995 resultados para Labor Stage Third


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Adults of Cyclocephala distincta are flower visitors of Neotropical palms (Arecaceae) and commonly found in the Atlantic Forest of Pernambuco, Brazil. Males and females were collected in the wild and subjected to captive rearing and breeding. The egg hatching rate, the life cycle, longevity of immatures and adults, and oviposition parameters in captivity were analyzed. The average duration of the life cycle of C. distinctawas 108.2 days (n = 45). The egg stage lasted on average 10.9 days, and the egg-hatching rate was 73.9%. The immature stage lasted on average 93.4 days. The larvae stage exhibited negative phototaxis, and the size of their head capsules increased at a constant rate of 1.6 between instars, following Dyar's rule. The average duration of the first instar was 24.8 days (n = 88), whereas the second and third instars lasted for 17.2 (n = 76) and 40.4 (n = 74) days respectively, and survival rates were 21.6%, 86.4% and 97.4%. The pre-pupal stage was recorded, and pupal chambers were built before pupation. The average number of eggs laid per female was 15.5, the total reproductive period lasted for 3.3 days, and the total fertility was 81.2%. Adults that emerged in captivity exhibited an average longevity of 18.9 days. Adult C. distincta exhibited thanatosis behavior upon manipulation, a strategy observed for the first time in Cyclocephala.

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Nyssomyia whitmani (Antunes and Coutinho, 1939) has been considered as a complex of cryptic species, and some of the populations of this complex plays an important role in the transmission of Leishmania spp. in Brazil. The present study reports the biological aspects concerning the productivity out of eggs and the development time of the descendants of females obtained in Dourados municipality, Mato Grosso do Sul state. The females were captured with modified electric aspirators, fed in hamsters and further individualized in containers for breeding. At the insectary, temperature and relative humidity were maintained on average of 24.5 °C and 67.3%, respectively. From 944 females 3737 eggs were obtained, 748 (20.0%) evolved to the stage of larvae, and 93 (12.4%) of these reached adult stage. The life cycle lasted 80.6 days and the last larval instar was the longest. The use of a higher protein diet revealed a significant improvement in larval development.

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ABSTRACT Third stage larvae and pupae are described based on specimens collected in Mexico: Oaxaca (Cerro Zempoaltepetl), and Chiapas (Amatenango), respectively. Pupal characters are described for the first time for American Hopliinae. Habitus images and figures of diagnostic characters as well as comments on the differences between these larvae and those of Hoplia callipyge LeConte, 1856 and H. equina LeConte, 1880, the only Hopliinae larvae previously known in New World, are also included.

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[Abstract] Reading volume and mammography screening performance appear positively correlated. Performance was compared across organised Swiss screening programmes, which target relatively small populations. Except for accreditation of 2nd readers radiologists (restrictive vs non-restrictive strategy), Swiss programmes have similar screening regimen/procedures and duration, which maximises comparability. Variation in performance was explored in order to improve mammography practice and optimise screening performance. Indicators of quality and effectiveness were evaluated for about 200,000 screens performed over 4 screening rounds in the 3 longest-standing Swiss cantonal programmes (of Vaud, Geneva and Valais). Interval cancers were identified by linkage with cancer registries records. Most European standards of performance were met with a favourable cancer stage shift. Several performance indicators showed substantial variation across programmes. In subsequent rounds, compared with programmes (Vaud and Geneva) which accredited few 2nd readers to increase their individual reading volume, proportions of in situ lesions and of small cancers (? 1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. Differences in performance could partly be explained by a selective strategy for 2nd readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume Swiss programmes.

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Nicotine cessation programmes in Switzerland, which are commonly based on the stage of change model of Prochaska and DiClemente (1983), are rarely offered to patients with illicit drug dependence. This stands in contrast to the high smoking rates and the heavy burden of tobacco-related problems in these patients. The stage of change was therefore assessed by self-administered questionnaire in 100 inpatients attending an illegal drug withdrawal programme. Only 15% of the patients were in the contemplation or decision stage. 93% considered smoking cessation to be difficult or very difficult. These data show a discrepancy between the motivation to change illegal drug consumption habits and the motivation for smoking cessation. The high proportion of patients remaining in the precontemplation stage for smoking cessation, in spite of their motivation for illicit drug detoxification, may be due to the perception that cessation of smoking is more difficult than illicit drug abuse cessation.

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BACKGROUND: MYCN oncogene amplification has been defined as the most important prognostic factor for neuroblastoma (NB), the most common solid extracranial neoplasm in children. High copy numbers are strongly associated with rapid tumor progression and poor outcome, independently of tumor stage or patient age, and this has become an important factor in treatment stratification. PROCEDURE: By real-time quantitative PCR analysis, we evaluated the clinical relevance of circulating MYCN DNA of 267 patients with locoregional or metastatic NB in children less than 18 months of age. RESULTS: For patients in this age group with INSS stage 4 or 4S NB and stage 3 patients, serum-based determination of MYCN DNA sequences had good sensitivity (85%, 83%, and 75% respectively) and high specificity (100%) when compared to direct tumor gene determination. In contrast, the approach showed low sensitivity patients with stages 1 and 2 disease. CONCLUSION: Our results show that the sensitivity of the serum-based MYCN DNA sequence determination depends on the stage of the disease. However, this simple, reproducible assay may represent a reasonably sensitive and very specific tool to assess tumor MYCN status in cases with stage 3 and metastatic disease for whom a wait and see strategy is often recommended.

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Diabetic nephropathy is the first cause of endstage renal disease. The demographic expansion, the increase in the incidence of diabetes and the prolonged survival rates explain the steep increase observed these last 30 years. In the United States, improved treatment has brought to a decline in the incidence of end-stage renal disease in the diabetic population since the mid nineties. We examined the change in prevalence of diabetics on dialysis from 2001 and 2009 in the Canton de Vaud, Switzerland. The prevalence of diabetics on dialysis increased from 18% to 31% in dialysis centers and increased from 1.1/1000 to 1.9/1000 in the diabetic population. These are strong indicators that efforts are needed to improve the renal outcome of patients with diabetic nephropathy.

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Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 x 10). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.

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14C dating models are limited when considering recent groundwater for which the carbon isotopic signature of the total dissolved inorganic carbon (TDIC) is mainly acquired in the unsaturated zone. Reducing the uncertainties of dating thus implies a better identification of the processes controlling the carbon isotopic composition of the TDIC during groundwater recharge. Geochemical interactions between gas, water and carbonates in the unsaturated zone were investigated for two aquifers (the carbonate-free Fontainebleau sands and carbonate-bearing Astian sands, France) in order to identify the respective roles of CO2 and carbonates on the carbon isotopic signatures of the TDIC; this analysis is usually approached using open or closed system terms. Under fully open system conditions, the seasonality of the 13C values in the soil CO2 can lead to important uncertainties regarding the so-called "initial 14C activity" used in 14C correction models. In a carbonate-bearing unsaturated zone such as in the Astian aquifer, we show that an approach based on fully open or closed system conditions is not appropriate. Although the chemical saturation between water and calcite occurs rapidly within the first metre of the unsaturated zone, the carbon isotopic contents (δ13C) of the CO2 and the TDIC evolve downward, impacted by the dissolution-precipitation of the carbonates. In this study, we propose a numerical approach to describe this evolution. The δ13C and the A 14C (radiocarbon activity) of the TDIC at the base of the carbonate-hearing unsaturated zone depends on (i) the δ13C and the A 14C of the TDIC in the soil determined by the soil CO2, (ii) the water's residence time in the unsaturated zone and (iii) the carbonate precipitation-dissolution fluxes. In this type of situation, the carbonate δ13C-A 14C evolutions indicate the presence of secondary calcite and permit the calculation of its accretion flux, equal to ~ 4.5 ± 0.5 x 10-9 mol grock-1 yr-1. More generally, for other sites under temperate climate and with similar properties to the Astian sands site, this approach allows for a reliable determination of the carbon isotopic composition at the base of the unsaturated zone as the indispensable "input function" data of the carbon cycle into the aquifer.

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Hand development in the European shrew Crocidura russula is described, based on the examination of a cleared and double-stained ontogenetic series and histological sections of a c. 20-day-old embryo and a neonate. In the embryo all carpal elements are still mesenchymal condensations, and there are three more elements than in the adult stage: the 'lunatum', which fuses with the scaphoid around birth; a centrale, which either fuses with another carpal element or just disappears later in ontogeny; and the anlage of an element that later fuses with the radius. Carpal arrangement in the neonate and the adult is the same. In order to compare the relative timing of the onset of ossification in forelimb bones in C. russula with that of other therians, we built up two matrices of events based on two sets of data and used the event-pair method. In the first analysis, ossification of forelimb elements in general was examined, including that of the humerus, radius, ulna, the first carpal and metacarpal to ossify, and the phalanges of the third digit. The second analysis included each carpal, humerus, radius, ulna, the first metacarpal and the first phalanx to ossify. Some characters (= event-pairs) provide synapomorphies for some clades examined. There have been some shifts in the timing of ossification apparently not caused by ecological and/or environmental influences. In two species (Oryctolagus and Myotis), there is a tendency to start the ossification of the carpals relatively earlier than in all other species examined, the sauropsid outgroups included.

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Inversors però, principalment professionals de l'àmbit agrari, per tal de buscar una diversificació de l'activitat agrícola i ramadera que desenvolupen a les seves finques, sobretot joves emprenedors, poden estar interessats en produccions alternatives com la producció d'ànecs per a foie-gras, per tal de complementar la seva renda agrària. Actualment cal augmentar la competitivitat de les finques agrícoles per tal que aquestes siguin econòmicament viables. L’objectiu de l'estudi és determinar la viabilitat econòmica d’una explotació ramadera d’ànecs per a la producció de foie-gras, en el terme municipal de Fontanals de Cerdanya, analitzant les diverses alternatives en quant a dimensionament i disseny de les instal·lacions, segons el cicle productiu de l’animal. L'alternativa escollida per realitzar l'estudi es la de semi-integració (cria, engreix i embocat), de règim semi-intensiu (durant l'etapa de l'engreix), amb animals mascles de la raça híbrida Mulard. Les instal·lacions tindran una capacitat de 6.500 animals, amb lots de 250 caps. Aquest dimensionament permet, durant la fase d'embocat, en la qual es requereix més dedicació, que la demanda de mà d'obra pugui ser satisfeta per un únic treballador. La principal conclusió que es pot extreure de l'estudi és que la inversió projectada és massa elevada i que aquesta econòmicament no és viable o rendible, ja que la despesa és massa elevada. Es mouen uns fluxos de caixa molt elevats i el marge comercial és molt reduït. Únicament si l'objectiu del promotor és obtenir una remuneració per la seva feina, sempre i quan és produeixi un augment del preu actual de la carn i una disminució del preu del pinso, es podria recomanar que es portés a terme la implantació de l'explotació, intentant, però, reduir la despesa d'execució de construccions i instal·lacions.

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La empresa moderna, se encuentra en una situación actual de incertidumbre en la que además está más expuesta a factores externos con el aumento de la competencia y el impacto de la globalización. Se enfrenta a un panorama que debe ser gestionado adecuadamente para asegurar su supervivencia y el éxito de su existencia. En este TFC, se presenta una de las herramientas ‘buque insignia’ del Management moderno, aquella que está destinada a ser la base de la Gestión de la empresa y que cada vez más se hace imprescindible para la construcción de un futuro cada vez más incierto, la Planificación Estratégica. El Plan Estratégico 2012-2015 de AESL se desarrolla en varios apartados que intentarán dar con las claves de la dirección que la empresa debe seguir y propone los objetivos que encontrará a través de la puesta en marcha de las acciones y estrategias determinadas. La primera etapa, y la más extensa, realiza un Análisis de la situación externa e interna de la empresa además de un Diagnóstico de la misma. Se analizan diversos factores que pueden contribuir o hacer peligrar el futuro de la empresa, y constituye el punto de partida de la planificación. En la segunda etapa, y con la información de la anterior fase, comienza la fijación de los Objetivos Corporativos y la definición de las Decisiones Estratégicas que han de transformar nuestro rumbo actual en el logro de esos objetivos. Las estrategias no sólo comportarán un ámbito corporativo, también se centrarán en estrategias funcionales con un carácter más definitorio en el interior de la empresa. Por último, la tercera y última etapa, aglutinará todas estas Decisiones estratégicas para transformarlas en las Decisiones Operativas, aquellas que se encargarán de gestionar el día a día de la empresa a través de los Planes de Acción, que suponen la etapa de mayor concreción del Plan. Este Plan a 3 años deberá erigirse como la herramienta de planificación más importante de la empresa, debiendo guiar las principales decisiones tomadas y convirtiéndose en un instrumento de consulta no sólo para decidir hoy lo que se hará en el futuro sino también para mantener unos niveles altos de competitividad en el tremendo esfuerzo que supone la gestión de una PYME.

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BACKGROUND: Since 1981 Princess Margaret Hospital has used initial active surveillance (AS) with delayed treatment at relapse as the preferred management for all patients with clinical stage I nonseminomatous germ cell tumors (NSGCT). OBJECTIVE: Our aim was to report our overall AS experience and compare outcomes over different periods using this non-risk-adapted approach. DESIGN, SETTING, AND PARTICIPANTS: Three hundred and seventy-one patients with stage I NSGCT were managed by AS from 1981 to 2005. For analysis by time period, patients were divided into two cohorts by diagnosis date: initial cohort, 1981-1992 (n=157), and recent cohort, 1993-2005 (n=214). INTERVENTION: Patients were followed at regular intervals, and treatment was only given for relapse. MEASUREMENTS: Recurrence rates, time to relapse, risk factors for recurrence, disease-specific survival, and overall survival were determined. RESULTS AND LIMITATIONS: With a median follow-up of 6.3 yr, 104 patients (28%) relapsed: 53 of 157 (33.8%) in the initial group and 51 of 214 (23.8%) in the recent group. Median time to relapse was 7 mo. Lymphovascular invasion (p<0.0001) and pure embryonal carcinoma (p=0.02) were independent predictors of recurrence; 125 patients (33.7%) were designated as high risk based on the presence of one or both factors. In the initial cohort, 66 of 157 patients (42.0%) were high risk and 36 of 66 patients (54.5%) relapsed versus 17 of 91 low-risk patients (18.7%) (p<0.0001). In the recent cohort, 59 of 214 patients (27.6%) were high risk and 29 of 59 had a recurrence (49.2%) versus 22 of 155 low-risk patients (14.2%) (p<0.0001). Three patients (0.8%) died from testis cancer. The estimated 5-yr disease-specific survival was 99.3% in the initial group and 98.9% in the recent one. CONCLUSIONS: Non-risk-adapted surveillance is an effective, simple strategy for the management of all stage I NSGCT.

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BACKGROUND: Fully efficient vaccines against malaria pre-erythrocytic stage are still lacking. The objective of this dose/adjuvant-finding study was to evaluate the safety, reactogenicity and immunogenicity of a vaccine candidate based on a peptide spanning the C-terminal region of Plasmodium falciparum circumsporozoite protein (PfCS102) in malaria naive adults. METHODOLOGY AND PRINCIPAL FINDINGS: Thirty-six healthy malaria-naive adults were randomly distributed into three dose blocks (10, 30 and 100 microg) and vaccinated with PfCS102 in combination with either Montanide ISA 720 or GSK proprietary Adjuvant System AS02A at days 0, 60, and 180. Primary end-point (safety and reactogenicity) was based on the frequency of adverse events (AE) and of abnormal biological safety tests; secondary-end point (immunogenicity) on P. falciparum specific cell-mediated immunity and antibody response before and after immunization. The two adjuvant formulations were well tolerated and their safety profile was good. Most AEs were local and, when systemic, involved mainly fatigue and headache. Half the volunteers in AS02A groups experienced severe AEs (mainly erythema). After the third injection, 34 of 35 volunteers developed anti-PfCS102 and anti-sporozoite antibodies, and 28 of 35 demonstrated T-cell proliferative responses and IFN-gamma production. Five of 22 HLA-A2 and HLA-A3 volunteers displayed PfCS102 specific IFN-gamma secreting CD8(+) T cell responses. Responses were only marginally boosted after the 3(rd) vaccination and remained stable for 6 months. For both adjuvants, the dose of 10 microg was less immunogenic in comparison to 30 and 100 microg that induced similar responses. AS02A formulations with 30 microg or 100 microg PfCS102 induced about 10-folds higher antibody and IFN-gamma responses than Montanide formulations. CONCLUSIONS/SIGNIFICANCE: PfCS102 peptide was safe and highly immunogenic, allowing the design of more advanced trials to test its potential for protection. Two or three immunizations with a dose of 30 microg formulated with AS02A appeared the most appropriate choice for such studies. TRIAL REGISTRATION: Swissmedic.ch 2002 DR 1227.

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The US labor market witnessed two apparently unrelated secular movements in thelast 30 years: a decline in unemployment between the early 1980s and the early 2000s,and a decline in participation since the early 2000s. Using CPS micro data and a stock-flow accounting framework, we show that a substantial, and hitherto unnoticed, factorbehind both trends is a decline in the share of nonparticipants who are at the margin ofparticipation. A lower share of marginal nonparticipants implies a lower unemploymentrate, because marginal nonparticipants enter the labor force mostly through unemployment,while other nonparticipants enter the labor force mostly through employment.