946 resultados para Determinant
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This study addresses the issue of Spanish plural marking considering data from three sources: existent words, loan words and nonce words. Specifically, we are interested in the role of stress placement and word-final sound in the use of /-es/ for plural formation. We present data concerning the interaction of these two features for children and adults. Our findings suggest that this phenomenon is a classic example of over generalization in acquisition. Stress does not seem a determining feature by itself. Its main effect is produced when it interacts with the structure of the syllable
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All developmental transitions throughout the life cycle of a plant are influenced by light. In Arabidopsis, multiple photoreceptors including the UV-A/blue-sensing cryptochromes (cry1-2) and the red/far-red responsive phytochromes (phyA-E) monitor the ambient light conditions. Light-regulated protein stability is a major control point of photomorphogenesis. The ubiquitin E3 ligase COP1 (constitutively photomorphogenic 1) regulates the stability of several light-signaling components. HFR1 (long hypocotyl in far-red light) is a putative transcription factor with a bHLH domain acting downstream of both phyA and the cryptochromes. HFR1 is closely related to PIF1, PIF3, and PIF4 (phytochrome interacting factor 1, 3 and 4), but in contrast to the latter three, there is no evidence for a direct interaction between HFR1 and the phytochromes. Here, we show that the protein abundance of HFR1 is tightly controlled by light. HFR1 is an unstable phosphoprotein, particularly in the dark. The proteasome and COP1 are required in vivo to degrade phosphorylated HFR1. In addition, HFR1 can interact with COP1, consistent with the idea of COP1 directly mediating HFR1 degradation. We identify a domain, conserved among several bHLH class proteins involved in light signaling , as a determinant of HFR1 stability. Our physiological experiments indicate that the control of HFR1 protein abundance is important for a normal de-etiolation response.
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BACKGROUND: Pulse wave velocity (PWV), an index of arterial wall stiffness, is modulated by blood pressure (BP). Whether heart rate (HR) is also a modulator of PWV is controversial. Recent research involving mainly patients with high aortic PWV have found either no change or a positive correlation between the two. Given that PWV is increasingly being measured in cardiovascular studies, the relationship between HR and PWV should be known in patients with preserved arterial wall elasticity. OBJECTIVE: The aim of this study was to evaluate the importance of HR as a determinant of the variability in PWV in patients with a low degree of atherosclerosis. DESIGN AND METHODS: Fourteen patients (five female, nine male; aged 68 +/- 8 years) were evaluated post pacemaker implantation due to sick sinus or carotid hypersensitivity syndromes. Carotid-femoral PWV was measured at rest and during atrial pacing at 80, 90 and 100 bpm (paced HR). Arterial femoral blood flow (AFBF) was measured by echodoppler. RESULTS: PWV increased from 6.2 +/- 1.5 m/s (mean +/- SD) during resting sinus rhythm (HR 62 +/- 8 bpm; mean +/- SD) to 6.8 +/- 1.0, 7.0 +/- 0.9, and 7.6 +/- 1.1 m/s at pacing rates of 80, 90 and 100 bpm, respectively (P < 0.0001). Systolic (SBP) and mean blood pressure (MBP) remained constant at all HR levels, whereas AFBF increased in a linear fashion. CONCLUSIONS: These results demonstrate that even in patients with a low degree of atherosclerosis, HR is a potential modulator of carotid-femoral PWV.
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Background: Since generic drugs have the same therapeutic effect as the original formulation but at generally lower costs, their use should be more heavily promoted. However, a considerable number of barriers to their wider use have been observed in many countries. The present study examines the influence of patients, physicians and certain characteristics of the generics' market on generic substitution in Switzerland.Methods: We used reimbursement claims' data submitted to a large health insurer by insured individuals living in one of Switzerland's three linguistic regions during 2003. All dispensed drugs studied here were substitutable. The outcome (use of a generic or not) was modelled by logistic regression, adjusted for patients' characteristics (gender, age, treatment complexity, substitution groups) and with several variables describing reimbursement incentives (deductible, co-payments) and the generics' market (prices, packaging, co-branded original, number of available generics, etc.).Results: The overall generics' substitution rate for 173,212 dispensed prescriptions was 31%, though this varied considerably across cantons. Poor health status (older patients, complex treatments) was associated with lower generic use. Higher rates were associated with higher out-of-pocket costs, greater price differences between the original and the generic, and with the number of generics on the market, while reformulation and repackaging were associated with lower rates. The substitution rate was 13% lower among hospital physicians. The adoption of the prescribing practices of the canton with the highest substitution rate would increase substitution in other cantons to as much as 26%.Conclusions: Patient health status explained a part of the reluctance to substitute an original formulation by a generic. Economic incentives were efficient, but with a moderate global effect. The huge interregional differences indicated that prescribing behaviours and beliefs are probably the main determinant of generic substitution.
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The relationship between ingestion of microfilariae (mf), production of infective larvae (L3) and mf density in human blood has been suggested as an important determinant in the transmission dynamics of lymphatic filariasis. Here we assess the role of these factors in determining the competence of a natural vector Culex quinquefasciatus and a non vector Aedes aegypti to transmit Wuchereria bancrofti. Mosquitoes were infected via a membrane feeding procedure. Both mosquito species ingested more than the expected number of microfilariae (concentrating factor was 1.28 and 1.81 for Cx. quinquefasciatus and Ae. aegypti, respectively) but Cx. quinquefasciatus ingested around twice as many mf as Ae. aegypti because its larger blood meal size. Ae. aegypti showed a faster mf migration capacity compared to Cx. quinquefasciatus but did not allow parasite maturation under our experimental conditions. Similar proportions of melanized parasites were observed in Ae. aegypti (2.4%) and Cx. quinquefasciatus (2.1%). However, no relationship between rate of infection and melanization was observed. We conclude that in these conditions physiological factors governing parasite development in the thorax may be more important in limiting vectorial competence than the density of mf ingested.
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This paper examines the determinants of young innovative companies’ (YICs) R&D activities taking into account the autoregressive nature of innovation. Using a large longitudinal dataset comprising Spanish manufacturing firms over the period 1990-2008, we find that previous R&D experience is a fundamental determinant for mature and young firms, albeit to a smaller extent in the case of the YICs, suggesting that their innovation behaviour is less persistent and more erratic. Moreover, our results suggest that firm and market characteristics play a distinct role in boosting the innovation activity of firms of different age. In particular, while market concentration and the degree of product diversification are found to be important in boosting R&D activities in the sub-sample of mature firms only, YICs’ spending on R&D appears to be more sensitive to demand-pull variables, suggesting the presence of credit constraints. These results have been obtained using a recently proposed dynamic type-2 tobit estimator, which accounts for individual effects and efficiently handles the initial conditions problem.
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A report on the All-Ireland Social Capital and Health Survey. This is the first report in Ireland, North or South, which measures and identifies systematically the connections between perceived health and an extensive range of demographic and socio-economic characteristics and lifestyle behaviours. The concept of social capital and the ways in which social capital may be an important determinant of health is receiving increased attention from policy-makers. The Institute of Public Health in Ireland produced a report in 2004 based on its All Ireland Social Capital and Health Survey. The report explores how people feel about their health and highlights how this is linked with perceptions of the local social environment as well as to demographic and socio-economic circumstances and lifestyle behaviours.
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Independent regulatory agencies are one of the main institutional features of the 'rising regulatory state' in Western Europe. Governments are increasingly willing to abandon their regulatory competencies and to delegate them to specialized institutions that are at least partially beyond their control. This article examines the empirical consistency of one particular explanation of this phenomenon, namely the credibility hypothesis, claiming that governments delegate powers so as to enhance the credibility of their policies. Three observable implications are derived from the general hypothesis, linking credibility and delegation to veto players, complexity and interdependence. An independence index is developed to measure agency independence, which is then used in a multivariate analysis where the impact of credibility concerns on delegation is tested. The analysis relies on an original data set comprising independence scores for thirty-three regulators. Results show that the credibility hypothesis can explain a good deal of the variation in delegation. The economic nature of regulation is a strong determinant of agency independence, but is mediated by national institutions in the form of veto players.
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0 Abstract L'incidence du mélanome est en nette augmentation en Europe et aux Etats-Unis. La Chirurgie peut être curative au stade précoce de la maladie,la radiothérapie se pratique À visée palliative, les chimiothérapies n'ont montré que peu d'effet. Les progress actuels se font via l'immunothérapie. Des traitements par l'interleukine-2 et l'interféron-α se sont montrés efficaces chez certains patients, mais leur utilisation est limitée par leur forte toxicité. Depuis 2011, en Suisse, une nouvelle molécule a été mise sur le marché, l'ipilimumab (Yervoy®). Il s'agit d'un anticorps! monoclonal humain dirigé contre le CTLA4. Il en résulte une activation non spécifique du système immunitaire. Une étude randomisée de phase IIIa été conduite au Etats-Unis. Elle démontre une augmentation de la survie chez les patients atteints de melanoma métastatique traits par ipilimumab, sans traitement préalable des métastases. Le but de cette etude est de determiner s'il est possible, par le biais de l'imagerie PET-CTau 18F-FDG, de prédire la réponse individuelle au traitement par ipilimumab, afin d'optimiser la prise en charge de ces patients. 0.1 Méthode Les patients atteints de mélanome métastatique sont exposés au traitement d'ipilimumab selon les recommandations de Bristol-Myers Squibb. Puis ils effectuent des PET-CT au F-18-FDG selon! le! protocole (CER 400/11, annexé) de l'étude. Les images sont!analysées selon les critères PERCIST (PETResponse Criterias In Solid Tumors) et le TLG (Total Lesion Glycolysis) est calculé. Parallèlement, des prises de sang sont effectuées et les échantillons sont analysés à l'institut Ludwig (LICR, Unil) selon les critères imRC qui determinant la réponse immunologique au traitement. 0.2 Résultats Nous notons une discrépance dans les résultats. Lorsque nous observons une maladie stable avec les critères immunologiques imRC, nous observons une maladie progressive avec lescritères PERCIST. 0.3 Discussion - Conclusion Nous n'avons pu faire entrer que cinq patients dans l'étude, dont trois étaient vivants à trois mois, ce qui a restreint le nombre de données analysables. Les discrépances que nous observons dans nos résultats pourraient être dues au fait que le PET-CT au 18FDG ne nous permet pas de différencier l'activité tumorale de l'activité inflammatoire péri-tumorale. Ce biais pourrait être à l'avenir prévenu en utilisant du 18FLT, un marqueur plus sélectif des cellules tumorales.L'analyse desimages avec les critères de total-lesion glycolysis a été impossible au vu du nombre de lésions que présentaient certains patients. Les critères PERCIST exigent un protocole d'acquisition très strict. La corrélation entre les images, les données immunologiques et la clinique mérite d'être suivie sur le long terme, car il pourrait y avoir une réponse positive plus tardive du traitement par ipilimumab.
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El treball de recerca “Fonaments i actuacions de lideratge sistèmic d’un equip de bàsquet professional i futures aplicacions” fa l’anàlisi d’una experiència real vinculada al món de l’esport professional. Es pretén donar a conèixer com l’estructuració del coneixement de l’entrenador pot afavorir el bon funcionament de l’equip. L’estructuració ens genera criteri i coherència a l’hora de prendre decisions.Es reconeix a l’entrenador com una persona treballadora, apassionada per la seva feina i en constant creixement individual. Valors com la humilitat, l’entusiasme, el compromís, la generositat i l’autoexigència es converteixen en adjectius fonamentals del nostre entrenador.L’estudi en l’autoconeixement en conceptes com lideratge, nivells neurològics, talent i motivació esdevenen el pal de paller en la construcció de l’equip. Un equip amb identitat pròpia, on el benefici pel bé comú (equip) està per sobre de tot, cooperatiu, compromès, i on la figura de l’entrenador intuïtiu amb coneixement influeix més per convenciment que per autoritat.El treball del dia a dia de l’entrenador i de l´equip es fonamenta en l’organització dels pilars de l’entrenador: flexibilitat, creixement de l’entrenador, equip, marges col·lectiu i individual són els motors del bon funcionament del col·lectiu. En el treball presentat, es destaca la importància de saber diferenciar, en el rendiment d’un equip, dues vessants: una més objectiva (tècnica, tàctica, estratègia i física) i l’altra on el factor humà és determinant. La investigació aprofundeix en aquest segon factor i el reconeix com a preferent. Per acabar es presenten tot un seguit d’actuacions utilitzades al llarg de la investigació amb la finalitat de generar, mantenir i millorar l’equip al mateix temps que es mostren diferents eines per tal d’optimitzar l’eficiència de les actuacions. La investigació pretén ser una experiència útil i enriquidora a l’hora d’estructurar el coneixement per tal de poder ser utilitzat en futures aplicacions.
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OBJECTIVES: The purpose of this study was to assess short- and mid-term results of in-situ revascularisation (ISR) using silver-coated Dacron prostheses and bowel repair for management of secondary aorto-enteric fistulae (SAEF). DESIGN: Single-centre retrospective chart review. MATERIAL AND METHODS: This study includes all the patients treated by ISR using silver-coated Dacron for SAEF between 2006 and 2010. Primary end points were mortality and survival rates. Secondary end points were reinfection-free survival and secondary patency rates. RESULTS: Eighteen male patients with SAEF with a median age of 64 years were operated by ISR using silver-coated Dacron during the study period without operative death. The 30-day mortality was 22% and the in-hospital mortality rate was 39%. Indeed, during hospitalisation, a duodenal leak was observed in four patients including three who died. Four others patients died due to multi-system organ failure. Median follow-up was 16 months (range 1-66). The survival rate at 12 months was 55%. One duodenal leak was observed leading to death. The reinfection-free survival and the secondary patency rates at 12 months were 60% and 89%, respectively. CONCLUSION: In-situ revascularisation with silver-coated Dacron provides acceptable results in terms of mortality. This treatment may be useful for simple vascular reconstruction and allow greater attention to bowel repair that is a determinant in short- and mid-term survival.
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La neumonía es una complicación frecuente de la ventilación mecánica. El diagnóstico de sospecha se ha realizado clásicamente por criterios clínicos establecidos por Johanson. El objetivo principal es comprobar si la antibioticoterapia empírica es la adecuada en la prevención de la NNAVM en nuestra unidad. Tipo de estudio: observacional descriptivo, de cohortes prospectivo. Resultados: 35 pacientes presentan NNAVM. 77.14% varones, 22.85% mujeres. El principal factor de riesgo para desarrollar esta patología es la ventilación mecánica La adecuación del tratamiento empírico es un factor determinante en la supervivencia.
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A woman's risk of breast cancer is strongly affected by her reproductive history. The hormonal milieu is also a key determinant of the course of the disease. Combining mouse genetics with tissue recombination techniques, we have established that the female reproductive hormones, estrogens, progesterone, and prolactin, act sequentially on the mammary epithelium to trigger distinct developmental steps. The hormones impinge directly on a subset of luminal mammary epithelial cells that express the respective hormone receptors and act as sensor cells translating and amplifying systemic signals into local stimuli. Local signaling is stage and age specific. During puberty, estrogens promote proliferation using the EGF family member, amphiregulin, as essential paracrine mediator. In adulthood, progesterone, rather than estrogen, is the major inducer of stem cell activation and cell proliferation of the mammary epithelium. Hormonal signaling modulates crucial developmental pathways that impinge on mammary stem cell populations, while Notch signaling, by inhibiting p63, is central to mammary cell fate determination. Cell proliferation occurs in two waves. The first results from direct stimulation of the small fraction of hormone receptor positive cells. It is followed by a second wave of progesterone-induced proliferation involving mostly hormone receptor negative cells, in which RANKL is a key mediator. A model in which repeated activation of paracrine signaling by progesterone with resulting stem cell activation promotes breast carcinogenesis is proposed.
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La beca concedida ha anat destinada a desenvolupar la tesi doctoral que duu per nom "Les ciutats turístiques, les noves ciutats. Anàlisi de l'evolució del model turístic en destinacions de litoral madures a partir de l'anàlisi de paràmetres urbanístics". L’àrea d’estudi comprèn els municipis de Cambrils, Salou i La Pineda (Vila-seca) que conformen la Costa Daurada central, destinació madura de litoral mediterrani, que basa el seu desenvolupament d’acord el model turístic de sol i platja. Arribats en aquest punt de finalització de la beca, cal destacar que s’ha complert amb l'objectiu d'analitzar el procés de transformació de les ciutats turístiques, tot establint com el turisme litoral mediterrani s'ha convertit en un factor de creació de ciutat. Així mateix també s'han complert els objectius específics tals com: analitzar l'evolució de les destinacions turístiques consolidades del litoral mediterrani, recopilar informació per a la creació d'índexs i eines que serveixin per l'anàlisi del procés de tranformació de les ciutats turístiques a ciutats tradicionals a partir del tractament dels plans parcials, recopilar i analitzar les polítiques de planificació que han condicionat l'area d'estudi, modelitzar el procés de construcció de l'espai turístic a partir de l'establiment d'unes unitats bàsiques en la descripció i anàlisi territorial i paisatgístic, i crear un SIG per culminar el procés d'anàlisi tot creant una base de dades i la representació dels resultats en cartogradia temàtica. Pel que fa al disseny i l’execució de la metodologia, es poden considerar dos vessants, una vessant més qualitativa i una altra més quantitativa per al tractament de la informació recopilada. Igualment la generació de cartografia específica completa el procés amb la producció de cartografia específica, tal i com es desenvolupa en la present memòria. La tesi parteix del guió que contempla: un prier capítol d'introducció, un segon dedicat al marc teòric, un tercer apartat on s'exposaran les hipòtesis de les quals es parteix, i un quart dedicat a la metodologia. Pren especial importància l'apartat dedicat a l’ànalisi, així com el dedicat a la discussió dels resultats obtinguts, que es desenvoluparà en el sisè apartat. Per últim resta destacar el setè apartat dedicat a les conclusions a les que s'ha arribat.
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L'objectiu d'aquest projecte és que els nens i adolescents amb dolor crònic puguin gaudir d'una millor qualitat de vida. El projecte té dues línies de recerca complementàries. El primer objectiu específic és crear i adaptar instruments per avaluar l’experiència dolorosa a la població infantil. Dues són les mesures que s'han estudiat en escolars: l'escala numèrica verbal (vNRS-11) tant en paper com en format electrònic, i una versió modificada de la versió pediàtrica del Survey of Pain Attitudes (Peds-SOPA). El segon objectiu específic és avaluar els efectes de la teràpia cognitiva (TC) en una mostra de nens de 12 a 18 anys que pateixen dolor crònic. En concret, volem estudiar si algunes característiques personals i familiars dels joves (per exemple, creences relacionades amb la salut, intensitat del dolor, estratègies d'afrontament, expectatives del tractament) estan associades a l'adherència a les recomanacions terapèutiques i, en conseqüència, són variables que afavoreixen la recuperació d’aquests pacients. Un tractament de 10 sessions es porta a terme per aconseguir aquest objectiu. S’ofereix als pacients un conjunt d'habilitats i estratègies específiques per a què puguin exercir un major control dels seus símptomes i reduir l'impacte d'aquests en les seves vides. Els resultats d'aquests estudis seran de gran interès per millorar el maneig del dolor infantil. A més, els resultats determinaran quines són les variables associades amb l’adherència a les prescripcions terapèutiques. Aquest és un tema particularment d’interès pel fet de que un factor determinant de l’èxit clínic és el grau en què una persona s'adhereix a les recomanacions. D'altra banda, el desenvolupament de les mesures de dolor pediàtric és de gran rellevància tant per a clínics com per a investigadors, ja que moltes de les decisions clíniques es basen en allò que el pacient ha informat sobre el seu dolor.