992 resultados para 181-1125B
Resumo:
In the 21st Century much of the world will experience untold wealth and prosperity that could not even be conceived only some three centuries before. However as with most, if not all, of the human civilisations, increases in prosperity have accumulated significant environmental impacts that threaten to result in environmentally induced economic decline. A key part of the world’s response to this challenge is to rapidly decarbonise economies around the world, with options to achieve 60-80 per cent improvements (i.e. in the order of Factor 5) in energy and water productivity now available and proven in every sector. Drawing upon the 2009 publication “Factor 5”, in this paper we discuss how to realise such large-scale improvements, involving complexity beyond technical and process innovation. We begin by considering the concept of greenhouse gas stabilisation trajectories that include reducing current greenhouse gas emissions to achieve a ‘peaking’ of global emissions, and subsequent ‘tailing’ of emissions to the desired endpoint in ‘decarbonising’ the economy. Temporal priorities given to peaking and tailing have significant implications for the mix of decarbonising solutions and the need for government and market assistance in causing them to be implemented, requiring careful consideration upfront. Within this context we refer to a number of examples of Factor 5 style opportunities for energy productivity and decarbonisation, and then discuss the need for critical economic contributions to take such success from examples to central mechanisms in decarbonizing the global economy.
Factors affecting antihypertensive medications adherence among hypertensive patients in Saudi Arabia
Resumo:
Hypertension is a health problem that has increasing prevalence worldwide. Antihypertensive medications are the key for achieving controlled blood pressure. Little is known about predictors of antihypertensive medications adherence in Saudi Arabia. This is a cross-sectional study of 308 participants from a general hospital in Jeddah city, Saudi Arabia conducted between July 2013 and February 2014. Out of the 308 participants, the results showed that 27.9% were classified as perfect adherents and 72.1% were classified as non-perfect adherents to antihypertensive medications. Significant predictors of non-perfect antihypertensive medications in this study were having non-formal education (p=0.031, OR=2.3, 95%CI = [1.82-5]), reporting a poor relationship with physicians (p=0.004, OR=2.25, 95%CI= [1.29-3.9]), and having no co-morbidities (p=0.048, OR=1.86, 95%CI [1.00-3.46]). The outcome of this study highlights the need for policies and interventions that enhance the level of formal education at a population level and improve physician-patient relationships in health care settings.
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Aims The aim of the study was to evaluate the significance of total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyltransferase (GGT) for predicting outcome in sepsis-associated cholestasis. Methods: A retrospective cohort review of the hospital records was performed in 181 neonates admitted to the Neonatal Care Unit. A comparison was performed between subjects with low and high liver values based on cut-off values from ROC analysis. We defined poor prognosis to be when a subject had prolonged cholestasis of more than 3.5 months, developed severe sepsis, septic shock or had a fatal outcome. Results: The majority of the subjects were male (56%), preterm (56%) and had early onset sepsis (73%). The poor prognosis group had lower initial values of GGT compared with the good prognosis group (P = 0.003). Serum GGT (cut-off value of 85.5 U/L) and AST (cut-off value of 51 U/L) showed significant correlation with the outcome following multivariate analysis. The odds ratio (OR) of low GGT and high AST were OR 4.3 (95% CI:1.6 to11.8) and OR 2.9 (95% CI:1.1 to 8), respectively, for poor prognosis. In subjects with normal AST values, those with low GGT value had relative risk of 2.52 (95% CI:1.4 to 3.5) for poorer prognosis compared with those with normal or high GGT. Conclusion: Serum GGT and AST values can be used to predict the prognosis of patients with sepsis-associated cholestasis
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Background We have previously demonstrated that circulating NT-proBNP is truncated at the N and C termini. Aims of this study are three-fold: firstly to determine whether the NT-proBNP levels correlate with NYHA functional classes when measuring with different antibody pairs; secondly to evaluate the diagnostic potential of ProBNP and; thirdly to investigate whether combining NT-proBNP assays with or without ProBNP would lead to better diagnostic accuracies. Methods Plasma samples were collected from healthy controls (n = 52) and HF patients (n = 46). Customized AlphaLISA® immunoassays were developed and validated to measure the concentrations of proBNP and NT-proBNP (with antibodies targeting 13–45, 13–76, 28–76). The diagnostic performance and predictive value of proBNP and NT-proBNP assays and their combinations were evaluated. Results Plasma proBNP assay showed acceptable diagnostic performance. NT-proBNP13–76 assay is useful in diagnosing and stratifying HF patients. The diagnostic performance of NT-proBNP13–76 demonstrated improvement over commercial NT-proBNP tests. The combination of NT-proBNP13–76 with NT-proBNP28–76 assays gave the best diagnostic assay performance. Conclusion Our results demonstrate that while there is major heterogeneity in circulating NT-proBNP, specific epitopes of the peptides are extraordinarily stable, providing ideal targets for clinically useful diagnostic assays. Future new clinical diagnostic clinical trials should include a multimarker approach rather than using a single marker to diagnose HF.
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Aims Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Methods Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Results Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290–0.811, p<0.001; and 0.762, 95% CI 0.303–1.221, p = 0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181– 0.753, p = 0.001). Statistical heterogeneity between studies was moderate. Conclusions Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.
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Summary High bone mineral density on routine dual energy X-ray absorptiometry (DXA) may indicate an underlying skeletal dysplasia. Two hundred fifty-eight individuals with unexplained high bone mass (HBM), 236 relatives (41% with HBM) and 58 spouses were studied. Cases could not float, had mandible enlargement, extra bone, broad frames, larger shoe sizes and increased body mass index (BMI). HBM cases may harbour an underlying genetic disorder. Introduction High bone mineral density is a sporadic incidental finding on routine DXA scanning of apparently asymptomatic individuals. Such individuals may have an underlying skeletal dysplasia, as seen in LRP5 mutations. We aimed to characterize unexplained HBM and determine the potential for an underlying skeletal dysplasia. Methods Two hundred fifty-eight individuals with unexplained HBM (defined as L1 Z-score ≥ +3.2 plus total hip Z-score ≥ +1.2, or total hip Z-score ≥ +3.2) were recruited from 15 UK centres, by screening 335,115 DXA scans. Unexplained HBM affected 0.181% of DXA scans. Next 236 relatives were recruited of whom 94 (41%) had HBM (defined as L1 Z-score + total hip Z-score ≥ +3.2). Fifty-eight spouses were also recruited together with the unaffected relatives as controls. Phenotypes of cases and controls, obtained from clinical assessment, were compared using random-effects linear and logistic regression models, clustered by family, adjusted for confounders, including age and sex. Results Individuals with unexplained HBM had an excess of sinking when swimming (7.11 [3.65, 13.84], p < 0.001; adjusted odds ratio with 95% confidence interval shown), mandible enlargement (4.16 [2.34, 7.39], p < 0.001), extra bone at tendon/ligament insertions (2.07 [1.13, 3.78], p = 0.018) and broad frame (3.55 [2.12, 5.95], p < 0.001). HBM cases also had a larger shoe size (mean difference 0.4 [0.1, 0.7] UK sizes, p = 0.009) and increased BMI (mean difference 2.2 [1.3, 3.1] kg/m 2, p < 0.001). Conclusion Individuals with unexplained HBM have an excess of clinical characteristics associated with skeletal dysplasia and their relatives are commonly affected, suggesting many may harbour an underlying genetic disorder affecting bone mass.
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Permissions are special case of deontic effects and play important role compliance. Essentially they are used to determine the obligations or prohibitions to contrary. A formal language e.g., temporal logic, event-calculus et., not able to represent permissions is doomed to be unable to represent most of the real-life legal norms. In this paper we address this issue and extend deontic-event-calculus (DEC) with new predicates for modelling permissions enabling it to elegantly capture the intuition of real-life cases of permissions.
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The baculovirus expression system using the Autographa californica nuclear polyhedrosis virus (AcNPV) has been extensively utilized for high-level expression of cloned foreign genes, driven by the strong viral promoters of polyhedrin (polh) and p10 encoding genes. A parallel system using Bombyx mori nuclear polyhedrosis virus (BmNPV) is much less exploited because the choice and variety of BmNPV-based transfer vectors are limited. Using a transient expression assay, we have demonstrated here that the heterologous promoters of the very late genes polh and p10 from AcNPV function as efficiently in BmN cells as the BmNPV promoters. The location of the cloned foreign gene with respect to the promoter sequences was critical for achieving the highest levels of expression, following the order +35 > +1 > -3 > -8 nucleotides (nt) with respect to the polh or p10 start codons. We have successfully generated recombinant BmNPV harboring AcNPV promoters by homeologous recombination between AcNPV-based transfer vectors and BmNPV genomic DNA. Infection of BmN cell lines with recombinant BmNPV showed a temporal expression pattern, reaching very high levels in 60-72 h post infection. The recombinant BmNPV harboring the firefly luciferase-encoding gene under the control of AcNPV polh or p10 promoters, on infection of the silkworm larvae led to the synthesis of large quantities of luciferase. Such larvae emanated significant luminiscence instantaneously on administration of the substrate luciferin resulting in 'glowing silkworms'. The virus-infected larvae continued to glow for several hours and revealed the most abundant distribution of virus in the fat bodies. In larval expression also, the highest levels were achieved when the reporter gene was located at +35 nt of the polh.
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Modeling and analysis of wave propagation in elastic solids undergoing damage and growth process are reported in this paper. Two types of diagnostic problems, (1) the propagation of waves in the presence of a slow growth process and (2) the propagation of waves in the presence of a fast growth process, are considered. The proposed model employs a slow and a fast time scale and a homogenization technique in the wavelength scale. A detailed analysis of wave dispersion is carried out. A spectral analysis reveals certain low-frequency bands, where the interaction between the wave and the growth process produces acoustic metamaterial-like behavior. Various practical issues in designing an efficient method of acousto-ultrasonic wave based diagnostics of the growth process are discussed. Diagnostics of isotropic damage in a ductile or quasi-brittle solid by using a micro-second pulsating signal is considered for computer simulations, which is to illustrate the practical application of the proposed modeling and analysis. The simulated results explain how an estimate of signal spreading can be effectively employed to detect the presence of a steady-state damage or the saturation of a process.
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This paper presents an off-line (finite time interval) and on-line learning direct adaptive neural controller for an unstable helicopter. The neural controller is designed to track pitch rate command signal generated using the reference model. A helicopter having a soft inplane four-bladed hingeless main rotor and a four-bladed tail rotor with conventional mechanical controls is used for the simulation studies. For the simulation study, a linearized helicopter model at different straight and level flight conditions is considered. A neural network with a linear filter architecture trained using backpropagation through time is used to approximate the control law. The controller network parameters are adapted using updated rules Lyapunov synthesis. The off-line trained (for finite time interval) network provides the necessary stability and tracking performance. The on-line learning is used to adapt the network under varying flight conditions. The on-line learning ability is demonstrated through parameter uncertainties. The performance of the proposed direct adaptive neural controller (DANC) is compared with feedback error learning neural controller (FENC).
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A mathematician tends to have an intense relationship with treatises – one which is more akin to that of a historian than that of her colleagues in the ‘hard’ sciences. A book may be a century or two old and still be relevant as a source of information or inspiration, well-thumbed textbooks from youth might be still consulted decades later, and fierce arguments rage about relative merits of different treatments of the same subject. And much like any book-lover, a mathematician is forever arguing with herself whether she can afford to buy this volume or the other. When the price label is in dollars or euros and the salary paid in rupees, this last dilemma is particularly acute.
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Aerosols from biomass burning can alter the radiative balance of the Earth by reflecting and absorbing solar radiation(1). Whether aerosols exert a net cooling or a net warming effect will depend on the aerosol type and the albedo of the underlying surface(2). Here, we use a satellite-based approach to quantify the direct, top-of-atmosphere radiative effect of aerosol layers advected over the partly cloudy boundary layer of the southeastern Atlantic Ocean during July-October of 2006 and 2007. We show that the warming effect of aerosols increases with underlying cloud coverage. This relationship is nearly linear, making it possible to define a critical cloud fraction at which the aerosols switch from exerting a net cooling to a net warming effect. For this region and time period, the critical cloud fraction is about 0.4, and is strongly sensitive to the amount of solar radiation the aerosols absorb and the albedo of the underlying clouds. We estimate that the regional-mean warming effect of aerosols is three times higher when large-scale spatial covariation between cloud cover and aerosols is taken into account. These results demonstrate the importance of cloud prediction for the accurate quantification of aerosol direct effects.
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A modified method has been developed for the deposition of transparent semiconducting thin films of tin oxide, involving the chemical vapour phase oxidation of tin iodide. These films show sheet resistances greater than 100 Ω/□ and an average optical transmission in the visible range exceeding 80%. The method avoids uncontrolled contamination, resulting in better reproducibility of the films. The films showed direct and indirect transitions and the possibility of an indirect forbidden transition. X-ray diffraction studies reveal that the films are polycrystalline. The low mobility values of the films have been attributed to the grain boundary scattering effect.
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Carol and I just missed each other in the early 1990s: Carol left Manchester for Australia in 1990, while I an·iv·ed in Manchester from Australia in 1993. Sixteen years later and on the very opposite side of the world, we found ourselves sharing an adjacent room during the 2009 Agri-Food Research Network conference in Auckland. Carol was already an accomplished sociologist; I was a newbie PhD student, presenting on a thesis topic that was only just starting to take shape...
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Grass and broad-leaved weeds can reduce both yields and product marketability of desmanthus (Desmanthus virgatus) seed crops, even when cultural control strategies are used. Selective herbicides might economically control these weeds, but, prior to this study, the few herbicides tolerated by desmanthus did not control key weed contaminants of desmanthus seed crops. In this study, the tolerance of desmanthus cv. Marc to 55 herbicides used for selective weed control in other leguminous crops was assessed in 1 pot trial and 3 Queensland field trials. One field trial assessed the tolerance of desmanthus seedlings to combinations of the most promising pre-emergent and post emergent herbicides. The pre-emergent herbicides, imazaquin, imazethapyr, pendimethalin, oryzalin and trifluralin, gave useful weed control with very little crop damage. The post-emergent herbicides, haloxyfop, clethodim, propyzamide, carbetamide and dalapon, were safe for controlling grass weeds in desmanthus. Selective post-emergence control of broad-leaved weeds was achieved using bentazone, bromoxynil and imazethapyr. One trial investigated salvaging second-year desmanthus crops from mature perennial weeds, and atrazine, terbacil and hexazinone showed some potential in this role. Overall, our results show that desmanthus tolerates herbicides which collectively control a wide range of weeds encountered in Queensland. These, in combination with cultural weed control strategies, should control most weeds in desmanthus seed crops.