999 resultados para OUTCOME DOMAIN
Resumo:
Aux soins intensifs néonataux, les professionnels et les parents évaluent le pronostic du développement et de la qualité de vie (QdV). Le but de cette thèse est de comprendre comment les parents prédisent la QdV future de leurs enfants. Cette étude qualitative basée sur la théorisation ancrée comprend dix entrevues avec des parents. Les résultats indiquent que le pronostic développemental influence les prédictions parentales de QdV, mais il n’est pas suffisant, car la QdV est multidimensionnelle. Les parents utilisent des mécanismes d’adaptation pour gérer la maladie et l’hospitalisation de leur enfant. Ceux qui pensent qu’ils, et leur enfant, seront capables de s’adapter à un mauvais état développemental, prévoient une QdV réévaluée. Le pronostic neuro-développemental et la QdV future ne sont pas facilement estimés et les professionnels doivent en être conscients. Aider les parents à identifier des mécanismes d’adaptation peut les amener à estimer un meilleur pronostic de la QdV.
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Le cycle glycérolipides/acides gras libres (GL/FFA) est une voie métabolique clé qui relie le métabolisme du glucose et des acides gras et il est composé de deux processus métaboliques appelés lipogenèse et lipolyse. Le cycle GL/FFA, en particulier la lipolyse des triglycérides, génère diverses molécules de signalisation pour réguler la sécrétion d'insuline dans les cellules bêta pancréatiques et la thermogenèse non-frissonnante dans les adipocytes. Actuellement, les lipides provenant spécifiquement de la lipolyse impliqués dans ce processus sont mal connus. L’hydrolyse des triglycérides dans les cellules β est réalisée par les actions successives de la triglycéride lipase adipocytaire pour produire le diacylglycérol, ensuite par la lipase hormono-sensible pour produire le monoacylglycérol (MAG) et enfin par la MAG lipase (MAGL) qui relâche du glycerol et des acides gras. Dans les cellules bêta, la MAGL classique est très peu exprimée et cette étude a démontré que l’hydrolyse de MAG dans les cellules β est principalement réalisée par l'α/β-Hydrolase Domain-6 (ABHD6) nouvellement identifiée. L’inhibition d’ABHD6 par son inhibiteur spécifique WWL70, conduit à une accumulation des 1-MAG à longues chaines saturées à l'intérieur des cellules, accompagnée d’une augmentation de la sécrétion d'insuline stimulée par le glucose (GSIS). Baisser les niveaux de MAG en surexprimant ABHD6 dans la lignée cellulaire bêta INS832/13 réduit la GSIS, tandis qu’une augmentation des niveaux de MAG par le « knockdown » d’ABHD6 améliore la GSIS. L'exposition aiguë des monoacylglycérols exogènes stimule la sécrétion d'insuline de manière dose-dépendante et restaure la GSIS supprimée par un inhibiteur de lipases appelé orlistat. En outre, les souris avec une inactivation du gène ABHD6 dans tous les tissus (ABHD6-KO) et celles avec une inactivation du gène ABHD6 spécifiquement dans la cellule β présentent une GSIS stimulée, et leurs îlots montrent une augmentation de la production de monoacylglycérol et de la sécrétion d'insuline en réponse au glucose. L’inhibition d’ABHD6 chez les souris diabétiques (modèle induit par de faibles doses de streptozotocine) restaure la GSIS et améliore la tolérance au glucose. De plus, les résultats montrent que les MAGs non seulement améliorent la GSIS, mais potentialisent également la sécrétion d’insuline induite par les acides gras libres ainsi que la sécrétion d’insuline induite par divers agents et hormones, sans altération de l'oxydation et l'utilisation du glucose ainsi que l'oxydation des acides gras. Nous avons démontré que le MAG se lie à la protéine d’amorçage des vésicules appelée Munc13-1 et l’active, induisant ainsi l’exocytose de l'insuline. Sur la base de ces observations, nous proposons que le 1-MAG à chaines saturées agit comme facteur de couplage métabolique pour réguler la sécrétion d'insuline et que ABHD6 est un modulateur négatif de la sécrétion d'insuline. En plus de son rôle dans les cellules bêta, ABHD6 est également fortement exprimé dans les adipocytes et son niveau est augmenté avec l'obésité. Les souris dépourvues globalement d’ABHD6 et nourris avec une diète riche en gras (HFD) montrent une faible diminution de la prise alimentaire, une diminution du gain de poids corporel et de la glycémie à jeun et une amélioration de la tolérance au glucose et de la sensibilité à l'insuline et ont une activité locomotrice accrue. En outre, les souris ABHD6-KO affichent une augmentation de la dépense énergétique et de la thermogenèse induite par le froid. En conformité avec ceci, ces souris présentent des niveaux élevés d’UCP1 dans les adipocytes blancs et bruns, indiquant le brunissement des adipocytes blancs. Le phénotype de brunissement est reproduit dans les souris soit en les traitant de manière chronique avec WWL70 (inhibiteur d’ABHD6) ou des oligonucléotides anti-sense ciblant l’ABHD6. Les tissus adipeux blanc et brun isolés de souris ABHD6-KO montrent des niveaux très élevés de 1-MAG, mais pas de 2-MAG. L'augmentation des niveaux de MAG soit par administration exogène in vitro de 1-MAG ou par inhibition ou délétion génétique d’ABHD6 provoque le brunissement des adipocytes blancs. Une autre évidence indique que les 1-MAGs sont capables de transactiver PPARα et PPARγ et que l'effet de brunissement induit par WWL70 ou le MAG exogène est aboli par les antagonistes de PPARα et PPARγ. L’administration in vivo de l’antagoniste de PPARα GW6471 à des souris ABHD6-KO inverse partiellement les effets causés par l’inactivation du gène ABHD6 sur le gain de poids corporel, et abolit l’augmentation de la thermogenèse, le brunissement du tissu adipeux blanc et l'oxydation des acides gras dans le tissu adipeux brun. L’ensemble de ces observations indique que ABHD6 régule non seulement l’homéostasie de l'insuline et du glucose, mais aussi l'homéostasie énergétique et la fonction des tissus adipeux. Ainsi, 1-MAG agit non seulement comme un facteur de couplage métabolique pour réguler la sécrétion d'insuline en activant Munc13-1 dans les cellules bêta, mais régule aussi le brunissement des adipocytes blancs et améliore la fonction de la graisse brune par l'activation de PPARα et PPARγ. Ces résultats indiquent que ABHD6 est une cible prometteuse pour le développement de thérapies contre l'obésité, le diabète de type 2 et le syndrome métabolique.
Resumo:
Improving the appearance of the trunk is an important goal of scoliosis surgical treatment, mainly in patients' eyes. Unfortunately, existing methods for assessing postoperative trunk appearance are rather subjective as they rely on a qualitative evaluation of the trunk shape. In this paper, an objective method is proposed to quantify the changes in trunk shape after surgery. Using a non-invasive optical system, the whole trunk surface is acquired and reconstructed in 3D. Trunk shape is described by two functional measurements spanning the trunk length: the lateral deviation and the axial rotation. To measure the pre and postoperative differences, a correction rate is computed for both measurements. On a cohort of 36 scoliosis patients with the same spinal curve type who underwent the same surgical approach, surgery achieved a very good correction of the lateral trunk deviation (median correction of 76%) and a poor to moderate correction of the back axial rotation (median correction of 19%). These results demonstrate that after surgery, patients are still confronted with residual trunk deformity, mainly a persisting hump on the back. That can be explained by the fact that current scoliosis assessment and treatment planning are based solely on radiographic measures of the spinal deformity and do not take trunk deformity into consideration. It is believed that with our novel quantitative trunk shape descriptor, clinicians and surgeons can now objectively assess trunk deformity and postoperative shape and propose new treatment strategies that could better address patients' concern about their appearance. © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
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The thesis is the outcome of the experimental and theoretical investigations carried out on a novel slotted microstrip antenna.The antenna excites two resonance frequencies and provides orthogonal polarization. The radiation characteristics of the antenna are studied in detail. The antenna design is optimized using IE3D electromagnetic simulation tool. The frequency-Difference Time-Domain (FDTD) method is employed for the analysis of the antenna.The antenna can be used for personal and satellite communication applications.
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The thesis is the outcome of the experimental and theoretical Investigations on novel feeding techniques for bandwidth enhancement of microstrip patches. The new feeding techniques provide bandwidth enhancement without deteriorating the radiation characteristics of the antenna. The antenna is analysed using finite Difference Time Domain (FDTD) method. The predicated results are compared with the experimental results and excellent agreement is observed. The results are also verified using IE3D simulation software. The antenna is suitable for personal and broadband communications.
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The thesis explores the outcome of the exhaustive theoretical and experimental investigations performed on Octagonal Microstrip Antenna configurations. Development of the MATLAB TM backed 3D-Conformal Finite Difference Time Domain (CFDTD)Modeller for the numerical computation of the radiation characteristics of the antenna is the theme of the work. The predicted results are verified experimentally and by IE3D TM simulation. The influence of the patch dimensions,feed configurations,feed dimensions and feed positions upon the radiation performance of the antenna is studied in detail. Octagonal Microstrip Antenna configurations suitable for Mobile-Bluetooth application is dealt in detail. A simple design formula for the regular Octagonal geometry is also presented. A compact planar multi band antenna for GPS/DCS/2.4/5.8GHz WLAN application is included as appendix A. Planar near field measurement technique is explained in appendix B.
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The thesis is the outcome of the exhaustive theoretical and experimental investigations performed on Printed Monopole Antennas loaded with different geometries .The work presented in this thesis describes the development of a 3D- FDTD(Finite Difference Time Domain) Modeller using MATLAB for the numerical computation of the radiation characteristics of the antenna. The predicted results are verified experimentally and also through simulation using Ansoft HFSS.The effect of top loading of the monopole with different geometries ,the dimensions of the loading patch and ground plane and the material parameters of the dielectric substrate upon the radiation performance of the antenna is studied in detail. Optimized Printed Monopole antennas suitable for Ultra Wide Band (UWB) applications have been developed.
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The detection of buried objects using time-domain freespace measurements was carried out in the near field. The location of a hidden object was determined from an analysis of the reflected signal. This method can be extended to detect any number of objects. Measurements were carried out in the X- and Ku-bands using ordinary rectangular pyramidal horn antennas of gain 15 dB. The same antenna was used as the transmitter and recei er. The experimental results were compared with simulated results by applying the two-dimensional finite-difference time-domain(FDTD)method, and agree well with each other. The dispersi e nature of the dielectric medium was considered for the simulation.
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A Monte Carlo simulation study of the vacancy-assisted domain growth in asymmetric binary alloys is presented. The system is modeled using a three-state ABV Hamiltonian which includes an asymmetry term. Our simulated system is a stoichiometric two-dimensional binary alloy with a single vacancy which evolves according to the vacancy-atom exchange mechanism. We obtain that, compared to the symmetric case, the ordering process slows down dramatically. Concerning the asymptotic behavior it is algebraic and characterized by the Allen-Cahn growth exponent x51/2. The late stages of the evolution are preceded by a transient regime strongly affected by both the temperature and the degree of asymmetry of the alloy. The results are discussed and compared to those obtained for the symmetric case.
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Data mining is one of the hottest research areas nowadays as it has got wide variety of applications in common man’s life to make the world a better place to live. It is all about finding interesting hidden patterns in a huge history data base. As an example, from a sales data base, one can find an interesting pattern like “people who buy magazines tend to buy news papers also” using data mining. Now in the sales point of view the advantage is that one can place these things together in the shop to increase sales. In this research work, data mining is effectively applied to a domain called placement chance prediction, since taking wise career decision is so crucial for anybody for sure. In India technical manpower analysis is carried out by an organization named National Technical Manpower Information System (NTMIS), established in 1983-84 by India's Ministry of Education & Culture. The NTMIS comprises of a lead centre in the IAMR, New Delhi, and 21 nodal centres located at different parts of the country. The Kerala State Nodal Centre is located at Cochin University of Science and Technology. In Nodal Centre, they collect placement information by sending postal questionnaire to passed out students on a regular basis. From this raw data available in the nodal centre, a history data base was prepared. Each record in this data base includes entrance rank ranges, reservation, Sector, Sex, and a particular engineering. From each such combination of attributes from the history data base of student records, corresponding placement chances is computed and stored in the history data base. From this data, various popular data mining models are built and tested. These models can be used to predict the most suitable branch for a particular new student with one of the above combination of criteria. Also a detailed performance comparison of the various data mining models is done.This research work proposes to use a combination of data mining models namely a hybrid stacking ensemble for better predictions. A strategy to predict the overall absorption rate for various branches as well as the time it takes for all the students of a particular branch to get placed etc are also proposed. Finally, this research work puts forward a new data mining algorithm namely C 4.5 * stat for numeric data sets which has been proved to have competent accuracy over standard benchmarking data sets called UCI data sets. It also proposes an optimization strategy called parameter tuning to improve the standard C 4.5 algorithm. As a summary this research work passes through all four dimensions for a typical data mining research work, namely application to a domain, development of classifier models, optimization and ensemble methods.
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The magnetic properties of BaFe12O19 and BaFe10.2Sn0.74Co0.66O19 single crystals have been investigated in the temperature range (1.8 to 320 K) with a varying field from -5 to +5 T applied parallel and perpendicular to the c axis. Low-temperature magnetic relaxation, which is ascribed to the domain-wall motion, was performed between 1.8 and 15 K. The relaxation of magnetization exhibits a linear dependence on logarithmic time. The magnetic viscosity extracted from the relaxation data, decreases linearly as temperature goes down, which may correspond to the thermal depinning of domain walls. Below 2.5 K, the viscosity begins to deviate from the linear dependence on temperature, tending to be temperature independent. The near temperature independence of viscosity suggests the existence of quantum tunneling of antiferromagnetic domain wall in this temperature range.
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This thesis is an outcome of the investigations carried out on the development of an Artificial Neural Network (ANN) model to implement 2-D DFT at high speed. A new definition of 2-D DFT relation is presented. This new definition enables DFT computation organized in stages involving only real addition except at the final stage of computation. The number of stages is always fixed at 4. Two different strategies are proposed. 1) A visual representation of 2-D DFT coefficients. 2) A neural network approach. The visual representation scheme can be used to compute, analyze and manipulate 2D signals such as images in the frequency domain in terms of symbols derived from 2x2 DFT. This, in turn, can be represented in terms of real data. This approach can help analyze signals in the frequency domain even without computing the DFT coefficients. A hierarchical neural network model is developed to implement 2-D DFT. Presently, this model is capable of implementing 2-D DFT for a particular order N such that ((N))4 = 2. The model can be developed into one that can implement the 2-D DFT for any order N upto a set maximum limited by the hardware constraints. The reported method shows a potential in implementing the 2-D DF T in hardware as a VLSI / ASIC