871 resultados para Transfusion Requirements
Resumo:
Despite being generally perceived as detrimental to the cardiovascular system, testosterone has marked beneficial vascular effects; most notably it acutely and directly causes vasodilatation. Indeed, men with hypotestosteronaemia can present with myocardial ischemia and angina which can be rapidly alleviated by infusion of testosterone. To date, however, in vitro studies have failed to provide a convincing mechanism to account for this clinically important effect. Here, using whole-cell patch-clamp recordings to measure current flow through recombinant human L-type Ca2+ channel alpha(1C) subunits (Ca(v)1.2), we demonstrate that testosterone inhibits such currents in a concentration-dependent manner. Importantly, this occurs over the physiological range of testosterone concentrations (IC50 34 nM), and is not mimicked by the metabolite 5alpha-androstan-17beta-ol-3-one (DHT), nor by progesterone or estradiol, even at high (10 microM) concentration. L-type Ca2+ channels in the vasculature are also important clinical targets for vasodilatory dihydropyridines. A single point mutation (T1007Y) almost completely abolishes nifedipine sensitivity in our recombinant expression system. Crucially, the same mutation renders the channels insensitive to testosterone. Our data strongly suggest, for the first time, the molecular requirements for testosterone binding to L-type Ca2+ channels, thereby supporting its beneficial role as an endogenous Ca2+ channel antagonist in the treatment of cardiovascular disease.
Resumo:
The United Kingdom’s pharmacy regulator contemplated using continuing professional development (CPD) in pharmacy revalidation in 2009, simultaneously asking pharmacy professionals to demonstrate the value of their CPD by showing its relevance and impact. The idea of linking new CPD requirements with revalidation was yet to be explored. Our aim was to develop and validate a framework to guide pharmacy professionals to select CPD activities that are relevant to their work and to produce a score sheet that would make it possible to quantify the impact and relevance of CPD. METHODS: We adapted an existing risk matrix, producing a CPD framework consisting of relevance and impact matrices. Concepts underpinning the framework were refined through feedback from five pharmacist teacher-practitioners. We then asked seven pharmacists to rate the relevance of the framework’s individual elements on a 4-point scale to determine content validity. We explored views about the framework through focus groups with six and interviews with 17 participants who had used it formally in a study. RESULTS: The framework’s content validity index was 0.91. Feedback about the framework related to three themes of penetrability of the framework, usefulness to completion of CPD, and advancement of CPD records for the purpose of revalidation. DISCUSSION: The framework can help professionals better select CPD activities prospectively, and makes assessment of CPD more objective by allowing quantification, which could be helpful for revalidation. We believe the framework could potentially help other health professionals with better management of their CPD irrespective of their field of practice.
Resumo:
An extensive off-line evaluation of the Noah/Single Layer Urban Canopy Model (Noah/SLUCM) urban land-surface model is presented using data from 15 sites to assess (1) the ability of the scheme to reproduce the surface energy balance observed in a range of urban environments, including seasonal changes, and (2) the impact of increasing complexity of input parameter information. Model performance is found to be most dependent on representation of vegetated surface area cover; refinement of other parameter values leads to smaller improvements. Model biases in net all-wave radiation and trade-offs between turbulent heat fluxes are highlighted using an optimization algorithm. Here we use the Urban Zones to characterize Energy partitioning (UZE) as the basis to assign default SLUCM parameter values. A methodology (FRAISE) to assign sites (or areas) to one of these categories based on surface characteristics is evaluated. Using three urban sites from the Basel Urban Boundary Layer Experiment (BUBBLE) dataset, an independent evaluation of the model performance with the parameter values representative of each class is performed. The scheme copes well with both seasonal changes in the surface characteristics and intra-urban heterogeneities in energy flux partitioning, with RMSE performance comparable to similar state-of-the-art models for all fluxes, sites and seasons. The potential of the methodology for high-resolution atmospheric modelling application using the Weather Research and Forecasting (WRF) model is highlighted. This analysis supports the recommendations that (1) three classes are appropriate to characterize the urban environment, and (2) that the parameter values identified should be adopted as default values in WRF.
Resumo:
This paper demonstrates that the use of GARCH-type models for the calculation of minimum capital risk requirements (MCRRs) may lead to the production of inaccurate and therefore inefficient capital requirements. We show that this inaccuracy stems from the fact that GARCH models typically overstate the degree of persistence in return volatility. A simple modification to the model is found to improve the accuracy of MCRR estimates in both back- and out-of-sample tests. Given that internal risk management models are currently in widespread usage in some parts of the world (most notably the USA), and will soon be permitted for EC banks and investment firms, we believe that our paper should serve as a valuable caution to risk management practitioners who are using, or intend to use this popular class of models.
Resumo:
Businesses need property in order to generate turnover and profits. If real estate owners are to be able to provide properties and related services that are desirable, it is crucial that they understand tenants’ requirements and preferences. Changes in the way businesses operate might well lead to an overall reduction in space requirements in all sectors. Faced with reductions in demand, landlords will find themselves in an increasingly competitive marketplace for tenants. Of the array of strategies available to landlords, what strategies should they employ for maximum effect? This paper examines what United Kingdom tenants want from commercial property (retail, industrial and office). The first part provides an analysis of data from several hundred interviews with occupiers of commercial properties owned by some of the largest UK real estate investment companies. Results are presented for each of the asset classes separately. The second part compares the findings with previous research and discusses the strategic implications for landlords.
Resumo:
Changes to client requirements are inevitable during construction. Industry discourse is concerned with minimizing and controlling changes. However, accounts of practices involved in making changes are rare. In response to calls for more research into working practices, an ethnographic study of a live hospital project was undertaken to explore how changes are made. A vignette of a meeting exploring the investigation of changes illustrates the issues. This represents an example from the ethnographic fieldwork, which produced many observations. There was a strong emphasis on using change management procedures contained within the contract to investigate changes, even when it was known that the change was not required. For the practitioners, this was a way of demonstrating best practice, transparent and accountable decision-making regarding changes. Hence, concerns for following procedures sometimes overshadowed considerations about whether or not a change was required to improve the functionality of the building. However, the procedures acted as boundary objects between the communities of practice involved on the project by coordinating the work of managing changes. Insights suggest how contract procedures facilitate and impede the making of changes, which can inform policy guidance and contract drafting.
Resumo:
Flexibility of information systems (IS) have been studied to improve the adaption in support of the business agility as the set of capabilities to compete more effectively and adapt to rapid changes in market conditions (Glossary of business agility terms, 2003). However, most of work on IS flexibility has been limited to systems architecture, ignoring the analysis of interoperability as a part of flexibility from the requirements. This paper reports a PhD project, which proposes an approach to develop IS with flexibility features, considering some challenges of flexibility in small and medium enterprises (SMEs) such as the lack of interoperability and the agility of their business. The motivation of this research are the high prices of IS in developing countries and the usefulness of organizational semiotics to support the analysis of requirements for IS. (Liu, 2005).
Resumo:
This paper describes an application of Social Network Analysis methods for identification of knowledge demands in public organisations. Affiliation networks established in a postgraduate programme were analysed. The course was executed in a distance education mode and its students worked on public agencies. Relations established among course participants were mediated through a virtual learning environment using Moodle. Data available in Moodle may be extracted using knowledge discovery in databases techniques. Potential degrees of closeness existing among different organisations and among researched subjects were assessed. This suggests how organisations could cooperate for knowledge management and also how to identify their common interests. The study points out that closeness among organisations and research topics may be assessed through affiliation networks. This opens up opportunities for applying knowledge management between organisations and creating communities of practice. Concepts of knowledge management and social network analysis provide the theoretical and methodological basis.
Resumo:
Cosmic shear requires high precision measurement of galaxy shapes in the presence of the observational point spread function (PSF) that smears out the image. The PSF must therefore be known for each galaxy to a high accuracy. However, for several reasons, the PSF is usually wavelength dependent; therefore, the differences between the spectral energy distribution of the observed objects introduce further complexity. In this paper, we investigate the effect of the wavelength dependence of the PSF, focusing on instruments in which the PSF size is dominated by the diffraction limit of the telescope and which use broad-band filters for shape measurement. We first calculate biases on cosmological parameter estimation from cosmic shear when the stellar PSF is used uncorrected. Using realistic galaxy and star spectral energy distributions and populations and a simple three-component circular PSF, we find that the colour dependence must be taken into account for the next generation of telescopes. We then consider two different methods for removing the effect: (i) the use of stars of the same colour as the galaxies and (ii) estimation of the galaxy spectral energy distribution using multiple colours and using a telescope model for the PSF. We find that both of these methods correct the effect to levels below the tolerances required for per cent level measurements of dark energy parameters. Comparison of the two methods favours the template-fitting method because its efficiency is less dependent on galaxy redshift than the broad-band colour method and takes full advantage of deeper photometry.