993 resultados para Sub-unit Vaccines


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This Agreement made and entered i into this 1 1st day of July 2009, at Des Moines, Iowa, pursuant to the provisions of Chapter 20 of the Iowa Code, by and between the State of Iowa (hereinafter referred to as the Employer) and UE Local 893/Iowa United Professionals, and its appropriate affiliated locals, as representatives of employees employed by the State of Iowa, as set forth specifically in Appendix A (hereinafter referred to as the Union).

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Avaliou-se a aptidão para reflorestamento das terras das partes não edificadas da vertente norte do maciço da Tijuca, sub-bacias dos canais do Mangue e do Cunha, com o intuito de subsidiar ações do Programa Mutirão Reflorestamento da Secretaria Municipal de Meio Ambiente do Rio de Janeiro. A avaliação da aptidão das terras estimou graus de limitação dos parâmetros: deficiência de nutrientes, deficiência de água, susceptibilidade à erosão e impedimentos ao manejo. Estes graus de limitação foram estimados para os componentes das unidades de mapeamento de solos, considerando as informações de solos e paisagens do mapeamento existente. Para a digitalização e organização das informações geradas, foram utilizados sistemas de informações geográficas. As seguintes classes de aptidão para reflorestamento foram determinadas: 11,2 % de Regular, 81,5 % de Restrita e 7,3 % de Inapta. A declividade representa o fator limitante de maior importância para as terras da classe de aptidão restrita, seguida da presença de rochosidade.

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Monitoring the performance is a crucial task for elite sports during both training and competition. Velocity is the key parameter of performance in swimming, but swimming performance evaluation remains immature due to the complexities of measurements in water. The purpose of this study is to use a single inertial measurement unit (IMU) to estimate front crawl velocity. Thirty swimmers, equipped with an IMU on the sacrum, each performed four different velocity trials of 25 m in ascending order. A tethered speedometer was used as the velocity measurement reference. Deployment of biomechanical constraints of front crawl locomotion and change detection framework on acceleration signal paved the way for a drift-free integration of forward acceleration using IMU to estimate the swimmers velocity. A difference of 0.6 ± 5.4 cm · s(-1) on mean cycle velocity and an RMS difference of 11.3 cm · s(-1) in instantaneous velocity estimation were observed between IMU and the reference. The most important contribution of the study is a new practical tool for objective evaluation of swimming performance. A single body-worn IMU provides timely feedback for coaches and sport scientists without any complicated setup or restraining the swimmer's natural technique.

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In diabetes mellitus, it is expected to see a common, mainly sensitive, distal symmetrical polyneuropathy (DPN) involving a large proportion of diabetic patients according to known risk factors. Several other diabetic peripheral neuropathies are recognized, such as dysautonomia and multifocal neuropathies including lumbosacral radiculoplexus and oculomotor palsies. In this review, general aspects of DPN and other diabetic neuropathies are examined, and it is discussed why and how the general practionner has to perform a yearly examination. At the present time, some consensuses emerge to ask help from neurologist when faced to other forms of peripheral neuropathies than distal symmetrical DPN.

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Rapport de synthèse :Le céfépime a été associé à un taux de mortalité supérieur à celui des autres bêta-lactamines chez les patients traités pour un sepsis sévère. Une des hypothèses avancées pour expliquer ces échecs thérapeutiques sont de possibles effets secondaires cachés (par ex. neurologiques) ou des paramètres pharmacocinétiques/pharmacodynamiques (PK/PD) inadaptés. Le présent travail a étudié cette problématique en mesurant prospectivement la pharmacocinétique du céfépime chez 21 patients consécutifs hospitalisés aux soins intensifs adultes (SIAD) pour une pneumonie nosocomiale. La population étudiée avec un âge médian 55,1 ans, a reçu par voie intraveineuse du céfépime à raison de 2 g toutes les 12 heures pour une clairance de la créatinine (Clcr)>50 mI/ min, et 2 g toutes les 24 heures ou 36 heures pour une Clcr<50 ml /min. Les taux plasmatiques de céfépime ont été mesurés à plusieurs reprises avant et après administration du médicament après la lèoe dose et à l'état d'équilibre par chromatographie en phase liquide à haute pression. Les taux plasmatiques ont considérablement varié entre les patients. Cent pour cent (21/21) des patients ont eu une durée appropriée d'antibiothérapie avec des taux plasmatiques supérieures à la CMI du céfépime (T>CMI>50%) pour les agents pathogènes retrouvés dans cette étude (CMI<4 mg/I), mais seulement 45-65% d'entre eux ont eu une couverture appropriée pour les agents pathogènes potentiels présentant une CMI> 8 mg/I pour le céfépime. Deux patients avec une insuffisance rénale (Clcr<30 ml/min) ont présenté des symptômes compatibles avec une épilepsie non-convulsive (état confusionnel et myoclonies) attribuée dans un 2ème temps à une toxicité du céfépime après que les taux plasmatiques aient été communiqués aux soignants qui ont suspendu l'antibiothérapie avec disparition des symptômes. Les résultats de cette étude empirique confirment l'existence d'effets secondaires cachés et de paramètres PK/PD inappropriés (pour les agents pathogènes ayant des CMI de limite supérieure) dans notre population de SIAD. En outre, ils mettent en évidence une fenêtre thérapeutique efficace pour une posologie de céfépime de 2 g toutes les 12 heures chez les patients ayant une Clcr>50 ml/min infectés par des pathogènes avec des CMI pour le céfépime <4 mg/I. Les échecs thérapeutiques constatés dans cette étude sont probablement liés à des taux sériques inadaptés, résultant de la difficulté de prescription dans les situations cliniques complexes. Dans ce contexte, un prompt dosage plasmatique du céfépime doit être considéré en cas de diminution de la Clcr ou en présence de CMI élevées.

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Objective.- The Patient-Rated Wrist Evaluation is a specific questionnaire for the wrist [1]. It consists of 15 questions with a total score of 100. It was recently translated into French [2]. However, its validity has not been tested in this language. The Disabilities Arm Shoulder and Hand (DASH), with well-established psychometric properties, is considered as the reference questionnaire for the evaluation of upper extremities. The objective of this study is to measure the construct validity of the PRWE-F with the DASH-F in patients with wrist pathology.Patients and methods.- Fifty-one patients (40 m, 11 w, mean age 42 years), 25 fractures of the radius and 26 lesions of the carpus.Questionnaires PRWE-F and DASH-F at entry and at discharge (0 to 100). Calculation of the construct validity of the PRWE-F comparing with the DASH-F with Pearson correlation coefficients (r) at entry and at discharge. Level of significance (alpha) was set at 5%.Results.- Correlation DASH/PRWE at entry: r = 0.799 (95% CI 0.671 to 0.881), P < 0.0001. Correlation DASH/PRWE at discharge: r = 0.847 (95% CI: 0.745 to 0.910), P < 0.0001.Discussion.- The construct validity of the two instruments indicates that they measure the same concept. Our correlation between DASH-F and PRWE-F, going from 0.799 to 0.847, are comparable to those published in different languages (0.71 to 0.84) [3,4]. The questionnaires PRWE-F can thus be used in rehabilitation patients presenting with wrist pathologies; it is comparable to the DASH but described by MacDermid [1] to be more specific. Compared to the DASH it has the advantage of consisting of two dimensions. Its construct validity is excellent. This questionnaire should be evaluated in other populations, and it should be compared with hand questionnaires more specific than the DASH.

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A simulação da distribuição espacial da erosão do solo consiste em uma ferramenta poderosa para o planejamento conservacionista em bacias hidrográficas, sendo uma importante aplicação da Equação Universal de Perdas de Solo (EUPS) associada a princípios de interpolação espacial, principalmente a geoestatística. Este trabalho objetivou simular a distribuição espacial da erosão hídrica numa sub-bacia hidrográfica da região do Alto Rio Grande (MG), aplicando ferramentas geoestatísticas para distribuição espacial e mapeamento. Diferentes cenários de uso do solo foram analisados. A erosão foi estimada com base na EUPS aplicada a células, considerando as unidades pedológicas e diferentes usos em cada célula. O fator topográfico (LS) das células foi obtido com base no Modelo Digital de Elevação da sub-bacia, identificando comprimento e direção principal do escoamento. A erosividade média anual da região é de 8.030 MJ mm ha-1 h-1 ano-1, e a erodibilidade dos solos foi extraída da literatura. A EUPS foi aplicada a cada célula, levando-se em conta a situação atual do solo, áreas degradadas plantadas com eucalipto, pastagem plantada e plantio convencional de milho, considerando a ocupação de toda a sub-bacia hidrográfica. Na situação atual, a sub-bacia apresenta taxas de erosão inferiores aos limites de tolerância para os respectivos solos, com exceção das áreas degradadas ocupadas por eucalipto e pastagem em Cambissolo. No entanto, em todas as situações analisadas, seu lado leste apresentou as maiores perdas de solo, especialmente para os cenários de eucalipto nas condições atuais e plantio convencional de milho em Cambissolo e Latossolo Vermelho-Amarelo, sendo necessária a aplicação de técnicas conservacionistas.

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Several unit root tests in panel data have recently been proposed. The test developed by Harris and Tzavalis (1999 JoE) performs particularly well when the time dimension is moderate in relation to the cross-section dimension. However, in common with the traditional tests designed for the unidimensional case, it was found to perform poorly when there is a structural break in the time series under the alternative. Here we derive the asymptotic distribution of the test allowing for a shift in the mean, and assess the small sample performance. We apply this new test to show how the hypothesis of (perfect) hysteresis in Spanish unemployment is rejected in favour of the alternative of the natural unemployment rate, when the possibility of a change in the latter is considered.

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In this paper we assume inflation rates in European Union countries may in fact be fractionally integrated. Given this assumption, we obtain estimations of the order of integration by means a method based on wavelets coefficients. Finally, results obtained allow reject the unit root hypothesis on inflation rates. It means that a random shock on the rate of inflation in these countries has transitory effects that gradually diminish with the passage of time, that this, said shock hasn¿t a permanent effect on future values of inflation rates

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This paper tests for real interest parity (RIRP) among the nineteen major OECD countries over the period 1978:Q2-1998:Q4. The econometric methods applied consist of combining the use of several unit root or stationarity tests designed for panels valid under cross-section dependence and presence of multiple structural breaks. Our results strongly support the fulfilment of the weak version of the RIRP for the studied period once dependence and structural breaks are accounted for.

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Introduction: Delirium is frequent in hospitalized older people, with incidence rate up to 40% in acute care. Delirium is associated with several adverse consequences, including increased mortality and institutionalization. This study aims to investigate the prevalence, incidence, and consequences of delirium in patients hospitalized in an acute care unit for elderly (ACE unit). Methods: Over a 3 months period, every patient (N = 93, mean age 84.1 ± 7.8 years, 66/93(71%) women) admitted to a 28-bed ACE unit were systematically assessed for delirium. Trained nurses used the Confusion Assessment Method (CAM) instrument to determine the presence of delirium at admission and on each subsequent day over patients' stay. Delirium prevalence rate was defined as the proportion of patients with a positive CAM within 24 hours of admission to the ACE unit. Delirium incidence rate was defined as the proportion of patients with a negative CAM at admission whose CAM became positive at least once during their stay. This evaluation was part of a functional assessment, including Basic Activities of Daily Life (Katz BADL, from 0 to 6, higher score indicating better function). Delirium prevention interventions and specific treatment was provided if needed. Results: Overall,25/93(27%)patients had delirium during their stay. Prevalence of delirium at admission was 10/93 (11%), with an incidence of 15/83(18%). Compared with non-delirious patients, those with delirium were more frequently men (10/25(40%) vs 17/68(25%), p <.001) and had reduced functional status at admission(BADL 2.0 ± 1.9 vs 3.6 ± 2.1, p = .004). They tended to be older (86.0 ± 6.7 vs 83.3 ± 8.1 years, p = .110). At discharge, delirium was associated with reduced functional status (BADL 2.0 ± 2.1 vs 4.3 ± 1.9, p <.001), lower rate of home discharge (6/20(30%) vs 28/65 (43%), p = .009) and increased mortality (5/25 (20%) vs 3/68 (5%), p <.001). On average, patients with delirium stayed 5.7 days longer (17.0 ± 9.8 vs 11.31 ± 6.3, p = .011). Conclusion: Delirium occurred in almost a third of these older patients, even though its incidence was relatively low in this frail population. Despite specific management, delirium remained associated with higher risk for adverse outcomes at discharge. These results suggest that early preventive interventions, implemented as soon as possible after hospital admission, might be needed in similar population to achieve better outcomes. Effectiveness of such interventions will be evaluated in future studies.

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This paper tests for real interest parity (RIRP) among the nineteen major OECD countries over the period 1978:Q2-1998:Q4. The econometric methods applied consist of combining the use of several unit root or stationarity tests designed for panels valid under cross-section dependence and presence of multiple structural breaks. Our results strongly support the fulfilment of the weak version of the RIRP for the studied period once dependence and structural breaks are accounted for.

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O desenvolvimento de modelos hidrológicos capazes de predizer o impacto de fontes difusas de poluição e do uso e ocupação do solo na qualidade das águas superficiais e subterrâneas tem auxiliado o estudo de agroecossistemas. Com esse objetivo, foi utilizado o modelo SWAT 2005 (Soil and Water Assessment Tool) para avaliar sua sensibilidade na predição da vazão e do fluxo de massa do P total. O estudo foi realizado em duas microbacias hidrográficas contíguas, dos rios Conrado e Pinheiro, afluentes do rio Pato Branco, localizadas nos municípios de Pato Branco e Mariópolis, no Estado do Paraná. Foram utilizados dados climatológicos do período 1979/2006 e dados observados de vazão e concentração de P total dos anos 2004/2005 de duas estações de monitoramento, localizadas na parte inferior do curso principal dos rios Conrado e Pinheiro. Utilizou-se a interface AvSWAT-X, com o SIG ArcView 3.3® e a extensão Spatial Analyst 2.0®, para entrada e manipulação dos dados. As médias anuais e mensais observadas de vazão e P total foram comparadas aos dados simulados. O Coeficiente de Eficiência de Nash-Sutcliffe (COE) foi utilizado para avaliar a eficiência do modelo. A modelagem foi melhorada com a associação de análise de sensibilidade, autocalibração e calibração manual, verificando-se que, com frequência de amostragem regular, o modelo SWAT 2005 realizou de forma aceitável as simulações de vazão e de exportação de P total. Já com frequência de amostragem irregular e pequeno número de dados, os procedimentos de análise de sensibilidade e de autocalibração não foram eficientes na calibração do modelo SWAT 2005 para a simulação de vazão e exportação de P total. Foram encontrados diferentes níveis de sensibilidade entre as duas estações, refletindo as desigualdades entre as Unidades de Resposta Hidrológica. A distribuição mensal simulada das exportações de P mostrou a heterogeneidade da aplicação do nutriente ao longo do ano.