922 resultados para Directly Observed Therapy


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Measuring shallow seismic sources provides a way to reveal processes that cannot be directly observed, but the correct interpretation and value of these signals depend on the ability to distinguish source from propagation effects. Furthermore, seismic signals produced by a resonating source can look almost identical to those produced by impulsive sources, but modified along the path. Distinguishing these two phenomena can be accomplished by examining the wavefield with small aperture arrays or by recording seismicity near to the source when possible. We examine source and path effects in two different environments: Bering Glacier, Alaska and Villarrica Volcano, Chile. Using three 3-element seismic arrays near the terminus of the Bering Glacier, we have identified and located both terminus calving and iceberg breakup events. We show that automated array analysis provided a robust way to locate icequake events using P waves. This analysis also showed that arrivals within the long-period codas were incoherent within the small aperture arrays, demonstrating that these codas previously attributed to crack resonance were in fact a result of a complicated path rather than a source effect. At Villarrica Volcano, seismometers deployed from near the vent to ~10 km revealed that a several cycle long-period source signal recorded at the vent appeared elongated in the far-field. We used data collected from the stations nearest to the vent to invert for the repetitive seismic source, and found it corresponded to a shallow force within the lava lake oriented N75°E and dipping 7° from horizontal. We also used this repetitive signal to search the data for additional seismic and infrasonic properties which included calculating seismic-acoustic delay times, volcano acoustic-seismic ratios and energies, event frequency, and real-time seismic amplitude measurements. These calculations revealed lava lake level and activity fluctuations consistent with lava lake level changes inferred from the persistent infrasonic tremor.

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Originally developed in the context of quantum field theory, the concept of supersymmetry can be used to systematically design a new class of optical structures. In this work, we demonstrate how key features arising from optical supersymmetry can be exploited to control the flow of light for mode division multiplexing applications. Superpartner configurations are experimentally realized in coupled optical networks, and the corresponding light dynamics in such systems are directly observed. We show that supersymmetry can be judiciously utilized to remove the fundamental mode of a multimode optical structure, while establishing global phase matching conditions for the remaining set of modes. Along these lines, supersymmetry may serve as a promising platform for versatile optical components with desirable properties and functionalities.

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The Sun shows strong variability in its magnetic activity, from Grand minima to Grand maxima, but the nature of the variability is not fully understood, mostly because of the insufficient length of the directly observed solar activity records and of uncertainties related to long-term reconstructions. Here we present a new adjustment-free reconstruction of solar activity over three millennia and study its different modes. Methods. We present a new adjustment-free, physical reconstruction of solar activity over the past three millennia, using the latest verified carbon cycle, 14C production, and archeomagnetic field models. This great improvement allowed us to study different modes of solar activity at an unprecedented level of details. Results. The distribution of solar activity is clearly bi-modal, implying the existence of distinct modes of activity. The main regular activity mode corresponds to moderate activity that varies in a relatively narrow band between sunspot numbers 20 and 67. The existence of a separate Grand minimum mode with reduced solar activity, which cannot be explained by random fluctuations of the regular mode, is confirmed at a high confidence level. The possible existence of a separate Grand maximum mode is also suggested, but the statistics is too low to reach a confident conclusion. Conclusions. The Sun is shown to operate in distinct modes – a main general mode, a Grand minimum mode corresponding to an inactive Sun, and a possible Grand maximum mode corresponding to an unusually active Sun. These results provide important constraints for both dynamo models of Sun-like stars and investigations of possible solar influence on Earth’s climate.

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Short range nucleon-nucleon correlations in nuclei (NN SRC) carry important information on nuclear structure and dynamics. NN SRC have been extensively probed through two-nucleon knock- out reactions in both pion and electron scattering experiments. We report here on the detection of two-nucleon knock-out events from neutrino interactions and discuss their topological features as possibly involving NN SRC content in the target argon nuclei. The ArgoNeuT detector in the Main Injector neutrino beam at Fermilab has recorded a sample of 30 fully reconstructed charged current events where the leading muon is accompanied by a pair of protons at the interaction vertex, 19 of which have both protons above the Fermi momentum of the Ar nucleus. Out of these 19 events, four are found with the two protons in a strictly back-to-back high momenta configuration directly observed in the final state and can be associated to nucleon Resonance pionless mechanisms involving a pre-existing short range correlated np pair in the nucleus. Another fraction (four events) of the remaining 15 events have a reconstructed back-to-back configuration of a np pair in the initial state, a signature compatible with one-body Quasi Elastic interaction on a neutron in a SRC pair. The detection of these two subsamples of the collected (mu- + 2p) events suggests that mechanisms directly involving nucleon-nucleon SRC pairs in the nucleus are active and can be efficiently explored in neutrino-argon interactions with the LAr TPC technology.

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The cell envelope of mycobacteria, which include the causative agents of tuberculosis and leprosy, is crucial for their success as pathogens. Despite a continued strong emphasis on identifying the multiple chemical components of this envelope, it has proven difficult to combine its components into a comprehensive structural model, primarily because the available ultrastructural data rely on conventional electron microscopy embedding and sectioning, which are known to induce artifacts. The existence of an outer membrane bilayer has long been postulated but has never been directly observed by electron microscopy of ultrathin sections. Here we have used cryo-electron microscopy of vitreous sections (CEMOVIS) to perform a detailed ultrastructural analysis of three species belonging to the Corynebacterineae suborder, namely, Mycobacterium bovis BCG, Mycobacterium smegmatis, and Corynebacterium glutamicum, in their native state. We provide new information that accurately describes the different layers of the mycobacterial cell envelope and challenges current models of the organization of its components. We show a direct visualization of an outer membrane, analogous to that found in gram-negative bacteria, in the three bacterial species examined. Furthermore, we demonstrate that mycolic acids, the hallmark of mycobacteria and related genera, are essential for the formation of this outer membrane. In addition, a granular layer and a low-density zone typifying the periplasmic space of gram-positive bacteria are apparent in CEMOVIS images of mycobacteria and corynebacteria. Based on our observations, a model of the organization of the lipids in the outer membrane is proposed. The architecture we describe should serve as a reference for future studies to relate the structure of the mycobacterial cell envelope to its function.

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Rare event search experiments using liquid xenon as target and detection medium require ultra-low background levels to fully exploit their physics potential. Cosmic ray induced activation of the detector components and, even more importantly, of the xenon itself during production, transportation and storage at the Earth's surface, might result in the production of radioactive isotopes with long half-lives, with a possible impact on the expected background. We present the first dedicated study on the cosmogenic activation of xenon after 345 days of exposure to cosmic rays at the Jungfraujoch research station at 3470m above sea level, complemented by a study of copper which has been activated simultaneously. We have directly observed the production of 7Be, 101Rh, 125Sb, 126I and 127Xe in xenon, out of which only 125Sb could potentially lead to background for a multi-ton scale dark matter search. The production rates for five out of eight studied radioactive isotopes in copper are in agreement with the only existing dedicated activation measurement, while we observe lower rates for the remaining ones. The specific saturation activities for both samples are also compared to predictions obtained with commonly used software packages, where we observe some underpredictions, especially for xenon activation.

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Upwelling velocities w in the equatorial band are too small to be directly observed. Here, we apply a recently proposed indirect method, using the observed helium isotope (3He or 4He) disequilibria in the mixed layer. The helium data were sampled from three cruises in the eastern tropical Atlantic in September 2005 and June/July 2006. A one-dimensional two-box model was applied, where the helium air-sea gas exchange is balanced by upwelling from 3He-rich water below the mixed layer and by vertical mixing. The mixing coefficients Kv were estimated from microstructure measurements, and on two of the cruises, Kv exceeded 1 x 10**-4 m**2/s, making the vertical mixing term of the same order of magnitude as the gas exchange and the upwelling term. In total, helium disequilibrium was observed on 54 stations. Of the calculated upwelling velocities, 48% were smaller than 1.0 x 10**-5 m/s, 19% were between 1.0 and 2.0 x 10**-5 m/s, 22% were between 2.0 and 4.0 x 10**-5 m/s, and on 11% of upwelling velocities exceeded this limit. The highest upwelling velocities were found in late June 2006. Meridional upwelling distribution indicated an equatorial asymmetry with higher vertical velocities between the equator and 1° to 2° south compared to north of the equator, particularly at 10°W. Associated heat flux into the mixed layer could be as high as 138 W/m**2, but this depends strongly on the chosen depths where the upwelled water comes from. By combining upwelling velocities with sea surface temperature and productivity distributions, a mean monthly equatorial upwelling rate of 19 Sv was estimated for June 2006 and a biweekly mean of 24 Sv was estimated for September 2005.

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An epidemiological model of tuberculosis has been developed and applied to five regions of the world. Globally, 6.7 million new cases of tuberculosis and 2.4 million deaths from tuberculosis are estimated for 1998. Based on current trends in uptake of the World Health Organization’s strategy of directly observed treatment, short-course, we expect a total of 225 million new cases and 79 million deaths from tuberculosis between 1998 and 2030. Active case-finding by using mass miniature radiography could save 23 million lives over this period. A single contact treatment for tuberculosis could avert 24 million cases and 11 million deaths; combined with active screening, it could reduce mortality by nearly 40%. A new vaccine with 50% efficacy could lower incidence by 36 million cases and mortality by 9 million deaths. Support for major extensions to global tuberculosis control strategies will occur only if the size of the problem and the potential for action are recognized more widely.

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Objectives: To document the existence of drug resistance in a tuberculosis treatment programme that adheres strictly to the DOTS principles (directly observed treatment, short course) and to determine the extent of drug resistance in a prison setting in one of the republics of the former Soviet Union.

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Engineering site-specific amino acid substitutions into the protein-tyrosine phosphatase (PTPase) PTP1 and the dual-specific vaccinia H1-related phosphatase (VHR), has kinetically isolated the two chemical steps of the reaction and provided a rare opportunity for examining transition states and directly observing the phosphoenzyme intermediate. Changing serine to alanine in the active-site sequence motif HCXXGXXRS shifted the rate-limiting step from intermediate formation to intermediate hydrolysis. Using phosphorus 31P NMR, the covalent thiol-phosphate intermediate was directly observed during catalytic turnover. The importance of the conserved aspartic acid (D92 in VHR and D181 in PTP1) in both chemical steps was established. Kinetic analysis of D92N and D181N mutants indicated that aspartic acid acts as a general acid by protonating the leaving-group phenolic oxygen. Structure-reactivity experiments with native and aspartate mutant enzymes established that proton transfer is concomitant with P-O cleavage, such that no charge develops on the phenolic oxygen. Steady- and presteady-state kinetics, as well as NMR analysis of the double mutant D92N/S131A (VHR), suggested that the conserved aspartic acid functions as a general base during intermediate hydrolysis. As a general base, aspartate would activate a water molecule to facilitate nucleophilic attack. The amino acids involved in transition-state stabilization for cysteinylphosphate hydrolysis were confirmed by the x-ray structure of the Yersinia PTPase complexed with vanadate, a transition-state mimic that binds covalently to the active-site cysteine. Consistent with the NMR, x-ray, biochemical, and kinetic data, a unifying mechanism for catalysis is proposed.

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Objectives: Coaches are a primary influence on athletes' development in youth sport (Horn, 2008). However, the intervention tone of coaches' behaviour has not been directly observed. The purpose of this study was to examine associations between the intervention tone exhibited by youth sport coaches and athletes' individual developmental trajectories over the course of a season. Design: Short-term longitudinal study with behavioural observation. Method: Fifty-five athletes and their coaches from five youth volleyball teams were observed at three time points, and the intervention tone of interactive behaviour was systematically coded and organized by coach-athlete dyad. Athletes completed measures of the 4C's of athlete development (competence, confidence, connection, character) at each time point, which were used to create individualized developmental trajectories. Person-centred analyses were used to examine associations between athletes' developmental trajectories and their unique interactive experiences with their coach. Results: Cluster analysis revealed the presence of three distinct clusters based on athletes' developmental trajectories: 1) high and increasing, 2) low and decreasing, and 3) moderate and maintaining, with athletes from each team distributed across clusters. Analysis of dyadic interaction profiles revealed significant differences in interactive behaviour between clusters. Conclusions: Results suggest that differences in coach-athlete interactive experiences are associated with different developmental trajectories over the course of a season, even for athletes working with the same coach, highlighting the individualized nature of coaches' influence on young athletes. Practical implications for coaches include a critical awareness of their unique interactive relationship with each athlete independently, as well as the importance of fostering these relationships with regard to young people as more than just athletes.

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Thesis (Master's)--University of Washington, 2016-06

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To investigate the incidence of non-lethal predation in Southern Hemisphere whales, more than 3400 fluke-identification photographs from resight histories of 1436 east Australian humpback whales were examined for evidence of predatory markings. Photographs were obtained from 1984 to 1996 at various locations along the east coast of Australia, from northern Queensland to southern New South Wales. Photographs were classified in terms of the level and type of scarring. The possible predator and whether the markings appeared fresh were also noted. In all, 17% of identified east Australian humpbacks possessed some form of predatory scarring, 57% of which was minor and 43% major. Almost all predatory scarring was consistent with that inflicted by killer whales. Only three whales demonstrated an increase in the level of predatory scarring after their first sightings. Two incidents of fresh scarring were recorded, and one fatal killer whale attack on a humpback whale calf was directly observed. The overall level of predatory scarring found in this study is comparable to those found in studies for Northern Hemisphere humpback whales. The low incidence of adult whales showing their first sign of predatory scarring after their initial sighting, and the small number possessing recent scarring, support the idea that east Australian humpback whales experience most predatory attacks early in life.

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This study aimed to analyze the practice of nurses regarding the development of the nursing process in the consultation to the patient with tuberculosis. This is a descriptive study with quantitative approach, performed with 60 nurses of the Primary units of the city of Natal, RN Health. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte. To collect data, we used a structured questionnaire, developed from the "Consultation of Nursing," the Nursing Protocol for the Treatment of Tuberculosis Directly Observed in Primary Care, Ministry of Health. The instrument was subjected to pre- -test and contained questions regarding the elements used by the nurse in consultation with the patient with tuberculosis and an open question about the feasibility of implementing the Nursing Process in Primary Health Care. data collection was conducted between September and October 2014, in health units work of each participant. Data were analyzed using SPSS 20. The answers to the open question were analyzed for themes and quantified for analysis. With respect to the elements of nursing process used in consultation with the patient with tuberculosis, were on the history of nursing at the expense of survey nursing diagnosis, action planning, implementation and evaluation. Step in the history of nursing, however, the actions were toward complaints and symptoms of the disease (100% of the nurses always investigating). Social and cultural aspects involved in for tuberculosis, as stigma and difficulties in routine work, were less addressed by nurses (43.3% never investigated suffering stigma; 46.7% sometimes investigating changes in the work routine patient ). The physical examination was focused on measuring patient weight (100% held). To the understanding of nurses on the implementation of the nursing process Primary Health Care, favorable factors were identified, such as that this implementation can promote greater scientific basis for nursing (36.7%); and hindering aspects, such as the understanding that Primary Health Care is pervaded by bureaucratic issues and high demand (13.3%). Be established in consultation with the nurse fragmentations, since elements as identification of nursing diagnoses, action planning and evaluation were not made in full by the professionals. Highlights the need for continuing education for nurses who are included in Primary Health Care, seeking to maximize the autonomy of these professionals in developing a practice grounded in scientific knowledge

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Objectives: Coaches are a primary influence on athletes' development in youth sport (Horn, 2008). However, the intervention tone of coaches' behaviour has not been directly observed. The purpose of this study was to examine associations between the intervention tone exhibited by youth sport coaches and athletes' individual developmental trajectories over the course of a season. Design: Short-term longitudinal study with behavioural observation. Method: Fifty-five athletes and their coaches from five youth volleyball teams were observed at three time points, and the intervention tone of interactive behaviour was systematically coded and organized by coach-athlete dyad. Athletes completed measures of the 4C's of athlete development (competence, confidence, connection, character) at each time point, which were used to create individualized developmental trajectories. Person-centred analyses were used to examine associations between athletes' developmental trajectories and their unique interactive experiences with their coach. Results: Cluster analysis revealed the presence of three distinct clusters based on athletes' developmental trajectories: 1) high and increasing, 2) low and decreasing, and 3) moderate and maintaining, with athletes from each team distributed across clusters. Analysis of dyadic interaction profiles revealed significant differences in interactive behaviour between clusters. Conclusions: Results suggest that differences in coach-athlete interactive experiences are associated with different developmental trajectories over the course of a season, even for athletes working with the same coach, highlighting the individualized nature of coaches' influence on young athletes. Practical implications for coaches include a critical awareness of their unique interactive relationship with each athlete independently, as well as the importance of fostering these relationships with regard to young people as more than just athletes.