1000 resultados para marés


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Hartley proposes that what we need is a 'respect for a "law" of interdependent toleration of positions with which we don't agree, which are held by people we don't like. The usual name for this remarkable achievement is -"TV comedy." '

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Background The effects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical Surgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confirmed mesothelioma and were deemed fit enough to undergo trimodal therapy were included. In a prerandomisation registration phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. After further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratified by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (five patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in five patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively after receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92-3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21-6·26; p=0·016). Median survival was 14·4 months (5·3-18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no significant differences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients. Funding Cancer Research UK (CRUK/04/003), the June Hancock Mesothelioma Research Fund, and Guy's and St Thomas' NHS Foundation Trust. © 2011 Elsevier Ltd.

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For a planetary rover to successfully traverse across unstructured terrain autonomously, one of the major challenges is to assess its local traversability such that it can plan a trajectory to achieve its mission goals efficiently while minimising risk to the vehicle itself. This paper aims to provide a comparative study on different approaches for representing the geometry of Martian terrain for the purpose of evaluating terrain traversability. An accurate representation of the geometric properties of the terrain is essential as it can directly affect the determination of traversability for a ground vehicle. We explore current state-of-the-art techniques for terrain estimation, in particular Gaussian Processes (GP) in various forms, and discuss the suitability of each technique in the context of an unstructured Martian terrain. Furthermore, we present the limitations of regression techniques in terms of spatial correlation and continuity assumptions, and the impact on traversability analysis of a planetary rover across unstructured terrain. The analysis was performed on datasets of the Mars Yard at the Powerhouse Museum in Sydney, obtained using the onboard RGB-D camera.

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Smartphone technology provides free or inexpensive access to mental health and wellbeing resources. As a result the use of mobile applications for these purposes has increased significantly in recent years. Yet, there is currently no app quality assessment alternative to the popular ‘star’-ratings, which are often unreliable. This presentation describes the development of the Mobile Application Rating Scale (MARS) a new measure for classifying and rating the quality of mobile applications. A review of existing literature on app and web quality identified 25 published papers, conference proceedings, and online resources (published since 1999), which identified 372 explicit quality criteria. Qualitative analysis identified five broad categories of app quality rating criteria: engagement, functionality, aesthetics, information quality, and overall satisfaction, which were refined into the 23-item MARS. Independent ratings of 50 randomly selected mental health and wellbeing mobile apps indicated the MARS had excellent levels of internal consistency (α = 0.92) and inter-rater reliability (ICC = 0.85). The MARS provides practitioners and researchers with an easy-to-use, simple, objective and reliable tool for assessing mobile app quality. It also provides mHealth professionals with a checklist for the design and development of high quality apps.

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In 2013, ten teams from German universities and research institutes participated in a national robot competition called SpaceBot Cup organized by the DLR Space Administration. The robots had one hour to autonomously explore and map a challenging Mars-like environment, find, transport, and manipulate two objects, and navigate back to the landing site. Localization without GPS in an unstructured environment was a major issue as was mobile manipulation and very restricted communication. This paper describes our system of two rovers operating on the ground plus a quadrotor UAV simulating an observing orbiting satellite. We relied on ROS (robot operating system) as the software infrastructure and describe the main ROS components utilized in performing the tasks. Despite (or because of) faults, communication loss and breakdowns, it was a valuable experience with many lessons learned.

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The Molecular Adsorbent Recirculating System (MARS) is an extracorporeal albumin dialysis device which is used in the treatment of liver failure patients. This treatment was first utilized in Finland in 2001, and since then, over 200 patients have been treated. The aim of this thesis was to evaluate the impact of the MARS treatment on patient outcome, the clinical and biochemical variables, as well as on the psychological and economic aspects of the treatment in Finland. This thesis encompasses 195 MARS-treated patients (including patients with acute liver failure (ALF), acute-on-chronic liver failure (AOCLF) and graft failure), and a historical control group of 46 ALF patients who did not undergo MARS. All patients received a similar standard medical therapy at the same intensive care unit. The baseline data (demographics, laboratory and clinical variables) and MARS treatment-related and health-related quality-of-life data were recorded before and after treatment. The direct medical costs were determined for a period of 3.5 years.Additionally, the outcome of patients (survival, native liver recovery and need for liver transplantation) and survival predicting factors were investigated. In the outcome analysis, for the MARS-treated ALF patients, their 6-month survival (75% vs. 61%, P=0.07) and their native liver recovery rate (49% vs. 17%, P<0.001) were higher, and their need for transplantations was lower (29% vs. 57%, P= 0.001) than for the historical controls. However, the etiological distribution of the ALF patients referred to our unit has changed considerably over the past decade and the percentage of patients with a more favorable prognosis has increased. The etiology of liver failure was the most important predictor of the outcome. Other survival predicting factors in ALF included hepatic encephalopathy, the coagulation factors and the liver enzyme levels prior to MARS treatment. In terms of prognosis, the MARS treatment of the cirrhotic AOCLF patient seems meaningful only when the patient is eligible for transplantation. The MARS treatment appears to halt the progression of encephalopathy and reduce the blood concentration of neuroactive amino acids, albumin-bound and water-soluble toxins. In general, the effects of the MARS treatment seem to stabilize the patients, thus allowing additional time either for the native liver to recover, or for the patients to endure the prolonged waiting for transplantation. Furthermore, for the ALF patients, the MARS treatment appeared to be less costly and more cost-efficient than the standard medical therapy alone. In conclusion, the MARS treatment appears to have a beneficial effect on the patient outcome in ALF and in those AOCLF patients who can be bridged to transplantation.

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The planet Mars is the Earth's neighbour in the Solar System. Planetary research stems from a fundamental need to explore our surroundings, typical for mankind. Manned missions to Mars are already being planned, and understanding the environment to which the astronauts would be exposed is of utmost importance for a successful mission. Information of the Martian environment given by models is already now used in designing the landers and orbiters sent to the red planet. In particular, studies of the Martian atmosphere are crucial for instrument design, entry, descent and landing system design, landing site selection, and aerobraking calculations. Research of planetary atmospheres can also contribute to atmospheric studies of the Earth via model testing and development of parameterizations: even after decades of modeling the Earth's atmosphere, we are still far from perfect weather predictions. On a global level, Mars has also been experiencing climate change. The aerosol effect is one of the largest unknowns in the present terrestrial climate change studies, and the role of aerosol particles in any climate is fundamental: studies of climate variations on another planet can help us better understand our own global change. In this thesis I have used an atmospheric column model for Mars to study the behaviour of the lowest layer of the atmosphere, the planetary boundary layer (PBL), and I have developed nucleation (particle formation) models for Martian conditions. The models were also coupled to study, for example, fog formation in the PBL. The PBL is perhaps the most significant part of the atmosphere for landers and humans, since we live in it and experience its state, for example, as gusty winds, nightfrost, and fogs. However, PBL modelling in weather prediction models is still a difficult task. Mars hosts a variety of cloud types, mainly composed of water ice particles, but also CO2 ice clouds form in the very cold polar night and at high altitudes elsewhere. Nucleation is the first step in particle formation, and always includes a phase transition. Cloud crystals on Mars form from vapour to ice on ubiquitous, suspended dust particles. Clouds on Mars have a small radiative effect in the present climate, but it may have been more important in the past. This thesis represents an attempt to model the Martian atmosphere at the smallest scales with high resolution. The models used and developed during the course of the research are useful tools for developing and testing parameterizations for larger-scale models all the way up to global climate models, since the small-scale models can describe processes that in the large-scale models are reduced to subgrid (not explicitly resolved) scale.

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Sedimentary rocks on Mars provide insight into past aqueous and atmospheric processes, climate regimes, and potential habitability. The stratigraphic architecture of sedimentary rocks on Mars is similar to that of Earth, indicating that the processes that govern deposition and erosion on Mars can be reasonably inferred through reference to analogous terrestrial systems. This dissertation aims to understand Martian surface processes through the use of (1) ground-based observations from the Mars Exploration Rovers, (2) orbital data from the High Resolution Imaging Science Experiment onboard the Mars Reconnaissance Orbiter, and (3) the use of terrestrial field analogs to understand bedforms and sediment transport on Mars. Chapters 1 and 2 trace the history of aqueous activity at Meridiani Planum, through the reconstruction of eolian bedforms at Victoria crater, and the identification of a potential mudstone facies at Santa Maria crater. Chapter 3 uses Terrestrial Laser Scanning to study cross-bedding in pyroclastic surge deposits on Earth in order to understand sediment transport in these events and to establish criteria for their identification on Mars. The final chapter analyzes stratal geometries in the Martian North Polar Layered Deposits using tools for sequence stratigraphic analysis, to better constrain past surface processes and past climate conditions on Mars.

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Diurnal variations and geographic distribution of zooplankton and micronekton are studied in the Angola Dome. The small zooplankton species (Copepodids, Copepods, Amphipods, Ostracods, Chaetognaths, etc.) undertake vertical migrations within a 100 m water layer. Most of the micronekton species are below this layer during the day and move towards the surface during the night. The whole region prospected is rich in zooplankton and micronekton species that are present in the upper 100 m layer during the day. Only the South-West region is poor. On the contrary, this latter region is abundant in species that migrate below this layer during the day. The authors think there are 3 main difficulties in establishing good relationships between micronekton and tunas distribution: 1 - inability of micronekton nets to catch the tunas preys; 2 - the great diversity of tunas food; and 3 - the too large delay between micronekton studies and those of stomach contents of tunas.

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The evolution of a plankton copepod population in the Mauritania upwelling was studied by following a drogue for 9 days, from the point of upwelling till the water-mass dives under offshore waters. The Shannon index of specific diversity and the tropic structure allow separation into several stages in the studied succession. The upwelling brings near the shore a rather poor, highly diverse fauna, with a low filter-feeder rate. The phytoplanktonic development induces an increase in the copepod number. The filter-feeders become dominant and the diversity decreases. When the increase of copepod number stops, the diversity decreases and the omnivore and carnivore rate increases.