Comorbidity and nutritional indices as predictors of morbidity after transurethral procedures: A prospective cohort study.

INTRODUCTION: Preoperative scores are widely used predictors of complications after major surgery. These scores, however, are not widely used in transurethral procedures. The aim of this study was to assess the value of the Charlson Comorbidity Index (CCI), the age-adjusted CCI, the American Society of Anesthesiologist score (ASA) and the Nutritional Risk Score (NRS) in predicting early morbidity after transurethral urological procedures. METHODS: Consecutive patients undergoing transurethral resection of the bladder or the prostate were prospectively enrolled. The scores were calculated preoperatively; 30-day complications were prospectively recorded according to the Dindo-Clavien classification. Univariate logistic regression was performed to investigate the value of each score and of other factors (i.e., age, sex, body mass index, anemia, smoking habit, type of operation and anaesthesia) as predictors of complications. A multivariate model was then calculated using these predictors. RESULTS: Overall, 197 patients were included. The mean age was 72 (standard deviation ± 10). In total, 26.9% patients had at least 1 complication. Using univariate analysis, we found that each score significantly predicted complications. In multivariate analysis, only the ASA (odds ration [OR] 2.11; 95% confidence interval [CI] 1.01-4.43) and the NRS (OR 2.42; 95% CI 1.56-3.74) remained independent predictors. The best model incorporated ASA, NRS and gender, and predicted morbidity with an area under the curve of 76%. Our study's main limitations are population heterogeneity and limited sample size. CONCLUSION: The ASA and the NRS are important and independent determinants of early morbidity after transurethral procedures. The use of these indices may assist clinicians in the decision-making process to balance the possible benefits of transurethral procedures with the potential risks.

Guía sobre la tributación de las rentas derivadas de la cesión de los derechos de imagen en el IRPF: en particular el régimen especial (artículo 76 Ley del IRPF)

El presente artículo trata la regulación jurídica del derecho al valor comercial de la propia imagen ('Publicity right' según terminología anglosajona), la regulación tributaria del derecho al valor comercial de la propia imagen y el régimen especial de la tributación de rentas derivadas de la cesión del derecho a la explotación comercial de la imagen.

Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes.

BACKGROUND: Both nutritional and genetic factors are involved in the pathogenesis of nonalcoholic fatty liver disease and insulin resistance. OBJECTIVE: The aim was to assess the effects of fructose, a potent stimulator of hepatic de novo lipogenesis, on intrahepatocellular lipids (IHCLs) and insulin sensitivity in healthy offspring of patients with type 2 diabetes (OffT2D)--a subgroup of individuals prone to metabolic disorders. DESIGN: Sixteen male OffT2D and 8 control subjects were studied in a crossover design after either a 7-d isocaloric diet or a hypercaloric high-fructose diet (3.5 g x kg FFM(-1) x d(-1), +35% energy intake). Hepatic and whole-body insulin sensitivity were assessed with a 2-step hyperinsulinemic euglycemic clamp (0.3 and 1.0 mU x kg(-1) x min(-1)), together with 6,6-[2H2]glucose. IHCLs and intramyocellular lipids (IMCLs) were measured by 1H-magnetic resonance spectroscopy. RESULTS: The OffT2D group had significantly (P < 0.05) higher IHCLs (+94%), total triacylglycerols (+35%), and lower whole-body insulin sensitivity (-27%) than did the control group. The high-fructose diet significantly increased IHCLs (control: +76%; OffT2D: +79%), IMCLs (control: +47%; OffT2D: +24%), VLDL-triacylglycerols (control: +51%; OffT2D: +110%), and fasting hepatic glucose output (control: +4%; OffT2D: +5%). Furthermore, the effects of fructose on VLDL-triacylglycerols were higher in the OffT2D group (group x diet interaction: P < 0.05). CONCLUSIONS: A 7-d high-fructose diet increased ectopic lipid deposition in liver and muscle and fasting VLDL-triacylglycerols and decreased hepatic insulin sensitivity. Fructose-induced alterations in VLDL-triacylglycerols appeared to be of greater magnitude in the OffT2D group, which suggests that these individuals may be more prone to developing dyslipidemia when challenged by high fructose intakes. This trial was registered at clinicaltrials.gov as NCT00523562.

Tavaratalojohtajien osaamisesta kohti koko organisaation kehittämistä - Case K-citymarket Oy

Tämän tutkimuksen tavoitteena oli tarkastella tietojohtamista organisaation inhimillisen pääoman (human capital) näkökulmasta. Erityisesti tässä työssä tarkasteltiin johtajien osaamista, motivaatiota ja motivointia, sitoutumista ja sitouttamista sekä johtajien vuorovaikutustaitoja ja edellä mainittujen aiheiden merkitystä organisaatiolle pääomien kasvattamisen näkökulmasta. Tutkimuksen empiirisessä osassa käytettiin kvantitatiivista ja kvalitatiivista tutkimusotetta. Tutkimusmenetelmänä käytettiin SPSS for Windows (12.0.1.) -tilasto-ohjelmaa sekä puolistrukturoituja teemahaastatteluja. Tutkimus osoitti selkeästi inhimillisen pääoman (osaamisen, motivaation ja sitoutumisen) tärkeyden ja merkityksen organisaatiolle. Tulevaisuuden kilpailukyky rakentuu paljolti juuri inhimillisen pääoman varaan. Kilpailukyvyn kannalta juuri inhimillisen pääoman merkityksen tunnistaminen ja hyödyntäminen on tärkeää. Johtajilla on oma merkityksensä organisaation kehitykselle, kuitenkin organisaation koostuu kaikista siinä vaikuttavista ihmisistä.

T&K-yhteistyöprojektinvalintakriteerit ja - päätösprosessi: Case VR Cargo

Tutkimuksen tavoitteena oli löytää yritysten välisten tutkimus- ja kehityshankkeiden valintaan liittyviä kriittisiä tekijöitä ja luoda T&K-verkostojen analysointiin soveltuva malli, jonka avulla tutkimuksen caseyritys VR Cargo voi tehdä päätöksiä panostuksistaan eri hankkeisiin ja ylipäätänsä siitä, missä kannattaa olla mukana sekä kuinka löytää strategisia kehityskumppaneita. Työn teoriaosuus tehtiin kirjallisuuskatsauksena aiempaan T&K-tutkimukseen ja empiria osuus suoritettiin tekemällä teemahaastatteluja VR Cargossa sekä kahdessa vertailuyrityksessä. Tutkimuksessa havaittiin useita erilaisia kriittisiä tekijöitä T&K-yhteistyöhankkeisiin liittyen. Yrityksen on mm. huomioitava T&K-hankkeen strateginen sopivuus ja lisäarvo, määriteltävä motiivit ja riskit, yrityskohtaisten tekijöiden ovat oltava kunnossa, on tiedettävä millainen on yritykselle hyvä ja sopiva partneri sekä yhteistyötason tekijät on huomioitava. Tutkimuksessa rakennettua hankkeiden valintaan liittyvää päätöspuumallia, ei ole tarkoitettu tekemään lopullista valintapäätöstä, vaan sen tarkoituksena on helpottaa ja tukea valintaprosessia ja alentaa näin todennäköisyyttä unohtaa jokin tärkeä seikka valintaprosessissa.

Armazenamento refrigerado sob atmosfera modificada de pedúnculos de cajueiro-anão-precoce dos clones CCP-76, end-157, end-183 e end-189

Pedúnculos de clones de cajueiro-anão-precoce, dos clones CCP-76, END-157, END-183 e END-189, foram armazenados durante 25 dias, sob refrigeração associada a atmosfera modificada, com o objetivo de avaliar o efeito das condições atualmente utilizadas (5ºC e 85-90% de UR) para conservação, transporte e comercialização de cajus in natura. Os pedúnculos foram avaliados a cada 5 dias quanto às seguintes características: perda de peso, firmeza, cor (antocianinas), sólidos e açúcares solúveis, acidez, pH, vitamina C e compostos fenólicos. O uso da refrigeração (5ºC e 85% U.R), associada a atmosfera modificada, proporcionou uma vida útil pós-colheita de 10 dias para o clone END 189, de até 15 dias para o clone END 157 e de até 25 dias para os clones CCP 76 e END 183. A temperatura de 5ºC não se mostrou adequada para armazenamento de pedúnculos de coloração mais intensa (END 157 e END 189) que a testemunha (CCP 76), provocando perda de cor (antocianinas) a partir do 10º dia de armazenamento. A atmosfera modificada reduziu significativamente a perda de peso, favorecendo a aparência do produto para comercialização, independentemente do clone estudado.

Association of MMP-2 polymorphisms with severe and very severe COPD: a case control study of MMPs-1, 9 and 12 in a European population.

BACKGROUND: Genetic factors play a role in chronic obstructive pulmonary disease (COPD) but are poorly understood. A number of candidate genes have been proposed on the basis of the pathogenesis of COPD. These include the matrix metalloproteinase (MMP) genes which play a role in tissue remodelling and fit in with the protease--antiprotease imbalance theory for the cause of COPD. Previous genetic studies of MMPs in COPD have had inadequate coverage of the genes, and have reported conflicting associations of both single nucleotide polymorphisms (SNPs) and SNP haplotypes, plausibly due to under-powered studies. METHODS: To address these issues we genotyped 26 SNPs, providing comprehensive coverage of reported SNP variation, in MMPs- 1, 9 and 12 from 977 COPD patients and 876 non-diseased smokers of European descent and evaluated their association with disease singly and in haplotype combinations. We used logistic regression to adjust for age, gender, centre and smoking history. RESULTS: Haplotypes of two SNPs in MMP-12 (rs652438 and rs2276109), showed an association with severe/very severe disease, corresponding to GOLD Stages III and IV. CONCLUSIONS: Those with the common A-A haplotype for these two SNPs were at greater risk of developing severe/very severe disease (p = 0.0039) while possession of the minor G variants at either SNP locus had a protective effect (adjusted odds ratio of 0.76; 95% CI 0.61 - 0.94). The A-A haplotype was also associated with significantly lower predicted FEV1 (42.62% versus 44.79%; p = 0.0129). This implicates haplotypes of MMP-12 as modifiers of disease severity.

Motion artifact reduction and vessel enhancement for free-breathing navigator-gated coronary MRA using 3D k-space reordering.

Breathing-induced bulk motion of the myocardium during data acquisition may cause severe image artifacts in coronary magnetic resonance angiography (MRA). Current motion compensation strategies include breath-holding or free-breathing MR navigator gating and tracking techniques. Navigator-based techniques have been further refined by the applications of sophisticated 2D k-space reordering techniques. A further improvement in image quality and a reduction of relative scanning duration may be expected from a 3D k-space reordering scheme. Therefore, a 3D k-space reordered acquisition scheme including a 3D navigator gated and corrected segmented k-space gradient echo imaging sequence for coronary MRA was implemented. This new zonal motion-adapted acquisition and reordering technique (ZMART) was developed on the basis of a numerical simulation of the Bloch equations. The technique was implemented on a commercial 1.5T MR system, and first phantom and in vivo experiments were performed. Consistent with the results of the theoretical findings, the results obtained in the phantom studies demonstrate a significant reduction of motion artifacts when compared to conventional (non-k-space reordered) gating techniques. Preliminary in vivo findings also compare favorably with the phantom experiments and theoretical considerations. Magn Reson Med 45:645-652, 2001.

Calculation of Activity Coefficients of Uni-Univalent Electrolytes by Equations Containing No Adjustable Parameters in Aqueous Solutions at 298.15 K

Normally either the Güntelberg or Davies equation is used to predict activity coefficients of electrolytes in dilute solutions when no better equation is available. The validity of these equations and, additionally, of the parameter-free equations used in the Bates-Guggenheim convention and in the Pitzerformalism for activity coefficients were tested with experimentally determined activity coefficients of HCl, HBr, HI, LiCl, NaCl, KCl, RbCl, CsCl, NH4Cl, LiBr,NaBr and KBr in aqueous solutions at 298.15 K. The experimental activity coefficients of these electrolytes can be usually reproduced within experimental errorby means of a two-parameter equation of the Hückel type. The best Hückel equations were also determined for all electrolytes considered. The data used in the calculations of this study cover almost all reliable galvanic cell results available in the literature for the electrolytes considered. The results of the calculations reveal that the parameter-free activity coefficient equations can only beused for very dilute electrolyte solutions in thermodynamic studies.

Potentiometric titration as a method of determining the stoichiometric dissociation constants of weak acids from the thermodynamic dissociation constants of aqueous solutions at 298.15 K

The simple single-ion activity coefficient equation originating from the Debye-Hückel theory was used to determine the thermodynamic and stoichiometric dissociation constants of weak acids from data concerning galvanic cells. Electromotive force data from galvanic cells without liquid junctions, which was obtained from literature, was studied in conjuction with the potentiometric titration data relating to aqueous solutions at 298.15 K. The dissociation constants of weak acids could be determined by the presented techniques and almost all the experimental data studied could be interpreted within the range of experimental error. Potentiometric titration has been used here and the calculation methods were developed to obtain the thermodynamic and stoichiometric dissociation constants of some weak acids in aqueous solutions at 298.15 K. The ionic strength of titrated solutions were adjusted using an inert electrolyte, namely, sodium or potassium chloride. Salt content alonedetermines the ionic strength. The ionic strength of the solutions studied varied from 0.059 mol kg-1 to 0.37 mol kg-1, and in some cases up to 1.0 mol kg-1. The following substances were investigated using potentiometric titration: aceticacid, propionic acid, L-aspartic acid, L-glutamic acid and bis(2,2-dimethyl-3-oxopropanol) amine.

Efeitos da aplicação de calcário no desenvolvimento, no estado nutricional e na produção de matéria seca de mudas de maracujazeiro

Este trabalho objetivou avaliar os efeitos da aplicação de calcário ao substrato de produção das mudas de maracujazeiro, acompanhando os benefícios no desenvolvimento, na produção de matéria seca e no estado nutricional das plantas. O delineamento experimental foi em blocos ao acaso, com cinco tratamentos e quatro repetições. As doses de calcário calcinado foram aplicadas objetivando elevar em meia; uma vez; uma vez e meia, e duas vezes a dose para elevar o V = 80%, correspondendo a 0,44; 0,88; 1,32; 1,76 g por vaso, respectivamente, além da testemunha sem aplicação. As mudas receberam doses de N, P, K, Zn e B de 300; 450; 150; 5,0 e 0,5 mg dm-3, respectivamente, sendo o N e o K parcelados em três vezes (30; 45 e 60 dias após a semeadura). O experimento foi conduzido em casa de vegetação da FCAV/Unesp, em Jaboticabal-SP, no período dezembro/2002 até abril/2003. A unidade experimental foi constituída por vasos com 2 dm³ de substrato de um Latossolo Vermelho distrófico. Após 80 dias da semeadura, avaliaram-se: o diâmetro do caule, a altura, o número de folhas, a área foliar e a matéria seca da parte aérea e das raízes, bem como os teores de macro e micronutrientes. As mudas de maracujazeiro responderam à aplicação de calcário. O maior desenvolvimento das plantas esteve associado à saturação por bases do solo de 56% e a concentrações de Ca e Mg no solo de 20 e 8 mmol c dm-3, e a teores de Ca e Mg na parte aérea de 12,8 e 4,0 g kg-1, respectivamente.

Superfícies de resposta do tangor 'Murcott' à fertilização com N, P e K

O valor de comercialização no mercado de fruta fresca e a maior resistência a doenças, como o declínio e a clorose variegada dos citros, comparado às variedades de laranjas, estimularam a produção de tangerinas e de 'Murcott' na última década. Por outro lado, faltam informações seguras para o diagnóstico das necessidades de adubação para esses cítricos. Assim, o presente trabalho foi planejado com os objetivos de estudar a demanda por nutrientes e estabelecer doses de fertilizantes para maximizar a produtividade e a qualidade dos frutos de tangor 'Murcott' e definir critérios de diagnóstico da análise de folhas para o manejo nutricional dessas plantas. O experimento foi desenvolvido durante seis anos, num pomar comercial da variedade Murcott sobre limoeiro 'Cravo', com 4 anos de idade. Os tratamentos foram arranjados no delineamento fatorial fracionado, do tipo ½ (4³) e constituídos por níveis de N (30; 100; 170 e 240 kg N ha-1), de P (20; 80; 140 e 200 kg ha-1 de P2O5) e de K (30; 110; 190 e 270 kg ha-1 de K2O). O N aumentou a produção média do período, enquanto o efeito do K foi negativo. Não houve efeito significativo para doses de P. A produção máxima de frutos foi obtida com as doses 155; 20 e 30 kg ha-1, respectivamente, de N, P2O5 e K2O, enquanto, para otimizar o tamanho dos frutos, foi necessário elevar a doses de K para 270 kg ha-1 de K2O. Outras características de qualidade dos frutos também foram estudas, bem como critérios para a interpretação de resultados de análises de folhas.

Zn and K influence in fruit sizes of Valencia orange

In orange commercial farms, Zn deficiencies symptoms and small fruits were observed in Corrientes, Argentine. During four years (1995 to 1998), Valencia orange (Citrus sinensis Osb.) on Rough lemon (C. jambhiri Lush.) rootstock, implanted in 1974 in sandy soil, where six treatments were tested. Treatments varied from 1 to 3 Kg KCl.tree-1.year-1 (applied in April and December) with and without Zineb 80, 0,35%. year-1, 20 L. tree-1 (13,3 g Zn.tree-1 applied in December). The experimental design was a randomized complete block with four replications, with a single tree and borders in the experimental plot. Foliar sample were taken every year in Autumn and Summer, foliar concentrations of Zn and K were determined by atomic spectrum absorption. Harvested fruits were classified into small, medium and big. Analysis of Variance, Tukey test and Pearson correlations between production and foliar concentrations were performed. Higher fertilization levels of K with Zn increased medium and big fruits production (Kg and percentage). Foliar concentrations of K and Zn were positively correlated with big and medium fruit production and negatively correlated with small one. Chemical names used: Ethilenbis-ditiocarbamate of Zn (Zineb).

Hormonal regulation of (Na+,K+)-ATPase biosynthesis in the toad bladder. Effect of aldosterone and 3,5,3'-triiodo-L-thyronine.

Aldosterone stimulates transepithelial Na+ transport in the toad bladder, and thyroid hormone antagonizes this mineralocorticoid action. In the present study, we assessed the influence of these two hormones on the biosynthesis of (Na+,K+)ATPase, the major driving force of Na+ transport. Rates of enzyme synthesis were estimated by immunoprecipitation with monospecific alpha (96,000 daltons) and beta (60,000 daltons) subunit antibodies. After a 30-min pulse of intact tissue with [35S]methionine, the anti-alpha-serum recognized the 96,000-dalton alpha subunit and the anti-beta-serum, a 42,000-dalton protein, in total cell extracts. The biosynthesis rates of both these proteins were increased 2.8- and 2.4-fold respectively, over controls by 80 nM aldosterone after 18 h of hormone treatment. The hormonal effect was not apparent up to 3 h of incubation and was dose dependent between 0.2 and 20 nM aldosterone. The hormonal induction was antagonized by spironolactone (500-fold excess) but not by amiloride. The action of aldosterone thus seems to be a receptor-mediated process and a primary event independent of the Na+ permeability of the apical membrane. Thyroid hormone, on the other hand, had no effect on either basal or aldosterone-stimulated synthesis rates of both enzyme proteins. The results demonstrate a direct effect of aldosterone on gene expression of the (Na+,K+)-ATPase. Ultimately, this phenomenon could be linked to the late mineralocorticoid action of this hormone. On the other hand, thyroid hormone, in contrast to the situation in mammals, does not stimulate de novo enzyme synthesis in amphibia. Neither can the antimineralocorticoid action of thyroid hormone in the toad bladder be explained by an inhibition of the (Na+,K+)-ATPase synthesis.