980 resultados para secondary 5
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The recommended foundation level for school funding shall be determined based on a methodlogy which incorporates the basic education expenditures of low-spending schools exhibiting high academic performance.
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Includes index.
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Shipping list no.: 2000-0215-P (pt. 1).
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Reuse of record except for individual research requires license from Congressional Information Service, Inc.
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OBJECTIVE- Diabetes, a major health problem worldwide, increases the risk of cardiovascular disease and its associated mortality. Evidence of the overall benefits of lipid modification in this area is needed. RESEARCH DESIGN AND METHODS- The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) trial showed that cholesterol-lowering treatment with pravastatin reduced mortality and coronary heart disease (CHD) events in 9,014 patients aged 31-75 years with CHD and total cholesterol 4.0-7.0 mmol/l. We measured the effects of pravastatin therapy, 40 mg/day over 6.0 years, on the risk of CHD death or nonfatal myocardial infarction and other cardiovascular outcomes in 1,077 LIPID patients with diabetes and 940 patients with impaired fasting glucose (IFG). RESULTS- in patients allocated to placebo, the risk of a major CHD event was 61% higher in patients with diabetes and 23% higher in the IFG group than in patients with normal fasting glucose, and the risk of any cardiovascular event was 37% higher in the diabetic group and 19% higher in the IFG group. Pravastatin therapy reduced the risk of a major CHD event overall from 15.9 to 12.3% (relative risk reduction [RRR] 24%, P < 0.001) and from 23.4 to 19.6% in the diabetic group (19%, P = 0.11); in the diabetic group, the reduction was not significantly different from the reductions in the other groups. Pravastatin reduced the risk of any cardiovascular event from 52.7 to 45.2% (21%, P < 0.008) in patients With diabetes and from 45.7 to 37.1% (26%, P = 0.003) in the IFG group. Pravastatin reduced the risk of stroke from 9.9 to 6.3% in the diabetic group (RRR 39%, Cl 7-61%, P = 0.02) and from 5.4 to 3.4% in the IFG group (RRR 42%, Cl -9 to 69%, P = 0.09). Pravastatin did not reduce the incidence of diabetes. Over 6 years, pravastatin therapy prevented one major,CHD event (CHD death or nonfatal myocardial infarction) in 23 patients with IFG and 18 patients with diabetes. A meta-analysis of other major trials confirmed the high absolute risks of diabetes and IFG and the absolute benefits of statin therapy in these patients. CONCLUSIONS- Cholesterol-lowering treatment with pravastatin therapy prevents cardiovascular events, including stroke, in patients with diabetes or IFG and established CHD.
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Background/Purpose: Several pull-through procedures are available for the surgical management of Hirschsprung's disease (HD) in children. The authors have adopted a laparoscopic approach since 1995, including laparoscopic Swenson procedure (LSw), both for one-stage primary and 2-stage secondary procedures. The aim of this study was to examine the role of LSw in children with HD in both primary and secondary procedures. Methods: From January 1995 to December 2001, 42 children with biopsy-proven HD underwent laparoscopic pull-through procedure for HD. This group included 29 children who underwent LSw, a detailed analysis of which forms the basis of this report. Results: Sixteen children underwent a single-stage neonatal LSw; the median weight of this group at the time of surgery was 3.2 kg and the median age was 5 days. Secondary LSw was performed in the remaining 13 children, which included 3 children with total colonic HD who underwent laparoscopic total colectomy and LSw. The median operating time was 105 minutes (range, 66 to 175 minutes). The median time to commence full diet was 48 hours (range, 24 to 86 hours), and median time to return to normal play and activity was 72 hours (range, 48 hours to 5 days). There was no difference in operating time between primary and secondary pull-through procedures. There were no intraoperative complications, and no patient required open conversion. Postoperative ileus was noted in 3 children and enterocolitis in 2. The median hospital stay was 4 days (range, 2 to 6 days). Follow-up was between 6 months to 7 years with a median follow-up of 2.2 years. At follow-up, 2 children required laparoscopic antegrade continence enema procedure. A satisfactory continence was noted in 15 of the 19 children who were older than 3 years at the time of last follow-up. Conclusions: LSw seems to be a suitable procedure for laparoscopic management of HD in children. LSw is safe and effective, both for primary and secondary type of pull-through procedures, with good short-term results.
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Histological sections of primary segmental arteries and associated interarterial anastomoses and secondary vessels from the long-finned eel Anguilla reinhardtii were examined by light and transmission electron microscopy. Interarterial anastomoses were found to originate from the primary vasculature as depressions through the tunica intima and media, from where they ran perpendicularly to the adventitial layer, before coiling extensively. From here the anastomoses travelled a relatively linear path in the outer margin of the adventitia to anastomose with a secondary vessel running in parallel with the primary counterpart. In contrast to findings from other species, secondary vessels had a structure quite similar to that of primary vessels; they were lined by endothelial cells on a continuous basement membrane, with a single layer of smooth muscle cells surrounding the vessel. Smooth muscle cells were also found in the vicinity of interarterial anastomoses in the adventitia, but these appeared more longitudinally orientated. The presence of smooth muscle cells on all aspects of the secondary circulation suggests that this vascular system is regulated in a similar manner as the primary vascular system. Because interarterial anastomoses are structurally integrated with the primary vessel from which they originate, it is anticipated that flow through secondary vessels to some extent is affected by the vascular tone of the primary vessel. Immunohistochemical studies showed that primary segmental arteries displayed moderate immunoreactivity to antibodies against 5-hydroxytryptamine and substance P, while interarterial anastomoses and secondary vessels showed dense immunoreactivity. No immunoreactivity was observed on primary or secondary arteries against neuropeptide Y or calcitonin gene-related peptide.
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In humans, a polymorphic gene encodes the drug-metabolizing enzyme NATI (arylamine N-acetyltransferase Type 1), which is widely expressed throughout the body. While the protein-coding region of NATI is contained within a single exon, examination of the human EST (expressed sequence tag) database at the NCBI revealed the presence of nine separate exons, eight of which were located in the 5'non-coding region of NATI. Differential splicing produced at least eight unique mRNA isoforms that could be grouped according to the location of the first exon, which suggested that NATI expression occurs from three alternative promoters. Using RT (reverse transcriptase)-PCR, we identified one major transcript in various epithelial cells derived from different tissues. In contrast, multiple transcripts were observed in blood-derived cell lines (CEM, THP-1 and Jurkat), with a novel variant, not identified in the EST database, found in CEM cells only. The major splice variant increased gene expression 9-11-fold in a luciferase reporter assay, while the other isoforrns were similar or slightly greater than the control. We examined the upstream region of the most active splice variant in a promoter-reporter assay, and isolated a 257 bp sequence that produced maximal promoter activity. This sequence lacked a TATA box, but contained a consensus Sp1 site and a CAAT box, as well as several other putative transcription-factor-binding sites. Cell-specific expression of the different NATI transcripts may contribute to the variation in NATI activity in vivo.
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Phytochemical exploration of a wood bark extract from Durio zibethinus afforded two new triterpenoids, namely, methyl 27-O-trans-caffeoylcylicodiscate (1) and methyl 27-O-cis-caffeoylcylicodiscate (2), a new phenolic, 1,2-diarylpropane-3- ol (3), and seven known compounds, fraxidin, eucryphin, boehmenan, threo-carolignan E, (-)-(3R, 4S)-4-hydroxymellein, methyl protocatechuate, and (+)-(R)-de-O-methyllasiodiplodin (4). In addition, chemical analysis of a wood bark extract from Durio kutejensis yielded the new triterpenes 3 beta-O-trans-caffeoyl-2R-hydroxyolean-12-en-28-oic acid (5) and 3 beta-trans-caffeoyl-2R-hydroxytaraxest-12-en-28-oic acid (6) together with four known compounds, maslinic acid, arjunolic acid, 2,6-dimethoxy-p-benzoquinone, and fraxidin. The structures of all compounds were determined on the basis of spectroscopic data.
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La Sequenza Sismica Emiliana del 2012 ha colpito la zona compresa tra Mirandola e Ferrara con notevoli manifestazioni cosismiche e post-sismiche secondarie, soprattutto legate al fenomeno della liquefazione delle sabbie e alla formazione di fratturazioni superficiali del terreno. A fronte del fatto che la deformazione principale, osservata tramite tecniche di remote-sensing, ha permesso di individuare la posizione della struttura generatrice, ci si è interrogati sul rapporto tra strutture profonde e manifestazioni secondarie superficiali. In questa tesi è stato svolto un lavoro di integrazione di dati a varia scala, dalla superficie al sottosuolo, fino profondità di alcuni chilometri, per analizzare il legame tra le strutture geologiche che hanno generato il sisma e gli effetti superficiali percepiti dagli osservatori. Questo, non solo in riferimento allo specifico del sisma emiliano del 2012, ma al fine di trarre utili informazioni in una prospettiva storica e geologica sugli effetti di un terremoto “tipico”, in una regione dove le strutture generatrici non affiorano in superficie. Gli elementi analizzati comprendono nuove acquisizioni e rielaborazioni di dati pregressi, e includono cartografie geomorfologiche, telerilevamenti, profili sismici a riflessione superficiale e profonda, stratigrafie e informazioni sulla caratterizzazione dell’area rispetto al rischio sismico. Parte dei dati di nuova acquisizione è il risultato dello sviluppo e la sperimentazione di metodologie innovative di prospezione sismica in corsi e specchi d’acqua continentali, che sono state utilizzate con successo lungo il Cavo Napoleonico, un canale artificiale che taglia ortogonalmente la zona di massima deformazione del sisma del 20 Maggio. Lo sviluppo della nuova metodologia di indagine geofisica, applicata ad un caso concreto, ha permesso di migliorare le tecniche di imaging del sottosuolo, oltre a segnalare nuove evidenze co-sismiche che rimanevano nascoste sotto le acque del canale, e a fornire elementi utili alla stratigrafia del terreno. Il confronto tra dati geofisici e dati geomorfologici ha permesso di cartografare con maggiore dettaglio i corpi e le forme sedimentarie superficiali legati alla divagazione fluviale dall’VIII sec a.C.. I dati geofisici, superficiali e profondi, hanno evidenziato il legame tra le strutture sismogeniche e le manifestazioni superficiali seguite al sisma emiliano. L’integrazione dei dati disponibili, sia nuovi che da letteratura, ha evidenziato il rapporto tra strutture profonde e sedimentazione, e ha permesso di calcolare i tassi geologici di sollevamento della struttura generatrice del sisma del 20 Maggio. I risultati di questo lavoro hanno implicazioni in vari ambiti, tra i quali la valutazione del rischio sismico e la microzonazione sismica, basata su una caratterizzazione geomorfologico-geologico-geofisica dettagliata dei primi 20 metri al di sotto della superficie topografica. Il sisma emiliano del 2012 ha infatti permesso di riconoscere l’importanza del substrato per lo sviluppo di fenomeni co- e post-sismici secondari, in un territorio fortemente eterogeneo come la Pianura Padana.
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Two experiments are reported that examine the effects of caffeine consumption on attitude change by using different secondary tasks to manipulate message processing. The first experiment employed an orientating task whilst the second experiment employed a distracter task. In both experiments participants consumed an orange-juice drink that either contained caffeine (3.5?mg/kg body weight) or did not contain caffeine (placebo) prior to reading a counter-attitudinal communication. The results across both experiments were similar. When message processing was reduced or under high distraction, there was no attitude change irrespective of caffeine consumption. However, when message processing was enhanced or under low distraction, there was greater attitude change in the caffeine vs. placebo conditions. Furthermore, attitudes formed after caffeine consumption resisted counter-persuasion (Experiment 1) and led to indirect attitude change (Experiment 2). The extent that participants engaged in message-congruent thinking mediated the amount of attitude change. These results provide evidence that moderate amounts of caffeine increase systematic processing of the arguments in the message resulting in greater agreement.
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The optometric profession in the UK has a major role in the detection, assessment and management of ocular anomalies in children between 5 and 16 years of age. The role complements a variety of associated screening services provided across several health care sectors. The review examines the evidence-base for the content, provision and efficacy of these screening services in terms of the prevalence of anomalies such as refractive error, amblyopia, binocular vision and colour vision and considers the consequences of their curtailment. Vision screening must focus on pre-school children if the aim of the screening is to detect and treat conditions that may lead to amblyopia, whereas if the aim is to detect and correct significant refractive errors (not likely to lead to amblyopia) then it would be expedient for the optometric profession to act as the major provider of refractive (and colour vision) screening at 5-6 years of age. Myopia is the refractive error most likely to develop during primary school presenting typically between 8 and 12 years of age, thus screening at entry to secondary school is warranted. Given the inevitable restriction on resources for health care, establishing screening at 5 and 11 years of age, with exclusion of any subsequent screening, is the preferred option. © 2004 The College of Optometrists.
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The mechanisms by which drops of secondary liquid dispersion ie. <100μ m, are collected, coalesced and transferred have been studied in particulate beds of different sizes and heights of glass ballotini. The apparatus facilitated different coalescer cell arrangements. The liquid-liquid system was toluene/de-ionised water. The inlet drop size distribution was measured by microscopy and using the Malvern Particle Size analyser; the outlet dispersion was sized by photography. The effect of packed height and packing size upon critical velocity, pressure drop and coalescence efficiency have been investigated. Single and two phase flow pressure drops across the packing were correlated by modified Blake-Kozeny equations. Two phase pressure drop was correlated by two equations, one for large ballotini sizes (267μm - 367μm), the other for small ballotini sizes (93μm- 147.5μm). The packings were efficient coalescers up to critical velocities of 3 x 10-2 m/s to 5 x 10-2 m/s. The saturation was measured across the bed using relative permeability and a mathematical model developed which related this profile to measured pressure drops. Filter coefficients for the range of packing studied were found to be accurately predicted from a modified queueing drop model.
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The literature relating to haze formation, methods of separation, coalescence mechanisms, and models by which droplets <100 μm are collected, coalesced and transferred, have been reviewed with particular reference to particulate bed coalescers. The separation of secondary oil-water dispersions was studied experimentally using packed beds of monosized glass ballotini particles. The variables investigated were superficial velocity, bed depth, particle size, and the phase ratio and drop size distribution of inlet secondary dispersion. A modified pump loop was used to generate secondary dispersions of toluene or Clairsol 350 in water with phase ratios between 0.5-6.0 v/v%.Inlet drop size distributions were determined using a Malvern Particle Size Analyser;effluent, coalesced droplets were sized by photography. Single phase flow pressure drop data were correlated by means of a Carman-Kozeny type equation. Correlations were obtained relating single and two phase pressure drops, as (ΔP2/μc)/ΔP1/μd) = kp Ua Lb dcc dpd Cine A flow equation was derived to correlate the two phase pressure drop data as, ΔP2/(ρcU2) = 8.64*107 [dc/D]-0.27 [L/D]0.71 [dp/D]-0.17 [NRe]1.5 [e1]-0.14 [Cin]0.26 In a comparison between functions to characterise the inlet drop size distributions a modification of the Weibull function provided the best fit of experimental data. The general mean drop diameter was correlated by: q_p q_p p_q /β Γ ((q-3/β) +1) d qp = d fr .α Γ ((P-3/β +1 The measured and predicted mean inlet drop diameters agreed within ±15%. Secondary dispersion separation depends largely upon drop capture within a bed. A theoretical analysis of drop capture mechanisms in this work indicated that indirect interception and London-van der Waal's mechanisms predominate. Mathematical models of dispersed phase concentration m the bed were developed by considering drop motion to be analogous to molecular diffusion.The number of possible channels in a bed was predicted from a model in which the pores comprised randomly-interconnected passage-ways between adjacent packing elements and axial flow occured in cylinders on an equilateral triangular pitch. An expression was derived for length of service channels in a queuing system leading to the prediction of filter coefficients. The insight provided into the mechanisms of drop collection and travel, and the correlations of operating parameters, should assist design of industrial particulate bed coalescers.
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Several brain regions, including the primary and secondary somatosensory cortices (SI and SII, respectively), are functionally active during the pain experience. Both of these regions are thought to be involved in the sensory-discriminative processing of pain and recent evidence suggests that SI in particular may also be involved in more affective processing. In this study we used MEG to investigate the hypothesis that frequency-specific oscillatory activity may be differentially associated with the sensory and affective components of pain. In eight healthy participants (four male), MEG was recorded during a visceral pain experiment comprising baseline, anticipation, pain and post-pain phases. Pain was delivered via intraluminal oesophageal balloon distension (four stimuli at 1 Hz). Significant bilateral but asymmetrical changes in neural activity occurred in the beta-band within SI and SII. In SI, a continuous increase in neural activity occurred during the anticipation phase (20-30 Hz), which continued during the pain phase but at a lower frequency (10-15 Hz). In SII, oscillatory changes only occurred during the pain phase, predominantly in the 20-30 Hz beta band, and were coincident with the stimulus. These data provide novel evidence of functional diversity within SI, indicating a role in attentional and sensory aspects of pain processing. In SII, oscillatory changes were predominantly stimulus-related, indicating a role in encoding the characteristics of the stimulus. We therefore provide objective evidence of functional heterogeneity within SI and functional segregation between SI and SII, and suggest that the temporal and frequency dynamics within cortical regions may offer valuable insights into pain processing.