992 resultados para Direct tool
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Objective: To assess the possibility of Dentists being able to screen patients with higher risk of vascular diseases. Materials: Kodak 8000C Orthopantomographer, eco-Doppler Logiq-500 General Electric at the Lisbon Hospital Particular. Methods: Assessment of orthopantomographies made to 142 patients aged 50 or more, as well as the existing risk factors. Conduction of carotid eco-Doppler to patients who appear to have calcified plaques of the atheroma. Results: Strong dependence between dichotomised age and having the pathology (p = 0.02).Smokers are twice more likely to present plaques (OR= 2). Being hypertensive increases in about 1.4 the likelihood of having a stroke (OR= 1.4). Of the 27 individuals who presented calcifications in the Orthopantomography, they were all submitted to an eco-Doppler and 21 had the pathology confirmed. 27 individuals, who did not show any plaques in the Orthopantomography, were randomly selected to be the control group. They were submitted to an eco-Doppler. And 23 confirmed the non-existence of plaques. Conclusions: Orthopantomography used for assessing the oral cavity reveals more information which should be the object of the Dentist"s attention
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In this master's thesis a mechanical model that is driven with variable speed synchronous machine was developed. The developed mechanical model simulates the mechanics of power transmission and its torsional vibrations. The mechanical model was developed for the need of the branched mechanics of a rolling mill and the propulsion system of a tanker. First, the scope of the thesis was to clarify the concepts connected to the mechanical model. The clarified concepts are the variable speed drive, the mechanics of power transmission and the vibrationsin the power transmission. Next, the mechanical model with straight shaft line and twelve moments of inertia that existed in the beginning was developed to be branched considering the case of parallel machines and the case of parallel rolls. Additionally, the model was expanded for the need of moreaccurate simulation to up to thirty moments of inertia. The model was also enhanced to enable three phase short circuit situation of the simulated machine. After that the mechanical model was validated by comparing the results of the developed simulation tool to results of other simulation tools. The compared results are the natural frequencies and mode shapes of torsional vibration, the response of the load torque step and the stress in the mechanical system occurred by the permutation of the magnetic field that is arisen from the three phase short circuit situation. The comparisons were accomplished well and the mechanical model was validated for the compared cases. Further development to be made is to develop the load torque to be time-dependent and to install two frequency converters and two FEM modeled machines to be simulated parallel.
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The complex chemical and physical nature of combustion and secondary organic aerosols (SOAs) in general precludes the complete characterization of both bulk and interfacial components. The bulk composition reveals the history of the growth process and therefore the source region, whereas the interface controls--to a large extent--the interaction with gases, biological membranes, and solid supports. We summarize the development of a soft interrogation technique, using heterogeneous chemistry, for the interfacial functional groups of selected probe gases [N(CH(3))(3), NH(2)OH, CF(3)COOH, HCl, O(3), NO(2)] of different reactivity. The technique reveals the identity and density of surface functional groups. Examples include acidic and basic sites, olefinic and polycyclic aromatic hydrocarbon (PAH) sites, and partially and completely oxidized surface sites. We report on the surface composition and oxidation states of laboratory-generated aerosols and of aerosols sampled in several bus depots. In the latter case, the biomarker 8-hydroxy-2'-deoxyguanosine, signaling oxidative stress caused by aerosol exposure, was isolated. The increase in biomarker levels over a working day is correlated with the surface density N(i)(O3) of olefinic and/or PAH sites obtained from O(3) uptakes as well as with the initial uptake coefficient, γ(0), of five probe gases used in the field. This correlation with γ(0) suggests the idea of competing pathways occurring at the interface of the aerosol particles between the generation of reactive oxygen species (ROS) responsible for oxidative stress and cellular antioxidants.
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Tumour localisation and tumour to normal tissue ratios of a chimeric anti-carcinoembryonic antigen (CEA) monoclonal antibody (MAb), in intact form and as an F(ab')2 fragment labelled with 125I and 131I, were compared in groups of nude mice bearing four different colon cancer xenografts, T380, Co112 or LoVo, of human origin, or a rat colon cancer transfected with human CEA cDNA, called '3G7'. For each tumour, three to four mice per time point were analysed 6, 12, 24, 48 and 96 h after MAb injection. In the different tumours, maximal localisation of intact MAb was obtained at 24 to 48 h, and of F(ab')2 fragment 12 to 24 h after injection. Among the different tumours, localisation was highest with colon cancer T380, with 64% of the injected dose per gram (% ID/g) for the intact MAb and 57% for its F(ab')2 fragment, while in the three other tumours, maximal localisation ranged from 14 to 22% ID g-1 for the intact MAb and was about 11% for the F(ab')2. Tumour to normal tissue ratios of intact MAb increased rapidly until 24 h after injection and remained stable or showed only a minor increase thereafter. In contrast, for the F(ab')2 fragment, the tumour to normal tissue ratios increased steadily up to 4 days after injection reaching markedly higher values than those obtained with intact MAb. For the four different xenografts, tumour to blood ratios of F(ab')2 were about 2, 3 and 5 to 16 times higher than those of intact antibodies at 12, 24 and 96 h after injection, respectively.
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Tavoitteena diplomityössä oli tutkia, miten hankintastrategiaa saataisiin paremmin toteutettua jokapäiväisessä työssä. Strategian implementointiin käytettiin strategiakarttaa sekä balanced scorecard -mittareita. Tutkimus toteutettiin hankintaosastolla Vaasan & Vaasan Oy:ssä, joka toimii leipomotoimialalla viidessä maassa Itämeren alueella. Hankinnan strategiakartta ja balanced scorecard -mittarit laadittiin olemassa olevan hankintastrategian pohjalta. Perinteisiä balanced scorecard -näkökulmia muokattiin paremmin hankintatoimeen sopiviksi. Malliin lisättiin toimittajanäkökulma ja hankinnan rooli pääprosessien tukifunktiona otettiin huomioon muuttamalla balanced scorecardin asiakasnäkökulma sisäisen asiakkaan näkökulmaksi. Strategiakartta myös laadittiin niin, että hankinnan sisäisten asiakkaiden odotukset ovat kartassa tasavertaisina taloudellistentavoitteiden kanssa. Balanced scorecard -mittareiden määrä pidettiin pienenä, jotta niiden toimintaa ohjaava vaikutus olisi mahdollisimman suuri. Mittareita voidaan vaihtaa strategian muuttuessa. Työssä todettiin, että strategiakartta ja balanced scorecard ovat hyviä välineitä strategian muuttamiseen konkreettisiksi toimenpiteiksi myös tukifunktiossa, kun esimerkiksi mallin näkökulmia muokataan tapauskohtaisesti. Strategiakartat ja balanced scorecard tulisi kytkeä osaksi koko yrityksen strategista suunnittelua. Strategiakartan ja balanced scorecardin käytöstä on hankinnalle monia hyötyjä. Työntekijät hahmottavat paremmin oman panoksensa yrityksen tavoitteiden saavuttamisessa. Käytetyt työkalut voivat tukea myös konsernin yksiköiden hankintojen keskittämiskehitystä.
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This article details the use of photographic rectification as support for the graphic documentation of historical and archaeological heritage and specifically the southern facade of the Torre del Pretori (Praetorium Tower) in Tarragona. The Praetorium Tower is part of a larger monumental complex and one of the towers that connected different parts of the Tarraco Provincial Forum, the politic-administrative centre of the ancient capital of Hispania Citerioris. It is therefore a valuable example of the evolution of Roman urban architecture. The aim of this project is to provide accurate graphic documentation of the structure to facilitate the restoration and conservation of the tower, as well as to provide a more profound architectural and archaeological understanding of the Roman forum. The use of photographic rectification enabled us to overcome the spatial and time difficulties involved in collecting data caused by the size and location of the building. Specific software made it easier to obtain accurate two-dimensional images. For this reason, in our case, photographic rectification helped us to make a direct analysis of the monument and facilitated interpretation of the architectural stratigraphy. We currently separate the line of research into two concepts: the construction processes and the architecture of the building. The documentation collected permitted various analyses: the characterisation of the building modules, identification of the tools used to work the building materials, etc. In conclusion, the use of orthoimages is a powerful tool that permits the systematic study of a Roman building that has evolved over the centuries and is now in a modern urban context.
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Background Analysing the observed differences for incidence or mortality of a particular disease between two different situations (such as time points, geographical areas, gender or other social characteristics) can be useful both for scientific or administrative purposes. From an epidemiological and public health point of view, it is of great interest to assess the effect of demographic factors in these observed differences in order to elucidate the effect of the risk of developing a disease or dying from it. The method proposed by Bashir and Estève, which splits the observed variation into three components: risk, population structure and population size is a common choice at practice. Results A web-based application, called RiskDiff has been implemented (available at http://rht.iconcologia.net/riskdiff.htm webcite), to perform this kind of statistical analyses, providing text and graphical summaries. Code from the implemented functions in R is also provided. An application to cancer mortality data from Catalonia is used for illustration. Conclusions Combining epidemiological with demographical factors is crucial for analysing incidence or mortality from a disease, especially if the population pyramids show substantial differences. The tool implemented may serve to promote and divulgate the use of this method to give advice for epidemiologic interpretation and decision making in public health.
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This paper aims to present an ePortfolio project led for two years in a multilingual and interdisciplinary Master's program in public discourse and communication analysis offered by the Faculty of Arts of the University of Lausanne (Switzerland). Globally, the project - named Learn to communicate skills - offers a reflection about academic skills and their transferability to the professional world. More precisely, the aim of the project is to make students aware of the importance of reflexive learning to make their skills transferable to other contexts.
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Low energy x-ray fluorescence (LEXRF) detection was optimized for imaging cerebral glucose metabolism by mapping the fluorine LEXRF signal of 19 F in 19 FDG, trapped as intracellular 19 F-deoxyglucose-6-phosphate ( 19 FDG-6P) at 1μm spatial resolution from 3μm thick brain slices. 19 FDG metabolism was evaluated in brain structures closely resembling the general cerebral cytoarchitecture following formalin fixation of brain slices and their inclusion in an epon matrix. 2-dimensional distribution maps of 19 FDG-6P were placed in a cytoarchitectural and morphological context by simultaneous LEXRF mapping of N and O, and scanning transmission x-ray (STXM) imaging. A disproportionately high uptake and metabolism of glucose was found in neuropil relative to intracellular domains of the cell body of hypothalamic neurons, showing directly that neurons, like glial cells, also metabolize glucose. As 19 F-deoxyglucose-6P is structurally identical to 18 F-deoxyglucose-6P, LEXRF of subcellular 19 F provides a link to in vivo 18 FDG PET, forming a novel basis for understanding the physiological mechanisms underlying the 18 FDG PET image, and the contribution of neurons and glia to the PET signal.
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Työn tavoitteena oli kehittää kosmetiikan suoramyyntiyrityksen hinnoittelustrategiaa. Tarkoitus oli saattaa normaalihinnat oikealle tasolle määritellyn kilpailuaseman mukaan. Työn etenemisen myötä huomattiin tarvetta myös koko hinnoitteluprosessin uudelleenluomiselle, sillä aikaisempi toimintatapa ei toiminut enää nykyisessä tilanteessa konsernin tiukkojen raportointitarpeiden ja esitteiden analyysin tukena tarvittavissa määrin. Aluksi tutustuttiin hinnoitteluun vaikuttaviin tekijöihin ja eri hintastrategisiin vaihtoehtoihin sekä hinnan rooliin markkinoinnin kilpailukeinona. Työssä tutustuttiin lisäksi suoramyyntitavan ominaispiirteisiin. Teorian pohjalta selkiytettiin Oriflame Finland Oy:n hinnoittelustrategia jalaadittiin pohjat tuotekohtaiselle ja myyntijaksottaiselle hinnoittelulle. Hinnoittelupohjan tuli tukea myös yrityksen talousosastoa ja olla hyödyllinen raportointityökalu myyntiennusteita varten. Erityisesti uusi hinnoittelumalli tehtiin tukemaan yrityksen päämyyntivälineen eli jaksottaisen myyntiesitteen analysoimista. Hinnoittelu on keskeisessä osassa koko yritysstrategiassa, sillä se vaikuttaa suoraan mielikuviin. Hinnoittelun tulee jatkossa tukea enemmän yrityksen kilpailullisia ja markkinoinnillisia tavoitteita, ja sen säännöllinen kehittäminen ja kilpailutilanteen päivitys kuuluu jatkossa yhtenä määriteltynä osana hinnoitteluprosessiin.
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Although severe patient-ventilator asynchrony is frequent during invasive and non-invasive mechanical ventilation, diagnosing such asynchronies usually requires the presence at the bedside of an experienced clinician to assess the tracings displayed on the ventilator screen, thus explaining why evaluating patient-ventilator interaction remains a challenge in daily clinical practice. In the previous issue of Critical Care, Sinderby and colleagues present a new automated method to detect, quantify, and display patient-ventilator interaction. In this validation study, the automatic method is as efficient as experts in mechanical ventilation. This promising system could help clinicians extend their knowledge about patient-ventilator interaction and further improve assisted mechanical ventilation.
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Dissolved organic matter (DOM) is a complex mixture of organic compounds, ubiquitous in marine and freshwater systems. Fluorescence spectroscopy, by means of Excitation-Emission Matrices (EEM), has become an indispensable tool to study DOM sources, transport and fate in aquatic ecosystems. However the statistical treatment of large and heterogeneous EEM data sets still represents an important challenge for biogeochemists. Recently, Self-Organising Maps (SOM) has been proposed as a tool to explore patterns in large EEM data sets. SOM is a pattern recognition method which clusterizes and reduces the dimensionality of input EEMs without relying on any assumption about the data structure. In this paper, we show how SOM, coupled with a correlation analysis of the component planes, can be used both to explore patterns among samples, as well as to identify individual fluorescence components. We analysed a large and heterogeneous EEM data set, including samples from a river catchment collected under a range of hydrological conditions, along a 60-km downstream gradient, and under the influence of different degrees of anthropogenic impact. According to our results, chemical industry effluents appeared to have unique and distinctive spectral characteristics. On the other hand, river samples collected under flash flood conditions showed homogeneous EEM shapes. The correlation analysis of the component planes suggested the presence of four fluorescence components, consistent with DOM components previously described in the literature. A remarkable strength of this methodology was that outlier samples appeared naturally integrated in the analysis. We conclude that SOM coupled with a correlation analysis procedure is a promising tool for studying large and heterogeneous EEM data sets.
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BACKGROUND: The literature suggests that intraoperative fractures of the greater trochanter and the metaphysis are increased with uncemented stems and the direct anterior approach. This study aims to determine the incidence and assess the functional and radiological outcome after such fractures. METHODS: 484 consecutive total hip replacements (THR) (64 ± 12 years) were analyzed. We treated trochanteric fractures conservatively without any further denuding, and secured metaphyseal fissures with cerclages. Postoperative X-rays and at the latest follow-up were compared to assess secondary fracture displacement and stem subsidence. Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after 1 year were analyzed. For each patient sustaining a fracture, two patients without fractures were matched in terms of age, body mass index and gender. RESULTS: 13 (2.7 %, 5 male, 68 ± 9 years) patients with intraoperative fractures of the greater trochanter (n = 8) or the metaphysis (n = 5) were analyzed. Consolidation was observed in 7/8 patients sustaining a trochanteric fracture while secondary displacement of the fragment occurred in one case. Stem subsidence was observed in 2/5 cases (5 and 7 mm). Patients who sustained a fracture showed a trend towards poorer WOMAC scores at 1 year postoperatively, compared to patients without fractures. A significantly increased joint stiffness was also observed. CONCLUSION: The intraoperative fracture risk in this series of THR through a direct anterior approach was 2.7 %. Trochanteric fractures do heal without primary fixation. Metaphyseal fractures heal well if immediately stabilized with a cerclage.
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ABSTRACT:¦BACKGROUND: The Spiritual Distress Assessment Tool (SDAT) is a 5-item instrument developed to assess unmet spiritual needs in hospitalized elderly patients and to determine the presence of spiritual distress. The objective of this study was to investigate the SDAT psychometric properties.¦METHODS: This cross-sectional study was performed in a Geriatric Rehabilitation Unit. Patients (N = 203), aged 65 years and over with Mini Mental State Exam score ≥ 20, were consecutively enrolled over a 6-month period. Data on health, functional, cognitive, affective and spiritual status were collected upon admission. Interviews using the SDAT (score from 0 to 15, higher scores indicating higher distress) were conducted by a trained chaplain. Factor analysis, measures of internal consistency (inter-item and item-to-total correlations, Cronbach α), and reliability (intra-rater and inter-rater) were performed. Criterion-related validity was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) and the question "Are you at peace?" as criterion-standard. Concurrent and predictive validity were assessed using the Geriatric Depression Scale (GDS), occurrence of a family meeting, hospital length of stay (LOS) and destination at discharge.¦RESULTS: SDAT scores ranged from 1 to 11 (mean 5.6 ± 2.4). Overall, 65.0% (132/203) of the patients reported some spiritual distress on SDAT total score and 22.2% (45/203) reported at least one severe unmet spiritual need. A two-factor solution explained 60% of the variance. Inter-item correlations ranged from 0.11 to 0.41 (eight out of ten with P < 0.05). Item-to-total correlations ranged from 0.57 to 0.66 (all P < 0.001). Cronbach α was acceptable (0.60). Intra-rater and inter-rater reliabilities were high (Intraclass Correlation Coefficients ranging from 0.87 to 0.96). SDAT correlated significantly with the FACIT-Sp, "Are you at peace?", GDS (Rho -0.45, -0.33, and 0.43, respectively, all P < .001), and LOS (Rho 0.15, P = .03). Compared with patients showing no severely unmet spiritual need, patients with at least one severe unmet spiritual need had higher odds of occurrence of a family meeting (adjOR 4.7, 95%CI 1.4-16.3, P = .02) and were more often discharged to a nursing home (13.3% vs 3.8%; P = .027).¦CONCLUSIONS: SDAT has acceptable psychometrics properties and appears to be a valid and reliable instrument to assess spiritual distress in elderly hospitalized patients.