating rate and temperature output from a chemistry–climate model with realistic spatiotemporal variability and realistic chemical and radiative parameterizations, it is found that a linear regressionmodel can capture more than 80% of the variance in longwave heating rates throughout most of the stratosphere and mesosphere, provided that the damping rate is allowed to vary with height, latitude, and season. The linear model describes departures from the climatological mean, not from radiative equilibrium. Photochemical damping rates in the upper stratosphere are similarly diagnosed. Threeimportant exceptions, however, are found.The approximation of linearity breaks down near the edges of the polar vortices in both hemispheres. This nonlinearity can be well captured by including a quadratic term. The use of a scale-independentdamping rate is not well justified in the lower tropical stratosphere because of the presence of a broad spectrum of vertical scales. The local assumption fails entirely during the breakup of the Antarctic vortex, where large fluctuations in temperature near the top of the vortex influence longwave heating rates within the quiescent region below. These results are relevant for mechanistic modeling studies of the middle atmosphere, particularly those investigating the final Antarctic warming.

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We consider conditions which allow the embedding of linear hypergraphs of fixed size. In particular, we prove that any k-uniform hypergraph H of positive uniform density contains all linear k-uniform hypergraphs of a given size. More precisely, we show that for all integers l >= k >= 2 and every d > 0 there exists Q > 0 for which the following holds: if His a sufficiently large k-uniform hypergraph with the property that the density of H induced on every vertex subset of size on is at least d, then H contains every linear k-uniform hypergraph F with l vertices. The main ingredient in the proof of this result is a counting lemma for linear hypergraphs, which establishes that the straightforward extension of graph epsilon-regularity to hypergraphs suffices for counting linear hypergraphs. We also consider some related problems. (C) 2009 Elsevier Inc. All rights reserved.

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O conjunto de tecnologias aplicadas ao sistema de produção agrícola tem como características principais a verticalização da produtividade, diminuição de custos, melhoria nas características físicas, químicas e biológicas do solo para proporcionarem o crescimento sustentável do meio de produção. Desta forma, o trabalho teve como objetivo determinar a variabilidade e as correlações lineares e especiais entre os atributos da planta e do solo, visando selecionar um indicador da qualidade física do solo de boa representatividade para produção de forragem. No ano agrícola de 2006, na Fazenda Bonança, município de Pereira Barreto (SP), foram analisados a produtividade de forragem do milho outonal (FDM) em sistema plantio direto irrigado e os atributos físicos do solo, num Latossolo Vermelho distrófico. O objetivo foi estudar a variabilidade e as correlações lineares e espaciais entre os atributos da planta e os do solo, visando selecionar um indicador da qualidade física do solo de boa representatividade para a produtividade da forragem. Foi instalada a malha geoestatística, para coleta de dados do solo e planta, contendo 125 pontos amostrais, numa área de 2.500 m². Os atributos estudados, além de não terem variado aleatoriamente, apresentaram variabilidade dos dados entre baixa e muito alta e seguiram padrões espaciais bem definidos, com alcances entre 7,8 e 38,0 m. Por outro lado, a correlação linear entre os atributos da planta com o do solo foi baixa e extremamente significativa. Os pares Massa Seca de forragem versus Microporosidade e Diâmetro do colmo versus Densidade do Solo foram melhor correlacionados na camada de 0-0.10m, enquanto os outros pares - Massa Seca de Forragem versus Macroporosidade - e Porosidade Total - apresentaram correlação inversa para a mesma camada. Entretanto, do ponto de vista espacial, houve uma alta correlação inversa entre Massa Seca de Forragem com Microporosidade, de modo que a microporosidade na camada de 0-0.10m pode ser considerada um bom indicador de qualidade física do solo, tendo em vista a produção de forragem de milho.

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A simple calorimetric method was employed to study the kinetics of the hydrolysis of the solventless TMOS-water mixtures, under ultrasound stimulation, as a function of the concentration of oxalic acid. The reaction rates were obtained, in relative units, from the measured thermal peak of the reaction as a non-separated function of both the sonication time and the instantaneous temperature of the medium. For concentrations of oxalic acid below 0.01 M, polycondensation reaction starts before complete hydrolysis. For concentrations of oxalic acid above 0.01 M, hydrolysis is complete and, in addition, the inverse of the time, as measured from the starting of ultrasound action until the maximum hydrolysis heat release, was found to be a reasonable relative measure of the average hydrolysis rate constant. The average hydrolysis rate constant was found to be proportional to the square root of the molar concentration of the oxalic acid. This result is in agreement with the literature if we assume small dissociation degree for the catalyst in such a solventless alkoxyde-water medium.

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This paper discusses the dynamic behaviour of a nonlinear two degree-of-freedom system consisting of a harmonically excited linear oscillator weakly connected to a nonlinear attachment having linear and cubic restoring forces. The effects of the system parameters on the shape of the frequency-response curve are investigated, in particular those yielding the appearance and disappearance of outer and inner detached resonance curves. In contrast to the case when the linear stiffness of the attachment is zero, it is found that multivaluedness occurs at low frequencies as the resonant peak bends to the right. It is also found that as the coefficient of the linear term increases, the range of parameters yielding detached curves reduces. Compared to the case when the attached system has no linear stiffness term, this range of parameters corresponds to smaller values of the damping and nonlinear coefficients. Approximate analytical expressions for the jump-up and jump-down frequencies of the system under investigation are also derived. (C) 2011 Elsevier Ltd. All rights reserved.