850 resultados para positive duties
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Digital technologies have often been perceived as imperilling traditional cultural expressions (TCE). This angst has interlinked technical and socio-cultural dimensions. On the technical side, it is related to the affordances of digital media that allow, among other things, instantaneous access to information without real location constraints, data transport at the speed of light and effortless reproduction of the original without any loss of quality. In a socio-cultural context, digital technologies have been regarded as the epitome of globalisation forces - not only driving and deepening the process of globalisation itself but also spreading its effects. The present article examines the validity of these claims and sketches a number of ways in which digital technologies may act as benevolent factors. We illustrate in particular that some digital technologies can be instrumentalised to protect TCE forms, reflecting more appropriately the specificities of TCE as a complex process of creation of identity and culture. The article also seeks to reveal that digital technologies - and more specifically the Internet and the World Wide Web - have had a profound impact on the ways cultural content is created, disseminated, accessed and consumed. We argue that this environment may have generated various opportunities for better accommodating TCE, especially in their dynamic sense of human creativity.
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BACKGROUND Trastuzumab has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. The standard of care is 1 year of adjuvant trastuzumab, but the optimum duration of treatment is unknown. We compared 2 years of treatment with trastuzumab with 1 year of treatment, and updated the comparison of 1 year of trastuzumab versus observation at a median follow-up of 8 years, for patients enrolled in the HERceptin Adjuvant (HERA) trial. METHODS The HERA trial is an international, multicentre, randomised, open-label, phase 3 trial comparing treatment with trastuzumab for 1 and 2 years with observation after standard neoadjuvant chemotherapy, adjuvant chemotherapy, or both in 5102 patients with HER2-positive early breast cancer. The primary endpoint was disease-free survival. The comparison of 2 years versus 1 year of trastuzumab treatment involved a landmark analysis of 3105 patients who were disease-free 12 months after randomisation to one of the trastuzumab groups, and was planned after observing at least 725 disease-free survival events. The updated intention-to-treat comparison of 1 year trastuzumab treatment versus observation alone in 3399 patients at a median follow-up of 8 years (range 0-10) is also reported. This study is registered with ClinicalTrials.gov, number NCT00045032. FINDINGS We recorded 367 events of disease-free survival in 1552 patients in the 1 year group and 367 events in 1553 patients in the 2 year group (hazard ratio [HR] 0·99, 95% CI 0·85-1·14, p=0·86). Grade 3-4 adverse events and decreases in left ventricular ejection fraction during treatment were reported more frequently in the 2 year treatment group than in the 1 year group (342 [20·4%] vs 275 [16·3%] grade 3-4 adverse events, and 120 [7·2%] vs 69 [4·1%] decreases in left ventricular ejection fraction, respectively). HRs for a comparison of 1 year of trastuzumab treatment versus observation were 0·76 (95% CI 0·67-0·86, p<0·0001) for disease-free survival and 0·76 (0·65-0·88, p=0·0005) for overall survival, despite crossover of 884 (52%) patients from the observation group to trastuzumab therapy. INTERPRETATION 2 years of adjuvant trastuzumab is not more effective than is 1 year of treatment for patients with HER2-positive early breast cancer. 1 year of treatment provides a significant disease-free and overall survival benefit compared with observation and remains the standard of care. FUNDING F Hoffmann-La Roche (Roche).
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A Tn916-like transposon (TnFO1) was found in the multiple antibiotic resistant Enterococcus faecalis strain FO1 isolated from a raw milk cheese. In this strain, the tetracycline determinant was localized by DNA-DNA hybridization with a tetM nucleotide probe on the chromosome and on a 30-kb plasmid. The transposon TnFO1 was identified and characterized by DNA-DNA hybridization experiments with the five internal HincII fragments of Tn916. The tetracycline resistance determinant was identified by its complete nucleotide sequence as TetM. Transposon TnFO1 was also detected in its circular form by DNA-DNA hybridization and PCR amplification. Both ends including the joining region of the closed circular transposon TnFO1 were sequenced. TnFO1 could be transferred by conjugation from Enterococcus faecalis into Enterococcus faecalis, Lactococcus lactis subsp. lactis biovar. diacetylactis, Listeria innocua, Leuconostoc mesenteroides and Staphylococcus aureus, and from Lactococcus lactis subsp. lactis biovar. diacetylactis into Listeria innocua. Pulsed-field electrophoresis of genomic DNA from E. faecalis FO1 transconjugants showed that transposon TnFO1 integrated at different sites.
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Mit dem Ziel, einen Beitrag zum Verständnis der Emotionsentstehung in der Schule zu liefern, wird ein Überblick über Forschungsarbeiten (N=25) gegeben, die explizit die Entwicklung von Freude und Wohlbefinden in der Schule fokussieren, und es wird auf dabei gängige Forschungsmethoden eingegangen. Folgende Fragen werden behandelt: (1) Welche Emotionen erleben Kinder und Jugendliche in der Schule? (2) Worauf sind die Entstehung positiver Emotionen und die Entwicklung des Wohlbefindens in der Schule zurückzuführen? Hintergrund ist auch der pädagogische Anspruch, dass eine Schule aktiv dazu beitragen kann, von den Schülerinnen und Schülern nicht als primär unangenehm, angsteinflößend oder langweilig erlebt zu werden. Als relevante und zugleich von der Schule beeinflussbare Faktoren erwiesen sich beispielsweise die Gestaltung leistungsförderlicher Lernumgebungen und die soziale Integration in der Schule bzw. in der Klasse. Aufgrund des gegenwärtigen Stands der Erkenntnisse wird künftig ein noch differenzierterer Zugang sowohl zu den emotionalen Erlebensqualitäten, den Quellen und Ursachen als auch zu den Konsequenzen von Emotionen und Wohlbefinden in der Schule gefordert.
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We prove that any isotropic positive definite function on the sphere can be written as the spherical self-convolution of an isotropic real-valued function. It is known that isotropic positive definite functions on d-dimensional Euclidean space admit a continuous derivative of order [(d − 1)/2]. We show that the same holds true for isotropic positive definite functions on spheres and prove that this result is optimal for all odd dimensions.
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Background There will be increasing competition for young physicians worldwide as more and more physicians retire. While enthusiasm towards GP work is important for GP teachers as role models, satisfaction within the profession has declined. This study aims to determine if medical students’ desire to become GPs is related to the job satisfaction of their teaching GPs and explore the factors tied to this job satisfaction. Methods In this cross-sectional, correlational study, teaching GPs of the University of Bern and the fourth year medical students completing internships with them filled in separate questionnaires. Results Whether or not the GP teacher is perceived by a student to be satisfied with her/his job is correlated to that student’s satisfaction with the internship, which in turn, is correlated with student’s wish to be a GP after the internship. Results show which factors are most related to GP job satisfaction and the effect of working hours and their composition. Conclusions Medical students’ perception of their GP teachers’ job satisfaction positively affect their wish to become GPs, and their satisfaction with their internships adds to this. Enhancing the positive aspects of GP work, such as recognition, and improving negative ones, such as administrative duties, are necessary to attract medical students into the GP field.
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: Noncommunicable diseases (NCDs) account for a growing burden of morbidity and mortality among people living with HIV in low- and middle-income countries (LMICs). HIV infection and antiretroviral therapy interact with NCD risk factors in complex ways, and research into this "web of causation" has so far been largely based on data from high-income countries. However, improving the understanding, treatment, and prevention of NCDs in LMICs requires region-specific evidence. Priority research areas include: (1) defining the burden of NCDs among people living with HIV, (2) understanding the impact of modifiable risk factors, (3) evaluating effective and efficient care strategies at individual and health systems levels, and (4) evaluating cost-effective prevention strategies. Meeting these needs will require observational data, both to inform the design of randomized trials and to replace trials that would be unethical or infeasible. Focusing on Sub-Saharan Africa, we discuss data resources currently available to inform this effort and consider key limitations and methodological challenges. Existing data resources often lack population-based samples; HIV-negative, HIV-positive, and antiretroviral therapy-naive comparison groups; and measurements of key NCD risk factors and outcomes. Other challenges include loss to follow-up, competing risk of death, incomplete outcome ascertainment and measurement of factors affecting clinical decision making, and the need to control for (time-dependent) confounding. We review these challenges and discuss strategies for overcoming them through augmented data collection and appropriate analysis. We conclude with recommendations to improve the quality of data and analyses available to inform the response to HIV and NCD comorbidity in LMICs.
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The objects of study in this thesis are knots. More precisely, positive braid knots, which include algebraic knots and torus knots. In the first part of this thesis, we compare two classical knot invariants - the genus g and the signature σ - for positive braid knots. Our main result on positive braid knots establishes a linear lower bound for the signature in terms of the genus. In the second part of the thesis, a positive braid approach is applied to the study of the local behavior of polynomial functions from the complex affine plane to the complex numbers. After endowing polynomial function germs with a suitable topology, the adjacency problem arises: for a fixed germ f, what classes of germs g can be found arbitrarily close to f? We introduce two purely topological notions of adjacency for knots and discuss connections to algebraic notions of adjacency and the adjacency problem.
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The deceptive Iris lutescens (Iridaceae) shows a heritable and striking flower colour polymorphism, with both yellow- and purple-flowered individuals growing sympatrically. Deceptive species with flower colour polymorphism are mainly described in the family Orchidaceae and rarely found in other families. To explain the maintenance of flower colour polymorphism in I.lutescens, we investigated female reproductive success in natural populations of southern France, at both population and local scales (within populations). Female reproductive success was positively correlated with yellow morph frequency, at both the population scale and the local scale. Therefore, we failed to observe negative frequency-dependent selection (NFDS), a mechanism commonly invoked to explain flower colour polymorphism in deceptive plant species. Flower size and local flower density could also affect female reproductive success in natural populations. Pollinator behaviour could explain the positive effect of the yellow morph, and our results suggest that flower colour polymorphism might not persist in I.lutescens, but alternative explanations not linked to pollinator behaviour are discussed. In particular, NFDS, although an appealingly simple explanation previously demonstrated in orchids, may not always contribute to maintaining flower colour polymorphism, even in deceptive species.
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INTRODUCTION Proteinuria (PTU) is an important marker for the development and progression of renal disease, cardiovascular disease and death, but there is limited information about the prevalence and factors associated with confirmed PTU in predominantly white European HIV+ persons, especially in those with an estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m(2). PATIENTS AND METHODS Baseline was defined as the first of two consecutive dipstick urine protein (DPU) measurements during prospective follow-up >1/6/2011 (when systematic data collection began). PTU was defined as two consecutive DUP >1+ (>30 mg/dL) >3 months apart; persons with eGFR <60 at either DPU measurement were excluded. Logistic regression investigated factors associated with PTU. RESULTS A total of 1,640 persons were included, participants were mainly white (n=1,517, 92.5%), male (n=1296, 79.0%) and men having sex with men (n=809; 49.3%). Median age at baseline was 45 (IQR 37-52 years), and CD4 was 570 (IQR 406-760/mm(3)). The median baseline date was 2/12 (IQR 11/11-6/12), and median eGFR was 99 (IQR 88-109 mL/min/1.73 m(2)). Sixty-nine persons had PTU (4.2%, 95% CI 3.2-4.7%). Persons with diabetes had increased odds of PTU, as were those with a prior non-AIDS (1) or AIDS event and those with prior exposure to indinavir. Among females, those with a normal eGFR (>90) and those with prior abacavir use had lower odds of PTU (Figure 1). CONCLUSIONS One in 25 persons with eGFR>60 had confirmed proteinuria at baseline. Factors associated with PTU were similar to those associated with CKD. The lack of association with antiretrovirals, particularly tenofovir, may be due to the cross-sectional design of this study, and additional follow-up is required to address progression to PTU in those without PTU at baseline. It may also suggest other markers are needed to capture the deteriorating renal function associated with antiretrovirals may be needed at higher eGFRs. Our findings suggest PTU is an early marker for impaired renal function.