Comparaison de stratégies thérapeutiques dans la prise en charge de l'hypertension artérielle [Comparison of therapeutic strategies in the management of hypertension]

Guidelines for the treatment of hypertension recommend reducing blood pressure to below 140/90 mmHg. However, there is little to guide the clinician on which pharmacological strategy to pursue: monotherapy with stepped-care, sequential monotherapy, or the initial use of combination therapy. The STRATHE study was designed to clarify this issue by comparing the three strategies. A low-dose combination of perindopril/indapamide was significantly superior to either stepped-care or sequential monotherapy in terms of reducing systolic blood pressure and in the percentage of patients achieving normalisation without adverse effects. Pulse pressure showed a trend to greater reductions with the low-dose combination. Although there must be caution about extrapolating these results to other combinations, which may not have the same pharmacological properties, the STRATHE study has shown that initiating antihypertensive therapy with a low-dose combination has advantages over the two other classical therapeutic strategies.

The Effectiveness of Currency Hedging Strategies. Case: Imatra Boards Business Unit of Stora Enso Corp.

Tutkimus tarkastelee vaihtoehtoisia termiinisuojaustrategioita metsäteollisuuden alan tulosyksikössä. Jälkitestauksen tarkoituksena on arvioida vaihtoehtoisten strategioiden tuloksellisuutta suojata case-yrityksen kassavirtoja seuraavan kolmen arviointikriteerin avulla: yksittäisten vieraan valuutan määräisten kassavirtojen vaihtelu; koko vieraan valuutan määräisen kassavirran vaihtelu; suojausvoitot ja -tappiot. Tutkimuksen teoreettinen viitekehys tarkastelee yrityksen päätöksentekoa, valuuttariskien suojausprosessia sekä esittelee yrityksen vaihtoehtoisia suojausstrategioita. Tutkimuksen empiirinen aineisto pohjautuu case- yrityksen historiallisiin myyntilukuihin ja on kerätty yrityksen tietojärjestelmästä. Muu tutkimuksessa käytetty dataon kerätty eri tietokannoista. Tutkimuksen tulokset osoittavat, että suojaaminen vähentää kassavirtojen vaihtelua. Suojaamisen taloudelliset tulokset ovat kuitenkin erittäin riippuvaisia valitusta suojausstrategiasta, joka voi johtaa merkittäviin suojausvoittoihin, mutta yhtä hyvin myos merkittäviin tappioihin. Johdon näkemykset ja riskitoleranssi määrittelevät mitä strategiaa yrityksessä tullaan viime kädessä noudattamaan.

Magazine publishers and their online strategies

It seems as if magazine publishers have only haphazardly listed multiple goals for their websites, and have not carefully reflectedon how to achieve them. We present a framework for defining a magazine's onlinestrategy based on previous studies and on secondary data from the industry. We identify three steps in the strategy process. The first is to determine whether the magazine would actually benefit from online presence: although most magazines will never make money from their websites, a web presence may still be justified. The second step is to choose an optimal online strategy that matches the magazine's competitive strategy. Finally, we argue that magazine publishers should carefully consider to what extent they should allow their readers to be involvedin the web pages. This interactivity could be seen as a key factor in exploiting the unique nature of the Internet. It is our understanding that virtual communities could, at best, be a way of creating more value for a magazine's readers, advertisers and editors, alike. We formulate a typology of five different onlinebusiness concepts for magazines based on these three strategic steps.

Glutathione deficit in schizophrenia: strategies to increase glutathione levels in " in vitro " and clinical studies

Summary: Decrease in glutathione (GSH) levels was observed in cerebrospinal fluid, prefrontal cortex and post-mortem striatum of schizophrenia patients. Evidences suggest a defect in GSH synthesis at the levels of the rate-limiting synthesizing enzyme, glutamate cysteine ligase (GCL). Indeed, polymorphisms in the gene of the modifier subunit of GCL (GCLM) was shown to be associated with the disease in three different populations, GCLM gene expression is decreaséd in fibroblasts from patients and the increase in GCL activity induced by an oxidative stress is lower in patients' fibroblasts compared to controls. GSH being a major antioxydant and redox regulator, its presence is of high importance for protecting cells against oxidative stress. The aim of the present work was to use various substances to increase GSH levels by diverse strategies. Since the synthesizing enzyme GCL is defective, bypassing this enzyme was the first strategy we used. GSH ethyl ester (GSHEE), a membrane permeable analog of GSH, succeeded in replenishing GSH levels in cultured neurons and astrocytes previously depleted in GSH by L-buthionine-(S,R)-sulfoximine (BSO), an inhibitor of GCL. GSHEE also abolished dopamine-induced decrease of NMDA-mediated calcium response observed in BSO-treated neurons. y-Glutamylcysteine ethyl ester (GCSE), a membrane permeable analog of the product of GCL, increased GSH levels only in astrocytes. The second strategy was to boost the defective enzyme GCL. While quercetin (flavonoid) could increase GSH levels only in astrocytes, curcumin (polyphenol) and tertbutylhydroquinone (quinone) were successful in both neurons and astrocytes, via an increase in the gene expression of the two subunits of GCL and, consequently, an increase in the activity of the enzyme. However, FK506, an immunosupressant, was unefficient. Treating astrocytes from GCLM KO mice showed that the modulatory subunit is necessary for the action of the substances. Finally, since cysteine is the limiting precursor in the synthesis of GSH, we hypothesized that we could increase GSH levels by providing more of this precursor. N-acetyl-cysteine (NAC), a cysteine donor, was administered to schizophrenia patients, using adouble-blind and cross-over protocol. NAC significantly improved the mismatch negativity (MMN), a component of the auditory evoked potentials, thought to reflect selective current flowing through open, unblocked NMDA channels. Considering that NMDA function is reduced when GSH levels are low, increasing these levels with NAC could improve NMDA function as reflected by the improvement in the generation of the MMN. Résumé: Les taux de glutathion (GSH) dans le liquide céphalo-rachidien, le cortex préfrontal ainsi que le striatum post-mortem de patients schizophrènes, sont diminués. L'enzyme limitante dans la synthèse du GSH, la glutamyl-cysteine ligase (GCL), est défectueuse. En effet, des polymorphismes dans le gène de la sous-unité modulatrice de GCL (GCLM) sont associés à la maladie, l'expression du gène GCLM est diminuée dans les fibroblastes de patients et, lors d'un stress oxidative, l'augmentation de l'activité de GCL est plus faible chez les patients que chez les contrôles. Le GSH étant un important antioxydant et régulateur du status redox, sa présence est primordiale afin de protéger les cellules contre les stress oxydatifs. Au cours du présent travail, une variété de substances ont été utilisées dans le but d'augmenter les taux de GSH. Passer outre l'enzyme de synthèse GCL qui est défectueuse fut la première stratégie utilisée. L'éthylester de GSH (GSHEE), un analogue du GSH qui pénètre la membrane cellulaire, a augmenté les taux de GSH dans des neurones et des astrocytes déficitaires en GSH dû au L-buthionine-(S,R)-sulfoximine (BSO), un inhibiteur du GCL. Dans ces neurones, le GSHEE a aussi aboli la diminution de la réponse NMDA, induite parla dopamine. L'éthyl-ester de y-glutamylcysteine (GCEE), un analogue du produit de la GCL qui pénètre la membrane cellulaire, a augmenté les taux de GSH seulement dans les astrocytes. La seconde stratégie était d'augmenter l'activité de l'enzyme GCL. Tandis que la quercétine (flavonoïde) n'a pu augmenter les taux de GSH que dans les astrocytes, la curcumin (polyphénol) et le tert-butylhydroquinone (quinone) furent efficaces dans les deux types de cellules, via une augmentation de l'expression des gènes des deux sous-unités de GCL et de l'activité de l'enzyme. Le FK506 (immunosupresseur) n' a démontré aucune efficacité. Traiter des astrocytes provenant de souris GCLM KO a permis d'observer que la sous-unité modulatoire est nécessaire à l'action des substances. Enfin, puisque la cysteine est le substrat limitant dans la synthèse du GSH, fournir plus de ce présurseur pourrait augmenter les taux de GSH. Nacétyl-cystéine (NAC), un donneur de cystéine, a été administrée à des schizophrènes, lors d'une étude en double-aveugle et cross-over. NAC a amélioré le mismatch negativity (MMN), un composant des potentials évoqués auditifs, qui reflète le courant circulant via les canaux NMDA. Puisque la fonctionnalité des R-NMDA est diminuée lorsque les taux de GSH sont bas, augmenter ces taux avec NAC pourrait améliorer la fonction des R-NMDA, réflété par une augmentation de l'amplitude du MMN.

A game theoretical approach to the algebraic counterpart of the Wagner hierarchy

La hiérarchie de Wagner constitue à ce jour la plus fine classification des langages ω-réguliers. Par ailleurs, l'approche algébrique de la théorie de langages formels montre que ces ensembles ω-réguliers correspondent précisément aux langages reconnaissables par des ω-semigroupes finis pointés. Ce travail s'inscrit dans ce contexte en fournissant une description complète de la contrepartie algébrique de la hiérarchie de Wagner, et ce par le biais de la théorie descriptive des jeux de Wadge. Plus précisément, nous montrons d'abord que le degré de Wagner d'un langage ω-régulier est effectivement un invariant syntaxique. Nous définissons ensuite une relation de réduction entre ω-semigroupes pointés par le biais d'un jeu infini de type Wadge. La collection de ces structures algébriques ordonnée par cette relation apparaît alors comme étant isomorphe à la hiérarchie de Wagner, soit un quasi bon ordre décidable de largeur 2 et de hauteur ω. Nous exposons par la suite une procédure de décidabilité de cette hiérarchie algébrique : on décrit une représentation graphique des ω-semigroupes finis pointés, puis un algorithme sur ces structures graphiques qui calcule le degré de Wagner de n'importe quel élément. Ainsi le degré de Wagner de tout langage ω-régulier peut être calculé de manière effective directement sur son image syntaxique. Nous montrons ensuite comment construire directement et inductivement une structure de n''importe quel degré. Nous terminons par une description détaillée des invariants algébriques qui caractérisent tous les degrés de cette hiérarchie. Abstract The Wagner hierarchy is known so far to be the most refined topological classification of ω-rational languages. Also, the algebraic study of formal languages shows that these ω-rational sets correspond precisely to the languages recognizable by finite pointed ω-semigroups. Within this framework, we provide a construction of the algebraic counterpart of the Wagner hierarchy. We adopt a hierarchical game approach, by translating the Wadge theory from the ω-rational language to the ω-semigroup context. More precisely, we first show that the Wagner degree is indeed a syntactic invariant. We then define a reduction relation on finite pointed ω-semigroups by means of a Wadge-like infinite two-player game. The collection of these algebraic structures ordered by this reduction is then proven to be isomorphic to the Wagner hierarchy, namely a well-founded and decidable partial ordering of width 2 and height $\omega^\omega$. We also describe a decidability procedure of this hierarchy: we introduce a graph representation of finite pointed ω-semigroups allowing to compute their precise Wagner degrees. The Wagner degree of every ω-rational language can therefore be computed directly on its syntactic image. We then show how to build a finite pointed ω-semigroup of any given Wagner degree. We finally describe the algebraic invariants characterizing every Wagner degree of this hierarchy.

A Theory of Representative Behavior in the Dictator Game

In this paper we present a model of representative behavior in the dictator game. Individuals have simultaneous and non-contradictory preferences over monetary payoffs, altruistic actions and equity concerns. We require that these behaviors must be aggregated and founded in principles of representativeness and empathy. The model results match closely the observed mean split and replicate other empirical regularities (for instance, higher stakes reduce the willingness to give). In addition, we connect representative behavior with an allocation rule built on psychological and behavioral arguments. An approach consistently neglected in this literature. Key words: Dictator Game, Behavioral Allocation Rules, Altruism, Equity Concerns, Empathy, Self-interest JEL classification: C91, D03, D63, D74.

Oral pathogens in duwl's: risk of infection and strategies for their control

Water lines are an important source of potentíal contamination. Every dental unit is equipped with small-bore flexible plastic tubing to bring water to different hand pieces, such as the air/water syringe, the ultrasonic scaler or the high-speed hand piece. Most dental units are connected directly to municipal distribution systems for potable water and chlorinated or not, this water contains diverse...

A situated analysis of football goalkeepers' experiences in critical game situations.

This study described elite football (soccer) goalkeepers' activity and performance in critical game situations. The 11 best French players (M age = 15.5 yr., SD = 0.5) participated in the study. Interviews focused on goalkeepers' experiences were conducted to identify meaningful events involved in failed actions. Players formulated 23 critical game situations. Verbatim encoding using a thematic analysis indicated that four main categories (coming off the line, goal-line clearance, one-on-one, and diving) represented the most critical situations encountered during matches. The relations among experience and action, inner states, background, attention contents, and intentions were elucidated. The discussion is grounded on the properties of such critical game situations and their implications for improving goalkeepers' performance.

Defining ecological strategies in neuroprosthetics.

Neurological disorders disrupt the equilibrium within the brain and spinal cord ecosystems. Ecology reuses, recycles, and reduces to help maintain the balance across ecosystems. Likewise, neuroprosthetics can help the brain help itself with ecoprosthetic designs that integrate the principles of the "three 'R's."

Breaking up the writing process: how wikis can support understanding the composition and revision strategies of young writers

Understanding how best to support immature writers in the development of their understanding of the writing process is an important concern for researchers and teachers. Social technologies have become key features of leisure and work place writing, yet knowledge about how to design educational settings that take full advantage of the affordances of web 2.0 technologies to support early writing is scarce. This paper presents a small scale study that investigated how writing in a wiki environment might facilitate and support students’ use of composition and revision strategies. Our findings show that wiki can enlarge young writers’ experience of the process of composition and revision both through their own efforts and by observing the process in others. In this study students employed a wide range of types of revisions both surface and text based changes. These revisions took place during the process of composition as well as at the end. It is argued here that writing in a wiki not only provides young writers with experience of a mode of composition prevalent in the contemporary work environment, but breaks up the process of writing in a way that may support students’ understanding of the processes of composition and revision.