A singular function and its relation with the number systems involved in its definition

Minkowski's ?(x) function can be seen as the confrontation of two number systems: regular continued fractions and the alternated dyadic system. This way of looking at it permits us to prove that its derivative, as it also happens for many other non-decreasing singular functions from [0,1] to [0,1], when it exists can only attain two values: zero and infinity. It is also proved that if the average of the partial quotients in the continued fraction expansion of x is greater than k* =5.31972, and ?'(x) exists then ?'(x)=0. In the same way, if the same average is less than k**=2 log2(F), where F is the golden ratio, then ?'(x)=infinity. Finally some results are presented concerning metric properties of continued fraction and alternated dyadic expansions.

El impacto de los servicios sanitarios sobre la salud

This paper reviews what has increased medical-care spending bought in terms of health benefitswith longitudinal data from the U.S and, more limited, from Spain. Health services contributionto health has been positive in average, especially during the last 50 years for the U.S andthe last 30 years for Spain. This contribution differs among countries and is much greater forsome diseases (cardiovascular) than for others (cancer). Benefits from health care interventionscan be valued on basis on the social willin gness to pay, observed or declared on the process ofestablishing health policy priorities. 30.000 euros per Quality Adjusted Life Year could providean efficiency threshold for financing publicly health services in Spain: Consensus andlegitimacy of the political process of establishing health priorities becomes, however, moreimportant than any approximate number. Attention is paid finally to bridging the gap betweenefficacy (the possibilities given by innovation and resources devoted to health care) andeffectiveness (the distance to the frontier) of the everyday working of a health system with itsinappropriate care and limited application of the existing knowledge.

L'Evidence-based nursing, un levier au changement des pratiques infirmières [Evidence-based nursing, a driver for change in nursing practice].

A urology nursing team examined its perioperative practices in the light of scientific data and implemented updated care practices adapted to this context.This experience favours the development of skills essential for interdisciplinary collaboration drawing on the resources of each profession, to work towards a common goal for the benefit of the patient.

The PPARbeta/delta agonist GW0742 relaxes pulmonary vessels and limits right heart hypertrophy in rats with hypoxia-induced pulmonary hypertension.

BACKGROUND: Pulmonary vascular diseases are increasingly recognised as important clinical conditions. Pulmonary hypertension associated with a range of aetiologies is difficult to treat and associated with progressive morbidity and mortality. Current therapies for pulmonary hypertension include phosphodiesterase type 5 inhibitors, endothelin receptor antagonists, or prostacyclin mimetics. However, none of these provide a cure and the clinical benefits of these drugs individually decline over time. There is, therefore, an urgent need to identify new treatment strategies for pulmonary hypertension. METHODOLOGY/PRINCIPAL FINDINGS: Here we show that the PPARbeta/delta agonist GW0742 induces vasorelaxation in systemic and pulmonary vessels. Using tissue from genetically modified mice, we show that the dilator effects of GW0742 are independent of the target receptor PPARbeta/delta or cell surface prostacyclin (IP) receptors. In aortic tissue, vascular relaxant effects of GW0742 were not associated with increases in cGMP, cAMP or hyperpolarisation, but were attributed to inhibition of RhoA activity. In a rat model of hypoxia-induced pulmonary hypertension, daily oral dosing of animals with GW0742 (30 mg/kg) for 3 weeks significantly reduced the associated right heart hypertrophy and right ventricular systolic pressure. GW0742 had no effect on vascular remodelling induced by hypoxia in this model. CONCLUSIONS/SIGNIFICANCE: These observations are the first to show a therapeutic benefit of 'PPARbeta/delta' agonists in experimental pulmonary arterial hypertension and provide pre-clinical evidence to favour clinical trials in man.

Sedation and analgesia for colonoscopy: patient tolerance, pain, and cardiorespiratory parameters.

BACKGROUND: Colonoscopy is generally performed with the patient sedated and receiving analgesics. However, the benefit of the most often used combination of intravenous midazolam and pethidine on patient tolerance and pain and its cardiorespiratory risk have not been fully defined. METHODS: In this double-blind prospective study, 150 outpatients undergoing routine colonoscopy were randomly assigned to receive either (1) low-dose midazolam (35 micrograms/kg) and pethidine (700 micrograms/kg in 48 patients, 500 micrograms/kg in 102 patients), (2) midazolam and placebo pethidine, or (3) pethidine and placebo midazolam. RESULTS: Tolerance (visual analog scale, 0 to 100 points: 0 = excellent; 100 = unbearable) did not improve significantly more in group 1 compared with group 2 (7 points; 95% confidence interval [-2-17]) and group 3 (2 points; 95% confidence interval [-7-12]). Similarly, pain was not significantly improved in group 1 as compared with the other groups. Male gender (p < 0.001) and shorter duration of the procedure (p = 0.004), but not amnesia, were associated with better patient tolerance and less pain. Patient satisfaction was similar in all groups. Oxygen desaturation and hypotension occurred in 33% and 11%, respectively, with a similar frequency in all three groups. CONCLUSIONS: In this study, the combination of low-dose midazolam and pethidine does not improve patient tolerance and lessen pain during colonoscopy as compared with either drug given alone. When applying low-dose midazolam, oxygen desaturation and hypotension do not occur more often after combined use of both drugs. For the individual patient, sedation and analgesia should be based on the endoscopist's clinical judgement.

Tax Credits Contingent Liabilities Brief December 8, 2006

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief April 2, 2007

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief July 17, 2007

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief October 3, 2007

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief December 7, 2007

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief April 2, 2008

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief July 31, 2008

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Tax Credits Contingent Liabilities Brief, October 3, 2008

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.

Percepció de dificultat i esforç en la mobilització de persones dependents, en el seu entorn domiciliari, per part dels seus cuidadors, abans i després de la utilització de llençols lliscants

Les persones amb dependència necessiten ajuda en la mobilització al llit, que suposa un esforç per a la persona cuidadora. La percepció de dificultat en dur a terme aquestes tasques pot afectar negativament la qualitat de vida de les persones cuidadores i també la de les persones dependents. L’objectiu d’aquest estudi va ser investigar si la utilització de superfícies de reducció de la fricció (tipus llençols lliscants) redueix la dificultat percebuda per les persones cuidadores i les persones dependents en la mobilització al llit. Mètodes: es va dur a terme un estudi quasi experimental a domicili en una mostra seleccionada a conveniència de 12 persones amb dependència i els seus cuidadors en diverses localitats. Es va avaluar la percepció de dificultat en la mobilització per part dels cuidadors i les persones dependents abans i després d’una intervenció formativa simultània a la utilització de llençols lliscants. Resultats: el perfil del cuidador és el d’una dona de mitjana edat amb una relació filial amb la persona dependent i sense formació específica en mètodes de mobilització de persones dependents. El perfil de la persona dependent és el d’una dona major de 80 anys amb una gran dependència que necessita ajuda de la persona que la cuida en les maniobres de redreçament i trasllat al llit. En una escala de percepció de la dificultat de 0 a 10, les mitjanes de les puntuacions observades en els cuidadors abans de la intervenció van ser de 6,9 (DE: 3,1) en el redreçament cap amunt i de 7,1 (DE: 3,1) en el trasllat lateral; després de la intervenció van ser d’1,25 (DE: 1,8) en el redreçament cap amunt i d’1,45 (DE: 1,6) en la mobilització lateral. En la mateixa escala, les mitjanes de les puntuacions observades en les persones dependents abans de la intervenció van ser de 8,6 (DE: 2,3) en el redreçament cap amunt i de 8,6 (DE: 2,3) en el trasllat cap als costats, i després de la intervenció van ser de 2 (DE: 2,6) en els redreçaments cap amunt i de 2 (DE: 2,6) en els trasllats cap als costats. Comparant les puntuacions d’abans i després de la intervenció, observem que la dificultat percebuda per part dels cuidadors de les persones dependents va disminuir de manera significativa (p & 0,001); en les persones dependents també va disminuir, però la disminució no va arribar a ser significativa (p = 0,057). Conclusions: els resultats observats mostren que la utilització de llençols lliscants millora la qualitat de vida dels cuidadors, mesurada per la percepció de la dificultat en les maniobres de mobilització al llit. Així mateix, la seva utilització pot contribuir a un millor envelliment actiu. Caldria fer estudis que permetin quantificar l’esforç físic necessari i el cost-benefici que suposa la utilització d’aquests dispositius.

Tax Credits Contingent Liabilities Brief December 8, 2008

The Tax Credits Contingent Liabilities Report was created by the Tax Research and Program Analysis Section of the Iowa Department of Revenue (IDR) for the benefit of the Revenue Estimating Conference (REC). This report is part of the Tax Credits Tracking and Analysis Program. The goal of the program is to provide a repository for information concerning the awarding, usage, and effectiveness of tax credits. This report forecasts tax credit claims assuming that all available awarded credits are issued and then, along with forecasted credits, are subsequently claimed.