Sample records for quiste aracnoideo tras

  1. Teacher Reporting Attitudes Scale (TRAS): confirmatory and exploratory factor analyses with a Malaysian sample.

    PubMed

    Choo, Wan Yuen; Walsh, Kerryann; Chinna, Karuthan; Tey, Nai Peng

    2013-01-01

    The Teacher Reporting Attitude Scale (TRAS) is a newly developed tool to assess teachers' attitudes toward reporting child abuse and neglect. This article reports on an investigation of the factor structure and psychometric properties of the short form Malay version of the TRAS. A self-report cross-sectional survey was conducted with 667 teachers in 14 randomly selected schools in Selangor state, Malaysia. Analyses were conducted in a 3-stage process using both confirmatory (stages 1 and 3) and exploratory factor analyses (stage 2) to test, modify, and confirm the underlying factor structure of the TRAS in a non-Western teacher sample. Confirmatory factor analysis did not support a 3-factor model previously reported in the original TRAS study. Exploratory factor analysis revealed an 8-item, 4-factor structure. Further confirmatory factor analysis demonstrated appropriateness of the 4-factor structure. Reliability estimates for the four factors-commitment, value, concern, and confidence-were moderate. The modified short form TRAS (Malay version) has potential to be used as a simple tool for relatively quick assessment of teachers' attitudes toward reporting child abuse and neglect. Cross-cultural differences in attitudes toward reporting may exist and the transferability of newly developed instruments to other populations should be evaluated.

  2. Teacher Reporting Attitudes Scale (TRAS): Confirmatory and Exploratory Factor Analyses with a Malaysian Sample

    ERIC Educational Resources Information Center

    Choo, Wan Yuen; Walsh, Kerryann; Chinna, Karuthan; Tey, Nai Peng

    2013-01-01

    The Teacher Reporting Attitude Scale (TRAS) is a newly developed tool to assess teachers' attitudes toward reporting child abuse and neglect. This article reports on an investigation of the factor structure and psychometric properties of the short form Malay version of the TRAS. A self-report cross-sectional survey was conducted with 667 teachers…

  3. Quiste neuroentérico intramedular: Reporte de caso y revisión bibliográfica

    PubMed Central

    Luque, Leopoldo Luciano; Marchetti, Maximo; Seclen, Daniel; Sainz, Ariel; Platas, Marcelo; Lambre, Jorge

    2018-01-01

    Resumen Los quistes neuroentéricos (QNE) son lesiones raras, congénitas y benignas, causadas por la comunicación persistente o anormal entre el neuroectodermo, la notocorda y el endodermo. Se presentan principalmente en pacientes pediátricos y adultos jóvenes, asociados a otras malformaciones vertebromedulares, gastrointestinales y respiratorias. Son lesiones intradurales extramedulares, siendo excepcional su presentación intramedular. El objetivo del presente artículo es reportar un caso de QNE intramedular cervical en un adulto joven, sin malformaciones concomitantes. El tratamiento quirúrgico es de elección según toda la bibliografía consultada, y por su alta tasa de recurrencia, el objetivo debe ser la resección total. El seguimiento con RMN es recomendado en resecciones subtotales. PMID:29900034

  4. Combating HER2-overexpressing breast cancer through induction of calreticulin exposure by Tras-Permut CrossMab

    PubMed Central

    Zhang, Fan; Zhang, Jie; Liu, Moyan; Zhao, Lichao; LingHu, RuiXia; Feng, Fan; Gao, Xudong; Jiao, Shunchang; Zhao, Lei; Hu, Yi; Yang, Junlan

    2015-01-01

    Although trastuzumab has succeeded in breast cancer treatment, acquired resistance is one of the prime obstacles for breast cancer therapies. There is an urgent need to develop novel HER2 antibodies against trastuzumab resistance. Here, we first rational designed avidity-imporved trastuzumab and pertuzumab variants, and explored the correlation between the binding avidity improvement and their antitumor activities. After characterization of a pertuzumab variant L56TY with potent antitumor activities, a bispecific immunoglobulin G-like CrossMab (Tras-Permut CrossMab) was generated from trastuzumab and binding avidity-improved pertuzumab variant L56TY. Although, the antitumor efficacy of trastuzumab was not enhanced by improving its binding avidity, binding avidity improvement could significantly increase the anti-proliferative and antibody-dependent cellular cytotoxicity (ADCC) activities of pertuzumab. Further studies showed that Tras-Permut CrossMab exhibited exceptional high efficiency to inhibit the progression of trastuzumab-resistant breast cancer. Notably, we found that calreticulin (CRT) exposure induced by Tras-Permut CrossMab was essential for induction of tumor-specific T cell immunity against tumor recurrence. These data indicated that simultaneous blockade of HER2 protein by Tras-Permut CrossMab could trigger CRT exposure and subsequently induce potent tumor-specific T cell immunity, suggesting it could be a promising therapeutic strategy against trastuzumab resistance. PMID:25949918

  5. "Tras de un Amoroso Lance" como Estructura Expresiva (The Poem, "Behind the Amorous Cast" as an Expressive Structure).

    ERIC Educational Resources Information Center

    Bratosevich, Nicolas

    1967-01-01

    An analysis of a poem by San Juan de la Cruz (St. John of the Cross), the sixteenth century Spanish mystic, identifies symbols and images, explains themes, and offers a synthesis of his structural patterns. The poem, "Tras de amoroso lance", deals with the theme of the search of the beloved (i.e., the soul) for the lover, and…

  6. Multi-Modal Interaction for Robotic Mules

    DTIC Science & Technology

    2014-02-26

    Multi-Modal Interaction for Robotic Mules Glenn Taylor, Mike Quist, Matt Lanting, Cory Dunham , Patrick Theisen, Paul Muench Abstract...Taylor, Mike Quist, Matt Lanting, Cory Dunham , and Patrick Theisen are with Soar Technology, Inc. (corresponding author: 734-887- 7620; email: glenn...soartech.com; quist@soartech.com; matt.lanting@soartech.com; dunham @soartech.com; patrick.theisen@soartech.com Paul Muench is with US Army TARDEC

  7. [Cambios en la salud sexual de los pacientes obesos tras cirugía bariátrica].

    PubMed

    Pomares-Callejón, María A; Ferrer-Márquez, Manuel; Solvas-Salmerón, María J

    2018-01-01

    Los objetivos del estudio fueron: 1) evaluar la salud sexual en pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica; y 2) valorar la evolución de la salud sexual tras 12 meses de la cirugía. Estudio descriptivo, prospectivo desde febrero de 2011 hasta junio de 2014. Se valoró la actividad sexual en los hombres a través del cuestionario EVAS-H y la función sexual en la mujer a través de la escala FSM (44 pacientes). Durante el estudio basal en los hombres, un 21% de la muestra presentó disfunción sexual en diferentes dimensiones, mientras que un 43% presentó problemas de eyaculación precoz. Tras 12 meses de la intervención, se observó un incremento de la actividad sexual global (p = 0.026). En torno al 70-89% de las mujeres, previamente a la cirugía, no presentaban trastorno. En la evolución no se observaron cambios medios relevantes (p > 0.05). Los pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica presentan alteraciones considerables en diversas dimensiones de la salud sexual. Después de 12 meses de seguimiento, la salud sexual parece mejorar en los hombres. The aims of the study were: 1) to assess sexual health patients severe/morbid obesity patients candidates for bariatric surgery; and 2) to assess sexual health evolution after 12 months of surgery. Descriptive, prospective study from February 2011 to June 2014. Sexual activity in men was valued through EVAS-H questionnaire and through FSM scale on women (44 patients). During the basal study in men, a 21% of the sample showed sexual disfunction in different dimensions, while a 43% showed problems with premature ejaculation. 12 months after surgery, global sexual activity was improved significantly (p = 0,026). Approximately 70-89% of women presented no disturbance before surgery. No average relevant changes were observed within the evolution (p > 0.05). Morbid/severe obesity patients candidates to bariatric surgery, show considerable alterations on diverse

  8. Skylab

    NASA Image and Video Library

    1972-08-21

    Terry C. Quist (center), high school student from San Antonio, Texas, discusses his proposed Skylab experiment with Marshall Space Flight Center’s (MSFC) Henry Floyd (left), coordinator of the Skylab Student Experiment Project, and DR. Raymond Gause, scientific advisor to Quist. The student’s experiment, “Earth Orbital Neutron Analysis”, was aimed at learning more about the source of neutrons in the solar system by seeking the number and direction from which each comes. Quist was among the 25 winners of a contest in which some 3,500 high school students proposed experiments for the following year’s Skylab mission. Of the 25 students, 6 did not see their experiments conducted on Skylab because the experiments were not compatible with Skylab hardware and timelines. Of the 19 remaining, 11 experiments required the manufacture of equipment, such as Quist’s experiment, which required detector hardware.

  9. Satellite test of the isotropy of the one-way spe ed of light using ExTRAS

    NASA Technical Reports Server (NTRS)

    Wolf, Peter

    1995-01-01

    A test of the second postulate of special relativity, the universality of the speed of light, using the ExTRAS (Experiment on Timing Ranging and Atmospheric Sounding) payload to be flown on board a Russian Meteor-3M satellite (launch date January 1997) is proposed. The propagation time of a light signal transmitted from one point to another without reflection would be measured directly by comparing the phases of two hydrogen maser clocks, one on board and one on the ground, using laser or microwave time transfer systems. An estimated uncertainty budget of the proposed measurements is given, resulting in an expected sensitivity of the experiment of delta c/c is less than 8xl0(exp -10) which would be an improvement by a factor of approximately 430 over previous direct measurements and by a factor of approximately 4 over the best indirect measurement. The proposed test would require no equipment additional to what is already planned and so is of inherently low-cost. It could be carried out by anyone having access to a laser or microwave ground station and a hydrogen maser.

  10. Anticipated uncertainty budgets of PRARETIME and T2L2 techniques as applied to ExTRAS

    NASA Technical Reports Server (NTRS)

    Thomas, Claudine; Wolf, Peter; Uhrich, Pierre J. M.; Schaefer, W.; Nau, H.; Veillet, Christian

    1995-01-01

    The Experiment on Timing Ranging and Atmospheric Soundings, ExTRAS, was conceived jointly by the European Space Agency, ESA, and the Russian Space Agency, RSA. It is also designated the 'Hydrogen-maser in Space/Meteor-3M project'. The launch of the satellite is scheduled for early 1997. The package, to be flown on board a Russian meteorological satellite includes ultra-stable frequency and time sources, namely two active and auto-tuned hydrogen masers. Communication between the on-board hydrogen masers and the ground station clocks is effected by means of a microwave link using the modified version for time transfer of the Precise Range And Range-rate Equipment, PRARETIME, technique, and an optical link which uses the Time Transfer by Laser Link, T2L2, method. Both the PRARETIME and T2L2 techniques operate in a two-directional mode, which makes it possible to carry out accurate transmissions without precise knowledge of the satellite and station positions. Due to the exceptional quality of the on-board clocks and to the high performance of the communication techniques with the satellite, satellite clock monitoring and ground clocks synchronization are anticipated to be performed with uncertainties below 0.5 ns (1 sigma). Uncertainty budgets and related comments are presented.

  11. Skylab

    NASA Image and Video Library

    1973-01-01

    The rate of neutron flow is commonly referred to as a flux. The measurement of neutron fluxes in Skylab was the subject of a proposal by Terry Quist of San Antonio, Texas. This chart describes Quist's experiment, Neutron Analysis, Skylab student experiment ED-76. These measurements were considered important not only by NASA but also by the scientific community for four reasons. High energy neutrons can be harmful to human tissue if they are present in significant quantities. Fluxes of neutrons can damage film and other sensitive experimental equipment in a marner similar to those produced by x-rays or other radiation. Furthermore, neutron fluxes can be used as a calibration source for other space-oriented particle physics experiments. Finally, neutron fluxes can affect sensitive x-ray and gamma-ray astronomy observations. Quist's objectives were to measure the neutron fluxes present in Skylab and, with the assistance of NASA and other physicists, to attempt determination of their origin as well as their energy range or spectrum. This experiment had stimulated interest in further studies of neutron phenomena in space. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  12. Neutron Analysis - Skylab Student Experiment ED-76

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The rate of neutron flow is commonly referred to as a flux. The measurement of neutron fluxes in Skylab was the subject of a proposal by Terry Quist of San Antonio, Texas. This chart describes Quist's experiment, Neutron Analysis, Skylab student experiment ED-76. These measurements were considered important not only by NASA but also by the scientific community for four reasons. High energy neutrons can be harmful to human tissue if they are present in significant quantities. Fluxes of neutrons can damage film and other sensitive experimental equipment in a marner similar to those produced by x-rays or other radiation. Furthermore, neutron fluxes can be used as a calibration source for other space-oriented particle physics experiments. Finally, neutron fluxes can affect sensitive x-ray and gamma-ray astronomy observations. Quist's objectives were to measure the neutron fluxes present in Skylab and, with the assistance of NASA and other physicists, to attempt determination of their origin as well as their energy range or spectrum. This experiment had stimulated interest in further studies of neutron phenomena in space. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  13. Flaxseed oil-trastuzumab interaction in breast cancer.

    PubMed

    Mason, Julie K; Chen, Jianmin; Thompson, Lilian U

    2010-01-01

    Flaxseed oil (FO), which is rich in n-3 fatty acid, is commonly consumed by breast cancer patients because of its potential anti-cancer effects. Trastuzumab (TRAS) is the primary drug for epidermal growth factor receptor 2 (HER2) positive breast cancer. We investigated in athymic mice whether combining dietary FO (8%) with TRAS treatment (2.5 or 5mg/kg body weight) can cause better or adverse effect on established human breast tumors overexpressing HER2 (BT-474). Control tumors significantly grew 187%, TRAS2.5 treated tumors did not change, while TRAS5, FO+TRAS2.5 and FO+TRAS5 treated tumors significantly regressed 75%, 89% and 84%, respectively, after 4weeks treatment. Two weeks after stopping TRAS treatment while continuing on same diet, tumor size in FO+TRAS2.5 group was 87% lower than in TRAS2.5 group and was not different from TRAS5 group with or without FO. Combined TRAS2.5 treatment with FO caused a significantly lower tumor cell proliferation and higher apoptosis compared to TRAS2.5 treatment alone and showed similar effect to TRAS5 treatment with or without FO. Hence, FO did not interfere with TRAS but rather enhanced its tumor-reducing effects and combined FO and low dose TRAS was as effective as high dose TRAS treatment. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  14. Calculation of the standard partial molal thermodynamic properties and dissociation constants of aqueous HCl{sup 0} and HBr{sup 0} at temperatures to 1000 C and pressures to 5 kbar

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pokrovskii, V.A.

    1999-04-01

    Dissociation constants of aqueous ion pairs HCl{sup 0} and HBr{sup 0} derived in the literature from vapor pressure and supercritical conductance measurements (Quist and Marshall, 1968b; Frantz and Marshall, 1984) were used to calculate the standard partial molal thermodynamic properties of the species at 25 C and 1 bar. Regression of the data with the aid of revised Helgeson-Kirkham-Flowers equations of state (Helgeson et al., 1981; Tanger and Helgeson, 1988; Shock et al., 1989) resulted in a set of equations-of-state parameters that permits accurate calculation of the thermodynamic properties of the species at high temperatures and pressures. These properties andmore » parameters reproduce generally within 0.1 log unit (with observed maximum deviation of 0.23 log unit) the log K values for HBr{sup 0} and HCl{sup 0} given by Quist and Marshall (1968b) and Frantz and Marshall (1984), respectively, at temperatures to 800 C and pressures to 5 kbar.« less

  15. Phase III, Randomized Study of Dual Human Epidermal Growth Factor Receptor 2 (HER2) Blockade With Lapatinib Plus Trastuzumab in Combination With an Aromatase Inhibitor in Postmenopausal Women With HER2-Positive, Hormone Receptor-Positive Metastatic Breast Cancer: ALTERNATIVE.

    PubMed

    Johnston, Stephen R D; Hegg, Roberto; Im, Seock-Ah; Park, In Hae; Burdaeva, Olga; Kurteva, Galina; Press, Michael F; Tjulandin, Sergei; Iwata, Hiroji; Simon, Sergio D; Kenny, Sarah; Sarp, Severine; Izquierdo, Miguel A; Williams, Lisa S; Gradishar, William J

    2018-03-10

    Purpose Human epidermal growth factor receptor 2 (HER2) targeting plus endocrine therapy (ET) improved clinical benefit in HER2-positive, hormone receptor (HR)-positive metastatic breast cancer (MBC) versus ET alone. Dual HER2 blockade enhances clinical benefit versus single HER2 blockade. The ALTERNATIVE study evaluated the efficacy and safety of dual HER2 blockade plus aromatase inhibitor (AI) in postmenopausal women with HER2-positive/HR-positive MBC who received prior ET and prior neo(adjuvant)/first-line trastuzumab (TRAS) plus chemotherapy. Methods Patients were randomly assigned (1:1:1) to receive lapatinib (LAP) + TRAS + AI, TRAS + AI, or LAP + AI. Patients for whom chemotherapy was intended were excluded. The primary end point was progression-free survival (PFS; investigator assessed) with LAP + TRAS + AI versus TRAS + AI. Secondary end points were PFS (comparison of other arms), overall survival, overall response rate, clinical benefit rate, and safety. Results Three hundred fifty-five patients were included in this analysis: LAP + TRAS + AI (n = 120), TRAS + AI (n = 117), and LAP + AI (n = 118). Baseline characteristics were balanced. The study met its primary end point; superior PFS was observed with LAP + TRAS + AI versus TRAS + AI (median PFS, 11 v 5.7 months; hazard ratio, 0.62; 95% CI, 0.45 to 0.88; P = .0064). Consistent PFS benefit was observed in predefined subgroups. Overall response rate, clinical benefit rate, and overall survival also favored LAP + TRAS + AI. The median PFS with LAP + AI versus TRAS + AI was 8.3 versus 5.7 months (hazard ratio, 0.71; 95% CI, 0.51 to 0.98; P = .0361). Common adverse events (AEs; ≥ 15%) with LAP + TRAS + AI, TRAS + AI, and LAP + AI were diarrhea (69%, 9%, and 51%, respectively), rash (36%, 2%, and 28%, respectively), nausea (22%, 9%, and 22%, respectively), and paronychia (30%, 0%, and 15%, respectively), mostly grade 1 or 2. Serious AEs were reported similarly across the three groups, and AEs leading to

  16. Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

    PubMed

    Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

    2017-01-01

    Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

  17. Translucency and learnability of Blissymbols in Setswana-speaking children: an exploration.

    PubMed

    Bornman, Juan; Alant, Erna; Du Preez, Anlie

    2009-12-01

    Although the importance of iconicity in the learning of symbols has been widely acknowledged, there have been few systematic investigations into the influence of culture on the ratings of symbol iconicity. The purposes of this study were two-fold: to determine (a) the translucency ratings of specific Blissymbols as rated by 6- to 7-year-old Setswana-speaking children (one of South Africa's 11 official languages); and (b) whether the ratings changed after second and third exposures in order to determine the learnability of these symbols. This study is partially based on the study by Quist et al. (1998), which utilized Dutch and American participants. Thirty-four Setswana children were exposed to 93 selected Blissymbols. A 3-point semantic differential scale consisting of three faces accompanied each Blissymbol, without the written gloss. This procedure was repeated over a period of 3 days. The results indicated that the majority of Blissymbols were rated as having high translucency ratings. The research further demonstrated significant differences in translucency between first and second exposures, suggesting that learning of the symbols had occurred. The comparison between the results of the current study and the results reported in the Quist et al. study reveal that the translucency ratings of the majority of the selected Blissymbols ranged from moderate to high for all three studies, but that the distribution of symbols across the ratings appears to be different.

  18. New Developments in the Technology Readiness Assessment Process in US DOE-EM - 13247

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Krahn, Steven; Sutter, Herbert; Johnson, Hoyt

    2013-07-01

    A Technology Readiness Assessment (TRA) is a systematic, metric-based process and accompanying report that evaluates the maturity of the technologies used in systems; it is designed to measure technology maturity using the Technology Readiness Level (TRL) scale pioneered by the National Aeronautics and Space Administration (NASA) in the 1980's. More recently, DoD has adopted and provided systematic guidance for performing TRAs and determining TRLs. In 2007 the GAO recommended that the DOE adopt the NASA/DoD methodology for evaluating technology maturity. Earlier, in 2006-2007, DOE-EM had conducted pilot TRAs on a number of projects at Hanford and Savannah River. In Marchmore » 2008, DOE-EM issued a process guide, which established TRAs as an integral part of DOE-EM's Project Management Critical Decision Process. Since the development of its detailed TRA guidance in 2008, DOE-EM has continued to accumulate experience in the conduct of TRAs and the process for evaluating technology maturity. DOE has developed guidance on TRAs applicable department-wide. DOE-EM's experience with the TRA process, the evaluations that led to recently developed proposed revisions to the DOE-EM TRA/TMP Guide; the content of the proposed changes that incorporate the above lessons learned and insights are described. (authors)« less

  19. Skylab

    NASA Image and Video Library

    1972-08-21

    San Antonio, Texas high school student, Terry C. Quist (left), and Dr. Raymond Gause of the Marshall Space Flight Center (MSFC), discuss the student’s experiment to be performed aboard the Skylab the following year. His experiment, “Earth Orbital Neutron Analysis” required detectors such as the one he is examining in this photo. The detector was to be attached to a water tank in Skylab. Neutrons striking the detectors left traces that were brought out by a chemical etching process after the Skylab mission. Quist’s experiment seeked to record neutron hits, count them, and determine their direction. This information was to help determine the source of neutrons in the solar system. Quist was among 25 winners of a contest in which some 3,500 high school students proposed experiments for the following year’s Skylab mission. The nationwide scientific competition was sponsored by the National Science Teachers Association and the National Aeronautics and Space Administration (NASA). The winning students, along with their parents and sponsor teachers, visited MSFC two months earlier where they met with scientists and engineers, participated in design reviews for their experiments, and toured MSFC facilities. Of the 25 students, 6 did not see their experiments conducted on Skylab because the experiments were not compatible with Skylab hardware and timelines. Of the 19 remaining, 11 experiments required the manufacture of additional equipment. The equipment for the experiments was manufactured at MSFC.

  20. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience.

    PubMed

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-10-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt-Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment.

  1. Getting TRAIL back on track for cancer therapy

    PubMed Central

    Lemke, J; von Karstedt, S; Zinngrebe, J; Walczak, H

    2014-01-01

    Unlike other members of the TNF superfamily, the TNF-related apoptosis-inducing ligand (TRAIL, also known as Apo2L) possesses the unique capacity to induce apoptosis selectively in cancer cells in vitro and in vivo. This exciting discovery provided the basis for the development of TRAIL-receptor agonists (TRAs), which have demonstrated robust anticancer activity in a number of preclinical studies. Subsequently initiated clinical trials testing TRAs demonstrated, on the one hand, broad tolerability but revealed, on the other, that therapeutic benefit was rather limited. Several factors that are likely to account for TRAs' sobering clinical performance have since been identified. First, because of initial concerns over potential hepatotoxicity, TRAs with relatively weak agonistic activity were selected to enter clinical trials. Second, although TRAIL can induce apoptosis in several cancer cell lines, it has now emerged that many others, and importantly, most primary cancer cells are resistant to TRAIL monotherapy. Third, so far patients enrolled in TRA-employing clinical trials were not selected for likelihood of benefitting from a TRA-comprising therapy on the basis of a valid(ated) biomarker. This review summarizes and discusses the results achieved so far in TRA-employing clinical trials in the light of these three shortcomings. By integrating recent insight on apoptotic and non-apoptotic TRAIL signaling in cancer cells, we propose approaches to introduce novel, revised TRAIL-based therapeutic concepts into the cancer clinic. These include (i) the use of recently developed highly active TRAs, (ii) the addition of efficient, but cancer-cell-selective TRAIL-sensitizing agents to overcome TRAIL resistance and (iii) employing proteomic profiling to uncover resistance mechanisms. We envisage that this shall enable the design of effective TRA-comprising therapeutic concepts for individual cancer patients in the future. PMID:24948009

  2. [Conservative management of tracheal rupture in a child after blunt trauma].

    PubMed

    Kucuk, Gonul; Ates, Ufuk; Gollu, Gulnur; Yagmurlu, Aydin

    2016-12-01

    La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. En general, se recomienda el tratamiento quirúrgico para la rotura traqueal, aunque también se ha informado recientemente el abordaje conservador en los pacientes con signos vitales y parámetros respiratorios estables. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría.

  3. Comparison between treadmill training with rhythmic auditory stimulation and ground walking with rhythmic auditory stimulation on gait ability in chronic stroke patients: A pilot study.

    PubMed

    Park, Jin; Park, So-yeon; Kim, Yong-wook; Woo, Youngkeun

    2015-01-01

    Generally, treadmill training is very effective intervention, and rhythmic auditory stimulation is designed to feedback during gait training in stroke patients. The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation (TRAS) or over ground walking training with rhythmic auditory stimulation (ORAS). Nineteen subjects were divided into two groups: a TRAS group (9 subjects) and an ORAS group (10 subjects). Temporal and spatial gait parameters and motor recovery ability were measured before and after the training period. Gait ability was measured by the Biodex Gait trainer treadmill system, Timed up and go test (TUG), 6 meter walking distance (6MWD) and Functional gait assessment (FGA). After the training periods, the TRAS group showed a significant improvement in walking speed, step cycle, step length of the unaffected limb, coefficient of variation, 6MWD, and, FGA when compared to the ORAS group (p <  0.05). Treadmill walking training during the rhythmic auditory stimulation may be useful for rehabilitation of patients with chronic stroke.

  4. Recent thymic emigrants are tolerized in the absence of inflammation

    PubMed Central

    Friesen, Travis J.; Ji, Qingyong

    2016-01-01

    T cell development requires a period of postthymic maturation. Why this is the case has remained a mystery, particularly given the rigors of intrathymic developmental checkpoints, successfully traversed by only ∼5% of thymocytes. We now show that the first few weeks of T cell residence in the lymphoid periphery define a period of heightened susceptibility to tolerance induction to tissue-restricted antigens (TRAs), the outcome of which depends on the context in which recent thymic emigrants (RTEs) encounter antigen. After encounter with TRAs in the absence of inflammation, RTEs exhibited defects in proliferation, diminished cytokine production, elevated expression of anergy-associated genes, and diminished diabetogenicity. These properties were mirrored in vitro by enhanced RTE susceptibility to regulatory T cell–mediated suppression. In the presence of inflammation, RTEs and mature T cells were, in contrast, equally capable of inducing diabetes, proliferating, and producing cytokines. Thus, recirculating RTEs encounter TRAs during a transitional developmental stage that facilitates tolerance induction, but inflammation converts antigen-exposed, tolerance-prone RTEs into competent effector cells. PMID:27139493

  5. Recent thymic emigrants are tolerized in the absence of inflammation.

    PubMed

    Friesen, Travis J; Ji, Qingyong; Fink, Pamela J

    2016-05-30

    T cell development requires a period of postthymic maturation. Why this is the case has remained a mystery, particularly given the rigors of intrathymic developmental checkpoints, successfully traversed by only ∼5% of thymocytes. We now show that the first few weeks of T cell residence in the lymphoid periphery define a period of heightened susceptibility to tolerance induction to tissue-restricted antigens (TRAs), the outcome of which depends on the context in which recent thymic emigrants (RTEs) encounter antigen. After encounter with TRAs in the absence of inflammation, RTEs exhibited defects in proliferation, diminished cytokine production, elevated expression of anergy-associated genes, and diminished diabetogenicity. These properties were mirrored in vitro by enhanced RTE susceptibility to regulatory T cell-mediated suppression. In the presence of inflammation, RTEs and mature T cells were, in contrast, equally capable of inducing diabetes, proliferating, and producing cytokines. Thus, recirculating RTEs encounter TRAs during a transitional developmental stage that facilitates tolerance induction, but inflammation converts antigen-exposed, tolerance-prone RTEs into competent effector cells. © 2016 Friesen et al.

  6. Status of Ongoing Work in Software TRAs/TRLs

    DTIC Science & Technology

    2010-04-29

    to changes/updates being driven by corporate market dynamics • Changes not under control or under the influence of the PMO! • On programs with long...observed and reported esearc articles, peer- reviewed white papers, point papers, early conceptual models n a ca em c , experimental as c researc

  7. Control de los escombros tras un desastre natural

    EPA Pesticide Factsheets

    PONER EN LA ACERA LOS ESCOMBROS QUE DEJA UN HURACÁN EN LAS ÁREAS PARTICIPANTES. Si sigue estas pautas específicas (PDF) se acelerará el proceso de recolección. Confirme con las autoridades del gobierno local lo que le corresponda a usted.

  8. Possible Mechanisms of Local Tissue Renin-Angiotensin System Activation in the Cardiorenal Metabolic Syndrome and Type 2 Diabetes Mellitus

    PubMed Central

    Hayden, Melvin R.; Sowers, Kurt M.; Pulakat, Lakshmi; Joginpally, Tejaswini; Krueger, Bennett; Whaley-Connell, Adam; Sowers, James R.

    2011-01-01

    The role of local tissue renin-angiotensin system (tRAS) activation in the cardiorenal metabolic syndrome (CRS) and type 2 diabetes mellitus (T2DM) is not well understood. To this point, we posit that early redox stress-mediated injury to tissues and organs via accumulation of excessive reactive oxygen species (ROS) and associated wound healing responses might serve as a paradigm to better understand how tRAS is involved. There are at least five common categories responsible for generating ROS that may result in a positive feedback ROS-tRAS axis. These mechanisms include metabolic substrate excess, hormonal excess, hypoxia-ischemia/reperfusion, trauma, and inflammation. Because ROS are toxic to proteins, lipids, and nucleic acids they may be the primary instigator, serving as the injury nidus to initiate the wound healing process. Insulin resistance is central to the development of the CRS and T2DM, and there are now thought to be four major organ systems important in their development. In states of overnutrition and tRAS activation, adipose tissue, skeletal muscle (SkM), islet tissues, and liver (the quadrumvirate) are individually and synergistically related to the development of insulin resistance, CRS, and T2DM. The obesity epidemic is thought to be the driving force behind the CRS and T2DM, which results in the impairment of multiple end-organs, including the cardiovascular system, pancreas, kidney, retina, liver, adipose tissue, SkM, and nervous system. A better understanding of the complex mechanisms leading to local tRAS activation and increases in tissue ROS may lead to new therapies emphasizing global risk reduction of ROS resulting in decreased morbidity and mortality. PMID:22096455

  9. Diabetes insipidus-like state complicating percutaneous transluminal renal stenting for transplant renal artery stenosis.

    PubMed

    Tian, Lu; He, Yangyan; Zhang, Hongkun; Wu, Ziheng; Li, Donglin; Chen, Shanwen

    2014-07-01

    To report the incidence, etiology, and treatments of diabetes insipidus-like state that complicate percutaneous transluminal renal stenting (PTRS) for transplant renal artery stenosis (TRAS). Data from 7 patients on whom PTRS for TRAS was performed between October 2008 and March 2012 were reviewed retrospectively. The parameters investigated included blood flow velocity, blood pressure, and creatinine levels before and after the intervention. The procedural success rate was 100%. Three cases developed a diabetes insipidus-like state in the immediate postprocedural period. Urine output returned to normal within 2 weeks after treatment. The median blood flow velocity was significantly reduced from 4.51 m/sec (4.31-4.61 m/sec) at the time of TRAS diagnosis to 1.33 m/sec (1.31-1.51 m/sec) at the most recent follow-up of the group with a diabetes insipidus-like state. The ratio of median blood flow velocity before and after stenting in the group with a diabetes insipidus-like state was significantly higher than that in the group without a diabetes insipidus-like state (3.39 vs. 1.93). Diabetes insipidus-like state that complicates PTRS for TRAS is not an uncommon event, but appears to be underreported in the medical literature. A high ratio of pre- and poststenting median blood flow velocity may be a predictor for a postprocedural diabetes insipidus-like state. The most probable cause may be the marked increase in renal arterial flow. Early recognition of the condition is essential to avoid dehydration and electrolyte imbalance. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Comparison of ferumoxytol-enhanced MRA with conventional angiography for assessment of severity of transplant renal artery stenosis.

    PubMed

    Fananapazir, Ghaneh; Bashir, Mustafa R; Corwin, Michael T; Lamba, Ramit; Vu, Catherine T; Troppmann, Christoph

    2017-03-01

    To determine the accuracy of ferumoxytol-enhanced magnetic resonance angiography (MRA) in assessing the severity of transplant renal artery stenosis (TRAS), using digital subtraction angiography (DSA) as the reference standard. Our Institutional Review Board approved this retrospective, Health Insurance Portability and Accountability Act-compliant study. Thirty-three patients with documented clinical suspicion for TRAS (elevated serum creatinine, refractory hypertension, edema, and/or audible bruit) and/or concerning sonographic findings (elevated renal artery velocity and/or intraparenchymal parvus tardus waveforms) underwent a 1.5T MRA with ferumoxytol prior to DSA. All DSAs were independently reviewed by an interventional radiologist and served as the reference standard. The MRAs were reviewed by three readers who were blinded to the ultrasound and DSA findings for the presence and severity of TRAS. Sensitivity, specificity, and accuracy for identifying substantial stenoses (>50%) were determined. Intraclass correlation coefficients (ICCs) were calculated among readers. Mean differences between the percent stenosis from each MRA reader and DSA were calculated. On DSA, a total of 42 stenoses were identified in the 33 patients. The sensitivity, specificity, and accuracy of MRA in detecting substantial stenoses were 100%, 75-87.5%, and 95.2-97.6%, respectively, among the readers. There was excellent agreement among readers as to the percent stenosis (ICC = 0.82). MRA overestimated the degree of stenosis by 3.9-9.6% compared to DSA. Ferumoxytol-enhanced MRA provides high sensitivity, specificity, and accuracy for determining the severity of TRAS. Our results suggest that it can potentially be used as a noninvasive examination following ultrasound to reduce the number of unnecessary conventional angiograms. 3 J. Magn. Reson. Imaging 2017;45:779-785. © 2016 International Society for Magnetic Resonance in Medicine.

  11. N-Succinimidyl guanidinomethyl iodobenzoate protein radiohalogenation agents: Influence of isomeric substitution on radiolabeling and target cell residualization

    PubMed Central

    Choi, Jaeyeon; Vaidyanathan, Ganesan; Koumarianou, Eftychia; McDougald, Darryl; Pruszynski, Marek; Osada, Takuya; Lahoutte, Tony; Lyerly, H. Kim; Zalutsky, Michael R.

    2014-01-01

    Introduction N-succinimidyl 4-guanidinomethyl-3-[*I]iodobenzoate ([*I]SGMIB) has shown promise for the radioiodination of monoclonal antibodies (mAbs) and other proteins that undergo extensive internalization after receptor binding, enhancing tumor targeting compared to direct electrophilic radioiodination. However, radiochemical yields for [131I]SGMIB synthesis are low, which we hypothesize is due to steric hindrance from the Boc-protected guanidinomethyl group ortho to the tin moiety. To overcome this, we developed the isomeric compound, N-succinimidyl 3-guanidinomethyl-5-[131I]iodobenzoate (iso-[131I]SGMIB) wherein this bulky group was moved from ortho to meta position. Methods Boc2-iso-SGMIB standard and its tin precursor, N-succinimidyl 3-((1,2-bis(tert-butoxycarbonyl)guanidino)methyl)-5-(trimethylstannyl)benzoate (Boc2-iso-SGMTB), were synthesized using two disparate routes, and iso-[*I]SGMIB synthesized from the tin precursor. Two HER2-targeted vectors — trastuzumab (Tras) and a nanobody 5F7 (Nb) — were labeled using iso-[*I]SGMIB and [*I]SGMIB. Paired-label internalization assays in vitro with both proteins, and biodistribution in vivo with trastuzumab, labeled using the two isomeric prosthetic agents were performed. Results When the reactions were performed under identical conditions, radioiodination yields for the synthesis of Boc2-iso-[131I]SGMIB were significantly higher than those for Boc2-[131I]SGMIB (70.7 ± 2.0% vs 56.5 ± 5.5%). With both Nb and trastuzumab, conjugation efficiency also was higher with iso-[131I]SGMIB than with [131I]SGMIB (Nb, 33.1 ± 7.1% vs 28.9 ± 13.0%; Tras, 45.1 ± 4.5% vs 34.8 ± 10.3%); however, the differences were not statistically significant. Internalization assays performed on BT474 cells with 5F7 Nb indicated similar residualizing capacity over 6 h; however, at 24 h, radioactivity retained intracellularly for iso-[131I]SGMIB-Nb was lower than for [125I]SGMIB-Nb (46.4 ± 1.3% vs 56.5 ± 2.5%); similar results were

  12. Atlantic Leatherback Migratory Paths and Temporary Residence Areas

    PubMed Central

    López-Mendilaharsu, Milagros; Miller, Philip; Domingo, Andrés; Evans, Daniel; Kelle, Laurent; Plot, Virginie; Prosdocimi, Laura; Verhage, Sebastian; Gaspar, Philippe; Georges, Jean-Yves

    2010-01-01

    Background Sea turtles are long-distance migrants with considerable behavioural plasticity in terms of migratory patterns, habitat use and foraging sites within and among populations. However, for the most widely migrating turtle, the leatherback turtle Dermochelys coriacea, studies combining data from individuals of different populations are uncommon. Such studies are however critical to better understand intra- and inter-population variability and take it into account in the implementation of conservation strategies of this critically endangered species. Here, we investigated the movements and diving behaviour of 16 Atlantic leatherback turtles from three different nesting sites and one foraging site during their post-breeding migration to assess the potential determinants of intra- and inter-population variability in migratory patterns. Methodology/Principal Findings Using satellite-derived behavioural and oceanographic data, we show that turtles used Temporary Residence Areas (TRAs) distributed all around the Atlantic Ocean: 9 in the neritic domain and 13 in the oceanic domain. These TRAs did not share a common oceanographic determinant but on the contrary were associated with mesoscale surface oceanographic features of different types (i.e., altimetric features and/or surface chlorophyll a concentration). Conversely, turtles exhibited relatively similar horizontal and vertical behaviours when in TRAs (i.e., slow swimming velocity/sinuous path/shallow dives) suggesting foraging activity in these productive regions. Migratory paths and TRAs distribution showed interesting similarities with the trajectories of passive satellite-tracked drifters, suggesting that the general dispersion pattern of adults from the nesting sites may reflect the extent of passive dispersion initially experienced by hatchlings. Conclusions/Significance Intra- and inter-population behavioural variability may therefore be linked with initial hatchling drift scenarios and be highly

  13. Hemodynamics in Transplant Renal Artery Stenosis and its Alteration after Stent Implantation Based on a Patient-specific Computational Fluid Dynamics Model.

    PubMed

    Wang, Hong-Yang; Liu, Long-Shan; Cao, Hai-Ming; Li, Jun; Deng, Rong-Hai; Fu, Qian; Zhang, Huan-Xi; Fei, Ji-Guang; Wang, Chang-Xi

    Accumulating studies on computational fluid dynamics (CFD) support the involvement of hemodynamic factors in artery stenosis. Based on a patient-specific CFD model, the present study aimed to investigate the hemodynamic characteristics of transplant renal artery stenosis (TRAS) and its alteration after stent treatment. Computed tomography angiography (CTA) data of kidney transplant recipients in a single transplant center from April 2013 to November 2014 were reviewed. The three-dimensional geometry of transplant renal artery (TRA) was reconstructed from the qualified CTA images and categorized into three groups: the normal, stenotic, and stented groups. Hemodynamic parameters including pressure distribution, velocity, wall shear stress (WSS), and mass flow rate (MFR) were extracted. The data of hemodynamic parameters were expressed as median (interquartile range), and Mann-Whitney U-test was used for analysis. Totally, 6 normal, 12 stenotic, and 6 stented TRAs were included in the analysis. TRAS presented nonuniform pressure distribution, adverse pressure gradient across stenosis throat, flow vortex, and a separation zone at downstream stenosis. Stenotic arteries had higher maximal velocity and maximal WSS (2.94 [2.14, 3.30] vs. 1.06 [0.89, 1.15] m/s, 256.5 [149.8, 349.4] vs. 41.7 [37.8, 45.3] Pa at end diastole, P= 0.001; 3.25 [2.67, 3.56] vs. 1.65 [1.18, 1.72] m/s, 281.3 [184.3, 364.7] vs. 65.8 [61.2, 71.9] Pa at peak systole, P= 0.001) and lower minimal WSS and MFRs (0.07 [0.03, 0.13] vs. 0.52 [0.45, 0.67] Pa, 1.5 [1.0, 3.0] vs. 11.0 [8.0, 11.3] g/s at end diastole, P= 0.001; 0.08 [0.03, 0.19] vs. 0.70 [0.60, 0.81] Pa, 2.0 [1.3, 3.3] vs. 16.5 [13.0, 20.3] g/s at peak systole, P= 0.001) as compared to normal arteries. Stent implantation ameliorated all the alterations of the above hemodynamic factors except low WSS. Hemodynamic factors were significantly changed in severe TRAS. Stent implantation can restore or ameliorate deleterious change of hemodynamic

  14. Hemodynamics in Transplant Renal Artery Stenosis and its Alteration after Stent Implantation Based on a Patient-specific Computational Fluid Dynamics Model

    PubMed Central

    Wang, Hong-Yang; Liu, Long-Shan; Cao, Hai-Ming; Li, Jun; Deng, Rong-Hai; Fu, Qian; Zhang, Huan-Xi; Fei, Ji-Guang; Wang, Chang-Xi

    2017-01-01

    Background: Accumulating studies on computational fluid dynamics (CFD) support the involvement of hemodynamic factors in artery stenosis. Based on a patient-specific CFD model, the present study aimed to investigate the hemodynamic characteristics of transplant renal artery stenosis (TRAS) and its alteration after stent treatment. Methods: Computed tomography angiography (CTA) data of kidney transplant recipients in a single transplant center from April 2013 to November 2014 were reviewed. The three-dimensional geometry of transplant renal artery (TRA) was reconstructed from the qualified CTA images and categorized into three groups: the normal, stenotic, and stented groups. Hemodynamic parameters including pressure distribution, velocity, wall shear stress (WSS), and mass flow rate (MFR) were extracted. The data of hemodynamic parameters were expressed as median (interquartile range), and Mann–Whitney U-test was used for analysis. Results: Totally, 6 normal, 12 stenotic, and 6 stented TRAs were included in the analysis. TRAS presented nonuniform pressure distribution, adverse pressure gradient across stenosis throat, flow vortex, and a separation zone at downstream stenosis. Stenotic arteries had higher maximal velocity and maximal WSS (2.94 [2.14, 3.30] vs. 1.06 [0.89, 1.15] m/s, 256.5 [149.8, 349.4] vs. 41.7 [37.8, 45.3] Pa at end diastole, P = 0.001; 3.25 [2.67, 3.56] vs. 1.65 [1.18, 1.72] m/s, 281.3 [184.3, 364.7] vs. 65.8 [61.2, 71.9] Pa at peak systole, P = 0.001) and lower minimal WSS and MFRs (0.07 [0.03, 0.13] vs. 0.52 [0.45, 0.67] Pa, 1.5 [1.0, 3.0] vs. 11.0 [8.0, 11.3] g/s at end diastole, P = 0.001; 0.08 [0.03, 0.19] vs. 0.70 [0.60, 0.81] Pa, 2.0 [1.3, 3.3] vs. 16.5 [13.0, 20.3] g/s at peak systole, P = 0.001) as compared to normal arteries. Stent implantation ameliorated all the alterations of the above hemodynamic factors except low WSS. Conclusions: Hemodynamic factors were significantly changed in severe TRAS. Stent implantation can restore or

  15. Department of Energy Technology Readiness Assessments - Process Guide and Training Plan

    DTIC Science & Technology

    2008-09-12

    Hanford Waste Treatment and Immobilization Plant ( WTP ) Analytical Laboratory, Low Activity Waste (LAW) Facility and Balance of Facilities (3 TRAs... WTP High-Level Waste (HLW) Facility – WTP Pre-Treatment (PT) Facility – Hanford River Protection Project Low Activity Waste Treatment Alternatives

  16. 78 FR 3363 - Airworthiness Directives; the Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ...-mechanical brake flex shaft (short flexshaft) of the thrust reverser actuation system (TRAS). This proposed... the electro-mechanical brake and center drive unit (CDU) cone brake to verify the holding torque, and... describes a functional test of the electro-mechanical brake and CDU cone brake to verify the holding torque...

  17. La EPA ayuda a restaurar el laboratorio de ciencias de Puerto Rico y las capacidades de monitorear la calidad del aire

    EPA Pesticide Factsheets

    La EPA continúa ayudando a Puerto Rico a responder tras los daños causados por los huracanes Irma y María. La EPA, conforme a una misión asignada por FEMA, y en estrecha cooperación con el gobierno de Puerto Rico, se encuentra apoya

  18. The Impact of Language Skills and Social Competence on Play Behaviour in Toddlers

    ERIC Educational Resources Information Center

    Brekke Stangeland, Elisabeth

    2017-01-01

    In this study, the relationship between play, language skills and social competence is explored in a sample (n = 1005) of 33-month-old toddlers in a Norwegian early childhood education setting--Barnehages--based on two observational materials ("Tras" and "Alle med"). The study has two aims: (1) to investigate whether there is a…

  19. Acoustic sensing of seed-cotton trash levels

    USDA-ARS?s Scientific Manuscript database

    Modern cotton gins have a limited capability for handling varying levels of trash in the seed cotton. They can however slow down to provide another level of control. Due to the economics of running the gin plant, this is however a last resort that should only be done for the highest levels of tras...

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, Siwei; Chen, Yan; Zhang, Lingling

    Ceramic-based proton conductors enable high-temperature hydrogen economy applications such as hydrogen separation membranes, fuel cells, and steam electrolyzers. BaZr 0.8Y 0.2O 3-δ(BZY) proton-conducting oxide possesses the highest level of proton conductivity reported to date, but poor sinterability hinders its widespread utilization. In this paper, we report a two-step reactive aid sintering (TRAS) method involving the introduction of BaCO 3 and B 2O 3-Li 2O for the preparation of dense BZY ceramics sintered at 1500°C. The resulting BZY samples showed a pure perovskite structure with a dramatic increase in the relative density to 91.5%. In addition, the shrinkage during sintering wasmore » improved to 19.3% by a TRAS method as compared to 2.6% by the conventional solid date reaction method. In conclusion, the bulk conductivity was improved due to enhanced densification, while the grain boundary conductivity decreased due to the blocking behavior of the sintering aid resulting in a decrease in the total conductivity of the samples.« less

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, Siwei; Chen, Yan; Zhang, Lingling

    Ceramic-based proton conductors enable high-temperature hydrogen economy applications such as hydrogen separation membranes, fuel cells, and steam electrolyzers. BaZr 0.8Y 0.2O 3-δ (BZY) proton-conducting oxide possesses the highest level of proton conductivity reported to date, but poor sinterability hinders its widespread utilization. Here, we report a two-step reactive aid sintering (TRAS) method involving the introduction of BaCO 3 and B 2O 3-Li 2O for the preparation of dense BZY ceramics sintered at 1500°C. The resulting BZY samples showed a pure perovskite structure with a dramatic increase in the relative density to 91.5%. In addition, the shrinkage during sintering was improvedmore » to 19.3% by a TRAS method as compared to 2.6% by the conventional solid date reaction method. Moreover, the bulk conductivity was improved due to enhanced densification, while the grain boundary conductivity decreased due to the blocking behavior of the sintering aid resulting in a decrease in the total conductivity of the samples.« less

  2. Two-Step Reactive Aid Sintering of BaZr0.8Y0.2O3- δ Proton-Conducting Ceramics

    NASA Astrophysics Data System (ADS)

    Wang, Siwei; Chen, Yan; Zhang, Lingling; Ren, Cong; Chen, Fanglin; Brinkman, Kyle S.

    2015-12-01

    Ceramic-based proton conductors enable high-temperature hydrogen economy applications such as hydrogen separation membranes, fuel cells, and steam electrolyzers. BaZr0.8Y0.2O3- δ (BZY) proton-conducting oxide possesses the highest level of proton conductivity reported to date, but poor sinterability hinders its widespread utilization. In this paper, we report a two-step reactive aid sintering (TRAS) method involving the introduction of BaCO3 and B2O3-Li2O for the preparation of dense BZY ceramics sintered at 1500°C. The resulting BZY samples showed a pure perovskite structure with a dramatic increase in the relative density to 91.5%. In addition, the shrinkage during sintering was improved to 19.3% by a TRAS method as compared to 2.6% by the conventional solid date reaction method. The bulk conductivity was improved due to enhanced densification, while the grain boundary conductivity decreased due to the blocking behavior of the sintering aid resulting in a decrease in the total conductivity of the samples.

  3. Two-Step Reactive Aid Sintering of BaZr 0.8Y 0.2O 3-δ Proton-Conducting Ceramics

    DOE PAGES

    Wang, Siwei; Chen, Yan; Zhang, Lingling; ...

    2015-10-14

    Ceramic-based proton conductors enable high-temperature hydrogen economy applications such as hydrogen separation membranes, fuel cells, and steam electrolyzers. BaZr 0.8Y 0.2O 3-δ (BZY) proton-conducting oxide possesses the highest level of proton conductivity reported to date, but poor sinterability hinders its widespread utilization. Here, we report a two-step reactive aid sintering (TRAS) method involving the introduction of BaCO 3 and B 2O 3-Li 2O for the preparation of dense BZY ceramics sintered at 1500°C. The resulting BZY samples showed a pure perovskite structure with a dramatic increase in the relative density to 91.5%. In addition, the shrinkage during sintering was improvedmore » to 19.3% by a TRAS method as compared to 2.6% by the conventional solid date reaction method. Moreover, the bulk conductivity was improved due to enhanced densification, while the grain boundary conductivity decreased due to the blocking behavior of the sintering aid resulting in a decrease in the total conductivity of the samples.« less

  4. Program and Abstracts of the Society for Research on Biological Rhythms (2nd) Held in Jacksonville, Florida on 9-13 May 1990

    DTIC Science & Technology

    1991-07-15

    4 Tram Schedule ................................................. 5 Amelia Island.................................................. 6 Program... Schedule .................................................. 7 Scientific Program.................................................. 8 Abstracts...and 5 4 -4- TRAM SCHEDULE 6" I Th)e Ameha Isand Tra-s 5 1 p taior, around teP I da-ly basis f~cn 6 1 5 a -MARSHSIDE Ia m Tra-T Stc-,S a’e -.E TRAM I

  5. Cost analysis of enhanced recovery after surgery in microvascular breast reconstruction.

    PubMed

    Oh, Christine; Moriarty, James; Borah, Bijan J; Mara, Kristin C; Harmsen, William S; Saint-Cyr, Michel; Lemaine, Valerie

    2018-06-01

    Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. A standardized ERAS pathway was developed through multidisciplinary collaboration. It addressed all phases of surgical care for patients undergoing free-flap breast reconstruction utilizing an abdominal donor site. In this retrospective cohort study, clinical variables associated with hospitalization costs for patients who underwent free-flap breast reconstruction with the ERAS pathway were compared with those of historical controls, termed traditional recovery after surgery (TRAS). All patients included in the study underwent surgery between September 2010 and September 2014. Predicted costs of the study groups were compared using generalized linear modeling. A total of 200 patients were analyzed: 82 in the ERAS cohort and 118 in the TRAS cohort. Clinical variables that were identified to potentially affect costs were found to have a statistically significant difference between groups and included unilateral versus bilateral procedures (p = 0.04) and the need for postoperative blood transfusion (p = 0.03). The cost regression analysis on the two cohorts was adjusted for these significant variables. Adjusted mean costs of patients with ERAS were found to be $4,576 lesser than those of the TRAS control group ($38,688 versus $43,264). Implementation of the ERAS pathway was associated with significantly decreased costs when compared to historical controls. There has been a healthcare focus toward prudent resource allocation, which dictates the need for plastic surgeons to recognize economic evaluation of clinical practice. The ERAS pathway can increase healthcare accountability by improving

  6. PubMed

    Real Delor, Raúl Emilio

    2018-04-23

    Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten.

  7. Semiannual Report to Congress on the Effectiveness of the Civil Aviation Security Program.

    DTIC Science & Technology

    1984-04-13

    AD-fl143 023 SEMIANNUAL REPORT TO CONGRESS ON THEUEFFECTIVENESS OF i/i THE CIVIL AVIATION SECURITY PROGRAM(U) FEDERAL AVIATION ADMINISTRATION...Semiannual Report to O Congress on the US Deportmnent of TrasEffectiveness ofi of TransportationFedewl Avkffim Avao The Civil Aviation - Security Program... Aviation Security Program 8. Performing OrgniaetioNi RePwt Us. Aviation Security Division 9. Performing Organistion Name and Address 10. Work Unit No

  8. Technology Readiness Assessment of Department of Energy Waste Processing Facilities

    DTIC Science & Technology

    2007-09-11

    Must Be Reliable, Robust, Flexible, and Durable 6 EM Is Piloting the TRA/AD2 Process Hanford Waste Treatment Plant ( WTP ) – The Initial Pilot Project...Evaluation WTP can only treat ~ ½ of the LAW in the time it will take to treat all the HLW. • There is a need for tank space that will get more urgent with...Facility before the WTP Pretreatment and High-Level Waste (HLW) Vitrification Facilities are available (Requires tank farm pretreatment capability) TRAs

  9. Luminescent Photoelectrochemical Cells. 6. Spatial Aspects of the Photoluminescence and Electroluminescence of Cadmium Selenide Electrodes.

    DTIC Science & Technology

    1981-10-06

    STRECKERT, J TONS, A B ELLIS N01478-C5633 UNCLASSI1FIED TRAS NL OFFICE OF NAVAL RESEARCH Contract No. N00014-78’-C-0633 Task No. NR 051-690 TECHNICAL REPORT...of Wisconsin NR 051-690 Madison, Wisconsin 53706 II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE *Office of Naval Research /Chemistry Program...identify by block number) Samples of single-crystal, n-type CdSe emit when excited with ultraband gap excitation. The emission band (Xmax 񔊐 nm) is

  10. [Anorexia nervosa as a cause of acute liver failure. Report of a case].

    PubMed

    Voltas-Arribas, Beatriz; Artero-Fullana, Ana; Ferrer-García, Juan Carlos; Sánchez-Juan, Carlos; Marco-Alacid, Cristian; Sanz-Revert, Pablo; García-Blasco, Lourdes

    2018-01-10

    Caso clínico: presentamos una paciente de 33 años con anorexia nerviosa de 15 años de evolución con uno de los pocos casos reportados de fallo hepático agudo severo secundario a la desnutrición.Discusión: tras el soporte nutricional protocolizado para evitar el síndrome de realimentación y un adecuado manejo multidisciplinar, la paciente evoluciona favorablemente logrando normalizar los electrolitos, la función hepática y las alteraciones en la coagulación.

  11. Absence of detectable transgenes in local landraces of maize in Oaxaca, Mexico (2003–2004)

    PubMed Central

    Ortiz-García, S.; Ezcurra, E.; Schoel, B.; Acevedo, F.; Soberón, J.; Snow, A. A.

    2005-01-01

    In 2000, transgenes were detected in local maize varieties (landraces) in the mountains of Oaxaca, Mexico [Quist, D. & Chapela, I. H. (2001) Nature 414, 541–543]. This region is part of the Mesoamerican center of origin for maize (Zea mays L.), and the genetic diversity that is maintained in open-pollinated landraces is recognized as an important genetic resource of great cultural value. The presence of transgenes in landraces was significant because transgenic maize has never been approved for cultivation in Mexico. Here we provide a systematic survey of the frequency of transgenes in currently grown landraces. We sampled maize seeds from 870 plants in 125 fields and 18 localities in the state of Oaxaca during 2003 and 2004. We then screened 153,746 sampled seeds for the presence of two transgene elements from the 35S promoter of the cauliflower mosaic virus and the nopaline synthase gene (nopaline synthase terminator) from Agrobacterium tumefaciens. One or both of these transgene elements are present in all transgenic commercial varieties of maize. No transgenic sequences were detected with highly sensitive PCR-based markers, appropriate positive and negative controls, and duplicate samples for DNA extraction. We conclude that transgenic maize seeds were absent or extremely rare in the sampled fields. This study provides a much-needed preliminary baseline for understanding the biological, socioeconomic, and ethical implications of the inadvertent dispersal of transgenes from the United States and elsewhere to local landraces of maize in Mexico. PMID:16093316

  12. Absence of detectable transgenes in local landraces of maize in Oaxaca, Mexico (2003-2004).

    PubMed

    Ortiz-García, S; Ezcurra, E; Schoel, B; Acevedo, F; Soberón, J; Snow, A A

    2005-08-30

    In 2000, transgenes were detected in local maize varieties (landraces) in the mountains of Oaxaca, Mexico [Quist, D. & Chapela, I. H. (2001) Nature 414, 541-543]. This region is part of the Mesoamerican center of origin for maize (Zea mays L.), and the genetic diversity that is maintained in open-pollinated landraces is recognized as an important genetic resource of great cultural value. The presence of transgenes in landraces was significant because transgenic maize has never been approved for cultivation in Mexico. Here we provide a systematic survey of the frequency of transgenes in currently grown landraces. We sampled maize seeds from 870 plants in 125 fields and 18 localities in the state of Oaxaca during 2003 and 2004. We then screened 153,746 sampled seeds for the presence of two transgene elements from the 35S promoter of the cauliflower mosaic virus and the nopaline synthase gene (nopaline synthase terminator) from Agrobacterium tumefaciens. One or both of these transgene elements are present in all transgenic commercial varieties of maize. No transgenic sequences were detected with highly sensitive PCR-based markers, appropriate positive and negative controls, and duplicate samples for DNA extraction. We conclude that transgenic maize seeds were absent or extremely rare in the sampled fields. This study provides a much-needed preliminary baseline for understanding the biological, socioeconomic, and ethical implications of the inadvertent dispersal of transgenes from the United States and elsewhere to local landraces of maize in Mexico.

  13. Progresos recientes en Astronomía de Rayos Gamma

    NASA Astrophysics Data System (ADS)

    Romero, G. E.

    Tras la exitosa misión del Compton Gamma-Ray Observatory durante los años 1990, la astronomía de rayos gamma ha entrado en una etapa de madurez, convirtiéndose en una de las principales herramientas para el estudio de procesos relativistas en el universo. En este reporte, presentaré una revisión de los principales tópicos abordados a través de estudios con rayos gamma en los últimos años, con particular énfasis en los intentos más recientes por establecer la naturaleza de las fuentes de rayos gamma no identificadas, detectadas por el instrumento EGRET.

  14. PubMed

    Fumis, María Agustina; Bidabehere, María Belén; Moyano, Yohana; Sardoy, Agustina; Gubiani, María Laura; Boldrini, María Pía; Pinardi, Beatriz Alicia

    2017-09-08

    La fascitis necrotizante por estrepotococo del grupo A es una infección infrecuente del tejido subcutáneo  y de la fascia, con una tasa de mortalidad elevada debido a su rápida progresión a shock y fallo multiorgánico. Se desarrolla generalmente en extremidades tras un traumatismo o lesión previa. El diagnóstico temprano es esencial así como también el manejo rápido y agresivo. Presentamos un caso de fascitis necrotizante de evolución rápida a pesar del diagnóstico precoz y tratamiento específico instaurado.

  15. [Not Available].

    PubMed

    Vales Montero, Marta; Chavarría Cano, Beatriz; Martínez Ginés, María Luisa; Díaz Otero, Fernando; Velázquez Pérez, José Miguel; Cuerda Compes, María Cristina; Bretón Lesmes, Irene

    2016-07-19

    La deficiencia de vitamina A es infrecuente en los países desarrollados. La cirugía bariátrica constituye un factor de riesgo de deficiencia de esta vitamina. Se han descrito varios casos en pacientes sometidos a técnicas con un importante componente malabsortivo, como la derivación biliopancreática. En este artículo se describe un caso de deficiencia clínica de vitamina A con manifestaciones oculares y cutáneas tras bypass gástrico y se revisan las publicaciones sobre este tema y las recomendaciones para la prevención de esta importante complicación.

  16. Improved estimation of ligand macromolecule binding affinities by linear response approach using a combination of multi-mode MD simulation and QM/MM methods

    NASA Astrophysics Data System (ADS)

    Khandelwal, Akash; Balaz, Stefan

    2007-01-01

    Structure-based predictions of binding affinities of ligands binding to proteins by coordination bonds with transition metals, covalent bonds, and bonds involving charge re-distributions are hindered by the absence of proper force fields. This shortcoming affects all methods which use force-field-based molecular simulation data on complex formation for affinity predictions. One of the most frequently used methods in this category is the Linear Response (LR) approach of Åquist, correlating binding affinities with van der Waals and electrostatic energies, as extended by Jorgensen's inclusion of solvent-accessible surface areas. All these terms represent the differences, upon binding, in the ensemble averages of pertinent quantities, obtained from molecular dynamics (MD) or Monte Carlo simulations of the complex and of single components. Here we report a modification of the LR approach by: (1) the replacement of the two energy terms through the single-point QM/MM energy of the time-averaged complex structure from an MD simulation; and (2) a rigorous consideration of multiple modes (mm) of binding. The first extension alleviates the force-field related problems, while the second extension deals with the ligands exhibiting large-scale motions in the course of an MD simulation. The second modification results in the correlation equation that is nonlinear in optimized coefficients, but does not lead to an increase in the number of optimized coefficients. The application of the resulting mm QM/MM LR approach to the inhibition of zinc-dependent gelatinase B (matrix metalloproteinase 9) by 28 hydroxamate ligands indicates a significant improvement of descriptive and predictive abilities.

  17. [In Process Citation].

    PubMed

    Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Lopes, Teresa; Sousa Guerreiro, António

    2016-03-25

    Introducción y objetivos: el cobre (Cu) es un oligoelemento muy estudiado, pero poco se sabe de su evolución en los pacientes alimentados por gastrostomía endoscópica (GEP). Pretendemos evaluar la evolución del Cu sérico desde la gastrostomía hasta 12 semanas después de la intervención en estos pacientes alimentados con preparaciones domésticas.  Métodos: realizamos un estudio observacional prospectivo para evaluar el Cu sérico, la albúmina, la transferrina y el índice de masa corporal (IMC) en el momento de la GEP, tras 4 semanas y 12 semanas después de la intervención. Los datos incluyen edad, género, NRS 2002 y enfermedad subyacente: cánceres de cabeza y cuello (CCC) y disfagia neurológica (DN). Después de la intervención, estos pacientes fueron alimentados conpreparaciones domésticas. Resultados: 146 enfermos (89 hombres), entre 21-95 años: CCC-56, DN-90. Valores de Cu entre 42-160 μg/dl (normal: 70-140 μg/dl); normales 89% (n = 130); bajos 11% (n = 16), albúmina baja: 53% (n = 77), transferrina baja: 65% (n = 94), IMC bajo: 53% (n = 78). Después de 4 semanas: valores normales de Cu en 93% y bajos en 7%, albúmina baja en 34%, transferrina baja en 52%. Tras 12 semanas: valores normales de Cu en 95% y bajos en 5%, albúmina baja en 25%, transferrina baja en 32%. No encontramos diferencias significativas en el Cusérico cuando se compara edad, género, enfermedad subyacente, IMC, albúmina y transferrina. Conclusiones: la mayoría de los enfermos presentan Cu sérico normal en el momento de la gastrostomía. Para los enfermos con Cu sérico bajo antes del procedimiento, la alimentación con preparaciones domésticas parece suficiente para su normalización progresiva.

  18. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Vázquez-Osorio, Igor; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-05-15

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol.

  19. [Competence in biocentric ethics.

    PubMed

    Stepke, Fernando Lolas

    2012-07-01

    ResumenEste artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social "investigación médica": miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su "cultura epistémica" propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales.

  20. Competencias en ética biocéntrica

    PubMed Central

    Stepke, Fernando Lolas

    2013-01-01

    Resumen Este artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social “investigación médica”: miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su “cultura epistémica” propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales. PMID:23459767

  1. A Conceptual Framework for the Assessment of Multiple Functions of Agro-Ecosystems: A Case Study of Tras-os-Montes Olive Groves

    ERIC Educational Resources Information Center

    Fleskens, Luuk; Duarte, Filomena; Eicher, Irmgard

    2009-01-01

    Multifunctionality in agriculture has received a lot of attention the last decade from researchers and policy-makers alike, perhaps most notably evidenced by the important changes made to the EU's Common Agricultural Policy. While the concept has been embraced by environmentalists envisioning positive impulses for decoupling and a range of local…

  2. Confieso que Divulgo. Reflexiones y Experiencias de una Astrofísica

    NASA Astrophysics Data System (ADS)

    Rodríguez Hidalgo, I.

    Este artículo presenta algunas reflexiones en torno a la popularización de la Ciencia, desarrolladas a lo largo de mi trayectoria profesional, un camino inacabado desde la intuición al oficio. Tras revisar las señas de identidad de la divulgación científica, se exponen ideas, experiencias y recursos, cribados por la práctica y su posterior análisis crítico. Se destacan las actividades relacionadas con la Astronomía, que se cuentan entre las más espectaculares y gratificantes. Confessions of a popularizer: This paper presents some author's thoughts about scientific outreach, developed along her professional path, an unfinished way from intuition to trade. First, identity signs of outreach are revised; then, ideas, experiences and resources, sifted by practice and further critical analysis, are reviewed. Activities related to Astronomy, being one of the most spectacular and rewarding, are remarked 1

  3. The message changes belief and the rest is theory: the "1% or less" milk campaign and reasoned action.

    PubMed

    Booth-Butterfield, Steve; Reger, Bill

    2004-09-01

    Theory-based approaches to public health interventions are useful for designing, implementing, and evaluating research. This paper describes and presents data to support the theoretical force behind the "1% or less" nutrition intervention studies. Using the Theory of Reasoned Action (TRA), high-fat (whole and 2%) milk users were targeted. Supermarket milk sale data were collected, and randomly selected intervention and comparison community residents were surveyed via telephone to assess milk use. TRA constructs were used in the surveys that were conducted immediately before and after a 6-week mass media campaign. Campaign messages were aimed at changing behavioral rather than normative beliefs. We found significant and predicted changes in intervention participants on intention, attitude, and behavioral beliefs, but not subjective norm outcomes. A path model showed support that TRA variables mediated significant changes in self-reported milk use. The analysis further validates the TRAs and supports a template using both the Principle of Compatibility and TRA to aid development and implementation of messages for effective behavior change field interventions.

  4. Social Representations of Gynecologic Cancer Screening Assessment a Qualitative research on Ecuadorian women.

    PubMed

    Godoy, Yolanda; Godoy, Clara; Reyes, Juan

    2016-06-01

    The purpose of this work was to explore: knowledge, attitudes, and beliefs regarding gynecologic cancer screening on Ecuadorian women users of primary care facilities, to identify the social representations that users of health services make about these programs and their influence on the decision to undergo a screening. An exploratory and qualitative research design was held using focus groups and in-depth interviews for data collection. A narrative content analysis of the results was conducted. Women's knowledge on gynecological cancer screening was confusing. Most frequent misconceptions related to the pap smear were: the belief that it could be useful for detecting pregnancy, ovarian cysts or infections. Most of the participants stated that the pap smear procedure is a traumatic and painful experience. Regarding to mammography women said it was used for sick woman and this procedure by itself may cause cancer. El propósito de esta investigación fue explorar los conocimientos, actitudes y creencias respecto a los programas de detección del cáncer ginecológico entre usuarias de centros de atención primaria de salud para identificar las representaciones sociales que las usuarias de los servicios de salud elaboran acerca de estos programas y de los diferentes procedimientos que comprenden. El diseño de la investigación fue exploratorio y cualitativo, mediante grupos focales y entrevistas a profundidad, con el respectivo análisis narrativo e interpretativo del contenido. Se encontró conocimiento confuso acerca de los programas de tamizaje de cáncer ginecológico y dificultades asociadas a la realización de los procedimientos. Los significados más frecuentes acerca de los programas fueron: el uso de la citología cérvico-vaginal para detectar embarazo, quistes ováricos o infecciones. La mayoría de los participantes asociaba este procedimiento con una experiencia dolorosa y traumática. Respecto al autoexamen de mamas, lo calificaron como un masaje

  5. Comparación de la efectividad de ranibizumab intravítreo para el tratamiento del edema macular diabético en ojos vitrectomizados y no vitrectomizados.

    PubMed

    Koyanagi, Yoshito; Yoshida, Shigeo; Kobayashi, Yoshiyuki; Kubo, Yuki; Yamaguchi, Muneo; Nakama, Takahito; Nakao, Shintaro; Ikeda, Yasuhiro; Ohshima, Yuji; Ishibashi, Tatsuro; Sonoda, Kohhei

    2017-07-11

    Objetivo: Comparar la efectividad de ranibizumab intravítreo (RIV) para el tratamiento del edema macular diabético (EMD) en ojos con y sin vitrectomía previa. Procedimientos: Evaluamos de manera prospectiva la mejor agudeza visual corregida (MAVC) y el grosor macular central (GMC) tras el tratamiento con RIV durante 6 meses. Resultados: No se observaron diferencias significativas en la MAVC o GMC inicial en ninguno de los dos grupos. En el grupo no vitrectomizado (n = 15), los cambios medios en la MAVC y GMC hasta el sexto mes de tratamiento con respecto al valor inicial resultaron significativos (p < 0,01). En el grupo vitrectomizado (n = 10), se observó una mejora más lenta, y la mejora media en la MAVC no resultó significativa (p = 0,5), aunque la media en la disminución del GMC sí que lo fue (p < 0,05). No se observaron diferencias significativas en los cambios medios en la MAVC y el GMC entre ambos grupos a los 6 meses del tratamiento. Conclusiones: La diferencia en la efectividad de RIV entre ambos grupos no resultó significativa. Ranibizumab intravítreo puede ser una opción de tratamiento incluso en pacientes vitrectomizados con EMD. © 2017 S. Karger AG, Basel.

  6. Desgarros del epitelio pigmentario de la retina: factores de riesgo, mecanismo y control terapéutico.

    PubMed

    Clemens, Christoph R; Eter, Nicole

    2017-07-11

    Los desgarros del epitelio pigmentario de la retina (EPR) se asocian en la mayoría de los casos con los desprendimientos vascularizados del EPR debido a una degeneración macular asociada a la edad (DMAE), y normalmente implican una pérdida adversa de la agudeza visual. Estudios recientes indican que ha habido un aumento en la incidencia de desgarros del EPR desde la introducción de fármacos anti-factor de crecimiento del endotelio vascular (anti-VEGF) así como una asociación temporal entre el desgarro y la inyección intravítrea. Dado que el número de pacientes con DMAE y el número de inyecciones anti-VEGF va en aumento, tanto la dificultad de prevenir desgarros del EPR como el tratamiento tras la formación de los desgarros han adquirido una mayor relevancia. De forma paralela, la evolución de la imagenología de la retina ha contribuido de manera significativa a comprender mejor el desarrollo de los desgarros del EPR en los últimos años. Esta revisión resume los conocimientos que se poseen actualmente sobre el desarrollo, los factores pronósticos y las estrategias terapéuticas de los desgarros del EPR antes y después de que estos se formen. © 2017 S. Karger AG, Basel.

  7. Synthesis, Crystal and Electronic Structures of the Pnictides AE 3TrPn 3 (AE = Sr, Ba; Tr = Al, Ga; Pn = P, As)

    DOE PAGES

    Stoyko, Stanislav; Voss, Leonard; He, Hua; ...

    2015-09-24

    New ternary arsenides AE 3TrAs 3 (AE = Sr, Ba; Tr = Al, Ga) and their phosphide analogs Sr 3GaP 3 and Ba 3AlP 3 have been prepared by reactions of the respective elements at high temperatures. Single-crystal X-ray diffraction studies reveal that Sr 3AlAs 3 and Ba 3AlAs 3 adopt the Ba 3AlSb 3-type structure (Pearson symbol oC56, space group Cmce, Z = 8). This structure is also realized for Sr 3GaP 3 and Ba 3AlP 3. Likewise, the compounds Sr 3GaAs 3 and Ba 3GaAs 3 crystallize with the Ba 3GaSb 3-type structure (Pearson symbol oP56, space groupmore » Pnma, Z = 8). Both structures are made up of isolated pairs of edge-shared AlPn 4 and GaPn 4 tetrahedra (Pn = pnictogen, i.e., P or As), separated by the alkaline-earth Sr 2+ and Ba 2+ cations. In both cases, there are no homoatomic bonds, hence, regardless of the slightly different atomic arrangements, both structures can be rationalized as valence-precise [AE 2+] 3[Tr 3+][Pn 3-] 3, or rather [AE 2+] 6[Tr 2Pn 6] 12-, i.e., as Zintl phases.« less

  8. Computed narrow-band azimuthal time-reversing array retrofocusing in shallow water.

    PubMed

    Dungan, M R; Dowling, D R

    2001-10-01

    The process of acoustic time reversal sends sound waves back to their point of origin in reciprocal acoustic environments even when the acoustic environment is unknown. The properties of the time-reversed field commonly depend on the frequency of the original signal, the characteristics of the acoustic environment, and the configuration of the time-reversing transducer array (TRA). In particular, vertical TRAs are predicted to produce horizontally confined foci in environments containing random volume refraction. This article validates and extends this prediction to shallow water environments via monochromatic Monte Carlo propagation simulations (based on parabolic equation computations using RAM). The computational results determine the azimuthal extent of a TRA's retrofocus in shallow-water sound channels either having random bottom roughness or containing random internal-wave-induced sound speed fluctuations. In both cases, randomness in the environment may reduce the predicted azimuthal angular width of the vertical TRA retrofocus to as little as several degrees (compared to 360 degrees for uniform environments) for source-array ranges from 5 to 20 km at frequencies from 500 Hz to 2 kHz. For both types of randomness, power law scalings are found to collapse the calculated azimuthal retrofocus widths for shallow sources over a variety of acoustic frequencies, source-array ranges, water column depths, and random fluctuation amplitudes and correlation scales. Comparisons are made between retrofocusing on shallow and deep sources, and in strongly and mildly absorbing environments.

  9. [Role of let-7 in maintaining characteristics of breast cancer stem cells].

    PubMed

    Sun, Xin; Fan, Chong; Hu, Li-juan; Du, Ning; Xu, Chong-wen; Ren, Hong

    2012-08-01

    To observe the expression of let-7 in breast cancer stem cells and explore the role of let-7 in maintaining the characteristics of breast cancer stem cells. We separated breast cancer stem cells (SP and NSP) from MCF-7 cell line using SP sorting, and observed the expression of let-7a/b/c on SP and NSP cells using quantitative real-time PCR and the expressions of Ras and ERK using Western blotting to study the mechanism by which let-7 maintains the characteristics of breast cancer stem cells. The SP cells accounted for 3.3% in MCF-7 cells, however, the rate dropped to 0.4% when verapamil was added into the process of seperation. The level of Let-7a/b/c in SP cells were lower than that in NSP cells, and among let-7 miRNAs, let-7b/c showed the most obvious difference. The expressions of t-Ras and t-ERK showed no difference between SP and NSP cells, nevertheless, the expressions of p-Ras, p-ERK were higher in SP cells than in NSP cells. SP sorting is an effective method to separate cancer stem cells. There do exist cancer stem cells in MCF-7 breast cancer cell line. Let-7 is down-regulated in SP cells, and the down-regulation makes let-7 lose the opportunity to restrain Ras mRNA, finally, p-Ras and p-ERK are activated. They play an important role in maintaining the characteristics of breast cancer stem cells.

  10. PubMed

    Ávila García, Manuel; Huertas Delgado, Francisco Javier Huertas Delgado; Tercedor Sánchez, Pablo

    2016-11-29

    Introducción: España es el tercer país europeo con mayor prevalencia de obesidad infantil, dando lugar a la aparición de programas de intervención destinados a fomentar hábitos alimentarios saludables y/o de actividad física (AF).Objetivo: el propósito de esta revisión sistemática fue conocer aquellos programas de intervención para la promoción de hábitos alimentarios y de AF desarrollados en escolares españoles de Educación Primaria (EP) y analizar la influencia que han tenido las intervenciones sobre la composición corporal, los hábitos alimentarios y la AF.Método: se revisaron los artículos publicados entre los años 2000 y 2015 en las siguientes bases de datos: Web of Science, Scopus, Dialnet, PubMed, Eric, Sportdiscus y Psycinfo por dos revisores independientes.Resultados: se contabilizaron un total de 813 artículos, de los cuales tras la eliminación de duplicados (192), lectura de títulos y resumen (587) y lectura del texto completo (17), tan solo 7 cumplieron con los criterios de inclusión.Conclusiones: los programas de intervención analizados mostraron cambios positivos en la mejora de la composición corporal en algo menos de la mitad de los estudios analizados; por otro lado, casi todos los programas de intervención analizados tuvieron un efecto positivo sobre conductas respecto a ciertos hábitos alimentarios, como la ingesta de frutas, y sobre el incremento del nivel de AF.

  11. Immune Thrombocytopenia

    PubMed Central

    Kistanguri, Gaurav; McCrae, Keith R.

    2013-01-01

    Immune thrombocytopenia (ITP) is a common hematologic disorder characterized by isolated thrombocytopenia. ITP presents as a primary form characterized by isolated thrombocytopenia (platelet count < 100 × 109/L) in the absence of other causes or disorders that may be associated with thrombocytopenia, or a secondary form in which immune thrombocytopenia develops in association with another disorder that is usually immune or infectious. ITP may affect individuals of all ages, with peaks during childhood and in the elderly, in whom the age specific incidence of ITP is greatest. Bleeding is the most common clinical manifestation of ITP, with the risk of bleeding and related morbidity increased in elderly patients. The pathogenesis of ITP is complex, involving alterations in humoral and cellular immunity. Thrombocytopenia is caused by antibodies that react with glycoproteins expressed on platelets and megakaryocytes (glycoprotein IIb/IIIa, Ib/IX and others), causing shortened survival of circulating platelets and impairing platelet production. Diminished numbers and function of regulatory T cells, as well as the effects of cytotoxic T cells also contribute to the pathogenesis of ITP. Corticosteroids remain the most common first line therapy for ITP, occasionally in conjunction with intravenous immunoglobulin (IVIg) and anti-Rh(D). However, these agents do not lead to durable remissions in the majority of adults with ITP, and considerable heterogeneity exists in the use of second line approaches, which may include splenectomy, Rituximab, or thrombopoietin receptor agonists (TRAs). This review summarizes the classification and diagnosis of primary and secondary ITP, as well as the pathogenesis and options for treatment. Remarkable advances in the understanding and management of ITP have been achieved over the last decade, though many questions remain. PMID:23714309

  12. Cómo aumentar la actividad física de los niños durante el período del recreo en las escuelas

    PubMed Central

    Ludwig, David

    2014-01-01

    Objetivos. Analizamos si la participación de las escuelas en el Programa de Mejoramiento del Recreo (PMR) en la primavera del año 2011 estuvo asociada a tasas más altas de actividad física intensa en los niños. Métodos. En el PMR, un coordinador dirige a los niños para que practiquen juegos adecuados para la edad a fin de aumentar su nivel de actividad física. Durante el recreo en 25 escuelas primarias públicas de la ciudad de Nueva York (15 participantes en el PMR, 10 no participantes en el PMR) los investigadores observaron algunas áreas predeterminadas (n = 1 339 observaciones) y registraron el número de niños que estaban sedentarios, caminando o muy activos. Resultados. Tras el análisis estadístico con múltiples variables se encontró que la participación en el PMR era una variable predictiva significativa (P = 0,027) de la tasa de actividad física intensa (porcentaje de niños muy activos en las áreas de observación) cuyas medias de los mínimos cuadrados fueron de 41% en las escuelas participantes en el PMR y de 27% en escuelas no participantes en el PMR. En las escuelas participantes en el PMR se siguió registrando una tasa significativamente superior incluso cuando el coordinador de juegos no estaba en el área de observación, lo que sugiere un cambio en la cultura del recreo en las escuelas que participan en este programa. Conclusiones. La tasa de actividad física intensa en las escuelas participantes en el PMR fue 14 puntos porcentuales (o 52%) superior a la tasa registrada en las escuelas no participantes en el PMR. Esta intervención de bajo costo podría ser un agregado valioso a las herramientas para combatir la obesidad infantil y podría valer la pena reproducirla en otros sitios. PMID:24899455

  13. PubMed

    Angulo Tabernero, Marina; Suñén Sánchez, Enrique; Peña Jiménez, Diego; Loste Ramos, Antonio; Tabuenca Sánchez, Antonio; Chárlez Marco, Alfredo; Rodríguez Vela, Javier

    2018-02-20

    Las lesiones traumáticas de la columna cervical son infrecuentes en los niños, representando el 1% de las fracturas pediátricas y el 2% de todas las lesiones raquídeas.Es importante conocer que la columna cervical en la infancia presenta variaciones anatómicas que en ocasiones pueden interpretarse como patológicas ya que en los niños una adecuada exploración física muchas veces puede ser complicada.El objetivo de este caso clínico es mostrar un hallazgo radiológico fisiológico de la columna cervical infantil que tiende a ser malinterpretado como patológico: la pseudosubluxación C2-C3.Se presenta un caso de un niño de 5 años de edad que acude a urgencias de traumatología pediátrica de nuestro centro por dolor cervical tras caída desde un tobogán. Se realizan radiografías cervicales de urgencias observando una disrupción de la línea cervical anterior y posterior entre C2 y C3. Una adecuada anamnesis junto con un meticuloso examen clínico y radiológico permite su correcto diagnostico sin necesidad de otras pruebas complementarias. La pseudoluxación anterior de C2 sobre C3 se puede estar presente en el 40% de los niños menores de 8 años. Este hallazgo puede diferenciarse de la luxación traumatic valorando la línea espinolaminar o línea de Swischuk, línea entre el borde anterior de las apófisis espinosas de C1 a C3. La interpretación adecuada de las radiografías de la columna cervical en la infancia requiere del conocimiento de estas variantes radiológicas y de las peculiares características de este segmento vertebral en la edad pediátrica.

  14. PubMed

    Domínguez, Vanihamín; Aguiñiga, Itzen; Moreno, Leticia; Torres, Beatriz; Santiago-Osorio, Edelmiro

    2017-12-01

    Introducción. El caseinato de sodio, una sal de la caseína utilizada como agente proinflamatorio en ratones, es capaz de inducir granulopoyesis en vivo e incrementar la producción de citocinas esenciales en dicho evento.Objetivo. Evaluar si el caseinato de sodio es capaz de inducir un efecto biológico en células de origen linfoide y la producción de citocinas involucradas con este linaje.Materiales y métodos: Se utilizaron ratones hembra BALB/c de 8 a 12 semanas de edad. Los animales se inyectaron cuatro veces, con intervalos de 48 horas, por vía intraperitoneal con 1 ml de caseinato de sodio (10 % de SFB p/v). La población de linfocitos B y la incorporación de bromodesoxiuridina (BrdU) se analizaron mediante citometría de flujo. La detección de la interleucina 7 se evaluó mediante la técnica de ELISA.Resultados. Tras la inyección por vía intraperitoneal, el número de linfocitos B 220+ provenientes del bazo de ratones tratados con caseinato de sodio aumentó comparados con los que solo recibieron el vehículo como tratamiento (89,01±1,03 Vs. 75,66±2,08), así como la incorporación de BrdU en células B220+ (38,59±4,48 Vs. 11,82±1,04). Se evidenció, asimismo, el incremento en la concentración de la interleucina 7 (IL-7) en el suero de los ratones tratados con caseinato de sodio, comparados con los que solo recibieron el vehículo (62,1±17,5 Vs. 26,9±4,4 pg/ml).Conclusión. El caseinato de sodio fue capaz de aumentar el número de linfocitos B en bazo de ratones, así como inducir la producción de IL-7, citocina clave para la linfopoyesis B.

  15. Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura

    PubMed Central

    Campero, Alvaro; Herreros, Isabel Cuervo-Arango; Barrenechea, Ignacio; Andjel, Germán; Ajler, Pablo; Rhoton, Albert

    2016-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde Junio de 2005 a Mayo de 2014, 13 pacientes con diagnóstico de EHF fueron intervenidos quirúrgicamente, realizando una DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. El tiempo medio entre el inicio de la sintomatología y la intervención quirúrgica osciló entre 3 y 9 años. En todos los casos el EHF era típico, uno de ellos con neuralgia trigeminal concomitante, observándose en todos compresión neurovascular intraoperatoria. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. El 62% presentó desaparición postquirúrgica inmediata de la sintomatología preoperatoria, el 30% desaparición tras un período de 3 semanas a 2 meses (8% con mejoría parcial), y en el 8% no hubo mejoría. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman (se recuperaron en un período de 6 meses), y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. PMID:27127708

  16. Estudo de propriedades estruturais e opticas de multicamadas epitaxiais emissoras de luz baseadas em InGaN/GaN

    NASA Astrophysics Data System (ADS)

    Pereira, Sergio Manuel de Sousa

    Esta tese apresenta os resultados de uma investigacao experimental em filmes epitaxiais emissores de luz baseados em InxGa1-xN. O InxGa1-xN e uma liga semicondutora ternaria do grupo III-N muito utilizada como camada activa numa gama de dispositivos optoelectronicos em desenvolvimento, incluindo diodos emissores de luz (LEDs) e diodos laser (LDs), para operacao na regiao do visivel e ultravioleta do espectro electromagnetico. Neste estudo, caracterizam-se as propriedade opticas e estruturais de camadas simples e pocos quânticos multiplos (Multiple Quantum Wells, MQWs) de InxGa1-xN/GaN, com enfase nas suas propriedades fisicas fundamentais. O objectivo central do trabalho prende-se com a compreensao mais profunda dos processos fisicos que estao por tras das suas propriedades opticas, preenchendo o fosso existente entre aplicacoes tecnologicas e o conhecimento cientifico. Nomeadamente, a tese aborda os problemas da medicao da fraccao de InN (x) em multicamadas ultrafinas sujeitas a tensoes, a influencia da composicao e das tensoes microscopicas nas propriedades opticas e estruturais. A questao relativa a segregacao de fases em multicamadas de InxGa1-xN/GaN e tambem discutida a luz dos resultados obtidos. A metodologia seguida assenta na integracao de resultados obtidos por tecnicas complementares atraves de uma analise sistematica e multidisciplinar. Esta abordagem passa pela combinacao de: 1) Crescimento de amostras por deposicao epitaxial em fase de vapor organometalico (MOVPE) com caracteristicas especificas de forma a tentar isolar parâmetros estruturais, tais como espessura e composicao; 2) Caracterizacao nanoestrutural por microscopia de forca atomica (AFM), microscopica electronica de varrimento (SEM), difraccao de raios-X e retro-dispersao de Rutherford (RBS); 3) Caracterizacao optica a escalas complementares por: espectroscopia de absorcao optica (OA), fotoluminescencia (PL), catodoluminescencia (CL) e microscopia confocal (CM) com analise espectral. Com

  17. PubMed

    Fernández Alba, Juan Jesús; Paublete Herrera, María Del Carmen; González Macías, María Del Carmen; Carral San Laureano, Florentino; Carnicer Fuentes, Concepción; Vilar Sánchez, Ángel; Torrejón Cardoso, Rafael; Moreno Corral, Luis Javier

    2016-11-29

    Introducción: el sobrepeso y la obesidad se asocian a una mayor probabilidad de que el parto finalice en cesárea. Dado que dicho incremento del riesgo podría estar sesgado por variables de confusión como la diabetes o la hipertensión, en el presente trabajo pretendemos determinar si este riesgo persiste tras ser ajustado por numerosas variables de control.Objetivo: determinar si el sobrepeso y/o la obesidad son factores de riesgo independientes para que el parto finalice en cesárea.Métodos: estudio de cohortes retrospectivo. Se han incluido gestantes adscritas al Hospital Universitario de Puerto Real. Periodo de estudio: 2002-2011. Se incluyeron dos grupos de estudio: sobrepeso al inicio de la gestación (IMC entre 25 y 29,9) y obesidad al inicio de la gestación (IMC ≥ 30). Grupo ontrol: IMC al inicio de la gestación normal (entre 18,5 y 24,9). El riesgo de cesárea fue analizado mediante un estudio de regresión logística múltiple incluyendo como covariables: edad materna, parto inducido, diabetes gestacional, diabetes pregestacional, macrosomía, hipertensión arterial, nuliparidad, cesárea anterior, parto pretérmino y parto postérmino.Resultados: de los 18.243 partos registrados, el IMC al inicio de la gestación constaba en 4.711 casos (25,8%). El 26,1% presentaban sobrepeso, el 12,4% obesidad y el 58,9% IMC normal. Sin ajustar por variables control, se asociaron a un incremento del riesgo de cesárea: sobrepeso (OR 1,48; IC95% 1,27-1,73); obesidad grado 1 (OR 2,09; IC95% 1,66-2,64); obesidad grado 2 (OR 3,23; IC95% 2,31-4,53); obesidad grado 3 (OR 2,57; IC95% 1,56-4,22). El riesgo aumentado se mantuvo significativo en el análisis multivariante: sobrepeso (OR 1,51; IC95% 1,24-1,84); obesidad (OR 2,15; IC95% 1,67-2,76).Conclusiones: encontramos una asociación significativa e independiente entre el sobrepeso/obesidad maternos y la finalización del parto mediante cesárea incluso ajustando por numerosas variables de control como: edad materna

  18. [Not Available].

    PubMed

    Zubiaga, Lorea; Ruiz-Tovar, Jaime; Giner, Lorena; González, Juan; Aguilar, María Del Mar; García, Alejandro; Calpena, Rafael; Durán, Manuel

    2016-07-19

    Introducción y objetivo: el IMC puede resultar engañoso para ciertas complexiones corporales, por lo que se han propuesto otros parámetros como la adiposidad (calculada a través de fórmula CUN-BAE,) el índice de Framingham de riesgo cardiovascular (IF) y el índice aterogénico (IA) (rCT/HDL-c) como predictores de riesgo cardiovascular. Se propone comparar estos factores como marcadores de éxito terapéutico tras cirugía en pacientes obesos sometidos a gastrectomía vertical laparoscópica (GVL) como procedimiento de cirugía bariátrica.Material y métodos: realizamos un estudio observacional prospectivo de pacientes sometidos a GVL y con un periodo de seguimiento mínimo de 1 año. Analizamos la evolución de IMC, adiposidad, IF e IA.Resultados: analizamos 140 pacientes. El IMC preoperatorio fue de 49,1 kg/m2, con una adiposidad del 54,8%, un IF 7,54% y un IA de 4,2. A los 12 meses el IMC era de 28,4 kg/m2, con una adiposidad del 39,4%, un IF del 3,7% y un IA de 1,64. En función de estos resultados, a los 12 meses el IMC medio está en rango de sobrepeso, la adiposidad en niveles de obesidad (obesidad: > 25% en hombres y > 35% en mujeres), el IF en rango de riesgo cardiovascular bajo (< 5%) y el IA dentro del rango de normalidad (< 3). Correlacionando estos parámetros observamos que el IMC se correlaciona con la adiposidad tanto en valores preoperatorios (Pearson 0,486; p = 0,004), posoperatorios (Pearson 0,957; p < 0,001), como en la diferencia entre ambos (Pearson 0,606; p = 0,017), lo cual es lógico, porque el IMC se incluye en la fórmula CUN-BAE para el cálculo de la adiposidad. En los valores posoperatorios se objetiva una correlación de la adiposidad con el IF (Pearson 0,814, p = 0,036) y con el IA (Pearson 0,517; p = 0,049). En los valores preoperatorios no se objetivan dichas correlaciones. El IMC no se correlacionó con la adiposidad.Conclusión: la adiposidad se correlaciona con índices de riesgo cardiovascular, como el índice de

  19. Percepção astronómica de um grupo de alunos do ensino médio de uma escola da rede estadual de São Paulo

    NASA Astrophysics Data System (ADS)

    de Oliveria, E. F.; Voelzke, M. R.

    2009-03-01

    éries e períodos, observando-se, dentre ou tras coi sas, que os estudantes do terceiro ano apresentam um percentual de acertos semelhante ao dos alunos do primeiro, caracterizando que a abordagem de tópicos relacionados à astronomia no Ensino Médio não tem contribuído de forma significativa para uma maior compreensão dos fenòmenos e conceitos.

  20. Habitus furibundo en el gueto estadounidense1

    PubMed Central

    Bourgois, Philippe; Castrillo, Fernando Montero; Hart, Laurie; Karandinos, George

    2014-01-01

    Resumen Durante cinco años, un torbellino cotidiano de tiroteos, apuñalamientos y asaltos afectó a la venta de drogas al aire libre en el vecindario puertorriqueño de Filadelfia, donde residíamos y conducíamos nuestro trabajo de campo. La industria de los narcóticos ha venido a llenar el vacío que dejó la desindustrialización, convirtiendo al antiguo distrito fabril de la ciudad en un mercado de narcóticos a cielo abierto que emplea en sus niveles más bajos a jóvenes puertorriqueños y cuyos clientes son principalmente heroinómanos blancos de bajos recursos. La capacidad para movilizar la furia asegura el éxito en la economía de las drogas, garantiza protección en las cárceles y le provee un ingreso mínimo a una población de bajos recursos estigmatizada cuyos miembros frecuentemente reciben diagnósticos médicos de discapacidad cognitiva. Muchos residentes buscan alianzas en redes sociales que los comprometen a participar en intercambios solidarios de violencia auxiliar. Una dinámica de acumulación primitiva corporizada mata, hiere, discapacita o encarcela a la mayoría de estos empleados de bajo nivel y a sus clientes. Los inflados márgenes de ganancia alrededor de esta dinámica dependen de la violencia y la coerción. Un habitus furibundo impulsa a los vendedores callejeros a defender violentamente el micro monopolio de poder de sus jefes en la economía subterránea como si fuese un asunto de diversión. Estos miembros de los niveles más bajos de la industria del narcotráfico se apresuran a fraguar transacciones comerciales en ausencia de un marco legal en un ambiente de escasez que sin embargo se ve inundado por enormes flujos de dinero, drogas adictivas y armas automáticas. Tras las drásticas reformas a los programas de seguridad social, la mano izquierda del Estado, en la forma de los servicios sociales, intenta prolongar los subsidios para individuos vulnerables diagnosticándolos como discapacitados cognitivos permanentes

  1. Change in genetic correlation due to selection using animal model evaluation.

    PubMed

    Strandén, I; Mäntysaari, E A; Mäki-Tanila, A

    1993-01-12

    énérations. La corrélation génétique après sélection a été comparée à différents niveaux de corrélations génétique et environnementale pour deux critères de sélection différents. Les changements de corrélation génétique étaient similaires dans les simulations et les prédictions analytiques. Après un cycle de sélection, la méthode récurrente AM et la simulation donnaient les prédictions similaires alors que la sélection phénotypique prédisait habituellement des changements de corrélations génétiques plus importants. Après plusieurs cycles de sélection, les deux formules analytiques prédisaient des changements de corrélation plus importants que la simulation. RÉSUMÉ: Cambio en la correlación genética debido a selección usando evaluaciones con modelo animal Se estudió el efecto de la selección sobre la correlación genética entre dos caracteres utilizando simulación de Monte Carlo y cálculos analíticos. El esquema de selección simulado estuvo basado en un núcleo adulto y cerrado de ovulación multiple y transferencia de embriones. El criterio de selección fue un indice calculado a partir de un modelo animal multicarácter (AM). Se derivaron fórmulas analíticas aplicables a cualquier método de evaluación para predecir cambios debidos a selección en las (co)varianzas genéticas bajo selección multicarácter usando distintos métodos de valoración. Se investigaron dos fórmulas, una que asumía selección fenotípica y la otra basada en un índice de selección AM recurrente con dos generaciones. El método AM recurrente aproximaba la información de parientes a través de una matriz de relaciones aditivas que contemplaba dos generaciones. La correlación genética tras la selección fue comparada bajo distintos niveles de correlación genética y ambiental iniciales con dos criterios de selección diferentes. Los cambios en correlatión genética fueron similares en las predicciones analíticas y con simulación. Tras un ciclo

  2. Geodesic survey and modernization of a route as the task of optimization

    NASA Astrophysics Data System (ADS)

    Nowak, Edward

    2014-06-01

    A geodesic survey of an existing route requires one to determine the approximation curve by means of optimization using the total least squares method (TLSM). The objective function of the LSM was found to be a square of the Mahalanobis distance in the adjustment field ν. In approximation tasks, the Mahalanobis distance is the distance from a survey point to the desired curve. In the case of linear regression, this distance is codirectional with a coordinate axis; in orthogonal regression, it is codirectional with the normal line to the curve. Accepting the Mahalanobis distance from the survey point as a quasi-observation allows us to conduct adjustment using a numerically exact parametric procedure. Analysis of the potential application of splines under the NURBS (non-uniform rational B-spline) industrial standard with respect to route approximation has identified two issues: a lack of the value of the localizing parameter for a given survey point and the use of vector parameters that define the shape of the curve. The value of the localizing parameter was determined by projecting the survey point onto the curve. This projection, together with the aforementioned Mahalanobis distance, splits the position vector of the curve into two orthogonal constituents within the local coordinate system of the curve. A similar system corresponds to points that form the control polygonal chain and allows us to find their position with the help of a scalar variable that determines the shape of the curve by moving a knot toward the normal line. Inwentaryzacja istniejącej tras y wymaga wyznaczenia krzywej aproksymującej w wyniku optymalizacji realizowanej metodą najmniejszych kwadratów (TLSM). Analiza funkcji celu LSM wykazała, że jest ona kwadratem odległości Mahalanobisa w przestrzeni poprawek. W zadaniach aproksymacyjnych odległość Mahalanobisa jest miarą odstępu pikiety od wyznaczanej krzywej, w przypadku regresji zwykłej odstęp ten ma kierunek osi układu wsp

  3. Fructose 1,6-biphosphate aldolase in the sera of Simmental young bulls Connection with the fattening capacity, muscle quantity and protein content.

    PubMed

    Križanović, D; Karadjole, I

    1993-01-12

    diaria media durante el último mes de la ceba. Tras una análisis regresiva se ha probado que los terneros con una actividad mayor del ALD en el suero a principios del proceso de su ceba tienen más músculos en total en la parte de costillas y m. longissimus dorsi mientras que tienen menos huesos. A base de la actividad del ALD durante el primer mes de la ceba es posible estimar el contenido de proteinas y grasa en m. long, dorsi. RÉSUMÉ: Fructose 1.6-biphosphate aldolase dans le sérum des taurillons de Simmental. Le rapport entre l'aptitude à l'angraissement, la proportion des muscles et la teneur en protéines On a déterminé l'activité de l'enzyme aldolase (ALD) dans le sérum des taurillons de Simmental afin de vérifier s'il existait un rapport entre l'activité des enzymes et l'aptitude à l'engraissement et si l'ALD pouvait être indicatrice de la proportion de muscles et de la teneur en protéines. A la base de l'activité initiale de l'ALD, il est possible d'évaluer le poids de la carcasse et le gain quotidien moyen au cours du dernier mois d'engrais. Par analyse régressive, il a été établi que les taurillons à l'activité supérieure de l'ALD dans le sérum avaient au début de l'engrais plus de muscles au total dans la région costale et le m. longissimus dorsi et moins d'os. A la base de l'activité de l'ALD au cours du premier mois d'engrais il est possible d'évaluer la teneur en protéines et en graisse dans le muscle longissimus dorsi. 1993 Blackwell Verlag GmbH.

  4. Climate change impacts on groundwater resources: modelled deficits in a chalky aquifer, Geer basin, Belgium

    NASA Astrophysics Data System (ADS)

    Brouyère, Serge; Carabin, Guy; Dassargues, Alain

    'eau du bassin du Geer en Belgique. Le modèle de nappe est décrit en détail et les résultats sont discutés en terme d'impact du changement climatique sur l'évolution des réserves souterraines. Les premiers résultats indiquent que des déficits d'eau souterraine peuvent apparaître dans le futur en Belgique. Se ha desarrollado un modelo hidrológico integrado (MOHISE) para estudiar el impacto del cambio climático en el ciclo hidrológico de cuencas representativas en Bélgica. Este modelo considera todos los procesos hidrológicos de forma coherente, especialmente en relación con los flujos de aguas subterráneas, que son modelados por medio de un enfoque de elementos finitos espacialmente distribuidos. Gracias a esta herramienta numérica precisa, y tras una calibración y validación detalladas, se puede obtener interpretaciones cuantitativas de los resultados del modelo del acuífero. Considerando escenarios de cambio climático IPCC, se ha aplicado el enfoque integrado a la evaluación del impacto de dicho cambio climático en el ciclo hidrológico de la cuenca del Geer. Se describe los detalles y resultados del modelo de las aguas subterráneas en términos del impacto del cambio climático en la evolución de las reservas de los acuíferos. Los resultados preliminares indican que es posible esperar déficits de aguas subterráneas en un futuro en Bélgica.

  5. A pilot study of the efficacy of wipes containing chlorhexidine 0.3%, climbazole 0.5% and Tris-EDTA to reduce Malassezia pachydermatis populations on canine skin

    PubMed Central

    Cavana, Paola; Peano, Andrea; Petit, Jean-Yanique; Tizzani, Paolo; Perrot, Sébastien; Bensignor, Emmanuel; Guillot, Jacques

    2015-01-01

    todos las gasas se aplicaron una vez al día en la axila izquierda, zona inguinal izquierda, y zona perianal (protocolo A), y dos veces al día en la axila derecha, zona inguinal derecha, y región umbilical (protocolo B) durante tres días. La actividad in vivo se evaluó mediante cuantificación de las colonias de Malassezia en placas de contacto de zonas seleccionadas del cuerpo antes y después de la aplicación de las gasas. La actividad de la solución en las que las gasas se empaparon se evaluó in vitro mediante pruebas de contacto siguiendo los estándares europeos UNI EN 1275. Resultados las muestras recogidas tras la aplicación de las gasas mostraron una reacción rápida y significativa de las colonias de Malassezia. No hubo significativas en la reducción de Malassezia en los dos protocolos. El ensayo in vitro demostró una actividad del 100% frente a Malassezia tras 15 minutos de contacto con la solución de las gasas. Conclusiones e importancia clínica las gasas que contienen clorhexidina, climbazol y Tris-EDTA reducen sustancialmente la población de Malassezia paquidermatis en la piel de perros. Aunque este era un estudio no controlado y desarrollado en un pequeño número de perros, los resultados sugieren que estas gasas pueden ser útiles para la terapia tópica de dermatitis producida por Malassezia en zonas de los labios, almohadillas plantares, y zonas perianales y pliegues de la piel. Zusammenfassung Hintergrund Feuchttücher, die Chlorhexidinund Azolderivate beinhalten, werden für den veterinärmedizinischen Gebrauch empfohlen. Es gibt keine Studie über ihre Wirkung im Einsatz gegen Malasseziapachydermatis. Hypothese/Ziele Eine Evaluierung der in vivo und der in vitro Aktivität dieser Feuchttücher in einer Chlorhexidin, Climbazol und Tris-EDTA Lösung gegen Malasseziapachydermatis. Tiere Fünf Shar-Peis aus einer Versuchstierkolonie. Methoden Die Feuchttücher wurden einmal täglich in der linken Achsel, in der linken Inguinalgegend und

  6. Estudio del comportamiento tribologico y de las interacciones de superficie de nuevos nanofluidos ionicos

    NASA Astrophysics Data System (ADS)

    Espinosa Rodriguez, Tulia

    tribocorrosion processes. The formation of a coating layer on magnesium alloys from phosphonate imidazolium ionic liquids by immersion and by chronoamperometry has been described. The new coatings reduce the abrasive wear in the magnesium-aluminium alloy but they are not effective in the magnesium-zinc alloy, which prevent the formation of continuous coatings. Los liquidos ionicos son sales liquidas a temperatura ambiente o bajas temperaturas que presentan excelentes propiedades fisico-quimicas. En el presente trabajo se estudian como lubricantes en problemas tribologicos complejos como la lubricacion de metales contra si mismos, el desarrollo de lubricantes base agua y de nuevas superficies autolubricadas. Cuando no es posible reducir la friccion y desgaste mediante lubricacion, como en las aleaciones de magnesio, los liquidos ionicos se han estudiado como precursores de recubrimientos protectores. Se han determinado las interacciones superficiales y los procesos de corrosion sobre cobre y sobre acero con diferentes liquidos ionicos proticos y aproticos para desarrollar nuevos lubricantes y aditivos. En el contacto cobre/cobre, excepto el liquido ionico protico derivado del oleato, todos los liquidos ionicos estudiados presentan mejor comportamiento tribologico que el lubricante comercial Polialfaolefina 6. En el contacto acero/zafiro, los nuevos liquidos ionicos proticos son buenos lubricantes cuando se utilizan en estado puro, y, como aditivos en agua, generan peliculas adsorbidas sobre la superficie del metal reduciendo la friccion y el desgaste tras la evaporacion del agua. Para evitar el periodo de alta friccion inicial en presencia de agua, se han generado peliculas superficiales de liquido ionico sobre el acero en condiciones estaticas. El mejor comportamiento lubricante tanto en el contacto cobre/cobre como en el contacto acero/zafiro se obtiene para el liquido ionico protico derivado del anion adipato, con dos grupos carboxilicos. Las interacciones de los grupos

  7. Scheme for development of monitoring networks for springs in Bavaria, Germany

    NASA Astrophysics Data System (ADS)

    Bender, Steffen; Einsiedl, Florian; Wohnlich, Stefan

    2001-03-01

    constituer un jeu de données de base pour guider la future surveillance. Une procédure de sélection a été développée autour de quatre paramètres: (1) les unités géologiques, comprenant les principaux aquifères, (2) le débit des sources, (3) l'occupation du sol dans le bassin, et (4) la dimension approximative du bassin d'alimentation souterrain. Toutefois, dans la phase initiale de l'étude, seuls les trois premiers paramètres ont été étudiés. Ces paramètres constituent une matrice d'évaluation de chaque région hydrogéologique de Bavière pour aider à la sélection de sources supplémentaires destinées au réseau de surveillance proposé. Resumen. La red de muestreo actual de aguas subterráneas en Bavaria (Alemania) está formada sobre todo por pozos, mientras que apenas hay unos pocos manantiales naturales. Los análisis incluyen, principalmente, los parámetros físico-químicos habituales. Con el objeto de desarrollar un plan de gestión de las aguas subterráneas en Bavaria a largo plazo, el Consejo del Estado para la Gestión del Agua pretende establecer una red de muestreo de manantiales diferenciada en las once regiones en que se divide el estado desde el punto de vista de las aguas subterráneas. Como primer paso, se determinaron los parámetros físico-químicos significativos que mostraban una fluctuación anual considerable (tras un muestreo de 1 a 3 años), con la finalidad de crear una base de datos elemental que canalizara los muestreos futuros. Se desarrolló un procedimiento de selección con base en cuatro parámetros: (1) unidades geológicas y acuíferos principales; (2) caudal del manantial; (3) uso del suelo dentro de la cuenca; y (4) tamaño aproximado de la zona de captación subterránea. Sin embargo, sólo se investigaron los tres primeros parámetros durante la fase inicial del estudio. Con ellos, se estableció una matriz para evaluar cada zona acuífera dentro de Bavaria y ayudar en la inclusión de otros manantiales en la

  8. Hydrodynamic model of cells for designing systems of urban groundwater drainage

    NASA Astrophysics Data System (ADS)

    Zimmermann, Eric; Riccardi, Gerardo

    2000-08-01

    érée comme satisfaisante dans tous les cas. Afin de simuler des situations plus complexes, la nouvelle version proposée, CELSUB3, a été mise en œuvre dans un projet destiné à contrôler le niveau de la nappe à l'intérieur d'un système d'égouts, dans la ville de Chaar Ladeado (province de Santa Fe, Argentine). Différentes organisations du projet de drainage, qui ont été testées pour des conditions de recharge dynamique causées par la pluie au cours d'une année critique (la plus humide de la chronique disponible) et une année typique, sont brièvement décrites. Après analyse de dix organisations différentes, la meilleure solution technico-économique retenue est un système de drainage souterrain de conduites avec des stations de pompage et des canaux d'évacuation. Resumen. Se presenta un modelo matemático hidrodinámico cuasi-bidimensional de celdas, CELSUB3, apto para la simulación integral de sistemas de drenaje subterráneo basados en campos de bombeo o drenes subsuperficiales. El modelo de simulación presenta un ensamble de algoritmos, previamente desarrollados y testeados, que representan al escurrimiento a través del medio poroso saturado, escurrimiento en conducciones cerradas, estaciones de bombeo, etc. En la estructura del modelo se propone un nuevo tipo de vinculación entre celdas acuíferas y conductos de drenaje, la cual es verificada en problemas simples con solución analítica conocida arrojando, en todos los casos, resultados satisfactorios. Abordando situaciones más complejas, la nueva versión propuesta fue aplicada en un proyecto de control de niveles freáticos que acompaña un sistema de conductos cloacales, en la localidad de Chañar Ladeado, Santa Fe, Argentina. Se describen las alternativas de drenaje consideradas las cuales fueron evaluadas bajo recargas dinámicas provocadas por años críticamente lluviosos y en situaciones típicas. Los resultados derivados permitieron definir, tras analizar una decena de proyectos

  9. Seguridad del paciente en Radioterapia Intraoperatoria: Impacto de los elementos controlados por el Radiofisico

    NASA Astrophysics Data System (ADS)

    Tarjuelo, Juan Lopez

    Introduccion: En la administracion de la radioterapia intervienen profesionales y equipos de tratamiento, por lo que existe el riesgo de error y se precisa que dicho equipamiento funcione conforme a lo esperado. A los radiofisicos les corresponde participar en las actividades de garantia o aseguramiento de la calidad, incluyendo el control de calidad de los equipos, y en la evaluacion de los riesgos asociados. La radioterapia intraoperatoria (RIO) es una tecnica radioterapica de intensificacion de dosis, altamente selectiva, dirigida a volumenes anatomicos restringidos durante el tratamiento quirurgico oncologico, basada en la administracion de una dosis absorbida alta por medio de un haz de electrones tras el examen visual directo del lecho tumoral. Como incorporar los ultimos avances en el refuerzo de la seguridad en radioterapia es una tarea ambiciosa y compleja, resulta mas concreta y de inmediata aplicacion su introduccion en la RIO. El objetivo es analizar los elementos que reducen los riesgos y aumentan la seguridad en la RIO y su dosimetria, y valorar la funcion del radiofisico en esta labor. Material y metodos: Se emplearon el planificador Radiance de GMV y el acelerador lineal de los tratamientos de RIO Elekta Precise, controlado con el verificador diario de haces Daily QA Check 1090 y medido con las camaras de ionizacion PPC 40, FC65-G y FC65-P de PTW-Freiburg, a su vez verificadas con fuentes radiactivas adecuadas de estroncio-90 modelos CDP y CDC de IBA Dosimetry. Se realizo un analisis de modos de fallo y efectos (failure mode and effect analysis, FMEA) con el fin de identificar los elementos que forman la RIO y aplicar las herramientas necesarias para la minimizacion de los riesgos y la mejora de la seguridad en la tecnica. Se estudiaron las verificaciones diarias de dicho acelerador Precise con el control estadistico de procesos (statistical process control, SPC) y se simularon intervenciones para devolverlo al estado llamado en control. El SPC

  10. Distribution of stable isotopes in arid storms . II. A double-component model of kinematic wave flow and transport

    NASA Astrophysics Data System (ADS)

    Yakirevich, Alexander; Dody, Avraham; Adar, Eilon M.; Borisov, Viacheslav; Geyh, Mebus

    édible par rapport aux observations a été obtenu après un ajustement des paramètres par une méthode d'essais et d'erreurs. L'analyse de sensibilité et l'application du modèle ont ensuite été réalisés. Le modèle est plutôt sensible aux changements des paramètres caractérisant les zones de stockage dans les dépressions. Le modèle rend compte de l'effet de mémoire isotopique dans l'eau dans le stockage des dépressions entre les événements séquentiels de pluie. L'utilisation d'un modèle à double composante d'écoulement et de transport par onde cinématique permet un ajustement qualitatif et quantitatif adapté entre les distributions des δ18O calculées et observées dans l'écoulement de surface. Resumen Un nuevo método matemático basado en un modelo de doble componente de onda cinemática de flujo y transporte permite caracterizar la distribución isotópica dinámica de las tormentas en zonas áridas y la escorrentía. Este modelo describe el transporte y la evolución del δ18O en la lluvia, flujo superficial y escorrentía en una cuenca rocosa de clima árido con detención superficial distribuida uniformemente. El modelo se calibró numéricamente utilizando un conjunto de datos de descarga temporal y de distribución de δ18O para lluvia y escorrentía recogida en una pequeña cuenca rocosa en el Centro de Experimentación de Sede Boker, Israel. Se obtuvo un buen ajuste a los datos tras un ajuste de parámetros mediante prueba y error. Se realizó un análisis de sensibilidad que indicó que el modelo resulta ser bastante sensible a cambios en los parámetros que caracterizan las zonas de baja detención superficial. El modelo también refleja el efecto de la memoria isotópica en el agua de estas zonas de detención entre los distintos periodos de lluvias. El uso de un modelo de doble componente de onda cinemática de flujo y transporte proporciona un buen ajuste cualitativo y cuantitativo entre los datos medidos y calculados de δ18O en la

  11. Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data

    PubMed Central

    Vanobberghen, Fiona M; Kilama, Bonita; Wringe, Alison; Ramadhani, Angela; Zaba, Basia; Mmbando, Donan; Todd, Jim

    2015-01-01

    centres de santé et les établissements gouvernementaux étaient les moins susceptibles de changer de traitement. Conclusions Les taux d’échecs immunologiques du traitement et les besoins non satisfaits pour le traitement de 2nde ligne sont élevés en Tanzanie. La surveillance virologique, au moins pour les personnes avec un échec immunologique de traitement, est nécessaire pour minimiser les passages inutiles au traitement de 2nde ligne. Les établissements de santé gouvernementaux de niveau inférieur ont besoin de plus de support pour réduire les taux d’échec de traitement et pour améliorer l'adoption de la thérapie de 2nde ligne afin de maintenir les avantages d'une couverture accrue. Objetivos Las tasas de fallo de la terapia de primera línea y los cambios a la terapia de segunda línea son indicadores claves para los programas nacionales de VIH. Hemos evaluado los fallos en el tratamiento inmunológico definidos según criterios de la OMS dentro del programa nacional para VIH en Tanzania. Métodos Hemos incluido adultos que iniciaban la terapia de primera línea entre el 2004-2011 con un conteo de CD4 antes de recibir el tratamiento, y tras ≥6 meses de seguimiento. Hemos evaluado los subíndices de riesgo del fallo inmunológico en el tratamiento, y el cambio subsecuente a la segunda línea de tratamiento, utilizando análisis de riesgo competitivo para explicar las muertes. Resultados De 121,308 adultos, un 7% experimentó fallo inmunológico, y un 2% murió sin observarse un fallo inmunológico en el tratamiento, a lo largo de una mediana de 1.7 años. La probabilidad acumulada a lo largo de seis años de fallo terapéutico inmunológico era del 19.0% (IC 95% 18.5, 19.7) y de muerte del 5.1% (4.8,5.4). Los vaticinadores de fallo terapéutico inmunológico incluían haber empezado el tratamiento un año antes (p<0.001), haberlo iniciado en centros de menor nivel (SHR=2.23 [2.03,2.45] para dispensarios versus hospitales), ser ombre (1.27 [1