887 resultados para payload increase.
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To re-evaluate the safety of hormonal contraceptives (HC) after uterine evacuation of complete hydatidiform mole (CHM). Historical database review. Charing Cross Hospital Gestational Trophoblastic Disease Centre, London, United Kingdom. Two thousand four hundred and twenty-three women with CHM of whom 154 commenced HC while their human chorionic gonadotropin (hCG) was still elevated, followed between 2003 and 2012. We compared time to hCG remission between HC users and nonusers. The relationship between HC use and gestational trophoblastic neoplasia (GTN) development was assessed. The relationship between HC use and a high International Federation of Gynecology and Obstetrics (FIGO) risk score was determined. Time to hCG remission, risk of developing postmolar GTN and proportion of women with high FIGO risk score. No relationship was observed between HC use with mean time to hCG remission (HC users versus non-users: 12 weeks in both, P = 0.19), GTN development (HC users versus non-users: 20.1 and 16.7%, P = 0.26) or high-risk FIGO score (HC users versus nonusers: 0% and 8%, P = 0.15). Moreover, no association between HC and GTN development was found, even when an age-adjusted model was used (OR = 1.37, 95% CI 0.91-2.08, P = 0.13). The use of current HC is not associated with development of postmolar GTN or delayed time to hCG remission. Therefore, HC can be safely used to prevent a new conception following CHM regardless of hCG level. Non-concurrent cohort study to re-evaluate the safety of low dose HCs after uterine evacuation of CHM.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Purpose: To apply the technique of Isostretching in a group of people over age 50 years and compare the flexibility of the posterior muscular chain before and after treatment, observing whether there was improvement in quality of life after the end of the sessions. Method: Eleven healthy and sedentary people from 51 to 74 years old participated in the study, which was conducted in Brazil. To evaluate the flexibility we applied the SF-36 questionnaire and test flexion of the spine before and after the study. Eight domains were accessed with the scores ranging form zero to one hundred. Results And Discussion:The technique was effective to gain flexibility of the posterior muscle group, which results in better quality of life for the participants. The results show that the domains related to physical health obtained the highest scores (“functional capacity”, “limitation in physical aspects” and “pain”). These aspects are strongly emphasised in a physical therapy treatment.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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In this action research study of eighth grade mathematics, I investigated my students’ use of writing and solving word problems. I collected data to determine if writing and solving word problems would have a positive effect on students’ abilities to understand and solve word problems. These word problems are grade-level appropriate and are very similar to the problems on the eighth grade online assessment of state standards. Pre- and post-test data, weekly word problems that focus on specific mathematics topics, beginning and end surveys about word problem perceptions, and a teacher journal reveal that student engagement in this weekly practice of writing and solving word problems did influence the students’ overall abilities for, achievement in and attitudes toward solving word problems. Except for some students’ perceptions, the influence was largely positive. This suggests that word problems can be a constructive feature in eighth mathematics instruction.
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In this action research study of my 5th grade mathematics class, I investigated how students’ understanding of math vocabulary impacts their understanding of the curriculum. I discovered math vocabulary plays an important role in a student’s ability to understand daily lessons, complete homework, discuss ideas in groups, take tests and be successful on achievement tests. A student’s ability to understand the words around him (or her) in math class seem very related to his or her ability to solve word problems. Word problems are what our national assessments are all about. I also discovered that direct instruction and support of math vocabulary increased test scores and confidence in students as test takers. As a result of this research, I plan to continue to find ways to emphasize the vocabulary used in our current math curriculum. This process will start at the beginning of the year. I will continue to look for strategies that promote math vocabulary retention in my students. And finally, I will share my findings with my colleagues, so my research can be used as part of our School Improvement Goals.
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In this action research study of my classroom of 7th grade mathematics, I investigated whether the use of decoding would increase the students’ ability to problem solve. I discovered that knowing how to decode a word problem is only one facet of being a successful problem solver. I also discovered that confidence, effective instruction, and practice have an impact on improving problem solving skills. Because of this research, I plan to alter my problem solving guide that will enable it to be used by any classroom teacher. I also plan to keep adding to my math problem solving clue words and share with others. My hope is that I will be able to explain my project to math teachers in my district to make them aware of the importance of knowing the steps to solve a word problem.
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Landowners and agencies have expressed difficulty finding hunters willing to harvest the female portion of the ungulate populations, and likewise, hunters have expressed difficulty achieving access to private lands. Since 2003, the Montana “DoeCowHunt” website (www.doecowhunt.montana.edu) has provided an avenue to improve hunter-landowner contact and wild ungulate population management. A product of Montana State University Extension Wildlife Program, this website provides a means for hunters and landowners in Montana to contact each other by listing contact information (email address, physical address, and telephone number) for the purpose of harvesting antlerless ungulates. In the first year over 10,000 users visited the site. Of those who actually registered, 11 were landowners and 1334 were hunters. An evaluation survey resulted in a 40% response rate. The survey indicated the average registered landowner had 20 hunter contacts. Many landowners contacted hunters through use of the website but did not register or list their contact information on the site.
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Introduction: The increasing number of reports on the relation between transfusion of stored red blood cells (RBCs) and adverse patient outcome has sparked an intense debate on the benefits and risks of blood transfusions. Meanwhile, the pathophysiological mechanisms underlying this postulated relation remain unclear. The development of hemolysis during storage might contribute to this mechanism by release of free hemoglobin (fHb), a potent nitric oxide (NO) scavenger, which may impair vasodilation and microcirculatory perfusion after transfusion. The objective of this prospective observational pilot study was to establish whether RBC transfusion results in increased circulating fHb levels and plasma NO consumption. In addition, the relation between increased fHb values and circulating haptoglobin, its natural scavenger, was studied. Methods: Thirty patients electively received 1 stored packed RBC unit (n = 8) or 2 stored packed RBC units (n = 22). Blood samples were drawn to analyze plasma levels of fHb, haptoglobin, and NO consumption prior to transfusion, and 15, 30, 60 and 120 minutes and 24 hours after transfusion. Differences were compared using Pearson's chi-square test or Fisher's exact test for dichotomous variables, or an independent-sample t test or Mann-Whitney U test for continuous data. Continuous, multiple-timepoint data were analyzed using repeated one-way analysis of variance or the Kruskall-Wallis test. Correlations were analyzed using Spearman or Pearson correlation. Results: Storage duration correlated significantly with fHb concentrations and NO consumption within the storage medium (r = 0.51, P < 0.001 and r = 0.62, P = 0.002). fHb also significantly correlated with NO consumption directly (r = 0.61, P = 0.002). Transfusion of 2 RBC units significantly increased circulating fHb and NO consumption in the recipient (P < 0.001 and P < 0.05, respectively), in contrast to transfusion of 1 stored RBC unit. Storage duration of the blood products did not correlate with changes in fHb and NO consumption in the recipient. In contrast, pre-transfusion recipient plasma haptoglobin levels inversely influenced post-transfusion fHb concentrations. Conclusion: These data suggest that RBC transfusion can significantly increase post-transfusion plasma fHb levels and plasma NO consumption in the recipient. This finding may contribute to the potential pathophysiological mechanism underlying the much-discussed adverse relation between blood transfusions and patient outcome. This observation may be of particular importance for patients with substantial transfusion requirements.
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Today, approximately 29% of the world population use the Internet, against 38% in Brazil, which shows its importance in people's routine not only in Brazil, but also worldwide. Being the Internet a communication media, this research evaluates the influence of Interactivity as a factor to increase memorization of Internet sites. According to literature, multiway, immediacy and contingency factors increase Interactivity and sites that provide one or more of these factors influence memorization. 20 in-depth personal interviews were conducted to improve the understanding the issue, to identify leads and elaborate our hypothesis, followed by a quantitative survey of 300 people. Hypotheses were tested using Chi-square and a hierarchical and non-hierarchical cluster analysis. Results showed that the smaller the number of leads of a specific website, the larger are its memorization and access. The theoretical contribution of this investigation is that websites that offer fewer leads are more interactive, which causes them to be remembered. The managerial implication is that websites with a clear position and a small quantity of information or leads tend to be more remembered and accessed by internet users.
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The effects of adipose-derived mesenchymal stem cells (ADMSC) transplantation on degeneration, regeneration and skeletal muscle function were investigated in dystrophin-deficient mice (24-week-old). ADMSC transplantation improved muscle strength and, resistance to fatigue. An increase in fiber cross-sectional area and in the number of fibers with centralized nuclei and augment of myogenin content were observed. In ADMSC-treated muscles a decrease in muscle content of TNF-alpha, IL-6 and oxidative stress measured by Amplex(A (R)) reagent were observed. The level of TGF-beta 1 was lowered whereas that of VEGF, IL-10 and IL-4 were increased by ADMSC treatment. An increase in markers of macrophage M1 (CD11 and F4-80) and a decrease in T lymphocyte marker (CD3) and arginase-1 were also observed in ADMSCs-treated dystrophic muscle. No change was observed in iNOS expression. Increased phosphorylation of Akt, p70S6k and 4E-BP1 was found in dystrophic muscles treated with ADMSC. These results suggest that ADMSC transplantation modulates inflammation and improves muscle tissue regeneration, ameliorating the dystrophic phenotype in dystrophin-deficient mice.
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Background: Inspiratory muscle training (IMT) has been shown to increase diaphragm thickness. We evaluated the effect of IMT on mid-respiratory pressure (MRP) in patients with gastroesophageal reflux disease (GERD) and hypotensive lower esophageal sphincter (LES), and compared the results with a sham group. Methods: Twenty consecutive patients (progressive loading group) and 9 controls (sham group) were included. All patients had end expiratory pressure (EEP) between 5 and 10 mmHg, underwent esophageal manometry and pulmonary function tests before and after 8 weeks of training, and used a threshold IMT twice daily. The threshold IMT was set at 30% of the maximal inspiratory pressure for the progressive loading group; while, the threshold for sham-treated patients was set at 7 cmH(2)O for the whole period. Results: There was an increase in MRP in 15 (75%) patients in the progressive loading group, with an average gain of 46.6% (p<0.01), and in six (66%) patients in the sham group with a mean increase of 26.2% (p<0.01). However, there was no significant difference between the groups (p = 0.507). The EEP also increased compared with measurements before training (p<0.01), but it did not differ between groups (p = 0.727). Conclusion: IMT increased LES pressure in patients with GERD, in both the treatment and sham groups, after an eight-week program. Although there was no statistically significant difference between groups, suggesting the pressure increase in LES occurs regardless of the resistance load of the threshold IMT. These findings need to be confirmed in further studies with a larger sample. Registration number: 0922/09. (C) 2012 Elsevier Ltd. All rights reserved.
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PURPOSE: Describe a modified technique to increase nostril cross-sectional area using rib and septal cartilage graft over alar nasal cartilages. METHODS: A modified surgical technique was used to obtain, carve and insert cartilage grafts over alar nasal cartilages. This study used standardized pictures and measured 90 cadaveric nostril cross-sectional area using Autocad (c); 30 were taken before any procedure and 60 were taken after grafts over lateral crura (30 using costal cartilage and 30 using septal cartilage). Statistical analysis were assessed using a model for repeated measures and ANOVA (Analysis of Variance) for the variable "area". RESULTS: There's statistical evidence that rib cartilage graft is more effective than septal cartilage graft. The mean area after the insertion of septal cartilage graft is smaller than the mean area under rib graft treatment (no confidence interval for mean difference contains the zero value and all P-values are below the significance level of 5%). CONCLUSIONS: The technique presented is applicable to increase nostril cross section area in cadavers. This modified technique revealed to enhance more nostril cross section area with costal cartilage graft over lateral crura rather than by septal graft.
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Fleury Group