535 resultados para 1188
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Fac-ruthenium(II) tris-(5-carboxy-2,2'-bipyridine) has been synthesised as a single geometric isomer for the first time, and proves to be a good "building-block" to introduce new functionality with retention of the isomeric integrity.
Evolving European guidance on the medical management of neovascular age-related macular degeneration
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Initial findings from high-latitude ice-cores implied a relatively unvarying Holocene climate, in contrast to the major climate swings in the preceding late-Pleistocene. However, several climate archives from low latitudes imply a less than equable Holocene climate, as do recent studies on peat bogs in mainland north-west Europe, which indicate an abrupt climate cooling 2800 years ago, with parallels claimed in a range of climate archives elsewhere. A hypothesis that this claimed climate shift was global, and caused by reduced solar activity, has recently been disputed. Until now, no directly comparable data were available from the southern hemisphere to help resolve the dispute. Building on investigations of the vegetation history of an extensive mire in the Valle de Andorra, Tierra del Fuego, we took a further peat core from the bog to generate a high-resolution climate history through the use of determination of peat hurnification and quantitative leaf-count plant macrofossil analysis. Here, we present the new proxy-climate data from the bog in South America. The data are directly comparable with those in Europe, as they were produced using identical laboratory methods. They show that there was a major climate perturbation at the same time as in northwest European bogs. Its timinia, nature and apparent global synchronicity lend support to the notion of solar forcing of past climate change, amplified by oceanic circulation. This finding of a similar response simultaneously in both hemispheres may help validate and improve global climate models. That reduced solar activity might cause a global climatic change suggests that attention be paid also to consideration of any global climate response to increases in solar activity. This has implications for interpreting the relative contribution of climate drivers of recent 'global warming'. (c) 2006 Elsevier B.V. All rights reserved.
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Background Polymorphisms in ACE and AGTR1 genes have been assessed in multiple studies for association with diabetic nephropathy; however, results are conflicting. The ACE2 gene has not been studied extensively for association with diabetic nephropathy.
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Potential fecundity, number of oocytes in the mature ovary, and realized fecundity, number of eggs extruded and attached to the pleopods of female Nephrops, caught at the start of the incubation period were estimated for females from the eastern and western Irish Sea grounds. Potential fecundity was found to differ significantly between eastern and western Irish Sea stocks, while realized fecundity did not differ between areas. Inter-year comparison of realized fecundity, and effective fecundity (the number of mature eggs on the pleopods of females at the end of the incubation period) in the western Irish Sea stocks revealed no significant variation over time. Egg loss during the transition from oocytes in the ovary to mature eggs increased with female size, ranging from 40% at 25 mm carapace length (CL) to 65% at 40 mm CL. No relationship was found between egg diameter or volume and female size.
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Three-dimensional reconstruction from volumetric medical images (e.g. CT, MRI) is a well-established technology used in patient-specific modelling. However, there are many cases where only 2D (planar) images may be available, e.g. if radiation dose must be limited or if retrospective data is being used from periods when 3D data was not available. This study aims to address such cases by proposing an automated method to create 3D surface models from planar radiographs. The method consists of (i) contour extraction from the radiograph using an Active Contour (Snake) algorithm, (ii) selection of a closest matching 3D model from a library of generic models, and (iii) warping the selected generic model to improve correlation with the extracted contour.
This method proved to be fully automated, rapid and robust on a given set of radiographs. Measured mean surface distance error values were low when comparing models reconstructed from matching pairs of CT scans and planar X-rays (2.57–3.74 mm) and within ranges of similar studies. Benefits of the method are that it requires a single radiographic image to perform the surface reconstruction task and it is fully automated. Mechanical simulations of loaded bone with different levels of reconstruction accuracy showed that an error in predicted strain fields grows proportionally to the error level in geometric precision. In conclusion, models generated by the proposed technique are deemed acceptable to perform realistic patient-specific simulations when 3D data sources are unavailable.
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The only supernovae (SNe) to show gamma-ray bursts ( GRBs) or early x-ray emission thus far are overenergetic, broad- lined type Ic SNe ( hypernovae, HNe). Recently, SN 2008D has shown several unusual features: (i) weak x-ray flash (XRF), (ii) an early, narrow optical peak, (iii) disappearance of the broad lines typical of SN Ic HNe, and (iv) development of helium lines as in SNe Ib. Detailed analysis shows that SN 2008D was not a normal supernova: Its explosion energy (E approximate to 6 x 10(51) erg) and ejected mass [similar to 7 times the mass of the Sun ( M.)] are intermediate between normal SNe Ibc and HNe. We conclude that SN 2008D was originally a similar to 30 M. star. When it collapsed, a black hole formed and a weak, mildly relativistic jet was produced, which caused the XRF. SN 2008D is probably among the weakest explosions that produce relativistic jets. Inner engine activity appears to be present whenever massive stars collapse to black holes.
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Purpose/Objectives: To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer.
Research Approach: A qualitative approach based on symbolic interactionism.
Setting: A regional cancer center in a large teaching hospital in the United Kingdom.
Participants: 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer.
Methodologic Approach: Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection.
Findings: Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer.
Conclusions: Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals.
Interpretation: This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care.
Knowledge Translation: Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their families.
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Non-native species cause changes in the ecosystems to which they are introduced. These changes, or some of them, are usually termed impacts; they can be manifold and potentially damaging to ecosystems and biodiversity. However, the impacts of most non-native species are poorly understood, and a synthesis of available information is being hindered because authors often do not clearly define impact. We argue that explicitly defining the impact of non-native species will promote progress toward a better understanding of the implications of changes to biodiversity and ecosystems caused by non-native species; help disentangle which aspects of scientific debates about non-native species are due to disparate definitions and which represent true scientific discord; and improve communication between scientists from different research disciplines and between scientists, managers, and policy makers. For these reasons and based on examples from the literature, we devised seven key questions that fall into 4 categories: directionality, classification and measurement, ecological or socio-economic changes, and scale. These questions should help in formulating clear and practical definitions of impact to suit specific scientific, stakeholder, or legislative contexts.
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Introduction: Immediate reconstruction following mastectomy for breast cancer has been shown to be oncologically safe and associated with improved psychosocial outcomes for patients. Bostwick described a technique for one-stage implant based reconstruction, combining skin-sparing mastectomy with concurrent reduction of the skin envelope. This report reviews the experience of a single centre using skin-reducing mastectomy and one-stage implant reconstruction in both early stage breast cancer and risk-reducing mastectomy, with specific reference to frequency of complications, implant loss and oncological outcomes.
Methods and results: A retrospective review was undertaken to identify women who had undergone skin-reducing mastectomy and one-stage implant reconstruction using a de-epithelialised dermal flap, between October 2008 and October 2012. One hundred and four consecutive mastectomies, with reconstruction, were performed by two surgeons on 64 patients. No complications were seen in 43.8% of patients. At three months, four implants were lost (3.8% of breast reconstructions, 6.3% of patients), due to either peri-implant infection or mastectomy skin flap necrosis. One patient required unplanned return to theatre for evacuation of a haematoma. Minor mastectomy skin flap necrosis was seen in 10 breasts (9.6% of reconstructed breasts) and superficial wound infection in 8 breasts (7.7% of reconstructed breasts). All of these complications were managed conservatively and none required operative intervention. At a median follow up of 35 months (4-53 months) there had been one episode of ipsilateral axillary nodal recurrence.
Conclusion: One-stage implant reconstruction using a myo-dermal flap technique following skin-reducing mastectomy is safe and should be considered in selected patients. Most complications are minor and will resolve with conservative management. Major complications such as implant failure or immediate reoperation, were relatively uncommon (6.3% patients, 3.8% of reconstructed breasts). Early follow-up suggests that oncological outcomes are satisfactory, but longer follow-up is required to substantiate this. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.