950 resultados para Multi-choice aspiration levels


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Deux tiers des cancers du sein expriment des récepteurs hormonaux ostrogéniques (tumeur ER-positive) et la croissance de ces tumeurs est stimulée par l’estrogène. Des traitements adjuvant avec des anti-estrogènes, tel que le Tamoxifen et les Inhibiteurs de l’Aromatase peuvent améliorer la survie des patientes atteinte de cancer du sein. Toutefois la thérapie hormonale n’est pas efficace dans toutes les tumeurs mammaires ER-positives. Les tumeurs peuvent présenter avec une résistance intrinsèque ou acquise au Tamoxifen. Présentement, c’est impossible de prédire quelle patiente va bénéficier ou non du Tamoxifen. Des études préliminaires du laboratoire de Dr. Mader, ont identifié le niveau d’expression de 20 gènes, qui peuvent prédire la réponse thérapeutique au Tamoxifen (survie sans récidive). Ces marqueurs, identifié en utilisant une analyse bioinformatique de bases de données publiques de profils d’expression des gènes, sont capables de discriminer quelles patientes vont mieux répondre au Tamoxifen. Le but principal de cette étude est de développer un outil de PCR qui peut évaluer le niveau d’expression de ces 20 gènes prédictif et de tester cette signature de 20 gènes dans une étude rétrospective, en utilisant des tumeurs de cancer du sein en bloc de paraffine, de patients avec une histoire médicale connue. Cet outil aurait donc un impact direct dans la pratique clinique. Des traitements futiles pourraient être éviter et l’indentification de tumeurs ER+ avec peu de chance de répondre à un traitement anti-estrogène amélioré. En conséquence, de la recherche plus appropriée pour les tumeurs résistantes au Tamoxifen, pourront se faire.

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Les systèmes logiciels sont devenus de plus en plus répondus et importants dans notre société. Ainsi, il y a un besoin constant de logiciels de haute qualité. Pour améliorer la qualité de logiciels, l’une des techniques les plus utilisées est le refactoring qui sert à améliorer la structure d'un programme tout en préservant son comportement externe. Le refactoring promet, s'il est appliqué convenablement, à améliorer la compréhensibilité, la maintenabilité et l'extensibilité du logiciel tout en améliorant la productivité des programmeurs. En général, le refactoring pourra s’appliquer au niveau de spécification, conception ou code. Cette thèse porte sur l'automatisation de processus de recommandation de refactoring, au niveau code, s’appliquant en deux étapes principales: 1) la détection des fragments de code qui devraient être améliorés (e.g., les défauts de conception), et 2) l'identification des solutions de refactoring à appliquer. Pour la première étape, nous traduisons des régularités qui peuvent être trouvés dans des exemples de défauts de conception. Nous utilisons un algorithme génétique pour générer automatiquement des règles de détection à partir des exemples de défauts. Pour la deuxième étape, nous introduisons une approche se basant sur une recherche heuristique. Le processus consiste à trouver la séquence optimale d'opérations de refactoring permettant d'améliorer la qualité du logiciel en minimisant le nombre de défauts tout en priorisant les instances les plus critiques. De plus, nous explorons d'autres objectifs à optimiser: le nombre de changements requis pour appliquer la solution de refactoring, la préservation de la sémantique, et la consistance avec l’historique de changements. Ainsi, réduire le nombre de changements permets de garder autant que possible avec la conception initiale. La préservation de la sémantique assure que le programme restructuré est sémantiquement cohérent. De plus, nous utilisons l'historique de changement pour suggérer de nouveaux refactorings dans des contextes similaires. En outre, nous introduisons une approche multi-objective pour améliorer les attributs de qualité du logiciel (la flexibilité, la maintenabilité, etc.), fixer les « mauvaises » pratiques de conception (défauts de conception), tout en introduisant les « bonnes » pratiques de conception (patrons de conception).

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Située dans le discours actuel à la mode sur la diversité culturelle, l’objet de cette thèse consiste à comprendre l’orientation pratique d’une organisation internationale en matière de gestion de sa diversité culturelle interne. Il propose que, face aux changements qui ont modifié la configuration sociodémographique de la sphère organisationnelle, il serait intéressant de partir d’une organisation pour laquelle la diversité est une tradition tributaire de son fonctionnement. L’organisation sujet d’étude est internationale, affiliée à l’Unesco. Cette dernière étant reconnue pour son mandat qui valorise et protège les cultures. L’ancrage épistémologique de la thèse est bi-disciplinaire. Il considère deux champs théoriques sur lesquels se construit la diversité culturelle. Le premier est forgé dans les théories de management dites « occidentales » sur la diversité. Le deuxième champ, s’établit sur une approche dynamique de la culture apportée par les « Cross-Cultural Studies ». La méthodologie que nous avons mobilisée pour cette recherche est principalement qualitative. Elle est également diverse puisqu’elle veut identifier trois niveaux d’analyses. D’abord, l’étude historique réalisée se fonde sur l’analyse d’articles choisis tirés des archives de l’« organisation mère » (Unesco). Elle se veut être une étude exhaustive qui révèle l’évolution du discours « global » de cette organisation sur la diversité culturelle depuis sa création. Ensuite, afin de mieux comprendre le discours interne de l’Organisation sur la diversité culturelle, une analyse du contenu d’un « halo » de ses politiques internes a lieu. Elle nous permet de comprendre la valeur que prend la diversité culturelle dans son discours « organisationnel » dans la période de temps que nous traitons. Enfin, les histoires « individuelles » des acteurs de la diversité culturelle, apportent une description riche et, complètent l’analyse avec leurs interprétions des pratiques de gestions mises en place à leur égard. Des éléments de recherche sous adjacentes sont aussi amenés dans la thèse et font également partie du processus de l’analyse de la pratique de la diversité culturelle dans l’Organisation. En effet, la thèse se penche sur le problème conceptuel sur la « diversité culturelle ». Elle apporte des éclaircissements à la terminologie à travers l’analyse de ses différents emplois dans la littérature organisationnelle. Par ailleurs, elle clarifie la notion d’organisation internationale et propose une description du contexte unesquien défini par sa diversité culturelle interne. L’ensemble des niveaux examinés a permis de mettre en évidence une double constatation. D’une part, le paradoxe entre les trois niveaux. D’autre part, la neutralité des pratiques de gestion de la diversité culturelle pour les employés et la demande implicite de reconnaissance de leurs identités culturelles. Des recommandations sont proposées et des suggestions pour de recherches ultérieures sont formulées à la conclusion de la thèse.

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This thesis Entitled Buyer information and brand choice behaviour in markets with asymmetries.The period of transition set in by globalization and liberalization has ensued a onsiderable degree of homogeneity with western societies with respect to quantity and quality of goods and services.The study is aimed at finding out how the buyers adapt to the prevalent complex and dynamic market configuration by taking an archetypical situation of information gathering and brand- choice decision of select household consumer durables.The study was based on a set of 301 sample respondents who were either first time purchasers or repeat purchasers for household use, of the items under study in the sample area comprising of rural, urban and semi-urban areas. Data were collected using interview schedule and analysis of the same was done with standard statistical computer programs.Buyer confidence as perceived by buyers with respect to information acquisition and brand-choice represents the felt competence to effectively function in the market.In general, lower levels of education, income and occupation showed lower levels of search. The oldest were also low searchers. The repeat purchasers of the product searched less than the first purchasers. The most important source of information was word of mouth or information from others followed by television advertisements. The least important source of information was billboards, displays and similar forms of advertisements.The second factor is characterized by items representing ‘social attributes’ like, use by many others, use by peers, recommendation by significant others and reputation of the brand. The third factor represents ‘susceptibility to incentives and promotions’.

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The objective of the study was to evaluate the survival response of multi-drug resistant enteropathogenic Escherichia coli and Salmonella paratyphi to the salinity fluctuations induced by a saltwater barrier constructed in Vembanadu lake, which separates the lake into a freshwater dominated southern and brackish water dominated northern part. Therefore, microcosms containing freshwater, brackish water and microcosms with different saline concentrations (5, 10, 15, 20, 25 ppt) inoculated with E. coli/S. paratyphi were monitored up to 34 days at 20 and 30 WC. E. coli and S. paratyphi exhibited significantly higher (p <0.05) survival at 20 WC compared to 30 WC in all microcosms. Despite fresh/brackish water, E. coli and S. paratyphi showed prolonged survival up to 34 days at both temperatures. They also demonstrated better survival potential at all tested saline concentrations except 25 ppt where a significantly higher (p<0.0001) decay was observed. Therefore, enhanced survival exhibited by the multi-drug resistant enteropathogenic E. coli and S. paratyphi over a wide range of salinity levels suggest that they are able to remain viable for a very long time at higher densities in all seasons of the year in Vembanadu lake irrespective of saline concentrations, and may pose potential public health risks during recreational activities

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In a context of urgent global socio-ecological challenges, the aim of this paper has been to explore the potential of localised and socially connected food systems. More specifically, through a multi-case study of two alternative food networks in the city of Cluj-Napoca, Romania, their contribution to a sustainable food paradigm has been explored. An important synergy within the networks is how good food is equated with peasant produce, but issues regarding quantity, delivery arrangement, power relations and inclusiveness constitute potential conflicts. Although challenged by unfavourable trends on national and EU levels, the networks are becoming more embedded horizontally, through an intrinsic focus on community in one case and through quality food stimulating good relations in the other case. The networks contribute to a sustainable food paradigm by promoting agroecology, by reclaiming socio-cultural factors of food provisioning and by being part of a (re)-peasantisation process. Exploring how these kinds of initiatives can emerge, be sustained and be developed is of relevance, especially considering their potential for improving the prospects of environmentally sustainable and socially just futures in Romania and beyond.

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Introducción: La DSA es el método de elección para el seguimiento de pacientes con aneurismas intracraneales embolizados; esta se puede asociar a complicaciones incapacitantes o mortales. La MRA se ha propuesto como método alternativo por menor costo y menos morbi-mortalidad, aunque su desempeño diagnóstico permanece en discusión debido al desarrollo de nuevos protocolos, resonadores más potentes y nuevas aplicaciones de la DSA. Metodología: Exploramos la literatura hasta la actualidad y comparamos el desempeño diagnóstico de la MRA con la DSA para detectar flujo residual posterior a la embolización terapéutica de aneurismas intracraneales. Realizamos una revisión sistemática de la literatura y meta-análisis basados en 34 artículos detectados en la búsqueda que incluyó las bases de datos PubMed, Scopus, ScIELO y BVS. Resultados: La TOF-MRA demostró sensibilidad de 86.8% (84.3%-89.1%) y especificidad de 91.2% (89%-93.1%); la SROC para TOF-MRA demostró un AUC de 0.95. El desempeño de la CE-MRA demostró sensibilidad de 88.1% (84.6%-91.1%) y especificidad de 89.1% (85.7%-91.9%); la SROC presentó una AUC de 0.93. El análisis estratificado por potencia del resonador encontró que la TOF-MRA tiene mejor desempeño con el resonador de 3T, aunque no es estadísticamente significativo. La concordancia interobservador con TOF-MRA y CE-MRA fue moderada a muy buena. Discusión: El desempeño diagnóstico de la MRA en el seguimiento de aneurismas intracraneales embolizados demostró ser bueno, con sensibilidad mayor a 84%, siendo ligeramente mejor con TOF-MRA, sin lograr reemplazar la DSA. Sin embargo, los resultados deben ser evaluados con precaución por la heterogeneidad de los resultados de los estudios incluidos. (Abreviaturas: DSA: Angiografía por Sustracción Digital; MRA: Angiografía por Resonancia Magnética; TOF-MRA: Angiorresonancia por Tiempo de Vuelo; CE-MRA: Angiorresonancia contrastada).

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En les xarxes IP/MPLS sobre WDM on es transporta gran quantitat d'informacio, la capacitat de garantir que el trafic arriba al node de desti ha esdevingut un problema important, ja que la fallada d'un element de la xarxa pot resultar en una gran quantitat d'informacio perduda. Per garantir que el trafic afectat per una fallada arribi al node desti, s'han definit nous algoritmes d'encaminament que incorporen el coneixement de la proteccio en els dues capes: l'optica (WDM) i la basada en paquets (IP/MPLS). D'aquesta manera s'evita reservar recursos per protegir el trafic a les dues capes. Els nous algoritmes resulten en millor us dels recursos de la xarxa, ofereixen rapid temps de recuperacio, eviten la duplicacio de recursos i disminueixen el numero de conversions del trafic de senyal optica a electrica.

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Predicting metal bioaccumulation and toxicity in soil organisms is complicated by site-specific biotic and abiotic parameters. In this study we exploited tissue fractionation and digestion techniques, combined with X-ray absorption spectroscopy (XAS), to investigate the whole-body and subcellular distributions, ligand affinities, and coordination chemistry of accumulated Pb and Zn in field populations of the epigeic earthworm Lumbricus rubellus inhabiting three contrasting metalliferous and two unpolluted soils. Our main findings were (i) earthworms were resident in soils with concentrations of Pb and Zn ranging from 1200 to 27 000 mg kg(-1) and 200 to 34 000 mg kg(-1), respectively; (ii) Pb and Zn primarily accumulated in the posterior alimentary canal in nonsoluble subcellular fractions of earthworms; (iii) site-specific differences in the tissue and subcellular partitioning profiles of populations were observed, with earthworms from a calcareous site partitioning proportionally more Pb to their anterior body segments and Zn to the chloragosome-rich subcellular fraction than their acidic-soil inhabiting counterparts; (iv) XAS indicated that the interpopulation differences in metal partitioning between organs were not accompanied by qualitative differences in ligand-binding speciation, because crystalline phosphate-containing pyromorphite was a predominant chemical species in the whole-worm tissues of all mine soil residents. Differences in metal (Pb, Zn) partitioning at both organ and cellular levels displayed by field populations with protracted histories of metal exposures may reflect their innate ecophysiological responses to essential edaphic variables, such as Ca2+ status. These observations are highly significant in the challenging exercise of interpreting holistic biomarker data delivered by "omic" technologies.

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Projections of stratospheric ozone from a suite of chemistry-climate models (CCMs) have been analyzed. In addition to a reference simulation where anthropogenic halogenated ozone depleting substances (ODSs) and greenhouse gases (GHGs) vary with time, sensitivity simulations with either ODS or GHG concentrations fixed at 1960 levels were performed to disaggregate the drivers of projected ozone changes. These simulations were also used to assess the two distinct milestones of ozone returning to historical values (ozone return dates) and ozone no longer being influenced by ODSs (full ozone recovery). The date of ozone returning to historical values does not indicate complete recovery from ODSs in most cases, because GHG-induced changes accelerate or decelerate ozone changes in many regions. In the upper stratosphere where CO2-induced stratospheric cooling increases ozone, full ozone recovery is projected to not likely have occurred by 2100 even though ozone returns to its 1980 or even 1960 levels well before (~2025 and 2040, respectively). In contrast, in the tropical lower stratosphere ozone decreases continuously from 1960 to 2100 due to projected increases in tropical upwelling, while by around 2040 it is already very likely that full recovery from the effects of ODSs has occurred, although ODS concentrations are still elevated by this date. In the midlatitude lower stratosphere the evolution differs from that in the tropics, and rather than a steady decrease in ozone, first a decrease in ozone is simulated from 1960 to 2000, which is then followed by a steady increase through the 21st century. Ozone in the midlatitude lower stratosphere returns to 1980 levels by ~2045 in the Northern Hemisphere (NH) and by ~2055 in the Southern Hemisphere (SH), and full ozone recovery is likely reached by 2100 in both hemispheres. Overall, in all regions except the tropical lower stratosphere, full ozone recovery from ODSs occurs significantly later than the return of total column ozone to its 1980 level. The latest return of total column ozone is projected to occur over Antarctica (~2045–2060) whereas it is not likely that full ozone recovery is reached by the end of the 21st century in this region. Arctic total column ozone is projected to return to 1980 levels well before polar stratospheric halogen loading does so (~2025–2030 for total column ozone, cf. 2050–2070 for Cly+60×Bry) and it is likely that full recovery of total column ozone from the effects of ODSs has occurred by ~2035. In contrast to the Antarctic, by 2100 Arctic total column ozone is projected to be above 1960 levels, but not in the fixed GHG simulation, indicating that climate change plays a significant role.

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This paper reviews state-of-art statistical designs for dose-escalation procedures in first-into-man studies. The main focus will be on studies in oncology, as most statistical procedures for phase I trials have been proposed in this context. Extensions to situations such as the observation of bivariate outcomes and healthy volunteer studies are also discussed. The number of dose levels and cohort sizes used in early phase trials are considered. Finally, this paper raises some practical issues for dose-escalation procedures.

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The control of fishing mortality via fishing effort remains fundamental to most fisheries management strategies even at the local community or co-management level. Decisions to support such strategies require knowledge of the underlying response of the catch to changes in effort. Even under adaptive management strategies, imprecise knowledge of the response is likely to help accelerate the adaptive learning process. Data and institutional capacity requirements to employ multi-species biomass dynamics and age-structured models invariably render their use impractical particularly in less developed regions of the world. Surplus production models fitted to catch and effort data aggregated across all species offer viable alternatives. The current paper seeks models of this type that best describe the multi-species catch–effort responses in floodplain-rivers, lakes and reservoirs and reef-based fisheries based upon among fishery comparisons, building on earlier work. Three alternative surplus production models were fitted to estimates of catch per unit area (CPUA) and fisher density for 258 fisheries in Africa, Asia and South America. In all cases examined, the best or equal best fitting model was the Fox type, explaining up to 90% of the variation in CPUA. For lake and reservoir fisheries in Africa and Asia, the Schaefer and an asymptotic model fitted equally well. The Fox model estimates of fisher density (fishers km−2) at maximum yield (iMY) for floodplain-rivers, African lakes and reservoirs and reef-based fisheries are 13.7 (95% CI [11.8, 16.4]); 27.8 (95% CI [17.5, 66.7]) and 643 (95% CI [459,1075]), respectively and compare well with earlier estimates. Corresponding estimates of maximum yield are also given. The significantly higher value of iMY for reef-based fisheries compared to estimates for rivers and lakes reflects the use of a different measure of fisher density based upon human population size estimates. The models predict that maximum yield is achieved at a higher fishing intensity in Asian lakes compared to those in Africa. This may reflect the common practice in Asia of stocking lakes to augment natural recruitment. Because of the equilibrium assumptions underlying the models, all the estimates of maximum yield and corresponding levels of effort should be treated with caution.

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The vibrational energy levels of diazocarbene (diazomethylene) in its electronic ground state, (X) over tilde (3) Sigma(-) CNN, have been predicted using the variational method. The potential energy surfaces of (X) over tilde (3) A" CNN were determined by employing ab initio single reference coupled cluster with single and double excitations (CCSD), CCSD with perturbative triple excitations [CCSD(T)], multi-reference complete active space self-consistent-field (CASSCF), and internally contracted multi-reference configuration interaction (ICMRCI) methods. The correlation-consistent polarised valence quadruple zeta (cc-pVQZ) basis set was used. Four sets of vibrational energy levels determined from the four distinct analytical potential functions have been compared with the experimental values from the laser-induced fluorescence measurements of Wurfel et al. obtained in 1992. The CCSD, CCSD(T), and CASSCF potentials have not provided satisfactory agreement with the experimental observations. In this light, the importance of both non-dynamic (static) and dynamic correlation effects in describing the ground state of CNN is emphasised. Our best theoretical fundamental frequencies at the cc-pVQZ ICMRCI level of theory, v(1) = 1230, v(2) = 394, and v(3) = 1420 cm(-1) are in excellent agreement with the experimental values of v(1) = 1235, v(2) = 396, and v(3) = 1419cm(-1) and the mean absolute deviation between the 23 calculated and experimental vibrational energy levels is only 7.4 cm(-1). It is shown that the previously suggested observation of the v(3) frequency at about 2847cm(-1) was in fact the first overtone 2v(3).

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The main objectives of this paper are to: firstly, identify key issues related to sustainable intelligent buildings (environmental, social, economic and technological factors); develop a conceptual model for the selection of the appropriate KPIs; secondly, test critically stakeholder's perceptions and values of selected KPIs intelligent buildings; and thirdly develop a new model for measuring the level of sustainability for sustainable intelligent buildings. This paper uses a consensus-based model (Sustainable Built Environment Tool- SuBETool), which is analysed using the analytical hierarchical process (AHP) for multi-criteria decision-making. The use of the multi-attribute model for priority setting in the sustainability assessment of intelligent buildings is introduced. The paper commences by reviewing the literature on sustainable intelligent buildings research and presents a pilot-study investigating the problems of complexity and subjectivity. This study is based upon a survey perceptions held by selected stakeholders and the value they attribute to selected KPIs. It is argued that the benefit of the new proposed model (SuBETool) is a ‘tool’ for ‘comparative’ rather than an absolute measurement. It has the potential to provide useful lessons from current sustainability assessment methods for strategic future of sustainable intelligent buildings in order to improve a building's performance and to deliver objective outcomes. Findings of this survey enrich the field of intelligent buildings in two ways. Firstly, it gives a detailed insight into the selection of sustainable building indicators, as well as their degree of importance. Secondly, it tesst critically stakeholder's perceptions and values of selected KPIs intelligent buildings. It is concluded that the priority levels for selected criteria is largely dependent on the integrated design team, which includes the client, architects, engineers and facilities managers.

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Two experiments investigated the influence of implicit memory on consumer choice for brands with varying levels of familiarity. Priming was measured using a consideration-choice task, developed by Coates, Butler and Berry (2004). Experiment 1 employed a coupon-rating task at encoding that required participants to meaningfully process individual brand names, to assess whether priming could affect participants' final (preferred) choices for familiar brands. Experiment 2 used this same method to assess the impact of implicit memory on consideration and choice for unknown and leader brands, presented in conjunction with familiar competitors. Significant priming was obtained in both experiments, and was shown to directly influence final choice in the case of familiar and highly familiar leader brands. Moreover, it was shown that a single prior exposure could lead participants to consider buying an unknown, and indeed fictitious, brand. Copyright (c) 2006 John Wiley & Sons, Ltd.