Temporohyoid osteoarthropathy in the horse

Temporohyoid osteoarthropathy (THO) is a well-recognised clinical entity in horses. Temporohyoid osteoarthropathy is characterised by progressive osseous proliferation of the proximal portion of the stylohyoid and petrous temporal bones, and is generally described as a disease of middle-aged horses. More recent reports also attribute a variety of clinical syndromes in young horses to THO, requiring a diversification of approaches to confirm the diagnosis and its significance, and to guide conservative and surgical treatment options. This commentary will review the purported aetiology, clinical syndromes, available diagnostic tests and treatment options of equine THO.

Intrauterine instillation of diluted seminal plasma at oocyte pick-up does not increase the IVF pregnancy rate: a double-blind, placebo controlled, randomized study.

STUDY QUESTION Does intrauterine application of diluted seminal plasma (SP) at the time of ovum pick-up improve the pregnancy rate by ≥14% in IVF treatment? SUMMARY ANSWER Intrauterine instillation of diluted SP at the time of ovum pick-up is unlikely to increase the pregnancy rate by ≥14% in IVF. WHAT IS KNOWN ALREADY SP modulates endometrial function, and sexual intercourse around the time of embryo transfer has been suggested to increase the likelihood of pregnancy. A previous randomized double-blind pilot study demonstrated a strong trend towards increased pregnancy rates following the intracervical application of undiluted SP. As this study was not conclusive and as the finding could have been confounded by sexual intercourse, the intrauterine application of diluted SP was investigated in the present trial. STUDY DESIGN, SIZE, DURATION A single-centre, prospective, double-blind, placebo-controlled, randomized, superiority trial on women undergoing IVF was conducted from April 2007 until February 2012 at the University Department of Gynaecological Endocrinology and Reproductive Medicine, Heidelberg, Germany. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was powered to detect an 14% increase in the clinical pregnancy rate and two sequential tests were planned using the Pocock spending function. At the first interim analysis, 279 women had been randomly assigned to intrauterine diluted SP (20% SP in saline from the patients' partner) (n = 138) or placebo (n = 141) at the time of ovum pick-up. MAIN RESULTS AND THE ROLE OF CHANCE The clinical pregnancy rate per randomized patient was 37/138 (26.8%) in the SP group and 41/141 (29.1%) in the placebo group (difference: -2.3%, 95% confidence interval of the difference: -12.7 to +8.2%; P = 0.69). The live birth rate per randomized patient was 28/138 (20.3%) in the SP group and 33/141 (23.4%) in the placebo group (difference: -3.1%, 95% confidence interval of the difference: -12.7 to +6.6%; P = 0.56). It was decided to terminate the trial due to futility at the first interim analysis, at a conditional power of 62%. LIMITATIONS, REASONS FOR CAUTION The confidence interval of the difference remains wide, thus clinically relevant differences cannot reliably be excluded based on this single study. WIDER IMPLICATIONS OF THE FINDINGS The results of this study cast doubt on the validity of the concept that SP increases endometrial receptivity and thus implantation in humans. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by the department's own research facilities. TRIAL REGISTRATION NUMBER DRKS00004615.

Word encoding during sleep is suggested by correlations between word-evoked up-states and post-sleep semantic priming

To test whether humans can encode words during sleep we played everyday words to men while they were napping and assessed priming from sleep played words following waking. Words were presented during non rapid eye movement (NREM) sleep. Priming was assessed using a semantic and a perceptual priming test. These tests measured differences in the proces sing of words that had been or had not been played during sleep. Synonyms to sleep played words were the targets in the semantic priming test that tapped the meaning of sleep played words. All men responded to sleep played words by producing up states in their electroencephalogram. Up states are NREM sleep specific phases of briefly increased neuronal excitability. The word evoked up states might have promoted word processing during sleep. Yet, the mean performance in the priming tests administered following sleep was at chance level, which suggests that participants as a group failed to show priming following sleep. However, performance in the two priming tests was positively correlated to each other and to the magnitude of the word evoked up states. Hence, the larger a participant’s word evoked up states, the larger his perceptual and semantic priming. Those participants who scored high on all variables must have encoded words during sleep. We conclude that some humans are able to encode words during sleep, but more research is needed to pin down the factors that modulate this ability.

Using Informatics and the Electronic Medical Record to Describe Antimicrobial Use in the Clinical Management of Diarrhea Cases at 12 Companion Animal Practices

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.

Word encoding during sleep

To test whether humans can encode words during sleep we played everyday words to men while they were napping and assessed priming from sleep-played words following waking. Words were presented during non-rapid eye movement (NREM) sleep. Priming was assessed using a semantic and a perceptual priming test. These tests measured differences in the processing of words that had been or had not been played during sleep. Synonyms to sleep-played words were the targets in the semantic priming test that tapped the meaning of sleep-played words. All men responded to sleep-played words by producing up-states in their electroencephalogram. Up-states are NREM sleep-specific phases of briefly increased neuronal excitability. The word-evoked up-states might have promoted word processing during sleep. Yet, the mean performance in the priming tests administered following sleep was at chance level, which suggests that participants as a group failed to show priming following sleep. However, performance in the two priming tests was positively correlated to each other and to the magnitude of the word-evoked up-states. Hence, the larger a participant's word-evoked up-states, the larger his perceptual and semantic priming. Those participants who scored high on all variables must have encoded words during sleep. We conclude that some humans are able to encode words during sleep, but more research is needed to pin down the factors that modulate this ability.

Evaluation of the maxillary sinus in panoramic radiography—a comparative study

Background: The aim of this study was to evaluate the validity and the inter- and intra-examiner reliability of panoramic-radiograph-driven findings of different maxillary sinus anatomic variations and pathologies, which had initially been prediagnosed by cone beam computed tomography (CBCT). Methods: After pairs of two-dimensional (2D) panoramic and three-dimensional (3D) CBCT images of patients having received treatment at the outpatient department had been screened, the predefinition of 54 selected maxillary sinus conditions was initially performed on CBCT images by two blinded consultants individually using a questionnaire that defined ten different clinically relevant findings. Using the identic questionnaire, these consultants performed the evaluation of the panoramic radiographs at a later time point. The results were analyzed for inter-imaging differences in the evaluation of the maxillary sinus between 2D and 3D imaging methods. Additionally, two resident groups (first year and last year of training) performed two diagnostic runs of the panoramic radiographs and results were analyzed for inter- and intra-observer reliability. Results: There is a moderate risk for false diagnosis of findings of the maxillary sinus if only panoramic radiography is used. Based on the ten predefined conditions, solely maxillary bone cysts penetrating into the sinus were frequently detected differently comparing 2D to 3D diagnostics. Additionally, on panoramic radiographs, the inter-observer comparison demonstrated that basal septa were significantly often rated differently and the intra-observer comparison showed a significant lack in reliability in detecting maxillary bone cysts penetrating into the sinus. Conclusions: Panoramic radiography provides the most information on the maxillary sinus, and it may be an adequate imaging method. However, particular findings of the maxillary sinus in panoramic imaging may be based on a rather examiner-dependent assessment. Therefore, a persistent and precise evaluation of specific conditions of the maxillary sinus may only be possible using CBCT because it provides additional information compared to panoramic radiography. This might be relevant for consecutive surgical procedures; consequently, we recommend CBCT if a precise preoperative evaluation is mandatory. However, higher radiation dose and costs of 3D imaging need to be considered. Keywords: Panoramic radiography; Cone beam computed tomography; Maxillary sinus; Inter-imaging method differences; Inter-examiner reliability; Intra-examiner reliability

How to prevent overdiagnosis.

Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and that patients have no benefit to be aware of. It is neither a misdiagnosis (diagnostic error), nor a false positive result (positive test in the absence of a real abnormality). It mainly results from screening, use of increasingly sensitive diagnostic tests, incidental findings on routine examinations, and widening diagnostic criteria to define a condition requiring an intervention. The blurring boundaries between risk and disease, physicians' fear of missing a diagnosis and patients' need for reassurance are further causes of overdiagnosis. Overdiagnosis often implies procedures to confirm or exclude the presence of the condition and is by definition associated with useless treatments and interventions, generating harm and costs without any benefit. Overdiagnosis also diverts healthcare professionals from caring about other health issues. Preventing overdiagnosis requires increasing awareness of healthcare professionals and patients about its occurrence, the avoidance of unnecessary and untargeted diagnostic tests, and the avoidance of screening without demonstrated benefits. Furthermore, accounting systematically for the harms and benefits of screening and diagnostic tests and determining risk factor thresholds based on the expected absolute risk reduction would also help prevent overdiagnosis.

A qualitative and quantitative assessment of cancer patients' perceptions of barriers to treatment

This study examined barriers that cancer patients experience in obtaining treatment. The principal aim of the study was to conduct a comprehensive quantitative and qualitative assessment of barriers to cancer treatment for Texas cancer patients. The three specific aims of the study were to: (1) conduct a review and critique of published and unpublished research on barriers to cancer treatment; (2) conduct focus groups for the qualitative assessment of cancer patients' perceived barriers to cancer treatment; and (3) survey a representative sample of cancer patients regarding perceived barriers to treatment. The study was guided by the Aday and Andersen access framework of predisposing, enabling, and need determinants of care-seeking.^ To address the first specific aim, a total of 732 abstracts were examined, from which 154 articles were selected for review. Of these 154 articles, 57 that related directly to research on barriers to cancer treatment were chosen for subsequent analysis. Criteria were applied to each article to evaluate the strength of the study design, sampling and measurement procedures. The major barriers that were consistently documented to influence whether or not cancer patients sought or continued required treatment included problems with communication between the patient and provider, lack of information on side effects, the cost of treatment and associated difficulties in obtaining and maintaining insurance coverage, and the absence of formal and informal networks of social support. Access barriers were generally greater for older, minority women, and patients of lower socioeconomic status.^ To address the second specific aim, a total of eight focus groups (n = 44) were conducted across the State of Texas with cancer patients identified by the Texas Community Oncology Network, American Cancer Society, and community health centers. One important finding was that cost is the greatest hurdle that patients face. Another finding was that with the health care/insurance crisis, an increasing number of physicians are working with their patients to develop individually-tailored payment plans. For people in rural areas, travel to treatment sites is a major barrier due to the travel costs as well as work time forfeited by patients and their family members. A third major finding was the patients' family and church play important roles in providing social and emotional support for cancer patients.^ To address the third aim, a total of 910 cancer patients were surveyed during October and November, 1993. Approximately 65% of the cancer patients responded to the survey. The findings showed that the major barriers to treatment included costs of medications and diagnostic tests, transportation, lack of social support, problems understanding the written information regarding their disease as well as losing coverage or having higher premiums or copayments once they were diagnosed (particularly among blacks).^ Significant differences in reported barriers were found between racial groups. The minority respondents (i.e., blacks and Hispanics) tended to experience more barriers to treatment compared to the white respondents. More specifically, Hispanics were more likely to report transportation as a barrier to treatment than both white and blacks. Future research is needed to better understand the problems that minority cancer patients experience in receiving treatment. (Abstract shortened by UMI.) ^

Bayesian and survival model for tumor relapse status and disease-specific survival, with applications to breast cancer

Breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death in women in the United States. Studies on ipsilateral breast tumor relapse (IBTR) status and disease-specific survival will help guide clinic treatment and predict patient prognosis.^ After breast conservation therapy, patients with breast cancer may experience breast tumor relapse. This relapse is classified into two distinct types: true local recurrence (TR) and new ipsilateral primary tumor (NP). However, the methods used to classify the relapse types are imperfect and are prone to misclassification. In addition, some observed survival data (e.g., time to relapse and time from relapse to death)are strongly correlated with relapse types. The first part of this dissertation presents a Bayesian approach to (1) modeling the potentially misclassified relapse status and the correlated survival information, (2) estimating the sensitivity and specificity of the diagnostic methods, and (3) quantify the covariate effects on event probabilities. A shared frailty was used to account for the within-subject correlation between survival times. The inference was conducted using a Bayesian framework via Markov Chain Monte Carlo simulation implemented in softwareWinBUGS. Simulation was used to validate the Bayesian method and assess its frequentist properties. The new model has two important innovations: (1) it utilizes the additional survival times correlated with the relapse status to improve the parameter estimation, and (2) it provides tools to address the correlation between the two diagnostic methods conditional to the true relapse types.^ Prediction of patients at highest risk for IBTR after local excision of ductal carcinoma in situ (DCIS) remains a clinical concern. The goals of the second part of this dissertation were to evaluate a published nomogram from Memorial Sloan-Kettering Cancer Center, to determine the risk of IBTR in patients with DCIS treated with local excision, and to determine whether there is a subset of patients at low risk of IBTR. Patients who had undergone local excision from 1990 through 2007 at MD Anderson Cancer Center with a final diagnosis of DCIS (n=794) were included in this part. Clinicopathologic factors and the performance of the Memorial Sloan-Kettering Cancer Center nomogram for prediction of IBTR were assessed for 734 patients with complete data. Nomogram for prediction of 5- and 10-year IBTR probabilities were found to demonstrate imperfect calibration and discrimination, with an area under the receiver operating characteristic curve of .63 and a concordance index of .63. In conclusion, predictive models for IBTR in DCIS patients treated with local excision are imperfect. Our current ability to accurately predict recurrence based on clinical parameters is limited.^ The American Joint Committee on Cancer (AJCC) staging of breast cancer is widely used to determine prognosis, yet survival within each AJCC stage shows wide variation and remains unpredictable. For the third part of this dissertation, biologic markers were hypothesized to be responsible for some of this variation, and the addition of biologic markers to current AJCC staging were examined for possibly provide improved prognostication. The initial cohort included patients treated with surgery as first intervention at MDACC from 1997 to 2006. Cox proportional hazards models were used to create prognostic scoring systems. AJCC pathologic staging parameters and biologic tumor markers were investigated to devise the scoring systems. Surveillance Epidemiology and End Results (SEER) data was used as the external cohort to validate the scoring systems. Binary indicators for pathologic stage (PS), estrogen receptor status (E), and tumor grade (G) were summed to create PS+EG scoring systems devised to predict 5-year patient outcomes. These scoring systems facilitated separation of the study population into more refined subgroups than the current AJCC staging system. The ability of the PS+EG score to stratify outcomes was confirmed in both internal and external validation cohorts. The current study proposes and validates a new staging system by incorporating tumor grade and ER status into current AJCC staging. We recommend that biologic markers be incorporating into revised versions of the AJCC staging system for patients receiving surgery as the first intervention.^ Chapter 1 focuses on developing a Bayesian method to solve misclassified relapse status and application to breast cancer data. Chapter 2 focuses on evaluation of a breast cancer nomogram for predicting risk of IBTR in patients with DCIS after local excision gives the statement of the problem in the clinical research. Chapter 3 focuses on validation of a novel staging system for disease-specific survival in patients with breast cancer treated with surgery as the first intervention. ^

Discriminant analysis of the specialty of elite cyclist

The different demands of competition coupled with the morphological and physiological characteristics of cyclists have led to the appearance of cycling specialities. The aims of this study were to determine the differences in the anthropometric and physiological features in road cyclists with different specialities, and to develop a multivariate model to classify these specialities and predict which speciality may be appropriate to a given cyclist. Twenty male, elite amateur cyclists were classified by their trainers as either flat terrain riders, hill climbers, or all-terrain riders. Anthropometric and cardiorespiratory studies were then undertaken. The results were analysed by MANOVA and two discriminant tests. Most differences between the speciality groups were of an anthropometric nature. The only cardiorespiratory variable that differed significantly (p < 0.05) was maximum oxygen consumption with respect to body weight (VO2max/kg). The first discriminant test classified 100% of the cyclists within their true speciality; the second, which took into account only anthropometric variables, correctly classified 75%. The first discriminant model allows the likely speciality of still non-elite cyclists to be predicted from a small number of variables, and may therefore help in their specific training.

Diseño de un equipo experimental para el estudio de emisiones producidas durante procesos de autocombustión de sólidos

El objetivo de este proyecto es desarrollar un equipo para la realización de un ensayo de emisión de gases. Con esto se pretende simplificar el ensayo de calentamiento de sólidos y emisión de gases y hacerlo más fiable. Para la realización de este proyecto se utilizo un método de ensayo más rudimentario pero también eficaz. Así mismo se analizara el fenómeno de la autocombustión y las propiedades de distintos tipos de biomasa, en concreto dos tipos: astillas de madera y pellets de madera. Las propiedades que son caso de estudio son: las emisiones de gases que se producen durante el proceso de autocombustión; y las temperaturas de inflamación en capa a diferentes tamaños de grano y grosores de capa. Para analizar las propiedades de las muestras de biomasa se realizaran dos tipos de ensayos: ensayos de extracción de gases, y ensayos de temperatura mínima de inflamación en capa. Abstract: The main object of this Project is to develop an equipment to simplify our gas emissions test. During this project a more elementary method was used, however this method is extremely efficient. Also the self-heating phenomenon will be analyzed and several kinds of biomass properties, specifically two: wood chops and wood pellets. The properties that will be analyzed are: gas emissions during the self-heating process; and layer inflammation temperatures at several grain size and layer thickness. The biomass properties will be analyzed with two different tests: gas extraction tests, and TIMc.

Modelo de análisis organizativo para la mejora del desempeño de empresas sociales

La empresa social es un modelo organizativo que presenta un interesante potencial para resolver problemáticas sociales. La empresa social ha despertado interés tanto en países industrializados como en economías en vías de desarrollo porque representa un modelo dentro del capitalismo que persigue objetivos sociales mediante la realización de actividades de mercado (compra y venta de productos y/o servicios principalmente). A pesar de sus raíces lejanas en el tiempo se trata de un campo de conocimiento relativamente joven, donde la literatura académica presenta escasez de estudios empíricos. El desarrollo teórico para buscar claridad conceptual ha sido el principal caballo de batalla de los últimos años, y por tanto, se ha prestado poca atención a generar evidencias sobre cómo funcionan las empresas sociales y sobre sus claves de su éxito. Se considera que la mejora en la comprensión de este modelo organizativo pasa por la construcción de herramientas para que académicos y practicantes mejoren su conocimiento sobre los mecanismos internos de las empresas sociales. En este contexto nace la presente tesis doctoral sobre empresa social, que tiene por objetivo la creación de un marco de análisis que permita el estudio de las empresas sociales desde una dimensión organizativa, es decir, que aborde los elementos clave que describen el funcionamiento de este tipo de organizaciones. Para ello, en este trabajo se aborda la construcción del modelo para el análisis organizativo de las empresas sociales a partir del análisis semántico de las 45 principales definiciones de empresa social. A partir de este análisis se identifican dos dimensiones de análisis de la empresa social: -Cuatro principios, comunes a todas las manifestaciones del fenómeno, que recogen la esencia del concepto. -Ocho elementos organizativos específicos de la empresa social que describen la forma en la que cada iniciativa se implementa en un contexto determinado. Es decir, elementos de diseño presentes en diferente medida que dan lugar a tipologías de empresa social diferentes. Estos elementos son: la proposición de valor social, la búsqueda de impacto a largo plazo, la cultura organizativa, la conexión con los beneficiarios, el liderazgo emprendedor y los mecanismos de gobernanza, el ecosistema colaborativo, la estrategia empresarial y la orientación a la autosuficiencia económica. A partir de este marco de análisis, se construyen dos herramientas de diagnóstico que permiten su aplicación al estudio de empresas sociales: una tabla de indicadores para el análisis externo (por parte de un investigador ajeno a la organización) y un cuestionario de diagnóstico para el análisis interno (a través del personal de la empresa social objeto de estudio). Las herramientas intentan dar respuesta a la necesidad de desarrollar constructos para el estudio empírico de las empresas sociales. Para analizar la utilidad del modelo y de las herramientas se llevaron a cabo tres estudios de caso: -La empresa social ACCIONA Microenergía Perú que proporciona energía eléctrica a comunidades rurales aisladas en la región peruana de Cajamarca. -La empresa social Integra-e que propone un mecanismo de inserción socio-laboral en Madrid para jóvenes en riesgo de exclusión a través de la formación en Tecnologías de la Información y la Comunicación (TIC). -Un conjunto de redes de telecentros pertenecientes a la red LAC de la fundación Telecentres.org que proporcionan acceso a servicios de información (Internet entre otros) en diferentes países de Latinoamérica. La aplicación de las herramientas mostró ser útil en los tres estudios de caso para obtener una relación de evidencias con las que analizar la proximidad de una organización al ideal de empresa social. El ejercicio de análisis también resultó interesante como ejercicio reflexivo para las entidades participantes. Los resultados del cuestionario fueron especialmente interesantes en los telecentros de la Fundación Telecentre.org ya que al ser un estudio multicaso se pudo realizar un rico análisis estadístico sobre el funcionamiento de los telecentros y su desempeño. El estudio permitió identificar relaciones interesantes entre los ocho elementos de diseño del modelo propuesto y el desempeño de la organización. En particular, se detectó que para todos los casos estudiados: -La dimensión económica es la componente del desempeño que mayor desafíos plantea. -La existencia de una alta correlación entre el desempeño y siete de los ocho elementos organizativos del modelo. -La importancia de la cultura organizativa como elemento que explica el desempeño global de la organización y la satisfacción de los empleados. El campo de la empresa social presenta importantes retos de futuro, como la claridad conceptual, el desarrollo de estudios empíricos y la medida de su impacto social. El conocimiento de las claves organizativas puede ayudar a diseñar empresas sociales más robustas o a que organizaciones con fines sociales que no se basan en mecanismos de mercado consideren la posibilidad de incorporar éstos en su estrategia. ABSTRACT Social enterprise is an organizational model with a strong potential to help solving social problems. Recently, interest for the model has risen in both industrialized and developing countries because it is organized to achieve altruistic or social goals through market activities (mainly sales of products and services). Despite its historic roots, it is a relatively young field of research, where academic literature has little empirical data to accompany the theoretical development of social enterprise. Conceptual clarification has been the main challenge during the recent years, and there has been little attention given to generate evidence on how social enterprises operate and their keys to success. Progress in empirical study involves the construction of tools for researchers, in order to increase understanding of the internal mechanisms of social enterprises. This thesis aims to create a conceptual framework to study social enterprises from an organizational point of view, by analyzing the key elements that explain the operation and organization of this organizational model. The framework for the organizational analysis of social enterprises was built supported by the semantic analysis of 45 main definitions of social enterprise. The framework is divided into two dimensions: -There are four principles which capture the essence of the social enterprise concept, and are present in the manifestations of cases. -There are eight design elements which help analyze the characteristics of each particular social enterprise initiative: the social value proposition, social impact orientation, organizational culture, links to beneficiaries, entrepreneurial leadership, collaborative ecosystem, entrepreneurial strategy and orientation to economic self-sufficiency. Two diagnostic tools were developed to apply the framework to case studies: a scoreboard of indicators (to be used by the researcher during external analysis of the organization) and a questionnaire (to be answered by the social enterprise staff). The dissertation undertakes the study of three case studies: -ACCIONA Microenergia Peru, a social enterprise that provides electricity to isolated rural communities in the Peruvian region of Cajamarca. -Integra-e, a social enterprise located in Madrid that promotes socioprofessional integration of young people through training in ICT. -A sample of telecenters of the LAC network that provide access to information services (such as Internet) in Latin America. Applying the tools proved to be useful in all three cases, because it helped to obtain evidence to compare the proximity of an organization to an ideal type of social enterprise. In all the cases studied, the economic sustainability proved to be the biggest challenge for the organizations. The application of the questionnaire to the telecenters was especially informative because it was a multicase study which provided a rich statistical analysis on the performance of call centers. The study identified unique relationships between the model elements and the organziation performance. A statistical analysis shows a high correlation between performance and seven organizational elements described in the model. The organizational culture seems to be an important factor in explaining the overall organizational performance and employee satisfaction. The field of social enterprise has significant future challenges -such as conceptual clarity, the development of empirical studies and social impact assessment. A deep understanding of key organizational aspects of social enterprises can help in the design of more robust organizations and to bring success to social-purpose organizations.

Application of PZT and FBG impedance sensors for structural health monitoring of reinforced concrete beams strengthened with FRP composite materials

Esta Tesis tiene como objetivo principal el desarrollo de métodos de identificación del daño que sean robustos y fiables, enfocados a sistemas estructurales experimentales, fundamentalmente a las estructuras de hormigón armado reforzadas externamente con bandas fibras de polímeros reforzados (FRP). El modo de fallo de este tipo de sistema estructural es crítico, pues generalmente es debido a un despegue repentino y frágil de la banda del refuerzo FRP originado en grietas intermedias causadas por la flexión. La detección de este despegue en su fase inicial es fundamental para prevenir fallos futuros, que pueden ser catastróficos. Inicialmente, se lleva a cabo una revisión del método de la Impedancia Electro-Mecánica (EMI), de cara a exponer sus capacidades para la detección de daño. Una vez la tecnología apropiada es seleccionada, lo que incluye un analizador de impedancias así como novedosos sensores PZT para monitorización inteligente, se ha diseñado un procedimiento automático basado en los registros de impedancias de distintas estructuras de laboratorio. Basándonos en el hecho de que las mediciones de impedancias son posibles gracias a una colocación adecuada de una red de sensores PZT, la estimación de la presencia de daño se realiza analizando los resultados de distintos indicadores de daño obtenidos de la literatura. Para que este proceso sea automático y que no sean necesarios conocimientos previos sobre el método EMI para realizar un experimento, se ha diseñado e implementado un Interfaz Gráfico de Usuario, transformando la medición de impedancias en un proceso fácil e intuitivo. Se evalúa entonces el daño a través de los correspondientes índices de daño, intentando estimar no sólo su severidad, sino también su localización aproximada. El desarrollo de estos experimentos en cualquier estructura genera grandes cantidades de datos que han de ser procesados, y algunas veces los índices de daño no son suficientes para una evaluación completa de la integridad de una estructura. En la mayoría de los casos se pueden encontrar patrones de daño en los datos, pero no se tiene información a priori del estado de la estructura. En este punto, se ha hecho una importante investigación en técnicas de reconocimiento de patrones particularmente en aprendizaje no supervisado, encontrando aplicaciones interesantes en el campo de la medicina. De ahí surge una idea creativa e innovadora: detectar y seguir la evolución del daño en distintas estructuras como si se tratase de un cáncer propagándose por el cuerpo humano. En ese sentido, las lecturas de impedancias se emplean como información intrínseca de la salud de la propia estructura, de forma que se pueden aplicar las mismas técnicas que las empleadas en la investigación del cáncer. En este caso, se ha aplicado un algoritmo de clasificación jerárquica dado que ilustra además la clasificación de los datos de forma gráfica, incluyendo información cualitativa y cuantitativa sobre el daño. Se ha investigado la efectividad de este procedimiento a través de tres estructuras de laboratorio, como son una viga de aluminio, una unión atornillada de aluminio y un bloque de hormigón reforzado con FRP. La primera ayuda a mostrar la efectividad del método en sencillos escenarios de daño simple y múltiple, de forma que las conclusiones extraídas se aplican sobre los otros dos, diseñados para simular condiciones de despegue en distintas estructuras. Demostrada la efectividad del método de clasificación jerárquica de lecturas de impedancias, se aplica el procedimiento sobre las estructuras de hormigón armado reforzadas con bandas de FRP objeto de esta tesis, detectando y clasificando cada estado de daño. Finalmente, y como alternativa al anterior procedimiento, se propone un método para la monitorización continua de la interfase FRP-Hormigón, a través de una red de sensores FBG permanentemente instalados en dicha interfase. De esta forma, se obtienen medidas de deformación de la interfase en condiciones de carga continua, para ser implementadas en un modelo de optimización multiobjetivo, cuya solución se haya por medio de una expansión multiobjetivo del método Particle Swarm Optimization (PSO). La fiabilidad de este último método de detección se investiga a través de sendos ejemplos tanto numéricos como experimentales. ABSTRACT This thesis aims to develop robust and reliable damage identification methods focused on experimental structural systems, in particular Reinforced Concrete (RC) structures externally strengthened with Fiber Reinforced Polymers (FRP) strips. The failure mode of this type of structural system is critical, since it is usually due to sudden and brittle debonding of the FRP reinforcement originating from intermediate flexural cracks. Detection of the debonding in its initial stage is essential thus to prevent future failure, which might be catastrophic. Initially, a revision of the Electro-Mechanical Impedance (EMI) method is carried out, in order to expose its capabilities for local damage detection. Once the appropriate technology is selected, which includes impedance analyzer as well as novel PZT sensors for smart monitoring, an automated procedure has been design based on the impedance signatures of several lab-scale structures. On the basis that capturing impedance measurements is possible thanks to an adequately deployed PZT sensor network, the estimation of damage presence is done by analyzing the results of different damage indices obtained from the literature. In order to make this process automatic so that it is not necessary a priori knowledge of the EMI method to carry out an experimental test, a Graphical User Interface has been designed, turning the impedance measurements into an easy and intuitive procedure. Damage is then assessed through the analysis of the corresponding damage indices, trying to estimate not only the damage severity, but also its approximate location. The development of these tests on any kind of structure generates large amounts of data to be processed, and sometimes the information provided by damage indices is not enough to achieve a complete analysis of the structural health condition. In most of the cases, some damage patterns can be found in the data, but none a priori knowledge of the health condition is given for any structure. At this point, an important research on pattern recognition techniques has been carried out, particularly on unsupervised learning techniques, finding interesting applications in the medicine field. From this investigation, a creative and innovative idea arose: to detect and track the evolution of damage in different structures, as if it were a cancer propagating through a human body. In that sense, the impedance signatures are used to give intrinsic information of the health condition of the structure, so that the same clustering algorithms applied in the cancer research can be applied to the problem addressed in this dissertation. Hierarchical clustering is then applied since it also provides a graphical display of the clustered data, including quantitative and qualitative information about damage. The performance of this approach is firstly investigated using three lab-scale structures, such as a simple aluminium beam, a bolt-jointed aluminium beam and an FRP-strengthened concrete specimen. The first one shows the performance of the method on simple single and multiple damage scenarios, so that the first conclusions can be extracted and applied to the other two experimental tests, which are designed to simulate a debonding condition on different structures. Once the performance of the impedance-based hierarchical clustering method is proven to be successful, it is then applied to the structural system studied in this dissertation, the RC structures externally strengthened with FRP strips, where the debonding failure in the interface between the FRP and the concrete is successfully detected and classified, proving thus the feasibility of this method. Finally, as an alternative to the previous approach, a continuous monitoring procedure of the FRP-Concrete interface is proposed, based on an FBGsensors Network permanently deployed within that interface. In this way, strain measurements can be obtained under controlled loading conditions, and then they are used in order to implement a multi-objective model updating method solved by a multi-objective expansion of the Particle Swarm Optimization (PSO) method. The feasibility of this last proposal is investigated and successfully proven on both numerical and experimental RC beams strengthened with FRP.

The Conserved Core of a Human SIR2 Homologue Functions in Yeast Silencing

Silencing is a universal form of transcriptional regulation in which regions of the genome are reversibly inactivated by changes in chromatin structure. Sir2 (Silent Information Regulator) protein is unique among the silencing factors in Saccharomyces cerevisiae because it silences the rDNA as well as the silent mating-type loci and telomeres. Discovery of a gene family of Homologues of Sir Two (HSTs) in organisms from bacteria to humans suggests that SIR2’s silencing mechanism might be conserved. The Sir2 and Hst proteins share a core domain, which includes two diagnostic sequence motifs of unknown function as well as four cysteines of a putative zinc finger. We demonstrate by mutational analyses that the conserved core and each of its motifs are essential for Sir2p silencing. Chimeras between Sir2p and a human Sir2 homologue (hSir2Ap) indicate that this human protein’s core can substitute for that of Sir2p, implicating the core as a silencing domain. Immunofluorescence studies reveal partially disrupted localization, accounting for the yeast–human chimeras’ ability to function at only a subset of Sir2p’s target loci. Together, these results support a model for the involvement of distinct Sir2p-containing complexes in HM/telomeric and rDNA silencing and that HST family members, including the widely expressed hSir2A, may perform evolutionarily conserved functions.

Effectiveness of the postcoital test: randomised controlled trial

Objectives: To investigate the impact of the postcoital test on the pregnancy rate among subfertile couples and on the number of other diagnostic tests and treatments.