998 resultados para gastrointestinal change


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Els materials de canvi de fase (PCM) han estat considerats per a l’emmagatzematge tèrmic en edificis des de 1980. Amb la inclusió dels PCM en plaques de guix, guix, formigó o altres materials que s’utilitzen per a cobrir les parets, l’emmagatzematge tèrmic pot ser part de les estructures fins i tot en edificis lleugers. Les noves tècniques de microencapsulació han obert moltes possibilitats en aplicacions per a edificis. El treball que es presenta és el desenvolupament d’un formigó innovador mesclat amb PCM microencapsulat, amb un punt de fusió de 26 oC i una entalpia de canvi de fase de 110 kJ/kg. El primer experiment va ser la inclusió del PCM microencapsulat dins del formigó i la construcció d’una caseta amb aquest nou formigó-PCM. Es va construir una segona caseta al costat de la primera amb les mateixes característiques i orientació però amb formigó convencional que serveix com a referència. Durant els anys 2005 i 2006 es va analitzar el comportament d’ambdues casetes i més tard es va edificar un mur Trombe a la paret sud de totes dues per investigar la seva influència durant la tardor i l’hivern.

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This paper aims at evaluating the compatibility of coercive climate policies with liberal neutrality. More precisely, it focuses on the doctrine of state neutrality as associated with the "harm principle". It argues that given the difficulty of attributing causal responsibilities for climate harms to individuals, the harm principle doesn't work in this case, at least if one endorses a liberal atomistic ontology. Furthermore, the definition of what constitutes climate harms implies making moral assumptions, which makes it impossible to justify climate policies in a neutral way. Finally, the paper shows another consequence of applying neutrality to the case of climate change, that is the risk of a shift from political forms of decision-making to technocracy. Focusing too much on liberty of choice may (paradoxically) be to the detriment of political freedom. The paper concludes that climate change is an intrinsically moral issue and that it should be the occasion of a political debate about our current values and lifestyles. It should not be reduced to a mere question of carbon metric.

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Contexte et but de l'étude: La relation médecin-patient a subi d'importants changements et l'actuelle émancipation des patients a conduit à un véritable partenariat dans la prise de décisions thérapeutiques. Notre étude a pour but de déterminer les préférences des patients pour différents aspects de la prise de décisions au cours d'un traitement et de ses potentielles complications, de même que la quantité et le type d'information souhaitée avant une intervention chirurgicale digestive. Patients et méthodes : Il s'agit d'une étude prospective non-randomisée basée sur un questionnaire donné lors de la consultation préopératoire à 254 patients consécutifs prévus pour une chirurgie gastro-intestinale élective. Résultats : Pour les potentielles complications chirurgicales et la possibilité d'un séjour aux soins intensifs, 64% des patients souhaitent participer activement aux décisions médicales, et respectivement 89% et 60% des patients aimeraient discuter d'une éventuelle réanimation cardio-pulmonaire et de limitations au traitement. Respectivement 73%, 77% et 47% des patients ont souhaité une information très détaillée, une infoimation pour une possible hospitalisation en soins intensifs ou une éventuelle réanimation cardiaque. Les patients âgés ou avec un niveau de formation bas étaient significativement moins intéressés à une prise de décision partagée (p=0.003 et 0.015) et à une information complète (p=0.03 et 0.05), De plus, l'implication des familles dans les prises de décision n'était favorisée que si le patient est en coma (74%), et significativement moins importante chez les personnes âgées et de sexe masculin (p=0.04 et 0.03 respectivement). Ni le type de chirurgie prévue (majeure ou mineure) ni la sévérité de la pathologie (cancer ou non) ne furent des facteurs statistiquement significatifs pour un désir plus élevé de partager la prise de décision, pour plus d'information ou pour impliquer d'avantage la famille. Conclusions : Notre étude démontre que la majorité des patients chirurgicaux souhaitent recevoir une information préopératoire complète concernant leur maladie et le traitement planifié. Ils considèrent également comme crucial d'être impliqués dans les prises de décisions thérapeutiques pour le traitement et pour les possibles complications. Le rôle de la famille est limité aux situations ou le patient n'est plus en mesure de participer aux décisions.

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Chromosomal inversion polymorphisms are common in animals and plants, and recent models suggest that alternative arrangements spread by capturing different combinations of alleles acting additively or epistatically to favour local adaptation. It is also thought that inversions typically maintain favoured combinations for a long time by suppressing recombination between alternative chromosomal arrangements. Here, we consider patterns of linkage disequilibrium and genetic divergence in an old inversion polymorphism in Drosophila melanogaster (In(3R)Payne) known to be associated with climate change adaptation and a recent invasion event into Australia. We extracted, karyotyped and sequenced whole chromosomes from two Australian populations, so that changes in the arrangement of the alleles between geographically separated tropical and temperate areas could be compared. Chromosome-wide linkage disequilibrium (LD) analysis revealed strong LD within the region spanned by In(3R)Payne. This genomic region also showed strong differentiation between the tropical and the temperate populations, but no differentiation between different karyotypes from the same population, after controlling for chromosomal arrangement. Patterns of differentiation across the chromosome arm and in gene ontologies were enhanced by the presence of the inversion. These data support the notion that inversions are strongly selected by bringing together combinations of genes, but it is still not clear if such combinations act additively or epistatically. Our data suggest that climatic adaptation through inversions can be dynamic, reflecting changes in the relative abundance of different forms of an inversion and ongoing evolution of allelic content within an inversion.

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The aim of this study is to analyze how European integration and, especially, changes in ownership, has affected banking efficiency in Central and Eastern European countries which have recently experimented this process more intensely. Using a stochastic frontier approach (SFA) applied to panel data, we have estimated bank efficiency levels in a sample of 189 banks from 12 countries during the period 2000 to 2008 and we have analyzed the influence of some bank characteristics on these efficiency levels. The results show that European integration has significantly improved the cost efficiency of banks in these countries but profit efficiency has significantly decreased. We have found very small differences between different ownership types and only a very small impact of foreign ownership on cost efficiency, showing that the entry of foreign ownership is not enough to explain the significant variations in banking efficiency after the accession.

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Human cytomegalovirus-induced lesions resembling malignancies have been described in the gastrointestinal tract and include ulcerated or exophytic large masses. The aim of this study was to review the cases registered in the databases of two academic hospitals and formulate a hypothesis concerning the pathogenic mechanisms responsible for cytomegalovirus-induced pseudotumor development. All the diagnoses of human cytomegalovirus infections of the upper gastrointestinal tract recorded from 1991 to 2013 were reviewed. Cases of mucosal alterations misdiagnosed endoscopically as malignancies were selected. Large ulcers occurring in the stomach (three cases) and an irregular exophytic mass at the gastro-jejunal anastomosis were misdiagnosed endoscopically as malignancies (4 cases out of 53). Histologically, all lesions reflected hyperplastic mucosal changes with a prevalence of epithelial and stroma infected cells, without signs of cell atypia. The hypothesis presented is that the development of human cytomegalovirus-induced pseudotumors may be the morphological expression of chronic mucosa damage underlying long-term infection.

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The case of a 41-year-old alcoholic patient who presented with massive upper gastrointestinal bleeding is reported. The diagnosis was established rapidly by endoscopy which revealed bleeding through the papilla of Vater. Selective angiography of the superior mesenteric artery opacified the pancreatic duct as well as the duodenum. CT scan showed signs of chronic pancreatitis. Because of the recurrence of bleeding and shock, an urgent operation was necessary and a Whipple procedure was performed. Recovery was complete. The clinical presentation, the etiology, the diagnostic modalities and the treatment of this particular condition are discussed. Usually, hemorrhage through the pancreatic duct presents as repeated episodes of upper gastrointestinal bleeding with no source found at endoscopy. The presence of chronic pancreatitis or of epigastric pain during bleeding should suggest the diagnosis. Upper gastrointestinal endoscopy and angiography are the principal diagnostic tools. Definitive treatment requires surgery, and resection in most of the cases.

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To characterise the genetics of splenic marginal zone lymphoma (SMZL), we performed whole exome sequencing of 16 cases and identified novel recurrent inactivating mutations in Kruppel-like factor 2 (KLF2), a gene whose deficiency was previously shown to cause splenic marginal zone hyperplasia in mice. KLF2 mutation was found in 40 (42%) of 96 SMZLs, but rarely in other B-cell lymphomas. The majority of KLF2 mutations were frameshift indels or nonsense changes, with missense mutations clustered in the C-terminal zinc finger domains. Functional assays showed that these mutations inactivated the ability of KLF2 to suppress NF-κB activation by TLR, BCR, BAFFR and TNFR signalling. Further extensive investigations revealed common and distinct genetic changes between SMZL with and without KLF2 mutation. IGHV1-2 rearrangement and 7q deletion were primarily seen in SMZL with KLF2 mutation, while MYD88 and TP53 mutations were nearly exclusively found in those without KLF2 mutation. NOTCH2, TRAF3, TNFAIP3 and CARD11 mutations were observed in SMZL both with and without KLF2 mutation. Taken together, KLF2 mutation is the most common genetic change in SMZL and identifies a subset with a distinct genotype characterised by multi-genetic changes. These different genetic changes may deregulate various signalling pathways and generate cooperative oncogenic properties, thereby contributing to lymphomagenesis.

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Objective: The processes of change implied in weight management remain unclear. The present study aimed to identify these processes by validating a questionnaire designed to assess processes of change (the P-Weight) in line with the transtheoretical model. The relationship of processes of change with stages of change and other external variables is also examined. Methods: Participants were 723 people from community and clinical settings in Barcelona. Their mean age was 32.07 (SD = 14.55) years; most of them were women (75.0%), and their mean BMI was 26.47 (SD = 8.52) kg/m2. They all completed the P-Weight and the stages of change questionnaire (SWeight), both applied to weight management, as well as two subscales from the Eating Disorders Inventory-2 and Eating Attitudes Test-40 questionnaires about the concern with dieting. Results: A 34-item version of the PWeight was obtained by means of a refinement process. The principal components analysis applied to half of the sample identified four processes of change. A confirmatory factor analysis was then carried out with the other half of the sample, revealing that the model of four freely correlated first-order factors showed the best fit (GFI = 0.988, AGFI = 0.986, NFI = 0.986, and SRMR = 0.0559). Corrected item-total correlations (0.322-0.865) and Cronbach"s alpha coefficients (0.781-0.960) were adequate. The relationship between the P-Weight and the S-Weight and the concern with dieting measures from other questionnaires supported the validity of the scale. Conclusion: The study identified processes of change involved in weight management and reports the adequate psychometric properties of the P-Weight. It also reveals the relationship between processes and stages of change and other external variables.

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The current challenge in a context of major environmental changes is to anticipate the responses of species to future landscape and climate scenarios. In the Mediterranean basin, climate change is one the most powerful driving forces of fire dynamics, with fire frequency and impact having markedly increased in recent years. Species distribution modelling plays a fundamental role in this challenge, but better integration of available ecological knowledge is needed to adequately guide conservation efforts. Here, we quantified changes in habitat suitability of an early-succession bird in Catalonia, the Dartford Warbler (Sylvia undata) ― globally evaluated as Near Threatened in the IUCN Red List. We assessed potential changes in species distributions between 2000 and 2050 under different fire management and climate change scenarios and described landscape dynamics using a spatially-explicit fire-succession model that simulates fire impacts in the landscape and post-fire regeneration (MEDFIRE model). Dartford Warbler occurrence data were acquired at two different spatial scales from: 1) the Atlas of European Breeding Birds (EBCC) and 2) Catalan Breeding Bird Atlas (CBBA). Habitat suitability was modelled using five widely-used modelling techniques in an ensemble forecasting framework. Our results indicated considerable habitat suitability losses (ranging between 47% and 57% in baseline scenarios), which were modulated to a large extent by fire regime changes derived from fire management policies and climate changes. Such result highlighted the need for taking the spatial interaction between climate changes, fire-mediated landscape dynamics and fire management policies into account for coherently anticipating habitat suitability changes of early succession bird species. We conclude that fire management programs need to be integrated into conservation plans to effectively preserve sparsely forested and early succession habitats and their associated species in the face of global environmental change.

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This special issue of Natural Hazards and Earth System Sciences (NHESS) contains eight papers presented as oral or poster contributions in the Natural Hazards NH-1.2 session on"Extreme events induced by weather and climate change: evaluation, forecasting and proactive planning", held at the European Geosciences Union (EGU) General Assembly in Vienna, Austria, on 13-18 April 2008. The aim of the session was to provide an international forum for presenting new results and for discussing innovative ideas and concepts on extreme hydro-meteorological events, including: (i) the assessment of the risk posed by the extreme events, (ii) the expected changes in the frequency and intensity of the events driven by a changing climate and by multiple human- induced causes, (iii) new modelling approaches and original forecasting methods to predict extreme events and their consequences, and (iv) strategies for hazard mitigation and risk reduction, and for a improved adaptation to extreme hydro-meteorological events ...

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Tutkimuksen tavoite Tutkimuksen tavoite oli kerätä FI:n johdolle tietoa henkilöstön suhtautumisesta organisaatiomuutokseen. Tutkimus toimii pohjana muutosprosessin kriittiselle tarkastelulle ja mahdollisille muutoksille resurssien kohdentamisessa. Tutkimusmenetelmä Organisaatiomuutosta käsittelevä kirjallisuus muodosti tutkielman teoriapohjan. Tutkimuksen aineisto kerättiin kyselylomakkeella FI:n henkilöstölle ja neljällä haastattelulla henkilöstön ja johdon kanssa. Johtopäätökset Yleisesti tuloksista on nähtävissä, että vastaajat ovat aluksi vastustaneet muutosta, vaikka muutos itsessään onkin nähty positiivisena kehityksenä. Vastarintaa ovat aiheuttaneet pääasiallisesti muutoksen johtamisen tyyli ja tiedotuksen kokeminen riittämättömänä.

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This study evaluated the tolerance of mango cultivars 'Haden', 'Palmer', 'Tommy Atkins' and 'Uba' grafted on rootstock 'Imbú' to salt stress using chlorophyll fluorescence. Plants were grown in modified Hoagland solution containing 0, 15, 30, and 45 mmol L-1 NaCl. At 97 days the parameters of the chlorophyll fluorescence (F0, Fm, Fv, F0/Fm, Fv/Fm, Fv'/Fm', ΦPSII = [(Fm'-Fs)/(Fm')], D = (1- Fv'/Fm') and ETR = (ΦPSII×PPF×0,84×0,5) were determined. At 100 days, the leaf emission and leaf area, toxicity and leaf abscission indexes were determined. In all cultivars evaluated, in different degree, there were decreases in photochemical efficiency of photosystem II, enhanced concentrations from 15 mmol L-1 NaCl. The decreases in the potential quantum yield of photosystem II (Fv/Fm) were 27.9, 18.7, 20.5, and 27.4%, for cultivars 'Haden', 'Palmer', 'Tommy Atkins', and 'Uba', respectively, when grown in 45 mmol L-1 NaCl. It was found decreases in leaf emission and mean leaf area in all cultivars from 15 mmol L-1 NaCl. There were increases in leaf toxicity of 33.0, 67.5, 41.6 and 80.8% and in leaf abscission of 71.8, 29.2, 32.5, and 67.9% for the cultivars 'Haden', 'Palmer', 'Tommy Atkins', and 'Uba' respectively, when grown in 45 mmol L-1 NaCl. Leaf toxicity and leaf abscission were not observed in 15 mmol L-1 NaCl. The decrease in Fv/Fm ratio were accompanied by decreasing in leaf emission and increased leaf toxicity index, showing, therefore, the potential of chlorophyll fluorescence in the early detection of salt stress in mango tree.