924 resultados para Convergence insufficiency
Resumo:
We establish the convergence of pseudospectra in Hausdorff distance for closed operators acting in different Hilbert spaces and converging in the generalised norm resolvent sense. As an assumption, we exclude the case that the limiting operator has constant resolvent norm on an open set. We extend the class of operators for which it is known that the latter cannot happen by showing that if the resolvent norm is constant on an open set, then this constant is the global minimum. We present a number of examples exhibiting various resolvent norm behaviours and illustrating the applicability of this characterisation compared to known results.
Resumo:
BACKGROUND: In clinical practise the high dose ACTH stimulation test (HDT) is frequently used in the assessment of adrenal insufficiency (AI). However, there is uncertainty regarding optimal time-points and number of blood samplings. The present study compared the utility of a single cortisol value taken either 30 or 60 minutes after ACTH stimulation with the traditional interpretation of the HDT. METHODS: Retrospective analysis of 73 HDT performed at a single tertiary endocrine centre. Serum cortisol was measured at baseline, 30 and 60 minutes after intravenous administration of 250 µg synthetic ACTH1-24. Adrenal insufficiency (AI) was defined as a stimulated cortisol level <550 nmol/l. RESULTS: There were twenty patients (27.4%) who showed an insufficient rise in serum cortisol using traditional HDT criteria and were diagnosed to suffer from AI. There were ten individuals who showed insufficient cortisol values after 30 minutes, rising to sufficient levels at 60 minutes. All patients revealing an insufficient cortisol response result after 60 minutes also had an insufficient result after 30 minutes. The cortisol value taken after 30 minutes did not add incremental diagnostic value in any of the cases under investigation compared with the 60 minutes' sample. CONCLUSIONS: Based on the findings of the present analysis the utility of a cortisol measurement 30 minutes after high dose ACTH injection was low and did not add incremental diagnostic value to a single measurement after 60 minutes.
Resumo:
When genetic constraints restrict phenotypic evolution, diversification can be predicted to evolve along so-called lines of least resistance. To address the importance of such constraints and their resolution, studies of parallel phenotypic divergence that differ in their age are valuable. Here, we investigate the parapatric evolution of six lake and stream threespine stickleback systems from Iceland and Switzerland, ranging in age from a few decades to several millennia. Using phenotypic data, we test for parallelism in ecotypic divergence between parapatric lake and stream populations and compare the observed patterns to an ancestral-like marine population. We find strong and consistent phenotypic divergence, both among lake and stream populations and between our freshwater populations and the marine population. Interestingly, ecotypic divergence in low-dimensional phenotype space (i.e. single traits) is rapid and seems to be often completed within 100 years. Yet, the dimensionality of ecotypic divergence was highest in our oldest systems and only there parallel evolution of unrelated ecotypes was strong enough to overwrite phylogenetic contingency. Moreover, the dimensionality of divergence in different systems varies between trait complexes, suggesting different constraints and evolutionary pathways to their resolution among freshwater systems.
Resumo:
We discuss the topological nature of the boundary spacetime, the conformal infinity of the ambient cosmological metric. Due to the existence of a homothetic group, the bounding spacetime must be equipped not with the usual Euclidean metric topology but with the Zeeman fine topology. This then places severe constraints to the convergence of a sequence of causal curves and the extraction of a limit curve, and also to our ability to formulate conditions for singularity formation.
Resumo:
Background: The traditional surgical treatment for cervical insufficiency is vaginal placement of a cervical cerclage. However, in a small number of cases a vaginal approach is not possible. A transabdominal approach can become an option for these patients. Laparoscopic cervical cerclage is associated with good pregnancy outcomes but comes at the cost of a higher risk of serious surgical complications. The aim of the present study was to evaluate intraoperative and long-term pregnancy outcomes after laparoscopic cervical cerclage, performed either as an interval procedure or during early pregnancy, using a new device with a blunt grasper and a flexible tip. Methods: All women who underwent laparoscopic cervical cerclage for cervical insufficiency in our institution using the Goldfinger® device (Ethicon Endo Surgery, Somerville, NJ, USA) between January 2008 and March 2014 were included in the study. Data were collected from the patients' medical records and included complications during and after the above-described procedure. Results: Eighteen women were included in the study. Of these, six were pregnant at the time of laparoscopic cervical cerclage. Mean duration of surgery was 55 ± 10 minutes. No serious intraoperative or postoperative complications occurred. All patients were discharged at 2.6 ± 0.9 days after surgery. One pregnancy ended in a miscarriage at 12 weeks of gestation. All other pregnancies ended at term (> 37 weeks of gestation) with good perinatal and maternal outcomes. Summary: Performing a laparoscopic cervical cerclage using a blunt grasper device with a flexible tip does not increase intraoperative complications, particularly in early pregnancy. We believe that use of this device, which is characterized by increased maneuverability, could be an important option to avoid intraoperative complications if surgical access is limited due to the anatomical situation. However, because of the small sample size, further studies are needed to confirm our findings.
Resumo:
The congenital form of thrombotic thrombocytopenic purpura (TTP) is caused by genetic mutations in ADAMTS13. Some, but not all, congenital TTP patients manifest renal insufficiency in addition to microangiopathic hemolysis and thrombocytopenia. We included 32 congenital TTP patients in the present study, which was designed to assess whether congenital TTP patients with renal insufficiency have predisposing mutations in complement regulatory genes, as found in many patients with atypical hemolytic uremic syndrome (aHUS). In 13 patients with severe renal insufficiency, six candidate complement or complement regulatory genes were sequenced and 11 missense mutations were identified. One of these missense mutations, C3:p.K155Q mutation, is a rare mutation located in the macroglobulin-like 2 domain of C3, where other mutations predisposing for aHUS cluster. Several of the common missense mutations identified in our study have been reported to increase disease-risk for aHUS, but were not more common in patients with as compared to those without renal insufficiency. Taken together, our results show that the majority of the congenital TTP patients with renal insufficiency studied do not carry rare genetic mutations in complement or complement regulatory genes.
Resumo:
Fast-flowing ice streams discharge most of the ice from the interior of the Antarctic Ice Sheet coastward. Understanding how their tributary organisation is governed and evolves is essential for developing reliable models of the ice sheet's response to climate change. Despite much research on ice-stream mechanics, this problem is unsolved, because the complexity of flow within and across the tributary networks has hardly been interrogated. Here I present the first map of planimetric flow convergence across the ice sheet, calculated from satellite measurements of ice surface velocity, and use it to explore this complexity. The convergence map of Antarctica elucidates how ice-stream tributaries draw ice from the interior. It also reveals curvilinear zones of convergence along lateral shear margins of streaming, and abundant convergence ripples associated with nonlinear ice rheology and changes in bed topography and friction. Flow convergence on ice-stream tributaries and their feeding zones is markedly uneven, and interspersed with divergence at distances of the order of kilometres. For individual drainage basins as well as the ice sheet as a whole, the range of convergence and divergence decreases systematically with flow speed, implying that fast flow cannot converge or diverge as much as slow flow. I therefore deduce that flow in ice-stream networks is subject to mechanical regulation that limits flow-orthonormal strain rates. These properties and the gridded data of convergence and flow-orthonormal strain rate in this archive provide targets for ice- sheet simulations and motivate more research into the origin and dynamics of tributarization.
Resumo:
A 328 cm-long piston core (KODOS 02-01-02) collected from the northeast equatorial Pacific at 16°12'N, 125°59'W was investigated for eolian mass fluxes and grain sizes to test these proxies as a tool for the paleo-position of the Intertropical Convergence Zone (ITCZ). The eolian mass fluxes of the lower interval below 250 cm (15.5-7.6 Ma) are very uniform at 5 +/- 1 mg/cm**2/kyr, while those of the upper interval above 250 cm (from 7.6 Ma) are over 2 times higher than the lower interval at 12 +/- 1 mg/cm**2/kyr. The median grain size of the eolian dusts in the lower interval increases from 8.4 Phi to 8.0 Phi downward, while that of the upper interval varies in a narrow range from 8.8 Phi to 8.6 Phi. The determined values compare well in magnitude to those of central Pacific sediments for the upper interval and equatorial and southeast Pacific sediments for the lower interval. This result suggests a possibility that the study site had been under the influence of southeast trade winds at its earlier depositional period due to the northerly position of the ITCZ, and subsequently of the northeast trade winds for a later period when the upper sediments were deposited. This interpretation is consistent with a mineralogical and geochemical study published elsewhere that assigned the provenance of the study core dust to Central/South America for the lower interval and to Asia for the upper interval. This study suggests that the distinct differences in eolian mass flux and grain size observed across the ITCZ can be used to trace the paleo-latitude of the ITCZ.
Resumo:
More than one-third of the World Trade Organization-notified services trade agreements that were in effect between January 2008 and August 2015 involved at least one South or Southeast Asian trading partner. Drawing on Baier and Bergstrand’s (2004) determinants of preferential trade agreements and using the World Bank’s database on the restrictiveness of domestic services regimes (Borchert, Gootiiz, and Mattoo 2012), we examine the potential for negotiated regulatory convergence in Asian services markets. Our results suggest that Asian economies with high levels of preexisting bilateral merchandise trade and wide differences in services regulatory frameworks are more likely candidates for services trade agreement formation. Such results lend support to the hypothesis that the heightened “servicification” of production generates demand for the lowered services input costs resulting from negotiated market openings.
Resumo:
More than a third of the World Trade Organization (WTO)-notified services trade agreements (STAs) in effect over January 2008 - August 2015 have involved at least one (South or Southeast) Asian trading partner. Drawing on Baier and Bergstrand's (2004) determinants of preferential trade agreements and using the World Bank's database on the restrictiveness of domestic services regimes (Borchert et.al. 2012), we examine the potential for negotiated regulatory convergence in Asian services markets. Our results suggest that countries within Asia with high levels of pre-existing bilateral merchandise trade and wide differences in services regulatory frameworks are more likely candidates for STA formation. Such results lend support to the hypothesis that the heightened "servicification" of production generates a demand for the lowered service input costs resulting from negotiated market opening.
Resumo:
Studies on Western democracies have shown that deep-seated social cleavages stabilize the electoral behavior and thus reduce electoral volatility. But how do social cleavages affect a party system that is undergoing democratic consolidation, such as in Turkey? In this study, investigations were carried out on long- and short-term relationships between social cleavages (religiosity, ethnicity, and sectarism) and electoral volatility in Turkey during the 1961-2002 period. Cross-sectional multiple regressions were applied to electoral and demographic data at the provincial level. The results showed that in the long-term, social cleavages on the whole have increased volatility rather than reduced it. The cleavage-volatility relationship, however, has changed over time. Repeated elections have mitigated the volatile effect of social cleavages on the voting behavior, as political parties have become more representative of the existent social cleavages.