Ovarian suppression using luteinizing hormonereleasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: A meta-analysis of randomized studies

Background: The role of temporary ovarian suppression with luteinizing hormone-releasing hormone agonists (LHRHa) in the prevention of chemotherapy-induced premature ovarian failure (POF) is still controversial. Our meta-analysis of randomized, controlled trials (RCTs) investigates whether the use of LHRHa during chemotherapy in premenopausal breast cancer patients reduces treatment-related POF rate, increases pregnancy rate, and impacts disease-free survival (DFS). Methods: A literature search using PubMed, Embase, and the Cochrane Library, and the proceedings of major conferences, was conducted up to 30 April 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) for POF (i.e. POF by study definition, and POF defined as amenorrhea 1 year after chemotherapy completion) and for patients with pregnancy, as well hazard ratios (HRs) and 95% CI for DFS, were calculated for each trial. Pooled analysis was carried out using the fixed- and random-effects models. Results: A total of 12 RCTs were eligible including 1231 breast cancer patients. The use of LHRHa was associated with a significant reduced risk of POF (OR 0.36, 95% CI 0.23-0.57; P < 0.001), yet with significant heterogeneity (I2 = 47.1%, Pheterogeneity = 0.026). In eight studies reporting amenorrhea rates 1 year after chemotherapy completion, the addition of LHRHa reduced the risk of POF (OR 0.55, 95% CI 0.41-0.73, P < 0.001) without heterogeneity (I2 = 0.0%, Pheterogeneity = 0.936). In five studies reporting pregnancies, more patients treated with LHRHa achieved pregnancy (33 versus 19 women; OR 1.83, 95% CI 1.02-3.28, P = 0.041; I2 = 0.0%, Pheterogeneity = 0.629). In three studies reporting DFS, no difference was observed (HR 1.00, 95% CI 0.49-2.04, P = 0.939; I2 = 68.0%, Pheterogeneity = 0.044). Conclusion: Temporary ovarian suppression with LHRHa in young breast cancer patients is associated with a reduced risk of chemotherapy-induced POF and seems to increase the pregnancy rate, without an apparent negative consequence on prognosis.

Measuring function and mobility among clients with diabetes in Samoa

The aim of the thesis was to collect baseline data and to investigating suitable physical tests and a self-rapport questionnaire. Collected data was used to find a routine measurement when investigating foot health, function and mobility among clients suffering from diabetes in Samoa. Twenty-one participants suffering from diabetes were included in the study. Clients answered the Foot function index (FFI) questionnaire and performed physical tests, consisting of Bergs balance scale (BBS) and Time up and go (TUG). Results from the physical tests revealed a great balance disturbance and mobility limitations among the majority of the clients. General high weight and BMI was measured among both genders. Subjects with the highest BMI performed lowest time during TUG test. The statistic analyze revealed a strong correlation between the two physical tests, indicating that one of the tests could be applied as a routine measurement in the future, when evaluating function and mobility in Samoa. The compilation of self-report questionnaires indicated a general good foot health with a low amount of pain, disabilities and activity limitations.

Role of assessment components and recent adverse outcomes in risk estimation and prediction: use of the Short Term Assessment of Risk and Treatability (START) in an adult secure inpatient mental health service

The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its’component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

Chase-Lloyd House at 250: significance of function and integrity of form

(M. Historic Preservation) -- University of Maryland-College Park, 2015 Faculty Advisor: Dr. Constance Werner Ramirez. Program Director: Dr. Donald W. Linebaugh

Postoperative Bowel Function and Related Factors in Enhanced Recovery Protocol with Patients Undergoing Hepatectomy

Patients’ bowel dysfunction is a major factor that weakens the results of surgical care as it can cause pain and weaken patients’ rehabilitation. Bowel dysfunction is a common postoperative problem, yet most incidents remain undocumented. The nursing profession has a significant role in enhancing the bowel function postoperatively. However, studies of postoperative bowel function after hepatectomy are scarce and somewhat incongruous. Enhanced recovery protocols are innovative models of care aiming for better outcomes of surgical care. Enhanced recovery protocols can improve gastrointestinal function after surgery, yet patients are also known to be satisfied with their care. The aim was to investigate if postoperative bowel function day varies between patients in terms of age, gender, ASA score, type of surgery, histology, patients’ experienced pain and experienced satisfaction three days after discharge and three months after operation in patients undergoing hepatectomy. The goal was to produce information for basis of scientific research, to give nurses in clinical setting more tools to work with hepatectomy patients undergoing enhanced recovery protocol and to produce information to nurse managers to use in process management of patients undergoing enhanced recovery protocol. The design of this study is descriptive. Data was collected retrospectively from hepatectomy patients (n = 134) undergoing enhanced recovery protocol within the first year of enhanced recovery protocol implementation. The data was based on registers and analyzed statistically. Mean age of patients was 62 years and mean day of discharge was 4. Main (n = 72) histology of the patients was colorectal liver metastases. Mean bowel function day was 3. Most of the patients were very satisfied or satisfied with the care three days after discharge (99%) and three months (90%) after operation. Most of the patients (72%) experienced moderate pain three days after discharge, but three months after operation 47% of the patients did not experience pain and 48% experienced moderate pain. There were no statistically significant differences in bowel function between different age groups, genders, ASA score groups or histologies. Neither were there statistically significant differences in postoperative bowel function in terms of experienced satisfaction or pain. There were statistically significant differences in postoperative bowel function between different types of surgery (p < 0.01). Nurses should take into consideration hepatectomy patients’ type of surgery and pay special attention in supporting major open hepatectomy patients’ postoperative bowel function. Nurses should educate patients undergoing major open hepatectomy about prolonged postoperative bowel function.

Investigation and prediction of sea level variations in the northern coasts of Persian Gulf using artificial neural network

Sea- level variations have a significant impact on coastal areas. Prediction of sea level variations expected from the pre most critical information needs associated with the sea environment. For this, various methods exist. In this study, on the northern coast of the Persian Gulf have been studied relation to the effectiveness of parameters such as pressure, temperature and wind speed on sea leve and associated with global parameters such as the North Atlantic Oscillation index and NAO index and present statistic models for prediction of sea level. In the next step by using artificial neural network predict sea level for first in this region. Then compared results of the models. Prediction using statistical models estimated in terms correlation coefficient R = 0.84 and root mean square error (RMS) 21.9 cm for the Bushehr station, and R = 0.85 and root mean square error (RMS) 48.4 cm for Rajai station, While neural network used to have 4 layers and each middle layer six neurons is best for prediction and produces the results reliably in terms of correlation coefficient with R = 0.90126 and the root mean square error (RMS) 13.7 cm for the Bushehr station, and R = 0.93916 and the root mean square error (RMS) 22.6 cm for Rajai station. Therefore, the proposed methodology could be successfully used in the study area.

Formal function and phrase structure in contemporary music : Pierre Boulez’s late solo works and Sean Clarke’s "Lucretia Overture" and "4 Impromptus"

Cette thèse présente une théorie de la fonction formelle et de la structure des phrases dans la musique contemporaine, théorie qui peut être utilisée aussi bien comme outil analytique que pour créer de nouvelles œuvres. Deux concepts théoriques actuels aident à clarifier la structure des phrases : les projections temporelles de Christopher Hasty et la théorie des fonctions formelles de William Caplin, qui inclut le concept de l’organisation formelle soudée versus lâche (tight-knit vs. loose). Les projections temporelles sont perceptibles grâce à l’accent mis sur les paramètres secondaires, comme le style du jeu, l’articulation et le timbre. Des sections avec une organisation formelle soudée ont des projections temporelles claires, qui sont créées par la juxtaposition des motifs distincts, généralement sous la forme d'une idée de base en deux parties. Ces projections organisent la musique en phrases de présentation, en phrases de continuité et finalement, à des moments formels charnières, en phrases cadentielles. Les sections pourvues d’une organisation plus lâche tendent à présenter des projections et mouvements harmoniques moins clairs et moins d’uniformité motivique. La structure des phrases de trois pièces tardives pour instrument soliste de Pierre Boulez est analysée : Anthèmes I pour violon (1991-1992) et deux pièces pour piano, Incises (2001) et une page d’éphéméride (2005). Les idées proposées dans le présent document font suite à une analyse de ces œuvres et ont eu une forte influence sur mes propres compositions, en particulier Lucretia Overture pour orchestre et 4 Impromptus pour flûte, saxophone soprano et piano, qui sont également analysés en détail. Plusieurs techniques de composition supplémentaires peuvent être discernés dans ces deux œuvres, y compris l'utilisation de séquence mélodiques pour contrôler le rythme harmonique; des passages composés de plusieurs couches musicales chacun avec un structure de phrase distinct; et le relâchement de l'organisation formelle de matériels récurrents. Enfin, la composition de plusieurs autres travaux antérieurs a donné lieu à des techniques utilisées dans ces deux œuvres et ils sont brièvement abordés dans la section finale.

Adaptação e validação para a cultura portuguesa da Late-Life Function and Disability Instrument (LLFDI)

Introdução:O envelhecimento pressupõe alterações no organismo, sendo fundamental a medição das limitações da funcionalidade e da incapacidade na execução de tarefas individuais e sociais por parte dos idosos. As guidelines da ACSM enfatizam que os idosos obtêm benefícios na saúde com a realização de atividade física regular. Objetivo: Adaptar e validar para a cultura portuguesa a Late-Life Function and Disability Instrument (LLFDI). Material e Métodos: A versão portuguesa foi obtida através de um processo de metodologia sequencial. Para avaliar a validade e fiabilidade, esta versão foi administrada a 619 idosos (72±9). Destes, 77 foram submetidos a uma intervenção de fisioterapia com base em dois programas de exercícios, para determinar o poder de resposta. Resultados: Após obtenção da equivalência semântica e de conteúdo, a versão portuguesa da LLFDI demonstrou valores elevados de reprodutibilidade (CCI_função > 0,8 e CCI_incapacidade > 0,7) e níveis bastantes aceitáveis de consistência interna (α Cronbach > 0,82). As correlações obtidas entre a LLFDI e o MOS SF-36 são moderadas a altas. A análise fatorial confirmatória demonstra um modelo ajustado para a componente função (relações positivas e muito fortes) e incapacidade (relações no limiar da aceitabilidade). O Poder de resposta de 4 semanas, demonstrou valores de ESS <0,30 (função) e <0,28 (incapacidade). Os valores de RMS encontram-se entre 0,40 e 0,72 (função) e entre 0,27 e 0,59 (incapacidade). Conclusões: A versão portuguesa da LLFDI demonstrou valores aceitáveis de validade e fiabilidade, revelando valores baixos de poder de resposta.

Weight loss improves biomarkers endothelial function and systemic inflammation in obese postmenopausal Saudi women.

Background: Although postmenopausal associated disorders are important public health problems worldwide, to date limited studies evaluated the endothelial function and systemic inflammation response to weight loss in obese postmenopausal women. Objective: This study was done to evaluate the endothelial function and systemic inflammation response to weight loss in obese postmenopausal Saudi women. Material and methods: Eighty postmenopausal obese Saudi women (mean age 52.64±6.13 year) participated in two groups: Group (A) received aerobic exercise on treadmill and diet whereas, group (B) received no intervention. Markers of inflammation and endothelial function were measured before and after 3 months at the end of the study. Results: The values of body mass index(BMI), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1) and plasminogen activator inhibitor- 1 activity (PAI-1:Ac) were significantly decreased in group (A), while changes were not significant in group (B). Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Conclusion: Weight loss ameliorates inflammatory cytokines and markers of endothelial function in obese postmenopausal Saudi women.

Exploring the Function and Regulation of Arabidopsis EIN2 in Ethylene Signaling

Ethylene is an essential plant hormone involved in nearly all stages of plant growth and development. EIN2 (ETHYLENE INSENSITIVE2) is a master positive regulator in the ethylene signaling pathway, consisting of an N-terminal domain and a C-terminal domain. The EIN2 N-terminal domain localizes to the endoplasmic reticulum (ER) membrane and shows sequence similarity to Nramp metal ion transporters. The cytosolic C-terminal domain is unique to plants and signals downstream. There have been several major gaps in our knowledge of EIN2 function. It was unknown how the ethylene signal gets relayed from the known upstream component CTR1 (CONSTITUTIVE RESPONSE1) a Ser/Thr kinase at the ER, to EIN2. How the ethylene signal was transduced from EIN2 to the next downstream component transcription factor EIN3 (ETHYLENE INSENSITIVE3) in the nucleus was also unknown. The N-terminal domain of EIN2 shows homology to Nramp metal ion transporters and whether EIN2 can also function as a metal transporter has been a question plaguing the ethylene field for almost two decades. Here, EIN2 was found to interact with the CTR1 protein kinase, leading to the discovery that CTR1 phosphorylates the C-terminal domain of EIN2 in Arabidopsis thaliana. Using tags at the termini of EIN2, it was deduced that in the presence of ethylene, the EIN2 C-terminal domain is cleaved and translocates into the nucleus, where it could somehow activate downstream ethylene responses. The EIN2 C-terminal domain interacts with nuclear proteins, RTE3 and EER5, which are components of the TREX-2 mRNA export complex, although the role of these interactions remains unclear. The EIN2 N-terminal domain was found to be capable of divalent metal transport when expressed in E. coli and S. cerevisiae leading to the hypothesis that metal transport plays a role in ethylene signaling. This hypothesis was tested using a novel missense allele, ein2 G36E, substituting a highly conserved residue that is required for metal transport in Nramp proteins. This G36E substitution did not disrupt metal ion transport of EIN2, but the ethylene insensitive phenotype of this mutant indicates that the EIN2 N-terminal domain is important for positively regulating the C-terminal domain. The defect of the ein2 G36E mutant does not prevent proper expression or subcellular localization, but might affect protein modifications. The ein2 G36E allele is partially dominant, mostly likely displaying haploinsufficiency. Overexpression of the EIN2 N-terminal domain in the ein2 G36E mutant did not rescue ethylene insensitivity, suggesting the N-terminal domain functions in cis to regulate the C-terminal domain. These findings advance our knowledge of EIN2, which is critical to understanding ethylene signaling.

Does social–behavioral adjustment mediate the relation between executive function and academic readiness?

Research shows that executive function and social–behavioral adjustment during the preschool years are both associated with the successful acquisition of academic readiness abilities. However, studies bringing these constructs together in one investigation are lacking. This study addresses this gap by testing the extent to which social and behavioral adjustment mediated the association between executive function and academic readiness. Sixty-nine 63–76month old children, enrolled in the last semester of the preschool year, participated in the present study. Tasks were administered to measure executive function and preacademic abilities, and teachers rated preschoolers' social–behavioral adjustment. Hierarchical regression analyses revealed that social–behavioral adaptation was a significant mediator of the effect of executive function on academic readiness, even after controlling for maternal education and child verbal ability. These findings extend prior research and suggest that executive function contributes to early academic achievement by influencing preschoolers' opportunities to be engaged in optimal social learning activities.

Implementation of an intelligent sensor for measurement and prediction of solar radiation and atmospheric temperature

Dissertação de mestrado, Engenharia Electrónica e Telecomunicações, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2011

Reconciling Function- and Affordance-Based Design

Traditional engineering design methods are based on Simon's (1969) use of the concept function, and as such collectively suffer from both theoretical and practical shortcomings. Researchers in the field of affordance-based design have borrowed from ecological psychology in an attempt to address the blind spots of function-based design, developing alternative ontologies and design processes. This dissertation presents function and affordance theory as both compatible and complimentary. We first present a hybrid approach to design for technology change, followed by a reconciliation and integration of function and affordance ontologies for use in design. We explore the integration of a standard function-based design method with an affordance-based design method, and demonstrate how affordance theory can guide the early application of function-based design. Finally, we discuss the practical and philosophical ramifications of embracing affordance theory's roots in ecology and ecological psychology, and explore the insights and opportunities made possible by an ecological approach to engineering design. The primary contribution of this research is the development of an integrated ontology for describing and designing technological systems using both function- and affordance-based methods.