789 resultados para The missed encounter
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Introduction
Despite excellent first year outcomes in kidney transplantation, there remain significant long-term complications related to new-onset diabetes after transplantation (NODAT). The purpose of this study was to validate the findings of previous investigations of candidate gene variants in patients undergoing a protocolised, contemporary immunosuppression regimen, using detailed serial biochemical testing to identify NODAT development.
Methods
One hundred twelve live and deceased donor renal transplant recipients were prospectively followed-up for NODAT onset, biochemical testing at days 7, 90, and 365 after transplantation. Sixty-eight patients were included after exclusion for non-white ethnicity and pre-transplant diabetes. Literature review to identify candidate gene variants was undertaken as described previously.
Results
Over 25% of patients developed NODAT. In an adjusted model for age, sex, BMI, and BMI change over 12 months, five out of the studied 37 single nucleotide polymorphisms (SNPs) were significantly associated with NODAT: rs16936667:PRDM14 OR 10.57;95% CI 1.8–63.0;p = 0.01, rs1801282:PPARG OR 8.5; 95% CI 1.4–52.7; p = 0.02, rs8192678:PPARGC1A OR 0.26; 95% CI 0.08–0.91; p = 0.03, rs2144908:HNF4A OR 7.0; 95% CI 1.1–45.0;p = 0.04 and rs2340721:ATF6 OR 0.21; 95%CI 0.04–1.0; p = 0.05.
Conclusion
This study represents a replication study of candidate SNPs associated with developing NODAT and implicates mTOR as the central regulator via altered insulin sensitivity, pancreatic β cell, and mitochondrial survival and dysfunction as evidenced by the five SNPs.
General significance
1) Highlights the importance of careful biochemical phenotyping with oral glucose tolerance tests to diagnose NODAT in reducing time to diagnosis and missed cases.
2)This alters potential genotype:phenotype association.
3)The replication study generates the hypothesis that mTOR signalling pathway may be involved in NODAT development.
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We analyze a set of 760 475 observations of 333 026 unique main-belt objects obtained by the Pan-STARRS1(PS1) survey telescope between 2012 May 20 and 2013 November 9, a period during which PS1 discoveredtwo main-belt comets, P/2012 T1 (PANSTARRS) and P/2013 R3 (Catalina-PANSTARRS). PS1 cometdetection procedures currently consist of the comparison of the point spread functions (PSFs) of movingobjects to those of reference stars, and the flagging of objects that show anomalously large radial PSFwidths for human evaluation and possible observational follow-up. Based on the number of missed discoveryopportunities among comets discovered by other observers, we estimate an upper limit comet discoveryefficiency rate of 70% for PS1. Additional analyses that could improve comet discovery yields infuture surveys include linear PSF analysis, modeling of trailed stellar PSFs for comparison to trailed movingobject PSFs, searches for azimuthally localized activity, comparison of point-source-optimized photometryto extended-source-optimized photometry, searches for photometric excesses in objects withknown absolute magnitudes, and crowd-sourcing. Analysis of the discovery statistics of the PS1 surveyindicates an expected fraction of 59 MBCs per 106 outer main-belt asteroids (corresponding to a totalexpected population of 140 MBCs among the outer main-belt asteroid population with absolute magnitudesof 12 < HV < 19:5), and a 95% confidence upper limit of 96 MBCs per 106 outer main-belt asteroids(corresponding to a total of 230 MBCs), assuming a detection efficiency of 50%. We note howeverthat significantly more sensitive future surveys (particularly those utilizing larger aperture telescopes)could detect many more MBCs than estimated here. Examination of the orbital element distribution ofall known MBCs reveals an excess of high eccentricities (0:1 < e < 0:3) relative to the background asteroidpopulation. Theoretical calculations show that, given these eccentricities, the sublimation rate for atypical MBC is orders of magnitude larger at perihelion than at aphelion, providing a plausible physicalexplanation for the observed behavior of MBCs peaking in observed activity strength near perihelion.These results indicate that the overall rate of mantle growth should be slow, consistent with observationalevidence that MBC activity can be sustained over multiple orbit passages.
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Rosetta is ESA's new comet orbiter mission, launched in March 2004 and currently en route to Jupiter-family comet 67P/Churyumov-Gerasimenko. The probe will rendezvous with the comet in 2014 and remain in orbit around the nucleus for on-going detailed physical and compositional analysis. Pre-encounter observations of the target are important for characterization of the heliocentric light-curve behaviour and the physical properties of the nucleus, information that is critical for mission planning. The nucleus was first characterized using HST observations in 2003 (Lamy et al. 2006) and observed directly in May 2005 by ground based telescopes (Lowry et al. 2006) when it was at 5.6 AU from the Sun. An extensive database of nucleus observations have since been acquired, not only from large ground-based telescopes like the ESO VLT (Tubiana et al. 2008 & 2011), but also from Spitzer (Kelley et al. 2006 & 2009; Lamy et al. 2008).
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Background: Small adenomas may be missed during colonoscopy, but chromoscopy has been reported to enhance detection. The aim of this randomized-controlled trial was to determine the effect of total colonic dye spray on adenoma detection during routine colonoscopy.
Methods: Consecutive outpatients undergoing routine colonoscopy were randomized to a dye-spray group (0.1% indigo carmine used to coat the entire colon during withdrawal from the cecum) or control group (no dye).
Results: Two hundred fifty-nine patients were randomized, 124 to the dye-spray and 135 to the control group; demographics, indication for colonoscopy, and quality of the preparation were similar between the groups. Extubation from the cecum took a median of 9:05 minutes (range: 2:4824:44 min) in the dye-spray group versus 4:52 minutes (range: 1:42-15:21 min] in the control group (p <0.0001). The proportion of patients with at least 1 adenoma and the total number of adenomas were not different between groups. However, in the dye-spray group significantly more diminutive adenomas (
Conclusions: Dye-spray increases the detection of small adenomas in the proximal colon and patients with multiple adenomas, but long-term outcomes should be studied to determine the clinical value of these findings.
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In this chapter, I focus on how the example of CEDAW illustrates the methodological and conceptual difficulties that future work in comparative international human is likely to encounter. Despite the challenges, I suggest that the worked example of CEDAW has raised interesting lines for empirical analysis, and additional perspectives which may enrich normative inquiry, sufficient to justify comparative international human rights law being regarded as likely to give rise to insights that might not otherwise have emerged, and therefore to be as an approach worth pursuing in the future.
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Participatory and socially engaged art practices have, for a couple of decades, emerged a myriad of aesthetic and methodological strategies across different media. These are artistic practices that have a primary interest in participation, affecting social dynamics, dialogue and at times political activism. Nato Thompson in “Living Form: Socially Engaged Art from 1991-2011” surveys these
practices, which range from theatre to urban planning, visual art to healthcare. Linked to notions such as relational aesthetics (Bourriaud, 1998), community art and public art, socially engaged art often focuses on the development of a sense of ownership by the part of participants. If an artist is working truly collaboratively with participants and addressing the reality of a particular community, the long-term effect of a project lies in the process of engagement as well as in the artwork itself. Projects by New York based artist Pablo Helguera, for example, use different media to engage with social inequalities through participative action while rejecting the notion of art for art sake.
“Socially engaged art functions by attaching itself to subjects and problems that normally belong to other disciplines, moving them temporarily into a space of ambiguity. It is this temporary snatching away of subjects into the realm of art-making that brings new insights to a particular problem or condition and in turn makes it visible to other disciplines.” (Helguera, 2011)
Socially engaged practices develop the notion of artwork about or by a community, to work of a community. In this chapter we address how socially engaged, participatory approaches can form a context for the sonic arts, arguably less explored than practices such as theatre and performance art. The use of sound is clearly present in a wide range of socially engaged work (e.g. Helguera’s “Aelia Media” enabling a nomadic radio station in Bologna or Maria Andueza “Immigrant Sounds – Res(on)Art (Stockholm)” exploring ways of sonically resonating a city, or Sue MacCauley’s “The Housing Project” addressing ways of representing the views of urban dwellers on public scape through sound art. It is nevertheless rare to encounter projects which take our experience of sound in the everyday as a trigger for community social engagement in a participatory context.
We address concepts and methodologies behind the project Som da Maré, a participatory sonic arts project in the favelas of Maré, Rio de Janeiro.
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Recent analyses of sediment samples from "black mat" sites in South America and Europe support previous interpretations of an ET impact event that reversed the Late Glacial demise of LGM ice during the Bølling Allerød warming, resulting in a resurgence of ice termed the Younger Dryas (YD) cooling episode. The breakup or impact of a cosmic vehicle at the YD boundary coincides with the onset of a 1-kyr long interval of glacial resurgence, one of the most studied events of the Late Pleistocene. New analytical databases reveal a corpus of data indicating that the cosmic impact was a real event, most possibly a cosmic airburst from Earth's encounter with the Taurid Complex comet or unknown asteroid, an event that led to cosmic fragments exploding interhemispherically over widely dispersed areas, including the northern Andes of Venezuela and the Alps on the Italian/French frontier. While the databases in the two areas differ somewhat, the overall interpretation is that microtextural evidence in weathering rinds and in sands of associated paleosols and glaciofluvial deposits carry undeniable attributes of melted glassy carbon and Fe spherules, planar deformation features, shock-melted and contorted quartz, occasional transition and platinum metals, and brecciated and impacted minerals of diverse lithologies. In concert with other black mat localities in the Western USA, the Netherlands, coastal France, Syria, Central Asia, Peru, Argentina and Mexico, it appears that a widespread cosmic impact by an asteroid or comet is responsible for deposition of the black mat at the onset of the YD glacial event. Whether or not the impact caused a 1-kyr interval of glacial climate depends upon whether or not the Earth had multiple centuries-long episodic encounters with the Taurid Complex or asteroid remnants; impact-related changes in microclimates sustained climatic forcing sufficient to maintain positive mass balances in the reformed ice; and/or inertia in the Atlantic thermohaline circulation system persisted for 1kyr.
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The majority of children in our society are loved andcherished. The occasional cases of intentional injury to a childresulting in death or significant harm evoke powerful anduncomfortable feelings (Devaney et al, 2013), and the publicoutcry may result in health and social workers facing criticism.Identifying whether an infant is at risk of abuse is a challengefor practitioners, and can be a source of stress and anxiety(Brandon et al, 2011). Bruising is a strong indicator of childabuse involving intentional injury (Kemp et al, 2014). Theincidence of bruising correlates to developmental stage, withnon-mobile infants least likely to incur bruising. Therefore, itspresence in pre-mobile infants requires immediate assessment.A search of the literature around bruising in pre-mobile infantsrevealed themes of missed opportunities for early intervention,the role of the father in the family and the significance of childdevelopment. Sharing of knowledge and expertise within themultidisciplinary team is key to safeguarding infants.
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This piece contemplates whether the common law could fill the gaps in human rights protection if the UK's Human Rights Act 1998 were to be repealed. It looks at how the common law protected human rights before the Act came into force, what difference the Act has made, how the common law has become side-lined as a result, how in recent cases it has begun to play a more central role, and what more more needs to be done to develop it in ways which ensure that if the Human Rights Act were to be repealed it would not be particularly missed.
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Camera traps are used to estimate densities or abundances using capture-recapture and, more recently, random encounter models (REMs). We deploy REMs to describe an invasive-native species replacement process, and to demonstrate their wider application beyond abundance estimation. The Irish hare Lepus timidus hibernicus is a high priority endemic of conservation concern. It is threatened by an expanding population of non-native, European hares L. europaeus, an invasive species of global importance. Camera traps were deployed in thirteen 1 km squares, wherein the ratio of invader to native densities were corroborated by night-driven line transect distance sampling throughout the study area of 1652 km2. Spatial patterns of invasive and native densities between the invader’s core and peripheral ranges, and native allopatry, were comparable between methods. Native densities in the peripheral range were comparable to those in native allopatry using REM, or marginally depressed using Distance Sampling. Numbers of the invader were substantially higher than the native in the core range, irrespective of method, with a 5:1 invader-to-native ratio indicating species replacement. We also describe a post hoc optimization protocol for REM which will inform subsequent (re-)surveys, allowing survey effort (camera hours) to be reduced by up to 57% without compromising the width of confidence intervals associated with density estimates. This approach will form the basis of a more cost-effective means of surveillance and monitoring for both the endemic and invasive species. The European hare undoubtedly represents a significant threat to the endemic Irish hare.
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Accurate knowledge of the electron-impact ionization of the B atom is urgently needed in current fusion plasma experiments to help design ITER wall components. Since no atomic measurements exist, nonperturba- tive time-dependent close-coupling (TDCC) calculations are carried out to accurately determine the direct ionization cross sections of the outer two subshells of B. Perturbative distorted-wave and semiempirical binary encounter calculations are found to yield cross sections from 26% lower to an order of magnitude higher than the current TDCC results. Unlike almost all neutral atoms, large excitation-autoionization contributions are found for the B atom. Nonperturbative R matrix with pseudostates (RMPS) calculations are also carried out to accurately determine the total ionization cross section of B. Previous 60 LS-term RMPS calculations are found to yield cross sections up to 40% higher than the current more extensive 476 LS-term RMPS results
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This thesis investigates the use and significance of X-ray crystallographic visualisations of molecular structures in postwar British material culture across scientific practice and industrial design. It is based on research into artefacts from three areas: X-ray crystallographers’ postwar practices of visualising molecular structures using models and diagrams; the Festival Pattern Group scheme for the 1951 Festival of Britain, in which crystallographic visualisations formed the aesthetic basis of patterns for domestic objects; and postwar furnishings with a ‘ball-and-rod’ form and construction reminiscent of those of molecular models. A key component of the project is methodological. The research brings together subjects, themes and questions traditionally covered separately by two disciplines, the history of design and history of science. This focus necessitated developing an interdisciplinary set of methods, which results in the reassessment of disciplinary borders and productive cross-disciplinary methodological applications. This thesis also identifies new territory for shared methods: it employs network models to examine cross-disciplinary interaction between practitioners in crystallography and design, and a biographical approach to designed objects that over time became mediators of historical narratives about science. Artefact-based, archival and oral interviewing methods illuminate the production, use and circulation of the objects examined in this research. This interdisciplinary approach underpins the generation of new historical narratives in this thesis. It revises existing histories of the cultural transmissions between X-ray crystallography and the production and reception of designed objects in postwar Britain. I argue that these transmissions were more complex than has been acknowledged by historians: they were contingent upon postwar scientific and design practices, material conditions in postwar Britain and the dynamics of historical memory, both scholarly and popular. This thesis comprises four chapters. Chapter one explores X-ray crystallographers’ visualisation practices, conceived here as a form of craft. Chapter two builds on this, demonstrating that the Festival Pattern Group witnesses the encounter between crystallographic practice, design practice and aesthetic ideologies operating within social networks associated with postwar modernisms. Chapters three and four focus on ball-and-rod furnishings in postwar and present-day Britain, respectively. I contend that strong relationships between these designed objects and crystallographic visualisations, for example the appellation ‘atomic design’, have been largely realised through historical narratives active today in the consumption of ‘retro’ and ‘mid-century modern’ artefacts. The attention to contemporary historical narratives necessitates this dual historical focus: the research is rooted in the period from the end of the Second World War until the early 1960s, but extends to the history of now. This thesis responds to the need for practical research on methods for studying cross-disciplinary interactions and their histories. It reveals the effects of submitting historical subjects that are situated on disciplinary boundaries to interdisciplinary interpretation. Old models, such as that of unidirectional ‘influence’, subside and the resulting picture is a refracted one: this study demonstrates that the material form and meaning of crystallographic visualisations, within scientific practice and across their use and echoes in designed objects, are multiple and contingent.
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This study explores the extent to which work and organizational (W&O) psychology practitioners use evidence, how they apply it to the everyday contexts in which they work and the types of barriers they encounter in so doing. It adopts a mixed methods approach involving the administration of a survey to a UK sample (N=163) of W&O psychologists and a series of semi-structured interviews (N=25) exploring in greater depth how evidence is applied in practice. Findings reveal that practitioners consult a wide range of different types of evidence which they employ at various stages of engagement with client organisations and that this evidence is pressed into service in the pursuit of solutions which are both acceptable from the client perspective and consistent with the scientific standards underpinning professional knowledge and expertise in W&O psychology. Barriers to evidence-use were mainly practical in nature, concerning issues around managing the client-consultant relationship and the particularities of implementation context, both of which were shown to influence evidence utilisation. The study contributes to current debate on the extent to which W&O psychologists adopt an evidence-based approach and provides a valuable and much called-for empirical insight into the enactment of the scientist-practitioner model in W&O psychology
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Thesis (Ph.D.)--University of Washington, 2015
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Explores the relation between gender and the encounter of Jews with various conditions of Modernity. She makes clear that the study of the process of Jewish assimilation in contemporary times must include women and gender in its framework.