916 resultados para Myoelectric Manifestations
Resumo:
Dans notre effort de comprendre l’action enseignante a travers la relation entre l’objet enseigne et la gestion des taches, nous nous proposons de montrer dans cette contribution en quoi le rapport a un savoir est responsable de la cristallisation de certains gestes enseignants, d’une part, et de quelle façon les interactions en classe rendent compte de ce rapport, d’autre part. Les propriétés classiques de l’action (agentivité, intentionnalité/ causalité, descriptibilité) seront ici articulées a une perspective centrée sur le caractère déterminant de l’action. Nous rejoignons ici le traitement de l’intentionnalité comme « produit du processus interactionnel dans son ensemble » et non pas « comme une propriete des seules manifestations de l’agent » (Filliettaz, 2002: 187)
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El objeto de esta tesis es el análisis de la autorregulación regulada, es decir, el análisis de las normas y de los controles privados que poseen relevancia para el Derecho público. A pesar de su aparente desvinculación con el Derecho Administrativo, la autorregulación es una tendencia que se percibe cada vez con mayor nitidez; es, claramente, un fenómeno que se asocia principalmente al uso de nuevas tecnologías, pero que desborda con mucho este ámbito. La autorregulación es una noción directamente relacionada con la transformación de las formas de gobernanza impulsada desde la Unión Europea; es una nueva técnica o instrumento que las normas jurídico-públicas, a través de numerosas remisiones a la autorregulación, ponen en manos de la administración para gestionar los fines que ésta tiene encomendados. Existe, sin embargo una clara disociación entre las esperanzas puestas en la autorregulación y la falta de respuestas que ofrece el derecho positivo. Un análisis exhaustivo de la jurisprudencia y de la legislación que utilizan la voz "autorregulación" me ha llegado a concluir que este vocablo es en nuestro ordenamiento, un "término sin concepto". En esta fuentes se asimila la "autorregulación" con la capacidad de autonormación de un sujeto. Es el derecho comunitario el que la autorregulación como una alternativa o un complemento a la desreglamentación estatal y como una manifestación de un traslado de funciones y responsabilidades públicas a la sociedad. Por influencia del Derecho comunitario, el legislador pretende, a través de la autorregulación, alcanzar dos finalidades aparentemente contradictorias: (a) facilitar la función de garante que tiene atribuida el Estado, mediante una intervención más extensa i más intensa en las actividades privadas; (b) hacer efectivo los objetos propuestos con la desregulación, mediante una contención del ejercicio de la potestad reglamentaria y una disminución de los controles, preventivos o represivos, realizados directamente por la Administración. Para salvar esta contradicción, es necesario que el legislador establezca una regulación adecuada de la autorregulación. Dicha regulación es, hoy por hoy, manifiestamente insuficiente. Deberían fijarse con carácter general -y no sólo puntualmente y por sectores- las medidas adecuadas para el fomento de la autorregulación; los efectos públicos que ésta posee en cada caso y, significativamente, las garantías y controles necesarios para contrarrestar tales efectos. Esto es, los principios que rigen la actividad administrativa deberían ser aplicados también a la autorregulación en aquellos casos en los que sus diversas manifestaciones poseen efectos similares a los que son propios de los reglamentos, las inspecciones o las sanciones administrativas. Esta propuesta deja abierta la cuestión acerca de la incidencia recíproca de ambas técnicas; esto es , la incidencia de la regulación pública en la autorregulación de origen privado y, a la inversa, el impacto del desarrollo de la autorregulación regulada en el ejercicio de las potestades reglamentaria, autorizatoria, y sancionadora de la Administración. Esta cuestión sólo puede ser contestada hoy caso por caso, de modo que la respuesta es distinta si se analiza una norma técnica, un código ético, un manual de buenas prácticas, una certificación privada del cumplimiento de normas técnicas, el ejercicio de la potestad disciplinaria privada o el arbritaje. De lo que no cabe duda alguna es que ni la autorregulación es sólo una actividad de interés privado, ni la regulación pública conserva hoy sus rasgos tradicionales.
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A miocardiopatia hipertrófica (MH) é a doença cardíaca genética mais comum, afectando 1:500 indivíduos, apresentando um padrão de transmissão autossómico dominante, com mutações associadas a genes sarcoméricos e não sarcoméricos. A MH apresenta uma variedade de manifestações clínicas, desde indivíduosassintomáticos a indivíduos que manifestam uma progressão da severidade dos sintomas, podendo nalguns casos ocorrer morte súbita. O diagnóstico clínico é realizado por Electrocardiograma e Ecocardiograma. O diagnóstico genético baseia-se na Sequenciação Automática (SA) dos 5 principais genes sarcoméricos MYBPC3, MYH7, TNNT2, TNNI3 e MYL2, sendo considerada uma metodologia bastante dispendiosa e demorada e que não permite a identificação de mutações em cerca de 1/3 dos individuos. A Genotipagem por iPLEX MassARRAY revela-se uma boa alternativa à SA no diagnóstico genético de MH, uma vez que permite a análise de várias amostras em simultâneo, para um elevado número de mutações, num único ensaio, com uma maior rentabilidade de tempo e recursos. Este trabalho teve como objectivo a optimização e a validação desta metodologia, na detecção de 541 mutações em 33 genes, tendo-se verificado que 29 % das reacções multiplex necessitam de ser revistas, quer pelo desenho de novos conjuntos de primers, quer pela sua relocalização no chip.
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Clostridium perfringens é uma bactéria anaeróbia Gram positiva, formadora de esporos e produtora de toxinas capazes de causar um amplo espectro de doenças em humanos e animais. Em frangos de crescimento rápido e de plumagem branca pode causar lesões e manifestações clínicas severas como enterite necrótica aviária (ENA), associada a uma baixa eficiência produtiva e avultadas perdas económicas. Neste estudo pretendeu-se avaliar a utilização de um teste de ensaio imunocromatográfico de fluxo lateral, o Clostridium FirstTestTM, para deteção e quantificação precoce de C. perfringens em frangos de crescimento rápido e plumagem branca e posterior relação entre a presença do agente e as características dos bandos (peso médio à chegada, idade dos bandos à amostragem), fatores ambientais (densidade populacional, temperatura ambiente, humidade da cama) e os indicadores de produção (ganho médio diário, Índice de Conversão Alimentar e percentagem de mortalidade). Para tal, foram analisadas amostras fecais de trinta bandos, em dezoito explorações integradas, na Região de Lisboa e Vale do Tejo. De acordo com a classificação do Clostridium FirstTestTM, dos trinta bandos amostrados entre o décimo primeiro e o décimo quinto dia de vida, 30 % foram classificados como “Positivo” (n=9) e 10 % foram classificados como “Muito Positivo” (n=3); apresentando concentrações médias de C. perfringens de 0,1322 ng/ml e 0,3267 ng/ml, respectivamente. Os restantes bandos, 60% (n=18), foram considerados “Normal” e apresentaram concentrações médias de C. perfringens de 0,0283 ng/ml. As amostras fecais dos bandos classificados de “Positivo” e “Muito Positivo” foram posteriormente sujeitas a análise microbiológica apresentando ambos os grupos unidades formadoras de colónias (UFC), identificadas como C. perfringens. Verificou-se que não existe relação entre os resultados do Clostridium FirstTestTM e as características dos bandos, os fatores ambientais e os indicadores de produção. Verificou-se uma diminuição dos níveis de C. perfringens nos bandos sujeitos a tratamento.
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Introduction: Autosomal dominant polycystic kidney disease is the most common hereditary renal disease in humans. Objective: To examine the prevalence, clinical and laboratory characteristics of patients with polycystic kidneys and relate disease manifestations by gender. Methods: This was an observational and retrospective study. All the medical records of patients with polycystic kidneys who initiated hemodialysis between 1995 and 2012, in four centers that treat patients of the coverage area of the 15th regional health Paraná (Brazil), were analyzed. Results: The study included 48 patients with polycystic kidneys, the primary cause of stage 5 CKD. Disease prevalence was one in 10,912 people. The average age of dialysis initiation was 50.7 years and the follow-up time on dialysis until transplantation (36.5 months) was lower among men. Hypertension was the most frequent diagnosis in 73% of patients, predominantly in women (51.4%). The liver cyst was the most frequent extrarenal manifestations in men (60.0%). The death occurred in 10.4% of patients using hemodialysis, and 60% of men. The class of antihypertensive drug used was that acts on the renin-angiotensin system with higher frequency of use among women (53.3%). The post-dialysis urea was significantly higher in men. Conclusion: The prevalence of the disease is low among hemodialysis patients in southern Brazil. The differences observed between genders, with the exception of the post-dialysis urea, were not significant. The findings are different from those reported in North America and Europe.
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Este ensayo analiza ciertas normas dictadas por la Corona con el propósito de regular la vida urbana a lo largo del período colonial. El artículo centra su estudio en algunas disposiciones que buscaban refrenar el desorden público y mantener el orden y las normas del ""buen vivir"". Bajo esta perspectiva, se analizan algunas prácticas culturales que se apartaban de estas regulaciones, entre las que se incluyeron los albazos y carnavales. Muchas de estas manifestaciones fueron percibidas por el poder colonial como muestras de primitivismo latente. No obstante, el juego de carnaval, entre otras prácticas, se mantuvo reacio a acatar estas regulaciones.
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En este artículo el autor explora los cambios ocurridos en la configuración mundial del poder después del 11 de septiembre el 2001. A manera de comparación, describe las manifestaciones del imperialismo en el pasado como formas de terrorismo practicado desde la metrópoli y en la actualidad como formas de terrorismo privado o contra Estados Unidos. El autor rastrea el uso, la utilidad y el ocaso del concepto de ""imperialismo"" y sugiere utilizar el concepto de ""poder de la colonialidad"" para comprender las modalidades coloniales, nacionales y globales del imperialismo. Finalmente y en diálogo con el subcomandante Marcos, el autor identifica y describe las cinco piezas del rompecabezas del imperialismo global actual.
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Este artículo tiene como objetivo realizar un ágil análisis comparativo de la crisis ecuatoriana para establecer si es posible atribuirle a ésta las mismas causas, medidas correctivas, los mismos costos y duración, que se les asigna a crisis similares en otros países, revelando, además, los argumentos que permiten concluir que la crisis del sistema financiero ecuatoriano no ha terminado aún.
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Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador’s floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis, we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone – the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings.
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The k-means cluster technique is used to examine 43 yr of daily winter Northern Hemisphere (NH) polar stratospheric data from the 40-yr ECMWF Re-Analysis (ERA-40). The results show that the NH winter stratosphere exists in two natural well-separated states. In total, 10% of the analyzed days exhibit a warm disturbed state that is typical of sudden stratospheric warming events. The remaining 90% of the days are in a state typical of a colder undisturbed vortex. These states are determined objectively, with no preconceived notion of the groups. The two stratospheric states are described and compared with alternative indicators of the polar winter flow, such as the northern annular mode. It is shown that the zonally averaged zonal winds in the polar upper stratosphere at 7 hPa can best distinguish between the two states, using a threshold value of 4 m s−1, which is remarkably close to the standard WMO criterion for major warming events. The analysis also determines that there are no further divisions within the warm state, indicating that there is no well-designated threshold between major and minor warmings, nor between split and displaced vortex events. These different manifestations are simply members of a continuum of warming events.
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There is substantial evidence for the effectiveness of psychological treatments for OCD, and various approaches have been widely recommended. These approaches tend to be characterized by exposure and response prevention (ERP) and also tend to be applied equally to all forms of OCD. Patients/clients (and some therapists) often find ERP to be a difficult treatment, and both dropout and refusal rates are unacceptably high. Based on specific cognitive conceptualizations of different manifestations of OCD, new and refined cognitive treatment methods are now available. The present article describes a specific cognitively based approach to the treatment of compulsive checking.
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Unlike most domestic livestock species, sheep are widely known as an animal with marked seasonality of breeding activity. The annual cycle of daily photoperiod has been identified as the determinant factor of this phenomenon, while environmental temperature, nutritional status, social interactions, lambing date and lactation period are considered to modulate it. The aim of this paper is to review the current state of knowledge of the reproductive seasonality in sheep. Following general considerations concerning the importance of seasonal breeding as a reproductive strategy for the survival of species, the paper describes the manifestations of seasonality in both the ram and the ewe. Both determinant and modulating factors are developed and special emphasis is given to the neuroendocrine base of photoperiodic regulation of seasonal breeding. Other aspects such as the role of melatonin, the involvement of thyroid hormones and the concept of photorefractoriness are also reviewed. (C) 2003 Elsevier Science B.V. All rights reserved.
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Background: The objective was to evaluate the efficacy and tolerability of donepezil (5 and 10 mg/day) compared with placebo in alleviating manifestations of mild to moderate Alzheimer's disease (AD). Method: A systematic review of individual patient data from Phase II and III double-blind, randomised, placebo-controlled studies of up to 24 weeks and completed by 20 December 1999. The main outcome measures were the ADAS-cog, the CIBIC-plus, and reports of adverse events. Results: A total of 2376 patients from ten trials were randomised to either donepezil 5 mg/day (n = 821), 10 mg/day (n = 662) or placebo (n = 893). Cognitive performance was better in patients receiving donepezil than in patients receiving placebo. At 12 weeks the differences in ADAS-cog scores were 5 mg/day-placebo: - 2.1 [95% confidence interval (CI), - 2.6 to - 1.6; p < 0.001], 10 mg/day-placebo: - 2.5 ( - 3.1 to - 2.0; p < 0.001). The corresponding results at 24 weeks were - 2.0 ( - 2.7 to - 1.3; p < 0.001) and - 3.1 ( - 3.9 to - 2.4; p < 0.001). The difference between the 5 and 10 mg/day doses was significant at 24 weeks (p = 0.005). The odds ratios (OR) of improvement on the CIBIC-plus at 12 weeks were: 5 mg/day-placebo 1.8 (1.5 to 2.1; p < 0.001), 10 mg/day-placebo 1.9 (1.5 to 2.4; p < 0.001). The corresponding values at 24 weeks were 1.9 (1.5 to 2.4; p = 0.001) and 2.1 (1.6 to 2.8; p < 0.001). Donepezil was well tolerated; adverse events were cholinergic in nature and generally of mild severity and brief in duration. Conclusion: Donepezil (5 and 10 mg/day) provides meaningful benefits in alleviating deficits in cognitive and clinician-rated global function in AD patients relative to placebo. Increased improvements in cognition were indicated for the higher dose. Copyright © 2004 John Wiley & Sons, Ltd.
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Tick-borne encephalitis virus (TBEV) causes human epidemics across Eurasia. Clinical manifestations range from inapparent infections and fevers to fatal encephalitis but the factors that determine disease severity are currently undefined. TBEV is characteristically a hemagglutinating (HA) virus; the ability to agglutinate erythrocytes tentatively reflects virion receptor/fusion activity. However, for the past few years many atypical HA-deficient strains have been isolated from patients and also from the natural European host tick, Ixodes persulcatus. By analysing the sequences of HA-deficient strains we have identified 3 unique amino acid substitutions (D67G, E122G or D277A) in the envelope protein, each of which increases the net charge and hydrophobicity of the virion surface. Therefore, we genetically engineered virus mutants each containing one of these 3 substitutions; they all exhibited HA-deficiency. Unexpectedly, each genetically modified non-HA virus demonstrated increased TBEV reproduction in feeding Ixodes ricinus, not the recognised tick host for these strains. Moreover, virus transmission efficiency between infected and uninfected ticks co-feeding on mice was also intensified by each substitution. Retrospectively, the mutation D67G was identified in viruses isolated from patients with encephalitis. We propose that the emergence of atypical Siberian HA-deficient TBEV strains in Europe is linked to their molecular adaptation to local ticks. This process appears to be driven by the selection of single mutations that change the virion surface thus enhancing receptor/fusion function essential for TBEV entry into the unfamiliar tick species. As the consequence of this adaptive mutagenesis, some of these mutations also appear to enhance the ability of TBEV to cross the human blood-brain barrier, a likely explanation for fatal encephalitis. Future research will reveal if these emerging Siberian TBEV strains continue to disperse westwards across Europe by adaptation to the indigenous tick species and if they are associated with severe forms of TBE.
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It is contended that competitiveness is better understood as a discourse rather than as a characteristic that is supposedly possessed. The discourse of competitiveness derives its legitimacy from the enterprise culture that came to dominance during the 1980s. Current popularized theories of competitiveness are constituent parts of this broader discourse, which has had significant material implications for the UK construction sector. The dominant discourse of competitiveness amongst contracting firms is shaped by the need to achieve structural flexibility to cope with fluctuations in demand. Fashionable espoused improvement recipes such as total quality management, business process re-engineering, and lean construction legitimize and reinforce the material manifestations of the enterprise culture. In consequence, the UK industry is characterized by a plethora of hollowed-out firms that have failed to invest in their human capital. While the adopted model may be rational for individual firms, the systemic effect across the sector as a whole equates to a form of anorexia. However, the discourse of competitiveness is by no means monolithic and continues to be contested locally. There have also been numerous counter-discourses that have been mobilized in response to the undesirable externalities of unbridled enterprise. Currently, important counter-discourses promote the ideas of sustainability and corporate social responsibility.