Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases.

Cushing's syndrome is associated with hypertension in approximately 80% of cases. Hypertension contributes to the marked increased mortality risk of past or current Cushing's syndrome, largely because of increased cardiovascular risk. Observation of the pathophysiological effect of chronically elevated ACTH and cortisol values in patients with ectopic ACTH secretion complements the available data from acute studies of the effects of ACTH and glucocorticoid infusions in normal volunteers. In a retrospective case review, we identified 58 patients with Cushing's syndrome caused by ectopic ACTH secretion, who were treated at the National Institutes of Health between 1983-1997. The diagnosis of an ectopic ACTH cause was confirmed by inferior petrosal sinus sampling and/or pathologic examination of tumor. The commonest causes were bronchial carcinoid (40%) and thymic carcinoid (10%), but 18 of 58 (31%) patients had an unknown source of ectopic ACTH. Hypertension (systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg in adults) was noted in 45 of 58 (78%) ectopic Cushing's patients, a prevalence similar to that noted in other endogenous Cushing's syndrome etiologies. Hypertension was severe, deemed to require 3 or more drugs by the treating physicians, in 26 of 58 (45%) patients. Hypokalemia was much more prevalent than in patients with other causes of Cushing's syndrome, affecting 33 of 58 (57%) patients. The range of plasma ACTH (17-1557 pg/mL, normal

Simulation of the load-unload response ratio and critical sensitivity in the lattice solid model

The Load-Unload Response Ratio (LURR) method is an intermediate-term earthquake prediction approach that has shown considerable promise. It involves calculating the ratio of a specified energy release measure during loading and unloading where loading and unloading periods are determined from the earth tide induced perturbations in the Coulomb Failure Stress on optimally oriented faults. In the lead-up to large earthquakes, high LURR values are frequently observed a few months or years prior to the event. These signals may have a similar origin to the observed accelerating seismic moment release (AMR) prior to many large earthquakes or may be due to critical sensitivity of the crust when a large earthquake is imminent. As a first step towards studying the underlying physical mechanism for the LURR observations, numerical studies are conducted using the particle based lattice solid model (LSM) to determine whether LURR observations can be reproduced. The model is initialized as a heterogeneous 2-D block made up of random-sized particles bonded by elastic-brittle links. The system is subjected to uniaxial compression from rigid driving plates on the upper and lower edges of the model. Experiments are conducted using both strain and stress control to load the plates. A sinusoidal stress perturbation is added to the gradual compressional loading to simulate loading and unloading cycles and LURR is calculated. The results reproduce signals similar to those observed in earthquake prediction practice with a high LURR value followed by a sudden drop prior to macroscopic failure of the sample. The results suggest that LURR provides a good predictor for catastrophic failure in elastic-brittle systems and motivate further research to study the underlying physical mechanisms and statistical properties of high LURR values. The results provide encouragement for earthquake prediction research and the use of advanced simulation models to probe the physics of earthquakes.

Load-unload response ratio and accelerating moment/energy release critical region scaling and earthquake prediction

The main idea of the Load-Unload Response Ratio (LURR) is that when a system is stable, its response to loading corresponds to its response to unloading, whereas when the system is approaching an unstable state, the response to loading and unloading becomes quite different. High LURR values and observations of Accelerating Moment/Energy Release (AMR/AER) prior to large earthquakes have led different research groups to suggest intermediate-term earthquake prediction is possible and imply that the LURR and AMR/AER observations may have a similar physical origin. To study this possibility, we conducted a retrospective examination of several Australian and Chinese earthquakes with magnitudes ranging from 5.0 to 7.9, including Australia's deadly Newcastle earthquake and the devastating Tangshan earthquake. Both LURR values and best-fit power-law time-to-failure functions were computed using data within a range of distances from the epicenter. Like the best-fit power-law fits in AMR/AER, the LURR value was optimal using data within a certain epicentral distance implying a critical region for LURR. Furthermore, LURR critical region size scales with mainshock magnitude and is similar to the AMR/AER critical region size. These results suggest a common physical origin for both the AMR/AER and LURR observations. Further research may provide clues that yield an understanding of this mechanism and help lead to a solid foundation for intermediate-term earthquake prediction.

Critical comparison of Julius Kruttschnitt Mineral Research Centre (JKMRC) blast fragmentation models

Blast fragmentation can have a significant impact on the profitability of a mine. An optimum run of mine (ROM) size distribution is required to maximise the performance of downstream processes. If this fragmentation size distribution can be modelled and controlled, the operation will have made a significant advancement towards improving its performance. Blast fragmentation modelling is an important step in Mine to Mill™ optimisation. It allows the estimation of blast fragmentation distributions for a number of different rock mass, blast geometry, and explosive parameters. These distributions can then be modelled in downstream mining and milling processes to determine the optimum blast design. When a blast hole is detonated rock breakage occurs in two different stress regions - compressive and tensile. In the-first region, compressive stress waves form a 'crushed zone' directly adjacent to the blast hole. The second region, termed the 'cracked zone', occurs outside the crush one. The widely used Kuz-Ram model does not recognise these two blast regions. In the Kuz-Ram model the mean fragment size from the blast is approximated and is then used to estimate the remaining size distribution. Experience has shown that this model predicts the coarse end reasonably accurately, but it can significantly underestimate the amount of fines generated. As part of the Australian Mineral Industries Research Association (AMIRA) P483A Mine to Mill™ project, the Two-Component Model (TCM) and Crush Zone Model (CZM), developed by the Julius Kruttschnitt Mineral Research Centre (JKMRC), were compared and evaluated to measured ROM fragmentation distributions. An important criteria for this comparison was the variation of model results from measured ROM in the-fine to intermediate section (1-100 mm) of the fragmentation curve. This region of the distribution is important for Mine to Mill™ optimisation. The comparison of modelled and Split ROM fragmentation distributions has been conducted in harder ores (UCS greater than 80 MPa). Further work involves modelling softer ores. The comparisons will be continued with future site surveys to increase confidence in the comparison of the CZM and TCM to Split results. Stochastic fragmentation modelling will then be conducted to take into account variation of input parameters. A window of possible fragmentation distributions can be compared to those obtained by Split . Following this work, an improved fragmentation model will be developed in response to these findings.

Zygosity Diagnosis in the Absence of Genotypic Data: An Approach Using Latent Class Analysis

For zygosity diagnosis in the absence of genotypic data, or in the recruitment phase of a twin study where only single twins from same-sex pairs are being screened, or to provide a test for sample duplication leading to the false identification of a dizygotic pair as monozygotic, the appropriate analysis of respondents' answers to questions about zygosity is critical. Using data from a young adult Australian twin cohort (N = 2094 complete pairs and 519 singleton twins from same-sex pairs with complete responses to all zygosity items), we show that application of latent class analysis (LCA), fitting a 2-class model, yields results that show good concordance with traditional methods of zygosity diagnosis, but with certain important advantages. These include the ability, in many cases, to assign zygosity with specified probability on the basis of responses of a single informant (advantageous when one zygosity type is being oversampled); and the ability to quantify the probability of misassignment of zygosity, allowing prioritization of cases for genotyping as well as identification of cases of probable laboratory error. Out of 242 twins (from 121 like-sex pairs) where genotypic data were available for zygosity confirmation, only a single case was identified of incorrect zygosity assignment by the latent class algorithm. Zygosity assignment for that single case was identified by the LCA as uncertain (probability of being a monozygotic twin only 76%), and the co-twin's responses clearly identified the pair as dizygotic (probability of being dizygotic 100%). In the absence of genotypic data, or as a safeguard against sample duplication, application of LCA for zygosity assignment or confirmation is strongly recommended.

Conhecimentos, habilidades e atitudes: o conceito de compet??ncias no trabalho e seu uso no setor p??blico

Este estudo tem dois objetivos: revisar criticamente a produ????o cient??fica nacional sobre o tema ???compet??ncias no trabalho e nas organiza????es???; e apresentar o conceito e discutir sua utiliza????o no setor p??blico. Para tanto foram analisados relatos de pesquisa emp??rica e ensaios nacionais e estrangeiros ??? em peri??dicos de psicologia e administra????o. Foram discutidos: enfoques te??ricos, instrumentos de coleta de dados, procedimentos de an??lise, entre outros aspectos. Na an??lise da produ????o nacional, constatou-se que, em sua maioria, as pesquisas: descrevem compet??ncias ocupacionais ou profissionais; possuem desenho survey; apresentam pluralidade quanto ?? natureza da pesquisa e utiliza????o de m??todos e t??cnicas para coleta e an??lise de dados; e s??o realizadas principalmente no setor terci??rio da economia. Verificou-se, ainda, a converg??ncia do conceito de compet??ncia, diante da complexidade e fragmenta????o te??rica previamente constatadas na literatura. Entretanto, mesmo em evid??ncia, a produ????o cient??fica brasileira sobre o tema ?? recente e ainda h?? uma lacuna sobre a discuss??o do construto e sua aplica????o no setor p??blico, em especial no caso brasileiro, quando se trata da administra????o p??blica federal, direta, aut??rquica e fundacional.

A evasão discente no contexto da reestruturação universitária : o caso dos cursos de Administração e Ciências Contábeis da Universidade Federal do Espírito Santo

O objetivo desta pesquisa foi levantar os motivos que influenciam a evasão discente em quatro cursos de graduação da Universidade Federal do Espírito Santo. A reestruturação universitária proposta pelo REUNI - Programa de Apoio a Planos de Expansão das Universidades Federais serviu como contexto ao estudo, pois instituiu diretrizes para o combate à evasão no ensino superior. O modelo de evasão de cunho sociológico proposto por Tinto (1997) baseou as análises realizadas nesta pesquisa porque toma a instituição como responsável por ações capazes de criar um ambiente de aprendizado necessário à permanência do estudante. A pesquisa de campo quali-quantitativa foi realizada com os alunos evadidos e com os coordenadores dos cursos de Administração Diurno e Ciências Contábeis Noturno e dos novos cursos Administração Noturno e Ciências Contábeis Vespertino. Foram alcançados 95 alunos evadidos e os quatro coordenadores, sendo aplicado questionário semiaberto aos alunos evadidos e feitas entrevistas semiestruturadas com os coordenadores. Dados do sistema acadêmico (SIE/UFES) foram utilizados para o levantamento das variáveis. Os números fornecem evidências de que o resultado da aprendizagem traduzido pelo desempenho acadêmico torna-se um forte causador da evasão por abandono. O baixo coeficiente de rendimento relacionou-se ao desligamento por abandono na maioria dos casos. Em relação às formas de evasão, a desistência e o desligamento por abandono totalizaram 87,4% dos casos, com maior incidência de evasão no segundo e terceiro ano do curso. O ponto crítico da evasão parece confirmar-se do 2º ao 5º semestre e 62% dos casos de evasão que se situaram nesse lapso temporal apresentaram coeficiente de rendimento de 0,00 a 3,00. Os resultados evidenciaram os motivos que mais influenciaram os alunos a deixar o curso: i) a necessidade de trabalhar enquanto frequentava o curso, ii) a descoberta de novos interesses; iii) a incompatibilidade entre os horários do trabalho e do curso; iv) a escolha da carreira profissional ainda muito jovem e v) a falta de orientação aos alunos sobre normas, penalidades, planejamento do curso, periodização, etc. e deficiências na comunicação institucional.

Integrating environmental and economic life cycle analysis in product development: a material selection case study

Purpose Achieving sustainability by rethinking products, services and strategies is an enormous challenge currently laid upon the economic sector, in which materials selection plays a critical role. In this context, the present work describes an environmental and economic life cycle analysis of a structural product, comparing two possible material alternatives. The product chosen is a storage tank, presently manufactured in stainless steel (SST) or in a glass fibre reinforced polymer composite (CST). The overall goal of the study is to identify environmental and economic strong and weak points related to the life cycle of the two material alternatives. The consequential win-win or trade-off situations will be identified via a Life Cycle Assessment/Life Cycle Costing (LCA/LCC) integrated model. Methods The LCA/LCC integrated model used consists in applying the LCA methodology to the product system, incorporating, in parallel, its results into the LCC study, namely those of the Life Cycle Inventory (LCI) and the Life Cycle Impact Assessment (LCIA). Results In both the SST and CST systems the most significant life cycle phase is the raw materials production, in which the most significant environmental burdens correspond to the Fossil fuels and Respiratory inorganics categories. The LCA/LCC integrated analysis shows that the CST has globally a preferable environmental and economic profile, as its impacts are lower than those of the SST in all life cycle stages. Both the internal and external costs are lower, the former resulting mainly from the composite material being significantly less expensive than stainless steel. This therefore represents a full win-win situation. As a consequence, the study clearly indicates that using a thermoset composite material to manufacture storage tanks is environmentally and economically desirable. However, it was also evident that the environmental performance of the CST could be improved by altering its End-of-Life stage. Conclusions The results of the present work provide enlightening insights into the synergies between the environmental and the economic performance of a structural product made with alternative materials. Further, they provide conclusive evidence to support the integration of environmental and economic life cycle analysis in the product development processes of a manufacturing company, or in some cases even in its procurement practices.