878 resultados para 32F25 (Primary), 53C42 (Secondary)


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Tutkielman tavoitteena oli arvioida puutuotteen markkinapotentiaalia Saksassa, Ranskassa ja Hollannissa sekä tuottaa markkinainformaatiota case-yrityksen investointipäätösten pohjaksi. Teoreettista tietoa markkinapotentiaalin arvioimisesta ja kilpailun analysoimisesta sovellettiin tutkittavan tuotteen markkinoiden kartoittamiseksi. Työssä tutkittiin rakentamisessa käytettävien puutuotteiden markkinoihin vaikuttavia trendejä niiden markkinoiden tulevaisuuden kehityksen arvioimiseksi. Kyseessä oli soveltava case-tutkimus, joka toteutettiin kirjoituspöytä- ja haastattelututkimuksen yhdistelmänä. Primaaritutkimus suoritettiin puhelimitse ja henkilökohtaisella haastattelulla. Tutkimusaineistoa arvioitiin kvalitatiivisesti. Tutkimuksen avulla saatiin käsitys kyseisen puutuotteen markkinoiden koosta ja sen markkinoiden kehitykseen vaikuttavista tekijöistä. Tutkimuksessa arvioitiin myös korkean jalostusasteen puutuotteen markkinoijalta vaadittavia ominaisuuksia ja menestystekijöitä.

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Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. As SABR may be associated with serious toxicity, attention should be paid for an accurate patients' selection.

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Transarterial radioembolization consist in delivering small particles loaded with Yttrium90, a pure beta emitter, in order to treat primary and secondary liver tumors. This treatment needs precaution since inadequate delivery of these beads can lead to severe complications. Moreover, a precise radiation dosing is crucial to achieve a good clinical success and to avoid complications such as radioembolization-induced liver disease. This review describes all the precautions and highlights clinical and technical considerations that need to be taken to avoid complications.

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Diplomityön tavoitteena oli kokeellisen tutkimuksen keinoin selvittää juotettujen levylämmönsiirtimien levypakkarakenteessa virtausten käyttäytyminen ja jakautuminen sekä löytää ideoita ja kehitysehdotuksia levylämmönsiirtimen levypakan ja levyprofiilin kehittämiseksi. Kokeellinen tutkimus suoritettiin Oy Danfoss Ab LPM:n levylämmönsiirtimien tutkimuslaboratoriossa. Virtausjakauman tutkimusta varten suunniteltiin ja valittiin tutkimuslaitteisto, joka koostui termoelementtiantureista, tiedonkeruulaitteistosta sekä ohjelmistosta. Lämmönsiirtimistä mitattiin ensiö- ja toisiopuolen tilavuusvirrat ja painehäviöt sekä lämpötilat ennen ja jälkeen lämmönsiirtimen. Tutkimuslaitteiston avulla mitattiin lämpötiloja lämmönsiirtimen sisältä levyväleistä. Mittaukset suoritettiin neljällä levypakkarakenteella useilla massavirran arvoilla. Mittaustuloksista määritettiin levylämmönsiirtimien lämpö- ja virtaustekniset ominaisuudet nesteen Reynoldsin luvun funktiona sekä selvitettiin nesteen virtausjakaumat. Mittaustuloksien perusteella laskettuja virtausjakauman arvoja verrattiin teorian mukaan laskettuihin jakaumiin. Mitatuista siirtimistä lasketut massavirrat viittaavat siihen, että suurin osa nesteestä virtaa siirtimien keskeltä tai lähempää loppupäätä kuin alkupäästä. Teorian mukaan suurin nestemäärä virtaisi siirtimen alkupäästä vähentyen tasaisesti kohti levypakan loppupäätä. Teorian mukaiselle virtausjakaumalle ja lasketuille jakaumille ei löydetty yhteyttä. Tutkimuksessa havaittiin suuria, jopa yli 20 asteen, lämpötilaeroja levyväleistä ulostulevissa virtauksissa. Levyvälien virtauksen käyttäytymisen ja jakautumisen tutkiminen nähdäänkin levypakan pitkittäistä kehittämistä suurempana mielenkiinnon ja kehittämisen kohteena.

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Muscular function of the neck region may be of importance for the etiology of headache, especially of tension-type headache. However, very few data exist on the association of neck muscle function with different types of headache in adolescents. The main aim of the study was to examine the association of neck muscle function with adolescent headache. The associations between leisure time activities, endurance strength of the upper extremities (UE endurance) and mobility of the neck-shoulder region and adolescent headache were studied. In addition, the associations of force production, EMG/force ratio, co-activation and fatigue characteristics, and cross-sectional area (CSA) of neck muscles with adolescent headache were studied. The study is part of a population-based cohort study of 12-year-old children with and without headache. The study had five phases (years 1998-2003). At the age of 13 years, a sample of 183 adolescents (183/311) participated in endurance strength and mobility measurements of the neck-shoulder region. In addition, the type and level of physical and other leisure activity were elicited with open and structured questions. At the age of 17 years, a random sample of 89 adolescents (89/202) participated in force and EMG measurements of the neck-shoulder muscles. In addition, at the age of 17 years, a sample of 65 adolescents (65/89) participated in CSA measurements of the neck muscles. At the age of 13 years, intensive participation in overall sports activity was associated with migraine. Frequent computer use was associated both with migraine and tension-type headache. The type of sports or other leisure activity classified them on the basis of body loading was not associated with headache type. In girls, low UE endurance of both sides, and low cervical rotation of the dominant side, were associated with tension-type headache, and low UE endurance of non-dominant side with migraine. In boys, no associations occurred between UE endurance and mobility variables and headache types. At the age of 17 years, in girls, high EMG/force ratios between the EMG of the left agonist sternocleidomastoid muscle (SCM) and maximal neck flexion and neck rotation force to the right side as well as high co-activation of right antagonist cervical erector spinae (CES) muscles during maximal neck flexion force were associated with migraine-type headache. In girls, neck force production was not associated with headache types but low left shoulder flexion force was associated with tension-type headache. In boys, no associations were found between EMG and force variables and headache. Increased SCM muscles fatigue of both sides was associated with tension-type headache. In boys, the small CSA of the right SCM muscle and, in girls, of combined right SCM and scalenus muscles was associated with tension-type headache. Similarly, in boys, the large CSA of the right SCM muscle, of the combined right SCM and scalenus muscles, of the left semispinalis capitis muscle, of the combined left semispinalis and splenius muscles was associated with migraine. No other differences in the CSA of neck flexion or extension muscles were found. Differences in the neuromucular function of the neck-shoulder muscles were associated with adolescent headache, especially in girls. Differences in the cross-sectional area of unilateral neck muscles were associated with headache, especially in boys. Differences in the neuromuscular function and in the cross-sectional area of the neck muscles also occurred between different types of headache. It remains to be established whether the findings are primary or secondary to adolescent migraine and tension headache. Keywords: adolescent, cross-sectional area, electromyography, endurance strength, fatigue, force, headache, leisure time activity, migraine, mobility, neck muscles, tension-type headache

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BACKGROUND AND AIMS: Data from prospective cohorts describing dyslipidaemia prevalence and treatment trends are lacking. Using data from the prospective CoLaus study, we aimed to examine changes in serum lipid levels, dyslipidaemia prevalence and management in a population-based sample of Swiss adults. METHODS AND RESULTS: Cardiovascular risk was assessed using PROCAM. Dyslipidaemia and low-density lipoprotein cholesterol (LDL-C) target levels were defined according to the Swiss Group for Lipids and Atherosclerosis. Complete baseline and follow up (FU) data were available for n = 4863 subjects during mean FU time of 5.6 years. Overall, 32.1% of participants were dyslipidaemic at baseline vs 46.3% at FU (p < 0.001). During this time, lipid lowering medication (LLM) rates among dyslipidaemic subjects increased from 34.0% to 39.2% (p < 0.001). In secondary prevention, LLM rates were 42.7% at baseline and 53.2% at FU (p = 0.004). In multivariate analysis, LLM use among dyslipidaemic subjects, between baseline and FU, was positively associated with personal history of CVD, older age, hypertension, higher BMI and diabetes, while negatively associated with higher educational level. Among treated subjects, LDL-C target achievement was positively associated with diabetes and negatively associated with personal history of CVD and higher BMI. Among subjects treated at baseline, LLM discontinuation was negatively associated with older age, male sex, smoking, hypertension and parental history of CVD. CONCLUSIONS: In Switzerland, the increase over time in dyslipidaemia prevalence was not paralleled by a similar increase in LLM. In a real-life setting, dyslipidaemia management remains far from optimal, both in primary and secondary prevention.

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Elderly patients in palliative situations residing in a nursing home present characteristics and specificities that clearly distinguish them from patients with advanced cancer. Besides the difficulty to define a precise prognosis, their many comorbidities, their communication difficulties because of cognitive disorders, their high sensitivity to primary and secondary effects of drugs render their management a real challenge for physician and caregivers. Accompanying these patients at the end of their life also raises many ethical problems, especially when they are no longer able to express their wishes and have not previously expressed advance directives.

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BACKGROUND: Tinnitus is an often disabling condition for which there is no effective therapy. Current research suggests that tinnitus may develop due to maladaptive plastic changes and altered activity in the auditory and prefrontal cortex. Transcranial direct current stimulation (tDCS) modulates brain activity and has been shown to transiently suppress tinnitus in trials. OBJECTIVE: To investigate the efficacy and safety of tDCS in the treatment of chronic subjective tinnitus. METHODS: In a randomized, parallel, double-blind, sham-controlled study, the efficacy and safety of cathodal tDCS to the auditory cortex with anode over the prefrontal cortex was investigated in five sessions over five consecutive days. Tinnitus was assessed after the last session on day 5, and at follow-up visits 1 and 3 months post stimulation using the Tinnitus Handicap Inventory (THI, primary outcome measure), Subjective Tinnitus Severity Scale, Hospital Anxiety and Depression scale, Visual Analogue Scale, and Clinical Global Impression scale. RESULTS: 42 patients were investigated, 21 received tDCS and 21 sham stimulation. There were no beneficial effects of tDCS on tinnitus as assessed by primary and secondary outcome measures. Effect size assessed with Cohen's d amounted to 0.08 (95% CI: -0.52 to 0.69) at 1 month and 0.18 (95% CI: -0.43 to 0.78) at 3 months for the THI. CONCLUSION: tDCS of the auditory and prefrontal cortices is safe, but does not improve tinnitus. Different tDCS protocols might be beneficial.

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Objective: To evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis.

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[Summary] 2. Roles of quality control in the pharmaceutical and biopharmaceutical industries. - 2.1. Pharmaceutical industry. - 2.2. Biopharmaceutical industry. - 2.3. Policy and regulatory. - 2.3.1. The US Food and Drug Administration (FDA). - 2.3.2. The European Medicine Agency (EMEA). - 2.3.3. The Japanese Ministry of Work, Labor and Welfare (MHLW). - 2.3.4. The Swiss Agency for Therapeutic Products (Swissmedic). - 2.3.5. The International Conference on Harmonization (ICH). - - 3. Types of testing. - 3.1. Microbiological purity tests. - 3.2. Physiochemical tests. - 3.3. Critical to quality steps. - 3.3.1. API starting materials and excipients. - 3.3.2. Intermediates. - 3.3.3. APIs (drug substances) and final drug product. - 3.3.4. Primary and secondary packaging materials fro drug products. - - 4. Manufacturing cost and quality control. - 4.1.1. Pharmaceutical manufacturing cost breakdown. - 4.1.2. Biopharmaceutical manufacturing cost breakdown. - 4.2. Batch failure / rejection / rework / recalls. - - 5. Future trends in the quality control of pharmaceuticals and biopharmaceuticals. - 5.1. Rapid and real time testing. - 5.1.1. Physio-chemicals testing. - 5.1.2. Rapid microbiology methods

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The main objectives and findings of this first research report are presented in this chapter."The Implementation of the Internet in the Spanish Education System: State of Affairs and Future Prospects" is a large-scale research project that seeks to obtain relevant data about the introduction and dissemination of Information and Communication Technology, particularly the internet, in the practical and organizational general procedures of the Spanish schools and high schools. The project articulates the processes of ICT implementation on the primary and secondary education levels embracing a holistic approach, propped up by an empirical and analytical research methodology. Thus, our survey does not intend to detect which is the impact of ICT on school activities but how all the agents involved in the school community incorporate ICT and what use they make of it. We are especially interested in identifying the teachers' pedagogical and professional uses of ICT, how students use it in their activities and to what extent it contributes in reinforcing teamwork and participation proceedings in the institutions, as well as the relations between the latter and their context. It is also of our interest to know the factors that exert the strongest influence on the way teachers, head teachers and students make use of ICT. Finally, we intend to identify the ways ICT may contribute to the improvementof educational practices.

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The intervention in the organized conflicts and, particularly, the confrontation of hostile situations (based on the emotional alteration, the strain, the verbal aggressiveness, etc) is one of the aspects that worry the principals of the educative centres and, therefore, a main attention must be given to the initial and permanent training to have managing duties. Throughout the text we take some aspects into account in the development of these managing skills:a) we set the distinctive features; b) we answer to the dilemma about the existence of improvement possibilities; c) we state the need to star from the motivation and the active participation of the principals in their own personal development and, finally, d) we contribute with the design of a training activity to develop skills to confront hostile situations, addressed to the principals of primary and secondary schools, that was done in Girona, in November 2005

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A new model for the H2 antagonists binding site is postulated based on adsorption coefficient values of sixteen antagonists, in the affinities constants of the primary and secondary binding sites, and in the chemical characterization of these sites by 3D-QSAR. All study compounds are in the extended conformation and deprotonated form. The lateral validation of the QSARs, CoMFA analysis, affinity constants and chemical similarity data suggest that the antagonists block the proton pump in the H2 receptor interacting with two tyrosines - one in the helix 5, and other in the helix 6.

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This review reports the determination of absolute configuration of primary and secondary alcohols by ¹H NMR spectroscopy, using the Mosher method. This method consists in the derivatization of an alcohol possessig unknown absolute configuration with one or both enantiomers of an auxiliary reagent. The resulting diastereoisomer spectra are registered and compared, and the chemical shift differences (DdR,S = deltaR - deltaS) are measured. The determination of the absolute configuration of the alcohol molecule is based on the correlation between its chiral center and the auxiliary reagent's chiral center. Therefore, the determination of the absolute configuration depends on aromatic ring shielding effects on the substituents of the alcohol as evidenced by the ¹H NMR spectrum.

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The starting point of our investigation was the longstanding notion that bilingual individuals need effective mechanisms to prevent interference from one language while processing material in the other (e.g. Penfield and Roberts, 1959). To demonstrate how the prevention of interference is implemented in the brain we employed event-related brain potentials (ERPs; see Munte, Urbach, ¨ Duzel and Kutas, 2000, for an introductory review) ¨ and functional magnetic resonance imaging (fMRI) techniques, thus pursuing a combined temporal and spatial imaging approach. In contrast to previous investigations using neuroimaging techniques in bilinguals, which had been mainly concerned with the localization of the primary and secondary languages (e.g. Perani, Paulesu, Galles, Dupoux, Dehaene, Bettinardi, Cappa, Fazio and Mehler, 1998; Chee, Caplan, Soon, Sriram, Tan, Thiel and Weekes, 1999), our study addressed the dynamic aspects of bilingual language processing.