The schedule of growth, reproduction and survivorship of an individual are the key components of life history, which reflect fitness performance of a genotype. Examining the variation in life history performance among genotypes provides an avenue for which genotypic fitness differences can be compared. The parthenogenetic freshwater zooplankton, Daphnia pulicaria, is a model organism to investigate and disentangle the genotypic from the phenotypic influences of life history variation. While Daphnia spp. life history has been extensively studied, few have examined the effect of low food concentrations on life history traits. Since Daphnia spp. are frequently subjected to periods food limitation caused by natural phytoplankton cycles, it is necessary to understand how individuals respond in low food environments in order to obtain an accurate representation of life history responses among genotypes. In this study, I conducted a set of highly controlled laboratory experiments using multiple genotypes of Daphnia pulicaria under a range of food-limited conditions in order to gain insight into the environmental and genotypic responses of life history traits. I measured a suite of life history traits, growth, reproduction and survivorship, as discrete elements for each individual and synthesized these traits into a representation of the life history schedule. This provided an accurate method to compare genotypes and allowed for identification of trade-offs between life history traits. My results indicate a significant effect of low food concentration on life history traits, causing a decrease in performance of all traits. Additionally, genotypic differences occurred in most traits, however these differences only manifested within the intermediate food levels. There were no genotypic differences in daily reproductive rate, indicating that genotypes only differ in the number of individuals reproducing within an environment. Allocation-based trade-offs among these life history traits were examined within a genotype, however the only trade-off identified was between reproduction and survivorship and this only manifested at low food levels. Even though these genotypes do not co-exist in the same lakes, similar patterns occurred in trade-offs among genotypes. This potentially indicates that trade-offs among genotypes occur due to the same physiological mechanisms witnessed at the individual level. / Thesis (Master, Biology) -- Queen's University, 2011-08-14 11:32:27.808

No description available.

Verbal memory (VM) has been shown to be impacted in brain tumor (BT) survivors, but the nature of VM problems and underlying neuropathology are poorly understood and a long-term outlook is lacking. Our study examined hippocampus volume (HV) and VM in adult survivors of pediatric BT (n=32) and controls (n=48). Results indicate that disruption to a maturing brain in childhood is detectable 17 years (mean) after diagnosis, as HV is significantly lower in survivors compared to controls. Analysis of the VM scores shows that survivors have significantly lower overall immediate recall compared to controls, but learning slope, retention, and recognition are not different across the groups. Survivors’ memory profile indicates that auditory attention and retrieval difficulties could be contributing to their lower immediate recall. For survivors, HV is significantly correlated with delayed free recall but not with other VM indices. Implications of these findings are discussed.

Breast cancer incidence in Chinese women is rising in North America. However, a critical review of the empirical research reveals a clear under-representation of the breast cancer survivorship experiences of ethnic minority women, particularly those of Chinese origin. A breast cancer diagnosis not only disrupts a woman’s everyday life but also, and more importantly, her self-identity: who she was before the cancer diagnosis and who she becomes after the diagnosis. The purpose of this study was to understand the lived survivorship experience of Chinese women with breast cancer, in particular the way they reconstruct their self-identity while living under the constant threat of premature mortality. A hermeneutic phenomenology was employed to illuminate the essence of the lived experience. A purposeful sample of 24 Chinese women was recruited, and audiotaped face-to-face semi-structured interviews were conducted in English or Mandarin. An iterative process was carried out to identify themes and interwoven them into the four existentials of lifeworld to lend structural meaning to the lived experience. The self-identity of Chinese women living with breast cancer did not fit the current combative survivor identity and narrative as represented in the North America media. Rather, a ‘quiet’, modest and practical narrative underscoring the Chinese virtues of self-reliance, endurance, and social responsibility and harmony characterized their lived experience and self-identity. They endured unexpected major life events and accepted what life offers in an effort to move on with their lives of being a normal person again. An understanding of the way Chinese women manage the impact of breast cancer and their survivorship experience will significantly contribute to building our knowledge about this minority population within the Canadian context. In turn, this understanding will support health care professionals with the development of culturally sensitive psychosocial/supportive care services to maximize adaptation and recovery.

Integrating cultural weed management practices with herbicides is an important strategy to reduce wild oat (Avena fatua L.) populations in Alberta, Canada. The purpose of this thesis is to expand the knowledge on wild oat seed banks and seedling emergence within integrated weed management systems. Field experiments were conducted from 2006-2007 to examine the impact of crop rotation, barley cultivar, barley seeding rate and herbicide rate on wild oat seed bank density, seed mortality, seedling emergence and seedling survivorship. Management systems consisting of diverse crop rotations, tall barley cultivars and increased barley seeding rates reduced wild oat seed bank density, seedling emergence and seedling survivorship, especially at low herbicide rates. Wild oat seed banks predicted subsequent wild oat emergence, whereas biomass and emergence strongly predicted seed banks. Lastly, 50% wild oat emergence was achieved at 537 and 509 growing degree days in 2006 and 2007, respectively, in Lacombe, Alberta. / Plant Science

This thesis consists of four essays on the topic of asset management. The first essay, Performance and Characteristics of Swedish Mutual Funds studies the relation between fund performance and fund attributes in the Swedish market. The results show, among other things, that good performance is to be found among small equity funds, low-fee funds, funds whose trading activity is high, and in some cases, funds with good past performance. The second essay, Does Active Trading Create Value? An Evaluation of Fund Managers' Decisions decomposes fund performance and examines how it is influenced by fund managers' strategic and tactical decisions. The results support the value of active portfolio management in Sweden. The essay also finds a positive relation between performance and fund managers' voluntary trading decisions. In contrast, there is some evidence of inferior trading decisions when fund managers are forced to trade. The third essay, Investment Strategies, Fund Performance, and Portfolio Characteristics analyzes the relation between fund performance and fund managers' investment strategies. The results show that neither momentum characteristics nor the valuation of stocks in the fund portfolio can explain differences in fund performance. The findings also show a positive relation between performance and the degree of diversification of the fund portfolio. The last essay, Costly Information, Diversification, and International Mutual Fund Performance examines how fund managers' costly search for information affects the performance of mutual funds that invest in Asia and Europe. The essay shows that fund managers who select from a smaller set of Asian stocks perform better than those who select from a larger set. Moreover, the performance of large international mutual fund companies is similar to that of their small competitors. This suggests that there are no economies of scale in the costly search for information. / Diss. Stockholm : Handelshögskolan, 2001

Background: With advances in medical treatments, the numbers of cancer survivors have grown considerably over recent years. Following completion of cancer treatment, patients can experience a range of physical and psychological difficulties, particularly around critical transition phases such as adjustment to survivorship. One of the most common difficulties cited by cancer survivors is that of fear of cancer recurrence (FOR). Existing treatments for improving psychological wellbeing in this population appear to offer limited efficacy, and there are very few interventions directly targeting FOR. Acceptance-based approaches, with an underlying aim of improving psychological flexibility, offer one novel alternative approach to addressing these difficulties. Methods: This thesis presents a systematic review and meta-analysis of the literature in relation to the effectiveness of acceptance-based interventions for post treatment cancer survivors, with a particular focus on Mindfulness-Based Interventions (MBI). A cross sectional questionnaire study is then reported which explores the potential role of psychological flexibility in mediating the relationship between FOR and distress and quality of life (QoL)outcomes. Results: The findings of the review offer tentative support for the effectiveness of MBI in reducing stress and depressive symptoms, while less convincing results emerged for anxiety. Results from the empirical study suggest that while psychological flexibility does not appear to significantly mediate the impact of FOR on distress and QoL, value based living and cognitive fusion did emerge as significant mediating variables within these relationships. Conclusions: Findings suggest that acceptance-based approaches, may be of benefit in reducing the burden of distress and improving the lives of cancer survivors. Supporting cancer survivors to become less entangled with their thoughts and live in accordance with their values may be particularly beneficial. Further studies using larger samples and longitudinal designs are warranted.

INTRODUÇÃO: Delirium é um problema médico frequente em idosos e está potencialmente associado a desfechos desfavoráveis, como prolongamento da hospitalização, declínio funcional e cognitivo, e maior mortalidade. Contudo, considerando que, geralmente, ocorre em situações de grande complexidade clínica, o efeito ajustado de delirium e seus subtipos motores sobre o prognóstico de pacientes acometidos ainda não foi suficientemente explorado. OBJETIVOS: Investigar em idosos agudamente enfermos hospitalizados: (1) a associação independente entre ocorrência de delirium e tempo para óbito intra-hospitalar, e em 12 meses de seguimento; (2) a associação independente entre subtipos motores de delirium e tempo para óbito intra-hospitalar, e em 12 meses de seguimento. MÉTODOS: Estudo de coorte prospectivo realizado em uma enfermaria de geriatria de um hospital universitário terciário, em São Paulo, Brasil. Foram incluídas internações de pacientes agudamente enfermos, com idade igual ou superior a 60 anos, hospitalizados entre junho de 2009 e maio de 2014. Delirium foi detectado pelo Confusion Assessment Method e classificado de acordo com o subtipo motor em hipoativo, hiperativo, ou misto. Os desfechos primários foram tempo para óbito intra-hospitalar, e tempo para óbito em 12 meses (para a amostra que recebeu alta). Os pacientes foram avaliados na admissão seguindo modelo de avaliação geriátrica ampla que incluiu variáveis sociodemográficas, clínicas, funcionais, cognitivas, e laboratoriais. Informações adicionais sobre a hospitalização foram registradas na alta ou no óbito. As análises multivariadas foram realizadas por meio de modelos de riscos proporcionais de Cox. Foi examinada a presença de modificação do efeito de delirium sobre os desfechos por análises de interação com outros fatores clínicos. RESULTADOS: Incluímos 1.034 hospitalizações, com uma média de idade de 80 anos. Na amostra geral, 61% eram mulheres, e 35% tinham demência. A mortalidade intra-hospitalar foi de 22%, com uma mortalidade cumulativa de 44% em 12 meses. Delirium ocorreu em 52% das internações, e o subtipo motor predominante foi o hipoativo (53%). Nas hospitalizações com delirium, 32% dos idosos faleceram no hospital, com uma taxa de óbitos cumulativa de 59% em 12 meses. Verificamos que delirium teve associação independente com tempo até óbito intra-hospitalar (HR=1,63 IC95%=1,11-2,40), porém não encontramos associação estatisticamente significante com sobrevida em 12 meses após ajuste para as covariáveis selecionadas. Constatamos, ainda, que os subtipos hipoativo e misto se associaram independentemente com o desfecho intra-hospitalar (HR=1,87 IC95%=1,24-2,83; HR=1,65 IC95%=1,022,67), mas não houve associação estatisticamente significante com o desfecho em 12 meses. O efeito de delirium sobre o tempo até óbito intrahospitalar não foi modificado de modo significativo por sua interação com idade, câncer, desnutrição, ou valores de albumina sérica. CONCLUSÕES: Um terço dos idosos agudamente enfermos internados que tiveram delirium faleceu ainda no hospital. Delirium se associou a menor tempo de sobrevida intra-hospitalar, mesmo após ajuste para características clínicas coexistentes. Além disso, profissionais da saúde devem ter especial atenção com os subtipos hipoativo e misto de delirium, que também se associaram independentemente com maior mortalidade intra-hospitalar em idosos / BACKGROUND: Delirium in older adults is common and potentially associated with unfavorable outcomes, such as longer hospital stay, functional and cognitive decline, and higher mortality. However, given that it usually occurs in a context of great clinical complexity, the adjusted effect of delirium and its motor subtypes on the prognosis of affected patients has not been sufficiently explored. OBJECTIVES: To investigate in acutely ill hospitalized older adults: (1) the independent association between delirium and time to death in the hospital, and in a 12-month follow-up; (2) the independent association between delirium motor subtype and time to death in the hospital, and in a 12-month follow-up. METHODS: Prospective cohort study completed in a geriatric ward of a tertiary university hospital, in Sao Paulo, Brazil. We included admissions of acutely ill patients aged 60 years and over, who were hospitalized from June 2009 to May 2014. Delirium was detected using the Confusion Assessment Method and classified according to its motor subtype in hypoactive, hyperactive, or mixed. Primary outcomes were time to death in the hospital, and time to death in 12 months (for the discharged sample). Patients were evaluated at admission according to a comprehensive geriatric assessment model that included socio-demographic, clinical, functional, cognitive, and laboratory variables. Further clinical data were documented upon death or discharge. Multivariate analyses were performed using Cox proportional hazards models. We investigated the potential modification of the effect of delirium on outcomes including an interaction term between delirium and other clinical variables. RESULTS: We included 1,034 hospitalizations, with a mean age of 80 years. Overall, 61% were women, and 35% had dementia. The proportion of in-hospital deaths was of 22%, with a cumulative mortality of 44% in 12 months. Delirium ensued in 52% of the admissions, and the predominant motor subtype was hypoactive (53%). In-hospital death occurred in 32% of the cases with delirium, while cumulative 12-month mortality reached 59% in this group. We verified that delirium was independently associated with time to in-hospital death (HR=1.63 95%CI=1.11-2.40), but did not find statistically significant association with 12month survival after adjusting for selected covariates. We additionally found that hypoactive and mixed motor subtypes were independently associated with in-hospital death (HR=1.87 95%CI=1.24-2.83; HR=1.65 95%CI=1.02-2.67), but there were no significant associations with 12-month mortality. The effect of delirium on time to in-hospital death was not significantly modified by its interaction with age, cancer, malnutrition, or serum albumin levels. CONCLUSIONS: One third of acutely ill hospitalized older adults who suffered delirium died in the hospital. Delirium was associated with decreased survival in the hospital, even after adjusting for coexistent clinical characteristics. In addition, health care providers should be attentive for the hypoactive and mixed subtypes of delirium, as they were also independently associated with poorer in-hospital outcomes in older adults

INTRODUÇÃO: Os linfomas B atualmente podem ser agrupados de acordo semelhanças moleculares e imunoistoquímicas com o linfócito do centro germinativo (CG) ou linfócito ativado (LA/pós CG), sendo este de pior prognóstico. O objetivo deste trabalho foi analisar a expressão de CD10, BCL-6 e MUM1 em pacientes portadores de LBPM e correlacionar com prognóstico. MÉTODOS: análise retrospectiva das variáveis clínicas e de tratamento de 44 pacientes portadores de LBPM. Estudo imunoistoquímico de CD10, BCL-6 e MUM1 em 29 pacientes com material disponível. RESULTADOS: idade mediana foi de 28 anos e 70% eram do sexo feminino. A positividade para CD10, BCL-6 e MUM1 foi de: 24%, 65% e 58%. De acordo com o modelo de Hans, 38% foi classificado como CG e 62% como pós CG. A sobrevida global em 5 anos e sobrevida livre de doença foi de 47% e 81%, respectivamente. Resposta Completa após quimioterapia de primeira linha (p=0,0001), radioterapia de mediastino (p=0,004) e IPI (0,039) tiveram associação com a sobrevida. A positividade para MUM1 esteve associado a pior sobrevida global (p=0,014). Aplicando o modelo de Hans não foi observada nenhuma associação com sobrevida. Na análise multivariada apenas Resposta (RR 4,28 (IC 95% 1,3-13,6) e MUM1 (RR 3,54 (1,1-11,5) correlacionaram com a sobrevida. CONCLUSÃO: Para este grupo de pacientes com características clínicas homogêneas, resposta completa e expressão de MUM1 estiveram associados à sobrevida. A classificação deste linfoma em CG e pós-CG utilizando CD10, BCL-6 e MUM1 não se correlacionou com evolução. Estudos futuros com casuística maior são necessários para melhor definir os fatores prognósticos do LBPM / INTRODUCTION: Primary Mediastinal Large B Cell Lymphoma (PMLBCL) is a distinct clinico-pathologic entity that differs from other Diffuse Large B Cell Lymphomas (DLBCL). Classification of DLBCL in GC and post-GC according can identify two subgroups of lymphomas with distinct prognosis. The aim of this study is to analyze the expression of CD10, BCL-6 and MUM1 in PMLBCL and correlate with prognosis. METHODS: retrospective analysis of clinical variables of 44 patients with PMLBCL and expression of CD10, BCL- 6 and MUM1 in 29 patients with available tissue. RESULTS: median age was 28 years and 70% of the patients were female. CD10, BCL-6 and MUM1 was positive in 24%, 65% and 58%, respectively. According to Hans classification, 38% were classified as GC and 62% as post-GC. Five year OS and DFS was 47% and 81%, respectively. In univariate analysis Complete Response (p=0.0001), Radiation therapy (p=0.004), IPI (0.039), and MUM1 expression (0.014) correlated with OS. No correlation was seen with Hans classification and survival. CONCLUSION: for this group of patients with homogeneous clinical features, response to therapy and MUM1 expression were associated with prognosis. The Hans algorithm proposed for aggressive lymphomas was not a predictive tool for survival in PMLBCL. Further studies are necessary to validate our finding and identify better prognostic variable for PMLBCL

Orientadores: Ilka de Fátima Santana Ferreira Boin, Cristina Aparecida Arrivabene Caruy / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T17:26:07Z (GMT). No. of bitstreams: 1 Shimozono_Emica_M.pdf: 4271192 bytes, checksum: ec937b4448d3157cccab1d06c8b5a8d3 (MD5) Previous issue date: 2014 / Resumo: A Hipertensão Portopulmonar (HPP) é caracterizada pelo desenvolvimento da hipertensão arterial pulmonar associada à hipertensão portal, com ou sem doença hepática. É definida como pressão arterial pulmonar média (PAPM) acima de 25 mmHg, resistência vascular pulmonar (RVP) acima de 240 dinas.s.cm?? e a pressão de oclusão da artéria pulmonar (POAP) normal, menor de 15 mmHg. A associação de hipertensão pulmonar com cirrose e hipertensão portal é pouco diagnosticada, sendo a sua prevalência estimada entre 2 - 6%. A mortalidade é diretamente proporcional à medida da pressão arterial pulmonar média e da resistência vascular pulmonar. Alguns estudos sugerem que a pressão da artéria pulmonar média pré-operatória seja um preditor independente para mortalidade, e muitos centros consideram que pressão arterial pulmonar média acima de 50 mmHg seja uma contraindicação absoluta para o transplante de fígado (TF). Objetivo: Analisar a prevalência, as complicações e a sobrevida dos pacientes portadores de HPP submetidos a transplante de fígado. Método: Foram analisados de modo retrospectivo, prontuários e o banco de dados da Unidade de Transplante Hepático do Hospital de Clínicas da Universidade Estadual de Campinas dos pacientes submetidos a transplante de fígado, num período de 21 anos. Dividiu-se a população em dois grupos de acordo com as medidas da pressão da artéria pulmonar média: PAPM ? 25 mmHg e PAPM > 25 mmHg. Foram estudados os exames pré-operatórios, as variáveis hemodinâmicas, bem como as complicações intraoperatórias, eventos relacionados e a sobrevida. Resultado: Foram encontrados 50 casos com PAPM > 25 mmHg e apenas um caso preencheu os critérios diagnósticos de PAPM > 25 mmHg, RVP > 240 dinas.s.cm-5 e POAP < 15 mmHg , de acordo com a European Respiratory Society Task Force on Pulmonary Hepatic Vascular Disorders (2004), e dois casos de PAPM > 50 mmHg que tiveram os procedimentos suspensos, portanto a nossa prevalência da HPP em pacientes submetidos a TF foi de 0,25%. As complicações intraoperatórias foram semelhantes nos dois grupos. A sobrevida no grupo PAPM > 25 mmHg foi menor que no grupo PAPM ? 25 mmHg. Conclusão: A prevalência da HPP observada foi menor que a descrita na literatura, ou seja, 50 (12,9%) pacientes apresentaram PAPM > 25 mmHg, sendo que destes, 49 (12,6%) apresentaram resistência vascular pulmonar < 240 dinas.s.cm-5, portanto sem HPP, e provavelmente tratava-se de circulação hiperdinâmica e/ou sobrecarga de volume. O fato de o paciente apresentar pressão arterial pulmonar média maior que 25 mmHg, não influenciou na sobrevida do enxerto / Abstract: Portopulmonary hypertension (PPH) is characterized by the development of pulmonary artery hypertension associated with portal hypertension, with or without liver disease. It is defined as a mean pulmonary artery pressure (MPAP) above 25 mmHg, pulmonary vascular resistance (PVR) above 240 dynes.s.cm-5 and the pulmonary capillary wedge pressure (PCWP) normal under 15 mmHg. The association of pulmonary hypertension with cirrhosis and portal hypertension is underdiagnosed, with an estimated prevalence of two to 6%. The mortality is directly proportional to the measured mean pulmonary artery pressure and pulmonary vascular resistance. Some studies suggest that the mean pulmonary artery pressure preoperatively is an independent predictor for mortality, and many centers consider that the mean pulmonary artery pressure above 50 mmHg is one absolute contraindication for liver transplantation (LT). Objective: To analyze the PPH prevalence, complications and survival in patients undergoing liver transplantation. Method: We analyzed retrospectively, records and data base from the Liver Transplantation Unit of the Clinical Hospital of UNICAMP of patients undergoing liver transplantation, a 21 year period. The population was separated into two groups according to the measurements of mean pulmonary artery pressure: MPAP ? 25 mmHg and MPAP > 25 mmHg. We studied the preoperative examinations, hemodynamic variables, as well as intraoperative complications, related events to PPH and survival. Result: We found 50 cases with MPAP > 25 mmHg, and one case met the diagnostic criteria for MPAP > 25 mmHg, PVR > 240 dynes.s.cm-5 and PCWP < 15 mmHg, according to European Respiratory Society Task Force on Pulmonary Hepatic Vascular Disorders (2004), and two cases of MPAP > 50 mmHg who had the procedure canceled, so our PPH prevalence in patients undergoing LT was 0,25%. The intraoperative complications were similar in both groups. The survival in group MPAP > 25 mmHg was lower than in group MPAP ? 25 mmHg. Conclusion: The prevalence rate observed was lower than described in literature, that is, 50 (12,9%) patients showed MPAP > 25 mmHg, and 49 (12,6%) of these patients had pulmonary vascular resistance < 240 dynes.s.cm-5 and therefore no PPH. This was probably due to hyperdynamic circulation and/or volume overload. The fact that mean pulmonary artery pressure was > 25 mmHg in these patients had no influence on graft survival / Mestrado / Fisiopatologia Cirúrgica / Mestra em Ciências