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HbA1c-Variabilität in Abhängigkeit des Hämoglobins und der Erythropoietin Rezeptor stimulierenden Präparate bei Hämodialysepatienten - HESA Studie -Beckmann, Julia 04 February 2016 (has links) (PDF)
Der Diabetes mellitus zählt zu den Hauptursachen einer terminalen Niereninsuffizienz. Aufgrund der veränderten Erythropoiese ist die Verwendung des HbA1c für die Beurteilung der Stoffwechseleinstellung bei Diabetikern mit einer chronischen Nierenerkrankung im Stadium 5 nach KDOQI immer noch in Frage gestellt.
Die vorliegende Arbeit untersuchte die HbA1c-Variabilität in Abhängigkeit der ESA-Dosis und des ESA-Präparates bei Hämodialysepatienten. Zum Einsatz kamen entweder das klassische Epoetin-Analogon Erythropoietin α oder ein Wirkstoff der neueren Generation Methoxy-Polyethylenglycol-Epoetin beta.
Es wurden 102 Hämodialysepatienten, darunter 41 Diabetiker und 61 Nicht-Diabetiker, über einen Zeitraum von neun Monaten beobachtet. Von den Untersuchungsteilnehmern erhielten 48 Patienten Epoetin α und 54 Patienten Methoxy-Polyethylenglycol-Epoetin beta.
Unsere Daten konnten zeigen, dass es zu einer Beeinflussung des HbA1c durch die Therapie mit ESA-Präparaten kommt. Das als alternativer Stoffwechselparameter fungierende Fructosamin unterlag keiner derartigen Beeinflussung, korrelierte jedoch nur ungenügend mit den höheren Blutzuckerwerten, sodass seine Anwendbarkeit bei Diabetikern ebenfalls erheblich einschränkt ist.
In der Gegenüberstellung der beiden ESA-Präparate erzielten beide Wirkstoffe vergleichbare Ergebnisse bezüglich des Erreichens der Hämoglobin-Zielwerte. Methoxy-Polyethylenglycol-Epoetin beta zeigte im Gegensatz zu Epoetin α eine seltener notwendige Dosisanpassung und längere Applikationsintervalle.
Aus der vorliegenden Arbeit geht hervor, dass bei Hämodialysepatienten das HbA1c kritisch und mit Bedacht auf mögliche Einflussfaktoren interpretiert werden sollte. Es ist dennoch derzeit der konstanteste Parameter in der Stoffwechselverlaufskontrolle bei Diabetes mellitus.
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Late earlier stone age sites in the Mapungubwe National Park, South Africa: a technological studyKempson, Helen 25 April 2008 (has links)
Dr K. Kuman initiated the Limpopo research programme that at present is based on
excavations conducted at three sites, Hackthorne, Kudu Koppie and Keratic Koppie.
They are situated atop a remnant of an ancient Miocene terrace, approximately 4km
from the present day course of the Limpopo River in the Mapungubwe National Park.
A broad range of stone tool types is represented in the area, with mostly Earlier and
Middle Stone Age artefacts found on the higher ground and Later Stone Age pieces
found primarily on the Limpopo’s floodplain. One of the obstacles to understanding
the archaeology of the region is the widespread episodic deflation that occurred here
during arid periods of the Pleistocene, which had an impact on stratified sequences in
the Stone Age. While all three sites have been subject to deflation, Hackthorne and
Keratic Koppie are single component sites. Kudu Koppie, however, preserves some
stratigraphy and provides a means of comparing and assessing the single component
assemblages which have undergone varying degrees of mixing. It was therefore vital
to establish a pattern of change through time at Kudu Koppie, with a sequence of late
Earlier, Middle and Later Stone Age deposits, using a combination of strategies
including typology, technological analysis and a study of raw material exploitation.
These data suggest that Hackthorne is primarily a late Earlier Stone Age (ESA)
assemblage with some Middle Stone Age (MSA) mixing, while Keratic Koppie
preserves an ESA assemblage with a more significant MSA component. The ESA
component is further argued to be a final post-Acheulean industry with a major
component of woodworking tools, suggesting it may be a local variant of the Sangoan
Industrial Complex.
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HbA1c-Variabilität in Abhängigkeit des Hämoglobins und der Erythropoietin Rezeptor stimulierenden Präparate bei Hämodialysepatienten - HESA Studie -Beckmann, Julia 17 December 2015 (has links)
Der Diabetes mellitus zählt zu den Hauptursachen einer terminalen Niereninsuffizienz. Aufgrund der veränderten Erythropoiese ist die Verwendung des HbA1c für die Beurteilung der Stoffwechseleinstellung bei Diabetikern mit einer chronischen Nierenerkrankung im Stadium 5 nach KDOQI immer noch in Frage gestellt.
Die vorliegende Arbeit untersuchte die HbA1c-Variabilität in Abhängigkeit der ESA-Dosis und des ESA-Präparates bei Hämodialysepatienten. Zum Einsatz kamen entweder das klassische Epoetin-Analogon Erythropoietin α oder ein Wirkstoff der neueren Generation Methoxy-Polyethylenglycol-Epoetin beta.
Es wurden 102 Hämodialysepatienten, darunter 41 Diabetiker und 61 Nicht-Diabetiker, über einen Zeitraum von neun Monaten beobachtet. Von den Untersuchungsteilnehmern erhielten 48 Patienten Epoetin α und 54 Patienten Methoxy-Polyethylenglycol-Epoetin beta.
Unsere Daten konnten zeigen, dass es zu einer Beeinflussung des HbA1c durch die Therapie mit ESA-Präparaten kommt. Das als alternativer Stoffwechselparameter fungierende Fructosamin unterlag keiner derartigen Beeinflussung, korrelierte jedoch nur ungenügend mit den höheren Blutzuckerwerten, sodass seine Anwendbarkeit bei Diabetikern ebenfalls erheblich einschränkt ist.
In der Gegenüberstellung der beiden ESA-Präparate erzielten beide Wirkstoffe vergleichbare Ergebnisse bezüglich des Erreichens der Hämoglobin-Zielwerte. Methoxy-Polyethylenglycol-Epoetin beta zeigte im Gegensatz zu Epoetin α eine seltener notwendige Dosisanpassung und längere Applikationsintervalle.
Aus der vorliegenden Arbeit geht hervor, dass bei Hämodialysepatienten das HbA1c kritisch und mit Bedacht auf mögliche Einflussfaktoren interpretiert werden sollte. Es ist dennoch derzeit der konstanteste Parameter in der Stoffwechselverlaufskontrolle bei Diabetes mellitus.
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Zapojení GIS a DPZ ve výuce zeměpisu na středních školách / POSSIBILITIES OF GIS AND REMOTE SENSING IMPLEMENTATION IN GEOGRAPHY LESSONS AT SECONDARY SCHOOLSKymrová, Hana January 2011 (has links)
The main objective of this paper is to show the possibility of involvement of GIS and remote sensing applications in teaching geography in secondary schools. The work introduces the basics of GIS and remote sensing, and proposes a way of engaging in teaching geography in secondary schools in form of worksheets and manuals for teachers. The worksheets are designed for the LeoWorks software and ESA School Atlas. The survey questionnaire for a selected sample of teachers and students examined the user-friendliness of the LeoWorks software and students' abilities to resolve the tasks created for them.
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CONCEPTUAL DESIGN OF A MODIFIED XBT TELEMETRY SYSTEM FOR USE IN THE OCEANS OF TITANMitchell, B. J. 10 1900 (has links)
International Telemetering Conference Proceedings / October 17-20, 1994 / Town & Country Hotel and Conference Center, San Diego, California / Current theories concerning the surface of Titan postulate the existence of large,
possibly oceanic, bodies of liquid ethane/ammonia plus various other chemicals.
ESA's Huygens probe is designed to gather oceanographic data on Titan. If the
postulated oceans or lakes do exist, follow up missions of an oceanographic nature
will be planned. This paper provides a concept for a modified XBT (eXpendable
Bathymetric Thermograph) probe design that will provide more data than just
temperature as a function of depth. By judicious use of acoustic telemetering links,
data on the sound speed profile and constituents of the ocean can be obtained. The
exo-oceanographic data collected will have important ramifications for oceanographic
studies on Earth.
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Electrostatic Self-Assembly of Biocompatible Thin FilmsDu, Weiwei 12 June 2000 (has links)
The design of biocompatible synthetic surfaces is an important issue for medical applications. Surface modification techniques provide good approaches to control the interactions between living systems and implanted materials by modifying the surface characteristics.
This thesis work demonstrates the feasibility and effectiveness of the novel and low-cost electrostatic self-assembly (ESA) technique for the manufacturing of biocompatible thin film coatings. The ESA process is based on the alternating adsorption of molecular layers of oppositely charged polymers/nanoparticles, and can be applied in the fabrication of well-organized multilayer thin films possessing various biocompatible properties. ESA multilayer assemblies incorporating various biomaterials including metal oxides and polymers were fabricated, the uniformity, thickness, layer-by-layer linearity, and surface morphology of the films were characterized by UV/vis spectroscopy, ellipsometry, and AFM imaging.
Preliminary biocompatibility testing was conducted, concentrating on contact angle surface characterization and the in vitro measurements of protein adsorption. The use of Fourier Transform Infrared Reflection-Absorption Spectroscopy (FT-IRAS) for the investigation of the protein adsorption behavior upon the ESA multilayer films is presented. / Master of Science
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Konvergence sektoru finančních institucí v zemích Evropské unieSlavíček, Michal January 2020 (has links)
Slavíček, M. Convergence of the sector financial corporations in the European Union countries. Diploma thesis. Brno: Mendel University, 2020. The diploma thesis deals with the possible convergence between the years 2004–2018 within the sector account of a financial corporations (defined by the ESA 2010 methodology) across the countries of the European Union, with an emphasis on Central European countries. The stated goal of the work was fulfilled by selecting suitable indicators that were used for the creation of cluster analysis and for calculating the standard deviations in the indicators. More specifically, these are indicators dealing with financial transactions (F.1–F.8), credit market concentration, number of credit institutions, number of employees in credit institutions and premiums written. However, the empirical results of the work did not prove or refute financial convergence across EU countries, as the clusters have changed over the years and even the development in standard deviations did not indicate demonstrable convergence.
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Hemocompatible polymer thin films fabricated by Electrostatic Self-Assembly (ESA)Cheung, Yeuk Kit 16 March 2005 (has links)
Stent is one of the coronary angioplasty techniques that expands the narrowed coronary arteries due to the accumulation of fat, cholesterol and other substances in the lumen of the arteries. The major complication of stent is restenosis. Current development of drug-eluting stents shows successfully reduce the occurrence of restenosis. Other than using drugs, electrostatic self assembled (ESAd) thin films may be the potential candidates to prevent restenosis.
ESA is a process to fabricate thin films bases on the electrostatic attraction between two oppositely charges. We used this technique to fabricate four PVP films and four PEI films. All films were examined by XPS and AFM. XPS data showed our coatings were successfully fabricated on substrates. AFM images revealed PVP coating was uniform, but PEI coatings had different morphologies due to diffusion and pH during the process.
Three preliminary hemocompatibility testes were performed to evaluate the hemocompatibility of the coatings. Platelet adhesion study showed the thin films inhibited platelet adhesion. All thin films were able to inhibit coagulation and were less cytotoxic. The studies suggested the ESA films were potentially hemocompatible. / Master of Science
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Détecteurs micro-bolométriques non refroidis : Application pour une mission spatiale vers les petits corps du système solaireBrageot, Emily 30 November 2012 (has links)
Les micro-bolomètres non-refroidis bénéficient de développements technologiques récents qui se traduisent par des matrices de plus en plus grandes (1024*768 pixels), pour des pixels de plus en plus petits (17 µm) et de plus en plus sensibles bien que non-refroidis (NETD<60 mK @300 K). L'objectif de cette thèse est d'étudier les détecteurs micro-bolométriques non-refroidis afin de tester leurs capacités en imagerie et en spectroscopie en vue de leur utilisation dans le cadre d'une mission spatiale vers les petits corps du système solaire, dont en particulier la mission Marco Polo R. J'ai étudié le fonctionnement de ces détecteurs en prenant pour exemple le détecteur Nano640Etm de la société Ulis, représentatif de la technologie des micro-bolomètres non-refroidis disponible actuellement. J'ai mesuré la stabilité dans le temps de son signal, l'homogénéité de la matrice du détecteur, et l'influence de différents paramètres de fonctionnement (température du plan focal, temps d'intégration des pixels, gain). La réponse du détecteur est linéaire en fonction de la température de scène à la puissance 4. Les résultats de cette caractérisation m'ont permis de mesurer le NETD du détecteur dans le cadre de cette expérience. J'ai ensuite testé les capacités du détecteur Nano640Etm en imagerie radiométrique calibrée afin d'estimer les erreurs maximales de calibration pour un, deux, ou trois points de calibration placés différemment dans la gamme de température observée / The recent progress of the uncooled micro-bolometer technology has lead to larger detector matrices (1024*768 pixels), with smaller pixel sizes (17 µm) and a higher sensitivity although it is an uncooled technology (NETD<60 mK @300 K). The objective of this thesis is to study uncooled micro-bolometer detectors in order to assess their performance for imagery and spectroscopy within the framework of a space mission towards small bodies of the solar system, including the Marco Polo R mission. I have studied these detectors through the example of the Nano640Etm detector of the Ulis society, which represents well the currently available uncooled micro-bolometer technology. I have measured its signal stability through time, the detector's matrix homogeneity, and the influence of various operating parameters (focal plane temperature, integration time of the pixels, gain). The detector's response is linear as a function of the scene temperature to the power of 4. The results of this characterization allowed me to measure the detector's NETD within this experiment. Then, I tested the Nano640Etm detector's ability to perform calibrated radiometric images in order to estimate the maximum calibration error for one, two, or three calibration points chosen differently within the observed temperature range. Lastly, I assessed the detector's performances for dispersive spectroscopic measurements, using its signal to noise ratio, as a function of the observation wavelength, the scene temperature, and the spectral resolution. The results of these tests are very positive.
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Utilization patterns and economic impact of IV iron and Erythropoiesis Stimulating Agents in Chronic Kidney Disease patients: A multi-hospital studyJoshi, Avani 01 October 2010 (has links)
Background: Chronic kidney disease (CKD) affects approximately 20 million Americans and is the cause of significant morbidity and mortality. Anemia, common in CKD, develops early in the disease process. It contributes to increased risk of cardiovascular disease, hospitalization, mortality, and diminishes health-related quality of life. Intravenous iron and Erythropoiesis Stimulating Agents (ESAs) are recommended for anemia management in CKD. The utilization patterns of IV iron and ESA, and their impact on hospital costs and length of stay merits investigation. Objectives: There were five general objectives of this investigation. The rate and extent of utilization of IV iron in anemic CKD patients was quantified across teaching hospitals in the US. Patient characteristics of those receiving IV iron and ESA and ESA alone were evaluated in detail. Predictors of IV iron and ESA use were determined. The impact of IV iron and ESA use was examined separately for total hospital costs and length of stay (LOS) while adjusting for confounding. Methods: This is a retrospective cohort analysis within the University Health System Consortium data warehouse. Eligible patients are those who were admitted to a hospital and received either IV iron and ESA or both at least once during the period of January 1, 2006, and December 31, 2008. Inclusion criteria include age > 18 years old with a primary or secondary diagnosis of CKD. The exposure of interest was IV iron and ESA therapy, and the outcome was the difference in total hospital costs and length of stay between patients only on ESA, and those on ESA and IV iron. A clustered binomial logistic regression using the GEE methodology was used to identify predictors of IV iron utilization. Propensity scores were used to control for confounding. A generalized estimating equations (GEE) model using a gamma distribution and log link was used to determine the adjusted hospital cost and length of stay for the IV iron and ESA and ESA alone therapy groups. Results: During the study period, 82,947 patients met all the inclusion and exclusion criteria. Of the 82,947 CKD patients on ESA therapy, only 8% (n = 6678) patients were on IV iron supplementation. Age, race, primary payer, admission status, severity of illness, dialysis status and physician specialty were identified as strong predictors of IV iron use in CKD patients. According to the multivariate model, the overall mean hospital cost for all 82,947 patients was $31,674. For patients using both IV iron and ESA (n=6678), mean costs were $34,756 compared to $31,404 for ESA users alone (n=76,269) – a difference of $3,352. The overall mean LOS for all patients was 9.75 days. For those using IV iron, the LOS was 10.71 days, and for those only using ESA, the LOS was 9.66 days– a difference of approximately 1 day. Conclusions: This inquiry is the first large multi-center investigation to quantify the impact of IV iron and ESA use on total hospital costs and LOS. Our investigation showed significant reduction in ESA doses with the use of IV iron supplementation, however, the overall prevalence of IV iron usage was low. Intravenous iron users were associated with a higher total hospital cost and longer length of stay than ESA users.
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