995 resultados para 809.814


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The Iowa community colleges transmit the Fall 2000 enrollments to the Department of Education after the 14th day of the fall term start date. All data in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college transmittal sheet. The Fall 2000 unduplicated credit headcount enrollment of 65,473 demonstrates an increase of 3 percent over Fall 1999 enrollment of 63,809.

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BACKGROUND: Most societies elaborate ways to contain increasing health care expenditures. In Switzerland out of pocket payments and cuts in the catalogue of reimbursed services are used as cost-containment measures. The aims of the study were to estimate the extent of health care renunciation for economic reasons and to identify associated factors. METHODS: A population-based cross-sectional survey (2008-2009) of a representative sample in the Canton of Geneva, Switzerland. Health care underuse, income level categories (<CHF 3000/month, 3000-4999, 5000-6999, 7000-9499, 9500-13 000, >13 000), education, occupation, insurance status and cardiovascular comorbidities were collected using self-rated questionnaires. RESULTS: 765 men and 814 women aged 35-74 years participated. 14.5% (229/1579) (95%CI 12.7-16.2) renounced health care for economic reasons. Among those who renounced (N = 229), 74% renounced dental care, 37% physician consultation (22% specialist, 15% general practitioner), 26% health devices, 13% medication, and 5% surgery. Income was negatively correlated with renouncement (r = -0.18, p <.0001). Each decrease in income level category provided a 48% increased risk of renouncing health care for economic reasons (OR 1.48, 1.31-1.65). This association remained when dental care was excluded from the definition of health care renunciation. CONCLUSIONS: In a region of Switzerland with a high cost of living, such as Geneva, socioeconomic status may influence the use of the health care system, and renunciation for economic reasons was not uncommon. More than 30% of the lowest income group renounced health care for economical reasons in the previous year. Health care underuse and renunciation may worsen the health status of a substantial part of society.

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OBJECTIVE(S): To investigate the relationship between detection of HIV drug resistance by 2 years from starting antiretroviral therapy and the subsequent risk of progression to AIDS and death. DESIGN: Virological failure was defined as experiencing two consecutive viral loads of more than 400 copies/ml in the time window between 0.5 and 2 years from starting antiretroviral therapy (baseline). Patients were grouped according to evidence of virological failure and whether there was detection of the International AIDS Society resistance mutations to one, two or three drug classes in the time window. METHODS: Standard survival analysis using Kaplan-Meier curves and Cox proportional hazards regression model with time-fixed covariates defined at baseline was employed. RESULTS: We studied 8229 patients in EuroSIDA who started antiretroviral therapy and who had at least 2 years of clinical follow-up. We observed 829 AIDS events and 571 deaths during 38,814 person-years of follow-up resulting in an overall incidence of new AIDS and death of 3.6 per 100 person-years of follow-up [95% confidence interval (CI):3.4-3.8]. By 96 months from baseline, the proportion of patients with a new AIDS diagnosis or death was 20.3% (95% CI:17.7-22.9) in patients with no evidence of virological failure and 53% (39.3-66.7) in those with virological failure and mutations to three drug classes (P = 0.0001). An almost two-fold difference in risk was confirmed in the multivariable analysis (adjusted relative hazard = 1.8, 95% CI:1.2-2.7, P = 0.005). CONCLUSION: Although this study shows an association between the detection of resistance at failure and risk of clinical progression, further research is needed to clarify whether resistance reflects poor adherence or directly increases the risk of clinical events via exhaustion of drug options.

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Over the past years, cardiovascular magnetic resonance (CMR) has proven its efficacy in large clinical trials, and consequently, the assessment of function, viability, and ischaemia by CMR is now an integrated part of the diagnostic armamentarium in cardiology. By combining these CMR applications, coronary artery disease (CAD) can be detected in its early stages and this allows for interventions with the goal to reduce complications of CAD such as infarcts and subsequently chronic heart failure (CHF). As the CMR examinations are robust and reproducible and do not expose patients to radiation, they are ideally suited for repetitive studies without harm to the patients. Since CAD is a chronic disease, the option to monitor CAD regularly by CMR over many decades is highly valuable. Cardiovascular magnetic resonance also progressed recently in the setting of acute coronary syndromes. In this situation, CMR allows for important differential diagnoses. Cardiovascular magnetic resonance also delineates precisely the different tissue components in acute myocardial infarction such as necrosis, microvascular obstruction (MVO), haemorrhage, and oedema, i.e. area at risk. With these features, CMR might also become the preferred tool to investigate novel treatment strategies in clinical research. Finally, in CHF patients, the versatility of CMR to assess function, flow, perfusion, and viability and to characterize tissue is helpful to narrow the differential diagnosis and to monitor treatment.

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Aquest article té com a objecte establir la relació existent entre les formes materials que adopta el creixement urbi i les caracteristiques del mercat del sòl i del m rcat immobiliari. La proposició inicial de la qual es parteix és l'afirmació e la dependència de les primeres respecte al grau de desenvolupament del mercat; i això en dos aspectes: primer, en l'origen d'una determinada forma urbaba; segon, en la seva posterior evolució. El cas analitzat, el procés de creixement urbà de Lleida en uns anys de gran creixement econòmic -canvi agrícola basat en l'especialització fruitera i en la difusió de les granges d'estabulació ramadera- i demogràfic -41.464 habitants el 1940, 106.814 habitants el 1981- pretén servir per treure unes remarques qenerals, formulades en el present treball com a hipòtesis, que poden orientar aquelles recerques que busquen en les característiques d'una formació social la variable independent que ha de permetre la comprensió d'unes morfologies. El marc eneral de referència és la teoria sobre la "producció de l'espai", encara que matisada i acotada a aquells aspectes que poden ser més rellevants en la comprensió del sorgiment de les formes materials urbanes.

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OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14.8 million births 1990-2009; 2.89% multiple births. METHODS: DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases. MAIN OUTCOME MEASURES: Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome. STATISTICAL ANALYSIS: Poisson and logistic regression stratified for maternal age, country and time. RESULTS: Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53-0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co-twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25-0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23-1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50-0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27-0.59]). CONCLUSIONS: The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.

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Prominent doping cases in certain sports have recently raised public awareness of doping and reinforced the perception that doping is widespread. Efforts to deal with doping in sport have intensified in recent years, yet the general public believes that the 'cheaters' are ahead of the testers. Therefore, there is an urgent need to change the antidoping strategy. For example, the increase in the number of individual drug tests conducted between 2005 and 2012 was approximately 90 000 and equivalent to an increase of about 50%, yet the number of adverse analytical findings remained broadly the same. There is also a strikingly different prevalence of doping substances and methods in sports such as a 0.03% prevalence of anabolic steroids in football compared to 0.4% in the overall WADA statistics. Future efforts in the fight against doping should therefore be more heavily based on preventative strategies such as education and on the analysis of data and forensic intelligence and also on the experiences of relevant stakeholders such as the national antidoping organisations, the laboratories, athletes or team physicians and related biomedical support staff. This strategy is essential to instigate the change needed to more effectively fight doping in sport.

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In Amazonia, topographical variations in soil and forest structure within "terra-firme" ecosystems are important factors correlated with terrestrial invertebrates' distribution. The objective of this work was to assess the effects of soil clay content and slope on ant species distribution over a 25 km² grid covering the natural topographic continuum. Using three complementary sampling methods (sardine baits, pitfall traps and litter samples extracted in Winkler sacks), 300 subsamples of each method were taken in 30 plots distributed over a wet tropical forest in the Ducke Reserve (Manaus, AM, Brazil). An amount of 26,814 individuals from 11 subfamilies, 54 genera, 85 species and 152 morphospecies was recorded (Pheidole represented 37% of all morphospecies). The genus Eurhopalothrix was registered for the first time for the reserve. Species number was not correlated with slope or clay content, except for the species sampled from litter. However, the Principal Coordinate Analysis indicated that the main pattern of species composition from pitfall and litter samples was related to clay content. Almost half of the species were found only in valleys or only on plateaus, which suggests that most of them are habitat specialists. In Central Amazonia, soil texture is usually correlated with vegetation structure and moisture content, creating different microhabitats, which probably account for the observed differences in ant community structure.

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O objetivo deste trabalho foi determinar os recursos forrageados por Polistes versicolor em área de reflorestamento com eucalipto e identificar as presas forrageadas. No período de janeiro a dezembro de 2007, foram realizadas 24 observações da atividade forrageadora de colônias de P. versicolor presentes em um reflorestamento de eucalipto, em Juiz de Fora, MG, totalizando 240 horas de registros. Durante as dez horas de observação diária, foram registrados e qualificados, a cada 30 minutos, os retornos das operárias para a colônia. Foram registrados 1.809 retornos, dos quais 51,63% foram com néctar; 6,85%, com água; 4,7%, com fibra vegetal; 17,41%, com presas; e 19,40%, sem recurso forrageado (improdutivos). As operárias de P. versicolor predaram exclusivamente lagartas de lepidópteros, que foram a única fonte de proteína animal oferecida aos insetos imaturos, na colônia. Dessa forma, a espécie estudada apresenta potencial como agente controlador biológico de herbívoros desfolhadores de eucalipto.

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Different signatures of natural selection persist over varying time scales in our genome, revealing possible episodes of adaptative evolution during human history. Here, we identify genes showing signatures of ancestral positive selection in the human lineage and investigate whether some of those genes have been evolving adaptatively in extant human populations. Specifically, we compared more than 11,000 human genes with their orthologs inchimpanzee, mouse, rat and dog and applied a branch-site likelihood method to test for positive selection on the human lineage. Among the significant cases, a robust set of 11 genes were then further explored for signatures of recent positive selection using SNP data. We genotyped 223 SNPs in 39 worldwide populations from the HGDP Diversity panel and supplemented this information with available genotypes for up to 4,814 SNPs distributed along 2 Mb centered on each gene. After exploring the allele frequency spectrum, population differentiation and the maintainance of long unbroken haplotypes, we found signals of recent adaptative phenomena in only one of the 11 candidate gene regions. However, the signal ofrecent selection in this region may come from a different, neighbouring gene (CD5) ratherthan from the candidate gene itself (VPS37C). For this set of positively-selected genes in thehuman lineage, we find no indication that these genes maintained their rapid evolutionarypace among human populations. Based on these data, it therefore appears that adaptation forhuman-specific and for population-specific traits may have involved different genes.