877 resultados para excursion guidance criteria


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Anàlisi de les interaccions, a nivell neuronal, que tenen lloc durant el desenvolupament embrionari entre el receptor Unc5B (receptor present a la membrana) i les proteïnes Netrin-1 i FLRT3 (fibronectin and leucine-rich transmembrane proteins). La interacció entre aquest receptor i Netrin-1 ha estat profundament estudiada fins al moment, de manera que es coneix que aquesta promou una repulsió en la guia d’axons durant el desenvolupament embrionari. A més, la interacció està implicada en la senyalització per a diferents processos com l’angiogènesi i la supervivència cel·lular. Per altra banda, la interacció entre neurones Unc5B positives i FLRT3, promou un retard en la migració de les neurones. Diversos estudis demostren que aquest retard en la migració està relacionat amb certes patologies mentals.

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Des parents semblent ignorer la limite entre ce que l'on est en droit de montrer et ce que l'on doit traiter avec pudeur. Une sorte d'ambiguïté les amène à être négligents et par là à tolérer des comportements ou des propos grivois de leurs enfants ou à en rire. Les thérapeutes sont invités à entreprendre un travail pédagogique de guidance parentale quand les frontières de l'intime sont floues et quand la confusion touche les jeunes devenant vulnérables et symptomatiques. Les auteurs exposent un cas d'anorexie chez une adolescente, dont la souffrance se trouve masquée par une série de comportements désinhibés. La surexcitation qui en découle peut apparaître comme une solution défensive pour lutter contre la dépression liée à l'expérience de séparation et de deuil. Pour favoriser la construction de représentations des territoires de l'intime plus respectueuses de la vulnérabilité des adolescents, les auteurs ont aussi proposé la sculpture familiale.Parental guidance and respect of intimacy. Young people's mourning and erotism. - Parents seem to be unaware of the borderline between what one may show and what one should handle with reserve. A kind of ambiguity drive them to be careless. As a result, they put up with suggestive behaviour or language from their children and even laugh at it. The therapists are invited to undertake an educational work of parental guidance when the boderlines of the intimate are hazy and when the confusion is affecting young people who become vulnerable and symptomatic. The authors present an anorexia case of a teenager whose distress is concealed by a series of uninhibited behaviours. The ensuing overexcitement could seem to be a defensive solution to fight against the depression related to parting and mourning experience. To encourage the building of representations of the territories of the intimate which would be more respectful of the teenagers vulnerability, the authors also suggest the technique of family sculpture.

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This article presents a modification of intraoperative external fixation for mandibular reconstruction with free tissue flaps. This technique is indicated when preregistration of the reconstruction plate is not possible due to transmandibular tumor extension. Once standard external fixation has been carried out and prior to segmental mandibulectomy, additional pins are fixed to the connecting rod that delineate the mandibular contour in three-dimensional (3D) space. Following mandibulectomy, these pins allow accurate contouring of the reconstruction plate and improved restoration of mandibular contour, projection, and dental occlusion. A step-by-step description of the technique using models and intraoperative photos is presented. This method of mandibular reconstruction is a simple and time-effective alternative to intraoperative computer navigation and 3D modeling in select cases of oral carcinoma where tumor infiltration of the outer mandibular cortex precludes prebending of the reconstruction plates.

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We study biased, diffusive transport of Brownian particles through narrow, spatially periodic structures in which the motion is constrained in lateral directions. The problem is analyzed under the perspective of the Fick-Jacobs equation, which accounts for the effect of the lateral confinement by introducing an entropic barrier in a one-dimensional diffusion. The validity of this approximation, based on the assumption of an instantaneous equilibration of the particle distribution in the cross section of the structure, is analyzed by comparing the different time scales that characterize the problem. A validity criterion is established in terms of the shape of the structure and of the applied force. It is analytically corroborated and verified by numerical simulations that the critical value of the force up to which this description holds true scales as the square of the periodicity of the structure. The criterion can be visualized by means of a diagram representing the regions where the Fick-Jacobs description becomes inaccurate in terms of the scaled force versus the periodicity of the structure.

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A high resolution mineralogical study (bulk-rock and clay-fraction) was carried out upon the hemipelagic strata of the Angles section (Vocontian Basin, SE France) in which the Valanginian positive C-isotope excursion occurs. To investigate sea-level fluctuations and climate change respectively, a Detrital Index (DI: (phyllosilicates and quartz)/calcite) and a Weathering Index (WI: kaolinite/(illite + chlorite)) were established and compared to second-order sea-level fluctuations. In addition, the mineralogical data were compared with the High Nutrient Index (HNI, based on calcareous nannofossil taxa) data obtained by Duchamp-Alphonse et al. (2007), in order to assess the link between the hydrolysis conditions recorded on the surrounding continents and the trophic conditions inferred for the Vocontian Basin. It appears that the mineralogical distribution along the northwestern Tethyan margin is mainly influenced by sea-level changes during the Early Valanginian (Pertransiens to Stephanophorus ammonite Zones) and by climate variations from the late Early Valanginian to the base of the Hauterivian (top of the Stephanophorus to the Radiatus ammonite Zones). The sea-level fall observed in the Pertransiens ammonite Zone (Early Valanginian) is well expressed by an increase in detrital inputs (an increase in the DI) associated with a more proximal source and a shallower marine environment, whereas the sea-level rise recorded in the Stephanophorus ammonite Zone corresponds to a decrease in detrital influx (a decrease in the DI) as the source becomes more distal and the environment deeper. Interpretation of both DI and WI, indicates that the positive C-isotope excursion (top of the Stephanophorus to the Verrucosum ammonite Zones) is associated with an increase of detrital inputs under a stable, warm and humid climate, probably related to greenhouse conditions, the strongest hydrolysis conditions being reached at the maximum of the positive C-isotope excursion. From the Verrucosum ammonite Zone to the base of the Hauterivian (Radiatus ammonite Zone) climatic conditions evolved from weak hydrolysis conditions and, most likely, a cooler climate (resulting in a decrease in detrital inputs) to a seasonal climate in which more humid seasons alternated with more arid ones. The comparison of the WI to the HNI shows that the nutrification recorded al: the Angles section from the top of the Stephanophorus to the Radiatus ammonite Zones (including the positive C-isotope shift), is associated with climatic changes in the source areas. At that time, increased nutrient inputs were generally triggered by increased weathering processes in the source areas due to acceleration in the hydrological cycle under greenhouse conditions This scenario accords with the widely questioned palaeoenvironmental model proposed by Lini et al., (1992) and suggests that increasing greenhouse conditions are the main factor that drove the palaeoenvironmental changes observed in the hemipelagic realm of the Vocontian Basin, during the Valanginian positive C-isotope shift. This high-resolution mineralogical study highlights short-term climatic changes during the Valanginian, probably associated to rapid changes in the C-cycle. Coeval Massive Parana-Etendeka flood basalt eruptions may explain such rapid perturbations. (C) 2011 Elsevier B.V. All rights reserved.

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This document is produced by Iowa Department of Public Health about a checklist of what people need to know about international travel.

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INTRODUCTION: Focal therapy may reduce the toxicity of current radical treatments while maintaining the oncological benefit. Irreversible electroporation (IRE) has been proposed to be tissue selective and so might have favourable characteristics compared to the currently used prostate ablative technologies. The aim of this trial is to determine the adverse events, genito-urinary side effects and early histological outcomes of focal IRE in men with localised prostate cancer. METHODS: This is a single centre prospective development (stage 2a) study following the IDEAL recommendations for evaluating new surgical procedures. Twenty men who have MRI-visible disease localised in the anterior part of the prostate will be recruited. The sample size permits a precision estimate around key functional outcomes. Inclusion criteria include PSA ≤ 15 ng/ml, Gleason score ≤ 4 + 3, stage T2N0M0 and absence of clinically significant disease outside the treatment area. Treatment delivery will be changed in an adaptive iterative manner so as to allow optimisation of the IRE protocol. After focal IRE, men will be followed during 12 months using validated patient reported outcome measures (IPSS, IIEF-15, UCLA-EPIC, EQ-5D, FACT-P, MAX-PC). Early disease control will be evaluated by mpMRI and targeted transperineal biopsy of the treated area at 6 months. DISCUSSION: The NEAT trial will assess the early functional and disease control outcome of focal IRE using an adaptive design. Our protocol can provide guidance for designing an adaptive trial to assess new surgical technologies in the challenging landscape of health technology assessment in prostate cancer treatment.

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The Iowa Department of Transportation Office of Research & Analytics has created this Guide to help researchers and contractors of the Iowa DOT attain compliance with Federal and Iowa DOT Public Access Policies for transportation-related research publications and datasets. This guide provides direction for filling out the data management plan template (also attached to this record) that will help satisfy Iowa DOT and U.S. DOT requirements.

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A general criterion for the design of adaptive systemsin digital communications called the statistical reference criterionis proposed. The criterion is based on imposition of the probabilitydensity function of the signal of interest at the outputof the adaptive system, with its application to the scenario ofhighly powerful interferers being the main focus of this paper.The knowledge of the pdf of the wanted signal is used as adiscriminator between signals so that interferers with differingdistributions are rejected by the algorithm. Its performance isstudied over a range of scenarios. Equations for gradient-basedcoefficient updates are derived, and the relationship with otherexisting algorithms like the minimum variance and the Wienercriterion are examined.

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The aim of radiotherapy is to deliver enough radiation to the tumor in order to achieve maximum tumour control in the irradiated volume with as few serious complications as possible with an irradiation dose as low as possible to normal tissue. The quality of radiotherapy is essential for optimal treatment and quality control is to reduce the bias in clinical trials avoiding possible major deviations. The assurance and quality control programs have been developed in large european (EORTC, GORTEC) and american cooperative groups (RTOG) of radiation oncology since the 1980s. We insist here on the importance of quality assurance in radiotherapy and the current status in this domain and the criteria for quality control especially for current clinical trials within GORTEC are discussed here.

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Introduction: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes. Objective: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months. Material and methods: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery. Results: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable. Conclusion: Overall evolution according to von Arx and Kurt agreed most closely with the other scales