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Alzheimer’s disease (AD) is a neurodegenerative disorder that is one of such diseases associated with protein aggregation. Aβ is the main protein component of senile plaques in AD, and is neurotoxic when aggregated. In particular, soluble oligomeric forms of Aβ are closely related to neurotoxicity. In this dissertation, we examine the differences in Aβ aggregation intermediates, and final structures formed when only a simple modification in Aβ aggregation conditions is made, the presence or absence of mixing during aggregation. We show that intermediates in the aggregation pathway show significantly different structural rearrangements. The protein stabilities of Αβ species show that spherical aggregates corresponding to the most toxic Αβ species change their structure the most rapidly in denaturant, and that in general, increased toxicity correlated with decreased aggregate stability. In Alzheimer’s disease, even delaying Aβ aggregation onset or slowing its progression might be therapeutically useful, as disease onset is late in life. Small heat shock proteins (sHsps) may be useful for prevention of Αβ aggregation, since sHsps can interact with partly folded intermediate states of proteins to prevent incorrect folding and aggregation. In this research, several small heat shock proteins (sHsps) are tested to prevent Aβ aggregation and toxicity. sHsps used in this research are Hsp17.7, Hsp27, and Hsp20. All types of Hsp20, Hsp20-MBP, His-Hsp20 and His-Hsp20 without 11 residues in C-terminus, can prevent Aβ1-40 aggregation. Hsp20 also prevents Aβ toxicity in the same concentration ranges of it aggregation prevention activity. Hsp17.7 and Hsp27, however, can inhibit Αβ1-40 aggregation but not toxicity. A number of experiments to examine the mechanism of Hsp20 suggest that multivalent binding of sHsp to Aβ is necessary for the toxicity prevention activity. Conclusively, different Aβ incubation conditions in vitro can affect the rate of Aβ fibril formation, the morphology, the toxicity and the conformation of intermediates in the aggregation pathway. Hsp20 rather than other sHsps may be a useful molecular model for the drug design of the next generation of Aβ aggregation inhibitors to be used in the treatment of AD.

With the high development of society and economy, the rising level of national education, and the awareness of consumer rights in Taiwan, consumers¡¦ demands for medical and health care is increasing. The role of consumers has transformed to actively select and require medical and health care. The implementation of the National Health Insurance leads to the role change of the medical provider from a price maker to a price receiver, which benefits hospitals with mass product and cost control. Therefore, price-drive medical consumers become quality¡Vdriven ones, which benefits hospitals with good faculty, facilities and service. Nowadays, the hospital business environment is becoming more and more competitive. It is vital not only for hospital substantial business to create customer value of service and quality but also for hospital competitiveness to satisfy customer needs. The business strategy of hospitals is to greatly strengthen internal management and actively seek for the interaction with the external environment to keep survival and growth. Besides, hospitals apply CRM in order to attract new customers, retain old customers and to increase the profits of the customer contribution. Because of the limit of cost and budget tight policy, large hospitals are increasing their scale and the limited resource /number of customers. In this case, it is necessary for hospital¡¦s business strategy to focus on both quality and cost effectiveness. Hospitals build the tight relationship with customers so that they are willing to be diagnosed. Thus, Customer Relationship Management is the core competitive advantage for hospitals. Nevertheless, hospitals are less willing to purchase extracorporeal shock wave lithotripsy machines for the sake of the tight finance budget. As far as medical device suppliers are concerned, they have to adopt BOT approach in order to maintain business growth. Regarding the medical service and cooperation model for renal calculus patients, we discover that it is the equipment suppliers that are responsible for CRM rather than hospitals establishment. The retention number and returning frequency is the key to the revenues of the equipment suppliers, which means the relationship between hospitals and suppliers are unbroken. Our research indicates that the business model of extracorporeal shock wave lithotripsy machine can apply the concept of CRM. The medical equipment business and medical organization develop the model of the patient service with the base; CRM, the core value: customers and the hospital vision. We construct the ¡§four wins¡¨ model for the hospital, the patient, the Health Insurance Bureau and the business with the decision-making strategy, customer service and IT application.

El presente trabajo de investigación fue planteado tomando en cuenta que se dispone de limitada información respecto a las alteraciones ácido base en pacientes ingresados en unidades de trauma shock que son pacientes con alto riesgo de mortalidad debido a descompensación de su salud que lo lleva a inestabilidad de diversos sistemas como el cardiovascular, respiratorio, nervioso entre otros. Existe limitada información respecto a que alteraciones ácido base y en que nivel de alteración puede conllevar a mayor mortalidad en estos pacientes; es por ello que se plantea el presente trabajo teniendo como problema el siguiente. El 54.4% de pacientes fueron de sexo masculino y el restante 45.6% fueron de sexo femenino. Las edades fueron muy dispersas teniendo pacientes entre los 15 y 94 años de edad, siendo el promedio de edad de 64 años y la mayoría pacientes mayores de 50 años lo que se asocio a mortalidad con un riesgo relativo de muerte de 4.5 con respecto a los menores de 50 años. La alteración gasométrica mas frecuente fue la mixta correspondiendo a la acidosis metabólica con acidosis respiratoria en 25.6% del total de pacientes. La presencia de un ph alterado se vio en 72.5% del total de casos siendo únicamente el 27.5% gasometrías con ph normal; la acidosis de diversos tipos se presento en 75% de gasometrías alteradas (excluyendo las de ph normal) como trastorno mas frecuente frente a la alcalosis que se presento en 25% de gasometrías alteradas. la acidosis metabólica con acidosis respiratoria fue el trastorno metabólico acido base mas frecuente presentado en los pacientes fallecidos (38% de fallecidos). / The present investigation work was outlined taking into account that has limited information regarding the alterations acid bases on patients entered in units of trauma shock that are patient with high risk of mortality due to life threatening condition of its health that takes it to uncertainty of diverse systems like the cardiovascular, breathing, nervous among others. Limited information exists regarding that alterations acid base and in that alteration level can bear to more mortality in these patients; it is for it that thinks about the present work having as problem the following one. Conclusions: 54.4% of patients was of masculine sex and the remaining 45.6% they were of female sex. The ages were very dispersed having patients between the 15 and 94 years of age, being the average of 64 year-old age and most patient bigger than 50 years what you associates to mortality with a relative risk of death of 4.5 with regard to those smaller than 50 years. The gasometry alteration but it frequents was mixed went corresponding to the metabolic acidosis with breathing acidosis in 25.6% of the total of patient. The presence of an altered ph was seen in 72.5% of the total of cases being only 27.5% gasometrys with normal ph; the acidosis of diverse types you presents in 75% of altered gasometrys (excluding those of normal ph) like dysfunction but it frequents in front of the alcalosis that you presents in 25% of altered gasometrys. the metabolic acidosis with breathing acidosis was the dysfunction metabolic acid it bases but it frequents presented in the patients died (38% of deceaseds). bigger risk of death.

OBJETIVO: Describir las características clínicas y epidemiológicas en los pacientes que ingresaron a la Unidad de Shock Trauma del Hospital Nacional Dos de Mayo durante los años Enero 2001- Diciembre 2002. DISEÑO: Es un estudio retrospectivo descriptivo, tipo serie de casos, realizado mediante la revisión de historias clínicas, lo cual nos permitió analizar las características de los pacientes que ingresaron a esta Unidad durante este periodo. MATERIALES Y MÉTODOS: Se revisaron los libros de registro y las historias clínicas de los pacientes que ingresaron a esta Unidad durante el periodo ya establecido, los datos se llenaron en fichas prefabricadas. En ellos se registraron 1549 pacientes de los cuales, cumplieron con los criterios de inclusión 1424, 724 pacientes del 2001 y 700 pacientes del 2002. RESULTADOS: Del estudio descriptivo se obtuvo que el 67,7% de pacientes fueron varones, existiendo una relación hombres a mujeres de 2:1, y el 54,1% de pacientes tenían entre 18 y 60 años. El 82,5% de pacientes ingresaron al servicio de shock trauma por el servicio de Emergencia. Se realizaron 1694 procedimientos de los cuales el 36,1% fueron Intubaciones Endotraqueales. En este periodo se realizaron 1742 Exámenes Auxiliares de los cuales el 15% fueron TAC cerebrales. La causa más frecuente de ingreso a la Unidad de Shock Trauma es el Traumatismo (27,3%), siendo el Traumatismo Encéfalo Craneano el más importante, seguido por la Insuficiencia Respiratoria Aguda. La principal causa de mortalidad fue la Insuficiencia Respiratoria Aguda con un 21%. El 41,57% de pacientes permaneció en la Unidad por un periodo comprendido entre 1 y 6 horas. El 42,71% de pacientes queda en hospitalización. En el análisis estadístico se encontró relación estadísticamente significativa entre el diagnóstico de traumatismo con la edad (p = 0,004) y con el sexo masculino; relación entre la Insuficiencia Respiratoria Aguda y la edad (p = 0.045). CONCLUSIONES: La Unidad de Shock Trauma atendió en este periodo el 1,7% de la población que acudió a la Emergencia del Hospital, el traumatismo y la insuficiencia respiratoria fueron las causas más frecuentes.

<p>Throughout the latter half of the 20^th century, many developing economies adopted a set of economic policies in order to transition to market economy. Reforms were introduced either simultaneously or gradually, fuelling the debate over whether the so-called shock-therapy reforms were more beneficial or less beneficial to growth than gradual reforms. This study focuses on the role of the mode of transition in determining the effectiveness of Foreign Direct Investment (FDI) on the growth of the Gross Domestic Product (GDP). FDI is valuable for development in transition economies since it has often been a main source of investment for these types of economies. An empirical analysis was conducted using sixty transitioning countries, examining the growth up to sixteen years after the initial reform. The results indicate that there is some evidence of a difference in the effects of FDI inflows on GDP growth between the shock-therapy and gradual reformers.</p>

Thesis (Ph. D.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains viii, 147 p. : ill. Vita. Includes abstract. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 100-104). Also available on the Internet.

Thesis (M.S.)--Rutgers University, 2009. / "Graduate Program in Mechanical and Aerospace Engineering." Includes bibliographical references (p. 105-106).

Thesis (Ph. D.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (p. 259-263). Also available via the World Wide Web.