Obstructive sleep apnoea predicts the development of preproliferative and proliferative retinopathy in patients with type 2 diabetes:a longitudinal analysis

Background and aims: Diabetic Retinopathy (DR) is a leading cause of blindness. OSA is associated with increased oxidative and nitrosative stress and endothelial dysfunction in patients with type 2 diabetes (T2DM). Hence, it is plausible that OSA can promote the development and progression of DR. Materials and methods: An observational longitudinal study in adults with T2DM. Patients with pre-existing OSA, end-stage renal disease and non-diabetic retinopathy were excluded. OSA (apnoea hypopnea index ≥ 5 events/hour) was assessed by a single overnight home-based cardio-respiratory monitoring (Alice PDX, etc.). DR was assesses using retinal images between 2007 and 2012. Sight threatening retinopathy (STR) was defined as pre-proliferative or proliferative DR, maculopathy or photocoagulation. Advanced DR was defined as pre-proliferative or proliferative DR. Results: 199 patients were included (57.3% men, 47.7% White Europeans). STR and OSA prevalence were 38.7 % and 62.8% respectively. STR preva-lence was higher in patients with OSA (OSA+) compared to those with-out (OSA-) [48.8% vs. 21.6%, p <0.001]. After adjustment for confounders, OSA remained independently associated with STR (OR 3.7, 95%CI 1.6-8.9, p=0.006, maculopathy (OR 4.5, 1.8-11.4, p=0.002) and advanced DR (OR 3.9, 1.02-15.3, p=0.047). Over 4.4±1 years, more OSA+ patients progressed from no or background DR to advanced DR (15.3% vs. 3%, p=0.01). OSA was an independent predictor of advanced DR development after adjustment (OR 6.6, 95%CI 1.2-35.1, p=0.03). OSA did not predict the development of maculopathy. Patients received continuous positive airway pressure treatment were less likely to develop advanced DR. Conclusion: OSA is independently associated with STR and predicts the development of preproliferative and proliferative DR. Interventional studies are needed to assess the impact of OSA treatment on DR.Supported by: NIHR (UK) and The UK Novo Nordisk Research Foundation.

Diagnosis of retinopathy in children younger than 12 years of age:implications for the diabetic eye screening guidelines in the UK

Aim: To assess whether the current starting age of 12 is suitable for diabetic retinopathy (DR) screening and whether diabetes duration should be taken into account when deciding at what age to start screening patients. Materials and methods: A retrospective analysis of 143 patients aged 12 years or younger who attended diabetic eye screening for the first time in the Birmingham, Solihull and Black Country Diabetic Eye Screening Programme was performed. Results: The mean age of the patients was 10.7 (7-12) years with 73 out of 143 aged below 12 years and 70 were 12 years of age. 98% had type 1 diabetes and mean diabetes duration was 5 (1 month-11 years) years. For those younger than 12 years, 7/73 (9.6%) had background DR (BDR), of these mean diabetes duration was 7 years (6-8). The youngest patient to present with DR was aged 8 years. In those aged 12 years, 5/70 (7.1%) had BDR; of these mean diabetes duration was 8 years (6-11). No patient developed DR before 6 years duration in either group. Conclusions: The results show that no patient younger than the age of 12 had sight-threatening DR (STDR), but BDR was identified. Based on the current mission statement of the Diabetic Eye Screening Programme to identify STDR, 12 years of age is confirmed as the right age to start screening, but if it is important to diabetic management to identify first development of DR, then screening should begin after 6 years of diabetes diagnosis.

A projektek és a változtatások szerepelméleteinek összehasonlítása (Comparison of role concepts of projects and changes)

A szerzők jelen cikkükben a projektmenedzsment és a változásmenedzsment szakirodalmában olvasható szerepelméleteket hasonlítják össze. A hasonlóságok szembeötlőek, de nem nyilvánvaló, hogy az egyes definíciók pontosan miben egyeznek vagy térnek el egymástól. A két szakterület irodalmában nem találtak ilyen összehasonlító elemzést. Először összehasonlítják a projekt, az elsőfokú (morfostatikus) és a másodfokú (morfogenetikus) változás közkeletű definícióit, hogy körülhatárolhassák a közöttük lévő átfedéseket, ahol egyáltalán van értelme összevetniük a különböző szerepmeghatározásokat. Találnak közöttük átfedést, ahol a különböző szerepdefiníciók egyaránt érvényesek, így összehasonlíthatók egymással. A két szakterület szerepmeghatározásainak tartalmát elemezve teljes egyezések, részleges hasonlóságok és különbségek is találhatók. Legfontosabb megállapításuk az, hogy a tartalmi átfedések és kapcsolódások miatt mindkét szakterület oktatói, kutatói és gyakorlati művelői komoly haszonnal forgathatják a másik terület szerepelméleti szakirodalmát is. ________ This paper compares the role concepts which are in current use in project management and change management literature. The similarities are noticeable at first sight but it is not clear where the domains of the different definitions of the two management disciplines overlap and where they vary from each other significantly. The authors have not found such an interdisciplinary comparison in the literature of the two fields. At first, they compared the widely used definitions of project, first order (or morphostatic) and second order (or morphogenetic) changes to find the overlapping areas where it is reasonable to compare the different role definitions at all. They found an overlapping area where the different role definitions are all valid and the role theories can be compared. The typical project stakeholders are: project sponsor, project manager, project management team, project team, influencers, customer/user, performing organization etc. The typical change roles are: sponsor (initiating and sustaining), agent, target, advocate, facilitator etc. The authors found samenesses, similarities and differences alike between the two sets of roles. The most important conclusion is that the findings enable participants working on these types of activities to rely on both bodies of knowledge properly.

Tradition, innovation and reform in local development. Conference proceedings

Understanding Local Development as the interaction of a complex mosaic of measures, resources and actors requires having an interdisciplinary perspective.‘Local’ means small-scale, focused, and within reach - one would suggest -, while comparing or understanding inter-regional dynamics (putting what we mean by ‘locality’ on the global map) is what brings into sight traits, which can be treated as universal, typical or individual. The sections of the conference tackled this kaleidoscope of themes that has evolved around tradition, innovation and reform, with roots in both academia and policy-making connected to entrepreneurship, governance, economic and social structure, the labor market and human capital.

The White Ibis and Wood Stork as indicators for restoration of the everglades ecosystem

Large numbers of colonially nesting herons, egrets, ibises, storks and spoonbills were one of the defining natural phenomena of the historical Everglades. Reproduction of these species has been tracked over at least a century, and some clear responses to dramatic anthropogenic hydrological alterations have been established. These include a marked decline in nesting populations of several species, and a movement of colonies away from the over-drained estuarine region. Ponding in a large portion of the freshwater marsh has favored species that hunt by sight in deep water (egrets, cf. 25–45 cm), while tactile feeders (ibises and storks) that depend on concentrated prey in shallow water (5–25 cm) have become proportionately much less common. There has been a marked increase in the interval between exceptionally large breeding aggregations of White Ibises (Eudocimus albus). Loss of short hydroperiod wetlands on the margins of the Everglades have delayed nest initiations 1–2 months by Wood Storks (Mycteria americana) resulting in poor nesting success. These responses are consistent with mechanisms that involve foraging, and the availability and production of prey animals, and each of the relationships is highly dependent on hydrology. Here, we define a group of characteristics about wading bird dynamics (= indicators) that collectively track the specific ecological relationships that supported ibises and storks in the past. We suggest four metrics as indicators of restoration success: timing of nesting by storks, the ratio of nesting ibises + storks to Great Egrets, the proportion of all nests located in the estuarine/freshwater ecotone, and the interval between years with exceptionally large ibis nestings. Each of these metrics has historical (e.g., predrainage) data upon which to base expectations for restoration, and the metrics have little measurement error relative to the large annual variation in numbers of nests. In addition to the strong scientific basis for the use of these indicators, wading birds are also a powerful tool for public communication because they have strong aesthetic appeal, and their ecological relationships with water are intuitively understandable. In the interests of communicating with the public and decision-makers, we integrate these metrics into a single-page annual “traffic-light” report card for wading bird responses. Collectively, we believe these metrics offer an excellent chance of detecting restoration of the ecosystem functions that supported historical wading bird nesting patterns.

Electronic Perception Technology Applications in Food Service

Electronic Perception Technology (EPT) enables automated equipment to gain artificial sight commonly referred to as "machine-vision” by employing specialty software and embedded sensors to create a “Visual" input field that can be used as a front-end application for transactional behavior. The authors review this new technology and present feasible future applications to the food service industry in enhancing guest services while providing a competitive advantage.

Tourism: Who Needs It?

Is tourism economically beneficial? If so, who benefits? How much of the money generated through tourism can be channeled into other projects so desperately needed by the community without harming the local tour market? Will tourism continue to grow forever, or is there an end in sight? The authors discuss how tourism will change in approaching the next century: and how people will change if tourism is to remain such an important economic facto

GENIAL Design: A System for Improving Guest Satisfaction with Hospitality Design

Over the past decades, hospitality design has lost sight of its basic goals of providing the guest with safe, pleasant, convenient accommodations and providing the owner with a facility which can be operated efficiently and profitably over the life of the structure. The author offers the acronym GE- NIAL, Guest, Environment, Needs, Interiors, Accessibility, and Long-term, as a means of keeping owners, developers, managers, and designers aware of the desired goals of the facility throughout its design and development. The author believes that the use of this acronym will promulgate de- signs more attuned to guest and owner/operator needs, resulting in in- creased guest satisfaction and increased profitability.

A "voz das ruas" e a rearticulação da ideologia conservadora

The aim of this paper is to analyze the street demonstrations occurred last June and July 2013, which appear as samples of the hegemonic fights in course in Brazil, during the so-called Big Wave of the social groups in conflict nowadays in the country. Among other questions, this study tries to explain how the varied stages of these fighting groups influenced their late ones. For that, it takes into consideration the bibliography available not only on these groups, but also on the social and political contemporary Brazil. That is why it evaluates political documents, as well as opinion pieces, news and others disseminated by the press or by political groups. Speeches made by political leaderships, as, for example, that one the President Dilma Roussef made on 21 July 2013, deserves close analysis. This also applies to contributions made by secondary data, poll institutions and IBGE’s socio-economic data. Categories and concepts of Antonio Gramsci’s political sociology are used here as theoretic bases. In fact, it favors the hypothesis that, during the dispute for the intellectual and moral command of demonstrations on July 2013, a certain middle-class conservative ideology emerged on scene. This group conquered the agreement of hegemonic mass media acting now as a political party, here designated as media party. These media resorted to platforms preexistent to the demonstration movements, especially their rejection to political organizations and programs in order to ascend as the demonstrations’ leaders along a certain period in which corruption appeared as the central theme of these efforts, while the government tried to get control of the situation. In view of the several forces and issues at stake, the present study contributes to the discussion about the current reality in Brazil and its perspectives, without losing sight of the centrality of the June Movements as political and ideological milestones

Estudo da variação da periodicidade e do acoplamento entre superfícies seletivas de frequência com elementos fractais e helicoidais em estruturas de multicamadas

This work aims to investigate the behavior of fractal and helical elements structures in planar microstrip. In particular, the frequency selective surfaces (FSSs) had changed its conventional elements to fractal and helical formats. The dielectric substrate used was fiberglass (FR-4) and has a thickness of 1.5 mm, a relative permittivity 4.4 and tangent loss equal to 0.02. For FSSs, was adopting the Dürer’s fractal geometry and helical geometry. To make the measurements, we used two antennas horns in direct line of sight, connected by coaxial cable to the vector network analyzer. Some prototypes were select for built and measured. From preliminary results, it was aimed to find practical applications for structures from the cascading between them. For FSSs with Dürer’s fractal elements was observed behavior provided by the multiband fractal geometry, while the bandwidth has become narrow as the level of iteration fractal increased, making it a more selective frequency with a higher quality factor. A parametric analysis allowed the analysis of the variation of the air layer between them. The cascading between fractal elements structure were considered, presented a tri-band behavior for certain values of the layer of air between them, and find applications in the licensed 2.5GHz band (2.3-2.7) and 3.5GHz band (3.3-3.8). For FSSs with helical elements, six structures were considered, namely H0, H1, H2, H3, H4 and H5. The electromagnetic behavior of them was analyzed separately and cascaded. From preliminary results obtained from the separate analysis of structures, including the cascade, the higher the bandwidth, in that the thickness of the air layer increases. In order to find practical applications for helical structures cascaded, the helical elements structure has been cascaded find applications in the X-band (8.0-12.0) and unlicensed band (5.25-5.85). For numerical and experimental characterization of the structures discussed was used, respectively, the commercial software Ansoft Designer and a vector network analyzer, Agilent N5230A model.

Os usos do território e a economia solidária no Rio Grande do Norte

The solidary economy as the organization of production, alternative to the capitalist economy provides new forms of organization and social behavior, that, in the sight of geography, it is shown by the different territory uses. The territory assume new meanings that, influenced by the Solidary Economy movement, tries to reach for new ways of acting that differ from social order already stablished. However, the different uses show themselves in a more complex and contradictory way, given that, in solidary undertakings, different corporative agents start to act, the State being a last resource on this process. Given this reality, our goal on the present paper is to analyze the different uses of the territory from the rural economic solidary undertakings and the relationship it establishes to the different agents involved on the socio-territorial dynamics on Rio Grande do Norte. Starting from a study that contemplates the territorial organization forms and contents of the analyzed phenomena, the methodology utilized for this research is based on a bibliographic review, with authors from the geography and areas related to the Solidary Economy, besides the use of secondary data, acquired from official offices such as SIES and IBGE, from the documented research, SENAES and field interviews conducted with local solidary undertakings. The results obtained in the study reveal the complexity of the agricultural use of the territory by Solidary Economy on the RN, while a resource of intensified use, from the state actions and important economical agents, and regulating the use while shelter, that marginalize solidary workers, making them subdued to the hegemonic logic. Therefore, we can infer that the solidary economy, despite its image of new form of organization between agricultural workers, given the expressivity of the rural solidary undertakings presented on RN, it hasn’t shown a full social development as an instrument of reproduction and emancipation of the associates. Nevertheless, the undertakings articulated in nets excel, even when considering its punctual and residual form. The given contradictions show that it is necessary to fortify the building of the solidary economy as being horizontal and popular based for it to have strength to surpass the regulative actions of the capitalist state and ownership created by the Capital.

Questionamentos acerca de valores axiológicos no turismo: uma abordagem fenomenológica hermenêutica

The study presents the possibility of interpretation of axiological values of tourism as a practice conceived on a human being or Dasein as being-in-the-world of tourism. The value, as an object of Axiology, was considered the predictor of the human being conduct in the phenomenon reflecting this same value in tourism. The aim was to comprehend and interpret through the way of being of Dasein in tourism, which axiological values are chosen to the practice of tourism and the intentional feelings directed to these values. A phenomenological hermeneutics research with exploratory characteristics was accomplished in order to survey the values. Ten episodic interviews were conducted from the hermeneutic situation - constituted by fore-having, fore-sight and fore-conception of each Dasein interviewed, by adopting a sympathetic conduct and sympathy of Max Scheler and the use of emotional intuition to capture the intentional feelings, interpreted afterwards by the analysis of a Martin Heidegger's phenomenology in Being and Time. The results showed that, even without categorisation, the totality of the living experiences, the way of being of positive values outnumber the negatives ones in the existence of each Dasein, leading them to the Learning, which are comprising: experiences to provide self-knowledge, historical-cultural values, and memory as part of the learning experiences, hospitality as a way of openness and socio-cultural exchange, solidarity and peace. Intentional feelings directed at the values for the choice for practicing tourism were: love, happiness, pleasure, respect and trust. Four evidences were found concerning the use of sentimental perspective and intentional feeling of Scheler and regarding the logic of the heart of Pascal used by this author. The sociocultural interrelationships and exchanges form the basis for developing tourism as phenomenon. Therefore the character being-with or Mitsein is prevalent in tourism activities. Despite the learning was the purpose of the experiences, the ultimate goal was the improvement and personal enrichment of Dasein´s humanity development. The study also showed the hermeneutic phenomenological seeing opens the access of the living experiences of values, without making arbitrarily judgment and achieve "to the thing themselves", which, by the overlapping of categories, dispositions and intentional feelings, form the evaluative experiences and are possible to access through the fundamental ontology of Heidegger. The study contributes to broaden the vision concerning to the totality of tourism and the practitioners Dasein of it. As possibilities for deepening studies, was pointed out: the total person of Scheler; the care or Sorge as a form of love in Heidegger; happiness and pleasure in the practice of tourism and human flourishing or eudaimonia.

Angular momentum of S0 galaxies

The aim of this thesis is to study the angular momentum of a sample of S0 galaxies. In the quest to understand whether the formation of S0 galaxies is more closely linked to that of ellipticals or that of spirals, our goal is to compare the amount of their specific angular momentum as a function of stellar mass with respect to spirals. Through kinematic comparison between these different classes of galaxies we aim to understand if a scenario of passive evolution, in which the galaxy’s gas is consumed and the star formation is quenched, can be considered as plausible mechanism to explain the transformation from spirals to S0s. In order to derive the structural and photometric parameters of galaxy sub-components we performed a bulge-disc decomposition of optical images using GALFIT. The stellar kinematic of the galaxies was measured using integral field spectroscopic data from CALIFA survey. The development of new original software, based on a Monte Carlo Markov Chain algorithm, allowed us to obtain the values of the line of sight velocity and velocity dispersion of disc and bulge components. The result that we obtained is that S0 discs have a distribution of stellar specific angular momentum that is in full agreement with that of spiral discs, so the mechanism of simple fading can be considered as one of the most important for transformation from spirals to S0s.

High resolution study of narrow tailed radio galaxies in clusters

Clusters of galaxies are the most massive and large gravitationally bounded systems in the whole Universe. Their study is of fundamental importance to constrain cosmological parameters and to obtain informations regarding various kind of emission in different wavebands. In particular, in the radio domain, beside the diffuse emission, the study is focused on the radio galaxies emission. Radio galaxies in clusters can have peculiar morphology, since they interact with the intracluster medium (ICM) in which they are embedded. Particularly, in this thesis we focused our attention on the so-called Narrow-Angle Tailed radio galaxies (NAT), which present radio jets that are bent at extreme angle, up to 90 degrees, from their original orientation. Some NAT show a narrow extended structure and the two radio tails are not resolved even with high resolution radio observations. An example is provided by the source IC310, in the Perseus Cluster, whose structure has been recently interpreted as due to Doppler boosting effects of a relativistic jet oriented at a small angle with respect to the line of sight. If the structure is due to relativistic effects, this implies that the jets are relativistic at about 400 kpc from the core, but this is in contrast with unified models, which predict that for low-power radio source (NAT are classified as FRI radio galaxies) the jets decelerate to sub-relativistic speed within a few kpc from the core. To investigate this scientific topic, in this thesis we have analyzed the innermost structure of a sample of eleven radio galaxies showing a very narrow NAT structure. We can conclude that the structure of these radio galaxies is different from that of IC310. These radio galaxies are indeed strongly influenced by environmental effects and are similar to classical NAT sources.

A key role for PTP1B in dendritic cell maturation, migration and T cell activation

Acknowledgements We thank the Iain Fraser Flow Cytometry Centre and the Medical Research Facility of the University of Aberdeen. We are grateful to Drs West, Zaru, and Davidson (University of Dundee) for the scientific discussion and technical assistance. Wethank Derek Mitchell (University of Dundee) for aiding with the quantification of focal contacts. Funding This work was supported by Saving Sight in Grampian and the Development Trust of the UoA (both to J.V.F.). Work on this project was partly funded by project grants from British Heart Foundation and European Foundation for the Study of Diabetes/Lilly diabetes programme grant (to M.D.).