Tacrolimus vs. Azathioprine in myasthenia gravis treatment: a multicenter, prospective, randomized, double blind, head to head clinical trial

Current evidences show that tacrolimus could be a good therapeutic option in patients non-responsive to first-line treatments and even it could become one of the first-line drugs for treating MG. Our study will try to determine the effectivity and safety of tacrolimus in 190 myasthenia gravis patients with suboptimal response to azathioprine: after 12 months of treatment they will be randomized to continue with azathioprine or they will be switched to tacrolimus. Patients will follow the allocated treatment during 14 months and the response will be assessed as well as adverse effectsPURPOSE: To compare azathioprine vs. tacrolimus effectivity and safety in MG patients with suboptimal response to azathioprine at 12 monthsDESIGN: A 14 months multicenter, prospective, randomized, double blind, head to head clinical trial

Targeted vs. standard treatment against Helicobacter pylori: safety assessment clinical trial

Helicobacter pylori (H. pylori) is a gram negative bacteria that represents a considerable global burden in the world and is related to many gastrointestinal diseases (peptic ulcer, gastric MALT lymphoma or gastric cancer). Currently the triple standard therapy is less used as there is an increase of the clarithromycin resistance. Therefore patients have to receive several lines of treatment with the consequence of adverse events and the possibility to interrupt the treatment. This is why the main objective is to determine if making a culture and antibiogram to do a targeted treatment cause less adverse events with the same eradication than making an empirical treatment to eradicate H. pylori. The secondary objective is to determine the prevalence of resistance to clarithromycin in the province of GironaThis is a multicentre clinical trial without blinding; patients are selected by non-probabilistic sampling, with a total sample of 868 patients randomized in two equal groups of 434 patients in each group. The study will last 2 years. The endpoints will be to evaluate the adverse events and eradication of each group of patients. Also it will be evaluated the resistance to clarithromycin

TCDI vs TCD for stroke risk prevention in children with sickle cell anemia: a cross-sectional study

Children with sickle cell anemia (SCA) are at increased risk of stroke. Elevated blood-flow velocities in the middle cerebral artery detected by Transcranial Doppler (TCD) are a good predictor of stroke risk in these children. Velocities obtained by TCD are measured by using a specific parameter, the time-averaged mean of the maximum velocity (TAMM). Children with TAMM velocities ≥200 cm/sec are at high risk of stroke, and transfusions as primary prevention might be done. Transcranial Doppler-imaging (TCDI) is now widely available and it allows the visualization of intracranial vessels.Few studies have compared the TAMM in TCD and TCDI, and no studies have established a cutoff point for TAMM in TCDI equivalent to the STOP criteria of “normal”, “conditional” and “abnormal”, which could predict a high risk of stroke in children with SCAObjectives: To compare the TAMM velocity obtained by TCDI with the TAMM velocity obtained with TCD in the middle cerebral artery, and to determine a cutoff point for TAMM in TCDI that could predict a high risk of stroke in children with SCAMethods: This study is a cross-sectional study of a diagnostic test. 78 children with sickle cell anemia between 2 to 16 years will be evaluated with both TCD and TCDI in order to determinate the TAMM with the two devices. Velocities obtained with both Doppler techniques will be compared using an intraclass correlation coefficient

El enfoque financiero vs. el enfoque social del microcrédito. un análisis comparativo mundial

La oferta del microcrédito por parte de las instituciones microfinancieras distingue dos enfoques, el llamado 'alivio de la pobreza' y el de 'autosostenibilidad financiera'. En este trabajo se hace una comparativa mundial de cuatro regiones de países en vías de desarrollo con el fin de identificar bajo qué enfoque la población accede al microcrédito y a su vez verificar si existe un trade off entre ambos enfoques. Para su contrastación se han utilizado diez indicadores financieros y sociales clasificados en dos categorías, la sostenibilidad financiera y el alcance (nivel de pobreza). Los resultados obtenidos concluyen que el modelo financiero se presenta con más notoriedad en las regiones de América Latina y el Caribe y Oriente Medio/África del Norte mientras que en África prevalece el modelo social y en la región de Asia Meridional se aprecia un equilibrio entre ambos enfoques. Igualmente, se constata la contribución al alivio de la pobreza cuando el acceso del microcrédito se dirige mayoritariamente a la mujer.

Innovaattorin dilemma - Kehittäminen vs. Parantaminen

Työssä tutkimme parantamis- ja kehittämisstrategiaa ja niiden yhteiskäyttöä eli ambidekstriaa. Tavoitteenamme on tuoda parantamis- ja kehittämisstrategian erot esille ja sijoittaa strategiat tuotteen elinkaarelle. Esittelemme organisaation ambidekstrian hallintaa ja vaikeuksia. Esittelemme ensin parantamis- ja kehittämisstrategian termit, eri innovaatiostrategiat ja tuotteen elinkaari mallit ja ambidekstrian kirjallisuuden pohjalta. Tämän jälkeen esittelemme case materiaalimme. Materiaalin pohjalta sijoitamme strategiat tuotteen elinkaarelle ja tuomme casessa esiintyneitä ambidekstrian ominaisuuksia esille. Tavoitteemme pohjalta voimme sanoa, että tuotteen elinkaaren vaiheilla ja parantamis- ja kehittämisstrategioilla on selvä yhteys ja strategiat sijoittuvat hyvin elinkaarelle. Ambidekstrian hallitseminen, eli parantamis- ja kehittämisstrategian tasapainon löytäminen ei ole helppoa, sillä strategiat ovat hyvin erilaisia keskenään. Hallinta vaatii paljon työtä, hyvän reagointikyvyn ja ennustamisen taidon, jotta yritys pysyy mukana muutoksessa ja mielellään hieman edellä, jos mielii teknologiajohtajaksi.

Estresse hídrico em plantio de Eucalyptus grandis vs. Eucalyptus urophylla, em função do solo, substrato e manejo hídrico de viveiro

O objetivo deste trabalho foi avaliar em campo os níveis de estresse hídrico das mudas de Eucalyptus grandis vs. Eucalyptus urophylla selecionado para tolerância ao déficit hídrico, em função dos substratos, do manejo hídrico e dos solos. As mudas foram produzidas em dois viveiros distintos do Estado de São Paulo: com o substrato Plantmax estacas® (PLX) em Bofete (SP) e com a mistura em partes iguais de casca de arroz carbonizada e vermiculita (CAC), em Ibaté (SP). A partir dos 60 dias após a estaquia (DAE), durante a rustificação as mudas foram manejadas com cinco frequências de irrigação por subsuperfície: F1 - irrigado uma vez ao dia, F2 - irrigado duas vezes ao dia, F3 - irrigado três vezes ao dia, F4 - irrigado quatro vezes ao dia e FD - mantido em irrigação, restabelecendo a capacidade de campo até o plantio aos 90 DAE, em um solo argiloso e outro arenoso. Foram realizadas avaliações dos níveis de estresse (brando, moderado e severo), que afetaram a sobrevivência nos dois solos, por meio de censo aos 15 e aos 30 dias após o plantio. Com relação aos níveis de estresse avaliados, verificou-se pouca influência do substrato, porém onde ocorreu o PLX proporcionou menores percentuais de plantas afetadas. Independentemente do tipo de solo onde as mudas foram plantadas, os sintomas de estresse nas plantas, de modo geral, foram semelhantes. O manejo de viveiro não influenciou na sobrevivência das mudas, embora tenham ocorrido algumas diferenças estatísticas quando se usaram CAC e plantio no solo arenoso, porém sem tendência clara de comportamento. Os critérios relativos à implantação foram mais determinantes na sobrevivência das mudas no campo até os 30 dias após o plantio, indicando a necessidade de replantio.

Suporte para pontos totais de segurança: modelo mk vs. modelo vs. convencional

Os autores comparam um modelo convencional de suporte para pontos totais de segurança da parede abdominal com um novo modelo desenvolvido pelo Instituto de Bioengenharia Erasto Gaertner (IBEG) - o modelo MK, avaliando sua efetividade, ocorrência de complicações, aspecto estético, dor na cicatriz cirúrgica e viabilidade econômica. Foram estudados 66 pacientes submetidos a cirurgia abdominal em dois hospitais de Curitiba (Hospital Erasto Gaertner e Hospital de Clínicas da Universidade Federal do Paraná), no período de maio a julho de 1996. Os pacientes foram divididos em dois grupos: no primeiro grupo foi utilizado o modelo MK, enquanto no segundo utilizou-se o modelo convencional. O modelo MK demonstrou menor índice de complicações, entre as quais: hematoma (p=0,01), coleção sero-hemática (p=0,01), abscesso subcutâneo (p=0,01) e úlcera decorrente dos pontos totais (p=0,02). No que diz respeito à dor, o modelo MK foi mais bem tolerado pelos pacientes, com diferença estatisticamente significativa (p=0,004). O resultado estético e a ocorrência de deiscência, evisceração, hérnia incisional e infecção não mostraram diferença significativa entre os dois grupos. O modelo MK mostrou ser efetivo como suporte para pontos totais de segurança, com uma menor incidência de complicações e menor índice de dor local.

University Image vs. University Identity: Congruence between Expectations and Experience

The aim of this thesis was to examine congruencies between university identity and university images of prospective and current students. Therefore, factors essentially influencing on expected and experienced university images were identified. Providing an understanding on the differences in the formation of both concepts allowed the analysis of potential incongruities between a university’s identity and the perceptions its students hold. The study was conducted in July and August 2013 at Lappeenranta University of Technology by means of a web-based research survey. The sample consisted of 160 international Master’s degree students who were admitted in 2011, 2012 and 2013. Descriptive and multivariate statistical analysis methods were used to process the data. The results of the study indicated statistically significant incongruities between the case university’s identity and its students’ images. Further, the expected and experienced university images showed incongruities to each other. Deviations were additionally detected to be dependent on the students’ home regions. All in all, there is potential for an improvement of the students’ experiences resulting from a low perception of the student’s preparation for future job life.

ERP Systems as Investments: Analysing Costs vs. Benefits

An ERP system investment analysis method using a Fuzzy Pay-Off approach for Real Option valuation is examined. It is studied, how the investment can be incrementally adopted and analyzed as a compounding Real Option model. The modeling allows follow-up. IS system development model COCOMO is presented as an example for investment analysis. The thesis presents the usage of Real Options as an alternative for the valuation of an investment. An idea is presented to use a continuous investment follow-up during the investment. This analysis can be performed using Real Options. As a tool for the analysis, the Fuzzy Pay-Off method is presented as an alternative for investment valuation.

Library vs publisher vs archive: managing the UK geospatial record

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014