976 resultados para Long-term care insurance
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The hypothesis of this study was that the absence of soil tillage in long-term no-tillage (NT) systems can be detrimental to soil aeration. The objective was to assess the aeration condition of an Oxisol (Rhodic Ferrasol), very clayey texture (750 g kg-1 of clay; 200 g kg-1 of sand), after 30 years of cultivation under NT. The physical property soil air permeability (Ka) is sensitive to changes in the soil pore system. Aside from Ka, the air-filled porosity (ε a) and indices of pore continuity (K1 and N), derived from the relationship between Ka and εa, were used as indices of soil aeration. From the soil layers 0.0-0.1 and 0.1-0.2 m, 240 undisturbed samples were collected along a transect perpendicular to the crop rows, at three sampling positions: corn plant row (CR); center of the interrow (INT); and the equidistant point between CR and INT (PE). The properties Ka and εa were determined at soil matric potentials (Ψm) of -2, -4, -6, -10, -30, and -50 kPa. Soil bulk density (BD) was also determined. The results confirmed the hypothesis. In the 0.0-0.1 m layer, Ka, K1, N and Ψa were significantly greater and BD significantly lower in CR than at the other sampling positions. At a Ψm of -10 kPa, the Ka of CR was 6.9 and 8.4 times higher than in PE and INT, respectively, in the 0.0-0.1 m layer. The properties Ka, K1 and N were sensitive enough to detect changes in the pore system and their differences between the sampling positions demonstrated the importance of the spatial location for soil sampling. Tilling the crop rows provides better soil aeration under NT.
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The area under the no-tillage system (NT) has been increasing over the last few years. Some authors indicate that stabilization of soil physical properties is reached after some years under NT while other authors debate this. The objective of this study was to determine the effect of the last crop in the rotation sequence (1st year: maize, 2nd year: soybean, 3rd year: wheat/soybean) on soil pore configuration and hydraulic properties in two different soils (site 1: loam, site 2: sandy loam) from the Argentinean Pampas region under long-term NT treatments in order to determine if stabilization of soil physical properties is reached apart from a specific time in the crop sequence. In addition, we compared two procedures for evaluating water-conducting macroporosities, and evaluated the efficiency of the pedotransfer function ROSETTA in estimating the parameters of the van Genuchten-Mualem (VGM) model in these soils. Soil pore configuration and hydraulic properties were not stable and changed according to the crop sequence and the last crop grown in both sites. For both sites, saturated hydraulic conductivity, K0, water-conducting macroporosity, εma, and flow-weighted mean pore radius, R0ma, increased from the 1st to the 2nd year of the crop sequence, and this was attributed to the creation of water-conducting macropores by the maize roots. The VGM model adequately described the water retention curve (WRC) for these soils, but not the hydraulic conductivity (K) vs tension (h) curve. The ROSETTA function failed in the estimation of these parameters. In summary, mean values of K0 ranged from 0.74 to 3.88 cm h-1. In studies on NT effects on soil physical properties, the crop effect must be considered.
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The Rebuild Iowa Office (RIO) continues to coordinate the state‘s recovery effort from the storms, tornadoes and floods of 2008. Much has been accomplished since the Office‘s last quarterly report was issued in July 2010. State funding has been disbursed to help Iowans with unmet needs and housing. Local governments and entities are utilizing millions of federal dollars so thousands of disaster-impacted homeowners can be offered a buyout. More infrastructure projects are under construction and new neighborhoods are being built with mitigation efforts in mind. However, as Iowa continues to celebrate many successes along the road to recovery, it must also address the numerous challenges that are encountered along the path. Recovering from the state‘s largest disaster must be looked at as a marathon, not a sprint. Over the past three months, the RIO has especially remained focused on helping small business owners impacted by the 2008 disasters. Many disaster-affected businesses have reopened their doors, however their debt load continues to be overwhelming and many still struggle with the timeliness of the disbursement of funds. This report describes how programs and recent modifications are working to assist recovering businesses. This report contains updates on housing progress while outlining the complexities behind certain programs and the bottlenecks communities are facing due to strict federal guidelines for implementation. This following pages also describe how Iowa is implementing Smart Planning principles, publicizing flood awareness through outreach efforts and preparing a blueprint for the state to follow when future disasters occur. As always, the RIO recognizes and thanks the countless leaders and front-line workers from local, regional, state and federal government, businesses, non-profit organizations and private citizens that have provided input, support and leadership. Their dedication to Iowa‘s disaster recovery has made the plans and projects on the following pages possible.
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Rapport de synthèse : Le traitement des leucémies aiguës chez l'enfant représente un des succès de la médecine moderne avec des taux de guérison avoisinant les 80% ce qui implique la nécessité de suivre les effets secondaires à long terme des traitements chez cette population de patients. Récemment plusieurs études internationales ont relevé une prévalence plus importante de surpoids et d'obésité chez les enfants traités pour une leucémie aiguë. L'origine de ce processus reste incertaine :aux effets secondaires bien connus et décrits des traitements (stéroïdes et radiothérapie) semblent s'ajouter des facteurs génétiques, familiaux (age, BMI au diagnostic, BMI parents et fratrie), environnementaux. L'objectif de ce travail est d'estimer la prévalence et les facteurs de risque pour le surpoids et l'obésité chez les enfants traités et guéris d'une leucémie aiguë en Suisse romande et de comparer ces résultats à ceux d'études internationales. Pour répondre à ces questions nous avons inclus 54 patients (40 de Lausanne et 14 de Genève) traités pour une leucémie aiguë. Seuls les enfants à 5 ans de leur première rémission clinique, sans atteinte du système nerveux central, testiculaire ou médullaire et traités par chimiothérapie seule sont retenus. Leur poids, taille sont enregistrés durant les phases précises de traitement (au diagnostic, à la rémission, fin de consolidation, milieumaintenance et en fin de traitement) puis annuellement jusqu'à 12 ans post fin de traitement. Le BMI (kg/ml) et sa déviation standard BMI-SDS (spécifique pour Page et le sexe) pour les patients et leurs parents sont calculés selon les valeurs internationales (IOTF) respectivement BMI-SDS >1.645 (p<0.05) pour le surpoids et> 1.96 (p<0.025) pour l'obésité. Les résultats de ce travail confirment une prévalence double de surpoids (30% versus 17%) et quadruple d'obésité (18% versus 4%) au sein de la population d'enfants traités pour une leucémie aiguë comparées à la population suisse standard. Les facteurs de risque impliqués sont le BMI initial au diagnostic et le BMI maternel contrairement à Page, sexe, stéroïdes et au BMI paternel. Ces données confirment une prévalence significative d'enfants en surpoids/obèses au sein de cette population avec des résultats similaires à ceux retrouvés dans des études internationales récentes. Les facteurs de risque identifiés semblent plutôt liés à l'environnement familial qu'aux traitements. Ces constatations pourraient être le résultat d'interactions complexes entre "le background génétique", les facteurs environnementaux, les habitudes socioculturelles (activité physique, status nutritionnel) paramètres non évalués dans cette revue. Des études plus larges, prospectives sont nécessaires pour clarifier les rôles des différents facteurs de risque et de leurs interactions ;celles-ci devraient inclure des données génétiques (LEPR), taux de leptine, activité physique et le status nutritionnel. Enfin, l'identification des patients à risque est cruciale afin de prévenir les effets secondaires cardio-vasculaires, métaboliques bien connus liés au surpoids et à l'obésité.
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At approximately 5pm on May 25, 2008, City of Parkersburger was struck by a powerful EF5 tornado, estimated to be three-quarters of a mile wide. As it moved across the southern half of the City, the tornado cased severe damage, destroying at least twenty businesses and over two hundred fifty homes along with city Hall and Aplington-Parkersburg High School. Numerous other homes, businesses and civic buildings were damaged. Approximately two weeks later, Beaver Creek was among the many Iowa streams to flood. While Parkersburg was not affected significantly by flooding, a number of properties were damaged, including Beaver Meadows Golf Course and a City park with athletic fields.
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OBJECTIVE: To assess porcine urothelial cell cultures and the in vitro induction of urothelial stratification in long-term cultures, to study their morphological, functional and genetic behaviour, and thus provide potential autologous urothelium for tissue-engineered substitutes for demucosalized gastric or colonic tissue. MATERIALS AND METHODS: Primary cultures of porcine urothelium were established and the cells passaged thereafter. Cell specificity was confirmed by cytokeratin analysis, cell membrane stability assessed using lactate dehydrogenase leakage, cell de-differentiation by gamma-glutamyl transferase activity and genomic stability by karyotype investigations. Histology and scanning electron microscopy were performed to study the cultured cells and the stratified constructs. Furthermore, collagen matrices were tested as cell scaffolds. RESULTS: The cells were cultured for 180 days; 10 subcultures were established during this period. Stratification was induced in a culture flask and on a collagen matrix. Cytokeratins 7, 8, 17 and 18 were expressed in all cultures, and cell membranes were stable, with no evident de-differentiation. The cultures were stable in their genotype and no chromosomal aberrations were found. The histology and immunohistochemistry of the stratified porcine constructs, and cell membrane stability and cell de-differentiation, were compared with those in the human system. CONCLUSION: Pig and human urothelial cells can be cultured over a long period with no signs of senescence. Urothelial stratification can be induced in vitro. The collagen matrix seems to be an excellent scaffold, allowing cell adherence and growth.
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Background/Purpose: Gouty arthritis (GA) is a chronic inflammatory disease. Targeting the inflammatory pathway through IL-1_ inhibition with canakinumab (CAN) may provide significant long-term benefits. CAN safety versus triamcinolone acetonide (TA) over initial 24 weeks (blinded study) for patients (pts) with history of frequent attacks (_3 in year before baseline) was reported earlier from core (_-RELIEVED [_-REL] and _-REL-II) and first extension (E1) studies1. Herein we present full 18-month long-term CAN safety data, including open-label second extension (E2) studies. Methods: GA pts completing _-REL E1 and _-REL-II E1 studies1 were enrolled in these 1-year, open-label, E2 studies. All pts entering E2, whether randomized to CAN or TA, received CAN 150 mg sc on demand upon new attack. Data are presented only for pts randomized to CAN, and are reported cumulatively, i.e. including corresponding data from previously reported core and E1 studies. Long-term safety outcomes and safety upon re-treatment are presented as incidence rate per 100 patient-years (pyr) of study participation for AEs and SAEs. Deaths are reported for all pts (randomized to CAN or TA). Selected predefined notable laboratory abnormalities are shown (neutrophils, platelets, liver and renal function tests). Long-term attack rate per year is also provided. Results: In total, 69/115 (60%) and 72/112 (64.3%) of the pts randomized to CAN in the two core studies entered the two E2 studies, of which 68 and 64 pts, respectively completed the E2 studies. The 2 study populations had differing baseline comorbidity and geographic origin. Lab data (not time adjusted) for neutropenia appears worse after retreatment in _-REL E2, and deterioration of creatinine clearance appears worse after retreatment (Table 1). The time-adjusted incidence rates for AEs were 302.4/100 pyr and 360/100 pyr, and for SAEs were 27.9/100 pyr and 13.9/100 pyr in _-REL E2 and _-REL-II E2 respectively (Table 1). The time-adjusted incidence rates of any AEs, infection AEs, any SAEs, and selected SAEs before and after re-treatment are presented in Table 1. Incidence rates for AEs and SAEs declined after re-treatment, with the exception of SAEs in _-REL-II E2, which increased from 2.9/100 pyr to 10.9/100 pyr (no infection SAEs after retreatment in _-REL-II E2, and other SAEs fit no special pattern). In the total safety population (N_454, core and all extensions), there were 4 deaths, 2 in the core studies previously reported1 and 2 during the _-REL E2 study (one patient in the CAN group died from pneumonia; one patient in the TA group who never received CAN died of pneumococcal sepsis). None of the deaths was suspected by investigators to be study drug related. The mean rates of new attacks per year on CAN were 1.21 and 1.18 in _-REL E2 and in _-REL-II E2. Conclusion: The clinical safety profile of CAN upon re-treatment was maintained long-term with no new infection concerns
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This paper analyzes the relationship between spatial density of economic activity and interregional differences in the productivity of industrial labour in Spain during the period 1860-1999. In the spirit of Ciccone and Hall (1996) and Ciccone (2002), we analyze the evolution of this relationship over the long term in Spain. Using data on the period 1860-1999 we show the existence of an agglomeration effect linking the density of economic activity with labour productivity in the industry. This effect was present since the beginning of the industrialization process in the middle of the 19th century but has been decreasing over time. The estimated elasticity of labour productivity with respect to employment density was close to 8% in the subperiod 1860-1900, reduces to a value of around 7% in the subperiod 1914-1930, to 4% in the subperiod 1965-1979 and becomes insignificant in the final subperiod 1985-1999. At the end of the period analyzed there is no evidence of the existence of net agglomeration effects in the industry. This result could be explained by an important increase in the congestion effects in large industrial metropolitan areas that would have compensated the centripetal or agglomeration forces at work. Furthermore, this result is also consistent with the evidence of a dispersion of industrial activity in Spain during the last decades.
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Purpose: To evaluate the long-term outcome (up to 7 years) of presumed ocular tuberculosis (TB) when the therapeutic decision was based on WHO guidelines. Methods: Twelve out of 654 new uveitic patients (1998-2004) presented with choroiditis and positive tuberculosis skin test (TST) (skin lesion diameter >15 mm). Therapy was administered according to WHO recommendations after ophthalmic and systemic investigation. The area size of ocular lesions at presentation and after therapy, measured on fluorescein and indocyanine green angiographies, was considered the primary outcome. Relapse of choroiditis was considered a secondary outcome. The T-SPOTTB test was performed when it became available. Results: Visual acuity (VA) significantly improved after therapy (p=0.0357). The mean total surface of fluorescein lesions at entry was 44.8±20.9 (arbitrary units) and decreased to 32.5±16.9 after therapy (p=0.0165). The mean total surface of indocyanine green lesions at entry was 24.5±13.3 and decreased to 10.8±5.4 after therapy (p=0.0631). The T-SPOT TB revealed 2 false TST-positive results. The mean follow-up was 4.5±1.5 years. Two relapses out of 10 confirmed ocular TB was observed after complete lesion healing, 2.5 years and 4.5 years after therapy, respectively. Conclusions: A decrease of ocular lesion mean size and a mean improvement of VA were observed after antituberculous therapy. Our long-term follow-up of chorioretinal lesions demonstrated relapse of ocular tuberculosis in 10% of patients with confirmed ocular TB, despite complete initial retinal scarring.
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Does a conflict between inborn motor preferences and educational standards during childhood impact the structure of the adult human brain? To examine this issue, we acquired high-resolution T1-weighted magnetic resonance scans of the whole brain in adult "converted" left-handers who had been forced as children to become dextral writers. Analysis of sulcal surfaces revealed that consistent right- and left-handers showed an interhemispheric asymmetry in the surface area of the central sulcus with a greater surface contralateral to the dominant hand. This pattern was reversed in the converted group who showed a larger surface of the central sulcus in their left, nondominant hemisphere, indicating plasticity of the primary sensorimotor cortex caused by forced use of the nondominant hand. Voxel-based morphometry showed a reduction of gray matter volume in the middle part of the left putamen in converted left-handers relative to both consistently handed groups. A similar trend was found in the right putamen. Converted subjects with at least one left-handed first-degree relative showed a correlation between the acquired right-hand advantage for writing and the structural changes in putamen and pericentral cortex. Our results show that a specific environmental challenge during childhood can shape the macroscopic structure of the human basal ganglia. The smaller than normal putaminal volume differs markedly from previously reported enlargement of cortical gray matter associated with skill acquisition. This indicates a differential response of the basal ganglia to early environmental challenges, possibly related to processes of pruning during motor development.