953 resultados para criteria of hypertrophy


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The propagation of an initially planar front is studied within the framework of the photosensitive Belousov-Zhabotinsky reaction modulated by a smooth spatial variation of the local front velocity in the direction perpendicular to front propagation. Under this modulation, the wave front develops several fingers corresponding to the local maxima of the modulation function. After a transient, the wave front achieves a stationary shape that does not necessarily coincide with the one externally imposed by the modulation. Theoretical predictions for the selection criteria of fingers and steady-state velocity are experimentally validated.

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Oculofaciocardiodental (OFCD) and Lenz microphthalmia syndromes form part of a spectrum of X-linked microphthalmia disorders characterized by ocular, dental, cardiac and skeletal anomalies and mental retardation. The two syndromes are allelic, caused by mutations in the BCL-6 corepressor gene (BCOR). To extend the series of phenotypes associated with pathogenic mutations in BCOR, we sequenced the BCOR gene in patients with (1) OFCD syndrome, (2) putative X-linked ('Lenz') microphthalmia syndrome, (3) isolated ocular defects and (4) laterality phenotypes. We present a new cohort of females with OFCD syndrome and null mutations in BCOR, supporting the hypothesis that BCOR is the sole molecular cause of this syndrome. We identify for the first time mosaic BCOR mutations in two females with OFCD syndrome and one apparently asymptomatic female. We present a female diagnosed with isolated ocular defects and identify minor features of OFCD syndrome, suggesting that OFCD syndrome may be mild and underdiagnosed. We have sequenced a cohort of males diagnosed with putative X-linked microphthalmia and found a mutation, p.P85L, in a single case, suggesting that BCOR mutations are not a major cause of X-linked microphthalmia in males. The absence of BCOR mutations in a panel of patients with non-specific laterality defects suggests that mutations in BCOR are not a major cause of isolated heart and laterality defects. Phenotypic analysis of OFCD and Lenz microphthalmia syndromes shows that in addition to the standard diagnostic criteria of congenital cataract, microphthalmia and radiculomegaly, patients should be examined for skeletal defects, particularly radioulnar synostosis, and cardiac/laterality defects.

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The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis patients remains challenging, mainly owing to overlapping symptoms of the underlying lung disease with clinical symptoms of ABPA. In addition, a varying mixture of diagnostic criteria, including clinical status, radiological findings and immunological measurements, has led to confusion and differing recommendations. In order to help simplify as well as standardize the diagnostic criteria for ABPA, different serological markers have been evaluated in the last 20 years and their usefulness has been assessed in many clinical studies. This review presents current diagnostic criteria of ABPA, with a special focus on serum markers supporting the diagnosis and explains why the hunt for a serological marker for ABPA is still ongoing.

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Objective: To examine whether prior statin use affects outcome and intracranial hemorrhage (ICH) rates in stroke patients receiving IV thrombolysis (IVT).Methods: In a pooled observational study of 11 IVT databases, we compared outcomes between statin users and nonusers. Outcome measures were excellent 3-month outcome (modified Rankin scale 0-1) and ICH in 3 categories. We distinguished all ICHs (ICH(all)), symptomatic ICH based on the criteria of the ECASS-II trial (SICH(ECASS-II)), and symptomatic ICH based on the criteria of the National Institute of Neurological Disorders and Stroke (NINDS) trial (SICH(NINDS)). Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals were calculated.Results: Among 4,012 IVT-treated patients, 918 (22.9%) were statin users. They were older, more often male, and more frequently had hypertension, hypercholesterolemia, diabetes, coronary heart disease, and concomitant antithrombotic use compared with nonusers. Fewer statin users (35.5%) than nonusers (39.7%) reached an excellent 3-month outcome (OR(unadjusted) 0.84 [0.72-0.98], p = 0.02). After adjustment for age, gender, blood pressure, time to thrombolysis, and stroke severity, the association was no longer significant (0.89 [0.74-1.06], p = 0.20). ICH occurred by trend more often in statin users (ICH(all) 20.1% vs 17.4%; SICH(NINDS) 9.2% vs 7.5%; SICH(ECASS-II) 6.9% vs 5.1%). This difference was statistically significant only for SICH(ECASS-II) (OR = 1.38 [1.02-1.87]). After adjustment for age, gender, blood pressure, use of antithrombotics, and stroke severity, the OR(adjusted) for each category of ICH (ICH(all) 1.15 [0.93-1.41]; SICH(ECASS-II) 1.32 [0.94-1.85]; SICH(NINDS) 1.16 [0.87-1.56]) showed no difference between statin users and nonusers.Conclusion: In stroke patients receiving IVT, prior statin use was neither an independent predictor of functional outcome nor ICH. It may be considered as an indicator of baseline characteristics that are associated with a less favorable course. Neurology (R) 2011;77:888-895

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Transplant glomerulopathy (TG) has received much attention in recent years as a symptom of chronic humoral rejection; however, many cases lack C4d deposition and/or circulating donor-specific antibodies (DSAs). To determine the contribution of other causes, we studied 209 consecutive renal allograft indication biopsies for chronic allograft dysfunction, of which 25 met the pathological criteria of TG. Three partially overlapping etiologies accounted for 21 (84%) cases: C4d-positive (48%), hepatitis C-positive (36%), and thrombotic microangiopathy (TMA)-positive (32%) TG. The majority of patients with confirmed TMA were also hepatitis C positive, and the majority of hepatitis C-positive patients had TMA. DSAs were significantly associated with C4d-positive but not with hepatitis C-positive TG. The prevalence of hepatitis C was significantly higher in the TG group than in 29 control patients. Within the TG cohort, those who were hepatitis C-positive developed allograft failure significantly earlier than hepatitis C-negative patients. Thus, TG is not a specific diagnosis but a pattern of pathological injury involving three major overlapping pathways. It is important to distinguish these mechanisms, as they may have different prognostic and therapeutic implications.

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En les cures pal·liatives pediàtriques es contemplen les dimensions essencials de la persona: la física, la psicològica, la social i l’espiritual. Tot i que s’han fet estudis sobre la dimensió espiritual, en la revisió bibliogràfica es mostra que és un àmbit poc desenvolupat. És important conèixer l’aspecte de creences i valors per tal que la infermera oncològica, juntament amb altres professionals, puguin proporcionar una atenció holística. L’objectiu d’aquest estudi és identificar les necessitats espirituals en adolescents (13 a 18 anys) malalts de càncer en situació avançada-terminal. S’utilitza la metodologia qualitativa. La mostra és de vuit adolescents, que són seleccionats d’acord amb els criteris d’inclusió. Aquests seran entrevistats per la infermera, la investigadora, la qual realitzarà entrevistes semiestructurades i un fotomuntatge depenent de la predisposició de l’adolescent. L’àmbit de realització d’aquest estudi és en un hospital de tercer nivell on es proporcioni atenció especialitzada amb pediatria oncològica i, concretament, en una unitat de cures pal·liatives pediàtriques. Per finalitzar, és important tenir en compte que les entrevistes i el fotomuntatge poden tenir les seves limitacions i que no sempre s’obtingui el resultat esperat.

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Aim To assess the geographical transferability of niche-based species distribution models fitted with two modelling techniques. Location Two distinct geographical study areas in Switzerland and Austria, in the subalpine and alpine belts. Methods Generalized linear and generalized additive models (GLM and GAM) with a binomial probability distribution and a logit link were fitted for 54 plant species, based on topoclimatic predictor variables. These models were then evaluated quantitatively and used for spatially explicit predictions within (internal evaluation and prediction) and between (external evaluation and prediction) the two regions. Comparisons of evaluations and spatial predictions between regions and models were conducted in order to test if species and methods meet the criteria of full transferability. By full transferability, we mean that: (1) the internal evaluation of models fitted in region A and B must be similar; (2) a model fitted in region A must at least retain a comparable external evaluation when projected into region B, and vice-versa; and (3) internal and external spatial predictions have to match within both regions. Results The measures of model fit are, on average, 24% higher for GAMs than for GLMs in both regions. However, the differences between internal and external evaluations (AUC coefficient) are also higher for GAMs than for GLMs (a difference of 30% for models fitted in Switzerland and 54% for models fitted in Austria). Transferability, as measured with the AUC evaluation, fails for 68% of the species in Switzerland and 55% in Austria for GLMs (respectively for 67% and 53% of the species for GAMs). For both GAMs and GLMs, the agreement between internal and external predictions is rather weak on average (Kulczynski's coefficient in the range 0.3-0.4), but varies widely among individual species. The dominant pattern is an asymmetrical transferability between the two study regions (a mean decrease of 20% for the AUC coefficient when the models are transferred from Switzerland and 13% when they are transferred from Austria). Main conclusions The large inter-specific variability observed among the 54 study species underlines the need to consider more than a few species to test properly the transferability of species distribution models. The pronounced asymmetry in transferability between the two study regions may be due to peculiarities of these regions, such as differences in the ranges of environmental predictors or the varied impact of land-use history, or to species-specific reasons like differential phenotypic plasticity, existence of ecotypes or varied dependence on biotic interactions that are not properly incorporated into niche-based models. The lower variation between internal and external evaluation of GLMs compared to GAMs further suggests that overfitting may reduce transferability. Overall, a limited geographical transferability calls for caution when projecting niche-based models for assessing the fate of species in future environments.

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BACKGROUND: This study identifies a set of psychosocial difficulties that are associated with short term changes in health outcomes across a heterogeneous set of brain disorders, neurological and psychiatric. METHODS: Longitudinal observational study over approximately 12 weeks with three time points of assessment and 741 patients with depression, bipolar disorders, multiple sclerosis, parkinson's disease, migraine, traumatic brain injury and stroke. The data on disability was collected with the checklist of the International Classification of Functioning, Disability and Health. The selected health outcomes were the Short Form 36 and the World Health Organization Disability Assessment Schedule. Multilevel models for change were applied controlling for age, gender and disease severity. RESULTS: The psychosocial difficulties that explain the variability and change over time of the selected health outcomes were energy and drive, sleep, and emotional functions, and a broad range of activities and participation domains, such as solving problems, conversation, areas of mobility and self-care, relationships, community life and recreation and leisure. CONCLUSIONS: Our findings are of interest to researchers and clinicians for interventions and health systems planning as they show that in addition to difficulties that are diagnostic criteria of these disorders, there are other difficulties that explain small changes in health outcomes over short periods of time.

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When hypothermic patients appear to be dead, the decision to resuscitate may be difficult due to lack of reliable criteria of death. To discover useful prognostic indicators, we reviewed the hospital charts of nine hypothermic victims of snow avalanches (group A: median value of rectal temperature, 29.6 degrees C; range, less than 12 degrees C to 34 degrees C) and of 15 patients with hypothermia following acute drug intoxication and/or cold exposure (group B: 28.8 degrees C; range, 25.5 degrees C to 32 degrees C. In group A, plasma potassium level on admission was extremely high (14.5 mmol/L; range, 6.8 to 24.5 mmol/L) compared with that obtained in group B (3.5 mmol/L; range, 2.7 to 5.3 mmol/L). All patients in group A were in cardiorespiratory arrest. None could be successfully resuscitated despite effective rewarming by cardiopulmonary bypass or peritoneal lavage. In contrast, all of the patients in group B recovered from hypothermia, including two in cardiorespiratory arrest. Thus, extreme hyperkalemia during acute hypothermia appears to be a reliable marker of death. It might be used to select those patients in whom heroic resuscitation efforts can be useful.

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Se presentan los resultados de los diversos estudios de poblaciones de aves realizados en los alcornocales catalanes, especialmente en cuanto a la riqueza específica de los mismos. Dado que los estudios publicados hasta el momento en esta materia eran referidos a la estación reproductora (primavera), se señalan los datos recogidos en los alcornocales de les Gavarres (NE peninsular), durante la estación invernal. Asimismo, se analizan las diversas tipologías de alcornocales que se encuentran en Catalunya, bosques en gestión activa, y por tanto sin sotobosque, y bosques abandonados en los que la biomasa del sotobosque es máxi-ma, y se exponen los resultados de la comparativa entre ambas tipologías de explotación cuando se aplica un índice de conservación de la avifauna, basado en la riqueza de cada una de las especies registradas, la presencia de especies amenazadas según los criterios de la UICN (SPEC) y su categoría de amenaza (non-SPEC, SPEC 4, SPEC 3, SPEC 2 y SPEC 1). Los resultados obtenidos muestran como las explotaciones abandonadas tienen un índice de conservación de avifauna más elevado que los bosques en explotación activa. Se discuten es-tos resultados en el contexto de la gestión forestal y las ayudas recibidas por parte de las ad-ministraciones para llevar a cabo estas prácticas de gestión

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Background:Transplant glomerulopathy (TG) has received much attention in recent years as a manifestation of chronic humoral rejection (CHR). However, many cases lack C4d deposition and/or circulating donor-specifi c antibodies, and the contribution of other potential causes has not been fully addressed.Methods: Of 209 consecutive renal allograft indication biopsies performed for chronic allograft dysfunction, 25 that met pathologic criteria of TG (>10% duplication of the GBM without immune complex deposition) were examined for various etiologies, including hepatitis C infection (HCV), thrombotic microangiopathy (TMA), and CHR. 29 cases of biopsy-proven isolated chronic calcineurin inhibitor toxicity from the same time period were used as controls for comparing the prevalence of HCV.Results: Three partially overlapping categories accounted for 84% of the cases: C4d+TG (48%), HCV+TG (36%) and TMA+TG (32%). The majority of TMA+ cases were HCV+ (63%) and the majority of HCV+ cases had TMA (56%). Donor specifi c antibodies were associated with C4d+TG (7/8 vs. 1/4 C4d-TG; P<0.02), but not with HCV+TG. The prevalence of HCV was higher in the TG group than in 29 control patients without TG (36% vs. 7%, P<0.01). HCV+TG patients developed allograft failure earlier than HCV-TG patients (67.2 ± 60.2 mo versus 153.4 ± 126.2 mo, P=0.02). On a multivariate analysis, out of HCV, TG and C4d, only HCV was found to be a signifi cant risk factor for a more rapid allograft loss.Conclusion: We conclude that TG is not a specifi c diagnosis, but a pattern of pathologic injury with 3 major overlapping pathways involving CHR, HCV infection and TMA. It is important to distinguish these mechanisms, as they may have differentprognostic and therapeutic implications.

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This abstract presents how we redesigned, with user-centred design methods, the way we organize and present the content on the UOC Virtual Library website. The content is now offered in a way that is more intuitive, usable and easy to understand, based on criteria of customization, transparency and proximity.The techniques used to achieve these objectives included benchmarking, interviews and focus groups during the user requirement capture phase and user tests to assess the process and results.

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When certain control parameters of nervous cell models are varied, complex bifurcation structures develop in which the dynamical behaviors available appear classified in blocks, according to criteria of dynamical likelihood. This block structured dynamics may be a clue to understand how activated neurons encode information by firing spike trains of their action potentials.

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Tämän case -tutkimuksen tarkoituksena on kartoittaa tekstiili- ja vaatetusmateriaalien ekologista elinjakson hallintaa Talousvarikon toiminnoissa ja tutkimalla mahdollisuuksia soveltaa saatuja tuloksia. Talousvarikko on Puolustusvoimien Materiaalilaitoksen alainen järjestelmävastuuvarikko, jonka tehtävänä on varusmiesten ja kadettien vaatetuksen hankinta- ja ylläpitotoiminnot. Talousvarikko jakautuu neljälle paikkakunnalle. Hämeenlinnassa on hankinta-, hallinto- ja materiaaliosasto. Säkylässä, Mikkelissä ja Sodankylässä ovat vaatetuskorjaamot. Tekstiilimateriaalien elinkaariajattelussa tarkastellaan raaka-aineiden jaottelua ja maailman kuitutuotantoa. Tekstiilikuidut jaotellaan luonnon- ja tekokuituihin. Luonnonkuidut ovat pääosin luonnon raaka-aineita ja tekokuidut ovat synteettisesti valmistettuja. Tekstiilikuitujen- ja materiaalien vaikutus ekologiseen elinjakson hallinnan vaiheisiin on riippuvainen raaka-aineidenalkuperästä. Vaatetus- ja tekstiilimateriaalin elinkaari muodostuu tuotekehityksestä, hankinnasta, valmistuksesta, käytöstä, huollosta ja hylkäyksestä. Ekologista elinjakson hallintaa tarkastellaan materiaalivirta- ja elinkaarianalyysien kautta. Elinkaarianalyysin tarkastelu painottuu vaikutusluokkien arvottamiseen ja materiaalivirta-analyysissä tarkastellaan ainevirtoja ja sitä kautta jätteiden määrän vähentämistä. Joutsenmerkin valintakriteerien pohjana on aina tuotteiden elinkaarianalyysi. Joutsenmerkin valintakriteerien soveltaminen Talousvarikon toimintoihin vaatetus- ja tekstiilimateriaalin elinkaaren jokaisessa vaiheessa antaa mahdollisuuden lisätä ekologista elinkaaren hallintaa Talousvarikon toiminnoissa. Ympäristönäkökohtien huomioiminen tuotekehityksessä ja hankinnoissa antaa mahdollisuuden tehdä tilauksia / sopimuksia yhteiskuntavastuullisilta yrityksiltä huomioiden valmistuksen yhdeksi osaksi hankinta ja logistiikka pääprosessia.

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Reflexión sobre los suburbios costeros de las principales ciudades de la provincia Hispania Citerior en base a criterios de dinamismo económico, concebidos como la causa principal de la aparición de las áreas periurbanas. Los procesos expansivos o regresivos se interrelacionan con la vitalidad de las actividades portuarias, determinantes en el crecimiento periurbano, o en la génesis de núcleos alejados de las ciudades ubicadas a escasa distancia de la costa. Este documento intenta aportar los rasgos comunes propios de la uniformidad urbanística del período altoimperial, y que desaparecieron en la antigüedad tardía como consecuencia de los procesos específicos de cada núcleo urbano, condicionado por la viabilidad de su modelo económico y su rol geoestratégico. De este modo, el análisis de las zonas suburbiales se manifiesta como el principal índice de prosperidad económica y urbanística. No en vano, estas mantuvieron su funcionalidad en época tardía, mientras la ciudad altoimperial fue desestructurándose.