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1
WADA, KENTARO, TOMOYUKI NODA, KENICHI HATTORI, HIDEKI MAKI, AKIRA KITO, and HIROFUMI OYAMA. "INFLAMMATORY INDEX AND TREATMENT OF BRAIN ABSCESS." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16742.
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Danyluk, Ken. "The development of an objective orthodontic treatment-need index." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0023/MQ32092.pdf.
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McNaugher, Gillian A. "Developing a community index of complete denture treatment need." Thesis, Queen's University Belfast, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300775.
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Ferreira, Dominique Abergail. "A critique of the index of the complexity, outcome and need." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The development of a uniform method of epidemiological assessment and grading of malocclusion has been of interest for several decades. Recently, Daniels and Richmond (2000) proposed a new orthodontic index namely the Index of Complexity, Outcome and Need (ICON). Their aim was to develop a single index for assessing treatment inputs and outcomes.The aim of this study was to critique the ICON and to assess to the extent to which each component of the ICON fulfils the ideal requirements of the ideal index as identified in a World Health Organization Report (WHO, 1966). The study was performed in three parts: 1) a gold standard was established to test reliability and validity of the ICON
2) to assess ease of use and simplicity of the index
3) and to test the applicability of the index on patients and study casts. The results showed that the ICON identified 25% of the cases as &lsquo
no treatment&rsquo
, as apposed to the 100% of the gold standard. Validity of the index was shown to be &lsquo
poor&rsquo
for complexity (? = 0.2) and degree of improvement (? = 0.34) and &lsquo
excellent&rsquo
for outcome. Reliability was high for all the components except for treatment need (? = 0.63). This study concluded that except for complexity and degree of improvement, the index performed well with respects to reliability, validity (of treatment outcome), ease of use and simplicity and applicability to patient and study casts.
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Baldwin, Andrew. "The treatment of seasonal commodities in the consumer price index." Thesis, University of Ottawa (Canada), 1986. http://hdl.handle.net/10393/4580.
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Song, Rui, Shikai Luo, Donglin Zeng, Hao Helen Zhang, Wenbin Lu, and Zhiguo Li. "Semiparametric single-index model for estimating optimal individualized treatment strategy." INST MATHEMATICAL STATISTICS, 2017. http://hdl.handle.net/10150/625783.
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Different from the standard treatment discovery framework which is used for finding single treatments for a homogenous group of patients, personalized medicine involves finding therapies that are tailored to each individual in a heterogeneous group. In this paper, we propose a new semiparametric additive single-index model for estimating individualized treatment strategy. The model assumes a flexible and nonparametric link function for the interaction between treatment and predictive covariates. We estimate the rule via monotone B-splines and establish the asymptotic properties of the estimators. Both simulations and an real data application demonstrate that the proposed method has a competitive performance.
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Wahl, Mark D. "Quantifying the Hydraulic Performance of Treatment Wetlands." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1275418194.
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Suter, Jesse. "The Wraparound Puzzle: Confirmatory Factor Analysis of the Wraparound Fidelity Index." ScholarWorks @ UVM, 2008. http://scholarworks.uvm.edu/graddis/224.
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With its widespread use across the country and increasing evidence of its effectiveness, the wraparound process has been accepted widely as a feasible alternative to restrictive residential treatments for children with severe emotional and behavioral disorders. Yet wraparound has been implemented and conceptualized in such a variety of ways that many have begun to question whether it truly is a single definable approach. Recently, a conceptual model for wraparound was offered that included ten essential elements as the key ingredients for this approach. Subsequently, the Wraparound Fidelity Index (WFI) was designed to measure the degree to which an intervention adheres to these ten elements. The purpose of the current study was to use data collected via the WFI to provide the first empirical test of wraparound’s conceptual model. Programs providing wraparound to children with severe emotional and behavioral disorders and their families used the WFI to collect data from caregivers (n = 481), youths (n = 355; 11 to 19 years), and resource facilitators (n = 610). Confirmatory factor analysis (CFA) was used to test the fit of a series of structural models consistent with the proposed element model of wraparound. First, CFA models were examined separately for each of the elements. Second, CFA models that represent the full wraparound model were tested, separately for each of the three informants. And third, a multitrait-multimethod (MTMM) analysis was conducted using a final CFA model including all elements (traits) and the three informants (methods). Findings supported the majority of elements and WFI items when tested separately at the first step. However, at the second step, only the youth model provided adequate fit to the data. Significant modification was necessary to yield admissible solutions for the caregiver and resource facilitator models. Finally, an inadmissible solution resulted when the three informants and revised model were tested in step three. Implications of the findings for the wraparound process, the WFI, and future research are discussed.
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Kumar, Shivendra. "An Analytical Index for Evaluating Low-Pressure Hollow-Fibre Membrane Systems." Thesis, Griffith University, 2015. http://hdl.handle.net/10072/366948.
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Water and wastewater treatment through the use of membrane filtration technology is one of the processes utilised currently to meet the growing demand for water. While new technologies can harness water from various non-traditional sources such as oceans, there remains the possibility of making drinking water more expensive through the use of costly treatment equipment. To prevent this and ensuing catastrophes around the world, the water industry needs a strategy that keeps the price of water and price of products aiding in the treatment of water controlled into the future. The overall aim of
this study is to develop an analytical index that could be used by the water industry to measure, monitor, and control the price of water. A structured method to evaluate membrane manufacturing costs against the lifetime performance of membranes was developed. The method was then extended and a costing model for the application of membrane in water and wastewater treatment plants was established. Thereafter, a software application was developed to aid in the implementation of the analytical index.
The results indicate that, with a measurable index in place, the evaluation of technologies with respect to the cost of water production can be effectively carried out.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Griffith School of Engineering
Science, Environment, Engineering and Technology
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Burden, Donald John. "The use of an orthodontic treatment need index by general dental practitioners." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337645.
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Loayza-Pérez, Jorge, and Marina Silva-Meza. "Gestión integral de residuos químicos generados en actividades industriales." Revista de Química, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/99162.
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La gestión integral de residuos químicos permite minimizar la cantidad de residuos generados, reaprovechar los residuos que puedan volver a ser utilizados, tratarlos para disminuir su peligrosidad, y real izar una disposición final segura de aquellos residuos que no puedan ser reducidos. Se presentan los principios de gestión, el análisis del ciclo de vida de un residuo y diversas opciones de tratamiento (físico, químico, térmico y biológico) para la disposición final.Integral management of chemical wastes generated in industrial activitiesThe integral management of chemical wastes allows to d iminish the amount of generated wastes, to reutilize wastes so as to diminish their danger, and to make safe use of the final disposition of those wastes that cannot be reduced. Here we present the principies of chemical wastes management, the analysis of the service I ife of a waste and diverse treatment options (physical, chemical, thermal and biological) for its final disposition
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Hernández, García Yulán, and María Moros. "An open nanowindow towards the specific treatment of cancer." Revista de Química, 2015. http://repositorio.pucp.edu.pe/index/handle/123456789/99028.
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El cáncer es, a día de hoy, una de las principales causas de muerte, lo que lo convierte en uno de los objetivos más importantes de la medicina moderna. Las terapias convencionales son, o bien altamente invasivas (cirugía), o bien poseen una baja selectividad (quimio- y radioterapia), lo cual disminuye la eficacia de estos tratamientos e induce la aparición de efectos secundarios. Los nanomateriales, debido a su tamaño nanométrico, poseen una serie de características especiales que pueden aportar grandes ventajas en cuanto al diagnóstico y tratamiento de esta serie de dolencias. Estos nuevos sistemas tienen un gran potencial para conducir a la detección del cáncer en estadíos más tempranos, y al diseño de terapias personalizadas que actúen únicamente en las zonas afectadas, consiguiendo mejores resultados.Nowadays, cancer is one of the main causes of death worldwide, the cure of which makes it one of the most important targets of modern medicine. Conventional therapies are, either highly invasive (surgery) or little selective (chemo- and radiotherapy), which diminishes the effectiveness of these treatments leading to undesired secondary effects. Nanomaterials, due to its nano size, possess new special features that may provide several advantages for the diagnosis and treatment of this disease in all of its forms. These new systems, have great potential for leading to an early detection of cancer and the design of personalized therapies working only at target zones, improving the results obtained.
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Tang, Lai King Endarra, and 鄧麗瓊. "Assessing treatment effectiveness of removable and fixed orthodontic appliances using the occlusal index." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1989. http://hub.hku.hk/bib/B31953906.
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Richardson, J., Phillip R. Scheuerman, and M. Benton. "Biosurvey of a Constructed Wetland Using a Newly Developed Treatment Wetlands Evaluation Index." Digital Commons @ East Tennessee State University, 1996. https://dc.etsu.edu/etsu-works/2912.
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Madison, Octavia D. "The effects on treatment outcomes of counselors' access to the addiction severity index scores of substance abusers." Diss., Virginia Tech, 1997. http://hdl.handle.net/10919/40242.
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An experimental design, (the pretest/posttest design) was used in this study to investigate the efficacy of substance abuse treatment using two instruments, the Addiction Severity Index (ASI) and the biopsychosocial assessment.
Fifty-six subjects admitted to the SYMBAS TEAM Substance Abuse Treatment Program were assessed during the initial stage of treatment using the biopsychosocial assessment and the ASI. Through the process of random selection, subjects were placed in one of two groups, an experimental group or a control group. Counselors working with the subjects in the experimental group had access to the results of the ASI and biopsychosocial assessment for treatment planning, and the counselors working with the subjects in the control group had access only to the results of the biopsychosocial assessment. At the end of treatment (gO-days), the subjects in both groups were re-assessed using the ASI to determine what differences, if any, occurred between the two sample groups.
Data was analyzed using descriptive statistics along with the Student test. Results revealed that there were no statistically significant differences between the two sample groups at the .05 alpha level. However, significant reductions between the ASI pre- and posttests mean scores were noted among several of the variables in both sample groups. Also, the counselors' perceptions of the ASI suggested that the ASI was preferred over the bippsychosocial assessment for treatment planning, because of its structure and the amount of time required to administer the instrument.Ed. D.
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Toyama, Miyagusuku Jorge, and Shigyo Marilú Merzthal. "Reflections on the jurisprudential treatment of managers and trusted personnel." THĒMIS-Revista de Derecho, 2014. http://repositorio.pucp.edu.pe/index/handle/123456789/107773.
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In labor relations, there are workers who, because of the role they play in the managementof a corporation or the privileged information they handle, receive a special treatment from Labor Law: Direction and reliable workers.Because of their particular situation, many questions may arise regarding the legal treatment and labor benefits that these workers may hold. In the present article, the authors try to answer to these questions, in the light of the jurisprudence of the Peruvian Supreme Court and our country’s Constitutional Court.En las relaciones laborales, existen trabajadores que, por las características de las funciones que desempeñan o por la información que manejan, reciben un tratamiento especial: Los así llamados trabajadores de dirección y de confianza.Dada su situación particular, pueden surgir muchas interrogantes respecto al tratamiento jurídico y los beneficios laborales con los que contarían este tipo de trabajadores. En el presente artículo, los autores buscan responder a las interrogantes surgidas al respecto, a la luz de la jurisprudencia de la Corte Suprema y del Tribunal Constitucional.
17
Followell, Timothy B. "Effect of Dental Treatment on Parental Stress as Measured by the Parenting Stress Index." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1276567183.
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Elías, Naranjo Silvana Patricia. "Treatment of Guaranteed Indebtedness Allowed in Airport Transportation Infrastructure Concession Contracts." Derecho & Sociedad, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/118824.
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Taking in account the need of financing of inversions to be done by the concessionaires on the frame of concession contracts, this article develops the treatment of Guaranteed Indebtedness Allowed in the concession contracts on airport matter, which general concepts are also applicable to other types of public use transport infrastructure. In this way, the concept of Creditor Allowed is explained, and the guarantees that can be given in the frame of the referred Indebtedness are analyzed, making a comparison of these concepts in the different concession contracts.Teniendo en consideración la necesidad de financiamiento a las inversiones a ser realizadas por los concesionarios en el marco de los contratos de concesión, en el presente artículo se desarrolla el tratamiento de los Endeudamientos Garantizados Permitidos en los contratos de concesión de infraestructura aeroportuaria, siendo los conceptos generales desarrollados en el mismo, aplicables a los demás tipos de infraestructura de transporte de uso público.De esta manera, se explica, además, el concepto de Acreedor Permitido y se analizan las garantías que pueden ser otorgadas en el marco de los citados Endeudamientos, realizando una comparación sobre el tratamiento de estos conceptos en los distintos contratos de concesión.
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Sanabria, Carretero Manuel. "Alcohol use by drug addicts during the treatment and follow-up." Pontificia Universidad Católica del Perú, 2002. http://repositorio.pucp.edu.pe/index/handle/123456789/101175.
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This study is about the use of alcohol and its influence during the recuperation of drug addict patients undergoing treatment. Levels of the use of illegal drugs and alcohol were compared before, during and after the treatment of 82 patients assessed over a one-and-a-half year follow-up study. The results show that after the intervention there is an increase of alcohol use by 50% of the addicts. The 10-13% exhibit excessive levels. The higher alcohol use coincide withthe end of the treatment. This tendency changes later (18 months) into similar levels as the initialones. These results do not allow to consider the aforementioned increase as a confirmationof the substitution hypothesis, that is the alcohol use-redirection towards other more socially tolerated substances.Se estudia la influencia del consumo de alcohol en la recuperación de drogadictos sometidos a tratamiento. Se relacionan los niveles de consumo de drogas ilegales y de alcohol de antes, durantey después del tratamiento en una muestra de 82 pacientes seguidos durante un año y medio. Se evidencia que tras la intervención aumenta el consumo de alcohol en el 50% de adictosy llega a niveles excesivos en un 10-13%. El mayor consumo coincide con la finalización del tratamiento. Posteriormente (18 meses) baja a niveles próximos a los iniciales. Estos resultados no permiten interpretar die ho aumento mediante la hipótesis de la sustitución, es decir, el desvío del consumo hacia sustancias más toleradas socialmente.
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Higa, Silva César, and Chung Víctor Saco. "Constitutionalization of international investment law: Indirect expropriation cases, fair and equitable treatment." Pontificia Universidad Católica del Perú, 2013. http://repositorio.pucp.edu.pe/index/handle/123456789/115320.
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The purpose of this paper is to explore the impact of international investment law rules in the Economic Constitutional Law, especially those included in investment chapters of Peruvian’s Free Trade Treaties. In particular, it is expected to demonstrate the following (i) International Investment Law is part of Peruvian Legal System; (ii) provisions of these laws are mandatory and should be applied domestically; and (iii) interpretation and implementation of this legal right should be executed consistently with domestic legal system and Peruvian international obligations. This agreed Interpretation between Investment Law and Economic Constitution will have a positive effect in rationalization of public entities actions avoiding abuses and maltreatment to investors, in order to improve investment climate as a key element forachieving country’s sustainable development.Este trabajo tiene como objeto explorar el impacto que tienen las normas del derecho internacional de las inversiones, en específico aquellas de los capítulos de inversiones de los Tratados de Libre Comercio celebrados por el Perú, en el derecho constitucional económico. En concreto, se pretende demostrar lo siguiente: (i) el derecho internacional de las inversiones es parte del Ordenamiento Jurídico del Perú; (ii) las disposiciones de este derecho son obligatorias y deben aplicarse a nivel interno, y (iii) este derecho debe interpretarse e implementarse de manera coherente con el resto del ordenamiento interno y con las obligaciones internacionales del Perú. Esta interpretación concordada del derecho de inversiones y la Constitución económica tendrá un impacto positivo en la racionalización de la actuaciónde los órganos estatales, evitando arbitrariedades cuando sus medidas puedan afectar a un inversionista. De esta manera mejorará el clima de inversiones, el cual es un elemento necesario para lograr el desarrollo sostenible del país.
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Serebe, Catherine. "The orthodontic treatment needs in children aged 12-15 years in a school in Khomas region, Namibia." University of the Western Cape, 2018. http://hdl.handle.net/11394/6658.
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Magister Scientiae Dentium - MSc(Dent)In modern day dentistry, aesthetics forms an integral part of our social perception almost as much as functionality. Malocclusion has been brought to the forefront of developmental anomalies as it can affect mastication, speech as well as the appearance of the face. Furthermore, pre-pubertal and pubertal changes have compounded existing malocclusions in this growth period thus spiraling the need for orthodontic treatment. Therefore, it is essential to determine the normative and selfperceived need for orthodontic treatment in a population. The epidemiological data collected can be used to facilitate policy changes to manage malocclusion in Khomas, Namibia. Aim: The aim of this study was to determine the orthodontic treatment needs of a population of 12-15 year-old children attending a school in Khomas and to express it as percentages of those with subjective and objective orthodontic treatment need over the whole sample population. The objectives were to find associations between treatment needs and some demographic and socioeconomic factors.
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Payet, Puccio José Antonio. "The Open Stock Corporation: some ideas for the reform of its legislative treatment." IUS ET VERITAS, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/123576.
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In this paper, the author focuses on the study of the legal institution of the Open Stock Corporation, analyzing the way how it has been treated in our legislation over time. Furthermore, he analyzes its current regulation in the General Law of Corporations, the Securities Market Law and some isolated legal provisions. Finally, he provides some ideas for the necessary reform of this institution.En el presente artículo, el autor se centra en el estudio de la institución jurídica de la Sociedad Anónima Abierta, analizando la forma como ha sido tratada en nuestra legislación a lo largo del tiempo. Asimismo, analiza su regulación actual en la Ley General de Sociedades, en la Ley del Mercado de Valores y en algunas disposiciones legales aisladas. Finalmente, brinda algunas ideas para la necesaria reforma de esta institución.
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Schmidt-Rogge, Nicola. "Quantitative und qualitative Auswertung kieferorthopädischer Behandlungen." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2001. http://dx.doi.org/10.18452/14616.
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Ziel dieser Studie war es, die Behandlungsqualität und Behandlungsdauer der Kiefer- orthopädischen Abteilung einer Universitätsklinik zu bestimmen. Dazu wurden die Behandlungsmodelle vor und nach der Behandlung mit Hilfe des PAR (Peer Assess- ment Rating)-Indexes beurteilt. Weiterhin wurden mögliche Einflußgrößen auf die Behandlungsqualität und Behandlungsdauer untersucht. Die Behandlungsunterlagen von 100 fortlaufend abgeschlossenen Patienten (62 weiblich, 38 männlich) wurden retrospektiv ausgewertet. Das durchschnittliche Alter bei Behandlungsbeginn lag bei 14,9 Jahren (7,4 - 42,2 Jahre). Am häufigsten wurde die Behandlung im Alter von 9 oder 10 Jahren begonnen, 24 Patienten waren er- wachsen. Die Angle-Klasse II (71%) war am zahlreichsten vertreten, gefolgt von der Angle-Klasse I (21%) und der Klasse III (8%). 77 Patienten versäumten vereinbarte Termine, 38 Patienten mußten wegen ungenügender Mitarbeit ermahnt werden. Es kam ein breites Spektrum kieferorthopädischer Behandlungsgeräte zum Einsatz. Bei 95 Patienten wurde eine festsitzende Apparatur verwendet. Bei 52 Patienten er- folgte die Behandlung ausnahmslos mit dieser Apparatur, 33 Patienten wurden auf- einanderfolgend mit herausnehmbaren und festsitzenden Geräten behandelt und 10 Patienten kombiniert kieferorthopädisch und kieferchirurgisch. Nur 5 Patienten wur- den ausschließlich mit herausnehmbaren funktionskieferorthopädischen Geräten the- rapiert. Bei 31 Patienten wurden während der kieferorthopädischen Behandlung Zähne extrahiert. Der PAR Wert vor Behandlungsbeginn lag für die Gesamtgruppe bei durchschnittlich 23,9 Punkten. Der PAR Wert nach Behandlungsende lag bei 5,2. Die prozentuale Verbesserung betrug 75,6%. 65 Patienten hatten nach Behandlungsende einen PAR Wert ? 5 und 89 Patienten einen PAR Wert ? 10. Nur 4 Patienten erreichten einen PAR Wert von null. Die Verteilung der Patienten auf die einzelnen Verbesserungs- Kategorien lautete: greatly improved" 33 Patienten, improved" 65 Patienten, worse - no different" 2 Patienten. Auf die Behandlungsqualität hatte keiner der untersuchten Faktoren (Behandlungsmittel, Extraktion/Nichtanlage, Angle-Klasse, Mitarbeit und Geschlecht) einen signifikanten Einfluß. Die mittlere Behandlungsdauer aller Patienten betrug 39,1 Monate (8 - 85 Monate). Auf die Behandlungsdauer hatten von den untersuchten Faktoren (PAR Anfangswert, Behandlungsmittel, Extraktion/Nichtanlage, Angle-Klasse, Mitarbeit, Geschlecht und Alter bei Behandlungsbeginn) der PAR Anfangswert bei festsitzender Behandlung, die Behandlungsmittel, die Mitarbeit und das Alter bei Behandlungsbeginn einen signifikanten Einfluß. Die Behandlung mit herausnehmbaren und anschließend fest- sitzenden Apparaturen dauerte mit durchschnittlich 56,2 Monaten erwartungsgemäß am längsten. Die alleinige Behandlung mit festsitzenden Apparaturen benötigte im Schnitt 30,3 Monate, eine kieferorthopädisch-kieferchirurgische Kombinationsthera- pie beanspruchte 27,1 Monate. Extraktionen und/oder Nichtanlagen zeigten Tenden- zen zu längeren Behandlungszeiten. Jüngere Patienten benötigten eine signifikant längere Behandlungszeit.The aim of this study was to assess the treatment standards and treatment time in a university clinic. Pre-treatment and post-treatment study casts were assessed by the PAR (Peer Assessment Rating) Index. The influence of various factors upon treat- ment quality and treatment duration was analysed. The treatment records of 100 consecutively finished patients (62 females and 38 males) were evaluated retrospectively. The mean age was 14.9 years (7.4 42.2 years) at the pre-treatment stage. Most of the patients were between the ages of 9 and 10 years old, 24 patients were over the age of 18. At the start of treatment, 71 patients had an Angle Class II, 21 an Angle Class I and 8 patients an Angle Class III. There were 77 patients who failed at least once to show up for their appointments and 38 patients had negative chart entries regarding appliance wear. There was a wide range of appliance types used in this sample. The treatment involved fixed appliances for 95 patients. 52 patients were treated only with this type of appliance, 33 were treated with removable and fixed appliances successively and 5 patients were treated solely with removable functional appliances. 10 patients received combined orthodontic treatment and orthognatic surgery. 31 patients had extractions of permanent teeth as part of their treatment. The average pre- and post-treatment PAR scores were 23.9 and 5.2, repectively. The mean percentage reduction in PAR score was 75.6%. Post-treatment, 65 patients fell in the 0-5 PAR score group and 89 patients had a PAR score of 10 or less. However, only 4 patients scored 0 at the end of treatment. 33 patients have been "greatly im- proved", 65 patients "improved" and 2 ranked "worse or no different". Of all the fac- tors examined (type of therapy, extractions/agenesis, Angle Classes, compliance and gender) none showed a significant influence on post-treatment PAR scores. The mean treatment duration was 39.1 months (8 - 85 months). When treatment time was analysed, with all the factors examined (pre-treatment PAR score, type of treat- ment, extractions/agenesis, Angle Classes, compliance, gender and age at treatment start) only pre-treatment PAR score in the fixed appliance group, type of treatment, compliance and age at treatment start, were significantly related. As expected, the sequence of removable and fixed appliances required the longest treatment time (56.2 months). Fixed appliance therapy alone took 30.3 months, a combination of orthodontics and orthognatic surgery lasted for 27.1 months on average. Extractions and/or congenitally missing permanent teeth showed a tendency to higher treatment times. Inadequate compliance did significantly prolong treatment duration. Younger patients required longer treatment times.
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Sanabria, Carretero Manuel. "The drug taking and the treatment in patients that are involved in illegal activities." Pontificia Universidad Católica del Perú, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/101108.
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The study focuses on the assessment of the implications that criminal behavior has, not only at the start of treatment for drug taking but also during its development and results. With this aim in mind a sample of 209 patients who had applied for treatment were selected and assessed inthe principal object areas of analysis over a period of ayear anda half at six monthly intervals.The results indicate that time spent in a therapeutic centre significantly reduces criminal behaviour. However, those patients with a greater past history present more difficulties and give a poorer initial response, although during the period of follow-up these differences tend to disappear.El trabajo se centra en valorar las implicaciones que la actividad delictiva tiene, tanto en el inicio como en la evolución, y los resultados del tratamiento por consumo de drogas. A tal fin, se seleccionó una muestra de 209 pacientes que solicitaron tratamiento. Ellos fueron valorados enlas principales áreas objeto de análisis y seguidos durante un año y medio; se realizaron valoraciones de su evolución cada seis meses. Los resultados indican que el paso por la institución terapéutica conlleva una reducción muy significativa de la actividad delictiva, aunque los pacientes con un mayor historial ofrecen más dificultades y una respuesta inicial más pobre; noobstante, en el seguimiento estas diferencias llegan a desaparecer.
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Vallejo, Samudio Álvaro Roberto, and Arévalo Martha Isabel Córdoba. "Treatments and attention." Pontificia Universidad Católica del Perú, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/100851.
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Sexual abuse mainly affects children of both genders and women, with serious consequences for the victims and their familial and the social environment. This article traces available literature on the actions on the part of public health systems in some countries, aimed at supporting survivors of sexual abuse. It also examines the most recommended psychological treatments for repairing the mental health of victims. Sexual abuse in developing countries should be a public safety issue, more so in Colombia, where rape of women is a weapon of war used by players in sociopolitical violence.El abuso sexual afecta fundamentalmente a niños de cualquier género y mujeres, dejando graves secuelas en las víctimas, y en su medio familiar y social. Este artículo rastrea las publicaciones disponibles en materia de acciones encaminadas al apoyo de sobrevivientes de abuso sexual, por parte de los sistemas de salud pública en algunos países, y los tratamientos de origen psicológico más recomendados para la reparación de la salud mental de las víctimas.El abuso sexual en países en desarrollo debe ser un asunto de seguridad pública, más aun en Colombia, donde la violación de mujeres es una arma de guerra usada por los actores de la violencia sociopolítica
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Partin, Allison Kaitlyn. "Hydrocyclone Implementation at Two Wastewater Treatment Facilities To Promote Overall Settling Improvement." Thesis, Virginia Tech, 2019. http://hdl.handle.net/10919/95488.
Full textAbstract:
Hydrocyclone density-driven particle separation may offer up improved settling performance for wastewater treatment facilities experiencing poor settleability. Hydrocyclones are fed mixed liquor through the feed inlet and experience a centrifugal motion that separates solids based on density. The variation in hydrocyclone nozzle sizes will report different calculated hydraulic and mass split percentages for the overflow and underflow. Previous research conducted with hydrocyclones have at multiple full-scale facilities used a 10 m3/hr hydrocyclone to promote better settleability as well as aid the formation of aerobic granular sludge (AGS). There has been a multitude of settling improvement experiments and initiatives for full scale wastewater treatment. However, little research has been produced utilizing larger hydrocyclones (20 m3/hr) at a full-scale wastewater treatment facility during continuous operation.
Two Hampton Roads Sanitation District (HRSD) plants served as sites for this research: James River (JR) Wastewater Treatment Plant located in Newport News, VA and Urbanna (UB) Wastewater Treatment Plant located in Urbanna, VA. Both treatment facilities have utilized the hydrocyclone for more than two years, to fulfill wasting requirements. The JR plant operates the hydrocyclone continuously for wasting purposes, while UB only uses the hydrocyclone for approximately 30-45 minutes per day. In order to evaluate the effectiveness of the hydrocyclone and its overall impact on settleability at the JR plant, eight hydrocyclones were installed. JR samples were taken from the underflow sample port (representing a mixture of underflow samples representing the number of hydrocyclones operational at the sample time) and overflow samples were taken from the outfall point of a single hydrocyclone. The UB plant only operated one 5 m3/hr hydrocyclone on Treatment Train 1 during wasting operations, while Treatment Train 2 served as the control train for the duration of this research. Hydrocyclone performance at JR was assessed through direct measurement of hydraulic and mass split of the underflow and overflow components, initial settling velocity (ISV), sludge volume index (SVI), and
SVI5/SVI30 ratio. UB hydrocyclone and settling performance was measured by ISV, SVI5, SVI30, and SVI5/SVI30 ratios during different comparison experiments: hydrocyclone vs. no hydrocyclone, hydrocyclone vs. polymer addition, and hydrocyclone with polymer addition to Train 1 vs. polymer-only addition to Train 2. Nutrient concentrations from both treatment trains were collected and analyzed to determine any significant changes based on hydrocyclone use.
T-test statistical analysis, and a dose response analysis included direct measurements of the ISV, SVI5, SVI30, mass split percentages, along with the effect of polymer with and without the use of a mechanical selector.
Hydrocyclone settleability measurements at JR over time revealed a statistically significant positive correlation with the ISV, SVI5, and SVI30 measurements of the aeration effluent. Therefore, the hydrocyclone statistically had a strong impact on three settling parameters that are instrumental in determining overall settling efficiency. Statistically, no strong correlation was determined between the hydrocyclone operation and the total phosphorus (TP) concentration in the secondary effluent, or the ferric addition to the secondary clarifiers. The dose response based on the underflow ISV rate provided understanding of the nozzle comparison and the effect it provided to the underflow sample.
Hydrocyclone performance at UB was hindered by the re-seed of Train 1 (inDENSE™) due to over wasting, and most of the data were not representative. Before the re-seed, hydrocyclone performance was improving the overall settleability of the mixed liquor in comparison to Train 2 (Control). All settling parameters measured were in favor of the hydrocyclone operation. After the re-seed the plant mixed liquor changed microbial populations for a brief time and was not representative of the overall treatment efficacy. The hydrocyclone did provide a quicker settling velocity than the polymer addition when the polymer addition was steady, and through both polymeric spikes. Polymeric addition to both trains, while inDENSE™ train still employing the hydrocyclone did not provide any conclusive data as to whether polymer addition with the use of a hydrocyclone was more effective than polymer-only addition. Nutrient profiles from UB did not provide any change in NH4-N, NO3-N, NO2-N, or PO4-P, with the hydrocyclone being operational or not on the secondary clarifier effluent.Master of Science
Wastewater treatment facilities rely on settling tests to be indicators for plant settling performance. A way to improve plant settling is to separate the sludge on a density basis and retain the dense sludge in the system for better performance downstream, while the less dense sludge is taken out of the system. By implementing a mechanical device that can ensure the separation of dense material and be retained in the system can aide in improved plant settling performance by improving settling parameter measurements. With the ability of using a mechanical device (a hydrocyclone) to physically separate sludge on a density-basis, it will improve settling measurements of the plants taken by operators on a daily basis.
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Haider, Zane Karrer. "AN EPIDEMIOLOGIC SURVEY OF EARLY ORTHODONTIC TREATMENT NEED IN PHILADELPHIA PEDIATRIC DENTAL PATIENTS USING THE INDEX FOR PREVENTIVE AND INTERCEPTIVE ORTHODONTIC NEEDS (IPION)." Master's thesis, Temple University Libraries, 2013. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/229832.
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Oral BiologyM.S.
Abstract Introduction: Early Orthodontic Treatment (EOT) has been extensively studied, but questions still remain regarding the prevalence of its need in the United States. Without information regarding the epidemiology of EOT need, it is difficult to make determinations as to its viability as a Medicaid service. The Index for Preventive and Interceptive Orthodontic Needs (IPION) developed by Coetzee is the only index specifically meant for children in the mixed dentition. The purpose of this study was to utilize the IPION to measure EOT need in two pediatric dental populations in Philadelphia. Methods: 87 children between the ages of 6 and 9 were screened using the IPION. Overall scores, demographic information, and prevalence of specific malocclusions were recorded and analyzed. Results: A substantial proportion of children fell into the definite treatment need category (60.92% ±5.2% when including restorations and caries in the score, 31.03%±5.0% when excluding restorations and caries from the score). Site of screenings, race and sex had no significant effects on prevalence of EOT need, while IPION rubric used (IPION6 versus IPION9) had marginally significant effects on the prevalence of EOT need. Conclusions: There is a significant proportion of children in Philadelphia pediatric dental populations who have unmet EOT needs. Patients, communities, Medicaid, orthodontists and residents could all benefit from treatment of these children if policy were changed to allow EOT to be covered by Medicaid in Pennsylvania.
Temple University--Theses
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Holmgren, Christopher Jonathan. "The estimation of the needs for periodontal treatment in adult Hong Kong Chinese using the community periodontal index of treatment needs (CPITN) and an evaluation of a minimal periodontal treatment programme." Thesis, University College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266166.
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Xia, Jintang, and 夏金堂. "Cost-effectiveness of laparoscopic cholecystectomy during the index admission in mild acute gallstone pancreatitis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39724694.
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Tubel, Carlos Alberto Malanconi. "Controle do indice de placa e gengival com um dentifricio contendo triclosan, em pacientes submetidos ao tratamento ortodontico." [s.n.], 1999. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290404.
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Orientador: Antonio Wilson SallumDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
Made available in DSpace on 2018-07-25T11:08:36Z (GMT). No. of bitstreams: 1 Tubel_CarlosAlbertoMalanconi_M.pdf: 5126326 bytes, checksum: 8ec90877f813bc397dc2f1e329110380 (MD5) Previous issue date: 1999
Resumo: O objetivo dessa pesquisa foi avaliar o controle químico-mecânico da placa bacteriana em pacientes submetidos ao tratamento ortodôntico, através da escovação associada a um dentifrício contendo Triclosan-Gantrez-Citrato de Zinco-Pirofosfato de Sódio, quando comparado um dentifrício placebo. Foi realizado um estudo paralelo duplo cego, utilizando uma amostra de 69 pacientes do curso de Especialização em Ortodontia, na Faculdade de Odontologia da Universidade Metropolitana de Santos, tratados pela técnica do Arco Reto (filosofia de Roth), leucodermas, de ambos os sexos, na faixa etária de 12 a 25 anos, com idade média de 14 anos, apresentando dentadura permanente completa, portadores de maloclusão Classe I e Classe II, divisão 1 e 2 de Angle, sendo orientados e supervisionados para realizarem a escovação (técnica de BASS modificada) juntamente com o dentifrício designado. o.s pacientes foram aleatoriamente divididos em dois grupos: grupo A (controle) com escovação associada a um dentifrício placebo; grupo B (teste) com escovação associada a um dentifrício contendo Triclosan. Durante a pesquisa foram realizadas cinco avaliações, sendo a primeira realizada antes da instalação do aparelho ortodôntico fixo; as demais avaliações foram avaliadas nos seguintes períodos 5, 10, 15 e 20 meses, após a instalação do aparelho ortodôntico fixo, onde foram registrados o índice de placa de SILNESS & LÓE 'POT. 93' e o índice gengival de LÓE & SILNESS 'POT. 57', de todos os pacientes, nas diferentes épocas. Para a análise estatística foi usado o teste não paramétrico de Wilcoxon. Conclui-se que: 1. A colocação do aparelho ortodôntico fixo favoreceu o aumento do índice de placa e índice gengival em ambos os grupos no período de 5 meses, em média 25%; 2. O índice de placa bacteriana do grupo controle diminuiu 43% no grupo teste 51 % do início ao término do experimento, não sendo esses valores estatisticamente significantes. 3. O índice gengival do grupo controle diminuiu 20% e do grupo teste 45%, do início ao término do experimento, sendo esses valores estatisticamente significantes. 4. Tanto o grupo teste como o grupo controle apresentaram-se eficientes no controle da placa bacteriana, o grupo teste apresentou melhora estatisticamente significante nos índices gengivais quando comparado ao grupo controle; 5. A. escovação mecânica pareceu ser o melhor meio no controle da remoção da placa bacteriana e manutenção da saúde dos tecidos gengivais; 6. O controle químico-mecânico da placa bacteriana e inflamação gengival associada a um dentifrício contendo Triclosan-Gantrez - Pirofosfato de Sódio - Citrato de Zinco mostrou uma redução estatisticamente significante quando comparado a um dentifrício placebo na redução da placa bacteriana supragengival, sangramento gengival e gengivite marginal
Abstract: The aim of the present investigation was to examine the supragingival plaque control in patients undergoing orthodontic treatment, through oral hygiene associated to a dentifuce containing Triclosan-gantrez-zinc citrate-sodium pyrophosphate, compared to a placebo dentifrice. It was a double blind cross over clinical study conduced on 69 patients of the Metropolitan University of Santos. All of them were Brazilian caucasian, from both sexes. The age range 12 to 25 years old, and has either Class I or Class II malocclusions. They were adequately oriented and supervised to perform oral hygiene associated to a dentifrice containing Triclosan or placebo. The patients were stratified into 2 groups: group A (control) with oral hygiene associated to a dentifrice placebo group B (test) with oral hygiene associated to a dentifuce containing Triclosan. During the present investigation were performed 5 trial, being the first before the orthodontic appliance were installed; the orthers one were after a period the 5, 10, 15 and 20 months, after the appliance were installed. The purpose of theses avaluations was to appraise any alterations in the plaque index (according to Silness & Lõe) and in the gingival index (according to Lõe & Silness). To the statistic analysis was used the non-parametric test, named Wilcoxon. Based on the analysis of the results obtained, we concluded that: 1. The orthodontic appliance increased the plaque and gingival index, in both groups at phase 5 months, mean 25%. 2. The plaque index in the control group decreased 43% and the test group 51% from begining to the end ofthe study, not being this values statistically significant. 3. The gingival index in the control group decreased 20% and in the group test 45%, form begining to the end ofthe experiment, being this values statistically significant. 4. Both test and control group showed satisfatory on plaque control, test gr-oup was statistically significant on gingival index when compared to control group. 5. Mouthbrushing showed to be the best way on plaque remotion and healthy stability of gingival tissues. 6. The plaque and gingival control associated to a dentifrice containg Triclosan-gantrez zinc citrate-sodium pyrophosphate showed decreased statistically significant when compared a placebo dentifrice on supragingival index, gingival bleeding and marginal gingivitis
Mestrado
Ortodontia
Mestre em Odontologia
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Leverentz-Brady, Kristen M. "Relationship Between Service Intensity, Care Coordination, And Child Outcomes." ScholarWorks @ UVM, 2008. http://scholarworks.uvm.edu/graddis/138.
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The current study examines the relationship between service utilization and child outcomes, and the role fidelity to the principles of the wraparound care coordination process plays in mediating that relationship. One hundred and twenty-one participants at three separate Children’s Mental Health Services (CMHS)-funded Systems of Care national evaluation sites in three states were administered the Wraparound Fidelity Index (WFI), designed to measure adherence to the principles of wraparound; child outcomes measures, including the Child Behavior Checklist (CBCL) and the Child and Adolescent Functional Assessment Scale (CAFAS); and the Multi-Sector Service Contact Questionnaire (MSSC), designed to assess services received. Data were analyzed using hierarchical multiple regression and linear mixed models in order to examine the mediational role fidelity plays at two levels, children and wraparound facilitators, and at three different time points, baseline, six-month follow-up, and twelve-month follow-up. No statistically significant relationships were found between wraparound fidelity and child outcomes at six-month follow-up. Also, at six-month follow-up, the level of services the child and family received significantly predicted child outcomes related to externalizing symptoms but not to internalizing symptoms or functional impairment; however, this relationship was not mediated by fidelity to the wraparound process. From baseline to six-month follow-up and twelve-month follow-up, no statistically significant relationships were found between wraparound fidelity and child outcomes across wraparound facilitators. Also, no statistically significant relationships were found between the level of services the child and family received and child outcomes. A mediation model from baseline to six-month follow-up and twelve-month follow-up was not viable due to the null findings. Exploratory analyses were conducted. Implications of these findings and directions for future studies are discussed.
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Hadla, Mohamad. "Exosomal Doxorubicin and the Treatment of Breast and Ovarian Cancers." Doctoral thesis, Università degli studi di Padova, 2017. http://hdl.handle.net/11577/3421921.
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Background
The application of nanotechnology in the medical field is called nanomedicine. This novel sector have got a lot of interest from many investigators nowadays due to the important development that happened in the last decades, in particular in cancer treatment. Cancer nanomedicine has been applied in different domains such as drug delivery, nanopharmaceuticals and nanodevices. The application of nanotechnology to pharmaceutical science allowed to build up system based on at least two stage vectors (drug/nanomaterial). New formulations based on that platform show often an improvement in drug pharmacokinetics (PK), bioavailability and biodistribution owing enhanced permeability and retention (EPR) effect to passively target tumor both decreasing side effect of free drug. Among natural nanovectors, exosomes (exo) were first described in 1981 as extracellular nanovesicles with a size range of 50-200 nm. Exosomes are produced by cells embedded of cellular information and represent a formidable natural cargo for long distance communication. The name "fedexosome" denotes the general idea that exosomes could deliver cargo that conveniently manipulated could be of help for patients therapy.
Aims
To develop exosomes loaded with doxorubicin (DOX)
To test the cytotoxic effect of exoDOX (exosomal doxorubincin) in vitro using cell
lines models compared to the parental drug (DOX)
To test the antitumor activity and the toxic side effects of exoDOX compared to the parental DOX in in vivo experimental models
To test tissue biodistribution and pharmacokinetics (PK) of exoDOX compared to DOX in vivo experimental models
To define the maximum tolerated dose (MTD) of exoDOX and DOX in in vivo experimental models
Materials and Methods
Purified exosomes from cell lines were loaded with DOX and characterized by nanoparticle tracking analysis (NTA), Scanning/Transmission electron microscopy (SEM/TEM) and western blot. The anti-tumoral effects of exoDOX were tested in vitro (MDA-MB-231 breast, HCT-116, LoVo and DLD1 colon and STOSE ovarian cancer cell lines) and in vivo using nude and FVB/N mice as breast and ovarian cancer models. The antitumor effect was assessed by measuring the tumor volumes. The toxic effects were evaluated by following the body weight and through histopathological analyses of mice organs. The biodistribution and PK of exoDOX and DOX were assessed by mass spectrometry (LC-MS).
Results
• In vitro studies showed no increased cytotoxic effect (cell viability) of exoDOX compared to DOX in all the investigated cell lines .
• Similar results were observed in the in vivo models indicating no significant differences in the tumor volume after treating mice with the same concentrations of exoDOX and DOX.
• In vivo toxicity analysis showed a significant reduction of cardio-toxic side effects by using exoDOX compared to free DOX. Mass spectrometry studies showed that the accumulation of exoDOX in the heart was reduced by about 40% compared to free DOX when using the same concentration of active drug.
ExoDOX avoids heart toxicity by partially limiting the crossing of DOX through the myocardial endothelial cells. For this reason, mice can be treated with higher concentration of exoDOX thus increasing the efficacy of DOX as demonstrated in breast and ovarian mouse tumors.
- Conclusions
Differently from previously published papers that focused on the efficacy of the doxorubicin encapsulated in exosomes, in this thesis for the first time, we demonstrated that unmodified exosomes loaded with DOX are less toxic than free DOX by altering the biodistribution of the drug, these results were published in Nanomedicine (Lond) Journal in 2015. ExoDOX is safer and more effective than free DOX using breast cancer model and importantly was confirmed using the first spontaneous transformed syngeneic model of high-grade serous ovarian cancer which open the road for providing a new therapeutic opportunity, which was published recently in Nanomedicine (Lond) Jounral in 2016.Introduzione L'applicazione delle nanotecnologie in medicina è chiamata nanomedicina. Questo settore è motivo di interesse da parte di molti ricercatori dovuto agli importanti avanzamenti avvenuti negli ultimi decenni, in particolare nel trattamento del cancro. In oncologia la nanomedicina è stata applicata in diversi settori quali la costruzione di nuovi sistemi di veicolazione del farmaco e nano dispositivi per la diagnosi. L'applicazione delle nanotecnologie alle scienze farmaceutiche ha permesso di costruire sistemi basati su almeno due vettori (farmaco/nanomateriali). Le nuove formulazioni spesso mostrano un miglioramento del profilo di farmacocinetica (PK), la biodisponibilità e biodistribuzione dimostrando una migliorata permeabilità e ritenzione passiva nel tumore (EPR effect) diminuendo gli effetti collaterali del farmaco libero. Tra i nanovettori naturali, gli esosomi (exo) sono stati descritti nel 1981 come nanovescicole extracellulari con una gamma di dimensioni da 50-200 nm. Gli esosomi sono prodotti dall invaginazione dalla conseguente gemmazione della membrana cellulare consentendo il caricamento di acidi nucleici e di componenti citoplasmatiche rappresentando formidabile mezzo naturale per la comunicazione a lunga distanza. Il nome "fedexosome" denota l'idea generale che exosomes potevano consegnare contenuti che adeguatamente ingegnerizzato potrebbe essere di aiuto per la terapia di pazienti. Scopo • Sviluppare esosomi caricati con doxorubicina (DOX) • Verificare l'effetto citotossico dell'exoDOX exosomal doxorubincin in vitro rispetto al farmaco libero (DOX), utilizzando modelli cellulari. • Testare l'attività antitumorale e la tossicità dell'exoDOX rispetto alla DOX libera in modelli sperimentali in vivo. • Valutare la biodistribuzione nei tessuti e la farmacocinetica (PK) dell'exoDOX rispetto al DOX in modelli sperimentali in vivo. • Definire la dose massima tollerata (MTD) dell' exoDOX e DOX in modelli sperimentali in vivo. Materiali e metodi Gli esosomi purificati da linee cellulari sono stati caricati con DOX e caratterizzati tramite nanoparticle tracking analysis (NTA), microscopia a scansione/ trasmissione elettronica (SEM/TEM) e western blot. Gli effetti anti-tumorali dell'exoDOX sono stati valutati in vitro in linee cellulari di tumore alla mammella (MDA-MB-231), colon (HCT-116, LoVo e DLD1) e ovaio (STOSE) e in vivo utilizzando topi nudi e FVB/N come modelli di tumore della mammella e dell'ovaio. L'effetto antitumorale è stato valutato misurando il volume del tumore. Gli effetti tossici sono stati determinati monitorando il peso corporeo e attraverso analisi istopatologiche degli organi dei topi. La biodistribuzione e la PK dell'exoDOX e DOX sono state definite mediante spettrometria di massa (LC-MS). Risultati • Studi in vitro hanno dimostrato un aumento dell'effetto citotossico (vitalità cellulare) dell'exoDOX rispetto alla DOX in tutte le linee cellulari esaminate. • Risultati simili sono stati ottenuti nei modelli in vivo e indicano differenze significative nel volume del tumore dopo aver trattato i topi con le stesse concentrazioni dell'exoDOX e DOX. • Le analisi della tossicità in vivo hanno mostrato una riduzione significativa degli effetti collaterali cardio-tossici dell'exoDOX rispetto alla DOX libera. Dalle analisi di spettrometria di massa è emerso un minore accumulo dell'exoDOX a livello del cuore di circa il 40% rispetto alla DOX libera a parità di concentrazione di farmaco attivo. • La minore tossicità cardiaca della exoDOX è dovuta ad un ridotto passaggio della DOX attraverso le cellule endoteliali del miocardio. Pertanto, come dimostrato in tumori alla mammella e all'ovaio, l'efficacia terapeutica della DOX può essere ottimizzata trattando i topi con una maggiore concentrazione dell' exoDOX. Conclusioni A differenza di quanto riportato in letteratura circa l'efficacia della doxorubicina incapsulata negli esosomi, dal nostro studio, pubblicato nel 2015 nella rivista Nanomedicine, emerge che: - la tossicità della DOX veicolata dagli esosomi è minore rispetto al farmaco libero; -la biodistribuzione della DOX veicolata dagli esosomi è diversa da quella del farmaco libero. In conclusione, lo studio effettuato dimostra che l'exoDOX è più biocompatibile ed efficace della DOX libera in modelli di tumore alla mammella. Inoltre, come da noi pubblicato di recente sulla rivista Nanomedicine, tale risultato è stato confermato con studi su un modello singenico di carcinoma ovarico sieroso, aprendo così la strada ad un nuovo approccio terapeutico per il cancro all'ovaio.
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Rampersadh, Yuvthi. "The perceived and normative orthodontic treatment need of a group of South African children." University of the Western Cape, 2015. http://hdl.handle.net/11394/4814.
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Magister Scientiae Dentium - MSc(Dent)Introduction: Improvement of aesthetics is often the reason patients seek orthodontic treatment. The ability to accurately assess aesthetic treatment need from the viewpoint of the patient is necessary. The threshold for orthodontic treatment is not constant in all countries and no previous attempts to determine this threshold has been made in South Africa. By ensuring that patient’s perceptions of treatment need are incorporated into the index chosen to assess perceived need, accurate data can be obtained. Determining perceived need from the patient’s viewpoint is important, and understanding its relationship with perceived need according to the professional, as well as normative need can facilitate better patient communication and management of expectations. Aims: There were three main aims of this study. First, South African children’s perceptions of treatment need according to the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was assessed to determine if they were similar to those of the dentists who established the threshold, or if the threshold of the grading system should be altered to better suit laypeople’s opinions. Second, the newly established threshold could then be used to determine the perceived needs for orthodontic treatment, and compare them to the normative need of the population. Finally, factors that may influence the perceived needs of the patients such as gender, ethnicity and socio-economic position could be investigated. Methodology: A cross-sectional study on 317 children aged between 11 and 14 years was done. 43.8% were male and 56.2 % were female. The sample was chosen from five schools in the Lekwa District of Mpumalanga using a multi-stage sampling technique. The study population comprised of four groups based on ethnicity; Asian (3%), black (74%), coloured (6%) and white (17%). The socio-economic position (SEP) was determined by Principal Component Analysis of household assets. Societal perceived, subjective perceived and self-perceived needs were assessed using a questionnaire and the child-rated AC of the IOTN. An intra-oral examination was conducted using the AC of the IOTN to assess objective perceived need and the modified Dental Health Component (DHC) of the IOTN to assess normative treatment need. Results: Treatment threshold was determined to be grade 3 of the AC of the IOTN according to societal perceived need of the group of South African children, and was confirmed by self-perceived need. Subjective perceived need for treatment was assessed using the AC grade participants felt best reflected their aesthetic impairment, and was found to be 20.2%, compared to actual self-perceived need of 38.5%. The latter was deduced by comparing the child-rated AC (subjective perceived need) to their perception of treatment need of that grade (societal perceived need). The objective perceived need measured by the examiner-rated AC was 60%. Definite need for orthodontic treatment based on the modified DHC of the IOTN was 41.2%. No significant difference between societal perceived or self-perceived need and gender or socio-economic position was found. White children have lower societal perceived treatment need regarding others’ aesthetic impairment. Conclusion: The treatment threshold grade should be lowered to better represent the societal perceived and self-perceived need of the South African population. Normative need was higher than perceived needs from the patients’ point of view (subjective perceived and self-perceived need), but lower than the perceived need from the professional’s point of view (objective perceived need). Ethnicity was found to have an influence on societal perceived need.
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Mehling, Christine. "Comparison of low glycemic index high carbohydrate, high glycemic index high carbohydrate and monounsaturated fat-enriched diets on insulin sensitivity in the treatment of impaired glucose tolerance." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0017/MQ54157.pdf.
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Vásquez, Nieva Óscar, and Quispe José Arias. "Influence of Linkage on the Declared Price for Customs Taxation: Treatment of Transfer Pricing in Customs Valuation." Derecho & Sociedad, 2015. http://repositorio.pucp.edu.pe/index/handle/123456789/117455.
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The Customs Value is the tax base for import taxes, defined in the Valuation Agreement of the WTO as the transaction value, the price actually paid or payable for the goods. However, the price agreed between related companies can be unacceptable, since they could be fixed to take advantage of tax environments where they are. Nonetheless, the relationship is not always a factor in determining the price, which can be tested by a Study of Transfer Pricing (for customs purposes) to develop the comparative method with respect to transactions between two unrelated companies under identical or similar conditions, contained in Andean Community Resolution 1684, providing evidence to apply the following procedures:a) Analysis of the Circumstances of the Sale, or b) Using a Criterion Value.El Valor en aduanas es la base imponible para los tributos a la importación, definido en el Acuerdo de Valoración de la OMC como el valor de transacción, es decir, el precio realmente pagado o por pagar por las mercancías. Sin embargo, el precio pactado entre empresas vinculadas podría no aceptarse, dado que podrían fijarse de manera que puedan sacar ventajas de los entornos fiscales donde se encuentran. Sin perjuicio de ello, la vinculación no siempre es un factor de determinación del precio, lo cual se puede probar mediante un Estudio de Precios de Transferencia (para efectos aduaneros) que desarrolle el procedimiento comparativo respecto de operaciones entre dos empresas no vinculadas en condiciones iguales o similares, contenido en la Resolución 1684 de la CAN, aportando pruebas que permitan aplicar los siguientes procedimientos: a) Análisis de las Circunstancias de la Venta, o b) Utilización de un Valor Criterio.
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Cores, Ferradas Roberto, and Ramírez Víctor Valdez. "Treatment of the Call Spread options and the premiums associates to financial options in the Income Tax." IUS ET VERITAS, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/123035.
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In this article, the authors explain the type of treatment the Call Spread options should be given. They argue that these should be treated as a unique derivative and not as one compound by two independent elements. Likewise, they outline the premium as an inherent element in the determination of any gains or losses from the financial options that it is decided to adopt. As an important point, they claim that adopting one specific side about the treatment of the Call Spread options and the premium implies having a viewpoint about their determination in the Income Tax.En el presente artículo, los autores explican el tipo de tratamiento que se debería dar a las opciones Call Spread. Sostienen que debería ser tratado como un derivado único y no como uno compuesto por dos elementos independientes. Asimismo, señalan a la prima como un elemento inherente a la determinación de las eventuales ganancias o pérdidas definitivas generadas por las opciones financieras que se decida adoptar. Como punto importante, indican que adoptar una posición específica sobre el tratamiento de las opciones Call Spread y de las primas supone una posición sobre su determinación en el Impuesto a la Renta.
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Pozo, Sánchez Julio, and Flores Carolina Ormeño. "Problematic areas in the real property subjects to a fiduciary domain: sales tax treatment and the provisionary measures." IUS ET VERITAS, 2018. http://repositorio.pucp.edu.pe/index/handle/123456789/123266.
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According to Peruvian legislation, through an escrow agreement a trustor transfers under a fiduciary domain in favor of an escrow agent various goods, rights and obligations, which must achieve certain purpose. These will constitute an autonomous patrimony that does not respond any obligation of the trustor and the agent escrow. Despite the clarity of this statement, the authors reveal that indeed there might be different interpretations about this agreement that have practical consequences with the treatment of real properties subject to fiduciary dominion.De acuerdo a la legislación peruana, a través del contrato de fideicomiso, el fideicomitente transfiere en dominio fiduciario a favor del fiduciario diversos bienes, derechos y obligaciones, los mismos que deben ser afectados a la consecución de un determinado fin. De tal manera se constituye un patrimonio autónomo que no responde por las obligaciones del fideicomitente ni del fiduciario. Pese a la claridad de dichas disposiciones, los autores evidencian que en la realidad se presentan situaciones problemáticas de concepto que tienen consecuencias prácticas con el tratamiento de los inmuebles sujetos a dominio fiduciario.
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Miner, Alison. "Quantifying Voice Change After Hydration Treatment in Primary Sjögren’s Syndrome Using the Cepstral Spectral Index of Dysphonia (CSID)." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/5746.
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Primary Sjögren's Syndrome (SS) is an autoimmune disease that causes dehydration of the eyes, mouth, and throat. Individuals with Primary SS are at risk for voice problems associated with vocal fold dehydration. Topical hydration treatments show promise in reducing the negative effects of vocal fold dehydration on voice production. However, no studies have examined the preventive effects of topical hydration treatments on voice production in individuals at risk for vocal fold dehydration. The purpose of this study was to quantify the effects of a topical vocal fold hydration treatment on voice production in individuals with Primary SS using the Cepstral Spectral Index of Dysphonia (CSID). Eight participants with Primary SS completed an eight-week study involving twice-daily audio recordings of sustained vowels and the Rainbow Passage. Participants received 9 mL of nebulized isotonic saline (0.9% Na+Cl-) immediately following morning and evening voice recordings during weeks 3, 4, 7, and 8 using an ABAB within-subjects experimental design. Baseline CSID values were in the mild range. Although CSID values decreased (improved) during the treatment phases of the study, no statistically significant changes were observed from baseline to treatment. Statistically significant correlations were observed among CSID values and patient-based ratings of vocal effort and dryness, which did improve with treatment (p < .05). These results indicate that topical saline treatments may prevent and treat some voice problems associated with vocal fold dehydration in at-risk populations.
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Gibbs, Joy Jaylene. "Queueing Variables and Leave-Without-Treatment Rates in the Emergency Room." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6207.
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Hospitals stand to lose millions of dollars in revenue due to patients who leave without treatment (LWT). Grounded in queueing theory, the purpose of this correlational study was to examine the relationship between daily arrivals, daily staffing, triage time, emergency severity index (ESI), rooming time, door-to-provider time (DTPT), and LWT rates. The target population comprised patients who visited a Connecticut emergency room between October 1, 2017, and May 31, 2018. Archival records (N = 154) were analyzed using multiple linear regression analysis. The results of the multiple linear regression were statistically significant, with F(9,144) = 2902.49, p < .001, and R2 = 0.99, indicating 99% of the variation in LWT was accounted for by the predictor variables. ESI levels were the only variables making a significant contribution to the regression model. The implications for positive social change include the potential for patients to experience increased satisfaction due to the high quality of care and overall improvement in public health outcomes. Hospital leaders might use the information from this study to mitigate LWT rates and modify or manage staffing levels, time that patients must wait for triage, room placement, and DTPT to decrease the rate of LWT in the emergency room.
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De, Bin Riccardo. "Integrated likelihood for the treatment of nuisance parameters." Doctoral thesis, Università degli studi di Padova, 2012. http://hdl.handle.net/11577/3422503.
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In literature, several tools have been proposed to make inference about a parameter of interest ψ in presence of nuisance parameters. Among these, the integrated likelihood seems to gain popularity. Commonly used in Bayesian inference, the integrated likelihood has been recently studied also under the frequentist paradigm. We contribute to this analysis studying first its properties in presence of many nuisance parameters, and in particular in situations when the number of nuisance parameters increases with the sample size. In this setting, indeed, the usual inferential tools, based on the profile likelihood, may perform poorly, and the use of the integrated likelihood can be an alternative to higher order methods. In particular, we focus on the asymptotic behaviour of the signed square root integrated likelihood ratio statistic, studied in a two-index asymptotics setting, in which both the sample size and the dimension of the nuisance parameter increase to infinity. As a second topic of the thesis, when there is a sufficient statistic for the nuisance parameter, we study conditions of equivalence of integrated and conditional likelihoods. Finally, some efforts are done to study the effect of the presence of nuisance parameters on pairwise likelihood and on the related score function. A correction useful to reduce the profile pairwise score bias is presented.In letteratura, vari strumenti sono stati introdotti per fare inferenza su un parametro di interesse ψ in presenza di parametri di disturbo. Tra questi, la verosimiglianza integrata sembra guadagnare popolarit`. Usata comunemente nell’inferenza bayesiana, la verosimiglianza integrata è stata recentemente oggetto di studi approfonditi anche in ambito frequentista. Il contributo della tesi in questo ambito consiste in primo luogo nello studiare le proprietà della verosimiglianza integrata in presenza di parametri di disturbo con dimensione elevata, in particolare in situazioni in cui il numero dei parametri di disturbo cresce all’aumentare della numerosità campionaria. In questo contesto, infatti, gli strumenti inferenziali usuali, basati sulla verosimiglianza profilo, possono fornire risultati inaccurati, e l’uso della verosimiglianza integrata risulta una valida alternativa a strumenti basati su approssimazioni asintotiche di ordine più elevato. Particolare attenzione è rivolta all’analisi del comportamento asintotico della statistica radice con segno del rapporto di verosmiglianza integrata, studiata in un doppio ordine asintotico, in cui sia la numerosità campionaria, sia la dimensione del parametro di disturbo, divergono. In presenza di una statistica sufficiente per il parametro di disturbo, inoltre, sono studiati i casi di equivalenza tra la verosimiglianza integrata e condizionata. Infine, sono presentati alcuni contributi relativi allo studio degli effetti della presenza di parametri di disturbo sulla verosimiglianza a coppie e sulla relativa funzione punteggio profilo, per la quale è presentata una correzione utile per ridurne la distorsione.
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GRILLO, RAFAELA OLIVEIRA. "THE FACE IS NO INDEX TO THE HEART: THE INFLUENCE OF RESILIENCE IN ADHERENCE TO TREATMENT OF HEART FAILURE." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2016. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=27264@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
Adesão é o estabelecimento de uma atividade conjunta, na qual o paciente não apenas obedece a orientação médica, mas entende, concorda e segue a prescrição recomendada pelo seu médico. Significa que deve existir uma aliança terapêutica entre médico e paciente, na qual são reconhecidas não somente a responsabilidade específica de cada um no processo, mas também de todos os que estão envolvidos direta ou indiretamente no tratamento. A adesão varia devido a inúmeros fatores que estão relacionados com a doença, o tratamento, o doente e o método de medição. Não há consenso absoluto na definição de adesão, contudo, estudiosos concordam que a adesão não é universal e que algum tipo de não adesão é sempre esperado, mesmo no caso de doenças graves. Existem diversos fatores psicossociais que influenciam a adesão ao tratamento, dentre eles a relação médico-paciente e a resiliência. As doenças cardiovasculares são hoje uma das maiores causadoras de internações e mortes no Brasil. A Insuficiência Cardíaca é uma síndrome, com múltiplas possíveis causas, em que a boa adesão ao tratamento faz a diferença entre a vida e a morte, assim como na qualidade de vida do paciente. O objetivo deste estudo foi investigar a influência da resiliência na adesão ao tratamento e quais são os outros fatores que mais ajudam e dificultam os pacientes a aderir. Métodos: Foram investigados 50 pacientes de um ambulatório de Insuficiência Cardíaca de Hospital Universitário no Rio de Janeiro. Instrumentos: Questionário Sociodemográfico, Inventário Beck de Ansiedade, Inventário Beck de Depressão, Escala de Avaliação de Agenciamento de Autocuidado (ASAS-R), Escala de Resiliência (RS-14), Questionário de Qualidade de Vida (SF-36) e entrevista semiestruturada. Os dados foram analisados com o programa SPSS e as respostas das entrevistas foram analisadas utilizando a metodologia qualiquanti. Resultados: O tipo de adesão mais forte é a medicamentosa (t49=4,30; p<0,05). A resiliência não se associou significativamente com a adesão medicamentosa (ρ=0,17; p>0,05) e a adesão às atividades físicas (ρ=0,30; p>0,05), mas apresentou significância estatística na adesão nutricional (ρ=0,39; p<0,05). Além disso, a relação médico-paciente apresentou-se como grande facilitadora da adesão ao tratamento. Em contrapartida, percebeu-se que a depressão atrapalha na adesão nutricional (ρ= -0,33; p<0,05) e às atividades físicas (ρ= -0,48; p<0,05), assim como no autocuidado (ρ= -0,42; p<0,05). Conclusão: Devido à amostra pequena, novos estudos com maior número de sujeitos devem ser realizados para uma melhor compreensão das atitudes dos sujeitos em relação ao tratamento. Contudo, tanto a resiliência como uma boa relação médico-paciente auxiliam o paciente a conquistar um maior grau de adesão ao tratamento.
Adherence is the establishment of a joint activity, in which the patient not only obeys the medical orientation, but understands, agrees and follows the prescription recommended by the doctor. It means that there must be a therapeutic alliance between doctor and patient in which not only the specific responsibilities of each party in the processis recognized, but also of all those involved directly or indirectly in treatment. The adherence varies due to several factors which are related to the disease, the treatment, the patient and the measuring method. There is no absolute consensus on the definition of adherence, but scholars agree that aderence is not universal and that some type of non-adherence is always expected, even in the case of serious diseases. There are several psychosocial factors that influence treatment adherence, including the doctor-patient relationship and resilience. Cardiovascular disease is now a major cause of hospitalization and death in Brazil. Heart failure is a syndrome with multiple possible causes, where the good treatment adherence makes the difference between life and death, as well as the quality of life of the patient. The objective of this study was to investigate the influence of resilience in adherence to treatment and what other factors that help and hinder patients adherence. Methods: Fifty patients from a heart failure clinic of University Hospital in Rio de Janeiro were investigated. Instruments: Socio-demographic questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, Appraisal of Self Care Agency - Revised (ASAS-R), Resilience Scale (RS-14) Quality of Life Questionnaire (SF-36) and semi-estructured interview. Th data was analyzed using SPSS and the responses of the interviews were analyzed using the quali quantitative analysis. Results: The strongest type of adherence is to the medication (t49=4,30; p<0,05). Resilience was not significantly associated with medication adherence (ρ=0,17; p>0,05), and adherence to physical activities (ρ=0,30; p>0,05), but it was statistically significant in nutritional adherence (ρ=0,39; p<0,05). In addition, the doctor-patient relationship has been shown as a great facilitator of adherence. On the other hand, it was noted that depression impairs the nutritional adherence (ρ= -0,33; p<0,05) and adherence to physical activities (ρ= -0,48; p<0,05), as well as self-care (ρ= -0,42; p<0,05). Conclusion: Due to small sample, further studies with larger numbers of subjects should be conducted to better understand the attitudes of the subjects regarding the treatment. However, both resilience as a good doctor-patient relationship help the patient to achieve a greater degree of adherence to treatment.
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Gu, Jiafeng. "Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating (PAR) Index." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1456142583.
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Becoña, Iglesias Elisardo, and Guadalupe Luis Armando Oblitas. "The psychology of health and addictions: therapeutic perspective." Pontificia Universidad Católica del Perú, 2003. http://repositorio.pucp.edu.pe/index/handle/123456789/101835.
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The addiction subject is nowadays a valid one, as well as in the past century. Not only because of the increase of people that are addict, but also because of the important effects that cause on people and their environments. There are many theoretical perspectives to approach the addiction problem, but the most convenient because of its therapeutic results is the one that issupported by the psychology of health. lt is based on the integral approach to the person. This paper describes a general therapeutic scheme to work with addicts from the cognitive behaviora lperspective.El tema de las adicciones sigue tan vigente como en el siglo pasado, no solo por el incremento del número de personas que lo padecen sino también por las importantes secuelas que produceen el individuo y en su entorno. Existen diferentes enfoques teóricos para abordar la problemáticade las adicciones, sin embargo el que nos parece más conveniente por sus resultados terapéuticos es el que proviene desde la Psicología de la salud, basado en un enfoque integral en el abordaje del sujeto. El artículo fundamentalmente describe un esquema terapéutico general de su aplicación a los adictos, desde el enfoque cognitivo-conductual.
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Vianello, Sara. "N-Butyryl arginine and 3-Hydroxybutyrate arginine, for the treatment of DMD through oral administration." Thesis, Paris 11, 2013. http://www.theses.fr/2013PA11T046/document.
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La dystrophie musculaire de Duchenne est une maladie neuromusculaire qui touche 1 enfant sur 3500, liée au chromosome X, caractérisée par l’absence de dystrophine, protéine située sous le sarcolemme qui confère stabilité à la membrane cellulaire en connectant l’actine du cytosquelette avec la matrice extracellulaire. Elle fait partie d’un complexe multi protéique, nommé « dystrophin associated protein complex (DAPC)», qui contient, entre autre, le -dystroglycane et l’oxyde nitrique synthase (NOS). Son absence cause la dérégulation de l’homéostasie calcique, la nécrose tissulaire, l’accumulation de tissu graisseux et fibreux, l’incapacité de mouvement et des déficits cardiaques et respiratoires qui aboutissent au décès des patients. Mon travail avait comme objectif l’amélioration de différents aspects du phénotype dystrophique. J’ai utilisé des molécules capables d’activer deux voies de signalisations (la voie du NO et l’inhibition des histones deacetylase (HDAC)), connues pour induire l’amélioration du phénotype dystrophique chez la souris mdx, modèle de la maladie. Plus particulièrement, j’ai testé chez la souris, deux mode d’administration du butyrate d’arginine (AB), la drogue de référence car déjà utilisée en clinique sur des jeunes patients pour une autre indication, par gavage et par injection intrapéritonéale. J’ai étudié aussi deux nouvelles molécules dérivées du AB, qui pourraient être administrées par voie orale et être efficace à faible dose : le 3-Hydroxybutyrate arginate (ABE) et le N-butyril arginine (ABA). AB, ABE et ABA ont été testés in vitro sur les myotubes de patients dystrophiques et in vivo sur des souris mdx. L’administration orale du AB a les mêmes effets positifs que l’injection intrapéritonéale chez les souris mdx. Ces résultats démontrent que l’administration par voie orale doit être prise en considération lors des futurs essais cliniques. Dans un deuxième temps, je me suis focalisée sur les défauts cardiaques. Un suivi par échocardiographie mensuelle a été réalisé sur des souris de 8 mois traitées avec du AB. En parallèle nous avons analysé les effets de l’administration par voie orale du AB sur les déformations de la colonne vertébrale. Enfin, les altérations des signaux de l’électromyogramme (réalisé avec une méthode non invasive développée en clinique et appliquée pour les animaux) ont été également analysées. L’ensemble des résultats obtenus montre que le AB est capable de préserver l’activité cardiaque, d’empêcher la déformation de la colonne vertébrale et de rétablir les paramètres d’excitabilité axonale mesurés chez les souris traitées.Différentes concentrations des ABE et ABA ont été testé in vivo et observé à des faibles doses les mêmes résultats bénéfiques sur de nombreux paramètres structuraux et fonctionnels, que ceux obtenu avec une dose importante de AB (800mg/kg/j). Les deux nouvelles drogues peuvent être administrées à une dose 10 fois inferieur que la dose de AB pour obtenir les mêmes effets. J’ai testé aussi in vitro, sur des cellules musculaires humaines, la capacité des deux produits à induire une augmentation des niveaux intracellulaires d’utrophine et des protéines associées (β-dystroglycan et la myosine embryonnaire). J’ai aussi démontré qu’une augmentation de l’expression de l’utrophine et des protéines associées pouvait être induite par les inhibiteurs d’HDAC (le butyrate, la trichostatine A, l’acide valproique et l’isobutyramide). Enfin, une étude portant sur l’homéostasie calcique a été réalisé car des altérations de cet équilibre sont en partie responsables de la nécrose/dégénérescence du tissue musculaire. En particulier, l’activité spontanée du Ca2+, enregistrée sur le myotubes humaine, été fortement réduite après un traitement agissant sur la voie d’activation du NO et/ou par des inhibiteurs des HDAC. L’ensemble des résultats obtenus apportent la preuve des effets bénéfiques du AB et de ses dérivés sur la DMD, a travers la voie du NO et en inhibant les HDACDuchenne muscular dystrophy is a X-linked progressive neuromuscular disease affecting 1:3500 boys at birth. It is caused by the absence of dystrophin, a subsarcolemmal protein that confers membrane stability linking cytoskeletal actin to the extracellular matrix. It is part of a multi-protein complex called dystrophin associated protein complex (DAPC), which contains, among the other components, -dystroglycan and nitric oxide synthase (NOS).The consequences of the absence of dystrophin are: deregulation of calcium homeostasis, tissues necrosis, progressive accumulation of fat and fibrosis, inability of the movements and cardiac and respiratory failures that lead to patient’s death, around the age of 20-30 years.The objective of my PhD work is to ameliorate different aspects of dystrophic phenotype. In particular I have tested two different ways of administration of arginine butyrate (AB), the reference drug, through feeding-force and intraperitoneal injection. Meanwhile I have studied two new pharmacological molecules, AB derived, which could be administered orally to DMD patients. These compounds are: 3-Hydroxybutyrate arginate (refer as ABE) and N-butyryl arginine (refer as ABA). All of these molecules partially restore dystrophic phenotype activating two independent pathways (both the nitric oxide pathway and the inhibition of the histone deacetilase), which are known to be beneficent for mdx mice.AB, ABE and ABA have been tested in vitro on human DMD myotubes and in vivo on the mdx mice. The first goal of my project is the observation that the positive effects obtained after intraperitoneal injections of AB can be detected also after oral protocol, promoting the idea that the oral way has to be developed for future clinical trials. I have focused my attention on heart defaults; in particular, starting from the 8th month, a monthly study on heart activity based on echocardiography has been performed on mdx mice treated with AB. We addressed the potential profits of the oral administration of arginine butyrate on vertebral column deformation and electromyogram defaults, with a non-invasive automatized method developed in clinic and then applied to animals. The results collected from these experiments show that AB preserve heart activity, reverse vertebral column deformity and all the axonal excitability parameters that were modified in saline-treated mdx mice.In complement, I have tested different concentrations of ABE and ABA in vivo. The positive effects on many structural and functional dystrophic parameters, previously obtained with high dose of AB administered per os (800 mg/kg/d), has been observed with doses 10 times lower with both new compounds.In parallel, both products were tested in vitro on human muscular cells cultures to investigate their capacity to increase utrophin level. Moreover, the potential ability of histone deacetylase inhibitors (byturate, valproic acid, trichostatin A and isobutyramide) to increase the expression of utrophin and related proteins (-dystroglycan and embryonic myosin) has been studied. Finally, the alteration of calcium homeostasis, largely implicated in the cascades resulting in muscle necrosis/degeneration, was investigated. The spontaneous Ca2+ activity recorded in patient myotubes, i.e. without sarcolemmal integrity was strongly reduced after treatment acting on the NO-pathway activation and/or with HDAC inhibitors. All together, these data constitute a proof of principle of the beneficial effects of arginine butyrate and its derivates on muscular dystrophy, by enhancing NO pathway and inhibiting HDAC
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Schmitt, Jochen, Elisabeth Heese, Gottfried Wozel, and Michael Meurer. "Effectiveness of Inpatient Treatment on Quality of Life and Clinical Disease Severity in Atopic Dermatitis and Psoriasis Vulgaris – A Prospective Study." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-135494.
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Background: Financial constraints challenge evidence of the effectiveness of dermatological inpatient management. Objective: To evaluate the effectiveness of hospitalization in atopic dermatitis and psoriasis regarding initial and sustained benefits. Methods: Prospective study on adults with psoriasis vulgaris (n = 22) and atopic dermatitis (n = 14). At admission, discharge, and 3 months after discharge, validated outcomes of objective and subjective disease severity were assessed by trained investigators. Results: Hospitalization resulted in substantial benefit in quality of life and clinical disease severity. Looking at mean scores, the observed benefit appeared stable until 3-month follow-up. The analysis of individual patient data revealed significant changes in disease severity between discharge and 3-month follow-up with some patients relapsing, others further improving. Reasons for hospitalization and treatment performed were not related to sustained benefit. Conclusions: In psoriasis vulgaris and atopic dermatitis, hospitalization effectively improved quality of life and clinical disease severity. Further research should focus on prognostic factors for sustained improvementDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Guldbrand, Hans. "Trials of Diets for Treatment of Diabetes : A comparison of diets for treatment of type 2 diabetes, aspects on long and short term effects." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-116691.
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Background Type 2 diabetes is a common disease and the prevalence has increased in large parts of the world. In treatment of diabetes the type of diet is of great importance considering metabolic factors such as glucose level and blood lipids. Which diet that is most beneficial to avoid diabetic complications has been heavily debated in recent decades. This thesis is based on two clinical studies designed to compare the effects of different macronutrients. Methods A clinical trial was designed to compare a low-carbohydrate diet (LCD) to a low-fat diet (LFD) in treatment of patients with type 2 diabetes. Sixty-one patients at two health care centres were included and randomized to get advice to eat a LCD or a LFD. The LCD had an energy content where 50 energy percent (E%) where from fat, 20 E% from carbohydrates and 30 E% from protein. For the LFD the nutrient composition was similar to what is traditionally recommended for treatment of type 2 diabetes in Sweden. Metabolic factors, anthropometrics and questionnaires were analysed. To study postprandial effects a trial was designed to compare three different diets. Twentyone patients with type 2 diabetes were included to in randomized order test the three types of diets on separate test days. On each test day the patients were served breakfast and lunch and blood samples were taken at six times these days. Glucose, lipids and hormones were analysed. Results There were equal weight reduction in the two groups in the first trial during the two-year study period. At six month when compliance was good according to diet-records, the glucose level (HbA1c) was lowered and the HDL-cholesterol was increased in the LCD group. The inflammatory markers IL-6 and IL-1Ra were significantly lower in the LCD group than in the LFD group. At 12 months the physical function, bodily pain and general health scores improved within the LCD group only. In the second trial the postprandial glucose and insulin levels were lower on the LCD compared to the LFD. However, the LCD resulted in a tendency to higher postprandial triglyceride levels. The Mediterranean type of diet with all energy intake at lunch resulted in a more pronounced insulin response and a glucose level at lunch similar to that of the low-fat diet. The increase-ratio of insulin correlated to the elevation of the incretin glucose-dependent insulinotropic peptide (GIP). Conclusions In the two-year study we found benefits for the LCD group regarding glucose control and insulin doses. Furthermore, only the LCD was found to improve the subclinical inflammatory state and there were some aspects of improved well-being in this group. Aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk factors compared with the traditional LFD and this approach could constitute a treatment alternative. In the postprandial state, the LCD induced lower insulin and glucose excursions than the LFD but at the same time a tendency of higher triglycerides. The long-term significance needs to be further examined. The accumulation of caloric intake from breakfast to lunch to a single large Mediterranean-style lunch-meal in type 2 diabetes might be advantageous from a metabolic perspective.
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Fowler, Chad Eric. "Relationship between Facial Attractiveness and Occlusal Treatment Outcomes: A Retrospective Study." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/1320.
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The goal of this study was to determine if a relationship exists between pretreatment facial attractiveness and posttreatment occlusal outcome in orthodontic patients. A randomized sample of forty-seven patients (26 males, 21 females) was selected for inclusion in this study. Orthodontic evaluators rated pretreatment patient photographs (frontal smile, frontal, profile) using a 100 mm visual analog scale (VAS). Occlusal outomes were evaluated using percentage reduction in weighted Peer Assessment Rating (PAR) index scores and the American Board of Orthodontics objective grading system (ABO-OGS). Spearman correlation coefficients were calculated to assess the relationship between pretreatment VAS attractiveness ratings and posttreatment occlusal scores. There was a fair correlation between facial attractiveness and reduction in weighted PAR index scores for all patients (r=.41, p<.01) and for male patients (r=.48, p<.05). The results showed a good correlation between facial attractiveness and the ABO-OGS for females (r=-.55, p<.05).
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Palmer, Michelle. "Variables affecting treatment outcomes in a 30-month post-graduate orthodontic residency." Thesis, NSUWorks, 2012. https://nsuworks.nova.edu/hpd_cdm_stuetd/51.
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A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry.
Objectives: The purpose of this study was to evaluate clinical outcomes based on the American Board of Orthodontics Objective Grading System (ABO-OGS) in a 30-month postgraduate orthodontic residency and to determine what factors affected these treatment outcomes. Methods: Consecutively debonded cases from July 1, 2010 to June 30, 2011 treated by residents in the Orthodontics Department at Nova Southeastern University were graded using the ABO-OGS. The age and sex of the patient, the treatment time, the missed appointments and the number of providers were documented. Discrepancy indices were calculated for each patient. These variables were assessed and their associations with the obtained treatment outcome scores were evaluated. Results: The average OGS score of the debonded cases was 33.87. There was no significant correlation between total OGS score and the demographic or explanatory variables. There were significant correlations found between the discrepancy index (DI) and the treatment time, the number of providers, but not the OGS. Significant correlations were also identified between treatment time and the number of failed appointments and the number of providers. Extraction cases were shown to have a significantly longer treatment time. Out of the eight objective measurements of the OGS, occlusal contacts, marginal ridges, buccolingual inclination and alignment/rotations scored the highest points in our evaluation with an average of 7.81, 6.37, 5.04, and 5.01 respectively. Conclusions: This study indicated the Nova Southeastern University Orthodontic Department average OGS score is about 6 points higher than the ABO clinical exam passing score. The initial complexity of a case was not a pre-determined factor for the final treatment results. This study identified several aspects of treatment outcomes that need improvement including, occlusal contacts, marginal ridges, correcting buccolingual inclination and improving the alignment.
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Schmitt, Jochen, Elisabeth Heese, Gottfried Wozel, and Michael Meurer. "Effectiveness of Inpatient Treatment on Quality of Life and Clinical Disease Severity in Atopic Dermatitis and Psoriasis Vulgaris – A Prospective Study." Karger, 2007. https://tud.qucosa.de/id/qucosa%3A27655.
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Background: Financial constraints challenge evidence of the effectiveness of dermatological inpatient management. Objective: To evaluate the effectiveness of hospitalization in atopic dermatitis and psoriasis regarding initial and sustained benefits. Methods: Prospective study on adults with psoriasis vulgaris (n = 22) and atopic dermatitis (n = 14). At admission, discharge, and 3 months after discharge, validated outcomes of objective and subjective disease severity were assessed by trained investigators. Results: Hospitalization resulted in substantial benefit in quality of life and clinical disease severity. Looking at mean scores, the observed benefit appeared stable until 3-month follow-up. The analysis of individual patient data revealed significant changes in disease severity between discharge and 3-month follow-up with some patients relapsing, others further improving. Reasons for hospitalization and treatment performed were not related to sustained benefit. Conclusions: In psoriasis vulgaris and atopic dermatitis, hospitalization effectively improved quality of life and clinical disease severity. Further research should focus on prognostic factors for sustained improvement.Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Vestlund, Sandra, and Linn Nykvist. "How does changes in symptom severity index relate to patients’ global impression of change?" Thesis, Umeå universitet, Tandläkarutbildning, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-178498.
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Background: The treatment outcome of temporomandibular disorders (TMD) can be assessed with Symptom Severity Index (SSI). In addition to this self-report measure, Patients’ Global Impression of Change (PGIC) provides information about the overall impression of change. The use of SSI and PGIC when assessing treatment outcome in the field of TMD, and their correlation, has not previously been reviewed. Aim: The aims of this study were to investigate the correlation between the scales SSI and PGIC, to gain knowledge about which factors that contribute to the impression of change and to identify the diagnoses that have the most improvement. Methods: Data from 193 patients was analyzed. The percentage change in symptoms between baseline and follow up was compared to PGIC. The patients were divided into three groups based on main diagnoses, for further analysis. PGIC categories “much improved” and “very much improved” were set as successful treatment outcome. Different factors impact on PGIC were analyzed. Results: Majority of the patients had a successful treatment outcome. A higher mean percentage change correlated with a better PGIC value. Patients with articular related diagnoses needed a greater reduction in SSI to rate the impression of change as improved. According to the regression analysis, diagnosis group, age, number of treatment visits and SSI-baseline were associated with treatment outcome. Conclusions: The present study supports the use of both SSI and PGIC for assessment of the treatment outcome when treating TMD. However, a possible discrepancy between the scales addresses the need for further examination and change of treatment approach.