911 resultados para deep venous thrombosis


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Following Ioffe's method of QCD sum rules the structure functions F2(x) for deep inelastic ep and en scattering are calculated. Valence u-quark and d-quark distributions are obtained in the range 0.1 less, approximate x <0.4 and compared with data. In the case of polarized targets the structure function g1(x) and the asymmetry Image Full-size image are calculated. The latter is in satisfactory agreement in sign and magnitude with experiments for x in the range 0.1< x < 0.4.

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Groundwater tables are rising beneath irrigated fields in some areas of the Lower Burdekin in North Queensland, Australia. The soils where this occurs are predominantly sodic clay soils with low hydraulic conductivities. Many of these soils have been treated by applying gypsum or by increasing the salinity of irrigation water by mixing saline groundwater with fresh river water. While the purpose of these treatments is to increase infiltration into the surface soils and improve productivity of the root zone, it is thought that the treatments may have altered the soil hydraulic properties well below the root zone leading to increased groundwater recharge and rising water tables. In this paper we discuss the use of column experiments and HYDRUS modelling, with major ion reaction and transport and soil water chemistry-dependent hydraulic conductivity, to assess the likely depth, magnitude and timing of the impacts of surface soil amelioration on soil hydraulic properties below the root zone and hence groundwater recharge. In the experiments, columns of sodic clays from the Lower Burdekin were leached for extended periods of time with either gypsum solutions or mixed cation salt solutions and change s in hydraulic conductivity were measured. Leaching with a gypsum solution for an extended time period, until the flow rate stabilised, resulted in an approximately twenty fold increase in the hydraulic conductivity when compared with a low salinity, mixed cation solution. HYDRUS modelling was used to high light the role of those factors which might influence the impacts of soil treatment, particularly at depth, including the large amounts of rain during the relatively short wet season and the presence of thick low permeability clay layers.

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A new method is suggested where the thermal activation energy is measured directly and not as a slope of an Arrhenius plot. The sample temperature T is allowed to fluctuate about a temperature T0. The reverse-biased sample diode is repeatedly pulsed towards zero bias and the transient capacitance C1 at time t1 is measured The activation energy is obtained by monitoring the fluctuations in C1 and T. The method has been used to measure the activation energy of the gold acceptor level in silicon.

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In a beam whose depth is comparable to its span, the distribution of bending and shear stresses differs appreciably from those given by the ordinary flexural theory. In this paper, a general solution for the analysis of a rectangular, single-scan beam, under symmetrical loading is developed. The Multiple Fourier procedure is employed using four series by which it has been possible to satisfy all boundary and the resulting relation among the co-efficient are derives.

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Electrically active deep levels related to nickel in silicon are studied under different diffusion conditions, quenching modes, and annealing conditions. The main nickel-related level is at Ev+0.32 eV. Levels at Ev+0.15 and Ev+0.54 eV are not related to nickel while those at Ev+0.50 and Ev+0.28 eV may be nickel related. Their concentrations depend on the quenching mode. There is no nickel-related level in the upper half of the band gap. The complicated annealing behavior of the main nickel-related level is explained on the basis of the formation and dissociation of a nickel-vacany complex. Journal of Applied Physics is copyrighted by The American Institute of Physics.

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Electrical properties of deep defects induced in n-silicon by -particles of about 10 MeV energy at a dose of 1014 and 1015 cm-2 are studied by DLTS. The levels at Ec -0.18 eV, Ec -0.26 eV, and Ec -0.48 eV are identified as A center, V2 (=/-) and V2 (-/0) on the basis of activation energy, electron capture cross section, and annealing behavior. Two other irradiation related levels at Ec -0.28 eV and Ec -0.51 eV could not be related to any known center.

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We thank Andrea Cariati for his comments in response to our article on ‘Risk factors for delayed healing in venous leg ulcers: a review of the literature’. The relationship between lymphoedema and venous disease has not yet been well explored and we acknowledge that impairment of lymph flow may be a risk factor for delayed healing of venous leg ulcers...

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This paper introduces a machine learning based system for controlling a robotic manipulator with visual perception only. The capability to autonomously learn robot controllers solely from raw-pixel images and without any prior knowledge of configuration is shown for the first time. We build upon the success of recent deep reinforcement learning and develop a system for learning target reaching with a three-joint robot manipulator using external visual observation. A Deep Q Network (DQN) was demonstrated to perform target reaching after training in simulation. Transferring the network to real hardware and real observation in a naive approach failed, but experiments show that the network works when replacing camera images with synthetic images.

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Background People admitted to intensive care units and those with chronic health care problems often require long-term vascular access. Central venous access devices (CVADs) are used for administering intravenous medications and blood sampling. CVADs are covered with a dressing and secured with an adhesive or adhesive tape to protect them from infection and reduce movement. Dressings are changed when they become soiled with blood or start to come away from the skin. Repeated removal and application of dressings can cause damage to the skin. The skin is an important barrier that protects the body against infection. Less frequent dressing changes may reduce skin damage, but it is unclear whether this practice affects the frequency of catheter-related infections. Objectives To assess the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections and other outcomes including pain and skin damage. Search methods In June 2015 we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched clinical trials registries for registered trials. There were no restrictions with respect to language, date of publication or study setting. Selection criteria All randomised controlled trials (RCTs) evaluating the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections on all patients in any healthcare setting. Data collection and analysis We used standard Cochrane review methodology. Two review authors independently assessed studies for inclusion, performed risk of bias assessment and data extraction. We undertook meta-analysis where appropriate or otherwise synthesised data descriptively when heterogeneous. Main results We included five RCTs (2277 participants) that compared different frequencies of CVAD dressing changes. The studies were all conducted in Europe and published between 1995 and 2009. Participants were recruited from the intensive care and cancer care departments of one children's and four adult hospitals. The studies used a variety of transparent dressings and compared a longer interval between dressing changes (5 to15 days; intervention) with a shorter interval between changes (2 to 5 days; control). In each study participants were followed up until the CVAD was removed or until discharge from ICU or hospital. - Confirmed catheter-related bloodstream infection (CRBSI) One trial randomised 995 people receiving central venous catheters to a longer or shorter interval between dressing changes and measured CRBSI. It is unclear whether there is a difference in the risk of CRBSI between people having long or short intervals between dressing changes (RR 1.42, 95% confidence interval (CI) 0.40 to 4.98) (low quality evidence). - Suspected catheter-related bloodstream infection Two trials randomised a total of 151 participants to longer or shorter dressing intervals and measured suspected CRBSI. It is unclear whether there is a difference in the risk of suspected CRBSI between people having long or short intervals between dressing changes (RR 0.70, 95% CI 0.23 to 2.10) (low quality evidence). - All cause mortality Three trials randomised a total of 896 participants to longer or shorter dressing intervals and measured all cause mortality. It is unclear whether there is a difference in the risk of death from any cause between people having long or short intervals between dressing changes (RR 1.06, 95% CI 0.90 to 1.25) (low quality evidence). - Catheter-site infection Two trials randomised a total of 371 participants to longer or shorter dressing intervals and measured catheter-site infection. It is unclear whether there is a difference in risk of catheter-site infection between people having long or short intervals between dressing changes (RR 1.07, 95% CI 0.71 to 1.63) (low quality evidence). - Skin damage One small trial (112 children) and three trials (1475 adults) measured skin damage. There was very low quality evidence for the effect of long intervals between dressing changes on skin damage compared with short intervals (children: RR of scoring ≥ 2 on the skin damage scale 0.33, 95% CI 0.16 to 0.68; data for adults not pooled). - Pain Two studies involving 193 participants measured pain. It is unclear if there is a difference between long and short interval dressing changes on pain during dressing removal (RR 0.80, 95% CI 0.46 to 1.38) (low quality evidence). Authors' conclusions The best available evidence is currently inconclusive regarding whether longer intervals between CVAD dressing changes are associated with more or less catheter-related infection, mortality or pain than shorter intervals.

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Two field experiments were established in central Queensland at Capella and Gindie to investigate the immediate and then residual benefit of deep placed (20 cm) nutrients in this opportunity cropping system. The field sites had factorial combinations of P (40 kg P/ha), K (200 kg K/ha) and S (40 kg S/ha) and all plots received 100 kg N/ha. No further K or S fertilizers were added during the experiment but some crops had starter P. The Capella site was sown to chickpea in 2012, wheat in 2013 and then chickpea in 2014. The Gindie site was sown to sorghum in 2011/12, chickpea in 2013 and sorghum in early 2015. There were responses to P alone in the first two crops at each site and there were K responses in half the six site years. In year 1 (a good year) both sites showed a 20% grain yield response to only to deep P. In year 2 (much drier) the effects of deep P were still evident at both sites and the effects of K were clearly evident at Gindie. There was a suggestion of an additive P+K effect at Capella and a 50% increase for P+K at Gindie. Year 3 was dry and chickpeas at Capella showed a larger response to P+K but the sorghum at Gindie only responded to deep K. These results indicate that responses to deep placed P and K are durable over an opportunity cropping system, and meeting both requirements is important to achieve yield responses.

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Background Around the world, guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) vary greatly. To prevent occlusion, most institutions recommend the use of heparin when the CVC is not in use. However, there is debate regarding the need for heparin and evidence to suggest normal saline may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased costs. Objectives To assess the clinical effects (benefits and harms) of heparin versus normal saline to prevent occlusion in long-term central venous catheters in infants, children and adolescents. Design A Cochrane systematic review of randomised controlled trials was undertaken. - Data sources: The Cochrane Vascular Group Specialised Register (including MEDLINE, CINAHL, EMBASE and AMED) and the Cochrane Register of Studies were searched. Hand searching of relevant journals and reference lists of retrieved articles was also undertaken. - Review Methods: Data were extracted and appraisal undertaken. We included studies that compared the efficacy of normal saline with heparin to prevent occlusion. We excluded temporary CVCs and peripherally inserted central catheters. Rate ratios per 1000 catheter days were calculated for two outcomes, occlusion of the CVC, and CVC-associated blood stream infection. Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin. However, between studies, all used different protocols with various concentrations of heparin and frequency of flushes. The quality of the evidence ranged from low to very low. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). Conclusions It remains unclear whether heparin is necessary for CVC maintenance. More well-designed studies are required to understand this relatively simple, but clinically important question. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

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Kidney transplantation (Tx) is the treatment of choice for end stage renal disease. Immunosuppressive medications are given to prevent an immunological rejection of the transplant. However, immunosuppressive drugs increase e.g. the risk of infection, cancer or nephrotoxicity. A major genetic contributors to immunological acceptance of the graft are human leukocyte antigen (HLA) genes. Also other non-HLA gene polymorphisms may predict the future risk of complications before Tx, possibly enabling individualised immunotherapy. Graft function after Tx is monitored using non-specific clinical symptoms and laboratory markers. The definitive diagnosis of graft rejection however relies on a biopsy of the graft. In the acute rejection (AR) diagnostics there is a need for an alternative to biopsy that would be an easily repeatable and simple method for regular use. Frequent surveillance of acute or subclinical rejection (SCR) may improve long-term function. In this thesis, associations between cytokine and thrombosis associated candidate genes and the outcome of kidney Tx were studied. Cytotoxic and co-stimulatory T lymphocyte molecule gene expression biomarkers for the diagnosis of the AR and the SCR were also investigated. We found that polymorphisms in the cytokine genes tumor necrosis factor and interleukin 10 (IL10) of the recipients were associated with AR. In addition, certain IL10 gene polymorphisms of the donors were associated with the incidence of cytomegalovirus infection and occurrence of later infection in a subpopulation of recipients. Further, polymorphisms in genes related to the risk of thrombosis and those of certain cytokines were not associated with the occurrence of thrombosis, infarction, AR or graft survival. In the study of biomarkers for AR, whole blood samples were prospectively collected from adult kidney Tx patients. With real-time quantitative PCR (RT-QPCR) gene expression quantities of CD154 and ICOS differentiated the patients with AR from those without, but not from the patients with other causes of graft dysfunction. Biomarkers for SCR were studied in paediatric kidney Tx patients. We used RT-QPCR to quantify the gene expression of immunological candidate genes in a low-density array format. In addition, we used RT-QPCR to validate the results of the microarray analysis. No gene marker differentiated patients with SCR from those without SCR. This research demonstrates the lack of robust markers among polymorphisms or biomarkers in investigated genes that could be included in routine analysis in a clinical laboratory. In genetic studies, kidney Tx can be regarded as a complex trait, i.e. several environmental and genetic factors may determine its outcome. A number of currently unknown genetic factors probably influence the results of Tx.

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This chapter provides a critical legal geography of outer Space, charting the topography of the debates and struggles around its definition, management, and possession. As the emerging field of critical legal geography demonstrates, law is not a neutral organiser of space, but is instead a powerful cultural technology of spatial production. Drawing on legal documents such as the Outer Space Treaty and the Moon Treaty, as well as on the analogous and precedent-setting legal geographies of Antarctica and the deep seabed, the chapter addresses key questions about the legal geography of outer Space, questions which are of growing importance as Space’s available satellite spaces in the geostationary orbit diminish, Space weapons and mining become increasingly viable, Space colonisation and tourism emerge, and questions about Space’s legal status grow in intensity. Who owns outer Space? Who, and whose rules, govern what may or may not (literally) take place there? Is the geostationary orbit the sovereign property of the equatorial states it supertends, as these states argued in the 1970s? Or is it a part of the res communis, or common property of humanity, which currently legally characterises outer Space? Does Space belong to no one, or to everyone? As challenges to the existing legal spatiality of outer Space emerge from spacefaring states, companies, and non-spacefaring states, it is particularly critical that the current spatiality of Space is understood and considered.

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At the beginning of 2008, I visited a watershed, located in Karkinatam village in the state of Karnataka, South India, where crops are intensively irrigated using groundwater. The water table had been depleted from a depth of 5 to 50 m in a large part of the area. Presently, 42% of a total of 158 water wells in the watershed are dry. Speaking with the farmers, I have been amazed to learn that they were drilling down to 500 m to tap water. This case is, of course, not isolated.