992 resultados para 282


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It remains challenging to accurately predict whether an individual arteriovenous fistula (AVF) will mature and be useable for haemodialysis vascular access. Current best practice involves the use of routine clinical assessment and ultrasonography complemented by selective venography and magnetic resonance imaging. The purpose of this literature review is to describe current practices in relation to pre-operative assessment prior to AVF formation and highlight potential areas for future research to improve the clinical prediction of AVF outcomes.

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BRCA1 is a major breast and ovarian cancer susceptibility gene, with mutations in this gene predisposing women to a very high risk of developing breast and ovarian tumours. BRCA1 primarily functions to maintain genomic stability via critical roles in DNA repair, cell cycle checkpoint control, transcriptional regulation, apoptosis and mRNA splicing. As a result, BRCA1 mutations often result in defective DNA repair, genomic instability and sensitivity to DNA damaging agents. BRCA1 carries out these different functions through its ability to interact, and form complexes with, a vast array of proteins involved in multiple cellular processes, all of which are considered to contribute to its function as a tumour suppressor. This review discusses and highlights recent research into the functions of BRCA1-related protein complexes and their roles in maintaining genomic stability and tumour suppression.

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Drastic biodiversity declines have raised concerns about the deterioration of ecosystem functions and have motivated much recent research on the relationship between species diversity and ecosystem functioning. A functional trait framework has been proposed to improve the mechanistic understanding of this relationship, but this has rarely been tested for organisms other than plants. We analysed eight datasets, including five animal groups, to examine how well a trait-based approach, compared with a more traditional taxonomic approach, predicts seven ecosystem functions below- and above-ground. Trait-based indices consistently provided greater explanatory power than species richness or abundance. The frequency distributions of single or multiple traits in the community were the best predictors of ecosystem functioning. This implies that the ecosystem functions we investigated were underpinned by the combination of trait identities (i.e. single-trait indices) and trait complementarity (i.e. multi-trait indices) in the communities. Our study provides new insights into the general mechanisms that link biodiversity to ecosystem functioning in natural animal communities and suggests that the observed responses were due to the identity and dominance patterns of the trait composition rather than the number or abundance of species per se.

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BACKGROUND: Patient-reported outcomes (PROs) might detect more toxic effects of radiotherapy than do clinician-reported outcomes. We did a quality of life (QoL) substudy to assess PROs up to 24 months after conventionally fractionated or hypofractionated radiotherapy in the Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer (CHHiP) trial.

METHODS: The CHHiP trial is a randomised, non-inferiority phase 3 trial done in 71 centres, of which 57 UK hospitals took part in the QoL substudy. Men with localised prostate cancer who were undergoing radiotherapy were eligible for trial entry if they had histologically confirmed T1b-T3aN0M0 prostate cancer, an estimated risk of seminal vesicle involvement less than 30%, prostate-specific antigen concentration less than 30 ng/mL, and a WHO performance status of 0 or 1. Participants were randomly assigned (1:1:1) to receive a standard fractionation schedule of 74 Gy in 37 fractions or one of two hypofractionated schedules: 60 Gy in 20 fractions or 57 Gy in 19 fractions. Randomisation was done with computer-generated permuted block sizes of six and nine, stratified by centre and National Comprehensive Cancer Network (NCCN) risk group. Treatment allocation was not masked. UCLA Prostate Cancer Index (UCLA-PCI), including Short Form (SF)-36 and Functional Assessment of Cancer Therapy-Prostate (FACT-P), or Expanded Prostate Cancer Index Composite (EPIC) and SF-12 quality-of-life questionnaires were completed at baseline, pre-radiotherapy, 10 weeks post-radiotherapy, and 6, 12, 18, and 24 months post-radiotherapy. The CHHiP trial completed accrual on June 16, 2011, and the QoL substudy was closed to further recruitment on Nov 1, 2009. Analysis was on an intention-to-treat basis. The primary endpoint of the QoL substudy was overall bowel bother and comparisons between fractionation groups were done at 24 months post-radiotherapy. The CHHiP trial is registered with ISRCTN registry, number ISRCTN97182923.

FINDINGS: 2100 participants in the CHHiP trial consented to be included in the QoL substudy: 696 assigned to the 74 Gy schedule, 698 assigned to the 60 Gy schedule, and 706 assigned to the 57 Gy schedule. Of these individuals, 1659 (79%) provided data pre-radiotherapy and 1444 (69%) provided data at 24 months after radiotherapy. Median follow-up was 50·0 months (IQR 38·4-64·2) on April 9, 2014, which was the most recent follow-up measurement of all data collected before the QoL data were analysed in September, 2014. Comparison of 74 Gy in 37 fractions, 60 Gy in 20 fractions, and 57 Gy in 19 fractions groups at 2 years showed no overall bowel bother in 269 (66%), 266 (65%), and 282 (65%) men; very small bother in 92 (22%), 91 (22%), and 93 (21%) men; small bother in 26 (6%), 28 (7%), and 38 (9%) men; moderate bother in 19 (5%), 23 (6%), and 21 (5%) men, and severe bother in four (<1%), three (<1%) and three (<1%) men respectively (74 Gy vs 60 Gy, ptrend=0.64, 74 Gy vs 57 Gy, ptrend=0·59). We saw no differences between treatment groups in change of bowel bother score from baseline or pre-radiotherapy to 24 months.

INTERPRETATION: The incidence of patient-reported bowel symptoms was low and similar between patients in the 74 Gy control group and the hypofractionated groups up to 24 months after radiotherapy. If efficacy outcomes from CHHiP show non-inferiority for hypofractionated treatments, these findings will add to the growing evidence for moderately hypofractionated radiotherapy schedules becoming the standard treatment for localised prostate cancer.

FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.

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In this paper we report a study conducted in Mongolia on the scope of morality, that is, the extent to which people moralize different social domains. Following Turiel’s moral-conventional task, we characterized moral transgressions (in contrast to conventional transgressions) in terms of two dimensions: authority independence
and generality of scope. Different moral domains are then defined by grouping such moral transgressions in terms of their content (following Haidt’s classification of morally relevant domains). There are four main results of the study. First, since all five Haidtian domains were moralized by the Mongolian participants, the study provides
evidence in favour of pluralism about moral domains. However, the study also suggests that the domain of harm can be reduced to the fairness domain. Furthermore, although the strong claim about reduction of all moral domains to the domain of fairness seems not to hold, a significant number of participants did indicate considerations of fairness across domains. Finally, a significant amount of participants moralized conventional transgressions a la Turiel, but it did not reach a statistical significance.

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Electron-impact ionization cross sections for argon are calculated using both non-perturbative R-matrix with pseudo-states (RMPS) and perturbative distorted-wave methods. At twice the ionization potential, the 3p(61)S ground-term cross section from a distorted-wave calculation is found to be a factor of 4 above crossed-beams experimental measurements, while with the inclusion of term-dependent continuum effects in the distorted-wave method, the perturbative cross section still remains almost a factor of 2 above experiment. In the case of ionization from the metastable 3p(5)4s(3)P term, the distorted-wave ionization cross section is also higher than the experimental cross section. On the other hand, the ground-term cross section determined from a nonperturbative RMPS calculation that includes 27 LS spectroscopic terms and another 282 LS pseudo-state terms to represent the high Rydberg states, and the target continuum is found to be in excellent agreement with experimental measurements, while the RMPS result is below the experimental cross section for ionization from the metastable term. We conclude that both continuum term dependence and interchannel coupling effects, which are included in the RMPS method, are important for ionization from the ground term, and interchannel coupling is also significant for ionization from the metastable term

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Although security plays an important role in the development of multiagent systems, a careful analysis of software development processes shows that the definition of security requirements is, usually, considered after the design of the system. One of the reasons is the fact that agent oriented software engineering methodologies have not integrated security concerns throughout their developing stages. The integration of security concerns during the whole range of the development stages can help towards the development of more secure multiagent systems. In this paper we introduce extensions to the Tropos methodology to enable it to model security concerns throughout the whole development process. A description of the new concepts and modelling activities is given along with a discussion on how these concepts and modelling activities are integrated to the current stages of Tropos. A real life case study from the health and social care sector is used to illustrate the approach.

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This study examines the Social Dominance Orientation of players of the online roleplaying game World of Warcraft. The World of Warcraft offers an opportunity to investigate social dominance and biological sex differences in an environment where there is no cultural dominance of one sex over another. Social Dominance Orientation has been found to be different between males and females, with males scoring higher. However, this might be the consequence of social context. To this end sex differences between male and female players were investigated in the World of Warcraft environment, as well as the effects of chosen character sex. Player sex and character sex were found to have effects on Social Dominance Orientation. These results add further support to claims that Social Dominance Orientation has the characteristics of a sexually selected disposition to acquire resources and out-compete rival groups.

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Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health-related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer-related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty-one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN-52 self-reported version. Data were analysed using mixed methods approach. 87.8% of the sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer-related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well-being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well-being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.

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Dissertação de Mestrado, Biologia Marinha, Especialização em Biotecnologia Marinha, Faculdade de Ciências do Mar e do Ambiente, Universidade do Algarve, 2008

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To succeed nowadays, tourism destinations must differentiate and create a competitive positioning, and this can only be done by addressing and adapting to the needs of their visitors. A value-attainment construct based on tourism experiences is proposed for the product development and promotion strategy of the destination Algarve.

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Musikalische Darbietungen sind in Krankenhäusern und Pflegeeinrichtungen nichts Ungewöhnliches. Doch werden die vielfältigen psychosozialen Möglichkeiten, die das Medium Musik bietet, außerhalb therapeutischer Settings kaum zu einer intensiven zwischenmenschlichen Kommunikation genutzt. Diese Publikation soll einen Einblick in ein bundesweites Modellprojekt ermöglichen, das unter der Bezeichnung „Interaktives Musizieren“ in Hannover durchgeführt worden ist. Interaktives Musizieren bezeichnet eine unmittelbar gelebte musikalische Praxis, in der die Interaktionsmusizierenden, die Patientinnen und Patienten oder Bewohnerinnen und Bewohner sowie alle weiteren Anwesenden aufeinander bezogen sind. Die Interaktionsmusizierenden bereichern klangarme Umgebungen und schaffen Raum für zwischenmenschliche Begegnungen, die sie als einen außergewöhnlichen Moment gestalten. Damit bringen speziell ausgebildete Musikerinnen und Musiker neue ästhetisch-atmosphärische Impulse in Krankenhäuser und Pflegeeinrichtungen und verbessern die dortige Klang- und Lebenswelt. Das hier vorgestellte Modellprojekt „Interaktives Musizieren“ bietet eine Grundlage für verschiedene Einsatzformen von Musik in Feldern des Gesundheitswesens und der Sozialen Arbeit.

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Purpose To analyse pacing strategies displayed by athletes achieving differing levels of performance during an elite level marathon race. Methods Competitors in the 2009 IAAF Women’s Marathon Championship were split into Groups 1, 2, 3, and 4 comprising the first, second, third, and fourth 25% of finishers respectively. Final, intermediate, and personal best (PB) times of finishers were converted to mean speeds, and relative speed (% of PB speed) was calculated for intermediate segments. Results Mean PB speed decreased from Group 1 to 4 and speed maintained in the race was 98.5 + 1.8%, 97.4 + 3.2%, 95.0 + 3.1% and 92.4 + 4.4% of PB speed for Groups 1-4 respectively. Group 1 was fastest in all segments and differences in speed between groups increased throughout the race. Group 1 ran at lower relative speeds than other groups for the first two 5 km segments, but higher relative speeds after 35km. Significant differences (P<0.01) in the percentage of PB speed maintained were observed between Groups 1 and 4, and 2 and 4 in all segments after 20 km, and Groups 3 and 4 from 20-25 km and 30-35 km. Conclusions Group 1 athletes achieved superior finishing times relative to their PB than athletes in other Groups who selected unsustainable initial speeds resulting in subsequent significant losses of speed. It is suggested that psychological factors specific to a major competitive event influenced decision making by athletes and poor decisions resulted in final performances inferior to those expected based on PB times.

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This paper links research and teaching through an applied Soft Systems Methodology case study. The case study focuses on the redevelopment of a Research and Professional Skills module to provide support for international postgraduate students through the use of formative feedback with the aim of increasing academic research skills and confidence. The stages of the Soft Systems Methodology were used as a structure for the redevelopment of module content and assessment. It proved to be a valuable tool for identifying complex issues, a basis for discussion and debate from which an enhanced understanding was gained and a successful solution implemented together with a case study that could be utilised for teaching Soft Systems Methodology concepts. Changes to the module were very successful and resulted in significantly higher grades and a higher pass rate.