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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Avaliação da integridade estrutural de um vaso de pressão danificado por trincas: análise numérica e adequação ao serviço. / Structural integrity assessment of a pressure vessel damaged by cracks: numerical analysis and fitness-for-servive.

COÊLHO, Gabriel de Castro. 10 April 2018 (has links)
Submitted by Lucienne Costa (lucienneferreira@ufcg.edu.br) on 2018-04-10T21:22:10Z No. of bitstreams: 1 GABRIEL DE CASTRO COÊLHO – DISSERTAÇÃO (PPGEM) 2018.pdf: 7666728 bytes, checksum: 7531b06d7808af28519bdc17c9bac069 (MD5) / Made available in DSpace on 2018-04-10T21:22:10Z (GMT). No. of bitstreams: 1 GABRIEL DE CASTRO COÊLHO – DISSERTAÇÃO (PPGEM) 2018.pdf: 7666728 bytes, checksum: 7531b06d7808af28519bdc17c9bac069 (MD5) Previous issue date: 2018-02-26 / Capes / Com o intuito de se ter uma melhor análise de engenharia (avaliação de vida útil remanescente) versus menor número de intervenções (parada de equipamento para manutenção) foram elaboradas normas técnicas de Fitness For Service (FFS – Adequação ao Serviço), que procuram explorar os limites de carregamentos, permitindo a utilização de estruturas e componentes danificados de forma mais eficiente, estendendo suas campanhas operacionais. Este trabalho teve como objetivo realizar os procedimentos de FFS das normas americana API-579/ASME FFS-1 (2016) e britânica BS 7910 (2013) por meio da análise de uma trinca superficial longitudinal localizada na superfície externa de um vaso de pressão cilíndrico, em cada nível de cada norma, tal que uma comparação entre as duas normas foi feita de modo a avaliar qual das duas normas é capaz de prover dimensões críticas maiores, que na prática proporcionariam maiores campanhas operacionais de estruturas e componentes danificados. Como ferramenta de análise, o MEF foi usado através do software ABAQUS®. Resultados indicaram em todas as comparações dos 3 (três) níveis de avaliação de cada norma que a BS 7910 (2013) oferece uma avaliação crítica de engenharia menos conservadora, já que tanto pelas soluções analíticas como pelos resultados via MEF, conseguiu-se por esta determinar tamanhos críticos maiores quando em comparação a norma americana. Conclui-se, portanto, que a BS 7910 (2013) desde a absorção da FITNET (2008) tornou-se um procedimento bem mais prático em termos de aplicação e menos conservador quando comparado a norma API 579/ASME FFS-1 (2016), para os casos estudados. / Intending on having a better engineering analysis (remaining life assessment) versus lower interventions (equipment stop for maintainance) Fitness For Service (FFS) standards were elaborated to explore the load limits, allowing the use of damaged structures and components in a more efficient way, extending their operational campains. This thesis implemented the FFS procedures of the American standard API 579/ASME FFS-1 (2016) and the British standard BS 7910 (2013) by the analysis of a surface longitudinal crack on the external surface of a cylindrical pressure vessel, in each level of assessment of each standard so that a comparison between each standard could be performed to evaluate which one is capable of providing higher critical dimensions that in real situation would mean higher operational time of dmamaged structures and components. FEM was used through the ABAQUS® software. Results indicated that in all comparisons of the 3 (three) assessment levels of each standard, BS 7910 (2013) provided a less conservative engineering critical assessment since, by both numerical and analytical solutions, this standard was able to determine higher critical sizes in comparison to the American standard. As a general concluding remark, BS 7910 (2013), since the absorption of the FITNET (2008) procedures, has become a much more practical and less conservative procedure when compared to the API 579/ASME FFS-1 (2016).
2

Cost-Effectiveness Evaluation of Integrated Pest Management (IPM) Extension Methods and Programs: The Case of Bangladesh

Ricker-Gilbert, Jacob 12 October 2005 (has links)
This study evaluates the cost-effectiveness of alternative Integrated Pest Management (IPM) training methods and programs aimed at diffusing IPM innovations to farmers in Bangladesh. Various IPM innovations are categorized as being simple, intermediate or complex, while dissemination methods used to extend these innovations are classified as being less intense, moderately intense, or more intense. Examples of less intense diffusion methods include mass media and field day demonstrations, and moderately intense methods include visits from agents. A "farmer field school" (FFS) is considered a more intense type of training method. The study evaluates the effectiveness of these IPM diffusion methods based on a number of criteria such as a methods ability to reach the greatest number of farmers with a given budget, their capability of reaching farmers quickly, and their ability to influence adoption of IPM. Additional components of effectiveness include influencing appropriate use of IPM, influencing retention of IPM, providing a level knowledge that participants can adapt to other areas on the farm, and providing accessibility to limited resource farmers. Data used in the analysis come from a field survey conducted on 350 rice and vegetable farmers in Bangladesh during July and August of 2004. Three ordered probit models are used to measure adoption of simple, intermediate and complex technologies. Results from these models indicate that FFS participants are more likely than non-participants to adopt simple, intermediate and complex practices, while farmers visited by agents are more likely than non-participants to adopt simple and intermediate practices. Field day attendees are more likely to adopt intermediate and complex practices than non-participants. These results may be influenced by endogeneity of unobserved factors that influence participation in FFS but also affect adoption. The study uses a binary probit model to measure appropriate use, but it does not detect any significant differences among farmers trained through different methods, nor does it find any significant differences in retention rates among farmers who have been to different training programs. Another probit model identifies farmers who have been visited by an agent as being more likely to discover an IPM practice through their own experimentation, indicating that farmers who have been visited by an agent have received enough knowledge to adapt IPM to different problems on their farm. Results of the study indicate that limited resource farms are well represented by their participation in the various training methods, but that a higher percentage of large farmers than small farmers in the sample have been visited by an agent or been to FFS. Informal diffusion of IPM information is found to be occurring among people in FFS villages for simple practices. However, for intermediate and complex practices, farmers who participated in FFS are no more likely to spread information to other people in their villages than are less intense formal training methods such as field days and agent visits. This result indicates that while FFS graduates may be likely to share simple practices with others, they should not be relied upon as the primary means of informally diffusing more complex practices to other farmers. The cost-effectiveness estimation incorporates components of the effectiveness evaluation along with the cost of administering the methods. The study calculates that agent visits are the most cost-effective method for diffusing simple and complex technologies and practices, while field days are the most cost-effective methods for extending intermediate technologies and practices. / Master of Science
3

Conception de faux substrats fluorescents (FFS) dans le cadre de l’étude du transporteur vésiculaire de nucléotides et de la Sialine / Design of fluorescent false substrates (FFS) to study vesicular nucleotide transporter and Sialin

Dubois, Lilian 15 November 2013 (has links)
Le concept de composés appelés FFS, pour faux substrats fluorescents (ou FFN pour les neurotransmetteurs), a été introduit par le groupe du Dr Sames qui a conçu et optimisé des molécules fluorescentes reconnues comme substrats par le Transporteur Vésiculaire de Monoamine (VMAT2). Ces composés, une fois accumulés dans des vésicules synaptiques, ont permis la visualisation de l’activité neuronale monoaminergique en temps réel. Ce concept a servi d’hypothèse pour ce travail de thèse. En effet, nous avons conçu, synthétisé et évalué la potentialité de deux familles chimiques comme substrats fluorescents de transporteurs de la famille SLC17 : VNUT (transporteur vésiculaire de nucléotides) et la Sialine (transporteur d’acide sialique). Les molécules fluorescentes synthétisées devront être capables de remplacer/mimer les substrats naturels de VNUT et de la Sialine (respectivement l’ATP et le Neu-5-Ac) et de couvrir une large gamme de longueurs d’ondes d’émission pour nous adapter aux problématiques biologiques. L’élaboration de tels composés a été effectuée par conception rationnelle en synergie avec les résultats des tests d’inhibition et de transport et à partir de touches issues du criblage virtuel. Deux composés ont été plus particulièrement étudiés. D’une part, l’ATP a été modifiée en remplaçant le motif adénine par un fluorophore (éthéno, coumarines, quinoléines…). D’autre part, une touche virtuelle (Fmoc-Lys(Cbz)-OH) issue d’un vHTS sur la Sialine a été sélectionnée pour sa structure facilement modifiable, qui a permis l’incorporation aisée de motifs fluorescents. Une cinquantaine de composés a donc été synthétisée et évaluée pour leur capacité d’inhibition ou de substrat sur les cibles sélectionnées. Les résultats prometteurs de plusieurs composés en tant qu’inhibiteur laissent de nombreuses perspectives pour la compréhension de la machinerie vésiculaire. / The concept of compounds called FFSs for false fluorescent substrates (or FFNs for neurotransmitters) was introduced by the group of Dr Sames who designed and optimized fluorescent molecules recognized as substrates by the Vesicular Monoamine Transporter (VMAT2). Once accumulated in synaptic vesicules, these compounds have allowed visualization of the monoaminergic neuronal activity in real time. This concept has been used as hypothesis for this thesis work. Indeed, we have designed, synthesized and evaluated the potential of two chemical families as fluorescent substrates of SLC17 transporter family: VNUT (Vesicular Nucleotide Transporter) and Sialin (sialic acid transporter). The synthesized fluorescent molecules must be able to replace/mimic the natural substrates of VNUT and Sialin ( ATP and Neu-5-Ac, respectively) and to cover a wide range of emission wavelengths to deal with biological problems. The development of such compounds was performed by rational design in synergy with the results of inhibition and transport tests and by virtual screening. Two compounds have been specifically studied. On one hand, ATP was modified by replacing the adenine pattern by a fluorophore (etheno, coumarins, quinolines…). On the other hand, a virtual hit (Fmoc-Lys(Cbz)-OH), derived from vHTS targeted to Sialin, was selected for the ease to incorporate fluorescent patterns. Therefore, fifty compounds were synthesized and evaluated for their inhibitory or substrate ability on selected targets. The promising results of several compounds as inhibitors give rise to perspectives for understanding vesicular machinery.
4

Einfluß von Propranolol auf den Fastenstoffwechsel des Schafes

Ottilie, Henry 28 November 2004 (has links) (PDF)
Die therapeutische Beeinflußbarkeit einer Leberverfettung gilt weltweit als unbefriedigend ge-löst, so daß ein letaler Ausgang besonders bei Wiederkäuern teilweise nicht zu verhindern ist. Die Nutzung von beta-Rezeptorenblockern hat bisher mit dieser Indikation keinen Eingang in die Veterinärmedizin gefunden. In den vorliegenden Untersuchungen wurden deshalb die Auswirkungen einer unspezifischen Blockade der beta-adrenergen Rezeptoren auf die Lipolyse, die klinischen und hämatologi-schen Funktionen sowie Leber-, Eiweiß- und Mineralstoffwechsel bei fastenden Schafen ge-prüft. Insbesondere wurde dabei die Wirkung einer Propranololapplikation auf die Lipolyse in der frühen Phase des Fastens untersucht. Zu diesem Zweck wurden insgesamt 15 weiblichen, klinisch gesunden, güsten Schafen der Rasse Merino-Fleisch während eines dreitägigen Futterentzuges mit Hilfe einer Dauertropfinfu-sion mit zwei 8stündigen Pausen 0,5 bzw. 1 mg Propranolol/kg KM/d bzw. den Tieren der Kontrollgruppe ein vergleichbares Volumen einer NaCl-Lösung appliziert. Neben der klini-schen Kontrolle von Puls- und Atemfrequenz, Körpertemperatur und Pansenaktivität erfolgte über die wiederholte Gewinnung von Blutproben aus der Vena jugularis externa eine Erfassung der Konzentrationen von Glucose, FFS, Bilirubin, BHB, K, Na, Mg, Gesamteiweiß und Albu-min im Blutserum. Zur Kontrolle der Leberfunktion wurden die Aktivitäten der GLDH und ASAT bestimmt. Die Wirkung des beta-Rezeptor-Antagonisten Propranolol auf die hämatolo-gischen Parameter wurde durch die Kontrolle der Leukozyten-, Erythrozyten- und Hämoglo-binkonzentrationen und den Hämatokrit der Schafe im Versuchsverlauf überprüft. In Übereinstimmung mit bisherigen Untersuchungen an Wiederkäuern und Nichtwiederkäuern kam es aufgrund der dreitägigen Futterdeprivation in allen Tiergruppen zu einer signifikanten Verminderung des Körpergewichtes um bis zu 9,8 %. Die Zahl der Pansenbewegungen redu-zierte sich bei allen Tieren signifikant bereits innerhalb der ersten 48 Stunden der Futterdepri-vation. Der stärkste Abfall der Pansenaktivität ließ sich bei den Schafen, denen 1 mg Propra-nolol/kg KM/d infundiert wurde, nachweisen. Puls- und Atemfrequenz, die Konzentrationen von Na, K, Mg, Gesamteiweiß und Albumin sowie die Aktivitäten von GLDH und ASAT im Blutserum blieben im Versuchsverlauf ohne signifikante Veränderungen. Eine Beeinflussung der hämatologischen Parameter ließ sich we-der bei den Schafen der Kontrollgruppe noch bei denen der Versuchsgruppen nachweisen. Während der Futterentzug in allen Tiergruppen zu einer tendenziellen Abnahme der Blut-serumkonzentration an Glucose führte, stiegen die Konzentrationen an FFS, Bilirubin und BHB im Blutserum aller Tiere an. Damit weisen die Veränderungen in den Konzentrationen von FFS, BHB und Bilirubin im Blutserum der Schafe der Kontrollgruppe die typischen Merkmale einer Fastenstoffwechsellage auf. In beiden Versuchsgruppen fielen diese Konzen-trationserhöhungen gegenüber denen der Kontrollgruppe statistisch gesichert niedriger aus. Unter Berücksichtigung der dabei erreichten Niveaus ließ sich für die Versuchsgruppen eine geringere Belastung von Energie- und Leberstoffwechsel als in der Kontrollgruppe feststellen. Der Übergang von der ersten in die zweite Phase des Fastenstoffwechsels ist in allen Tiergrup-pen, besonders deutlich in beiden Versuchsgruppen, zum Zeitpunkt um 48 h nach Versuchsbe-ginn an der Erhöhung der Körpertemperatur sowie den stärkeren Anstiegen der FFS-Konzentrationen erkennbar. Die besondere klinische und labordiagnostische Bedeutung der Änderungen der FFS-Konzentration im Blutserum zeigte sich in der zeitlich früheren und ausgeprägteren Reaktion als die Konzentrationsänderungen von Bilirubin und BHB. Bereits nach 24stündigem Fasten waren in allen Schafgruppen signifikant gegenüber den Ausgangswerten erhöhte FFS-Konzentrationen nachweisbar. In beiden Versuchsgruppen war bis zum Erreichen der Maxi-malwerte 48 h nach Beginn des Fastens ein geringerer Anstieg der FFS-Konzentration im Blut-serum als in der Kontrollgruppe nachzuweisen. Nach dem Erreichen der Maximalkonzentration kam es unter dem Propranololeinfluß in beiden Versuchsgruppen zu einem raschen, signifi-kantem Abfall der FFS-Konzentration um 44,7 bzw. 63,5 %. Die Abnahme der FFS-Konzentration im Blutserum vom Maximalwert bis zum Versuchsende betrug in der Kontroll-gruppe lediglich 8,6 %. und lag damit signifikant unter den Vergleichswerten der Versuchstie-re. Für die Konzentration der FFS fanden sich zum Versuchsende zwischen allen Gruppen si-gnifikante Unterschiede. Damit läßt sich eine dosisabhängige Wirkung einer Propranololappli-kation auf die Freisetzung von FFS aus den körpereigenen Fettdepots ableiten. Als Besonderheit war zu beobachten, daß sich die Konzentration der FFS in der Kontrollgrup-pe in den Zeiträumen der Infusion der NaCl-Lösung vermindert. Möglicherweise spielt hierbei der säuernde Einfluß des NaCl auf den pH-Wert im Blut eine Rolle. Unter dem Einfluß einer pH-Verminderung kommt es dabei zu einer Absenkung der Lipolyserate. Der zwischen den Infusionszeiten starke Konzentrationsanstieg der FFS in der Kontrollgruppe führt in dieser zu signifikant höheren FFS-Konzentrationen als in den Versuchsgruppen. Die Konzentrationsänderungen von direkt reagierendem und Gesamtbilirubin fielen bei den Schafen der Kontrollgruppe höher aus als bei den Tieren der Versuchsgruppen. Während die Maximalkonzentrationen für das Gesamtbilirubin in den Versuchsgruppen mit Dosierungen von 0,5 bzw. 1 mg Propranolol/kg KM/d 48 h nach Versuchsbeginn erreicht werden, ließen sich die maximalen Gesamtbilirubinkonzentrationen in der Kontrollgruppe erst 56 h nach Versuchsbe-ginn nachweisen. Die dabei vorhandenen Konzentrationsunterschiede zwischen den einzelnen Gruppen weisen auf eine geringere Belastung der Leber bei den Schafen der Versuchsgruppen hin. Auch die BHB-Konzentrationen im Blutserum der Schafe der Versuchsgruppen lagen zum Versuchsende unter denen der Tiere in der Kontrollgruppe. Damit liegt ein weiterer Indikator auf eine geringere Leberbelastung der Tiere in den Versuchsgruppen gegenüber den Schafen der Kontrollgruppe vor. Die absolut niedrigsten BHB-Konzentrationen waren bei den Schafen der Versuchsgruppe mit einer Propranololgabe von 1 mg/kg KM/d nachweisbar. In dieser Gruppe wurde die maximale BHB-Konzentration 32 h nach Fastenbeginn erreicht. Die vorliegenden Ergebnisse zeigen, daß sich mit Propranololgaben in Höhe von 0,5 bzw. 1 mg/kg KM/d beim Schaf eine Hemmung der Lipolyse innerhalb der ersten 64 Stunden eines Futterentzuges erreichen läßt, ohne dabei nachweisbaren Einfluß auf hämatologische Parameter auszuüben. Insbesondere weisen die zwischen Versuchs- und Kontrollgruppe vergleichbaren Anstiege der FFS-Konzentrationen in den infusionsfreien Zeiträumen auf den Einfluß des beta-adrenergen Antagonisten auf die Lipolyse während der Infusion hin. Die Konzentrationsände-rungen von Bilirubin und BHB in den Versuchsgruppen erfolgen in deutlich geringerem Um-fang als in der Kontrollgruppe. Damit läst sich auf eine geringere Belastung von Energie- und Leberstoffwechsel bei den Versuchstieren schließen. Die nicht signifikanten Veränderungen der Enzymaktivitäten von GLDH und ASAT bestätigen, daß durch die Anwendung von Propra-nolol keine negative Beeinflussung der Leberfunktion erfolgt. Aufgrund der stärkeren Reduzie-rung der Zahl der Pansenbewegungen und des verminderten Konzentrationsanstieges von FFS im Blutserum der Schafe, denen 1 mg Propranolol/kg KM/d appliziert wurde, gegenüber denen die 0,5 mg Propranolol/kg KM/d erhielten, ist von einer Dosisabhängigkeit der Propranolol-wirkung auszugehen. Die Applikation von Propranolol in einer Dosis von 0,5 bzw. 1 mg/kg KM/d stellt beim Schaf eine geeignete Methode dar, frühzeitig eine Verminderung der fasten-induzierten Lipolyse zu erreichen. / The treatment of the fatty liver disease is world-wide regarded as unsatisfactory, so that death of the affected ruminants is partly unavoidable. The administration of beta receptor blockers in such cases has not found its way into veterinary medicine until now. In this study, the effects of a nonspecific blockade of the beta adrenoceptors on lipolysis, clinical and hematological parameters as well as on the metabolism of the liver, proteins and minerals in fasting sheep were therefore tested. Especially, the effect of a Propranolol administration on the lipolysis in the early stage of fasting was examined. During a three-day period of food deprivation, 15 female, clinically healthy and non-pregnant sheep (Merino-Fleisch) were given 0.5 or 1 mg Propranolol/kg body weight per day via a continuous infusion with two interruptions of eight hours. During the experiment, pulse, respiration rate, body temperature and rumen activity were checked. The serum concentrations of glucose, FFA, bilirubin, beta-hydroxybutyrate, potassium, sodium, magnesium, total protein and albumin were controlled by repeatedly taking blood samples from the vena jugularis externa. The activity of the enzymes GLDH and AST were determined to check the liver function. The effect of the beta-receptor antagonist Propranolol on the hematological parameters was checked by examining the WBC, RBC, the hemoglobin concentrations and the packed cell volume. All test groups showed significant decrease in body weigth of up to 9.8 %, due to the three-day food deprivation. Even within the first 48 hours of food deprivation, rumen motility of all animals was decreasing significantly. Those sheep which received 1 mg Propranolol/kg body weight per day showed the strongest decrease in rumen activity. Pulse and respiration rate, the concentrations of potassium, sodium, magnesium, total protein and albumin as well as the activity of GLDH and AST in blood serum remained without significant changes during the experiment. Neither the sheep of the control group nor those of the experimental groups showed any influence on the hematological parameters. While the blood glucose concentration tended to be lower during the food deprivation in all groups, the concentrations of FFA, bilirubin and beta-hydroxybutyrate in blood serum were increasing. Thus, the changes of FFA, bilirubin and beta-hydroxybutyrate concentrations in the control group showed the typical characteristics of fasting metabolism. These absolute increases in concentrations were significantly lower in both experimental groups than those in the control group. With regard to the levels reached and compared to the control group, a smaller load of energy and liver metabolism could be determined in the experimental groups. The transition from the first to the second stage of the fasting metabolism in all groups (but especially in the experimental groups) was clearly discernible in the rises of body temperature and in the stronger increases of the FFA concentrations approximately 48 hours after the experiment started. The special clinical and diagnostic importance of the FFA concentration was indicated in an earlier and stronger change of the FFA concentration in the blood serum, compared to the changes of bilirubin and beta-hydroxybutyrate. As early as 24 hours after the beginning of the fasting, a significant rise of the FFA concentration in comparison to the initial concentration could be proved. In contrast to the control group the two experimental groups showed a smaller increase in the FFA concentration. All groups reached their maxima of FFA concentration 48 hours after the beginning of the experiment. Afterwards FFA concentrations in the two experimental groups were sinking fast and significantly by 44.7 % and 63.5 % respectively. In the control group, the decrease of the FFA concentration from the maximum until the end of the experiment was only 8.6 % and thus significantly lower than the comparative results. At the end of the experiment, significant differences in FFA concentrations between all groups could be proved. So, it can be assumed that there is a dose-dependent effect of Propranolol on the FFA release from the bodyŽs own fat depots. The FFA concentration in the control group was decreasing during the NaCl-infusion. This could be due to NaClŽs influence on the pH value of the blood. The reduction of the pH causes a decreasing rate of the lipolysis. The strong rise of FFA concentration between the infusion in the control group, lead to significantly higher results compared to the experimental groups. The changes of total and direct reacting bilirubin in the control group were higher than in the experimental groups. While maximum concentrations of total bilirubin acid in the experimental groups (which got 0.5 and 1 mg Propranolol/kg body weigth per day respectively) could be determined 48 hours after the experimentŽs start, maximum concentrations in the control group could be found only 56 hours after beginning of the fasting. Beta-hydroxybutyrate concentrations in the experimental groups were also lower than in the control group. These differences between the groups indicate a smaller strain of the liver in the experimental groups. The lowest beta-hydroxybutyrate concentrations could be proved in the experimental group with a dose of 1 mg Propranolol/kg body weight per day. In this group, the maximum beta-hydroxybutyrate concentration was reached 32 hours after the beginning of the fasting. These results suggest that by the administration of Propranolol at doses of 0.5 mg and 1 mg/kg body weigth per day respectively it is possible to inhibit the lipolysis within the first 64 hours after a food deprivation without effecting the hematological parameters. Particularly, the comparable increases in FFA concentrations in the experimental and control groups between the infusions indicate a direct effect of the beta-adrenergic antagonist on the lipolysis during the infusions. The changes of bilirubin and beta-hydroxybutyrate concentrations in the experimental groups were smaller than those in the control group. This suggests a smaller strain on the energy and liver metabolism in the experimental groups compared to the control group. The nonsignificant changes of the activity of GLDH and AST indicate no negative influence on the liver function after applicating Propranolol. The stronger reduction of rumen motility and the smaller increase of the FFA concentration in the group with 1 mg Propranolol/kg body weigth per day compared to the group with 0.5 mg Propranolol/kg body weigth per day shows the dose-dependent effect of Propranolol. The application of Propranolol at a dose of 0.5 mg or 1 mg/kg body weigth per day is a suitable method to early inhibit fasting-induced lipolysis in sheep.
5

Determining A Strategy For Favorable Acquisition And Utilization Of Complex Technologies: Flight Simulation Training Devices (fstd)

Boztas, Omer 01 September 2012 (has links) (PDF)
The thesis investigates the elements of a consistent strategy for favorable acquisition and utilization of Flight Simulation Training Devices (FSTD), thus Full Flight Simulators (FFS) and Flight Training Devices (FTD). The primary purpose is to determine a knowledge-based strategy for the end-user, acquisition professional, aviation firms and institutions. Hence, it could be possible to shed a light for cooperative groups and main institutions of national innovation system involved in entrepreneurial and innovative efforts regarding complex technologies like FSTD. In the sample study, 114 pilots from varied sources were administered a questionnaire and their FFS and FTD perceptions were statistically tested regarding each &ldquo / technology&rsquo / s usefulness&rdquo / in four types of training. Another variable, each &ldquo / technology&rsquo / s ease of operation and use&rdquo / was also tested additionally via agent-based model whether it had any effect on technologies&rsquo / selection processes. It could be inferred that that aviation institutions and firms could acquire and utilize FTD as a complementary to both aircraft and FFS within a range of 30-60% depending upon type of the training. Moreover, FTD could be acquired and utilized as a substitute to FFS for Instrument Flight Training (IFT). The FTD&rsquo / s usefulness for IFT was rated as 67% by the military pilots. The research also asserts that the aviation institutions and firms as well as cooperative groups and organizations could favor the established strategy and policy during their FSTD related efforts at &ldquo / micro and meso-level&rdquo / . The final aim is to create a collaborative medium and a synergy for those agents.
6

Impact of alternative payment plans on professional equity and daily distress of physicians

2014 December 1900 (has links)
The way physicians are paid for the provision of care is a relevant aspect of health care systems. Fee-for-service (FFS) payment system has been criticized for affecting quality of care, contributing to the fragmentation of health care, and for rising costs of health care systems. Alternative payment plans (APP) have been introduced as options to the traditional FFS payment scheme. Despite the link between payment methods and behavior of physicians that has been established; there is a lack of evidence about the impact of payment systems on wellness of physicians, specifically on their perception of professional equity and daily distress of physicians. The purpose of this study was to explore the effects of APP on physicians’ perceptions of professional equity and daily distress. The following questions guided this dissertation: 1) Does professional equity perceived by physicians vary among practitioners paid by FFS, APP, or blended alternatives? 2) Is the payment method associated with daily distress of medical practitioners? and 3) Are levels of professional equity, daily distress, and career satisfaction of physicians different by gender and payment methods? In 2011, a cross-sectional study was conducted with physicians practicing in the Saskatoon Health Region (SHR), the largest health authority of Saskatchewan, Canada. Physicians completed a questionnaire evaluating their perceptions of professional equity and daily distress. Analyses of variances (ANOVA) were performed to assess differences in professional equity (overall and by its fulfillment, financial, and recognition dimensions) and daily distress among physicians paid by FFS, APP, and blended schemes. As multivariable analyses, a linear regression was used to test the interaction between specialty and payment methods on the perception of professional equity, controlling for the number of patients, gender, and age group. A mixed linear regression model was built to predict daily distress, testing demographics, workload, complexity of patients, payment method, career satisfaction, and practice profile; the random component of the model considered the influence of geographic area of practice. Also, a multivariate analysis of variance (MANOVA) was conducted to evaluate differences among professional equity, daily distress, and career satisfaction by payment method and gender. In total, 382 (48.1%) physicians participated in the study. Response bias was tested and found to be negligible (Appendix F). The ANOVA identified that physicians paid by APP perceived higher professional equity than those paid by FFS (p=0.005), as well as higher levels of income (p=0.03) and recognition (p=0.001) equity than those with FFS. In the multivariable analyses, a higher level of professional equity was predicted among family practitioners (FPs) paid by APP and blended schemes in comparison to those paid by FFS. Additionally, the payment method was a predictor of daily distress when adjusted by other factors. Lower levels of distress were found among physicians who had more than 75% of patients with complex conditions and were paid by APP compared to those paid by FFS and blended methods. The MANOVA identified that female physicians had poorer wellness indicators than male practitioners. Multiple comparisons identified higher levels of equity among male physicians paid by APP than those with FFS, although this benefit was not observed among female ones. In conclusion, physicians paid by APP perceived higher professional equity (fair economic rewards and appropriate recognition) in comparison to those paid by FFS. Particularly, FPs paid by APP perceived higher professional equity than those FPs paid by FFS. Additionally, the payment method was identified as an associated factor with distress; lower levels of daily distress were predicted among physicians paid by APP who see high proportions of patients with complex conditions. Notwithstanding, female physicians had poorer wellness indicators and the impact of APP on professional equity was only distinguished among males. A potential unequal impact of APP must be recognized between female and male physicians.
7

Einfluß von Propranolol auf den Fastenstoffwechsel des Schafes

Ottilie, Henry 03 June 2001 (has links)
Die therapeutische Beeinflußbarkeit einer Leberverfettung gilt weltweit als unbefriedigend ge-löst, so daß ein letaler Ausgang besonders bei Wiederkäuern teilweise nicht zu verhindern ist. Die Nutzung von beta-Rezeptorenblockern hat bisher mit dieser Indikation keinen Eingang in die Veterinärmedizin gefunden. In den vorliegenden Untersuchungen wurden deshalb die Auswirkungen einer unspezifischen Blockade der beta-adrenergen Rezeptoren auf die Lipolyse, die klinischen und hämatologi-schen Funktionen sowie Leber-, Eiweiß- und Mineralstoffwechsel bei fastenden Schafen ge-prüft. Insbesondere wurde dabei die Wirkung einer Propranololapplikation auf die Lipolyse in der frühen Phase des Fastens untersucht. Zu diesem Zweck wurden insgesamt 15 weiblichen, klinisch gesunden, güsten Schafen der Rasse Merino-Fleisch während eines dreitägigen Futterentzuges mit Hilfe einer Dauertropfinfu-sion mit zwei 8stündigen Pausen 0,5 bzw. 1 mg Propranolol/kg KM/d bzw. den Tieren der Kontrollgruppe ein vergleichbares Volumen einer NaCl-Lösung appliziert. Neben der klini-schen Kontrolle von Puls- und Atemfrequenz, Körpertemperatur und Pansenaktivität erfolgte über die wiederholte Gewinnung von Blutproben aus der Vena jugularis externa eine Erfassung der Konzentrationen von Glucose, FFS, Bilirubin, BHB, K, Na, Mg, Gesamteiweiß und Albu-min im Blutserum. Zur Kontrolle der Leberfunktion wurden die Aktivitäten der GLDH und ASAT bestimmt. Die Wirkung des beta-Rezeptor-Antagonisten Propranolol auf die hämatolo-gischen Parameter wurde durch die Kontrolle der Leukozyten-, Erythrozyten- und Hämoglo-binkonzentrationen und den Hämatokrit der Schafe im Versuchsverlauf überprüft. In Übereinstimmung mit bisherigen Untersuchungen an Wiederkäuern und Nichtwiederkäuern kam es aufgrund der dreitägigen Futterdeprivation in allen Tiergruppen zu einer signifikanten Verminderung des Körpergewichtes um bis zu 9,8 %. Die Zahl der Pansenbewegungen redu-zierte sich bei allen Tieren signifikant bereits innerhalb der ersten 48 Stunden der Futterdepri-vation. Der stärkste Abfall der Pansenaktivität ließ sich bei den Schafen, denen 1 mg Propra-nolol/kg KM/d infundiert wurde, nachweisen. Puls- und Atemfrequenz, die Konzentrationen von Na, K, Mg, Gesamteiweiß und Albumin sowie die Aktivitäten von GLDH und ASAT im Blutserum blieben im Versuchsverlauf ohne signifikante Veränderungen. Eine Beeinflussung der hämatologischen Parameter ließ sich we-der bei den Schafen der Kontrollgruppe noch bei denen der Versuchsgruppen nachweisen. Während der Futterentzug in allen Tiergruppen zu einer tendenziellen Abnahme der Blut-serumkonzentration an Glucose führte, stiegen die Konzentrationen an FFS, Bilirubin und BHB im Blutserum aller Tiere an. Damit weisen die Veränderungen in den Konzentrationen von FFS, BHB und Bilirubin im Blutserum der Schafe der Kontrollgruppe die typischen Merkmale einer Fastenstoffwechsellage auf. In beiden Versuchsgruppen fielen diese Konzen-trationserhöhungen gegenüber denen der Kontrollgruppe statistisch gesichert niedriger aus. Unter Berücksichtigung der dabei erreichten Niveaus ließ sich für die Versuchsgruppen eine geringere Belastung von Energie- und Leberstoffwechsel als in der Kontrollgruppe feststellen. Der Übergang von der ersten in die zweite Phase des Fastenstoffwechsels ist in allen Tiergrup-pen, besonders deutlich in beiden Versuchsgruppen, zum Zeitpunkt um 48 h nach Versuchsbe-ginn an der Erhöhung der Körpertemperatur sowie den stärkeren Anstiegen der FFS-Konzentrationen erkennbar. Die besondere klinische und labordiagnostische Bedeutung der Änderungen der FFS-Konzentration im Blutserum zeigte sich in der zeitlich früheren und ausgeprägteren Reaktion als die Konzentrationsänderungen von Bilirubin und BHB. Bereits nach 24stündigem Fasten waren in allen Schafgruppen signifikant gegenüber den Ausgangswerten erhöhte FFS-Konzentrationen nachweisbar. In beiden Versuchsgruppen war bis zum Erreichen der Maxi-malwerte 48 h nach Beginn des Fastens ein geringerer Anstieg der FFS-Konzentration im Blut-serum als in der Kontrollgruppe nachzuweisen. Nach dem Erreichen der Maximalkonzentration kam es unter dem Propranololeinfluß in beiden Versuchsgruppen zu einem raschen, signifi-kantem Abfall der FFS-Konzentration um 44,7 bzw. 63,5 %. Die Abnahme der FFS-Konzentration im Blutserum vom Maximalwert bis zum Versuchsende betrug in der Kontroll-gruppe lediglich 8,6 %. und lag damit signifikant unter den Vergleichswerten der Versuchstie-re. Für die Konzentration der FFS fanden sich zum Versuchsende zwischen allen Gruppen si-gnifikante Unterschiede. Damit läßt sich eine dosisabhängige Wirkung einer Propranololappli-kation auf die Freisetzung von FFS aus den körpereigenen Fettdepots ableiten. Als Besonderheit war zu beobachten, daß sich die Konzentration der FFS in der Kontrollgrup-pe in den Zeiträumen der Infusion der NaCl-Lösung vermindert. Möglicherweise spielt hierbei der säuernde Einfluß des NaCl auf den pH-Wert im Blut eine Rolle. Unter dem Einfluß einer pH-Verminderung kommt es dabei zu einer Absenkung der Lipolyserate. Der zwischen den Infusionszeiten starke Konzentrationsanstieg der FFS in der Kontrollgruppe führt in dieser zu signifikant höheren FFS-Konzentrationen als in den Versuchsgruppen. Die Konzentrationsänderungen von direkt reagierendem und Gesamtbilirubin fielen bei den Schafen der Kontrollgruppe höher aus als bei den Tieren der Versuchsgruppen. Während die Maximalkonzentrationen für das Gesamtbilirubin in den Versuchsgruppen mit Dosierungen von 0,5 bzw. 1 mg Propranolol/kg KM/d 48 h nach Versuchsbeginn erreicht werden, ließen sich die maximalen Gesamtbilirubinkonzentrationen in der Kontrollgruppe erst 56 h nach Versuchsbe-ginn nachweisen. Die dabei vorhandenen Konzentrationsunterschiede zwischen den einzelnen Gruppen weisen auf eine geringere Belastung der Leber bei den Schafen der Versuchsgruppen hin. Auch die BHB-Konzentrationen im Blutserum der Schafe der Versuchsgruppen lagen zum Versuchsende unter denen der Tiere in der Kontrollgruppe. Damit liegt ein weiterer Indikator auf eine geringere Leberbelastung der Tiere in den Versuchsgruppen gegenüber den Schafen der Kontrollgruppe vor. Die absolut niedrigsten BHB-Konzentrationen waren bei den Schafen der Versuchsgruppe mit einer Propranololgabe von 1 mg/kg KM/d nachweisbar. In dieser Gruppe wurde die maximale BHB-Konzentration 32 h nach Fastenbeginn erreicht. Die vorliegenden Ergebnisse zeigen, daß sich mit Propranololgaben in Höhe von 0,5 bzw. 1 mg/kg KM/d beim Schaf eine Hemmung der Lipolyse innerhalb der ersten 64 Stunden eines Futterentzuges erreichen läßt, ohne dabei nachweisbaren Einfluß auf hämatologische Parameter auszuüben. Insbesondere weisen die zwischen Versuchs- und Kontrollgruppe vergleichbaren Anstiege der FFS-Konzentrationen in den infusionsfreien Zeiträumen auf den Einfluß des beta-adrenergen Antagonisten auf die Lipolyse während der Infusion hin. Die Konzentrationsände-rungen von Bilirubin und BHB in den Versuchsgruppen erfolgen in deutlich geringerem Um-fang als in der Kontrollgruppe. Damit läst sich auf eine geringere Belastung von Energie- und Leberstoffwechsel bei den Versuchstieren schließen. Die nicht signifikanten Veränderungen der Enzymaktivitäten von GLDH und ASAT bestätigen, daß durch die Anwendung von Propra-nolol keine negative Beeinflussung der Leberfunktion erfolgt. Aufgrund der stärkeren Reduzie-rung der Zahl der Pansenbewegungen und des verminderten Konzentrationsanstieges von FFS im Blutserum der Schafe, denen 1 mg Propranolol/kg KM/d appliziert wurde, gegenüber denen die 0,5 mg Propranolol/kg KM/d erhielten, ist von einer Dosisabhängigkeit der Propranolol-wirkung auszugehen. Die Applikation von Propranolol in einer Dosis von 0,5 bzw. 1 mg/kg KM/d stellt beim Schaf eine geeignete Methode dar, frühzeitig eine Verminderung der fasten-induzierten Lipolyse zu erreichen. / The treatment of the fatty liver disease is world-wide regarded as unsatisfactory, so that death of the affected ruminants is partly unavoidable. The administration of beta receptor blockers in such cases has not found its way into veterinary medicine until now. In this study, the effects of a nonspecific blockade of the beta adrenoceptors on lipolysis, clinical and hematological parameters as well as on the metabolism of the liver, proteins and minerals in fasting sheep were therefore tested. Especially, the effect of a Propranolol administration on the lipolysis in the early stage of fasting was examined. During a three-day period of food deprivation, 15 female, clinically healthy and non-pregnant sheep (Merino-Fleisch) were given 0.5 or 1 mg Propranolol/kg body weight per day via a continuous infusion with two interruptions of eight hours. During the experiment, pulse, respiration rate, body temperature and rumen activity were checked. The serum concentrations of glucose, FFA, bilirubin, beta-hydroxybutyrate, potassium, sodium, magnesium, total protein and albumin were controlled by repeatedly taking blood samples from the vena jugularis externa. The activity of the enzymes GLDH and AST were determined to check the liver function. The effect of the beta-receptor antagonist Propranolol on the hematological parameters was checked by examining the WBC, RBC, the hemoglobin concentrations and the packed cell volume. All test groups showed significant decrease in body weigth of up to 9.8 %, due to the three-day food deprivation. Even within the first 48 hours of food deprivation, rumen motility of all animals was decreasing significantly. Those sheep which received 1 mg Propranolol/kg body weight per day showed the strongest decrease in rumen activity. Pulse and respiration rate, the concentrations of potassium, sodium, magnesium, total protein and albumin as well as the activity of GLDH and AST in blood serum remained without significant changes during the experiment. Neither the sheep of the control group nor those of the experimental groups showed any influence on the hematological parameters. While the blood glucose concentration tended to be lower during the food deprivation in all groups, the concentrations of FFA, bilirubin and beta-hydroxybutyrate in blood serum were increasing. Thus, the changes of FFA, bilirubin and beta-hydroxybutyrate concentrations in the control group showed the typical characteristics of fasting metabolism. These absolute increases in concentrations were significantly lower in both experimental groups than those in the control group. With regard to the levels reached and compared to the control group, a smaller load of energy and liver metabolism could be determined in the experimental groups. The transition from the first to the second stage of the fasting metabolism in all groups (but especially in the experimental groups) was clearly discernible in the rises of body temperature and in the stronger increases of the FFA concentrations approximately 48 hours after the experiment started. The special clinical and diagnostic importance of the FFA concentration was indicated in an earlier and stronger change of the FFA concentration in the blood serum, compared to the changes of bilirubin and beta-hydroxybutyrate. As early as 24 hours after the beginning of the fasting, a significant rise of the FFA concentration in comparison to the initial concentration could be proved. In contrast to the control group the two experimental groups showed a smaller increase in the FFA concentration. All groups reached their maxima of FFA concentration 48 hours after the beginning of the experiment. Afterwards FFA concentrations in the two experimental groups were sinking fast and significantly by 44.7 % and 63.5 % respectively. In the control group, the decrease of the FFA concentration from the maximum until the end of the experiment was only 8.6 % and thus significantly lower than the comparative results. At the end of the experiment, significant differences in FFA concentrations between all groups could be proved. So, it can be assumed that there is a dose-dependent effect of Propranolol on the FFA release from the bodyŽs own fat depots. The FFA concentration in the control group was decreasing during the NaCl-infusion. This could be due to NaClŽs influence on the pH value of the blood. The reduction of the pH causes a decreasing rate of the lipolysis. The strong rise of FFA concentration between the infusion in the control group, lead to significantly higher results compared to the experimental groups. The changes of total and direct reacting bilirubin in the control group were higher than in the experimental groups. While maximum concentrations of total bilirubin acid in the experimental groups (which got 0.5 and 1 mg Propranolol/kg body weigth per day respectively) could be determined 48 hours after the experimentŽs start, maximum concentrations in the control group could be found only 56 hours after beginning of the fasting. Beta-hydroxybutyrate concentrations in the experimental groups were also lower than in the control group. These differences between the groups indicate a smaller strain of the liver in the experimental groups. The lowest beta-hydroxybutyrate concentrations could be proved in the experimental group with a dose of 1 mg Propranolol/kg body weight per day. In this group, the maximum beta-hydroxybutyrate concentration was reached 32 hours after the beginning of the fasting. These results suggest that by the administration of Propranolol at doses of 0.5 mg and 1 mg/kg body weigth per day respectively it is possible to inhibit the lipolysis within the first 64 hours after a food deprivation without effecting the hematological parameters. Particularly, the comparable increases in FFA concentrations in the experimental and control groups between the infusions indicate a direct effect of the beta-adrenergic antagonist on the lipolysis during the infusions. The changes of bilirubin and beta-hydroxybutyrate concentrations in the experimental groups were smaller than those in the control group. This suggests a smaller strain on the energy and liver metabolism in the experimental groups compared to the control group. The nonsignificant changes of the activity of GLDH and AST indicate no negative influence on the liver function after applicating Propranolol. The stronger reduction of rumen motility and the smaller increase of the FFA concentration in the group with 1 mg Propranolol/kg body weigth per day compared to the group with 0.5 mg Propranolol/kg body weigth per day shows the dose-dependent effect of Propranolol. The application of Propranolol at a dose of 0.5 mg or 1 mg/kg body weigth per day is a suitable method to early inhibit fasting-induced lipolysis in sheep.
8

RISK OF QT INTERVAL PROLONGATION, VENTRICULAR TACHYCARDIA AND SUDDEN CARDIAC ARREST ASSOCIATED WITH QT INTERVAL PROLONGING DRUGS IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION

Chien-Yu Huang (13162095) 27 July 2022 (has links)
<p>  </p> <p><strong>Background: </strong></p> <p>Torsades de pointes (TdP) is a polymorphic ventricular tachycardia (VT) associated with heart rate-corrected QT interval (QTc) prolongation on the electrocardiogram (ECG). TdP can cause sudden cardiac arrest (SCA), a catastrophic outcome. The antiarrhythmic drugs dofetilide and sotalol can cause QTc prolongation and arrhythmias, as can more than 200 other medications available on global markets. Heart failure (HF) with reduced ejection fraction (HFrEF) is a risk factor for drug-induced TdP, and HFrEF heightens sensitivity to drug-induced QTc lengthening. However, ~55% of patients with HF have preserved, rather than reduced, ejection fraction. It remains unknown whether patients with HF with preserved ejection fraction (HFpEF) are at increased risk for drug-induced VT/SCA. Assessment of the risk of drug-induced VT/SCA in HFpEF patients is important, so that recommendations can be made regarding the safety of QTc-prolonging drugs and need for enhanced ECG monitoring in this population. </p> <p><strong>Objective:</strong></p> <p>In aim 1, we sought to determine the risk of VT and SCA associated with dofetilide and sotalol in patients with HFpEF. In aim 2, we were able to use QTc interval to determine the odds of dofetilide/sotalol-associated QT interval prolongation in patients with HFpEF. In Aim 3, we investigated the influence of HFpEF on VT and SCA associated with a broader group of drugs known to cause TdP (“known “TdP drugs”), as designated by the QT drugs list at www.crediblemeds.org. </p> <p><strong>Methods:</strong></p> <p>In aim 1, we used Medicare claims (2014-2016) and ICD-9/10 codes to identify patients taking the QT interval-prolonging drugs dofetilide or sotalol, which are used commonly in patients with HF and atrial fibrillation, as well as non-dofetilide or sotalol users among 3 groups: HFpEF, HFrEF, and no HF. Multinomial propensity score-matching was performed. Cochran–Mantel–Haenszel statistics and standardized differences were used to compare baseline characteristics. A generalized Cox proportional hazards model was used to estimate hazard ratios (HRs) and test the association of VT and SCA among dofetilide/sotalol users, HFpEF, HFrEF, and no HF.</p> <p>In Aim 2, the data source was electronic health records from the Indiana Network for Patient Care (February 2010 to May 2021). After removing patients with overlapping diagnoses of HFpEF and HFrEF, no diagnosis code, absence of QT interval records, and no validated record of using dofetilide or sotalol, we identified patients taking dofetilide or sotalol among three groups: HFrEF, HFpEF, and no HF. Cochran–Mantel–Haenszel statistics were used to compare baseline characteristics. QT interval prolongation was defined as heart rate-corrected QT (QTc) > 500 ms during dofetilide/sotalol therapy. Unadjusted odds ratios (OR) of QT interval prolongation were determined by univariate analysis, and adjusted ORs were determined by generalized estimating equations (GEE) with logit link to account for an individual cluster with different times of hospitalization and covariates.</p> <p>In aim 3, we used Medicare enrollment in fee-for-service medical and pharmacy benefits (2014 to 2016) and ICD-9/10 codes, we identified patients taking drugs known to cause torsades de pointes (TdP drugs; www.crediblemeds.org) and non-TdP drug users among three groups: HFrEF, HFpEF, and no HF. Multinomial propensity score-matching was performed to minimize baseline differences in covariates (patient demographics, comorbidities, health care utilization and drug history). Cochran–Mantel–Haenszel statistics and standardized differences were used to compare baseline characteristics. A generalized Cox proportional hazards model was used to estimate HRs and test the association of VT and SCA among TdP drug users with HFpEF, HFrEF, and no HF.</p> <p><strong>Results:</strong></p> <p>In Aim 1, VT and SCA occurred in 166 (10.68%) and 16 (1.03%), respectively, of 1,554 dofetilide/sotalol users with HFpEF, 543 (38.76%) and 40 (2.86%) of 1,401 dofetilide/sotalol users with HFrEF, and 245 (5.06%) and 13 (0.27%) of 4,839 dofetilide/sotalol users with no HF. The adjusted HR for VT in patients with HFrEF was 7.00 (95% CI 6.12-8.02) and in patients with HFpEF was 1.99 (1.71-2.32). The risk of VT associated with dofetilide/sotalol was increased across the overall study population (HR: 2.47 [1.89-3.23]). Use of dofetilide/sotalol increased the risk of VT in patients with HFrEF (HR: 1.53 [1.07-2.20]) and in those with HFpEF (HR: 2.34 [1.11-4.95]). However, while the overall risk of SCA was increased in patients with HFrEF (HR: 5.19 [4.10-6.57]) and HFpEF (HR: 2.53 [1.98-3.23]) compared to patients with no HF, dofetilide/sotalol use was not significantly associated with an increased risk of SCA.</p> <p>In Aim 2, QTc prolongation associated with dofetilide/sotalol occurred in 51.2% of patients with HFpEF, 70.1% of patients with HFrEF, and 29.4% of patients with no HF. After adjusting for age, sex, race, serum potassium and magnesium concentrations, kidney function, concomitant drug therapy, and comorbid conditions, the adjusted odds of having QTc interval larger than 500ms during the hospital stay were 5.23 [3.15-8.67] for HFrEF and 1.98 [1.17-3.33] for HFpEF with no HF as the reference group. </p> <p>In Aim 3, of 23,910 known TdP drug users with HFrEF, VT and SCA occurred in 4,263 (17.8%) and 493 (2.1%) patients, respectively. In comparison, among 31,359 known TdP drug users with HFpEF, VT and SCA occurred in 1,570 (5.0%) and 340 (1.1%) patients. VT and SCA occurred in 3,154 (0.8%) and 528 (0.1%) of 384,824 known TdP drug users without HF. The overall HR of both VT and SCA was increased in patients with HFrEF (HR: 7.18 [6.13-8.40])  and in those with HFpEF (HR: 2.09 [1.80-2.42]). The risk of VT associated with known TdP drugs was increased across the overall population (HR: 1.34 [1.20-1.51]). Use of known TdP drugs significantly increased the risk of VT and SCA in patients with HFrEF (HR: 1.34 [1.07-1.67]), but not in patients with HFpEF.</p> <p><strong>Conclusion:</strong></p> <p>HFpEF may exhibit an enhanced response to drug-associated VT, and is associated with a higher risk of drug-associated QTc interval prolongation. Further study is needed to identify methods to minimize this risk for patients with HFpEF requiring therapy with dofetilide, sotalol, or drugs known to cause TdP. </p>
9

A study of charge symmetry violation in fragmentation functions extracted from semi-inclusive electroproduction of charged pions from protons and deuterons

Bhatt, Hem Datt 10 May 2024 (has links) (PDF)
We have measured the flavor dependence of multiplicities for $\\pi^+$ and $\\pi^-$ production in semi-inclusive deep-inelastic scattering (SIDIS) on proton and deuteron targets. We used a 10.6 GeV electron beam at Jefferson Lab, and 4 msr solid angle spectrometers (HMS for electrons, SHMS for pions), the lepton vertex spanned the kinematic range $0.3 < x < 0.6$, $2 < Q^2 < 5$ GeV$^2$, and $4 < W^2 < 11$ GeV$^2$. The pion fractional momentum range was $0.3 < z < 0.7$ and the small transverse momentum range was $0 < P_t < .25$ GeV. We used the multiplicities to form sum-and-difference ratios, testing the validity of factorization. We extracted two favored and two unfavored $W$ dependent fragmentation functions (FFs) from these multiplicities. Assuming factorization at low $P_t$, we find that the two ``favored" FFs allow for isospin breaking (charge symmetry violation) at low $W$, while converging to a common value at the highest $W$ of this experiment. The two unfavored FFs are consistent with each other within the experimental uncertainties.
10

Dynamique des faisceaux dans la section finale de focalisation du futur collisionneur linéaire / Beam dynamics in the final focus section of the future linear collider

Blanco, Oscar 03 July 2015 (has links)
L’exploration d’une nouvelle physique à l’échelle d’énergie des « Tera electron Volt » (TeV) nécessite de collisionner des leptons dans de grands accélérateurs linéaires à grande luminosité. Ces collisionneurs linéaires requiert une taille de faisceau à l’echelle nanométrique au Point d’Interaction (IP).Parmi les multiples effets participant à la degradation de la luminosité, la correction de la chromaticité, l’effet du rayonnement synchrotronique et la correction des erreurs dans la ligne sont parmi les trois effets à maîtriser afin de réduire la taille du faisceau dans la Section Finale de Focalisation (FFS).Cette these propose un nouveau schéma de correction de la chromaticitè que l’on appelera “non-entrelacé”, appliqué ici au projet CLIC. Lors de l’implementation de cette nouvelle methode, il a été mis en evidence que le probléme principal est la dispersion de deuxième ordre au Doublet Final (FD), qui traverse un sextupole utilisé pour annuler les composantes géometriques restantes.L’effet du rayonnement peut être evalué par méthode de tracking des particules ou par des approximations analytiques. Afin d’inclure ces effets du rayonnement et les paramétres optiques de la ligne pendant la conception et le processus d’optimisation, l’effet Oide et le rayonnement dû aux aimants dipolaires ont été etudiés.Le résultat analytique du rayonnement synchrotronique dans les aimants dipolaires fut generalisé dans les cas avec alpha et dispersion non-nulles à l’IP. Cette généralisation est utilisée pour améliorer le code de simulation PLACET.Le rayonnement dans les aimants quadripolaires finaux imposent une limite à la taille verticale minimale du faiceau, connu comme l’effet Oide. Celui-ci est uniquement important à 3 TeV, donc deux possibilités sont explorées pour atténuer sa contribution dans la taille du faisceau : doubler la longueur et réduire le gradient du dernièr quadripole (QD0), ou integrer une paire d’aimants octupolaires, un en amont et un en aval du QD0.Une partie des exigences du FFS pour les nouveaux collisionneurs linéaire à leptons est testée expérimentalement dans l’« Accelerator Test Facility » (ATF). La réduction de la taille du faisceau d’électrons en utilisant le schéma local de correction de la chromaticité est explorée dans une extension de la ligne originale, appellé ATF2, oú deux buts furent fixés : atteindre 37 nm de taille verticale du faisceau à l’IP, et stabiliser de l’ordre du nanomètre la position verticale du faisceau à l’IP. Depuis 2014, une taille de 44 nm avec un nombre de particules d’environ 0.1 × 10^10 par paquet est atteint de manière regulière.Des cavités radio-frequence seront utilisées pour la stabilisation du faisceau, et également pour détecter le déplacement/les fluctuations du faisceau au dehors la marge tolerable pour le systéme de mesure, ainsi que des erreurs non detectées dans l’optique.Un set de trois cavités furent installées et sont utilisées pour mesurer la trajectoire du faiceau dans la région de l’IP, fournissant ainsi des informations pour reconstruire la position et l’angle à l’IP. Les specifications pour l’optique nominale d’ATF2, i.e. 1 nm de résolution sur 10 μm de gamme dynamique à un nombre de particules de 1.0 × 10^10 par paquet, n’ont pas encore été atteint.La meilleur résolution atteinte jusqu’ici correspond à 50 nm pour 0.4 × 10^10 particules par paquet, où le bruit de l’éléctronique impose une limite de 10 nm par cavité sur la résolution. La gamme dynamique est de 10 μm à 0.4 × 10^10 particules par paquet et 10 dB d’attenuation du signal des cavités, nécéssitant de mettre l’électronique à niveau. Le test du système d’asservissement pour stabiliser le faisceau a atteint une réduction de la fluctuation jusqu’a 67 nm, compatible avec la résolution des cavités. / The exploration of new physics in the “Tera electron-Volt” (TeV) scale with precision measurements requires lepton colliders providing high luminosities to obtain enough statistics for the particle interaction analysis. In order to achieve design luminosity values, linear colliders feature nanometer beam spot sizes at the Interaction Point (IP).Three main issues to achieve the beam size demagnification in the Final Focus Section (FFS) of the accelerator are the chromaticity correction, the synchrotron radiation effects and the correction of the lattice errors.This thesis considers two aspects for linear colliders: push the limits of linear colliders design, in particular the chromaticity correction and the radiation effects at 3 TeV, and the instrumentation and experimental work on beam stabilization in a test facility.A new chromaticity correction scheme, called non-interleaved, is proposed to the local and non-local chromaticity corrections for CLIC. This lattice is designed and diagnosed, where the main issue in the current state of lattice design is the non-zero second order dispersion in the Final Doublet (FD) region where a strong sextupole is used to correct the remaining geometrical components.The radiation effect can be evaluated by tracking particles through the lattice or by analytical approximations during the design stage of the lattices. In order to include both, radiation and optic parameters, during the design optimization process, two particular radiation phenomena are reviewed: the Oide effect and the radiation caused by bending magnets .The analytical result of the radiation in bending magnets in was generalized to the case with non-zero alpha and non-zero dispersion at the IP, required during the design and luminosity optimization process. The closed solution for one dipole and one dipole with a drift is compared with the tracking code PLACET, resulting in the improvement of the tracking code results.The Oide effect sets a limit on the vertical beamsize due to the radiation in the final quadrupole. Only for CLIC 3 TeV this limit is significant, therefore two possibilities are explored to mitigate its contribution to beam size: double the length and reduce the QD0 gradient, or the integration of a pair of octupoles before and after QD0.Part of the requirements of the FFS for new linear accelerators are tested in The Accelerator Test Facility (ATF). The beam size reduction using the local chromaticity correction is explored by an extension of the original design, called ATF2 with two goals: achieve 37 nm of vertical beam size at the IP, and the stabilization of the IP beam position at the level of few nanometres. Since 2014 beam size of 44 nm are achieved as a regular basis at charges of about 0.1 × 10^10 particules per bunch.A set of three cavities (IPA, IPB and IPC), two upstream and one downstream of the nominal IP and on top of separate blocks of piezo-electric movers, were installed and are used to measure the beam trajectory in the IP region, thus providing enough information to reconstruct the bunch position and angle at the IP. These will be used to for beam stabilization and could detect beam drift/jitter beyond the tolerable margin and undetected optics mismatch affecting the beam size measurements. The specifications required of 1 nm resolution over 10 μm dynamic range at 1.0 × 10 10 particules per bunch with the ATF2 nominal optics have not been yet achieved.The minimum resolution achieved is just below 50 nm at 0.4 × 10^10 particules per bunch with a set of electronics impossing a noise limit on resolution of 10 nm per cavity. The dynamic range is 10 μm at 10 dB attenuation and 0.4 × 10^10 particules per bunch, indicating the need to upgrade theelectronics. The integration to the ATF tuning instruments is ongoing. Nonetheless, feedback has been tested resulting in reduction of beam jitterdown to 67 nm, compatible with resolution.

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