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Articoli di riviste sul tema "620.001 51":
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Reynolds, A. M., e K. M. Mullins. "0407 Sleep, Stress, Cardiovascular, and Psychological Health in College Students". Sleep 43, Supplement_1 (aprile 2020): A156. http://dx.doi.org/10.1093/sleep/zsaa056.404.
Abstract (sommario):
Abstract Introduction Epidemiological studies have long established that sleep factors, stress, and cardiovascular health are related. College students often struggle with the demands of college life, which leads to increased stress, symptoms of depression and anxiety, and poor sleep. The focus of the current study was to examine habitual sleep habits in college students, in association with psychological factors and physiological factors. Methods Participants included 51 undergraduate students (18 men, average age M=20.25 years, SD=1.78) who wore wrist actigraphs to measure their typical sleep habits. After one week, participants completed questionnaires about psychological symptoms (i.e., depression, anxiety, and stress; Depression Anxiety Stress Scale, DASS-21) and subjective physiological symptoms (i.e., fatigue; Multidimensional Assessment of Fatigue Scale, MAF). Blood pressure and heart rate were measured using a wrist cuff. Results Overall total sleep time was 6.59 hours and sleep efficiency was 82.55%. Pearson correlational analyses revealed a negative moderate association between sleep efficiency and diastolic blood pressure (r(49) = -.318, p = .024). Global PSQI scores were moderately associated with stress (r(49) = .419, p = .002). MAF Global Fatigue Index scores revealed positive associations with depression (r(49) = .344, p =.014), anxiety (r(49) = .474, p<.001), and stress (r(49) = .620 p<.001). Heart rate was positively associated with depressive symptoms r(49) = .296, p= .035), stress symptoms r(49) = .447, p= .001), and fatigue r(49) = .456, p= .001). Conclusion As expected, college students’ sleep was short in duration and poor in efficiency. Sleep factors, cardiovascular factors, psychological factors, and stress were all related, demonstrating the importance of sleep on physiological and psychological health. More research should be conducted to further examine the relationships and directionality between sleep, psychological factors, and stress as there may be underlying mechanisms important for cardiovascular health. Support None.
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Micol, Jean-Baptiste, Nicolas Boissel, Aline Renneville, Sylvie Castaigne, Claude Gardin, Claude Preudhomme e Herve Dombret. "The Role of Cytogenetic Abnormalities in Acute Myeloid Leukemia with NPM1 mutations and No FLT3 Internal Tandem Duplication." Blood 114, n. 22 (20 novembre 2009): 1594. http://dx.doi.org/10.1182/blood.v114.22.1594.1594.
Abstract (sommario):
Abstract Abstract 1594 Poster Board I-620 Background Nucleophosmin (NPM1) gene mutations are observed in almost one-third of adult acute myeloid leukemia (AML). If the favorable genotype defined by the presence of NPM1 mutations without fms-like tyrosine kinase 3 (FLT3) internal tandem duplication (ITD) is known to be associated with favorable outcome in patients with cytogenetically normal (CN) acute myeloid leukemia (AML), impact of these molecular abnormalities are still debated in those with cytogenetically abnormal (CA) AML. Patients and Methods We analyzed the role of these factors in newly diagnosed AML patients homogeneously treated in the Acute Leukemia French Association (ALFA) trials between 1990 and 2006 (ALFA 9000, 9801, 9802). Among 1529 patients (15-70 years of age), 554 patients were screened for NPM1 mutation, FLT3-ITD and have informative karyotype. Mutations screening were centrally performed according to previously described procedures. Karyotype was considered as normal if at least 20 normal marrow metaphases were present without any abnormal marrow metaphases. Favorable core binding factor (CBF) AML (74 patients) were excluded from this analysis. Results Among the 480 remaining patients, 137 (29%; median age 48 years, range 17-68) were NPM1 mutated, 22 of them (16%) having CA-AML. We found no difference between NPM1 mutated CN-AML patients (n=115) and NPM1 mutated non-CBF CA-AML patients (n=22) in term of complete remission rate (88% vs 83%; P= .49), overall survival (OS) (39% vs 38 % at 5 years, P= .85), event-free survival (EFS) (33% vs 25% at 5 years, P= .39). However, in the context of the favorable genotype, EFS was significantly longer in the 79 CN- than in the 16 CA-AML patients (41% vs 19% at 5 years ; P= .04) with a trend to better OS (51% vs 31% at 5 years ; P= .12). No significant differences were observed in patients with NPM1 mutated AML but FLT3-ITD (5-year EFS, 12% vs 40%; 5-year OS, 20% vs 60%; P= .47 and .27, respectively), even if the numbers of patients were here very low (35 CN- vs 5 CA-AML). More importantly, the favorable genotype was predictive of a longer EFS and OS in the 267 patients with CN-AML (5-year EFS, 41% vs 19%; 5-year OS, 51% vs 30%; P= .0001 and .001, respectively), while no differences were observed in the 213 patients with non-CBF CA-AML (5-year EFS, 19% vs 16%; 5-year OS, 31% vs 27%; P= .38 and .36, respectively). Conclusion As shown, patients with the favorable genotype but CA-AML had an outcome relatively similar to those with a non favorable genotype and either CA- or CN-AML. The favorable outcome associated with NPM1 mutation in the absence of FLT3-ITD might thus depend on the presence of a normal karyotype. We thus think that larger studies or overviews are needed to definitely answer this question. Disclosures Dombret: Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.
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Keating, Michael J., Susan O’Brien, Maher Albitar, Susan Lerner, William Wierda e Hagop Kantarjian. "Extended Follow-Up of a Chemo-Immunotherapy Regimen FCR (Fludarabine, F; Cyclophosphamide, C; and Rituximab, R) as Initial Therapy for Chronic Lymphocytic Leukemia (CLL)." Blood 106, n. 11 (16 novembre 2005): 2118. http://dx.doi.org/10.1182/blood.v106.11.2118.2118.
Abstract (sommario):
Abstract Combination regimens are increasingly being used in CLL. The addition of R to F±C has increased the complete response (CR) rate in previously untreated patients (pts) with CLL. FCR was given to 300 previously untreated pts with CLL; 70.3% male, 33% Rai stage III-IV, with median value and ranges for age − 57 years (17–86), hemoglobin − 12.5G% (6.1–18.7), white cell count − 76 x 103/μl (2.1–620), platelets − 154 x 103/μl (8–406). 51% had splenomegaly. All pts fulfilled the NCIWG indications for therapy. 72% achieved CR, 10% nodular partial remission (NPR), and 12% PR. The pretreatment characteristic most strongly associated with CR was the beta-2-microglobulin level (P<.001) with significant differences between those with a value less than twice normal versus higher values. Advanced age (≥ 70 yrs), advanced stage, low hemoglobin (<11G%), low albumin (<3.6G%), and elevated BUN (>23mg%) were all significantly associated with a lower CR rate (P<.01). CD38 was not associated with CR. Mutation status, ZAP70, and FISH cytogenetics were not routinely measured. Median follow-up was 43 months (18–73). Several characteristics were associated with remission duration (R Dur). Multivariate analysis showed that (1) PCR for IgVH, (2) NCIWG response, and (3) flow responses were all independently associated with R Dur. PCR negativity for IgVH was most strongly correlated with R Dur. Seven of 79 PCR negative pts have relapsed at 31, 39, 43, 44, 62, 64, and 67 months. Response Patients 4-Yr. R Dur Θ 4-Year Surv. Flow CR† PCR Neg.$ *P<.01;𝛉Projected;†Marrow CD5+CD19<1%;$PCR IgVH CR 217 83%* 84%* 165/208 (79%) 69/160 (43%) NPR 31 64% 84% 10/27 (37%) 7/19 (37%) PR 37 38% 50% 10/26 (38%) 3/13 (23%) Overall 300 77% (CR+PR) 83% 185/261 (71%) NA There was no significant difference in survival between CR and NPR pts despite a significantly shorter R Dur (P<.01) for NPR pts. Survival was similar for progressive Rai 0-II and III-IV pts with projected four-year survival of >80%. The median survival for the 300 patients and various prognostic subgroups has not been reached. Second cancers occurred in 53 cases (20 with non-melanomatous skin cancers). Three cases of AML and 3 additional cases of myelodysplastic syndrome occurred. Autoimmune hemolytic anemia (AIHA) or red cell aplasia (RCA) occurred in 25 and 6 cases respectively. These complications remain a significant clinical problem in CLL. There was no significant difference in the IgA or IgM levels over time but a lower mean initial IgG (837±567mg%) versus 690±338mg% six months after FCR was completed (P<.005) was noted. 56/72 (78%) who failed or relapsed have been started on salvage therapy. The salvage response rate on retreatment with FCR+alemtuzumab was 9/17 (53%). More pts failing after initial CR or NPR claimed a second response (17/29, 59%) compared with the PR or refractory pts (3/20, 16%; P=.002). Multivariate analysis of characteristics associated with CR rate and survival for FCR and preceding non-R protocols demonstrated a significant advantage for FCR (P<.001). Conclusion When compared with other completed chemotherapy protocols without R, FCR significantly improved CR rate, time-to-progression and treatment failure, and overall survival establishing FCR as the most successful protocol which we have conducted to date.
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Coustan-Smith, Elaine, Jose Sancho, Frederick G. Behm, Michael L. Hancock, Bassem I. Razzouk, Raul C. Ribeiro, Gaston K. Rivera et al. "Prognostic importance of measuring early clearance of leukemic cells by flow cytometry in childhood acute lymphoblastic leukemia". Blood 100, n. 1 (1 luglio 2002): 52–58. http://dx.doi.org/10.1182/blood-2002-01-0006.
Abstract (sommario):
Abstract Early clearance of leukemic cells is a favorable prognostic indicator in childhood acute lymphoblastic leukemia (ALL). However, identification of residual leukemic cells by their morphologic features is subjective and lacks sensitivity. To improve estimates of leukemia clearance, we applied flow cytometric techniques capable of detecting 1 leukemic cell in 10 000 or more normal cells and prospectively measured residual leukemia in bone marrow samples collected on day 19 of remission-induction chemotherapy from 248 children with newly diagnosed ALL. In 134 samples (54.0%), we identified at least 0.01% leukemic cells (0.01%-< 0.1% in 51 samples [20.6%], 0.1%-< 1% in 36 [14.5%], and ≥ 1% in 47 [19.0%]). Among 110 children treated within a single chemotherapy program, the 5-year mean ± SE cumulative incidence of relapse or failure to achieve remission was 32.2% ± 6.5% for the 59 patients with 0.01% residual leukemic cells or greater on day 19 and 6.0% ± 3.4% for the 51 patients with less than 0.01% leukemic cells (P < .001). The prognostic value of day-19 bone marrow status defined by flow cytometry was superior to that defined by morphologic studies and remained significant after adjustment for other clinical and biologic variables. Lack of detectable leukemic cells on day 19 was more closely associated with relapse-free survival than was lack of detectable residual disease at the end of remission induction (day 46). Thus, approximately half of the children with ALL achieve profound clearance of leukemic cells after 2 to 3 weeks of remission-induction chemotherapy, and these patients have an excellent treatment outcome.
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Fu, Guodong, Ronald S. Chazen, Christina MacMillan e Ian J. Witterick. "Discriminating Interpatient Variabilities of RAS Gene Variants for Precision Detection of Thyroid Cancer". JAMA Network Open 7, n. 5 (17 maggio 2024): e2411919. http://dx.doi.org/10.1001/jamanetworkopen.2024.11919.
Abstract (sommario):
ImportanceInterpatient variabilities in genomic variants may reflect differences in tumor statuses among individuals.ObjectivesTo delineate interpatient variabilities in RAS variants in thyroid tumors based on the fifth World Health Organization classification of thyroid neoplasms and assess their diagnostic significance in cancer detection among patients with thyroid nodules.Design, Setting, and ParticipantsThis prospective diagnostic study analyzed surgically resected thyroid tumors obtained from February 2016 to April 2022 and residual thyroid fine-needle aspiration (FNA) biopsies obtained from January 2020 to March 2021, at Mount Sinai Hospital, Toronto, Ontario, Canada. Data were analyzed from June 20, 2022, to October 15, 2023.ExposuresQuantitative detection of interpatient disparities of RAS variants (ie, NRAS, HRAS, and KRAS) was performed along with assessment of BRAF V600E and TERT promoter variants (C228T and C250T) by detecting their variant allele fractions (VAFs) using digital polymerase chain reaction assays.Main Outcomes and MeasuresInterpatient differences in RAS, BRAF V600E, and TERT promoter variants were analyzed and compared with surgical histopathologic diagnoses. Malignancy rates, sensitivity, specificity, positive predictive values, and negative predictive values were calculated.ResultsA total of 438 surgically resected thyroid tumor tissues and 249 thyroid nodule FNA biopsies were obtained from 620 patients (470 [75.8%] female; mean [SD] age, 50.7 [15.9] years). Median (IQR) follow-up for patients who underwent FNA biopsy analysis and subsequent resection was 88 (50-156) days. Of 438 tumors, 89 (20.3%) were identified with the presence of RAS variants, including 51 (11.6%) with NRAS, 29 (6.6%) with HRAS, and 9 (2.1%) with KRAS. The interpatient differences in these variants were discriminated at VAF levels ranging from 0.15% to 51.53%. The mean (SD) VAF of RAS variants exhibited no significant differences among benign nodules (39.2% [11.2%]), noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) (25.4% [14.3%]), and malignant neoplasms (33.4% [13.8%]) (P = .28), although their distribution was found in 41.7% of NIFTPs and 50.7% of invasive encapsulated follicular variant papillary thyroid carcinomas (P &lt; .001). RAS variants alone, regardless of a low or high VAF, were significantly associated with neoplasms at low risk of tumor recurrence (60.7% of RAS variants vs 26.9% of samples negative for RAS variants; P &lt; .001). Compared with the sensitivity of 54.2% (95% CI, 48.8%-59.4%) and specificity of 100% (95% CI, 94.8%-100%) for BRAF V600E and TERT promoter variant assays, the inclusion of RAS variants into BRAF and TERT promoter variant assays improved sensitivity to 70.5% (95% CI, 65.4%-75.2%), albeit with a reduction in specificity to 88.8% (95% CI, 79.8%-94.1%) in distinguishing malignant neoplasms from benign and NIFTP tumors. Furthermore, interpatient differences in 5 gene variants (NRAS, HRAS, KRAS, BRAF, and TERT) were discriminated in 54 of 126 indeterminate FNAs (42.9%) and 18 of 76 nondiagnostic FNAs (23.7%), and all tumors with follow-up surgical pathology confirmed malignancy.Conclusions and RelevanceThis diagnostic study delineated interpatient differences in RAS variants present in thyroid tumors with a variety of histopathological diagnoses. Discrimination of interpatient variabilities in RAS in combination with BRAF V600E and TERT promoter variants could facilitate cytology examinations in preoperative precision malignancy diagnosis among patients with thyroid nodules.
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Chow, Ryan Dz-Wei, Jessica B. Long, Sirad Hassan, Stephanie B. Wheeler, Lisa Spees, Michael Leapman, Michael E. Hurwitz, Hannah Dzimitrowicz McManus, Cary Philip Gross e Michaela Ann Dinan. "Evolution of systemic therapy from 2015 to 2019 for older patients in the United States with metastatic renal cell carcinoma." Journal of Clinical Oncology 41, n. 6_suppl (20 febbraio 2023): 610. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.610.
Abstract (sommario):
610 Background: Immune checkpoint inhibitors (IOs) and oral anti-cancer agents (OAAs) have demonstrated survival improvements in randomized trials of patients with metastatic renal cell carcinoma (mRCC). IOs were approved as second-line mRCC therapy in 2015 (nivolumab), followed by first-line approval in 2018 (ipilimumab/nivolumab). Real-world changes in overall treatment rates and IO usage have not been examined in patients over 65, who are often underrepresented in trials. Disparities in mRCC outcomes have persisted in the era of these novel therapies, raising the question of whether receipt of IOs and OAAs varies by race and ethnicity. Methods: We conducted a retrospective cohort study of Medicare beneficiaries over age 65 diagnosed with mRCC from 2015 through 2019 who were enrolled in fee-for-service Medicare Parts A, B, and D from 1 year prior to diagnosis through 1 year after presumed diagnosis or until death. We identified our cohort using diagnosis codes for primary or secondary kidney malignancy. We queried claims from 2014-2020, identifying receipt of IO, OAA, or other systemic therapies in the 2 months before through 1 year after diagnosis. Patients that received both IOs and OAAs were categorized as IO if both therapies were started within 60 days; otherwise, patients were categorized by the first therapy received. We assessed trends in treatment from 2015-2019, stratifying by race and ethnicity to compare non-Hispanic White (NHW) patients with Hispanic, Black, Asian, Pacific Islander, American Indian, Native Alaskan, or Other patients (grouped as non-NHW due to limited sample sizes). Results: We identified 15,407 patients who were diagnosed with mRCC between 2015-2019 and met study criteria. Non-Hispanic White patients comprised 84% of our sample. Receipt of IOs increased from 4% of patients in 2015 to 37% in 2019 ( P < .001). Among NHW patients, IO treatment receipt increased from 4% in 2015 to 38% in 2019 ( P < .001); for non-NHW patients, IO receipt grew from 3% in 2015 to 31% in 2019 ( P < .001). OAA usage decreased over time, from 31% of all patients in 2015 to 11% in 2019 ( P < .001). The percent of NHW patients treated with any systemic therapy increased from 51% in 2015 to 60% in 2019 ( P < .001), while there was no significant change for non-NHW patients (51% in 2015 to 54% in 2019; P = 0.27). Conclusions: Among Medicare beneficiaries, receipt of IO therapy for mRCC increased from 2015-2019. Receipt of any systemic therapy significantly increased over time for NHW patients, but not for non-NHW patients. [Table: see text]
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Fonseca, A. J. M., A. A. Dias-da-Silva e A. L. G. Lourenço. "Effects of maize and citrus-pulp supplementation of urea-treated wheat straw on intake and productivity in female lambs". Animal Science 73, n. 1 (aprile 2001): 123–36. http://dx.doi.org/10.1017/s1357729800058124.
Abstract (sommario):
AbstractTwo experiments with lambs given food indoors and individually penned were designed to study the effects of different levels of ground maize and citrus pulp as supplements of a diet based on urea-treated straw (5 kg urea per 100 kg straw) offered ad libitum over a period of 16 weeks (experiment 1) or 10 weeks (experiment 2). The voluntary intake, live-weight gain (LWG), organic matter digestibility (OMD), urinary allantoin-nitrogen (UAN) excretion and acetate clearance rate were measured. The lambs were blocked on weight and randomly assigned to the treatments described below. Ruminal outflow rate of the solid and liquid phases from the rumen were also measured in experiment 2.In experiment 1, 20 female lambs from the Ile-de-France breed, with an initial live weight (LW) of 43 (s.e. 3·3) kg were used. Wheat straw (WS) was supplemented with 50 g/kg of fish meal (FM) and with 0, 100, 200 or 300 g/kg of ground maize on a dry-matter (DM) basis (M0, M1, M2 and M3, respectively). In experiment 2, 25 female lambs from the Portuguese breed Churra-da-Terra-Quente, with an initial LW of 24·2 (s.e. 4·3) kg were used. The straw was offered ad libitum during 10 weeks and supplemented with 50 g/kg of FM and 0, 100, 200, 300, or 400 g/kg of dried citrus pulp on a DM basis (CP0, CP1, CP2, CP3 and CP4, respectively).During the experiments, all animals were moved to metabolism cages to measure OMD and UAN excretion. Two additional incubation studies were carried out with rumen fistulated rams (experiment 1) or cows (experiment 2) given the diets described above close to the maintenance feeding level.In experiment 1 daily straw DM intake linearly decreased (P < 0·05) from 21·6 to 17·7 g/kg LW and LWG linearly increased (P < 0·05) from 51 to 154 g/day for treatments M0, M1, M2 and M3, respectively. The rate of straw DM degradation was significantly decreased (P < 0·01) by maize supplementation. Straw OMD (kg/kg) was 0·562, 0·583, 0·547 and 0·520 and UAN (mg/day) was 620, 790, 854 and 859 for treatments M0, M1, M2 and M3, respectively. Acetate clearance rate, increased (P < 0·05) as the level of maize inclusion increased.In experiment 2 daily straw DM intake was 23·3, 25·8, 24·7, 23·5 and 18·6 g/kg LW per day and LWG was –9, 28, 44, 64 and 67 g/day for treatments CP0, CP1, CP2, CP3 and CP4, respectively. Supplementation significantly increased LWG (P < 0·001) but at the 400 g/kg level depressed straw DM intake. Straw OMD linearly decreased (P < 0·05) from 0·484 (CP0) to 0·428 (CP4) g/kg and UAN (mg/day) was 181, 303, 363, 384 and 392 for treatments CP0, CP1, CP2, CP3 and CP4, respectively. Rumen outflow rate of fibre particles was unaffected by supplementation while the outflow of liquid phase tended to be increased (P < 0·10). The rate of DM degradation was significantly reduced (P < 0·01) by citrus-pulp inclusion. Acetate clearance rate was unaffected (P > 0·05) by citrus-pulp supplementation.The results of these experiments demonstrate that supplementation of urea-treated straw with ground maize up to 200 g/kg or with citrus pulp up to 300 g/kg of the diet DM increased or did not depress straw intake, increased the supply of microbial protein and have no significant effect on straw digestibility. The efficiency of utilization of absorbed energy was apparently improved by maize but not by citrus-pulp supplementation.
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Abu Zaid, Mohammad, Paul C. Dinh, Patrick O. Monahan, Chunkit Fung, Omar El-Charif, Darren R. Feldman, Robert J. Hamilton et al. "Adverse Health Outcomes in Relationship to Hypogonadism After Chemotherapy: A Multicenter Study of Testicular Cancer Survivors". Journal of the National Comprehensive Cancer Network 17, n. 5 (maggio 2019): 459–68. http://dx.doi.org/10.6004/jnccn.2018.7109.
Abstract (sommario):
Background: This study examined the prevalence of hypogonadism, its clinical and genetic risk factors, and its relationship to adverse health outcomes (AHOs) in North American testicular cancer survivors (TCS) after modern platinum-based chemotherapy. Patients and Methods: Eligible TCS were <55 years of age at diagnosis and treated with first-line platinum-based chemotherapy. Participants underwent physical examinations and completed questionnaires regarding 15 AHOs and health behaviors. Hypogonadism was defined as serum testosterone levels ≤3.0 ng/mL or use of testosterone replacement therapy. We investigated the role of 2 single nucleotide polymorphisms (rs6258 and rs12150660) in the sex hormone–binding globulin (SHBG) locus implicated in increased hypogonadism risk in the general population. Results: Of 491 TCS (median age at assessment, 38.2 years; range, 18.7–68.4 years), 38.5% had hypogonadism. Multivariable binary logistic regression analysis identified hypogonadism risk factors, including age at clinical evaluation (odds ratio [OR], 1.42 per 10-year increase; P= .006) and body mass index of 25 to <30 kg/m2 (OR, 2.08; P= .011) or ≥30 kg/m2 (OR, 2.36; P= .005) compared with <25 kg/m2. TCS with ≥2 risk alleles for the SHBG SNPs had a marginally significant increased hypogonadism risk (OR, 1.45; P= .09). Vigorous-intensity physical activity appeared protective (OR, 0.66; P= .07). Type of cisplatin-based chemotherapy regimen and socioeconomic factors did not correlate with hypogonadism. Compared with TCS without hypogonadism, those with hypogonadism were more likely to report ≥2 AHOs (65% vs 51%; P= .003), to take medications for hypercholesterolemia (20.1% vs 6.0%; P<.001) or hypertension (18.5% vs 10.6%; P= .013), and to report erectile dysfunction (19.6% vs 11.9%; P= .018) or peripheral neuropathy (30.7% vs 22.5%; P= .041). A marginally significant trend for increased use of prescription medications for either diabetes (5.8% vs 2.6%; P= .07) or anxiety/depression (14.8% vs 9.3%; P= .06) was observed. Conclusions: At a relatively young median age, more than one-third of TCS have hypogonadism, which is significantly associated with increased cardiovascular disease risk factors, and erectile dysfunction. Providers should screen TCS for hypogonadism and treat symptomatic patients.
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Elliott, Cara G., Ally Murji, John Matelski, Adebanke Bianca Adekola, Jessica Chrzanowski e Lindsay Shirreff. "Unexpected malignancy at the time of hysterectomy performed for a benign indication: A retrospective review". PLOS ONE 17, n. 4 (1 aprile 2022): e0266338. http://dx.doi.org/10.1371/journal.pone.0266338.
Abstract (sommario):
Objective To determine the proportion of patients undergoing hysterectomy for a benign indication who have unexpected malignancy (UM) on postoperative pathology and characterize the nature of UMs. Methods This was a multi-center, retrospective study of patients undergoing hysterectomy for a benign indication from July 2016 to December 2019 at 7 Ontario, Canada hospitals (4 academic, 3 community). Hysterectomies for invasive placentation, malignant, and premalignant indications were excluded. Primary outcome was rate of unexpected malignancy as defined by the number of patients with malignancy on final pathology divided by the total number of hysterectomy cases. Data was extracted from health records and electronic charts. Patient, surgical, and surgeon characteristics were compared between benign and UM groups using bivariate methods. Associations between UM status and perioperative variables were assessed using bivariate logistic regression. Results In the study period, 2779 hysterectomies were performed. UM incidence was 1.8% (51 malignancies/2779 cases), with one patient having two malignancies (total UMs = 52). The most common UM types were endometrial (27/52, 51.9%) and sarcoma (13/52, 25%). Patients with UM were older (57.2 ± 11.4 years vs. 52.8 ± 12.5 years, p = .015), had more previous laparotomies (2 (1.25, 2.0) vs. 1 (1.0, 1.0), p < .001), and higher BMI (29.7 ± 7.2 kg/m2 vs. 28.0 ± 5.9 kg/m2, p = .049) and ASA class (p < .028). Regarding surgical factors, patients with UM had more adhesions (p = .001), transfusions (p = .020), and blood loss (p = .006) compared to those with benign pathology. Patient characteristics most strongly associated with UM were age (OR 2.57, 95% CI 1.78–3.72, p < .001) and preoperative diagnosis of pelvic mass (OR 2.76, 95% CI 1.11–6.20, p = .019). Conclusion Incidence of UM at hysterectomy for benign indication was 1.8%. Several perioperative variables are associated with an increased chance of UM.
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Luna, Marcos. "Effect of reproductive indices and bovine somatotropin on milk yield in Holstein cows experiencing climatic sub-fertility". Mljekarstvo 73, n. 3 (19 giugno 2023): 155–63. http://dx.doi.org/10.15567/mljekarstvo.2023.0302.
Abstract (sommario):
This study aimed at determining the association between reproductive indexes and the total milk yield in non-planed lactations ≥600 days in sub-fertile Holstein cows treated or not with recombinant bovine somatotropin (rbST) and experienced prolonged hyperthermia. A total of 1141 cows with a single lactation were enrolled in the study: 622 were not treated with rbST (control) and 519 were treated with rbST (500 mg every 14 days throughout lactation). Across parities, control cows with >480 days open, produced 5642 kg more milk (p<0.01) than cows with <380 days open. rbST-treated cows produced 5994 more (p<0.01) kg of milk during the entire lactation than cows with <380 days open. In control cows receiving ≥10 services, the average total milk yield was 1811 kg higher (p<0.01) than in cows receiving ≤10 services. In rbST-treated cows, the average total milk yield was 1680 kg higher (p<0.01) in cows receiving ≥10 services, compared to cows receiving ≤10 services. The overall conception rate for all services was 51% and 73% (p<0.01) for control and rbST-treated cows, respectively. In conclusion, the greater the delay to get pregnant and the greater the number of services per lactation the higher the total milk yield per lactation were observed. Thus, in this unusual situation where sub-fertile cows are retained with >380 days open and they continue to be inseminated after 10 unsuccessful services, the impact of delayed conception is not entirely negative as this disadvantage is more than outweighed by the extra milk that is produced when lactation is extended.
Tesi sul tema "620.001 51":
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Martín, Moreta Pedro José. "Flujo desbordado en ríos con llanuras de inundación : cálculo de la capacidad hidráulica en cauces compuestos de planta recta y meandriforme : aplicación a la modelación numérica". Doctoral thesis, Universitat Politècnica de Catalunya, 2014. http://hdl.handle.net/10803/284940.
Abstract (sommario):
El flujo desbordado en secciones de ríos con llanuras de inundación (secciones compuestas) presenta fuertes fenómenos tridimensionales que lo diferencian del flujo confinado en el cauce principal (asimilable a secciones simples). Estos fenómenos hacen que la modelación del flujo desbordado sea más compleja, y que los resultados obtenidos con los métodos clásicos de cálculo no representen adecuadamente la realidad. La diferencia de calado y de rugosidad entre el cauce principal y las llanuras provoca que las velocidades en las llanuras sean diferentes que las del cauce. Este gradiente de velocidad genera una capa de corte en la línea imaginaría que separa las zonas de cauce y llanuras, a través de la cual se produce una transferencia de cantidad de movimiento (momentum) entre ambas zonas. En el caso de cauces de planta recta (cauces prismáticos), la transferencia es debida únicamente a la tensión de interacción entre las masas fluidas de diferente velocidad, y en el caso de cauces de planta meandriforme, el intercambio de caudal entre cauce y llanuras y el ángulo que forman las direcciones del flujo entre ambos son otros factores que hay que tener en cuenta.
Tradicionalmente, la capacidad de las secciones compuestas se ha calculado adaptando los métodos utilizados en secciones simples a las diferencias de calado y rugosidad. Entre los años 1980-2000 se demostró experimentalmente que estos métodos no dan buenos resultados, especialmente cuando la rugosidad de las llanuras es mucho mayor que la del cauce principal, y se desarrollaron nuevos métodos de cálculo.
En cauces rectos, el Método de la Fuerza de Interacción, Apparent Shear Force Method (ASFM) en inglés, es el método más estudiado. En el ASFM es necesario calcular la tensión de interacción en la línea vertical de separación entre el cauce y las llanuras (Figura 1). Muchos autores han estimado esta tensión con fórmulas empíricas que son válidas únicamente para la geometría para la cual fueron deducidas En el presente trabajo se propone una formulación generalizada, basada en la hipótesis de la longitud de mezcla de Prandtl, para estimar la tensión de interacción
entre cauce y llanura en cauces prismáticos. Esta formulación depende del gradiente de velocidades al cuadrado y de un coeficiente de fricción entre superficies de agua, llamado coeficiente aparente de fricción (apparent friction coefficient en inglés) o coeficiente de interacción. El coeficiente aparente de fricción ha sido calibrado y validado con datos de tensiones de diversos autores La nueva formulación propuesta para la tensión de interacción se ha aplicado al cálculo uni-dimensional usando el método de la fuerza de interacción, Apparent Shear Force Method en inglés (ASFM). La comparación de los resultados con datos de canales de gran escala, el FCF (Flood Channel Facility), y de pequeña escala
demuestran la validez y precisión del método para una gran variedad de geometrías.
Otros métodos de cálculo, como los métodos tradicionales de separación en zonas, Divided Channel Method en inglés (DCM) o de sección completa, Single Channel Method en inglés (SCM) y los nuevos métodos desarrollados en los últimos años, el método de la Coherencia, Coherence Method (COHM), el método de divisiones promediadas, Weighted Divided Channel Method (WDCM), el método del intercambio
de caudales, Exchange Discharge Method (EDM), y el método de separación con interacción, Interacting Divided Channel Method (IDCM), se han aplicado al cálculo unidimensional y se han comparado entre sí en términos de caudal total y de distribución de caudales entre cauce y llanuras. Se mostrarán las ventajas e inconvenientes de cada método en cuanto a ajuste con los datos, sencillez de aplicación y fundamento físico del método.
En el caso de cauces naturales donde la geometría en planta es meandriforme, el problema se complica. Se han analizado algunos aspectos de este tipo de flujo, especialmente cuando las llanuras son más rugosas que el cauce, y se ha mostrado la importancia de fuentes de pérdidas como las debidas a la transferencia de caudal y a la interacción turbulenta. El flujo desbordado en cauces meandriformes es marcadamente tridimensional y los métodos tradicionales de cálculo dan errores mayores que en los cauces rectos. En esta tesis se ha generalizado un nuevo método que tiene en cuenta la transferencia de caudal entre el cauce y las llanuras y las tensiones de interacción entre ambas zonas. Este método, que propone una separación vertical entre el cauce y las llanuras, presenta mejoras respecto a los métodos tradicionales, especialmente en el caso de cauces meandriformes con llanuras más rugosas. Se ha demostrado que en estos casos la separación vertical representa mejor la realidad que la separación horizontal.
Finalmente, se han utilizado modelos numéricos en una, dos y tres dimensiones para simular el flujo desbordado en canales con datos disponibles y se ha comprobado la influencia de la condición de contorno en el resultado final. Las nuevas formulaciones presentadas para cauces rectos y meandriformes permiten mejorar la estimación de las condiciones de contorno que son habituales en los modelos numéricos, respecto a los
métodos tradicionalmente usados que no tienen en cuenta la interacción entre el cauce y las llanuras.This thesis deals with the interaction between main channel and floodplain flows during overbank in rivers with a compound section. In straight compound channel the interaction is mainly due to the turbulent shear stress between fluid masses with different velocity, but in meandering compound channels the mass exchange between main channel and floodplains has also to be considered. The present thesis summarizes the most important experimental data of apparent shear stress available in straight compound channels, covering a wide range of geometries, scales and roughness distributions. A dimensionally sound formula has been followed for estimating the apparent shear stress. The formula is depending on the square of the velocity gradient between the main channel and the floodplain and on the "apparent friction coefficient". The influence of cross-section geometry, asymmetry and roughness on the variation of the apparent friction coefficient has been studied, and a more general formula for estimating this coefficient has been developed, being calibrated from the laboratory data, which include small-scale flumes and the FCF, with smooth or rough floodplains and with rigid or mobile bed in the main channel. The formulae proposed are valid for small scale flumes and for large scale laboratory channels but it is necessary to point out the likely dependence on the scale. The new formulation has been applied to one-dimensional computation by using the ASFM. The results have been compared with experimental data from large channels, FCF, and small channels, showing the validity and accuracy of the ASFM for a wide variety of geometries. Traditional methods, like Single Channel Method (SCM) and Divided Channel Method (DCM), and new methods, like Coherence Methods (COHM), Weighted Divided Channel Method (WDCM), Exchange Discharge Method (EDM) and Interacting Divided Channel Method (IDCM), have been applied to the same data and the performance of these methods have been investigated in terms of total discharge and its distribution between the main channel and floodplains. In natural rivers the main channel usually meanders across the floodplains and the flow interaction is more complicated. In this thesis the overbank flow in a sinuous channel with floodplains has been also investigated, focusing on the effect of floodplain vegetation on different aspects of flow. The available data of the scale model of the Besós River has given the opportunity of working with roughness elements which simulate the natural vegetation of rivers. A complete analysis about the depth-averaged velocity distribution, the discharge distribution and the momentum balance between the main channel and floodplains have been presented. The effects of floodplain roughness (which is flexible vegetation) on discharge distribution and momentum balance have been also investigated. This advances in the compound sinuous channel flow have also been used to generalize a 1D model based on the momentum equation (Martín-Vide and López-Querol, 2004), which include new terms for the interaction between main channel and floodplains. For these terms a closure is presented so that this friction force is expressed in terms of depth and velocity gradients with the aid of one single coefficient (k), which is used throughout the tests. Finally, this thesis also attempts to compare the accuracy of one-dimensional (1D), two-dimensional (2D) depth-averaged and three-dimensional (3D) codes in the numerical simulation of free surface flows in compound open channels. Assessment was conducted using benchmark data collected from a straight compound channel at the UK EPSRC Flood Channel Facility (FCF) and the sinuous compound channel at the Besós river model. Assessment of the codes has been based on the prediction of water surface elevations and depth-averaged velocity traverses at the middle section of the straight channel and at around a meander bend for the sinuous channel.
2
Rincón, Charris Amílcar Alejandro. "Detección y diagnóstico de fallos múltiples en sistemas dinámicos usando análisis de componentes principales no lineal y residuos estructurados". Doctoral thesis, Universitat Politècnica de Catalunya, 2015. http://hdl.handle.net/10803/299369.
Abstract (sommario):
In recent years the detection and diagnosis of faults in devices and processes has been a field of research and development that has been addressed from multiple perspectives: control engineering, artificial intelligence and statistics among others. Within each with a number of techniques: expert systems , neural networks, case-based reasoning , signal analysis, observers equations analytical redundancy based on consistency, but only considering the presence of multiple failures and no diagnosis. In this thesis the detection and diagnosis of multiple faults in dynamic systems using nonlinear analysis for the detection and diagnosis for structured waste components will be studied. The study includes the development of a mathematical model of a gas turbine mini SR -30 and implementation of algorithms for detection and diagnosis of multiple faults in the system.
The detection and diagnosis of multiple faults is more complex than the detection and diagnosis of single faults. This is not only because it increases the number of failures, but also because of the emergence of new phenomena that should be considered, such as a combination or interaction of faults, compensation, and the combinatorial explosion of possible failure scenarios. The problem of multiple failures is important, since the single fault assumption can lead to incorrect diagnoses when multiple faults occur.En los últimos años la detección y el diagnóstico de fallos en dispositivos y en procesos ha sido un campo de investigación y desarrollo que se ha podido abordar desde múltiples perspectivas: la ingeniería de control, la inteligencia artificial y la estadística entre otros. Dentro de cada una de ellas con multitud de técnicas: sistemas expertos, redes neuronales, razonamiento basado en casos, análisis de señales, observadores, ecuaciones de redundancia analítica, diagnóstico basado en consistencia, pero considerando la presencia de fallos únicos y no múltiples. En esta tesis se estudiará la detección y el diagnóstico de fallos múltiples en sistemas dinámicos utilizando análisis de componentes no lineal para la detección y los residuos estructurados para el diagnóstico. El estudio incluye el desarrollo de un modelo matemático de una mini turbina de gas SR-30 y en la implementación de algoritmos de detección y diagnóstico de fallos múltiples en dicho sistema. La detección y el diagnóstico de fallos múltiples ha resultado ser más complejo que la detección y el diagnóstico de fallos únicos. Esto no es sólo porque aumenta el número de fallos, sino también debido a la aparición de nuevos fenómenos que deben ser considerados, tales como una combinación o la influencia mutua de los fallos, la compensación, y la explosión combinatoria de posibles escenarios de fallos. El problema de fallos múltiples es importante, ya que el supuesto de un solo fallo puede llevar a diagnósticos incorrectos cuando fallos múltiples ocurren.
3
Sun, Congcong. "Multi-layer model predictive control of complex water systems". Doctoral thesis, Universitat Politècnica de Catalunya, 2015. http://hdl.handle.net/10803/326739.
Abstract (sommario):
This thesis is devoted to design a multi-layer MPC controller applied to the complex water network taking into account that the different layers with different time scales and control objectives have their own controller. A two-layer temporal hierarchy coordinating scheme has been applied to coordinate the MPC controllers for the supply and transportation layers. An integrated real-time simulation-optimization approach which contributes to consider the effect of more complex dynamics, better represented by the simulation model, has been developed for regional water networks. The use of the combined approach of optimization and simulation coordination between simulator and optimizer allows to test the proposed multi-layer MPC in a feedback scheme using a realistic simulator of the regional network.
The second part of this thesis is focused on the design of a control scheme which uses the combination of linear MPC with a constraint satisfaction problem (CSP) to optimize the non-linear operational control of DWNs. The network aggregation method (NAM) is used to simplify a complex water network into an equivalent conceptual one for the bidirectional network before the use of CSP. The proposed approach is simulated using Epanet to represent the real DWN. Non-linear MPC is used for validation using a generic operational tool for controlling water networks named PLIO. A two-layer scheduling scheme for pump stations in a water distribution network has also been designed in the second part of this thesis. The tuning parameters of such algorithm are the lower layer control sampling period and the number of parallel pumps in the pump station.Aquesta tesi està dedicada a dissenyar un controlador MPC multicapa que s'aplica a una complexa xarxa regional emprant com a principal idea el fet de què les diferents capes treballen amb diferents escales de temps i objectius de control s'aconseguiran amb el seu propi controlador. Un esquema jeràrquic de coordinació temporal de dues capes s'ha aplicat per a coordinar als controladors MPC per a les xarxes de captació i transport. Un enfocament integrat de simulació-optimizació que contribueix a asegurar que l'efecte de les dinàmiques complexes, millor representades pel model de simulació s'hagin tingut en compte, s'ha propostat per la gestió operacional temps real de les xarxes regionals. La segona part d'aquesta tesi es centra en el disseny d'un esquema de control que utilitza la combinació del control MPC lineal amb una problema de satisfacció de restriccions (CSP) per optimitzar el control operacional no-lineal de les xarxes d'aigua potable. El mètode d'agregació de xarxes (NAM) s'utilitza per simplificar una xarxa d'aigua complexa en una xarxa conceptual bidireccional equivalent abans d'utilitzar el CSP. L'enfocament proposat es simula utilitzant Epanet per representar el comportament hidràulic de la xarxa d'aigua potable. Finalment, el MPC no lineal s'utilitza per a la validació fent ús de l'eina PLIO per a la seva implementació. I també, un esquema de planificació de dues capes per a estacions de bombament en una aigua xarxa de distribució ha estat proposat en la segona part d'aquesta tesi. Els paràmetres d'ajust d'aquest algorisme són el período de mostreig de control de la capa inferior i el número de bombes en paral·lel en la estació de bombament.
4
La, Red Martínez María del Carmen Montserrat. "Sistemas Inteligentes para el ajuste de Modelos Hidrológicos.Aplicación al río Paraná". Doctoral thesis, Universidad de Cantabria, 2013. http://hdl.handle.net/10803/120163.
Abstract (sommario):
El objetivo es la implementación de sistemas inteligentes para ajustar modelos
hidrológicos, comparando las series temporales con redes neuronales, que
permitan el aprendizaje y ajuste de parámetros para la obtención de modelos
que realicen predicciones óptimas de alturas del río Paraná, en períodos de
inundaciones.
El interés radica en su aplicación en la provincia de Corrientes, Argentina,
afectada por inundaciones que ocasionan pérdidas en la economía regional.
Se realiza un análisis previo con series temporales que permite establecer las
variables y factores que determinan las alturas hidrométricas, en períodos de
inundación en la localidad de Corrientes.
Posteriormente se presenta un pronóstico a corto plazo en períodos de
crecidas, que predice las alturas hidrométricas a tres días implementando
redes neuronales con función de penalización modificada. Se finaliza con un
pronóstico a mediano plazo, para períodos de inundación, de alturas
hidrométricas a siete días que se realiza con redes neuronales con diferentes
arquitecturas.The aim is the implementation of intelligent systems to adjust hydrological models comparing time series and neural networks which allow learning and setting parameters for models that make optimal predictions of the Paraná river heights in flood periods. The interest lies in its implementation in the province of Corrientes, Argentina, hit by floods causing losses in regional economy. We performed a time-series analysis to discover the variables and factors that influence the hydrometric height in flood periods in the town of Corrientes. Subsequently we present a short-term prediction for flood periods, which predicts the hydrometric heights three days in advance, using neural networks with a modified penalty function. Then we obtain a medium-term forecast for flood periods, seven days in advance, using neural networks with different architectures.
5
Jardí, Cedó Roger. "Enhancing Drivers’ Privacy in Urban Electronic Road Pricing Systems". Doctoral thesis, Universitat Rovira i Virgili, 2015. http://hdl.handle.net/10803/318586.
Abstract (sommario):
Durant l’últim segle els vehicles ha esdevingut el mitjà de transport per excel·lència. L’ús generalitzat d’aquests vehicles en la nostra societat ha significat una revolució en diferents àmbits com ara les relacions socials, la comoditat i l’economia. Malgrat això, també ha suposat nous inconvenients, com per exemple, un augment de la congestió del trànsit, dels accidents, i de la contaminació atmosfèrica.
Recentment, l’agreujament d’aquests fets, especialment en àrees urbanes, juntament amb l’aparició de les tecnologies de la informació i de la comunicació, i una major conscienciació de la societat amb aquestes problemàtiques, ha suposat el desenvolupament dels sistemes de telepeatge en ciutats. L’objectiu d’aquests sistemes és restringir l’accés de vehicles a determinades zones de la ciutat, anomenades “zones de baixes emissions” (LEZ), mitjançant el pagament de peatges en funció de les condicions del trànsit i les emissions del vehicle.
Des de la seva implantació, les solucions semblen prometedores. Tot i això, encara son lluny de ser ideals ja que, com s’ha demostrat, afecten la privadesa dels conductors i tenen un alt percentatge d’error en el control de frau.
Aquesta tesi té com objectiu proporcionar seguretat i privadesa als sistemes de peatge urbans mitjançant l’estudi de la privadesa i control de frau que ofereixen els sistemes existents. A més a més, basat amb les conclusions d’aquest estudi, es proposen dos nous sistemes de telepeatge per detectar el frau de manera determinista i preservar la privadesa dels conductors mitjançant anonimat revocable. Ambdues propostes permeten dispersar el trànsit procedent de zones amb alta densitat de trànsit amb l’objectiu de reduir les emissions contaminants. En la primera proposta, els conductors paguen en funció de la durada de l’estada a la LEZ, en canvi, en la segona, els conductors paguen d’acord amb trajecte recorregut. També inclouen un estudi de seguretat, privadesa i viabilitat.Durante el último siglo los vehículos se han convertido en el medio de transporte por excelencia. El uso generalizado de éstos en nuestra sociedad ha significado una revolución en ámbitos como las relaciones sociales y la economía. Sin embargo, también ha supuesto nuevos inconvenientes, como el aumento de la congestión del tráfico y de la contaminación atmosférica. Recientemente, el agravamiento de estos hechos, especialmente en áreas urbanas, junto con la aparición de las tecnologías de la información y de la comunicación, y una mayor concienciación de la sociedad con estas problemáticas, ha supuesto el desarrollo de los sistemas de telepeaje en ciudades. El objetivo de éstos es restringir el acceso de vehículos a determinadas zonas de la ciudad, llamadas "zonas de bajas emisiones" (LEZ), mediante el pago de peajes en función de las condiciones del tráfico y las emisiones del vehículo. Desde su implantación, las soluciones parecen prometedoras. Sin embargo, todavía son lejos de ser ideales ya que pueden afectar a la privacidad de los conductores y tienen un alto porcentaje de error en el control del fraude. Esta tesis tiene como objetivo proporcionar seguridad y privacidad a los sistemas de peaje urbanos mediante el estudio de la privacidad y control de fraude que ofrecen los sistemas existentes. Además, se proponen dos nuevos sistemas de telepeaje para detectar el fraude de manera determinista y preservar la privacidad de los conductores mediante anonimato revocable. Ambas propuestas permiten dispersar el tráfico procedente de zonas con alta densidad de tráfico con el objetivo de reducir las emisiones contaminantes. En la primera propuesta, los conductores pagan en función de la duración de la estancia en la LEZ, en cambio, en la segunda, los conductores pagan de acuerdo con trayecto recorrido. También incluyen un estudio de seguridad, privacidad y viabilidad.
Over the last century, vehicles have become the means of transport par excellence. The widespread vehicle adoption by our societies has been a revolution in terms of social interactions and economy. They undoubtedly bring many benefits, but they also entail some drawbacks such as an increase of traffic congestion and air pollution. Recently, the aggravation of these problems in urban areas and the emergence of the Information and Communication Technologies have led to solutions such as the deployment of Electronic Road Pricing (ERP) systems. The main purpose of these systems is to restrict the access of vehicles to certain city areas, named Low Emission Zones (LEZ), for which a toll is assessed according to traffic conditions and vehicle emissions. Since their adoption, these solutions have proven to be quite promising. However, current proposals are still far from being ideal. While reducing congestion to some extent, they exhibit several shortcomings. They still introduce a significant error percentage in the detection of fraudulent drivers. Moreover, they usually require toll systems to be equipped with cameras that take pictures of all the vehicles that pass through the control points, which may represent a serious privacy threat. This thesis aims at providing security and privacy to new LEZs. Two new urban ERP systems have been proposed with the aim of detecting fraud while preserving drivers’ privacy. They provide a deterministic fraud control and revocable anonymity for vehicles that misbehave. Both proposals allow to disperse traffic from areas with high traffic density with the aim of reducing the pollutant emissions. In the first proposal, drivers pay depending on the duration of the stay in the LEZ. In the second proposal, drivers pay according to the path they have covered. They include a study of security, privacy and feasibility.
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Burgos, Vergara Javier. "Numerical study of the heat and mass transfer processes with the Lattice Boltzmann method: Laminar Mixed Convection in a Square Open C". Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/395214.
Abstract (sommario):
El tema d’aquesta tesis és l’estudi numèric i implementació del mètode de Lattice Boltzmann utilitzant els models
D2Q9 amb múltiples temps de relaxació (MTR), aquest model es aplicat en el camp de fluids, temperatura i
concentració. Un codi font obert s’ha utilitzat i modificat amb la finalitat d’aplicar-lo als processos de transferència de
calor i de massa. La tesis esta dividida en dues parts, (I) l’estudi d’un flux laminar en un tub i un canal i la seva
simulació (llei de Poiseuille), així com una cavitat tancada amb tapa mòbil, i el puls Gaussià per a problemes de
convecció-difusió per als processos de calor i massa, convecció natural en la cavitat tancada i flux màssic en un plat
s’han realitzat per tal d’analitzar les condicions de contorn en el mètode Lattice Boltzmann. (II) l’objectiu principal va
ser l’estudi d’un flux laminar en estat estacionari i no estacionari en una cavitat oberta amb una font de calor a la part
inferior. Els resultats obtinguts amb el mètode de Lattice Boltzmann es van comparar amb els obtinguts amb el
programa comercial ANSYS-FLUENT per a la seva validació. La temperatura, velocitat i nombre de Nusselt es van
calcular amb el mètode tèrmic de Lattice Boltzmann, presentant una bona concordança per als conjunts de nombres
de Reynolds i de Richardson.El tema de esta tesis es el estudio numérico e implantación del método de Lattice Boltzmann usando los modelos D2Q9 con múltiples tiempos de relajación (MRT), este modelos es aplicado en el campo de fluidos, temperatura y concentración. Un código abierto fue usando y modificado con el fin de aplicarlo a los procesos de transferencia de calor y masa. La tesis está dividida en dos partes, (I) el estudio de un flujo laminar en un tubo y un canal fueron simulados (ley Poiseuille), así como también cavidad cerrada con tapa móvil y el pulso Gaussiano para problemas de conveccion-difusion, para los procesos de calor y masa, convección natural en la cavidad cerrada y flujo másico en un plato fueron realizados, con el fin de analizar las condiciones de contornos en método de Lattice Boltzmann. (ii) el principal objetivo fue el estudio de un flujo laminar en estado estacionario y no estacionario en una cavidad aberita con un fondo calentado. Los resultados obtenidos con el método de Lattice Boltzmann fueron comparados con los obtenidos por el programa comercial ANSYS-FLUENT para su validación. La temperatura, velocidad y el número de Nusselt fueron calculados con el método térmico de Lattice Boltzmann, presentando una buena concordancia para los conjuntos de números de Reynolds and número de Richardson.
The topic of this thesis is the numerical study and implementation of the LBM using D2Q9-model for Multiple Relaxation Time (MRT), this model was applied for the fluid flow, temperature and concentration field . A code was developed using an open-source LBM code and modified for the purpose to simulate the heat and mass transfer process. This thesis is divided in two parts. (I) Study of the laminar flow in a pipe and channel were simulate (Hagen-Poiseuille flow), as well as a Lid-driven cavity for a incompressible laminar flow and convection-diffusion problem of a Gaussian pulse was executed , for a heat and mass transfer, natural convection in a closed cavity and mass flux rate in a plate were performed with the objective to analyze the boundary condition of LBM for passive scalar concentration. (II) The main objective was the study of the steady and unsteady laminar flow in a channel with open square cavity and heated bottom wall. The Boussinesq approximation equation were applied, and it obtained a good accuracy and stability. LBM was compared against results obtained by ANSY-Fluent software for validation. Temperature, velocity and Nusselt number, calculated with TLBM presented very well agreement for the set of Reynolds and Richardson numbers studied.
Libri sul tema "620.001 51":
1
Smedley, Julia, Finlay Dick e Steven Sadhra. Musculoskeletal disorders. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199651627.003.0009.
Abstract (sommario):
Low back pain 254Work-related upper limb disorders 1 256Work-related upper limb disorders 2 258Osteoarthritis of the hip 260Bursitis 262• LBP has a lifetime prevalence of 60–80%, point prevalence of 15–40%, and annual incidence of 5%. It is:• the second most common cause of work-related ill health (prevalence 207 000, annual incidence 51 000)...
Capitoli di libri sul tema "620.001 51":
1
Ouknine, Lahcen, Giorgio S. Senesi, Fouad Khiri, Abderrahmane Ibhi e Mohamed Th S. Heikal. "Meteorite Finds in Africa". In African Meteorites, 58–88. BENTHAM SCIENCE PUBLISHERS, 2023. http://dx.doi.org/10.2174/9789815136296123010007.
Abstract (sommario):
Africa is a favorable site for meteorite recovery, with a total number of recoveries amounting to more than 1/6 of all meteorites recovered from the entire world. This work deals with the classification of meteorite finds in Africa, the distribution of their masses, and their alteration/weathering grades as affected by various factors. The African meteorite population includes an abundance of stony meteorites with a high percentage of the world collection of rare meteorites, i.e., Martian meteorites (62%), Ureilites (51%), Rumuruti (59%), Lunar (47%), and HED (46%). Furthermore, an important increase in achondrite meteorites finds occurred in the last two decades, compared to the Australian and Antarctic collections. The mass distribution of the African meteorite population shows that most recoveries (72%) have masses bigger than 100 g with peaks of about 1 kg, compared to about 0.1 kg for the Australian collection and 0.01 kg for the Antarctic finds. The distribution of weathering grades (W) shows the predominance of W1 (32%) and W2 (34%), which proves a better preservation of meteorites in this continent. The factors influencing the mechanism and rate of alteration of African finds include climate as the main factor, the mass, the terrestrial age, and the initial porosity of the sample.
2
Dooley, Brendan. "Galeazzo Gualdo Priorato and the Politics of Information". In La res publica di Galeazzo Gualdo Priorato (1606-1678) Storiografia, notizie, letteratura. Venice: Fondazione Università Ca’ Foscari, 2022. http://dx.doi.org/10.30687/978-88-6969-627-5/007.
Abstract (sommario):
As a historian of recent events, Galeazzo Gualdo Priorato relied on numerous types of sources for information. His particular relation to these sources is the subject of this article. After a rapid survey of what was available, we consider how his choices and his handling of them were affected by, and affected in turn, his relations to his patrons. News reports in manuscript and print were growing in importance. We focus on the Historia delle guerre (1640‑51) and link it to contemporary news reports of various kinds, taking stylistic aspects and strategic compositional techniques into account, to show how sources are interpreted and for which ends.
3
Olema, Jackson, Perez M. B. Mujuni e Dennis Zami Atibuni. "RISK AND SUCCESS FACTORS OF SUSTAINABLE GROWTH AND DEVELOPMENT OF SMALL AND MEDIUM ENTERPRISES (SMES) IN UGANDA". In Sustainability Practices: Cases from Businesses and Charities, 97–114. Türkiye Bilimler Akademisi, 2023. http://dx.doi.org/10.53478/tuba.978-625-8352-51-1.ch05.
Abstract (sommario):
This study examined the sustainability of SMEs in Arua District, northwestern Uganda. The cross-sectional study used mixed methodologies. The quantitative part used stratified random sampling, while the qualitative arm used purposive sampling. Quantitative data on success and risk factors of SME sustainable growth and development were collected using self-constructed questionnaires. The study found that institutional factors such as finances, infrastructures, location, technology, premise ownership, and board of directors positively impacted SME growth (β = 0.799, p .01). Taxes, legality, investment climate, competitiveness, inflation, and security had no statistically significant impact on SMEs in Arua District (β = 0.135, p =.546). Human variables such as management capacity and training, business planning, business assessment, customer complaint handling, and consumer purchasing power did not affect SMEs‘ sustainable growth and development (β = - 0.139, p= .491). Qualitative research found that SMEs might grow and thrive if their owners receive training and mentorship. SME owners and the government should address institutional, external, and human variables to improve SMEs‘ business efficacy
4
Feldman-Winter, Lori, Kinga Szucs, Aubri Milano, Elizabeth Gottschlich, Blake Sisk e Richard J. Schanler. "National Trends in Pediatricians’ Practices and Attitudes About Breastfeeding: 1995 to 2014". In Breastfeeding: Support, Challenges, and Benefits, 39–47. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/9781610022873-national_trends.
Abstract (sommario):
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics (AAP) has affirmed breastfeeding as the preferred method of infant feeding; however, there has been little systematic examination of how pediatricians’ recommendations, affiliated hospitals’ policies, counseling practices, and attitudes toward breastfeeding have shifted over the past 2 decades. These trends were examined from 1995 to 2014. METHODS Data are from the Periodic Survey (PS) of Fellows, a nationally representative survey of AAP members. PS #30 (1995; response rate = 72%; N = 832), PS #57 (2004; response rate = 55%; N = 675), and PS #89 (2014; response rate = 51%; N = 620) collected demographics, patient and practice characteristics, and detailed responses on pediatricians’ recommendations, affiliated hospitals’ policies, counseling practices, and attitudes toward breastfeeding. By using bivariate statistics and logistic regression models, the analysis investigated changes over time with predicted values (PVs). RESULTS From 1995 to 2014, more pediatricians reported their affiliated hospitals applied for “baby-friendly” designation (PV = 12% in 1995, PV = 56% in 2014; P < .05), and more reported that they recommend exclusive breastfeeding (65% to 76% [P < .05]). However, fewer respondents indicated that mothers can be successful breastfeeding (PV = 70% in 1995, PV = 57% in 2014; P < .05) and that the benefits outweigh the difficulties (PV = 70% in 1995, PV = 50% in 2014; P < .05). Younger pediatricians were less confident than older pediatricians in managing breastfeeding problems (P < .01). CONCLUSIONS Pediatricians’ recommendations and practices became more closely aligned with AAP policy from 1995 to 2014; however, their attitudes about the likelihood of breastfeeding success have worsened. These 2 divergent trends indicate that even as breastfeeding rates continue to rise, continued efforts to enhance pediatricians’ training and attitudes about breastfeeding are necessary.
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Batista, Paulo Henrique Mariano, Mário de Carvalho Leon Saint’Yves, Pedro Henrique Fonseca Nogueira e Bruna Maria Arede Pacheco. "Os avanços tecnológicos na cardiologia". In Fronteiras da inovação médica. Seven Editora, 2023. http://dx.doi.org/10.56238/frontinovacame-005.
Abstract (sommario):
Mesmo nos dias atuais, tanto para países desenvolvidos quanto para países subdesenvolvidos temos uma alta taxa de doença arterial coronariana, sendo que esta pode acometer cerca de uma grande quantidade de pessoas por ano. Embora a caracterização do quadro clínico e suas características sejam os principais fatores para diagnóstico da doença, o uso de métodos não invasivos trouxe grandes benefícios para a avaliação deste paciente. Podemos citar neste caso o eletrocardiograma e os marcadores laboratoriais como fatore importantes para diagnosticar e trazer maior conforto para estes pacientes. Os pontos abordados mostram que mesmo com o advento de novas tecnologias, novos métodos de diagnósticos e novos métodos de tratamento, ainda assim os números de doenças cardíacas estão ou aumentando ou se mantendo, o que gera grande preocupação, posto que era para ser o oposto. Uma doença que causa bastante estudos e que mesmo assim possui um “atraso” em medicações e ações mais modernas é a insuficiência cardíaca aguda descompensada (ICAD). Essa doença causa grande preocupação, pois possui alta taxa de morbimortalidade, logo, necessita de medidas urgentes de alta complexidade e de custos elevados. Foi observado que por não apresentar avanços significativos em medicações que possam reverter o quadro de falência ventricular aguda, os avanços passaram a ser nas maquinas de assistência circulatória, que por sua vez proporcionou os médicos cardiologistas novas formas de ofertar assistência circulatória de qualidade. Tanto como terapia ou como espera para um transplante cardíaco, esses dispositivos podem atualmente ser implantados de forma minimamente invasivas, afim de oferecer qualidade de vida digna e segura para os pacientes. Um outro fator a ser observado é que atualmente muitos avanços relacionados a imagens medicas obtidas através de radiações ionizantes, puderam reduzir as intervenções invasivas na cardiologia intervencionista. Porem o problema que encontramos para afirmar que este avanço trouxe benefícios abundantes é de que o longo período de exposição, gerando risco para a equipe que está em trabalho tanto quanto para o paciente que sofre os ataques radioativos. Quando pensamos em cirurgia vascular, um desenvolvimento quase que subsequente originou 3 formas distintas em sua abordagem. Ocorreu o surgimento da endarterectomia, by-pass e próteses vasculares. Esse movimento criacionista do ramo se deu a partir dos anos 60/70 e teve seu desenvolvimento pleno em meados dos anos 2000. No período da década de 80, foi quase que totalmente contemplado na utilização da clínica associada ao serviço de ultrassom e há isso se associou também a criação do laboratório vascular, que modificou completamente o diagnóstico e produziu grande impacto nas driving forces. No período dos anos 90, foi imensamente abordados as novas técnicas cirúrgicas chamadas comumente de “minimamente invasivas”, sendo estas constituídas basicamente na angioplastia por balão, nos stents e nas endoproteses vasculares. Com o advento da tecnologia, costumamos acreditar que todos os pacientes possuem instrução suficiente para poder caracterizar ou procurar o serviço medico afim de combater as doenças cardiovasculares (DCV), porem o que ocorre na pratica não é isso. Mesmo nos dias atuais ainda observamos que o desconhecimento em relação aos fatores de risco para o surgimento de DCV são enormes, mesmo que ainda sejam essas grandes partes das doenças responsáveis por aumentar a mortalidade em pacientes cujo acompanhamento médico não se fazem tão presentes. As doenças psicossociais entrem nos avanços tecnológicos sendo negativamente suas ações para os que sofrem com estas. A exploração de dados sociodemográficos e de hábitos de vida, depressão, ansiedade, são fatores que se tornaram presentes em paciente em âmbito domiciliar, porém afetam cada vez mais aqueles doentes em redes hospitalares. Um estudo recente mostrou que em um grupo de amostragem de 100% dos pacientes, 77% destes relatam conhecer os principais fatores de risco para DCV, porem deste mesmo grupo, 51% citam que os aspectos emocionais são os que mais afetam essas doenças. Na mesma pesquisa, 61% dos pacientes relatam ser sedentários, 47% são fumantes ou já foram e 41% relatam a ansiedade como maior predisposto para possíveis doenças do coração. Desta forma, fica claro que mesmo com o advento das tecnologias de forma geral, a população ainda considera alguns fatores não tão importantes para a predisposição há DCV como cigarro e sedentarismo. Desta forma, se faz necessário uma maior busca por instrução e adequação aos novos modelos de predisposto para o aparecimento de doenças cardíacas, seja por parte da equipe medica e enfermagem que muitas das vezes ou não explicam adequadamente ou deixam passar pontos importantes a serem discutidos com os pacientes, mas principalmente pelo paciente que deve cada vez mais se preocupar em saber o porquê de vários aspectos de sua saúde não caminharem da maneira mais adequada possível.
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"TABLE 9 Mineral Composition of Rye, Wheat, Barley, Corn, Oats, and Rice (mg/100 g, dry wt.) Barley Oats Rice Whole Kernel Whole Kernel Whole Kernel Rye Wheat grain only Corn grain only grain only Phosphorus 380 410 470 400 310 340 400 285 290 Potassium 520 580 630 600 330 460 380 340 120 Calcium 70 60 90 80 30 95 66 68 67 Magnesium 130 180 140 130 140 140 120 90 47 Iron 966 - 274 - 6 Copper 0.90.80.90.2450.30.4 Mangenese 7.55.51.80.65462 Zinc 3.44.44.0 - 3.91.5-2.21.2-2.1 Sodium 3.14.6 11.8 8.63.1-6.92.2-5.1 TABLE 10 Mineral Composition of Sorghum, Triticale, barley contains the highest average levels of phosphorus and Wild Ricea and whole grain rice the lowest (285 mg/100 g). From a di-Sorghum Triticale Wild rice etary standpoint, barley, corn, and rice are considered moderate sources of phosphorus (100-200 mg/100 g); Phosphorus 405 0.19% 0.4-0.5% buckwheat, millet, oats, brown rice, rice bran, rye, wheat, Potassium 400 1.21% 0.4-0.6% wheat germ, wheat bran and wild rice are classified as high Calcium 20 0.21% 0.01-0.03% sources (200-1200 mg/100 g) (Tables 13-16). Magnesium 150 0.16% 0.1-0.2% The data in Tables 13-16 indicate that quantities of Iron 6 12-51 ppm Copper 0.53.9 ppm 1.8-14.5 ppm phosphorus vary significantly from one wheat variety to Manganese 1.5 37 ppm another. This variation can also be seen in barley. In con-Zinc 0.0008% 36 ppm 40-121 ppm trast, phosphorus content from one variety of rye or oats to Sodium 0.00008% another does not vary significantly. In the Syvalahti and Korkman [42] study, phosphorus content of the grain was 'mg/100 g (dry wt.) unless otherwise noted. not affected by the fertilizer treatments of spring wheat, Refs. 15, 17, 35, 36. barley, and rye. Significant differences in phosphorus con-tent were seen in winter wheat and oats when different fer-[40], calcium levels in various rye and oat varieties tend to tilizer treatments were used (Tables 17-21). be reasonably consistent (Tables 13-16). The effects of various fertilizer treatments on mineral C. Magnesium content of spring and winter wheat, barley, oats and rye Eighty-seven percent of the magnesium in cereal grains is grown in 10 localities in Finland are shown in Tables located in the aleurone layer [34]. Because magnesium 17-21. These data [42] show that fertilizer treatment did binds with phytic acid, much of the magnesium is probably not result in a variation in calcium content in the grains present as Ca5 Mg phytate or as potassium-magnesium studied (Tables 17-21). phytate [34]. The remainder is likely to be present in phos-B. Phosphorus phates and sulfates [34]. From a dietary standpoint, brown rice is considered to Compared to other minerals, phosphorus is found in large be a poor source of magnesium (50-100 mg/100 g). Mod-quantities in cereal grains. It is mostly associated with erately good sources (100-200 mg/100 g) include barley, phytic acid (myoinositol hexaphosphoric acid) and its millet, oats, rye, wheat, and wild rice. Buckwheat, wheat salts. In wheat, rice, and maize, 80% or more of the total bran, and wheat germ are considered to be high sources of phosphorus is accounted for by the phytate [34]. Over 80% this mineral (200-400 mg/100 g) [1-3,6,8,37,43] (Tables of the phytate is located in the aleurone portion of wheat 13-16). In the mid-1970s the Food and Nutrition Board and the pericarp of rice; in corn, over 80% is found in the proposed that wheat flour be enriched with magnesium at germ [34]. In wheat, phosphorus becomes incorporated the rate of 200 mg/lb flour [9,14]. However, this proposal into phytic acid during maturation [34]. As seen in Table 9, was never implemented." In Handbook of Cereal Science and Technology, Revised and Expanded, 501–9. CRC Press, 2000. http://dx.doi.org/10.1201/9781420027228-49.
Atti di convegni sul tema "620.001 51":
1
Grant, M. B., T. Daniels, D. Claire e R. Lottenberg. "DIABETICS DEMONSTRATE A BLUNTED VON WILLEBRAND FACTOR RESPONSE TO DESMOPRESSIN INFUSION". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644130.
Abstract (sommario):
The increase in von Willebrand factor (vWF) following desmopressin (DDAVP) (1-desamino-8-D-arginine vasopressin) infusion was markedly blunted in severe hemophiliacs who had high vWF levels after treatment with vWF rich plasma concentrates. Diabetics with microangiopathy appear to have disease-induced elevation of vWF. In the current study, the vWF response to DDAVP infusion was measured in 30 diabetics (12 type I, 18 type II) and 16 controls, matched for age, sex and weight. Extent of nephropathy, macroangiopathy, and neuropathy was evaluated. Diabetic retinopathy was assessed by indirect ophthalmoscopy and fluorescein angiography (n=8 proliferative retinopathy, n=6 background retinopathy, n=16 no retinopathy). Plasma samples were collected in the supine, overnight-fasted state. DDAVP (0.3 μg/kg) was infused over 30 min and samples obtained at 0-60 min. vWF antigen was assayed by Laurell rocket electrophoresis. Tissue plasminogen activator (t-PA) activity was measured by a coupled chromogenic substrate assay. Results; Basal vWF levels for type I diabetics (124±16%, MeantSEM) and type II (178±14%) were increased as compared to controls (94±6%), p<.05 and p<.005, respectively. vWF levels for diabetics with proliferative retinopathy (194±29%) were significantly higher than for diabetics with background retinopathy (106±13%) p<.01. Diabetics with elevated basal levels of vWF (>150%) showed less of an increase in vWF following DDAVP infusion than diabetics with normal basal levels (p<.01). The percent increase in vWF following DDAVP administration inversely correlated with basal vWF levels (type I, r=.51; p<.01 and type II, r=.46; p<.01). The basal vWF level was the significant determinant of DDAVP response, not the presence or absence of diabetic complications. Peak t-PA levels showed no difference in controls or diabetics. In contrast to the vWF response, a normal t-PA response to DDAVP infusion was observed in diabetics. Conclusion: Diabetics with microvascular complications and high circulating levels of vWF demonstrate a blunted vWF response to DDAVP. This supports the existence of a negative feedback mechanism as previously reported for the transfused hemophiliacs.
2
Catalano, M., S. Belletti, E. Coazzoli, E. Gherardi, F. Lopriore, U. Russo e A. Libretti. "TREATMENT OF PERIPHERAL VASCULAR DISEASE WITH ILOPROST (ZK36374)". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644822.
Abstract (sommario):
The action of a stable analogue of prostacyclin, Iloprost, was studied in 18 male in-patients aged 51-69 yr (mean 61±7) with peripheral vascular disease Fontaine stage lib and III who gave informed consent. Entry criteria were Fontaine stage III or II with free interval at treadmill test ≺ 100 m. (4 km/h, without slope), ankle/arm arterial pressure index (API)≺0.7 at rest. Patients with arterial hypertension, diabetes, myocardial infarction in the previous 6 mo, heart failure, thrombocytopenia, hemorrhagic diathesis, or kidney or liver failure were excluded. The patients underwent 3 weeks' treatment with 6-h infusion/day of placebo for week 1, Iloprost 1 ng/kg/min for week 2, and Iloprost 2 ng/kg/min for week 3. Before treatment, at the end of each treatment week, and 15, 30 and 60 days after the end of treatment we evaluated: absolute pain-free interval(APFI), relative pain-free interval (RPFI), and API. Platelet aggregation by ADP and collagen and plasma BTG and PF levels were also determined, and complete blood tests and ECG performed. All the patients showed a progressive but variable increase in RPFI and APFI at 15, 30 and 60 days compared with the valuesat baseline and the end of the week on placebo (basal vs 15, 30 and 60 days, p≺0.01 for both parameters, AN0VA BR and Tukey's test). The % variations of APFI compared with baseline were 58.7, 62 and 95.5% at 15, 30 and 60 days. No other significant variations were observed. The results obtained seem to indicate that the drug is effective since there was an increase in the pain-free interval starting from 15 days after treatment suspension which persisted at 60 days. A first hypothesis is that this could be the result of increased flow due to improved collateral circulation by a mechanism not influenced by the platelet parameters considered that merits further study.
3
Кошмелева, М. В., Ю. Г. Самойлова, О. А. Олейник, М. В. Матвеева, В. Э. Муталими, Е. В. Горбатенко, Е. И. Трифонова e Д. А. Качанов. "ОПЫТ ПРИМЕНЕНИЯ ФЛЭШ-МОНИТОРИНГА ДЛЯ ДЕТЕЙ И ПОДРОСТКОВ С САХАРНЫМ ДИАБЕТОМ 1 ТИПА В ТОМСКОЙ ОБЛАСТИ". In X (XXIX) НАЦИОНАЛЬНЫЙ КОНГРЕСС ЭНДОКРИНОЛОГОВ с международным участием «Персонализированная медицина и практическое здравоохранение». ФГБУ «НМИЦ эндокринологии» Минздрава России, 2023. http://dx.doi.org/10.14341/cong23-26.05.23-111.
Abstract (sommario):
ЦЕЛЬ: провести сравнительный анализ основных параметров углеводного обмена при использовании
флэш-мониторинга у пациентов с сахарным диабетом 1 типа среди детей и подростков Томской области.
МАТЕРИАЛЫ И МЕТОДЫ: в исследование было включено 107 пациентов с сахарным диабетом 1 типа
(СД1), использующих устройства флэш-мониторинга для контроля уровня гликемии. Пациентам было про-
ведено 5 очных консультаций в течение года.
У всех пациентов были оценены гликированный гемоглобин (HbA1c), гликемия натощак (ммоль/л) и по-
казатели гликемического контроля - % времени выше целевого диапазона (ВВД), % времени в пределах
целевого диапазона (ВЦД), % времени ниже целевого диапазона (ВНД), средний уровень глюкозы, ммоль/л,
частота гипогликемии и ср. длительность, % принятия данных датчиком, частота ежедневных сканирова-
ний, коэффициент вариации гликемии, % (CV).
На каждом очном визите пациенты передавали графические отчеты с устройств флэш-мониторинга
врачу-эндокринологу для оценки гликемического профиля, режима физической нагрузки, питания и об-
раза жизни.
Статистический анализ проводился с помощью программы SPSS 23.0.
РЕЗУЛЬТАТЫ: средний возраст составил 11,8 лет (3-16 лет). Из них 56 чел. (52,3%) мальчики, и 51 чел.
(47,7%) девочки. Все пациенты были сопоставимы по полу и возрасту.
В ходе работы отмечалось снижение HbA1c с 8,5% до 8,0% (р<0,005). Средний уровень гликемии у паци-
ентов к концу исследования снизился на 0,8 ммоль/л (с 10,9 ммоль/л до 10,1 ммоль/л; (p<0,001). Отмечалось
снижение ВВД и ВНД на 5% и 0,4% соответственно к концу наблюдения (p=0,002, p<0,001 соответственно),
что, в свою очередь, обуславливает повышение ВЦД с 44,4% до 49,8% (р=0,003). У данной группы пациентов
отмечалось также снижение средней частоты гипогликемический явлений с 6,0 до 4,3 раз в неделю при
р<0,005 и их длительности с 90 мин. до 71 мин. (р=0,011). Коэффициент вариации имел незначительную
тенденцию к снижению – отмечалось снижение на 1,2% к концу исследования (р<0,005). Также в ходе ис-
следования пациентов разделили на группы согласно частоте ежедневных сканирований, что позволило
выявить значительное снижение HbA1c с 8,2% до 7,8% (p<0,001) к концу исследования в группе при частоте
ежедневных сканирований более 4р/сут в сравнении с группой, где частота сканирований была менее
4р/сут – снижение HbA1c на 0,1% (р=0,004).
ВЫВОДЫ: результаты исследования в Томской области подтверждают общероссийскую и мировую
динамику снижения гликированного гемоглобина при использовании флэш-технологий при сахарном
диабете 1 типа.
Только тщательный и частый самоконтроль позволяет достичь целевых значений HbA1c и ВЦД, и других
показателей компенсации сахарного диабета.
Постоянный непрерывный мониторинг, в том числе, флэш-мониторинг, является эффективным сред-
ством контроля и достижения гликемических целей у пациентов с сахарным диабетом 1 типа.
ФИНАНСИРОВАНИЕ: работа выполнена в рамках гранта ФГБОУ ВО СибГМУ Минздрава России
«О поддержке научно-исследовательских проектов, выполняемых молодыми учеными Приоритет 2030» -
«Формирование эко-системы непрерывного мониторинга гликемии для профилактики осложнений са-
харного диабета 1-го типа у детей» от 16.05.2022 №51.
4
Assunção, Silvaleide Ataides, Vinicius Lemos Nascimento, Bruno Henrique de Aguiar Brito, Carolina Daher de Alencar Neves, Laura Queiroz da Silva, Pedro Vinicyus Novais e. Souza, Fernando Santos de Azevedo e Lanúscia Morais de Santana. "NTRK MUTATION IN ADENOID CYSTIC CARCINOMA: A RARE TYPE OF TRIPLE NEGATIVE". In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2072.
Abstract (sommario):
Introduction: Breast cancer is one of the neoplasms that most cause death in women. Among these, there are some subtypes of greater biological aggressiveness, such as triple negative and HER overexpressed, which are associated with greater recurrence and mortality. Adenoid cystic carcinoma (ACC), salivary gland type, represents less than 0.1% of primary breast carcinomas and has indolent biological behavior and favorable prognosis compared with nonspecial triplenegative types. Case Report: A 51-year-old woman diagnosed with locally advanced ACC in the right breast, with negative immunohistochemistry for hormone receptors and HER2, underwent quadrantectomy with upfront axillary dissection, followed by adjuvant radiotherapy. After 12 years of diagnosis, she presented significant back pain, with magnetic resonance imaging scan evidencing bone lesion without medullary involvement in D7 and L1 suggestive of the secondary implant. Anatomopathology revealed the same histology as the primary tumor. Re-evaluation of chest tomography showed progression of pulmonary disease, 5 months after diagnosis of the first metastasis, underwent segmentectomy, with descriptive pathology identical to the initial lesion. Due to the oligoprogression and tumor type, somatic genetic research of the lung material was requested, which revealed a mutation in the NTRK gene, patient is still waiting for Larotrectinib in court. Discussion: The tumor has an unusual histological type, rare occurrence, slow progression course, and the absence of lymph node metastasis; the average incidence is around age 60. In this case, a young patient presented an ACC tumor with lung and bone metastasis. Due to the rarity, there is no definitive consensus regarding the ideal treatment, with the literature referring to the choice of mastectomy. Conclusions: Although malignant breast neoplasms and nonspecial subtypes, such as ductal and triple negative, have a poor prognosis, breast carcinoma of this aforementioned type has a favorable prognosis. The search for driver mutations in cancers of special types, together with the advances in genetic medicine, allows satisfactory results with target-specific treatments.
5
Miller, D. T., e A. P. Bode. "QUANTITATION OF MICROPARTICLES IN PLATELET SUSPENSIONS BY FLOW CYTOMETRY". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644594.
Abstract (sommario):
We have examined a platelet-poor, supernatant fraction from fresh and stored platelet suspensions with a FACS 440 (Becton-Dickinson) flow cytometer to study the distribution of small microparticles previously shown to be present in citrated plasma and serum (J. George et al., Blood 60: 834, 1982). Analysis by flow cytometry offers the advantage of discrimination of populations of particles by both light scattering and immunofluorescent properties. We found two distinctly different populations of particles: the predominant one had diameters in the range of 0.1 to 0.4um and was moderately autofluorescent (AF); the other was equally AF with particle diameters of 1.0 to 3.0um and probably included a few intact platelets. By adding a precise quantity of highly fluorescent beads of 0.9um diameter to each sample, relative concentrations of particles (small and/or large) could be quantified in platelet suspensions after various treatments using ratios of particle and bead counts. The lowest concentration of particles was found in samples from whole blood collected into CPDA-1 with PGE-1 and theophylline plus sodium azide (CPT-Az). Blood in CPDA-1 alone had twice the number of small and large particles; serum had a 20X higher particle concentration. A much larger number of particles was found in platelet concentrates (PC) stored for transfusion. Fresh PC had approx. 150X higher particle concentration than CPT-Az, rising to over 200X by the eighth day of storage at 22 C. Also, we noted a shift in distribution between particle populations in stored PC toward the larger size. The concentration of larger particles alone rose from 100X relative to CPT-Az to 350X after 8 days of storage. Similar changes in supernatant platelet factor 3 (PF3) activity were noted in stored PC in another study (A.P. Bode and D.T. Miller, Vox Sanguinis 51: 299, 1986), suggesting that supernatant PF3 activity may be related to one or the other population of particles seen by flow cytometry. This technique of examining and quantifying particles in platelet preparations by flow cytometry will facilitate and expand the characterization of platelet vesiculation and the released particles.
6
Ахмадуллина, Г. И., e М. Д. Михайлова. "ВЗАИМОСВЯЗЬ УРОВНЯ СТРЕССА И НАРУШЕНИЙ ПИЩЕВОГО ПОВЕДЕНИЯ В РАМКАХ ОПРЕДЕЛЕНИЯ РИСКА РАЗВИТИЯ САХАРНОГО ДИАБЕТА 2 ТИПА И СОСТОЯНИЯ КАЧЕСТВА ЖИЗНИ СРЕДИ ЛИЦ БЕЗ ЭНДОКРИННОЙ ПАТОЛОГИИ". In X (XXIX) НАЦИОНАЛЬНЫЙ КОНГРЕСС ЭНДОКРИНОЛОГОВ с международным участием «Персонализированная медицина и практическое здравоохранение». ФГБУ «НМИЦ эндокринологии» Минздрава России, 2023. http://dx.doi.org/10.14341/cong23-26.05.23-59.
Abstract (sommario):
ЦЕЛЬ: оценить риск развития сахарного диабета 2 типа среди лиц без эндокринной патологии и изучить
взаимосвязь с нарушениями пищевого поведения, уровнем стресса и качеством жизни.
МАТЕРИАЛЫ И МЕТОДЫ: опрошен 81 человек: 30 мужчин и 51 женщина, без эндокринной пато-
логии. Средний возраст составил 36±14,3 лет. Дефицит массы тела (ИМТ=17,4±0,39 кг/м2) обнару-
жен у 8 человек (9,9%); нормальная масса тела (ИМТ=21,63±2,05 кг/м2) – у 45 (55,6%); предожирение
(ИМТ=26,96±1,34 кг/м2) – у 16 (19,7%); ожирение 1 ст. (ИМТ=32,7±1,53 кг/м2) – у 9 (11%); ожирение 2 ст.
(ИМТ=37,05±1,77 кг/м2) – у 2 (2,47%) и ожирение 3 ст. (ИМТ=40,4 кг/м2) у одного респондента (1,2%).
Пищевое поведение (ПП) исследовали с помощью голландского опросника DEBQ, уровень стресса – теста
по В.Ю. Щербатых. Качество жизни оценивалось по опроснику SF-36 (русскоязычная версия, созданная
и рекомендованная МЦИКЖ), риск развития сахарного диабета 2 типа (СД 2 типа) – по опроснику FINDRISC.
Статистическая обработка данных проводилась с помощью пакета программ STATISTICA 6,0 американской
фирмы StatSoft (1995г.) и MedCalc 12.5.0.0..
РЕЗУЛЬТАТЫ: по данным опросника FINDRISC у 48 (59%) опрошенных был низкий риск развития СД,
у 17 (21%) – риск незначительно повышен, у 9 (11%) – умеренный риск, у 6 (7%) – высокий риск и у 1 ре-
спондента (1,2%) – очень высокий риск. По результатам голландского опросника DEBQ у 70,4 % опрошен-
ных были выявлены нарушения ПП: ограничительное нарушение – у 7 (8,6%) человек; эмоциогенное –
у 3 (3,7%); экстернальное – у 17 (21%); ограничительное и эмоциогенное – у 4 (4,9%); ограничительное
и экстернальное – у 7 (8,6%); эмоциогенное и экстернальное – у 6 (7,4%); все три типа – у 9 (11,1%) опро-
шенных. По результатам теста на определение уровня стресса у 15 (18,5%) опрошенных отсутствует стресс,
у 13 (16,3%) – выявлен умеренный стресс, у 29,9 (35,8%) – выраженный стресс, у 14 (17,3%) – сильный стресс
и у 10 опрошенных (12,5%) – истощение запасов адаптационной энергии. Качество жизни опрошенных
по данным опросника SF-36 оказалось повышенным по всем шкалам: интенсивность боли=77,6±21,1 бал-
лов; физическое функционирование=79,5±26,2 баллов; ролевое функционирование, обусловленное
физическим состоянием=80,56±30,6 баллов; общее состояние здоровья=70,9±18,6 баллов; жизненная
активность=60,9±19,4 баллов; социальное функционирование=76,5±21,6 баллов; ролевое функциониро-
вание, обусловленное эмоциональным состоянием=72,8±36,4; психическое здоровье=67,6±16,4 баллов.
Установлена взаимосвязь между стрессом и ограничительным типом ПП (r=0,282; p=0,01), между стрессом
и экстернальным типом (r=0,246; p=0,03), стрессом и риском развития СД 2 типа (r=0,371; p=0,0006), между
риском развития диабета и ограничительным нарушением ПП (r=0,258; p=0,02). Корреляционный анализ
установил статически значимые отрицательные связи слабой и средней силы между уровнем стресса
и со всеми шкалами, характеризующими качество жизни согласно опроснику SF-36.
ВЫВОДЫ: учитывая высокую частоту встречаемости нарушений пищевого поведения и различного
уровня стресса у лиц без эндокринной патологии, необходимо проводить оценку типов пищевого по-
ведения и уровня стресса у лиц с повышенным риском развития СД 2 типа, что позволит начать раннюю
персонифицированную терапию и снизить риск развития диабета.
7
Wallace, Elliot, Tessa Frohe e Jason Ramirez. "The Relationship Between Mental Health Symptoms and marijuana consequences mediated by coping motives for marijuana use". In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.21.
Abstract (sommario):
As marijuana continues to be legalized across the United States, it is imperative to investigate risk factors and consequences related to use. Previous studies among adult samples have found that mental health symptoms, including both depression and anxiety symptoms, are significant predictors of increased frequency of marijuana use. Little is known however regarding mental health symptoms and marijuana use among adolescents. This risk is particularly salient for adolescents given that many mental health disorders, like depression and anxiety, begin to emerge during this developmental period, and because earlier of age of marijuana use onset is associated with worse prospective health outcomes. Further, coping motives for marijuana use (i.e., using marijuana as an external avoidance or escape-based strategy) may serve as a mechanism for some adolescents to avoid distressing anxiety and depressive states. To address this gap in research, the aims of the current analysis were to 1) examine associations between mental health symptoms, marijuana use, and consequences among adolescents, and 2) examine coping motives as a mediator between mental health symptoms and marijuana outcomes. The current study included 107 late adolescents (15-18 years old, Mage = 17.01, SDage = 0.92, 51% female, 85% White/Caucasian, 60% high school student, 27% college student) recruited from Washington State. The sample was stratified by gender and marijuana use such that participants ranged from reporting infrequent to daily marijuana use. Participants were asked to complete three online assessments across six months. These included the PHQ-4, a 4-item measure of depression and anxiety symptoms in the past 2 weeks, in addition to measures of marijuana use, marijuana-related consequences, and marijuana use motives. We conducted two separate mediator models to examine if baseline mental health symptoms were mediated by coping motives at month 3 on (1) marijuana use and (2) marijuana-related consequences both reported at month 6. There was no significant mediation effect for baseline mental health symptoms predicting overall marijuana use at month 6 (B = .27, SE = .25, 95% CI [-.23, .76], p = .28). For the second model, motives at month 3 fully mediated the relationship between mental health symptoms at baseline and marijuana-related consequences at month 6 (B = .71, SE = .27, 95% CI [.17, 1.24], p ≤ .01). Thus, higher levels of mental health symptoms at baseline were associated with higher marijuana-related consequences as mediated by coping motives reported at month 3. Our results suggest that adolescents who experience more mental health symptoms do not use marijuana more than others who report fewer symptoms. However, these individuals may be at greater risk for experiencing negative consequences that result from their use. Further, results also suggest that the relationship between mental health symptoms and negative consequences may be largely accounted for by stronger motives to use marijuana to cope with mental health. Screening for mental health symptoms during adolescence may be beneficial in preventing negative outcomes by providing early interventions for healthy coping strategies for anxiety and depression.
8
Bastian, Andrea Verri, e Érica de Sousa Checcucci. "Inclusão de BIM em disciplina de Instalações Elétricas para Arquitetura". In IV ENCONTRO NACIONAL SOBRE O ENSINO DE BIM. ANTAC, 2022. http://dx.doi.org/10.46421/enebim.v4i00.1945.
Abstract (sommario):
O presente trabalho apresenta o relato de experiência da disciplina ARQ038 - Instalações I, obrigatória no curso diurno de graduação em Arquitetura e Urbanismo da Universidade Federal da Bahia, realizada no primeiro semestre de 2022, no âmbito do Projeto Célula BIM da UFBA. A disciplina possui 51 horas de carga horária distribuídas em 17 aulas, com três horas semanais cada, e objetiva discutir conceitos e elaborar projetos de instalações elétricas residenciais com base na norma NBR 5410 (Instalações elétricas de baixa tensão). Participaram da experiência 20 alunos. Sabe-se que desenvolver projetos de instalações elétricas utilizando representações bidimensionais dificulta a verificação de interferências, demandando mais tempo do projetista, mesmo existindo informações de outras disciplinas em plantas, cortes, vistas, etc. Desse modo, a intervenção foi realizada com finalidade de demonstrar a utilização de BIM no processo de modelagem do projeto elétrico de uma edificação e na compatibilização deste projeto com as disciplinas de arquitetura, estrutura e instalações hidrossanitárias. Esta experiência permitiu o desenvolvimento de competências individuais básicas oper e competências operacionais (o01 – modelagem; o03 – projeto e planejamento) (BIM EXCELLENCE, 2021) pelos estudantes. Trabalhou os seguintes usos do modelo: b. Foi desenvolvida uma abordagem teórico-prática no curso, que foi organizado em 4 blocos: (1) conceitos iniciais sobre projeto elétrico – 3 aulas; (2) previsão de cargas e divisão da instalação conforme Norma 5410 – 3 aulas; (3) seleção, instalação e dimensionamento dos componentes da instalação conforme Norma – 3 aulas; (4) Desenhos, diagramas e detalhes do projeto elétrico – 2 aulas e, (5) desenvolvimento de projeto elétrico residencial – 2 aulas. Assim, após o quinto bloco da disciplina, quando todos os conceitos sobre instalações elétricas residenciais já estavam fundamentados e os discentes já haviam desenvolvido projetos elétricos, foi iniciado o trabalho com BIM. O exercício consistiu no desenvolvimento de projeto elétrico residencial de baixa complexidade, com os alunos trabalhando em duplas e tendo pelo menos um dos componentes com conhecimentos do programa Revit, que foi um dos softwares utilizados. O trabalho fruto da intervenção foi dividido em três momentos: a primeira etapa durou 01 aula e consistiu no desenvolvimento da planta-baixa do projeto elétrico utilizando a ferramenta AutoCAD. Para tal foram fornecidos desenhos do projeto arquitetônico e os projetos de estruturas e instalações hidrossanitárias. Nessa fase os alunos quantificaram os pontos de tomada e iluminação, dividiram a instalação em circuitos, balancearam os circuitos entre as fases e dimensionaram fiação e eletrodutos. Para a segunda etapa do trabalho, que durou 02 aulas, foram fornecidos: (a) um template básico para projetos elétricos; (b) os modelos de arquitetura, estrutura e instalações de água fria da residência, todos elaborados na ferramenta Revit; e, (c) uma apostila com o passo a passo para uso do template que seria utilizado para modelagem do projeto elétrico. Utilizando esse template os alunos reproduziram o projeto feito no AutoCAD, no que se refere à locação das caixas de distribuição para pontos de tomadas, interruptores, iluminação e o quadro de distribuição, e ainda fizeram a interligação dos pontos com os eletrodutos. Além das ligações físicas entre os elementos das instalações, reproduziram a divisão dos circuitos, para posterior execução do balanceamento de cargas entre as fases. A última etapa da intervenção, que durou 01 aula, consistiu em analisar os problemas de compatibilização entre as instalações elétricas, estrutura e instalações de água fria. Nesse caso, o modelo de instalações de água fria foi inserido como vínculo no Revit, no arquivo do modelo de instalações elétricas desenvolvido pela dupla e, utilizando o módulo de verificação de interferências do próprio Revit, foi realizada a verificação de conflitos entre as instalações (e.g. eletrodutos passando por vigas, eletrodutos passando por aberturas de janelas, ponto de elétrica do chuveiro coincidindo com ponto de água do chuveiro, dentre outros). De posse do relatório de interferências, as duplas fizeram uma análise crítica, comparando os resultados encontrados no projeto original desenvolvido no AutoCAD e responderam um pequeno questionário de percepção sobre a atividade. Dentre as respostas, destaca-se que: 60 % das duplas não haviam percebido a maior parte dos problemas de compatibilização no desenvolvimento do projeto no AutoCAD; 100 % dos estudantes consideraram que o uso do modelo de instalações elétricas no Revit possibilitou um melhor entendimento do projeto elétrico; e 100% consideraram que o uso da ferramenta BIM agregou conhecimento para o desenvolvimento do projeto elétrico e sobre a localização dos componentes na edificação. A experiência permitiu o desenvolvimento de diferentes competências para o trabalho em BIM, mostrando ser válida a inserção desta modelagem no currículo, ainda que em poucas aulas e de forma introdutória.
Rapporti di organizzazioni sul tema "620.001 51":
1
Ley, Matt, Tom Baldvins, Hannah Pilkington, David Jones e Kelly Anderson. Vegetation classification and mapping project: Big Thicket National Preserve. National Park Service, 2024. http://dx.doi.org/10.36967/2299254.
Abstract (sommario):
The Big Thicket National Preserve (BITH) vegetation inventory project classified and mapped vegetation within the administrative boundary and estimated thematic map accuracy quantitatively. National Park Service (NPS) Vegetation Mapping Inventory Program provided technical guidance. The overall process included initial planning and scoping, imagery procurement, vegetation classification field data collection, data analysis, imagery interpretation/classification, accuracy assessment (AA), and report writing and database development. Initial planning and scoping meetings took place during May, 2016 in Kountze, Texas where representatives gathered from BITH, the NPS Gulf Coast Inventory and Monitoring Network, and Colorado State University. The project acquired new 2014 orthoimagery (30-cm, 4-band (RGB and CIR)) from the Hexagon Imagery Program. Supplemental imagery for the interpretation phase included Texas Natural Resources Information System (TNRIS) 2015 50 cm leaf-off 4-band imagery from the Texas Orthoimagery Program (TOP), Farm Service Agency (FSA) 100-cm (2016) and 60 cm (2018) National Aerial Imagery Program (NAIP) imagery, and current and historical true-color Google Earth and Bing Maps imagery. In addition to aerial and satellite imagery, 2017 Neches River Basin Light Detection and Ranging (LiDAR) data was obtained from the United States Geological Survey (USGS) and TNRIS to analyze vegetation structure at BITH. The preliminary vegetation classification included 110 United States National Vegetation Classification (USNVC) associations. Existing vegetation and mapping data combined with vegetation plot data contributed to the final vegetation classification. Quantitative classification using hierarchical clustering and professional expertise was supported by vegetation data collected from 304 plots surveyed between 2016 and 2019 and 110 additional observation plots. The final vegetation classification includes 75 USNVC associations and 27 park special types including 80 forest and woodland, 7 shrubland, 12 herbaceous, and 3 sparse vegetation types. The final BITH map consists of 51 map classes. Land cover classes include five types: pasture / hay ground agricultural vegetation; non ? vegetated / barren land, borrow pit, cut bank; developed, open space; developed, low ? high intensity; and water. The 46 vegetation classes represent 102 associations or park specials. Of these, 75 represent natural vegetation associations within the USNVC, and 27 types represent unpublished park specials. Of the 46 vegetation map classes, 26 represent a single USNVC association/park special, 7 map classes contain two USNVC associations/park specials, 4 map classes contain three USNVC associations/park specials, and 9 map classes contain four or more USNVC associations/park specials. Forest and woodland types had an abundance of Pinus taeda, Liquidambar styraciflua, Ilex opaca, Ilex vomitoria, Quercus nigra, and Vitis rotundifolia. Shrubland types were dominated by Pinus taeda, Ilex vomitoria, Triadica sebifera, Liquidambar styraciflua, and/or Callicarpa americana. Herbaceous types had an abundance of Zizaniopsis miliacea, Juncus effusus, Panicum virgatum, and/or Saccharum giganteum. The final BITH vegetation map consists of 7,271 polygons totaling 45,771.8 ha (113,104.6 ac). Mean polygon size is 6.3 ha (15.6 ac). Of the total area, 43,314.4 ha (107,032.2 ac) or 94.6% represent natural or ruderal vegetation. Developed areas such as roads, parking lots, and campgrounds comprise 421.9 ha (1,042.5 ac) or 0.9% of the total. Open water accounts for approximately 2,034.9 ha (5,028.3 ac) or 4.4% of the total mapped area. Within the natural or ruderal vegetation types, forest and woodland types were the most extensive at 43,022.19 ha (106,310.1 ac) or 94.0%, followed by herbaceous vegetation types at 129.7 ha (320.5 ac) or 0.3%, sparse vegetation types at 119.2 ha (294.5 ac) or 0.3%, and shrubland types at 43.4 ha (107.2 ac) or 0.1%. A total of 784 AA samples were collected to evaluate the map?s thematic accuracy. When each AA sample was evaluated for a variety of potential errors, a number of the disagreements were overturned. It was determined that 182 plot records disagreed due to either an erroneous field call or a change in the vegetation since the imagery date, and 79 disagreed due to a true map classification error. Those records identified as incorrect due to an erroneous field call or changes in vegetation were considered correct for the purpose of the AA. As a simple plot count proportion, the reconciled overall accuracy was 89.9% (705/784). The spatially-weighted overall accuracy was 92.1% with a Kappa statistic of 89.6%. This method provides more weight to larger map classes in the park. Five map classes had accuracies below 80%. After discussing preliminary results with the parl, we retained those map classes because the community was rare, the map classes provided desired detail for management or the accuracy was reasonably close to the 80% target. When the 90% AA confidence intervals were included, an additional eight classes had thematic accruacies that extend below 80%. In addition to the vegetation polygon database and map, several products to support park resource management include the vegetation classification, field key to the associations, local association descriptions, photographic database, project geodatabase, ArcGIS .mxd files for map posters, and aerial imagery acquired for the project. The project geodatabase links the spatial vegetation data layer to vegetation classification, plot photos, project boundary extent, AA points, and PLOTS database sampling data. The geodatabase includes USNVC hierarchy tables allowing for spatial queries of data associated with a vegetation polygon or sample point. All geospatial products are projected using North American Datum 1983 (NAD83) in Universal Transverse Mercator (UTM) Zone 15 N. The final report includes methods and results, contingency tables showing AA results, field forms, species list, and a guide to imagery interpretation. These products provide useful information to assist with management of park resources and inform future management decisions. Use of standard national vegetation classification and mapping protocols facilitates effective resource stewardship by ensuring the compatibility and widespread use throughout NPS as well as other federal and state agencies. Products support a wide variety of resource assessments, park management and planning needs. Associated information provides a structure for framing and answering critical scientific questions about vegetation communities and their relationship to environmental processes across the landscape.