881 resultados para Anastomosis Groups
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The aim of this study was to asses the impact of a visit to the NIHERST/NGC National Science Centre in Trinidad on four different school-age visitor groups. The research was conducted through the administering of a post-visit questionnaire immediately upon completion of each visit by each group, and via visitor feedback obtained in post-visit or pre-visit activities conducted within two weeks of the visit for three groups. Teachers/instructors who accompanied the groups on their visit also completed post-visit questionnaires and provided additional information on follow-up activities via an interview. The results of this investigation suggest that the visit to this science centre provided entertainment/enjoyment value and potential educational value to most individuals. The nature of this enjoyment was noted for various age groups and genders in this study. Quantification of the educational impact was not possible within the constraints of this study, which was unable to capture long-term effects of the supply of ‘new knowledge’ to visitors which the visit to the science centre had provided.
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This paper presents a two-step pseudo likelihood estimation technique for generalized linear mixed models with the random effects being correlated between groups. The core idea is to deal with the intractable integrals in the likelihood function by multivariate Taylor's approximation. The accuracy of the estimation technique is assessed in a Monte-Carlo study. An application of it with a binary response variable is presented using a real data set on credit defaults from two Swedish banks. Thanks to the use of two-step estimation technique, the proposed algorithm outperforms conventional pseudo likelihood algorithms in terms of computational time.
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BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]). CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period. TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712. Please see later in the article for the Editors' Summary.
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BACKGROUND: Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health - Knowledge Into Practice trial evaluated facilitation of community groups (2008-2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30-0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. METHODS: Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. RESULTS: To ensure eight active facilitators over 3 years, 11 Women's Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19-0.73) than control communes (n = 46). CONCLUSIONS: This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups' work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.
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Introdução: Sabe-se que a cirurgia de revascularização miocárdica está associada com alteração dos mediadores inflamatórios e da função imunitária, com ativação precoce dos linfócitos que poderia ser responsável pela linfopenia e diminuição da atividade dos linfócitos no pós-operatório. A elevação enzimática está diminuída na cirurgia sem circulação extracorpórea mas este achado não está associado a melhor evolução clínica. Nesta tese, testamos a hipótese de que a cirurgia de revascularização miocárdica realizada sem circulação extracorpórea pode levar a uma ativação linfocitária de menor intensidade do que a cirurgia com circulação extracorpórea. Métodos: A resposta da ativação linfocitária foi estudada durante o período trans e pósoperatório em 28 pacientes randomizados para cirurgia de coronária sem circulação extracorpórea (n=13) ou cirurgia convencional com circulação extracorpórea (n=15), utilizando citometria de fluxo para determinar a expressão de CD25, CD26, CD69 e DR em linfócitos T (CD3+) e B (CD19+), em sangue periférico. No mesmo período foram realizadas dosagens de troponina I por quimioluminescência e realizado ecocardiograma uni-bidimensional antes e após a cirurgia. Resultados: Não houve diferença estatisticamente significativa para nenhum dos marcadores de ativação linfocitária quando comparados os grupos operados sem ou com circulação extracorpórea (ANOVA bicaudal para medidas repetidas, p>0,05). Considerando todos os pacientes estudados, houve uma elevação da expressão proporcional de CD25 e CD69 em linfócitos T (CD3+) e B (CD19+). Nos linfócitos T, o valor proporcional médio mais elevado (+ EP) de CD69 foi observado 6 horas após terem sido completadas as anastomoses (+75 + 476%) e CD25 teve uma elevação mais gradual, com o pico de seu valor médio (+48 + 24 %) ocorrendo 24 horas após a revascularização. Em linfócitos B, o pico do valor médio de CD69 (+104 + 269 %) ocorreu também após o fim das anastomoses. CD25 teve seu pico de valor médio (+150 + 773 %) 112 horas após a revascularização e seu último valor medido ainda estava elevado. A expressão de CD26 em linfócitos T teve um aparente declínio nos seus valores proporcionais médios (-42 + 32 %) 12 horas após o fim das anastomoses. Não houve diferença significativa na elevação enzimática entre os dois grupos (teste estatístico >0,05). No ecocardiograma, o grupo operado sem circulação extracorpórea apresentou diminuição do volume diastólico (p=0,001) de da fração de ejeção (P=0,012), enquanto no grupo com circulação extracorpórea, diminuíram os volumes diastólico (p=0,006) e sistólico (p=0,01). Conclusões: 1) Comparando a cirurgia de revascularização miocárdica com circulação extracorpórea, a cirurgia sem circulação extracorpórea não reduz a ativação dos linfócitos. 2) A cirurgia de revascularização miocárdica produz uma ativação precoce dos linfócitos, com aumento da expressão de CD69 e CD25 em linfócitos T (CD3+) e B (CD19+), em sangue periférico. A elevação precoce de CD69, e elevação mais tardia de CD25, pode indicar duas partes de uma seqüência de ativação linfocitária. 3) O comportamento das enzimas cardíacas e dos achados ecocardiográficos não sugere benefício da cirurgia sem circulação extracorpórea sobre o dano miocárdio.
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A procura de um método que permita um melhor resultado na anastomose de um nervo completamente seccionado é antiga. Há muitos anos a técnica, dita convencional, para aproximação dos cotos afastados do nervo lesado, é realizada com pontos de fios microcirúrgicos. Mais recentemente, a utilização da cola de fibrina tem permitido a adesão de tecidos, como pele, fáscia e outras estruturas anatômicas. O uso da cola de fibrina, na aproximação das extremidades nervosas, tem sido propagada pela indústria como um fato incontestável. No entanto, somente com a realização de estudos comparativos clínicos e laboratoriais tornou-se possível comparar a eficácia da cola de fibrina como agente de reconstituição em lesões de nervos periféricos. Com o objetivo de comprovar essa afirmação foi realizado um trabalho através de uma mensuração nas bainhas de mielina de cotos regenerados de nervos entre diferentes tipos de anastomose nervosas em nervo isquiático de ratos da raça Wistar. Com esse mesmo escopo, foi mensurado o número de axônios em regeneração após o uso dessa cola. Foi utilizada uma amostra de 35 ratos divididos em 03 grupos (A, B e C). No grupo A, 25 ratos foram submetidos à cirurgia com o uso da cola de fibrina para a anastomose nervosa. No grupo B, 05 ratos foram submetidos ao mesmo procedimento; entretanto, ao reparo nervoso acrescentou-se a utilização de dois pontos opostos de mononylon 9-0, usando-se cola de fibrina no seu interior. No terceiro grupo (C), 05 ratos foram submetidos a neurorrafia com 6 a 8 pontos de mononylon 9-0 sem auxílio da cola de fibrina (anastomose nervosa convencional). Os animais foram submetidos a um novo procedimento após 90 dias, quando o nervo isquiático tratado foi retirado e encaminhado para o estudo. Após esse procedimento, os animais foram sacrificados. Cabe esclarecer que os espécimens foram submetidas a uma preparação histológica, sendo avaliados. Para tanto, foi realizada uma mensuração da espessura média da bainha de mielina das fibras regeneradas. Também foi realizada uma medição do número de axônios regenerados em um milímetro quadrado. Com base nesses achados, foram comparados os resultados.
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This paper introduces a model economy in which formation of coalition groups under technological progress is generated endogenously. The coalition formation depends crucially on the rate of arrival of new technologies. In the model, an agent working in the saroe technology for more than one period acquires skills, part of which is specific to this technology. These skills increase the agent productivity. In this case, if he has worked more than one period with the same technology he has incentives to construct a coalition to block the adoption of new technologies. Therefore, in every sector the workers have incentives to construct a coalition and to block the adoption of new technologies. They will block every time that a technology stay in use for more than one period.
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Differences-in-Differences (DID) is one of the most widely used identification strategies in applied economics. However, how to draw inferences in DID models when there are few treated groups remains an open question. We show that the usual inference methods used in DID models might not perform well when there are few treated groups and errors are heteroskedastic. In particular, we show that when there is variation in the number of observations per group, inference methods designed to work when there are few treated groups tend to (under-) over-reject the null hypothesis when the treated groups are (large) small relative to the control groups. This happens because larger groups tend to have lower variance, generating heteroskedasticity in the group x time aggregate DID model. We provide evidence from Monte Carlo simulations and from placebo DID regressions with the American Community Survey (ACS) and the Current Population Survey (CPS) datasets to show that this problem is relevant even in datasets with large numbers of observations per group. We then derive an alternative inference method that provides accurate hypothesis testing in situations where there are few treated groups (or even just one) and many control groups in the presence of heteroskedasticity. Our method assumes that we can model the heteroskedasticity of a linear combination of the errors. We show that this assumption can be satisfied without imposing strong assumptions on the errors in common DID applications. With many pre-treatment periods, we show that this assumption can be relaxed. Instead, we provide an alternative inference method that relies on strict stationarity and ergodicity of the time series. Finally, we consider two recent alternatives to DID when there are many pre-treatment periods. We extend our inference methods to linear factor models when there are few treated groups. We also derive conditions under which a permutation test for the synthetic control estimator proposed by Abadie et al. (2010) is robust to heteroskedasticity and propose a modification on the test statistic that provided a better heteroskedasticity correction in our simulations.
Resumo:
Differences-in-Differences (DID) is one of the most widely used identification strategies in applied economics. However, how to draw inferences in DID models when there are few treated groups remains an open question. We show that the usual inference methods used in DID models might not perform well when there are few treated groups and errors are heteroskedastic. In particular, we show that when there is variation in the number of observations per group, inference methods designed to work when there are few treated groups tend to (under-) over-reject the null hypothesis when the treated groups are (large) small relative to the control groups. This happens because larger groups tend to have lower variance, generating heteroskedasticity in the group x time aggregate DID model. We provide evidence from Monte Carlo simulations and from placebo DID regressions with the American Community Survey (ACS) and the Current Population Survey (CPS) datasets to show that this problem is relevant even in datasets with large numbers of observations per group. We then derive an alternative inference method that provides accurate hypothesis testing in situations where there are few treated groups (or even just one) and many control groups in the presence of heteroskedasticity. Our method assumes that we know how the heteroskedasticity is generated, which is the case when it is generated by variation in the number of observations per group. With many pre-treatment periods, we show that this assumption can be relaxed. Instead, we provide an alternative application of our method that relies on assumptions about stationarity and convergence of the moments of the time series. Finally, we consider two recent alternatives to DID when there are many pre-treatment groups. We extend our inference method to linear factor models when there are few treated groups. We also propose a permutation test for the synthetic control estimator that provided a better heteroskedasticity correction in our simulations than the test suggested by Abadie et al. (2010).
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The maternal and paternal genetic profile of Guineans is markedly sub-Saharan West African, with the majority of lineages belonging to L0-L3 mtDNA sub-clusters and E3a-M2 and E1-M33 Y chromosome haplogroups. Despite the sociocultural differences among Guinea-Bissau ethnic groups,marked by the supposedly strict admixture barriers, their genetic pool remains largely common. Their extant variation coalesces at distinct timeframes, from the initial occupation of the area to later inputs of people. Signs of recent expansion in mtDNA haplogroups L2a-L2c and NRY E3a-M2 suggest population growth in the equatorial western fringe, possibly supported by an early local agricultural centre, and to which the Mandenka and the Balanta people may relate. Non-West African signatures are traceable in less frequent extant haplogroups, fitting well with the linguistic and historical evidence regarding particular ethnic groups: the Papel and Felupe-Djola people retain traces of their putative East African relatives; U6 and M1b among Guinea-Bissau Bak-speakers indicate partial diffusion to Sahel of North African lineages; U5b1b lineages in Fulbe and Papel represent a link to North African Berbers, emphasizing the great importance of post-glacial expansions; exact matches of R1b-P25 and E3b1-M78 with Europeans likely trace back to the times of the slave trade.
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In this thesis we study the invariant rings for the Sylow p-subgroups of the nite classical groups. We have successfully constructed presentations for the invariant rings for the Sylow p-subgroups of the unitary groups GU(3; Fq2) and GU(4; Fq2 ), the symplectic group Sp(4; Fq) and the orthogonal group O+(4; Fq) with q odd. In all cases, we obtained a minimal generating set which is also a SAGBI basis. Moreover, we computed the relations among the generators and showed that the invariant ring for these groups are a complete intersection. This shows that, even though the invariant rings of the Sylow p-subgroups of the general linear group are polynomial, the same is not true for Sylow p-subgroups of general classical groups. We also constructed the generators for the invariant elds for the Sylow p-subgroups of GU(n; Fq2 ), Sp(2n; Fq), O+(2n; Fq), O-(2n + 2; Fq) and O(2n + 1; Fq), for every n and q. This is an important step in order to obtain the generators and relations for the invariant rings of all these groups.
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In captive common marmoset groups, the reproductive inhibition observed in subordinate female seems to be a result of olfactory, visual and behavioral cues from the dominant female. However, few studies have examined the relationship among adult males living in the same social group. These studies have shown that reproductive failure among peer males seems to be based on hormonal and behavioral mechanisms. New insights on sexual strategies in primates have been shown using fecal steroids, but so far no information is available for common marmoset males. In the present study, we evaluated the influence of light-dark cycle, age and reproductive condition on the profile of fecal androgens in males living in the same family group. Feces were collected from six fathers and six sons for androgen determination during the light phase of the 24-h cycle for eight days randomly distributed over a 4-week period. Androgen levels were determined by enzyme immunoassay technique. Adult sons showed higher androgen levels (166.97 ± 22.95 ng/g) than fathers (80.69 ± 44.38 ng/g) and juveniles (49.06 ± 23.15 ng/g; P < 0.05). No diurnal variation (P > 0.05) in fecal androgen profile was observed in adults or juveniles. No indication of androgen-mediated social competition between fathers and adult sons was demonstrable. These results provide basic information on fecal androgen profile useful to investigate the socioendocrinology of free-ranging common marmoset males and verify that, in contrast to daughters, the reproductive suppression of sons is not based on physiological inhibition of their gonads
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In order to evaluate the effect of energy intake and broiler genotype on performance, carcass yield, and fat deposition, 600 one-day-old male chicks from two different genetic groups (AgRoss 308 - commercial line and PCLC - Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) non-improved line) were fed diets with different metabolizable energy level (2950, 3200 and 3450 kcal/kg). A completely randomized experimental design in a 2X3 factorial arrangement with four replications of 25 birds per treatment was applied. In order to ensure different energy intake among treatments within each strain, feed intake was daily adjusted by pair-feeding schemes. AgRoss 308 broilers had better performance and carcass yield, and presented lower abdominal fat deposition rate. In both genetic groups, the highest dietary energy level increased weight gain, heart relative weight, and fat deposition. However, it reduced the difference between AgRoss 308 and PCLC for feed conversion ratio and carcass protein deposition. These findings allow concluding that genetic improvement had a significant effect on broiler energy metabolism, and that the highest performance differences between genetic groups are found when low-energy intake is imposed.