Cross-sectional study of 168 patients with hepatorenal tyrosinaemia and implications for clinical practice

Background: Hepatorenal tyrosinaemia (Tyr 1) is a rare inborn error of tyrosine metabolism. Without treatment, patients are at high risk of developing acute liver failure, renal dysfunction and in the long run hepatocellular carcinoma. The aim of our study was to collect cross-sectional data. Methods. Via questionnaires we collected retrospective data of 168 patients with Tyr 1 from 21 centres (Europe, Turkey and Israel) about diagnosis, treatment, monitoring and outcome. In a subsequent consensus workshop, we discussed data and clinical implications. Results: Early treatment by NTBC accompanied by diet is essential to prevent serious complications such as liver failure, hepatocellular carcinoma and renal disease. As patients may remain initially asymptomatic or develop uncharacteristic clinical symptoms in the first months of life newborn mass screening using succinylacetone (SA) as a screening parameter in dried blood is mandatory for early diagnosis. NTBC-treatment has to be combined with natural protein restriction supplemented with essential amino acids. NTBC dosage should be reduced to the minimal dose allowing metabolic control, once daily dosing may be an option in older children and adults in order to increase compliance. Metabolic control is judged by SA (below detection limit) in dried blood or urine, plasma tyrosine (<400 μM) and NTBC-levels in the therapeutic range (20-40 μM). Side effects of NTBC are mild and often transient. Indications for liver transplantation are hepatocellular carcinoma or failure to respond to NTBC. Follow-up procedures should include liver and kidney function tests, tumor markers and imaging, ophthalmological examination, blood count, psychomotor and intelligence testing as well as therapeutic monitoring (SA, tyrosine, NTBC in blood). Conclusion: Based on the data from 21 centres treating 168 patients we were able to characterize current practice and clinical experience in Tyr 1. This information could form the basis for clinical practice recommendations, however further prospective data are required to underpin some of the recommendations.

Modulation of the complement system in monocytes contributes to tuberculosis-associated immune reconstitution inflammatory syndrome.

Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a common complication in HIV-TB co-infected patients receiving combined antiretroviral therapy (cART). This study investigated a putative contribution of monocytes to the development of TB-IRIS.

The role of monocytes in the development of Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome

info:eu-repo/semantics/published

Cross-correlation frequency resolved optical gating analysis of broadband continuum generation in photonic crystal fiber: Simulations and experiments

Numerical simulations are used to study the temporal and spectral characteristics of broadband supercontinua generated in photonic crystal fiber. In particular, the simulations are used to follow the evolution with propagation distance of the temporal intensity, the spectrum, and the cross-correlation frequency resolved optical gating (XFROG) trace. The simulations allow several important physical processes responsible for supercontinuum generation to be identified and, moreover, illustrate how the XFROG trace provides an intuitive means of interpreting correlated temporal and spectral features of the supercontinuum. Good qualitative agreement with preliminary XFROG measurements is observed. © 2002 Optical Society of America.

Fracción de metales solubles en sedimentos del cauce del Río Matanza Argentina

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La Educación Matemática en Finlandia: un camino seguro para otros países o una anomalía

Finlandia últimamente ha recibido mucha fama por su éxito en la prueba de PISA. Varios libros, muchos artículos en revistas académicas y en la prensa popular han analizado dicho éxito. ¿Cuáles son algunas de las características demográficas de Finlandia y cómo se comparan con los países del Caribe? ¿Cuáles son algunos de los aspectos principales del éxito de Finlandia? ¿Cómo se comparan con los países del Caribe? ¿Qué debemos aprender de la experiencia de Finlandia?

Maintenance of a case-base for the retrieval of rotationally symmetric shapes for the design of metal castings

In this paper, we discuss the problem of maintenance of a CBR system for retrieval of rotationally symmetric shapes. The special feature of this system is that similarity is derived primarily from graph matching algorithms. The special problem of such a system is that it does not operate on search indices that may be derived from single cases and then used for visualisation and principle component analyses. Rather, the system is built on a similarity metric defined directly over pairs of cases. The problems of efficiency, consistency, redundancy, completeness and correctness are discussed for such a system. Performance measures for the CBR system are given, and the results for trials of the system are presented. The competence of the current case-base is discussed, with reference to a representation of cases as points in an n-dimensional feature space, and a Gramian visualisation. A refinement of the case base is performed as a result of the competence analysis and the performance of the case-base before and after refinement is compared.

Intelligent design assistant (IDA): a case base reasoning system for material and design

This paper describes the approach to the modelling of experiential knowledge in an industrial application of Case-Based Reasoning (CBR). The CBR involves retrieval techniques in conjunction with a relational database. The database is especially designed as a repository of experiential knowledge, and includes qualitative search indices. The system is intended to help design engineers and material engineers in the submarine cable industry. It consists of three parts: a materials database; a database of experiential knowledge; and a CBR system used to retrieve similar past designs based upon component and material qualitative descriptions. The system is currently undergoing user testing at the Alcatel Submarine Networks site in Greenwich.

Developing “middle leaders” in the public services? The realities of management and leadership development for public managers

Purpose – This paper aims to assess the actual contribution to organisational change of management and leadership development (MLD) activity for middle managers (MMs) in public service organisations (PSOs). Design/methodology/approach – Using the case study approach, the paper compares the content and outcomes of management and leadership training interventions for MMs in two large PSOs. The organisations, a fire brigade and a train operating company, are leaders in their sectors with respect to management development and “modernisation” of their services. Findings – The paper demonstrates how, in one case, MM development was largely an exercise in regulatory compliance, with little effect on individual MMs' performance or organisational outcomes. The second case demonstrates how MMs were effectively trained to enforce specific human resource policies which contributed to the successful implementation of top-down strategy yet paid little attention to the potential leadership role of MMs. Research limitations/implications – The paper highlights the need for further contextualised research at organisational level into the outcomes of MLD, especially in terms of different public service contexts. Practical implications – The paper demonstrates the dangers of designing and implementing development programmes without sufficient regard to professional practice and the realities of managerial discretion in PSOs. Originality/value – The paper provides an in-depth and contextualised insight into the conditions for success and failure in management development interventions in PSOs.

Socialising young literacy learners into a discourse of failure: Dominant discourses in literacy teaching and assessment and their impact on the progression of young literacy learners into employment

This paper argues that contemporary literacy programmes are a mismatch for the expectations of both the government and employers as well as the goals of learners. It submits that the dominant discourses in literacy provision have led to the emergence of a learning culture which not only fails the learners but is also incapable of meeting the aspirations of both the government and employers. To support this argument, the paper reports a small scale research project that analyses the perceptions of learners, teachers and employers who were involved in a work placement scheme for young literacy learners in a college of further education. Data for the study were collected through focus group and face to face interviews and analysed using the framework of discourse analysis provided by Gill (2000) with findings codified and analysed thematically. The study found that teachers were aware that their learners were not adequately prepared for the world of work because of the demands of the dominant discourses of quality and performance measurement which were most obviously manifested in their assessment, teaching methods and the attitudes of learners. It found that employers perceive young learners as inadequate in terms of the workplace expectations. Learners in the study revealed that their workplace culture and expectations were totally different from the culture to which they had been socialised in their studies. The study concludes that unless the dominance of these discourses is ameliorated, young literacy learners will continue to be socialised into a discourse of failure.

Twentieth Century Society Spring lecture series: second lives for Twentieth Century masterpieces

The Twentieth Century Society’s Spring lecture series (six in total) looks at the restoration and refurbishment of key C20 buildings in Britain and the US. Buildings covered: BBC Broadcasting House in London (G Val Meyer 1930-32, MacCormac Jamieson Prichard 2000-09). Speaker: Mark Hines (Mark Hines Architects), was the project architect and is the author of The Story of Broadcasting House: Home of the BBC. 5 February 2009. Crown Hall, Chicago (Mies van der Rohe 1952), the Art and Architecture Building, Yale University, New Haven (Paul Rudolf 1961-63) and the former Wills head office in Bristol (SOM with YRM 1970-75). Speaker: Patrick Bellew (Atelier 10 Engineers), 12 February 2009. Center for British Art, Yale University, New Haven (Louis Kahn 1969-77). Speaker: Peter Inskip (Inskip and Jenkins Architects), 17 February 2009. Brunswick Centre London (Patrick Hodgkinson 1967-72; Levitt Bernstein with Patrick Hodgkinson 2006). Speaker: Stuart Tappin (Stand Consulting Engineers Ltd), 26 February 2009. De La Warr Pavilion, Bexhill-on-Sea (Mendelsohn and Chermayeff 1934-5, John McAslan and Partners 2000-05). Speaker: Mark Cannata (HOK Architects), 5 March 2009. Finsbury Health Centre London (Lubetkin & Tecton 1938, first phase of conservation work Avanti Architects 1995.). Speaker: John Allan of Avanti Architects, 12 March 2009.

Education and climate change – some systemic connections

Unlike most papers on education and ecology, this one is not concerned with the content of education but its organisation as a system and hence its purpose or finality. The central contention of the paper, which takes English education and training (or ‘learning’) as a case in point, is that in a new market-state formation the pursuit of short-term goals is tied to the global free-market economy over which any attempt at democratic control has been relinquished. At a time when humanity worldwide faces increasing change in the ecology that sustains it, this is considered to be ‘ecocidally insane’ and the opposite of any sort of learning from experience to alter behaviour in the future. The re-regulated new global market is seen in conclusion as a crisis response to the end of the previous Keynesian welfare nation-state formation. As such, it is argued to be unsustainable in any sense.

The knowledge is out there

Review Essay. On Bourdieu, education and society, by Derek Robbins, Oxford, The Bardwell Press, 2006, 596 pp., £75, ISBN 0-95-486836-6. Bringing knowledge back in, from social constructivism to social realism in the sociology of education, by Michael Young, London, Routledge, 2008, 247 pp.,£23.99, ISBN 9-78-041532-121-1. Personal knowledge, towards a post-critical philosophy, by Michael Polanyi, Chicago, University of Chicago Press, 1962, 428 pp., £18.99, ISBN 0-22-667288-3.