834 resultados para limitations of therapy


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Herbivorous insects, their host plants and natural enemies form the largest and most species-rich communities on earth. But what forces structure such communities? Do they represent random collections of species, or are they assembled by given rules? To address these questions, food webs offer excellent tools. As a result of their versatile information content, such webs have become the focus of intensive research over the last few decades. In this thesis, I study herbivore-parasitoid food webs from a new perspective: I construct multiple, quantitative food webs in a spatially explicit setting, at two different scales. Focusing on food webs consisting of specialist herbivores and their natural enemies on the pedunculate oak, Quercus robur, I examine consistency in food web structure across space and time, and how landscape context affects this structure. As an important methodological development, I use DNA barcoding to resolve potential cryptic species in the food webs, and to examine their effect on food web structure. I find that DNA barcoding changes our perception of species identity for as many as a third of the individuals, by reducing misidentifications and by resolving several cryptic species. In terms of the variation detected in food web structure, I find surprising consistency in both space and time. From a spatial perspective, landscape context leaves no detectable imprint on food web structure, while species richness declines significantly with decreasing connectivity. From a temporal perspective, food web structure remains predictable from year to year, despite considerable species turnover in local communities. The rate of such turnover varies between guilds and species within guilds. The factors best explaining these observations are abundant and common species, which have a quantitatively dominant imprint on overall structure, and suffer the lowest turnover. By contrast, rare species with little impact on food web structure exhibit the highest turnover rates. These patterns reveal important limitations of modern metrics of quantitative food web structure. While they accurately describe the overall topology of the web and its most significant interactions, they are disproportionately affected by species with given traits, and insensitive to the specific identity of species. As rare species have been shown to be important for food web stability, metrics depicting quantitative food web structure should then not be used as the sole descriptors of communities in a changing world. To detect and resolve the versatile imprint of global environmental change, one should rather use these metrics as one tool among several.

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HeI photoelectron spectra of 1:1 electron donor-acceptor complexes are discussed in the light of molecular orbital calculations. The complexes discussed include those formed by BH3, BF3 and SO2. Some systematics have been found in the ionization energy shifts of the complexes compared to the free components and these are related to the strength of the donor-acceptor bond. Hel spectra of hydrogen bonded complexes are discussed in comparison with results from MO calculations. Limitations of such studies as well as scope for further investigations are indicated.

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Health-related quality of life (HRQoL) measurement has become an important outcome in treatment trials and in health policy decisions. HRQoL can be measured by using generic or disease-specific tools. Generic instruments can be used for comparing health status among patients in different health states and conditions but they do not focus specifically on the issues relevant in a particular disease. Disease-specific tools may be more responsive to changes within a specific condition. In earlier studies, impairment of HRQoL has been evident in patients with inflammatory bowel disease (IBD), especially when the disease is active. Data about the impact of comorbidity or demographic characteristics of the patients on HRQoL are partly controversial. This study, which comprised 2913 adult IBD patients, examined HRQoL using the disease-specific IBDQ and the general 15D instruments. The 15D scores of IBD patients were compared with scores of a gender and age matched general population sample. Frequency of IBD symptoms and arrangement of therapy were studied and compared with those of IBD patients in an earlier European study. Furthermore, data of other chronic diseases of the patients were obtained from the Social Insurance Institution s reimbursement register and comorbidity of IBD patients was compared with that of age and gender matched controls. --- Of the respondents, 37% reported that they suffered from disturbing IBD symptoms weekly. In 17% of the patients, the symptoms greatly affected the ability to enjoy leisure activities, and 14% stated that these symptoms greatly affected their capacity to work. Despite that, the great majority (93%) of patients expressed satisfaction with their current treatment, which exceeded the rate observed in the other European patients. The mean IBDQ score was 163, as the possible range is 32-224, and disease activity was strongly correlated with HRQoL. Older age, comorbid diseases, and female gender were also related to impairment of HRQoL. Lower HRQoL scores were seen also in newly-diagnosed patients and in those with a history of surgery, especially after stoma or ileal pouch-anal anastomosis (IPAA) operation. The range of 15D scores was 0.30-1.00, with mean of 0.87. As with the IBDQ, disease activity, older age and history of surgery were correlated with the score. Both the newly-diagnosed patients and patients with a long-lasting disease had lower scores than average even after adjusting for age. The 15D scores of IBD patients were significantly lower than those of the control group. A strong correlation was seen between the 15D and the IBDQ scores. Comorbidity with other chronic diseases was observed in 29% of IBD patients. Connective tissue diseases, chronic obstructive pulmonary diseases, pernicious anaemia, and coronary heart disease (CHD) were significantly increased in patients with IBD. Especially female IBD patients appeared to be at increased risk for CHD, and patients who reported weekly IBD symptoms had a higher risk for having other chronic diseases in addition to IBD. Comorbidity impaired HRQoL, as measured with both generic and disease-specific tools. In conclusion, HRQoL is impaired in IBD patients. An understanding of predictors of HRQoL will help to recognise patients who will need special support.

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Therapeutic work with the client’s present moment experience in existential therapy was studied by means of conversation analysis. Using publicly available video recordings of therapy sessions as data, an existential therapist’s practice of guiding a client into immediacy, or refocusing the talk on a client’s immediate experience, was described and compared with a therapist’s corresponding action in cognitive therapy. The study contributes to the description of interactional practice of existential therapy, and involves the first application of conversation analysis to a comparative study of psychotherapy process. The potential utility of this approach and the clinical and empirical implications of the present findings are discussed.

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Lactose is probably the most used tablet excipient in the field of pharmacy. Although lactose is thoroughly characterized and available in many different forms there is a need to find a replacer for lactose as a filler/binder in tablet formulations because it has some downsides. Melibiose is a relatively unknown disaccharide that has not been thoroughly characterized and not previously used as an excipient in tablets. Structurally melibiose is close to lactose as it is also formed from the same two monosaccharides, glucose and galactose. Aim of this research is to characterize and to study physicochemical properties of melibiose. Also the potential of melibiose to be used as pharmaceutical tablet excipient, even as a substitute for lactose is evaluated. Current knowledge about fundamentals of tableting and methods for determinating of deformation behavior and tabletability are reviewed. In this research Raman spectroscopy, X-ray powder diffraction (XRPD), near-infrared spectroscopy (NIR) and Fourier-transform infrared spectroscopy (FT-IR) were used to study differences between two melibiose batches purchased from two suppliers. In NIR and FT-IR measurements no difference between materials could be observed. XPRD and Raman however found differences between the two melibiose batches. Also the effects of moisture content and heating to material properties were studied and moisture content of materials seems to cause some differences. Thermal analytical methods, differential scanning calorimetry (DSC) and thermogravimetry (TG) were used to study thermal behaviour of melibiose and difference between materials was found. Other melibiose batch contains residual water which evaporates at higher temperatures causing the differences in thermal behaviour. Scanning electron microscopy images were used to evaluate particle size, particle shape and morphology. Bulk, tapped and true densities and flow properties of melibiose was measured. Particle size of the melibiose batches are quite different resulting causing differences in the flowability. Instrumented tableting machine and compression simulator were used to evaluate tableting properties of melbiose compared to α-lactose monohydrate. Heckel analysis and strain-rate sensitivity index were used to determine deformation mechanism of melibiose monohydrate in relation to α–lactose monohydrate during compaction. Melibiose seems to have similar deformation behaviour than α-lactose monohydrate. Melibiose is most likely fragmenting material. Melibiose has better compactibility than α – lactose monohydrate as it produces tablets with higher tensile strength with similar compression pressures. More compression studies are however needed to confirm these results because limitations of this study.

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Whether HIV-1 evolution in infected individuals is dominated by deterministic or stochastic effects remains unclear because current estimates of the effective population size of HIV-1 in vivo, N-e, are widely varying. Models assuming HIV-1 evolution to be neutral estimate N-e similar to 10(2)-10(4), smaller than the inverse mutation rate of HIV-1 (similar to 10(5)), implying the predominance of stochastic forces. In contrast, a model that includes selection estimates N-e>10(5), suggesting that deterministic forces would hold sway. The consequent uncertainty in the nature of HIV-1 evolution compromises our ability to describe disease progression and outcomes of therapy. We perform detailed bit-string simulations of viral evolution that consider large genome lengths and incorporate the key evolutionary processes underlying the genomic diversification of HIV-1 in infected individuals, namely, mutation, multiple infections of cells, recombination, selection, and epistatic interactions between multiple loci. Our simulations describe quantitatively the evolution of HIV-1 diversity and divergence in patients. From comparisons of our simulations with patient data, we estimate N-e similar to 10(3)-10(4), implying predominantly stochastic evolution. Interestingly, we find that N-e and the viral generation time are correlated with the disease progression time, presenting a route to a priori prediction of disease progression in patients. Further, we show that the previous estimate of N-e>10(5) reduces as the frequencies of multiple infections of cells and recombination assumed increase. Our simulations with N-e similar to 10(3)-10(4) may be employed to estimate markers of disease progression and outcomes of therapy that depend on the evolution of viral diversity and divergence.

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In this study, we model the long-term effect of climate change on commercially important teak (Tectona grandis) and its productivity in India. This modelling assessment is based on climate projections of the regional climate model of the Hadley Center (HadRM3) and the dynamic vegetation model, IBIS. According to the model projections, 30% of teak grids in India are vulnerable to climate change under both A2 and B2 SRES scenarios because the future climate may not be optimal for teak at these grids. However, the net primary productivity and biomass are expected to increase because of elevated levels of CO2. Given these directions of likely impacts, it is crucial to further investigate the climate change impacts on teak and incorporate such findings into long-term teak plantation programs. This study also demonstrates the feasibility and limitations of assessing the impact of projected climate change at the species level in the tropics.

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Maurice Merleau-Ponty (1908-1961) has been known as the philosopher of painting. His interest in the theory of perception intertwined with the questions concerning the artist s perception, the experience of an artwork and the possible interpretations of the artwork. For him, aesthetics was not a sub-field of philosophy, and art was not simply a subject matter for the aesthetic experience, but a form of thinking. This study proposes an opening for a dialogue between Merleau-Pontian phenomenology and contemporary art. The thesis examines his phenomenology through certain works of contemporary art and presents readings of these artworks through his phenomenology. The thesis both shows the potentiality of a method, but also engages in the critical task of finding the possible limitations of his approach. The first part lays out the methodological and conceptual points of departure of Merleau-Ponty s phenomenological approach to perception as well as the features that determined his discussion on encountering art. Merleau-Ponty referred to the experience of perceiving art using the notion of seeing with (voir selon). He stressed a correlative reciprocity described in Eye and Mind (1961) as the switching of the roles of the visible and the painter. The choice of artworks is motivated by certain restrictions in the phenomenological readings of visual arts. The examined works include paintings by Tiina Mielonen, a photographic work by Christian Mayer, a film by Douglas Gordon and Philippe Parreno, and an installation by Monika Sosnowska. These works resonate with, and challenge, his phenomenological approach. The chapters with case studies take up different themes that are central to Merleau-Ponty s phenomenology: space, movement, time, and touch. All of the themes are interlinked with the examined artworks. There are also topics that reappear in the thesis, such as the notion of écart and the question of encountering the other. As Merleau-Ponty argued, the sphere of art has a particular capability to address our being in the world. The thesis presents an interpretation that emphasises the notion of écart, which refers to an experience of divergence or dispossession. The sudden dissociation, surprise or rupture that is needed in order for a meeting between the spectator and the artwork, or between two persons, to be possible. Further, the thesis suggests that through artworks it is possible to take into consideration the écart, the divergence, that defines our subjectivity.

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The current standard of care for hepatitis C virus (HCV) infection - combination therapy with pegylated interferon and ribavirin - elicits sustained responses in only similar to 50% of the patients treated. No alternatives exist for patients who do not respond to combination therapy. Addition of ribavirin substantially improves response rates to interferon and lowers relapse rates following the cessation of therapy, suggesting that increasing ribavirin exposure may further improve treatment response. A key limitation, however, is the toxic side-effect of ribavirin, hemolytic anemia, which often necessitates a reduction of ribavirin dosage and compromises treatment response. Maximizing treatment response thus requires striking a balance between the antiviral and hemolytic activities of ribavirin. Current models of viral kinetics describe the enhancement of treatment response due to ribavirin. Ribavirin-induced anemia, however, remains poorly understood and precludes rational optimization of combination therapy. Here, we develop a new mathematical model of the population dynamics of erythrocytes that quantitatively describes ribavirin-induced anemia in HCV patients. Based on the assumption that ribavirin accumulation decreases erythrocyte lifespan in a dose-dependent manner, model predictions capture several independent experimental observations of the accumulation of ribavirin in erythrocytes and the resulting decline of hemoglobin in HCV patients undergoing combination therapy, estimate the reduced erythrocyte lifespan during therapy, and describe inter-patient variations in the severity of ribavirin-induced anemia. Further, model predictions estimate the threshold ribavirin exposure beyond which anemia becomes intolerable and suggest guidelines for the usage of growth hormones, such as erythropoietin, that stimulate erythrocyte production and avert the reduction of ribavirin dosage, thereby improving treatment response. Our model thus facilitates, in conjunction with models of viral kinetics, the rational identification of treatment protocols that maximize treatment response while curtailing side effects.

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An integrated model is developed, based on seasonal inputs of reservoir inflow and rainfall in the irrigated area, to determine the optimal reservoir release policies and irrigation allocations to multiple crops. The model is conceptually made up of two modules, Module 1 is an intraseasonal allocation model to maximize the sum of relative yields of all crops, for a given state of the system, using linear programming (LP). The module takes into account reservoir storage continuity, soil moisture balance, and crop root growth with time. Module 2 is a seasonal allocation model to derive the steady state reservoir operating policy using stochastic dynamic programming (SDP). Reservoir storage, seasonal inflow, and seasonal rainfall are the state variables in the SDP. The objective in SDP is to maximize the expected sum of relative yields of all crops in a year. The results of module 1 and the transition probabilities of seasonal inflow and rainfall form the input for module 2. The use of seasonal inputs coupled with the LP-SDP solution strategy in the present formulation facilitates in relaxing the limitations of an earlier study, while affecting additional improvements. The model is applied to an existing reservoir in Karnataka State, India.

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This paper critically appraises the limitations of the liquid-limit water content of clayey soils determined conventionally either by percussion cup or by the cone penetration method. It is shown that the conventional liquid limit and plastic limit are arbitrary, strength-based water contents and that they cannot represent the plasticity limits, and that the state of the soil-water system at the conventional liquid limit does not correspond to a stress-free reference state. The present investigation identifies three characteristic limiting water contents for a soil-water system which have well-defined, unique mechanisms controlling them, namely the free swell limit, settling limit and shrinkage limit. Simple procedures for the determination of the free swell limit and settling limit of natural soils are presented. The settling limit is shown to be the 'real liquid limit' of any clayey soil. With a number of experimental illustrations, it is clearly shown that the settling limit represents the maximum water-holding capacity of clayey soils and that it corresponds to the stress-free reference state.

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The various techniques available for the analysis of nonlinear systems subjected to random excitations are briefly introduced and an overview of the progress which has been made in this area of research is presented. The discussion is mainly focused on the basis, scope and limitations of the solution techniques and not on specific applications.

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Direct numerical simulation (DNS) results of autoignition in anon-premixed medium under an isotropic, homogeneous, and decaying turbulence are presented. The initial mixture consists of segregated fuel parcels randomly distributed within warm air, and the entire medium is subjected to a three-dimensional turbulence. Chemical kinetics is modeled by a four-step reduced reaction mechanism for autoignition of n-heptane/air mixture. Thus, this work overcomes the principal limitations of a previous contribution of the authors on two-dimensional DNS of autoignition with a one-step reaction model. Specific attention is focused on the differences in the effects of two- and three-dimensional turbulence on autoignition characteristics. The three-dimensional results show that ignition spots are most likely to originate at locations jointly corresponding to the most reactive mixture fraction and low scalar dissipation rate. Further, these ignition spots are found to originate at locations corresponding to the core of local vortical structures, and after ignition, the burning gases move toward the vortex periphery Such a movement is explained as caused by the cyclostrophic imbalance developed when the local gas density is variable. These results lead to the conclusion that the local ignition-zone structure does not conform to the classical stretched flamelet description. Parametric studies show that the ignition delay time decreases with an increase in turbulence intensity. Hence, these three-dimensional simulation results resolve the discrepancy between trends in experimental data and predictions from DNSs of two-dimensional turbulence. This qualitative difference between DNS results from three- and two-dimensional simulations is discussed and attributed to the effect of vortex stretching that is present in the former, but not in the latter.

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The work reported in this thesis is an attempt to enhance heat transfer in electronic devices with the use of impinging air jets on pin-finned heat sinks. The cooling per-formance of electronic devices has attracted increased attention owing to the demand of compact size, higher power densities and demands on system performance and re-liability. Although the technology of cooling has greatly advanced, the main cause of malfunction of the electronic devices remains overheating. The problem arises due to restriction of space and also due to high heat dissipation rates, which have increased from a fraction of a W/cm2to 100s of W /cm2. Although several researchers have at-tempted to address this at the design stage, unfortunately the speed of invention of cooling mechanism has not kept pace with the ever-increasing requirement of heat re- moval from electronic chips. As a result, efficient cooling of electronic chip remains a challenge in thermal engineering. Heat transfer can be enhanced by several ways like air cooling, liquid cooling, phase change cooling etc. However, in certain applications due to limitations on cost and weight, eg. air borne application, air cooling is imperative. The heat transfer can be increased by two ways. First, increasing the heat transfer coefficient (forced convec- tion), and second, increasing the surface area of heat transfer (finned heat sinks). From previous literature it was established that for a given volumetric air flow rate, jet im-pingement is the best option for enhancing heat transfer coefficient and for a given volume of heat sink material pin-finned heat sinks are the best option because of their high surface area to volume ratio. There are certain applications where very high jet velocities cannot be used because of limitations of noise and presence of delicate components. This process can further be improved by pulsating the jet. A steady jet often stabilizes the boundary layer on the surface to be cooled. Enhancement in the convective heat transfer can be achieved if the boundary layer is broken. Disruptions in the boundary layer can be caused by pulsating the impinging jet, i.e., making the jet unsteady. Besides, the pulsations lead to chaotic mixing, i.e., the fluid particles no more follow well defined streamlines but move unpredictably through the stagnation region. Thus the flow mimics turbulence at low Reynolds number. The pulsation should be done in such a way that the boundary layer can be disturbed periodically and yet adequate coolant is made available. So, that there is not much variation in temperature during one pulse cycle. From previous literature it was found that square waveform is most effective in enhancing heat transfer. In the present study the combined effect of pin-finned heat sink and impinging slot jet, both steady and unsteady, has been investigated for both laminar and turbulent flows. The effect of fin height and height of impingement has been studied. The jets have been pulsated in square waveform to study the effect of frequency and duty cycle. This thesis attempts to increase our understanding of the slot jet impingement on pin-finned heat sinks through numerical investigations. A systematic study is carried out using the finite-volume code FLUENT (Version 6.2) to solve the thermal and flow fields. The standard k-ε model for turbulence equations and two layer zonal model in wall function are used in the problem Pressure-velocity coupling is handled using the SIMPLE algorithm with a staggered grid. The parameters that affect the heat transfer coefficient are: height of the fins, total height of impingement, jet exit Reynolds number, frequency of the jet and duty cycle (percentage time the jet is flowing during one complete cycle of the pulse). From the studies carried out it was found that: a) beyond a certain height of the fin the rate of enhancement of heat transfer becomes very low with further increase in height, b) the heat transfer enhancement is much more sensitive to any changes at low Reynolds number than compared to high Reynolds number, c) for a given total height of impingement the use of fins and pulsated jet, increases the effective heat transfer coefficient by almost 200% for the same average Reynolds number, d) for all the cases it was observed that the optimum frequency of impingement is around 50 − 100 Hz and optimum duty cycle around 25-33.33%, e) in the case of turbulent jets the enhancement in heat transfer due to pulsations is very less compared to the enhancement in case of laminar jets.

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The Indian Summer Monsoon (ISM) precipitation recharges ground water aquifers in a large portion of the Indian subcontinent. Monsoonal precipitation over the Indian region brings moisture from the Arabian Sea and the Bay of Bengal (BoB). A large difference in the salinity of these two reservoirs, owing to the large amount of freshwater discharge from the continental rivers in the case of the BoB and dominating evaporation processes over the Arabian Sea region, allows us to distinguish the isotopic signatures in water originating in these two water bodies. Most bottled water manufacturers exploit the natural resources of groundwater, replenished by the monsoonal precipitation, for bottling purposes. The work presented here relates the isotopic ratios of bottled water to latitude, moisture source and seasonality in precipitation isotope ratios. We investigated the impact of the above factors on the isotopic composition of bottled water. The result shows a strong relationship between isotope ratios in precipitation (obtained from the GNIP data base)/bottled water with latitude. The approach can be used to predict the latitude at which the bottled water was manufactured. The paper provides two alternative approaches to address the site prediction. The limitations of this approach in identifying source locations and the uncertainty in latitude estimations are discussed. Furthermore, the method provided here can also be used as an important forensic tool for exploring the source location of bottled water from other regions. Copyright (C) 2011 John Wiley & Sons, Ltd.