908 resultados para Reserve forces


Relevância:

20.00% 20.00%

Publicador:

Resumo:

Pete Johnston fa un repàs del què poden representar els desenvolupaments recents en el camp de la formació electrònica per als professionals que es fan càrrec dels recursos d'informació requerits com a suport a l'ensenyament i l'aprenentatge.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

BACKGROUND: According to recent guidelines, patients with coronary artery disease (CAD) should undergo revascularization if significant myocardial ischemia is present. Both, cardiovascular magnetic resonance (CMR) and fractional flow reserve (FFR) allow for a reliable ischemia assessment and in combination with anatomical information provided by invasive coronary angiography (CXA), such a work-up sets the basis for a decision to revascularize or not. The cost-effectiveness ratio of these two strategies is compared. METHODS: Strategy 1) CMR to assess ischemia followed by CXA in ischemia-positive patients (CMR + CXA), Strategy 2) CXA followed by FFR in angiographically positive stenoses (CXA + FFR). The costs, evaluated from the third party payer perspective in Switzerland, Germany, the United Kingdom (UK), and the United States (US), included public prices of the different outpatient procedures and costs induced by procedural complications and by diagnostic errors. The effectiveness criterion was the correct identification of hemodynamically significant coronary lesion(s) (= significant CAD) complemented by full anatomical information. Test performances were derived from the published literature. Cost-effectiveness ratios for both strategies were compared for hypothetical cohorts with different pretest likelihood of significant CAD. RESULTS: CMR + CXA and CXA + FFR were equally cost-effective at a pretest likelihood of CAD of 62% in Switzerland, 65% in Germany, 83% in the UK, and 82% in the US with costs of CHF 5'794, euro 1'517, £ 2'680, and $ 2'179 per patient correctly diagnosed. Below these thresholds, CMR + CXA showed lower costs per patient correctly diagnosed than CXA + FFR. CONCLUSIONS: The CMR + CXA strategy is more cost-effective than CXA + FFR below a CAD prevalence of 62%, 65%, 83%, and 82% for the Swiss, the German, the UK, and the US health care systems, respectively. These findings may help to optimize resource utilization in the diagnosis of CAD.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

En aquest treball, s’ha dissenyat un mòdul d’acondicionament a fi de millorar les mesures de conductivitat realitzades amb un AFM (Microscopi de Forces Atòmiques). L’equip actual disposa d’un preamplificador de baix soroll amb un guany de 10 10V/A. Donat que els corrents que es pretenen mesurar són extremadament petits (~pA), s’ha dissenyat un filtre per eliminar diferents fonts de soroll, com ara el soroll que introdueix la xarxa elèctrica a 50Hz. Es pretén reduir aquesta component freqüencial un factor mínim de 10 (20dB). També s’ha afegit un filtre passa baixos per eliminar els soroll que es troba fora de l’amplada de banda del preamplificador. S’ha introduït una etapa d’amplificació de guany variable: 1, 10 i 100 per augmentar la flexibilitat de l’equip i finalment també s’ha dissenyat una etapa per eliminar la tensió d’offset d’aquest amplificador. L’abast del treball anirà des del disseny fins la implementació final sobre una placa PCB.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

OBJECTIVE: To examine whether a caregiver's attachment style is associated with patient cognitive trajectory after traumatic brain injury (TBI). SETTING: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. PARTICIPANTS: Forty Vietnam War veterans with TBI and their caregivers. MAIN OUTCOME MEASURE: Cognitive performance, measured by the Armed Forces Qualification Test percentile score, completed at 2 time points: preinjury and 40 years postinjury. DESIGN: On the basis of caregivers' attachment style (secure, fearful, preoccupied, dismissing), participants with TBI were grouped into a high or low group. To examine the association between cognitive trajectory of participants with TBI and caregivers' attachment style, we ran four 2 × 2 analysis of covariance on cognitive performances. RESULTS: After controlling for other factors, cognitive decline was more pronounced in participants with TBI with a high fearful caregiver than among those with a low fearful caregiver. Other attachment styles were not associated with decline. CONCLUSION AND IMPLICATION: Caregiver fearful attachment style is associated with a significant decline in cognitive status after TBI. We interpret this result in the context of the neural plasticity and cognitive reserve literatures. Finally, we discuss its impact on patient demand for healthcare services and potential interventions.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The Great Tohoku-Kanto earthquake and resulting tsunami has brought considerable attention to the issue of the construction of new power plants. We argue in this paper, nuclear power is not a sustainable solution to energy problems. First, we explore the stock of uranium-235 and the different schemes developed by the nuclear power industry to exploit this resource. Second, we show that these methods, fast breeder and MOX fuel reactors, are not feasible. Third, we show that the argument that nuclear energy can be used to reduce CO2 emissions is false: the emissions from the increased water evaporation from nuclear power generation must be accounted for. In the case of Japan, water from nuclear power plants is drained into the surrounding sea, raising the water temperature which has an adverse affect on the immediate ecosystem, as well as increasing CO2 emissions from increased water evaporation from the sea. Next, a short exercise is used to show that nuclear power is not even needed to meet consumer demand in Japan. Such an exercise should be performed for any country considering the construction of additional nuclear power plants. Lastly, the paper is concluded with a discussion of the implications of our findings.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Sandflies were collected in the base of tree-trunks in the seasons of high and least rainfall in the Ducke Forest Reserve, near Manaus in the State of Amazonas. Lutzomyia umbratilis was the most abundant sandfly species. Caryocar villosum, Chrysophyllum amazonicum, Dinizia excelsa, Eschweilera atropetiolata and Parkia multijuga were the tree species on which most sandflies were collected and relative abundance were related to trunk characteristics. Seasonal patterns of sandfly distribution in the forest were observed.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Forty-four marsupials, 77 rodents and 161 ticks were captured in an Atlantic Forest Reserve in Cotia county, State of São Paulo, where human cases of Lyme disease (LD) simile were reported. Twenty-one borrelia-like spirochete isolates were recovered from the mammals' blood and rodent livers or spleens, and triturated ticks inoculated into BSK II medium. Our results suggest that the reservoirs and ticks collected may harbor borrelia-like spirochetes, some of which have an antigenic similarity with the unknown causative agent of LD simile in Brazil, and/or with North American Borrelia burgdorferi s.s.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

A Protocol for Ensuring Equitable Access to Health and Social Care Services

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Report for the scientific sojourn carried out at the Darmouth College, from august 2007 until february 2008. It has been very successful, from different viewpoints: scientific, philosophical, human. We have definitely advanced, during the past six months, towards the comprehension of the behaviour of the fluctuations of the quantum vacuum in the presence of boundaries, moving and non-moving, and also in situations where the topology of space-time changes: the dynamical Casimir effect, regularization problems, particle creation statistics, according to different BC, etc. We have solved some longstanding problems and got in this subject quite remarkable results (as we will explain in more detail below). We also pursued a general approach towards a viable modified f(R) gravity in both the Jordan and the Einstein frames (which are known to be mathematically equivalent, but physically not so). A class of exponential, realistic modified gravities has been introduced by us and investigated with care. Special focus was made on step-class models, most promising from the phenomenological viewpoint and which provide a natural way to classify all viable modified gravities. One- and two-steps models were considered, but the analysis is extensible to N-step models. Both inflation in the early universe and the onset of recent accelerated expansion arise in these models in a natural, unified way, what makes them very promising. Moreover, it is monstrated in our work that models in this category easily pass all local tests, including stability of spherical body solution, non-violation of Newton's law, and generation of a very heavy positive mass for the additional scalar degree of freedom.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Schistosomiasis mansoni affects the hepatic functional reserve. Clinical treatment with oxamniquine is not 100% effective and there has been found strain of this parasite resistant to this drug. The aims of this investigation were: (1) to examine the presence of residual parasite burden after medical and surgical treatment on adolescents with surgical schistosomiasis mansoni and (2) to assess the effect on the hepatic functional reserve in patients with and without residual infection. Twenty nine children with hepatosplenic schistosomiasis mansoni and bleeding esophageal varices were treated with oxamniquine. They underwent splenectomy, ligature of the left gastric vein and autologous implantation of spleen tissue into the greater omentum. After a mean post-operative follow up of five years they underwent rectal biopsy for schistosomotic egg search. They were divided in patients with and without infection. In 20 patients the submucosal egg search was negative, however, in 9 it was positive. The hepatic functional reserve in the patients without infection was as follows: 17 were Child-Pugh A and 3 Child-Pugh B. In the patients who were still infected 6 were Child-Pugh A and 3 Child-Pugh B. The chi2 analysis of the hepatic functional reserve showed chi2 = 3.19 - p= 0.07. From the results the following conclusion can be drawn: residual infection or reinfection in the follow up period had not interfered with the distribution of the hepatic functional reserve of the patients in this series. However, there was a trend for a decrease of this parameter in patients with residual infection.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

A total of 128 ticks of the genus Amblyomma were recovered from 5 marsupials (Didelphis albiventris) - with 4 recaptures - and 17 rodents (16 Bolomys lasiurus and 1 Rattus norvegicus) captured in an urban forest reserve in Campo Grande, State of Mato Grosso do Sul, Brazil. Of the ticks collected, 95 (78.9%) were in larval form and 22 (21.1%) were nymphs; the only adult (0.8%) was identified as A. cajennense. Viewed under dark-field microscopy in the fourth month after seeding, 9 cultures prepared from spleens and livers of the rodents, blood of the marsupials, and macerates of Amblyomma sp. nymphs revealed spiral-shaped, spirochete-like structures resembling those of Borrelia sp. Some of them showed little motility, while others were non-motile. No such structures could be found either in positive Giemsa-stained culture smears or under electron microscopy. No PCR amplification of DNA from those cultures could be obtained by employing Leptospira sp., B. burgdorferi, and Borrelia sp. primers. These aspects suggest that the spirochete-like structures found in this study do not fit into the genera Borrelia or Leptospira, requiring instead to be isolated for proper identification.