825 resultados para Propensity
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The Australian Coal Industry Research Laboratory (ACIRL) furnace is scaled to simulate slagging and fouling in operating boilers. This requires that the gas and target temperatures, the heat flux, and the flow pattern be the same as those in real boilers. The gas and target temperatures are maintained by insulating the wall and cooling the target respectively. The flow pattern of a small burner cannot be the same as a large furnace. However, this flow pattern is partially compensated for by placing the slagging panels in three vertical locations. The paper develops the models of radiant heat transfer from the flame to the deposits both in pilot-scale and full-scale furnaces. They are used to compare the effective radiant heat transfer of the pilot- and full-scale furnaces. The experimental data both from the pilot- and full-scale furnaces are used to verify the incident heat flux and temperature profiles in the pilot- and full-scale furnaces. The results showed that the thermal condition in the pilot-scale furnace meets the requirements for studying the slagging regarding the gas temperature and the incident heat flux, particularly for the panel #1. The gas temperature in the convective section also meets the requirement for studying the fouling.
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Pulverised New Zealand coal samples have been tested from an initial temperature of 40 degreesC and reacted adiabatisally in an oven with oxygen to provide a full temperature history of auto-oxidation up to the self-sustained process of combustion. This procedure produces a self-heating rate index, R-70, calculated as the ratio of the time taken to reach 70 degreesC (degreesC/h). The R-70 index is a measure of the coal's propensity to spontaneous combustion. R-70 values for New Zealand coals are much higher than any previously published results. They show a rank dependence, whereby subbituminous coals have the highest propensity to spontaneous combustion (14.91-17.23 degreesC/h). A lignite sample has an R-70 value of 7.76 degreesC/h, and high-volatile bituminous B coals have R-70 values of 0.31-2.23 degreesC/h. Samples stored for 2 years show the same rank trend. The nature of this trend is most likely a function of the internal surface area of the coal that governs the available sites for oxidation. Calculating the Suggate rank; for any New Zealand coal can be used to rare its propensity to spontaneous combustion. Resin bodies in the subbituminous coal show no propensity to spontaneous combustion. (C) 2001 Elsevier Science B.V. All rights reserved.
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The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics
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Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Engenharia Clínica)
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Background- Formation of platelet plug initiates hemostasis after vascular injury and triggers thrombosis in ischemic disease. However, the mechanisms leading to the formation of a stable thrombus are poorly understood. Connexins comprise a family of proteins that form gap junctions enabling intercellular coordination of tissue activity, a process termed gap junctional intercellular communication. Methods and Results- In the present study, we show that megakaryocytes and platelets express connexin 37 (Cx37). Deletion of the Cx37 gene in mice shortens bleeding time and increases thrombus propensity. Aggregation is increased in murine Cx37(-/-) platelets or in murine Cx37(+/+) and human platelets treated with gap junction blockers. Intracellular microinjection of neurobiotin, a Cx37-permeant tracer, revealed gap junctional intercellular communication in platelet aggregates, which was impaired in Cx37(-/-) platelets and in human platelets exposed to gap junction blockers. Finally, healthy subjects homozygous for Cx37-1019C, a prognostic marker for atherosclerosis, display increased platelet responses compared with subjects carrying the Cx37-1019T allele. Expression of these polymorphic channels in communication-deficient cells revealed a decreased permeability of Cx37-1019C channels for neurobiotin. Conclusions- We propose that the establishment of gap junctional communication between Cx37-expressing platelets provides a mechanism to limit thrombus propensity. To our knowledge, these data provide the first evidence incriminating gap junctions in the pathogenesis of thrombosis.
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The impact of the adequacy of empirical therapy on outcome for patients with bloodstream infections (BSI) is key for determining whether adequate empirical coverage should be prioritized over other, more conservative approaches. Recent systematic reviews outlined the need for new studies in the field, using improved methodologies. We assessed the impact of inadequate empirical treatment on the mortality of patients with BSI in the present-day context, incorporating recent methodological recommendations. A prospective multicenter cohort including all BSI episodes in adult patients was performed in 15 hospitals in Andalucía, Spain, over a 2-month period in 2006 to 2007. The main outcome variables were 14- and 30-day mortality. Adjusted analyses were performed by multivariate analysis and propensity score-based matching. Eight hundred one episodes were included. Inadequate empirical therapy was administered in 199 (24.8%) episodes; mortality at days 14 and 30 was 18.55% and 22.6%, respectively. After controlling for age, Charlson index, Pitt score, neutropenia, source, etiology, and presentation with severe sepsis or shock, inadequate empirical treatment was associated with increased mortality at days 14 and 30 (odds ratios [ORs], 2.12 and 1.56; 95% confidence intervals [95% CI], 1.34 to 3.34 and 1.01 to 2.40, respectively). The adjusted ORs after a propensity score-based matched analysis were 3.03 and 1.70 (95% CI, 1.60 to 5.74 and 0.98 to 2.98, respectively). In conclusion, inadequate empirical therapy is independently associated with increased mortality in patients with BSI. Programs to improve the quality of empirical therapy in patients with suspicion of BSI and optimization of definitive therapy should be implemented.
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This paper analyses the effect of tobacco prices on the propensity tostart and quit smoking using a pool of the 1993, 1995 and 1997 editionsof the Spanish National Health Surveys. The estimates for severalparametric models of the hazard rate for starting and quitting suggestthat i) The public health measures applied as of 1992 have had asignificative effect on both reducing the hazard of starting andincreasing the hazard of quitting, ii) Prices have a very weak effect onthe hazard of starting in the male population and no significant effectin the female population, iii) The price floor of cigarrettes, proxiedby the average price of a pack of black cigarrettes, has a significanteffect on the quitting hazard which is robust across specifications andapplies to both men and women. The implied price elasticity of the timeup to quitting is situated around -1.4.
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We examine how much of an extra dollar of parental lifetime resources willultimately be passed on to adult children in the form of inter vivostransfers and bequests. We infer bequests from the stock of wealth late inlife. We use mortality rates and age specific estimates of the response oftransfers and wealth to permanent income to compute the expected presentdiscounted values of these responses to permanent income. Our estimatesimply parents pass on between 2 and 3 cents out of an extra dollar ofexpected lifetime resources in bequests and about 2 cents in transfers.The estimates increase with parental income and are smaller for nonwhites.They imply that about 15 percent of the effect of parental income onlifetime resources of adult children is through transfers and bequestsand about 85 percent is through the intergenerational correlation inearnings, although these estimates are sensitive to assumptions about theintergenerational earnings correlation, taxes, and the number of children.We compare our estimates to the implications of alternative computablebenchmark models of savings behavior in order to assess the likelyimportance of intended bequests for the wealth/income relationship.
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The 20 amino acid residue peptides derived from RecA loop L2 have been shown to be the pairing domain of RecA. The peptides bind to ss- and dsDNA, unstack ssDNA, and pair the ssDNA to its homologous target in a duplex DNA. As shown by circular dichroism, upon binding to DNA the disordered peptides adopt a beta-structure conformation. Here we show that the conformational change of the peptide from random coil to beta-structure is important in binding ss- and dsDNA. The beta-structure in the DNA pairing peptides can be induced by many environmental conditions such as high pH, high concentration, and non-micellar sodium dodecyl sulfate (6 mM). This behavior indicates an intrinsic property of these peptides to form a beta-structure. A beta-structure model for the loop L2 of RecA protein when bound to DNA is thus proposed. The fact that aromatic residues at the central position 203 strongly modulate the peptide binding to DNA and subsequent biochemical activities can be accounted for by the direct effect of the aromatic amino acids on the peptide conformational change. The DNA-pairing domain of RecA visualized by electron microscopy self-assembles into a filamentous structure like RecA. The relevance of such a peptide filamentous structure to the structure of RecA when bound to DNA is discussed.
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L'objectif principal de ce travail est d’étudier en profondeur certaines techniques biostatistiques avancées en recherche évaluative en chirurgie cardiaque adulte. Les études ont été conçues pour intégrer les concepts d'analyse de survie, analyse de régression avec “propensity score”, et analyse de coûts. Le premier manuscrit évalue la survie après la réparation chirurgicale de la dissection aigüe de l’aorte ascendante. Les analyses statistiques utilisées comprennent : analyses de survie avec régression paramétrique des phases de risque et d'autres méthodes paramétriques (exponentielle, Weibull), semi-paramétriques (Cox) ou non-paramétriques (Kaplan-Meier) ; survie comparée à une cohorte appariée pour l’âge, le sexe et la race utilisant des tables de statistiques de survie gouvernementales ; modèles de régression avec “bootstrapping” et “multinomial logit model”. L'étude a démontrée que la survie s'est améliorée sur 25 ans en lien avec des changements dans les techniques chirurgicales et d’imagerie diagnostique. Le second manuscrit est axé sur les résultats des pontages coronariens isolés chez des patients ayant des antécédents d'intervention coronarienne percutanée. Les analyses statistiques utilisées comprennent : modèles de régression avec “propensity score” ; algorithme complexe d'appariement (1:3) ; analyses statistiques appropriées pour les groupes appariés (différences standardisées, “generalized estimating equations”, modèle de Cox stratifié). L'étude a démontrée que l’intervention coronarienne percutanée subie 14 jours ou plus avant la chirurgie de pontages coronariens n'est pas associée à des résultats négatifs à court ou long terme. Le troisième manuscrit évalue les conséquences financières et les changements démographiques survenant pour un centre hospitalier universitaire suite à la mise en place d'un programme de chirurgie cardiaque satellite. Les analyses statistiques utilisées comprennent : modèles de régression multivariée “two-way” ANOVA (logistique, linéaire ou ordinale) ; “propensity score” ; analyses de coûts avec modèles paramétriques Log-Normal. Des modèles d’analyse de « survie » ont également été explorés, utilisant les «coûts» au lieu du « temps » comme variable dépendante, et ont menés à des conclusions similaires. L'étude a démontrée que, après la mise en place du programme satellite, moins de patients de faible complexité étaient référés de la région du programme satellite au centre hospitalier universitaire, avec une augmentation de la charge de travail infirmier et des coûts.
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Resumen tomado de la publicación