914 resultados para scenario-based assessment


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The first application of high field NMR spectroscopy (800 MHz for 1H observation) to human hepatic bile (as opposed to gall bladder bile) is reported. The bile sample used for detailed investigation was from a donor liver with mild fat infiltration, collected during organ retrieval prior to transplantation. In addition, to focus on the detection of bile acids in particular, a bile extract was analysed by 800 MHz 1H NMR spectroscopy, HPLC-NMR/MS and UPLC-MS. In the whole bile sample, 40 compounds have been assigned with the aid of two-dimensional 1H–1H TOCSY and 1H–13C HSQC spectra. These include phosphatidylcholine, 14 amino acids, 10 organic acids, 4 carbohydrates and polyols (glucose, glucuronate, glycerol and myo-inositol), choline, phosphocholine, betaine, trimethylamine-N-oxide and other small molecules. An initial NMR-based assessment of the concentration range of some key metabolites has been made. Some observed chemical shifts differ from expected database values, probably due to a difference in bulk diamagnetic susceptibility. The NMR spectra of the whole extract gave identification of the major bile acids (cholic, deoxycholic and chenodeoxycholic), but the glycine and taurine conjugates of a given bile acid could not be distinguished. However, this was achieved by HPLC-NMR/MS, which enabled the separation and identification of ten conjugated bile acids with relative abundances varying from approximately 0.1% (taurolithocholic acid) to 34.0% (glycocholic acid), of which, only the five most abundant acids could be detected by NMR, including the isomers glycodeoxycholic acid and glycochenodeoxycholic acid, which are difficult to distinguish by conventional LC-MS analysis. In a separate experiment, the use of UPLC-MS allowed the detection and identification of 13 bile acids. This work has shown the complementary potential of NMR spectroscopy, MS and hyphenated NMR/MS for elucidating the complex metabolic profile of human hepatic bile. This will be useful baseline information in ongoing studies of liver excretory function and organ transplantation.

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Geomagnetic activity has long been known to exhibit approximately 27 day periodicity, resulting from solar wind structures repeating each solar rotation. Thus a very simple near-Earth solar wind forecast is 27 day persistence, wherein the near-Earth solar wind conditions today are assumed to be identical to those 27 days previously. Effective use of such a persistence model as a forecast tool, however, requires the performance and uncertainty to be fully characterized. The first half of this study determines which solar wind parameters can be reliably forecast by persistence and how the forecast skill varies with the solar cycle. The second half of the study shows how persistence can provide a useful benchmark for more sophisticated forecast schemes, namely physics-based numerical models. Point-by-point assessment methods, such as correlation and mean-square error, find persistence skill comparable to numerical models during solar minimum, despite the 27 day lead time of persistence forecasts, versus 2–5 days for numerical schemes. At solar maximum, however, the dynamic nature of the corona means 27 day persistence is no longer a good approximation and skill scores suggest persistence is out-performed by numerical models for almost all solar wind parameters. But point-by-point assessment techniques are not always a reliable indicator of usefulness as a forecast tool. An event-based assessment method, which focusses key solar wind structures, finds persistence to be the most valuable forecast throughout the solar cycle. This reiterates the fact that the means of assessing the “best” forecast model must be specifically tailored to its intended use.

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Background Arboviruses have overlapping geographical distributions and can cause symptoms that coincide with more common infections. Therefore, arbovirus infections are often neglected by travel diagnostics. Here, we assessed the potential of syndrome-based approaches for diagnosis and surveillance of neglected arboviral diseases in returning travelers. Method To map the patients high at risk of missed clinical arboviral infections we compared the quantity of all arboviral diagnostic requests by physicians in the Netherlands, from 2009 through 2013, with a literature-based assessment of the travelers’ likely exposure to an arbovirus. Results 2153 patients, with travel and clinical history were evaluated. The diagnostic assay for dengue virus (DENV) was the most commonly requested (86%). Of travelers returning from Southeast Asia with symptoms compatible with chikungunya virus (CHIKV), only 55% were tested. For travelers in Europe, arbovirus diagnostics were rarely requested. Over all, diagnostics for most arboviruses were requested only on severe clinical presentation. Conclusion Travel destination and syndrome were used inconsistently for triage of diagnostics, likely resulting in vast under-diagnosis of arboviral infections of public health significance. This study shows the need for more awareness among physicians and standardization of syndromic diagnostic algorithms

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The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. Trial design The study is a randomised, controlled, non-superiority trial . Methods Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. Discussion In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013

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Práticas em gestão de projetos (GP), apesar de amplamente difundidas, utilizadas e pesquisadas, não garantem o desempenho (sucesso) do projeto em suas entregas em tempo e custos conforme planejamento. Observa-se que, apesar do uso extensivo de práticas de GP, falhas em relação ao atendimento do cronograma e orçamento são amplamente relatadas. Portanto, este trabalho tem como objetivo principal analisar a influência das práticas de gestão de projetos e do objetivo de desempenho no Comportamento de Cidadania Organizacional (OCB) da equipe de projetos. As dimensões que compuseram o OCB foram: Ajuda, Iniciativa e Compliance. Para testar a relação entre os fatores de práticas de GP (incipientes ou avançados) e objetivo de desempenho (normal ou desafiador) no comportamento da equipe foi utilizada a metodologia do experimento baseado em cenários (SBRP experiment). A amostra contou com 216 alunos de graduação e pós-graduação em administração. O estudo mostrou que a utilização de práticas em gestão de projetos não influenciou o Comportamento de Cidadania Organizacional da equipe de projetos. Entretanto, o objetivo de desempenho nas dimensões de tempo e custos influenciou o Comportamento Cidadão da equipe de projetos. Além desses resultados, a pesquisa mostrou que características pessoais, como experiência em liderar projetos, influenciou a propensão em aumento do comportamento cidadão mediante uma remuneração adicional. Como contribuição adicional este estudo mostra que existem diferenças de resultados nos diferentes grupos de respondentes (alunos de graduação e pós-graduação em administração), conforme encontrado em outros estudos. A utilização do experimento também foi um diferencial metodológico, em virtude de sua ainda baixa utilização em gestão de operações. Finalmente, este estudo também identificou as principais práticas utilizadas na gestão de projetos.

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The present article presents an assessment of PTS in Brazil including polychlorinated biphenyls, polycyclic aromatic hydrocarbons, benzene hexachloride, aldrin, dieldrin, endrin, p,p,-DDT, p,p,DDE, p,p,-DDD, hexachlorocyclohexanes (alpha-HCH, beta-HCH, gamma-HCH and delta-HCH), endossulfan, heptachlor and pentachlorophenol. The data presented here are related to a survey of PTS levels in different environmental matrixes (soil, sediment, water, air, biota) and human tissues (milk, blood, human hair), according to the scope of the UNEP-GEF Regionally Based Assessment of PTSs. Potential sources were evaluated considering national products and imports, since most of the literature does not allow source identification. Finally, Brazilian legislation was updated.

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Background: Duplex ultrasound scanning (DUS) is the method of choice for diagnosis of deep vein thrombosis (DVT). However, only a few studies have performed prospective serial DUS after an acute episode of DVT to assess its evolution. This study aimed to report our experience using DUS combined with a thrombosis score (TS) and a newly proposed vein diameter variation index (VDVI) to evaluate the rate of resolution of DVT by assessing and quantifying the early stages of vein recanalization in proximal vein segments within 6 months after an episode of acute lower extremity DVT.Methods: Twelve patients with first episode of acute lower extremity DVT confirmed by DUS as occurring in <= 10 days after the onset of venous thrombosis symptoms were followed up prospectively for 6 months. TS and VDVI were calculated at 1, 3, and 6 months to assess vein recanalization. Intra-thrombus arteriovenous fistula formation was also investigated and related to the recanalization process.Results: Seven (58%) women were included, with a total cohort median age of 53.5 +/- 19 years. The left lower extremity was affected in 7 (58%) patients. DVT was diagnosed in 55 proximal vein segments. All patients had proximal DVT, with involvement of the external iliac, femoral, and popliteal veins. After 6 months, there was a significant decrease in TS and increase in VDVI (P < 0.001) in all proximal vein segments assessed, indicating thrombus regression. The more distal the DVT was, the faster was the VDVI increase, with most popliteal veins being recanalized at 3 months (P < 0.001). Intra-thrombus arteriovenous fistula was identified in 50% of patients at 1 month while on anticoagulation.Conclusions: The combined use of two different DUS-based assessment tools, TS and the proposed VDVI, provided an effective method to prospectively assess vein recanalization rates after an episode of acute lower extremity DVT in this series of patients and may allow a correct evaluation of DVT and its resolution or progression.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Scenario-based analyses were computed for benefits and costs linked with hypothetical oral rabies vaccination (ORV) campaigns to contain or eliminate skunk-variant rabies in skunks (Mephitis mephitis) in California, USA. Scenario 1 assumed baiting eight zones (43,388 km2 total) that comprised 73% of known skunk rabies locations in the state. Scenario 2 also assumed baiting these eight zones, but further assumed that added benefits would result from preventing the spread of skunk-variant rabies into Los Angeles County, USA. Scenarios assumed a fixed bait cost ($1.24 each) but varied campaigns (one, two and three annual ORV applications), densities of baits (37.5/km2, 75/km2 and 150/km2), levels of prevention (50%, 75%, and 100%), and contingency expenditures if rabies recurred (20%, 40%, and 60% of campaign costs). Prorating potential annual benefits during a 12-yr time horizon yielded benefit-cost ratios (BCRs) between 0.16 and 2.91 and between 0.34 and 6.35 for Scenarios 1 and 2, respectively. Economic issues relevant to potentially managing skunk-variant rabies with ORV are discussed.

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Attraverso l’indagine di fonti altomedievali come le Leges dei barbari si è potuto valutare, da un punto di vista pragmatico e fattuale, l’intenzione umana – a volte incidentale e pure difficoltosa – di inquadrare e definire il rapporto con un animale domestico come il cane, che continua e si evolve tra Antichità ed Alto Medioevo e senza una cesura netta. Per completare il quadro culturale e storico-sociale della ricerca, oltre alla trattatistica antica e alla letteratura medievale sugli animali, si è passato in rassegna espressioni documentarie come i capitularia mundana ed ecclasiastica, che hanno destato ulteriore interesse in quanto in esse sussiste il riflesso di un’attenzione tutta “altomedievale” per il cane e per quell’attività che da millenni lega l’uomo a questo animale: la caccia. L’argomento venatorio presuppone l’associazione con il cane nella quasi totalità dei provvedimenti sulla caccia, trasmettendo testimonianze stimabili del connubio homo cum canibus. Ne risulta ora un’amicitia, ora un legame impedito come nelle continue interdizioni venatorie rivolte agli ecclesiastici, uomini – e donne – di Chiesa che andavano a caccia. Pur non fornendo le stesse informazioni minuziose sui cani delle Leggi dei barbari, i capitularia propongono suggestivi scorci di un mondo in cui la caccia, forse la sola attività attraverso cui uomo e cane condividono le medesime trepidazioni primordiali, non era violenza gratuita ma un fondamento della cultura, soprattutto, ma non solo, di ambito aristocratico.

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in the everyday clinical practice. Having this in mind, the choice of a simple setup would not be enough because, even if the setup is quick and simple, the instrumental assessment would still be in addition to the daily routine. The will to overcome this limit has led to the idea of instrumenting already existing and widely used functional tests. In this way the sensor based assessment becomes an integral part of the clinical assessment. Reliable and validated signal processing methods have been successfully implemented in Personal Health Systems based on smartphone technology. At the end of this research project there is evidence that such solution can really and easily used in clinical practice in both supervised and unsupervised settings. Smartphone based solution, together or in place of dedicated wearable sensing units, can truly become a pervasive and low-cost means for providing suitable testing solutions for quantitative movement analysis with a clear clinical value, ultimately providing enhanced balance and mobility support to an aging population.

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Il presente lavoro ha lo scopo di presentare gli studi e i risultati ottenuti durante l’attività di ricerca svolta sul Displacement-based Assessment (DBA) dei telai in cemento armato. Dopo alcune considerazioni iniziali sul tema della vulnerabilità sismica e sui metodi di analisi e verifica, si procede alla descrizione teorica del metodo. Sono stati analizzati tre casi studio di telai piani, progettati per soli carichi verticali e secondo normative non più in vigore che non prevedevano l’applicazione della gerarchia delle resistenze. I telai considerati, destinati ad abitazione civile, hanno diversa altezza e numero di piani, e diverso numero di campate. Si è proceduto all’applicazione del metodo, alla valutazione della vulnerabilità sismica in base alla domanda in termini di spostamento costituita da uno spettro elastico previsto dall’EC8 e alla validazione dei risultati ottenuti mediante analisi non lineari statiche e dinamiche e mediante l’applicazione dei teoremi dell’Analisi limite dei telai, proposta come procedura alternativa per la determinazione del meccanismo anelastico e della capacità in termini di taglio alla base. In ultimo si è applicata la procedura DBA per la valutazione della vulnerabilità sismica di un edificio scolastico, realizzato tra il 1969 e il 1975 in un sito caratterizzato da una accelerazione di picco orizzontale pari a 0,24g e una probabilità di superamento del 10% in 75 anni.

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Body-centric communications are emerging as a new paradigm in the panorama of personal communications. Being concerned with human behaviour, they are suitable for a wide variety of applications. The advances in the miniaturization of portable devices to be placed on or around the body, foster the diffusion of these systems, where the human body is the key element defining communication characteristics. This thesis investigates the human impact on body-centric communications under its distinctive aspects. First of all, the unique propagation environment defined by the body is described through a scenario-based channel modeling approach, according to the communication scenario considered, i.e., on- or on- to off-body. The novelty introduced pertains to the description of radio channel features accounting for multiple sources of variability at the same time. Secondly, the importance of a proper channel characterisation is shown integrating the on-body channel model in a system level simulator, allowing a more realistic comparison of different Physical and Medium Access Control layer solutions. Finally, the structure of a comprehensive simulation framework for system performance evaluation is proposed. It aims at merging in one tool, mobility and social features typical of the human being, together with the propagation aspects, in a scenario where multiple users interact sharing space and resources.

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The research hypothesis of the thesis is that “an open participation in the co-creation of the services and environments, makes life easier for vulnerable groups”; assuming that the participatory and emancipatory approaches are processes of possible actions and changes aimed at facilitating people’s lives. The adoption of these approaches is put forward as the common denominator of social innovative practices that supporting inclusive processes allow a shift from a medical model to a civil and human rights approach to disability. The theoretical basis of this assumption finds support in many principles of Inclusive Education and the main focus of the hypothesis of research is on participation and emancipation as approaches aimed at facing emerging and existing problems related to inclusion. The framework of reference for the research is represented by the perspectives adopted by several international documents concerning policies and interventions to promote and support the leadership and participation of vulnerable groups. In the first part an in-depth analysis of the main academic publications on the central themes of the thesis has been carried out. After investigating the framework of reference, the analysis focuses on the main tools of participatory and emancipatory approaches, which are able to connect with the concepts of active citizenship and social innovation. In the second part two case studies concerning participatory and emancipatory approaches in the areas of concern are presented and analyzed as example of the improvement of inclusion, through the involvement and participation of persons with disability. The research has been developed using a holistic and interdisciplinary approach, aimed at providing a knowledge-base that fosters a shift from a situation of passivity and care towards a new scenario based on the person’s commitment in the elaboration of his/her own project of life.

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The noticeable differences in the theoretical and operative definitions of envy across studies and approaches have produced a fragmentary representation and understanding of the envious emotion. The present dissertation aimed to clarify the inherent nature of the construct of envy through the integration of findings from three independent studies. We focused on malicious envy, and investigated it from both a dispositional and an episodic perspective. Studies 1 and 2 investigated the dimensionality of envy as a stable individual characteristic and an episodic emotional state, respectively. In order to elicit episodic envy, a scenario-based experiment was conducted. Results indicated that, in both its dispositional and episodic facets, envy is a bidimensional construct composed by an inner-directed dimension of inferiority and helplessness, and an outer-directed dimension of feelings of anger and ill will. Moreover, findings from Study 1 allowed to establish boundaries between envy and competing constructs that have often been included in conceptualizations of envy. The psychometrically validated definition of envy provided by Studies 1 and 2 represents a valuable contribution to empirical research. Implications for envy research concern the promotion of a shared operationalization of envy in future studies, which will arguably facilitate the comparison of findings between studies and between approaches. Study 3 examined the mechanisms through which dispositional envy affects individuals’ social adjustment and psychological wellbeing. Findings revealed that the detrimental effects of envy on perceived social support and subjective well-being are mostly mediated by other personal characteristics, such as neuroticism and self-esteem. By reducing global self-esteem, the envious disposition may damage supportive social networks via antisocial direct and indirect behaviors that may arise from envy and that are likely to drive others away. On the other hand, by damaging both emotional stability and self-worth, dispositional envy leads to reduced subjective well-being. Implications for clinical practice are discussed.