Ethnicity as a risk factor for obstructive sleep apnea: comparison of Japanese descendants and white males in São Paulo, Brazil

Some studies showed that Asians with obstructive sleep apnea (OSA) are thinner than Caucasians. Because obesity is a major risk factor for OSA, it was concluded that Asians are predisposed to OSA. However, body fat composition varies for a same body mass index (BMI) according to ethnicity. We firstly compared anthropometric characteristics, symptoms and associated disorders in all consecutive male Japanese descendants and white males with OSA referred for polysomnography. In a second analysis, all Japanese descendants were compared to a subgroup of white males, matched for apnea/hypopnea index and age. In the first analysis, age, symptoms, OSA severity and co-morbidities were similar among Japanese descendants (N = 54) and white patients (N = 466). However, Japanese descendants had a lower BMI than white patients: 27.1 (25.5-28.4) vs 29.4 (26.5-33.0) kg/m², respectively (P < 0.001). In the second analysis, Japanese descendants had a lower BMI than white patients (P < 0.001). Multiple linear regression considering the entire group revealed that age, BMI, neck circumference, Epworth sleepiness scale, ethnicity and %REM sleep were independent predictors for apnea/hypopnea index (P < 0.001). Ethnicity was no longer significantly associated with OSA severity when we adopted the World Health Organization criteria for obesity (≥25 and 30 kg/m² among Japanese descendants and white males, respectively). Japanese descendants with OSA have a lower BMI than white subjects of similar severity. However, ethnicity was not associated with OSA severity when an ethnical difference in obesity criteria was respected. Our data suggest that Japanese descendants are not predisposed to OSA.

A study of industrial co-operatives in kerala with special reference to modern small scale sector

The report of the Steering Committee of the Kerala State Planning Board for the preparation of the VIII five Year Plan on Industry and Hiningzslisted several factors inhibiting and promoting growth of small industrial units. Kerala's educated manpower, the native intelligence of the Keralites best suited for taking up logic—based professions and availability of a Hell—developed and broad~based physical infrastructure particularly in the transport and communications sectors, are a few of the positive factors identified. On the negative side, may be mentioned high wage rates, preference on the part of the educated for white collar Jobs, lack of entrepreneurship, paucity of essential resources for industrial use, high density of population and the distance factor which places Kerala away from the major domestic markets. In this context, it would appear that the industrial co-operative movement could possibly play a vital role in accelerating-the momentum of small industrial development of Kerala which has a Health of highly educated and skilled manpower. However, in spite of the encouragement extended by the Government, the movement does not seem to have.been picking up in the modern small scale sector. The present study is an attempt to analyse the factors that have affected the performance of the industrial co—operatives in the small scale industrial sector of Kerala.

Synthesis and Photoluminescence Properties of Novel Red Phosphors for White Light Emitting Diode Applications

Several series of Eu3+ based red emitting phosphor materials were synthesized using solid state reaction route and their properties were characterized. The present studies primarily investigated the photoluminescence properties of Eu3+ in a family of closely related host structure with a general formula Ln3MO7. The results presented in the previous chapters throws light to a basic understanding of the structure, phase formation and the photoluminescence properties of these compounds and their co-relations. The variation in the Eu3+ luminescence properties with different M cations was studied in Gd3-xMO7 (M = Nb, Sb, Ta) system.More ordering in the host lattice and more uniform distribution of Eu3+ ions resulting in the increased emission properties were observed in tantalate system.Influence of various lanthanide ion (Lu, Y, Gd, La) substitutions on the Eu3+ photoluminescence properties in Ln3MO7 host structures was also studied. The difference in emission profiles with different Ln ions demonstrated the influence of long range ordering, coordination of cations and ligand polarizability in the emission probabilities, intensity and quantum efficiency of these phosphor materials. Better luminescence of almost equally competing intensities from all the 4f transitions of Eu3+ was noticed for La3TaO7 system. Photoluminescence properties were further improved in La3TaO7 : Eu3+ phosphors by the incorporation of Ba2+ ions in La3+ site. New red phosphor materials Gd2-xGaTaO7 : xEu3+ exhibiting intense red emissions under UV excitation were prepared. Optimum doping level of Eu3+ in these different host lattices were experimentally determined. Some of the prepared samples exhibited higher emission intensities than the standard Y2O3 : Eu3+ red phosphors. In the present studies, Eu3+ acts as a structural probe determining the coordination and symmetry of the atoms in the host lattice. Results from the photoluminescence studies combined with the powder XRD and Raman spectroscopy investigations helped in the determination of the correct crystal structures and phase formation of the prepared compounds. Thus the controversy regarding the space groups of these compounds could be solved to a great extent. The variation in the space groups with different cation substitutions were discussed. There was only limited understanding regarding the various influential parameters of the photoluminescence properties of phosphor materials. From the given studies, the dependence of photoluminescence properties on the crystal structure and ordering of the host lattice, site symmetries, polarizability of the ions, distortions around the activator ion, uniformity in the activator distribution, concentration of the activator ion etc. were explained. Although the presented work does not directly evidence any application, the materials developed in the studies can be used for lighting applications together with other components for LED lighting. All the prepared samples were well excitable under near UV radiation. La3TaO7 : 0.15Eu3+ phosphor with high efficiency and intense orange red emissions can be used as a potential red component for the realization of white light with better color rendering properties. Gd2GaTaO7 : Eu3+, Bi2+ red phosphors give good color purity matching to NTSC standards of red. Some of these compounds exhibited higher emission intensities than the standard Y2O3 : Eu3+ red phosphors. However thermal stability and electrical output using these compounds should be studied further before applications. Based on the studies in the closely related Ln3MO7 structures, some ideas on selecting better host lattice for improved luminescence properties could be drawn. Analyzing the CTB position and the number of emission splits, a general understanding on the doping sites can be obtained. These results could be helpful for phosphor designs in other host systems also, for enhanced emission intensity and efficiency.

Alley cropping of willows and grassland for bioenergy provision: productivity, tree-crop interactions and energy balance

The demand for biomass for bioenergy has increased rapidly in industrialized countries in the recent years. Biogenic energy carriers are known to reduce CO2 emissions. However, the resource-inefficient production of biomass often caused negative impacts on the environment, e.g. biodiversity losses, nitrate leaching, and erosion. The detrimental effects evolved mainly from annual crops. Therefore, the aim of modern bioenergy cropping systems is to combine yield stability and environmental benefits by the establishment of mixed-cropping systems. A particular emphasis is on perennial crops which are perceived as environmentally superior to annual crops. Agroforestry systems represent such mixed perennial cropping systems and consist of a mix of trees and arable crops or grassland within the same area of land. Agroforestry practices vary across the globe and alley cropping is a type of agroforestry system which is well adapted to the temperate zone, with a high degree of mechanization. Trees are planted in rows and crops are planted in the alleyways, which facilitates their management by machinery. This study was conducted to examine a young alley cropping system of willows and two grassland mixtures for bioenergy provision under temperate climate conditions. The first part of the thesis identified possible competition effects between willows and the two grassland mixtures. Since light seemed to be the factor most affecting the yield performance of the understory in temperate agroforestry systems, a biennial in situ artificial shade experiment was established over a separate clover-grass stand to quantify the effects of shade. Data to possible below- and aboveground interactions among willows and the two grassland mixtures and their effects on productivity, sward composition, and quality were monitored along a tree-grassland interface within the alleys. In the second part, productivity of the alley cropping system was examined on a triennial time frame and compared to separate grassland and willow stands as controls. Three different conversion technologies (combustion of hay, integrated generation of solid fuel and biogas from biomass, whole crop digestion) were applied to grassland biomass as feedstock and analyzed for its energetic potential. The energetic potential of willow wood chips was calculated by applying combustion as conversion technique. Net energy balances of separate grassland stands, agroforestry and pure willow stands evaluated their energy efficiency. Results of the biennial artificial shade experiment showed that severe shade (80 % light reduction) halved grassland productivity on average compared to a non-shaded control. White clover as heliophilous plant responded sensitively to limited radiation and its dry matter contribution in the sward decreased with increasing shade, whereas non-leguminous forbs (mainly segetal species) benefited. Changes in nutritive quality could not be confirmed by this experiment. Through the study on interactions within the alleys of the young agroforestry system it was possible to outline changes of incident light, soil temperature and sward composition of clover-grass along the tree-grassland interface. Nearly no effects of trees on precipitation, soil moisture and understory productivity occurred along the interface during the biennial experiment. Considering the results of the productivity and the net energy yield alley cropping system had lower than pure grassland stands, irrespective of the grassland seed mixture or fertilization, but was higher than that for pure willow stands. The comparison of three different energetic conversion techniques for the grassland biomass showed highest net energy yields for hay combustion, whereas the integrated generation of solid fuel and biogas from biomass (IFBB) and whole crop digestion performed similarly. However, due to the low fuel quality of hay, its direct combustion cannot be recommended as a viable conversion technique, whereas IFBB fuels were of a similar quality to wood chip from willow.

Tratamiento de la ulcera venosa con escleroespuma versus manejo conservador

La úlcera venosa es una revelación clínica severa de la insuficiencia venosa crónica. Es la causa del 54-76% de las úlceras venosas de miembros inferiores. La ciencia médica ha generado diversos procedimientos en el manejo de esta patología, es así como a partir de conocimientos en fisiopatología de la ulceración venosa, se han aplicado procedimientos como opción de tratamiento. Objetivos: Valorar si el uso de rutina de la oclusión endoluminal con espuma guiada por ecografía del sistema venoso superficial insuficiente, en adicción al manejo convencional de la ulcera venosa (vendaje no compresivo, gasa vaselinada y curaciones) podría mejorar la tasa de curación a las 24 semanas de tratamiento. Diseño: Estudio clínico aleatorizado prospectivo de pacientes de la consulta externa de cirugía vascular del Hospital Occidente de Kennedy-Bogotá, durante el 01 de junio del 2011 hasta el 30 junio del 2012. Métodos: Un total de 44 pacientes con ulcera activa que cumplieron criterios de selección ingresaron al estudio, correspondientes a 48 extremidades con clasificación CEAP (C6), los pacientes fueron a aleatorizados a manejo convencional (control) o con manejo adicional de oclusión endoluminal con espuma eco-guiada. El objetivo principal fue el cierre de la ulcera a las 24 semanas. Resultados: La Curación de la ulcera a las 24 semanas de la aleatorización fue de 20 (83.3%) extremidades del grupo de oclusión endoluminal con espuma eco-guiada Vs 3(12.5%) para el grupo de control P: 0.0005 Discusión: Las tasas de curación de la ulcera luego de la oclusión endoluminal con espuma eco-guiada es muy superior al manejo convencional con curaciones y vendaje no compresivo, las tasa de curación son tan altas como las reportadas con sistemas de alta compresión y cirugía a las 24 semanas. La oclusión endoluminal eco-guiada es segura, mínimamente invasiva y clínicamente efectiva.

La travesía obsoleta: la indefensión del consumidor

La obsolescencia programada es el deseo de tener algo un poco más nuevo, un poco mejor, un poco más rápido de lo necesario. El texto estudia este fenómeno a la luz del Estatuto del Consumidor – Ley 1480 de 2011 para determinar si el consumidor colombiano está suficientemente protegido con él.

Análisis de la incidencia del White Paper, como herramienta de Política Exterior China, en las relaciones económicas y comerciales Sino-colombianas. Periodo 2008–2012

El propósito de este trabajo es analizar cuál ha sido la incidencia del White Paper, como herramienta de política exterior china, en las relaciones económicas y comerciales sino-colombianas entre los años 2008 y 2012. La mayoría del análisis se enfoca en los intercambios comerciales reflejados en la balanza comercial de ambos países y la incidencia que ha tenido el White Paper para la estabilización de una relación de acuerdo a los principios de su política exterior. Este trabajo busca describir los orígenes y la evolución de la relación económica y comercial bilateral y otros aspectos como los sectores que dinamizan tal relación de acuerdo a los intereses de China. Este trabajo describe las razones por las que, aunque la relación se ha fortalecido, hecho evidenciado en el incremento del flujo comercial, ésta sigue siendo desequilibrada y de dependencia.

La familia del paciente en Unidad de Cuidado Intensivo (UCI)

Introducción: Ingresar a la UCI no es una experiencia exclusiva del paciente; implica e involucra directamente a la familia, en aspectos generadores de estrés, estrategias de afrontamiento, temores, actitudes y expectativas, la participación de la familia en el cuidado y el rol del psicólogo. Objetivo: Revisar de los antecedentes teóricos y empíricos sobre la experiencia de la familia en UCI. Metodología: Se revisaron 62 artículos indexados en bases de datos. Resultados: la UCI es algo desconocido tanto para el paciente como para la familia, por esto este entorno acentúa la aparición de síntomas ansiosos, depresivos y en algunos casos estrés post traumático. La muerte es uno de los principales temores que debe enfrentar la familia. Con el propósito de ajustarse a las demandas de la UCI, los familiares exhiben estrategias de afrontamiento enfocadas principalmente en la comunicación, el soporte espiritual y religioso y la toma de decisiones. El cuidado centrado en la familia permite una mejor comunicación, relación con el paciente y personal médico. El papel del psicólogo es poco explorado en el espacio de la UCI, pero este puede promover estrategias de prevención y de rehabilitación en el paciente y su grupo familiar. Discusión: es importante tener en cuenta que la muerte en UCI es una posibilidad, algunos síntomas como ansiedad, depresión pueden aparecer y mantenerse en el tiempo, centrar el cuidado en la familia permite tomar las decisiones basados en el diagnóstico y pronóstico y promueve expectativas realistas. Conclusiones: temores, expectativas, actitudes, estrategias de afrontamiento, factores generadores de estrés permiten explicar y comprender la experiencia de la familia del paciente en UCI.

Information provision in procurement auctions

We analyze the optimal provision of information in a procurement auction with horizontally differentiated goods. The buyer has private information about her preferred location on the product space and has access to a costless communication device. A seller who pays the entry cost may submit a bid comprising a location and a minimum price. We characterize the optimal information structure and show that the buyer prefers to attract only two bids. Further, additional sellers are inefficient since they reduce total and consumer surplus, gross of entry costs. We show that the buyer will not find it optimal to send public information to all sellers. On the other hand, she may profit from setting a minimum price and that a severe hold-up problem arises if she lacks commitment to set up the rules of the auction ex-ante.

Decentralization and local government performance improving public service provision in Bolivia.

Este artículo analiza algunas de las justificaciones más importantes para el desarrollo de procesos de descentralización, analiza sus fundamentos teóricos, y posteriormente describe los elementos de una nueva teoría descentralización, la cual debería llevarnos más lejos en nuestro entendimiento de la efectividad y las implicaciones de la descentralización. Finalmente y de forma más importante, revisamos una gran cantidad de nueva información sobre los efectos de la descentralización en Bolivia. Encontramos fuerte evidencia de que la devolución de recursos y poderes a los gobiernos locales han (i) incrementado en la eficiencia de asignación en el sector público boliviano, (ii) generado una mayor estabilidad en los patrones de inversión pública entre sectores, (iii) llevado a un gobierno más orientado a las necesidades locales de lo que había sido posible a través de gobiernos centralizados, y (iv) muy probablemente incrementado el criterio de costo efectividad del sector público.

Natural resource windfalls and efficiency of local government expenditures: evidence from Peru

We study the role of natural resource windfalls in explaining the efficiency of public expenditures. Using a rich dataset of expenditures and public good provision for 1,836 municipalities in Peru for period 2001-2010, we estimate a non-monotonic relationship between the efficiency of public good provision and the level of natural resource transfers. Local governments that were extremely favored by the boom of mineral prices were more efficient in using fiscal windfalls whereas those benefited with modest transfers were more inefficient. These results can be explained by the increase in political competition associated with the boom. However, the fact that increases in efficiency were related to reductions in public good provision casts doubts about the beneficial effects of political competition in promoting efficiency.

Scope and Limitations of The Co-Drug Approach to Topical Drug Delivery

Many currently available drugs show unfavourable physicochemical properties for delivery into or across the skin and temporary chemical modulation of the penetrant is one option to achieve improved delivery properties. Pro-drugs are chemical derivatives of an active drug which is covalently bonded to an inactive pro-moiety in order to overcome pharmaceutical and pharmacokinetic barriers. A pro-drug relies upon conversion within the body to release the parent active drug (and pro-moiety) to elicit its pharmacological effect. The main drawback of this approach is that the pro-moiety is essentially an unwanted ballast which, when released, can lead to adverse effects. The term ‘co-drug’ refers to two or more therapeutic compounds active against the same disease bonded via a covalent chemical linkage and it is this approach which is reviewed for the first time in the current article. For topically applied co-drugs, each moiety is liberated in situ, either chemically or enzymatically, once the stratum corneum barrier has been overcome by the co-drug. Advantages include synergistic modulation of the disease process, enhancement of drug delivery and pharmacokinetic properties and the potential to enhance stability by masking of labile functional groups. The amount of published work on co-drugs is limited but the available data suggest the co-drug concept could provide a significant therapeutic improvement in dermatological diseases. However, the applicability of the co-drug approach is subject to strict limitations pertaining mainly to the availability of compatible moieties and physicochemical properties of the overall molecule.