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Maas, Cornelis Peter. "Nerve-sparing radical pelvic surgery /." Leiden, 2003. http://catalogue.bnf.fr/ark:/12148/cb402319098.
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Emami, Bafrani Jaber. "Insulin-sparing effect of hydroxychloroquine in rats." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq22979.pdf.
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Kazemi, Mohsen. "What makes a successful sparing Taekwondo athlete?" Thesis, University of South Wales, 2017. https://pure.southwales.ac.uk/en/studentthesis/what-makes-a-successful-sparing-taekwondo-athlete(bbc5deb0-c4ec-4c6b-9a53-9a31dcdd41c1).html.
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Taekwondo (TKD), a Korean striking martial art, has become one of the most popular martial arts since its inclusion in 2000 Olympic Games. Having practiced TKD as an athlete and provided care as a health professional for decades, I investigated a series of features of the Olympic TKD athlete including: profile, injury rate and distribution, weight cycling/cutting and each of their relationships to success in terms of gaining a medal. My studies (Kazemi et al. 2006; Kazemi, Perri and Casella, 2009; Kazemi et al. 2010; Kazemi et al. 2013; Kazemi et al. 2014; Kazemi et al. 2015; Kazemi and Pieter 2004; Pieter and Kazemi 2007; Kazemi, Chudolinski et al. 2009; Kazemi 2012; Kazemi et al. 2005; Kazemi and Shearer 2007; and Kazemi et al. 2011) have demonstrated that an athlete who avoids injury during competition (especially severe injury), practices systematic and gradual weight management and utilizes a more aggressive strategy with no fear of receiving Kyong-Gos, whilst avoiding receiving Gam-Jeoms is more likely to win. These investigations were published and presented at various seminars around the world. This portfolio depicts my contributions to these areas of knowledge as well as further critical analysis of my previous works giving birth to new concepts such as utilization of height categories instead of weight categories to eliminate the ill-effects of weight cutting; sparring Injury Report Form; and effect of rule changes on profile and injuries to name a few. Conducting this thesis has helped me to reflect on the shortcomings of my previous investigations and realize the future directions of research in these areas.
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Lippold, Kumiko M. "Lorcaserin as a potential opioid-sparing adjunct." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5427.
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Opioids, such as oxycodone, morphine, and fentanyl, are commonly used medications in the treatment of moderate to severe pain. In spite of their efficacious analgesic properties, their increased prescribing rates by physicians and inherent abuse-related effects have led to the ongoing opioid epidemic. Their clinical utility is limited by the risk of adverse dose-dependent side effects, such as constipation and respiratory depression, and the development of tolerance and dependence. Opioid-sparing adjunctive therapies are sought to address these issues by reducing the dose of opioid needed to achieve analgesia through alternative non-opioidergic mechanisms and as a result, reduce the incidence of the previously mentioned side effects. Serotonin type-2C receptor agonists have demonstrated antinociceptive efficacy in preclinical models of chronic pain. Lorcaserin is a selective 5-HT2C receptor agonist and was reported to attenuate the abuse-related effects of oxycodone. The antinociceptive properties of 5-HT2C receptor agonists and their potential to alter the abuse-related effects of commonly abused drugs suggest that lorcaserin may be a potential opioid-sparing therapeutic. The goal of these studies was to evaluate the utility of lorcaserin, in combination with opioids, in a preclinical model of acute pain. Based on previous studies demonstrating the antinociceptive activity of 5-HT2C agonists, the hypotheses for these studies were that lorcaserin would increase the acute antinociceptive effects of opioids and would attenuate the development of tolerance associated with chronic opioid consumption.
The results demonstrate that the acute antinociceptive effects and the time-course of activity of opioids were enhanced by doses of lorcaserin. These effects were mediated through activation of the 5-HT2C receptor and were not blocked by administration of naloxone. Additionally, the acute effects of lorcaserin to increase opioid potency and time course was not mediated through changes in opioid distribution in the blood or central tissues.
Opioid tolerance was evaluated in vivo, and tolerance was developed using two methods of treatment: an acute (single dose administration) model of tolerance and a multiple-injection model. Testing the effect of lorcaserin in these models was important because current research suggests that the mechanisms that underlie both models of tolerance are distinct from one another. The results demonstrate that lorcaserin significantly blocked the development of acute tolerance in the whole animal and on a single cell level in dorsal root ganglion cell cultures.
In the multiple-day tolerance model, lorcaserin partially attenuated the development of opioid antinociceptive tolerance. Chronic administration of an opioid is associated with desensitization of the MOR, and the effect of lorcaserin on opioid tolerance may be mediated through changes in MOR functional activity. Upon further investigation using agonist-stimulated [35S]GTPyS, the results showed that lorcaserin altered basal binding of [35S]GTPyS but not agonist-stimulated binding in mice that received chronic opioid treatment. These data suggest that the effect of lorcaserin on opioid tolerance, in the multiple-injection model, is not mediated through changes in MOR functional activity. Collectively, the tolerance studies suggest that the effect of 5-HT2C receptor activation by lorcaserin has differential effects on the stages of opioid tolerances and further supports the notion that the mechanisms that underlie the stages of opioid tolerance are distinct. Given the efficacy of lorcaserin to increase the acute antinociceptive effects of opioids and its ability to impair the development of opioid tolerance, collectively, these data suggest that lorcaserin may be a useful opioid-sparing adjunctive therapy.
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Brannon, Christopher Omer, and James Oliver Tanghal. "Sparing the Rod?: Social workers and corporal punishment." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2211.
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The purpose of this study was to develop a survey that would provide professionals with an idea as to the thoughts, feelings, and values that social workers held regarding physical punishment towards a child. Social workers stand in a position to intervene in the intergenerational transmission of violence.
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Penrose, Craig B. "Data requirements for availability based sparing the U.S. Marine Corps." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1998. http://handle.dtic.mil/100.2/ADA356861.
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Thesis (M.S. in Information Technology Management) Naval Postgraduate School, September 1998."September 1998." Thesis advisor(s): Kevin R. Gue, Mark E. Nissen. Includes bibliographical references (p. 49-50). Also available online.
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Kinskie, Steven W. "An evaluation of the budget and readiness impacts of battlegroup sparing." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1997. http://handle.dtic.mil/100.2/ADA337033.
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Benediktsson, Kristinn P. "Nipple-sparing subcutaneous mastectomy and immediate reconstruction with implants in breast cancer /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-199-9/.
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Udompol, Sirikamon. "Issues in international taxation : fiscal competition, transfer pricing, and tax sparing agreements." Thesis, University of Exeter, 2008. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.518796.
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Silva, Natalie Matos. "As cláusulas de tax sparing e matching credit nos acordos de bitributação." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/2/2133/tde-23032017-145757/.
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Este estudo tem por escopo analisar o conceito das cláusulas de tax sparing e matching credit, os principais argumentos favoráveis e contrários à utilização desses mecanismos e as hipóteses em que tais cláusulas são adotadas, nos âmbitos nacional e internacional. Sabe-se que, em um primeiro momento, a Organização para a Cooperação e Desenvolvimento Econômico (OCDE) chegou a recomendar a utilização das cláusulas de tax sparing nos acordos de bitributação celebrados entre países com graus diferentes de desenvolvimento econômico, como uma forma de atrair investimentos para os países menos desenvolvidos. No entanto, em relatório publicado em 1998, denominado Tax sparing: a reconsideration, a OCDE reviu sua posição inicial sobre o assunto, passando então a desencorajar o uso dessas cláusulas por seus países membros, através de diversas críticas e questionamentos acerca de sua adoção. O Brasil, por sua vez, desde os primeiros acordos de bitributação celebrados, nos primórdios da década de 1960, tem firmado a política de sempre negociar cláusulas de tax sparing e matching credit, especialmente nos acordos celebrados com países desenvolvidos. Considerando-se tal cenário, pretende-se, com o presente trabalho, estudar as cláusulas de tax sparing e matching credit de forma profunda, de modo a oferecer subsídios para um adequado enfrentamento da questão em futuras negociações de acordos de bitributação pelo País.The purpose of this study is to analyze the concept of tax sparing and matching credit clauses, the main arguments for and against the use of these mechanisms and the circumstances in which such clauses are adopted, nationally and internationally. It is known that, at first, the Organisation for Economic Co-operation and Development (OECD) used to recommend the inclusion of tax sparing clauses in double taxation conventions concluded between countries with different levels of economic development, as a way of attracting investments for less developed countries. However, the OECD revised its initial position on the subject in a report published in 1998, called \"Tax sparing: a reconsideration\", discouraging the use of such clauses by its member countries through various criticisms and questions about their adoption. In its turn, since the first double taxation agreements concluded in the early 1960s the Brazilian policy regarding the matter has always been to negotiate tax sparing and matching credit clauses, especially in conventions with developed countries. Given such a scenario, this paper aims at studying tax sparing and matching credit clauses deeply, in order to provide devices for an accurate understanding of the issue in future negotiations of double taxation conventions by the Country.
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Hayden, Anders. "Sharing the work, sparing the planet, reduced work time, overconsumption, and ecological sustainability." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22855.pdf.
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Keech, Janet L. "Use of availability based sparing in support of deploying U.S. Marine Corps Units." Thesis, Monterey, California. Naval Postgraduate School, 1998. http://hdl.handle.net/10945/32654.
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The U. S. Marine Corps realizes its goal of being ready to fight in any location primarily through the Marine Expeditionary Unit (MEU). An important component of the MEU's readiness is the availability of critical equipment repair parts when they are needed. We test with three sets of past MEU data an availability based sparing model that builds repair parts blocks and show that the model outperforms the current methodology in every case.
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Poursaeidi, Reihaneh. "An investigation of the design and function of knee joint-sparing massive endoprostheses." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10045208/.
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Distal femoral and proximal tibial joint-sparing bone tumour implants allow to preserve the knee, in limb salvage surgery. The aim of this thesis was to compare implant survival, functional outcomes, acceptance, proprioception and gait in patients with knee sparing implants and conventional knee sacrificing implants. Using FEA, a distal femoral implant and cadaver bone were modelled and parametrised to find the design that improves implant fixation. A survivorship study of 104 consecutive patients following knee sparing surgery (mean follow-up 36.1 ± 11.0 months) found an implant survival rate of 78% and this is comparable to the reported survival for joint sacrificing prostheses. Younger patients showed improved implant survival compared to older individuals. Plate fracture was not observed and aseptic loosening was the main reason for revision. Radiographic analysis indicated that implantation accuracy increased implant survival. Patient questionnaires showed that patients with knee sparing implants had more normal functional outcome and acceptance compared with patients with knee sacrificing implants. However, proprioception (joint position sense) was reduced in these patients. Using optoelectronic gait analysis system, hip, knee and ankle joint angle in 19 patients and 3 healthy subjects were measured. Ground reaction force and time in stance were also investigated. Joint symmetry in the joint sacrificing group was improved compared to the joint-sparing group, however overall, the joint-sparing tibial group demonstrated a more normal gait pattern. FEA results indicated that lower resection levels, reduced plate thickness and implant materials with lower modulus, decreased the stresses in the bone adjacent to the implant while loaded the bone more to reduce risk of stress shielding. To conclude, knee sparing endoprostheses provide a reliable alternative to knee sacrificing implants in limb reconstruction in selected patients. However, the current design of joint-sparing implants can be optimised to potentially improve bone remodelling and implant fixation.
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Robertson, Alan. "Allopurinol as a possible oxygen sparing agent during exercise in peripheral arterial disease." Thesis, University of Dundee, 2014. https://discovery.dundee.ac.uk/en/studentTheses/6d3e342c-d2fb-4cec-b678-082d1fb2e067.
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Patients with peripheral arterial disease (PAD) can only walk so far before they get leg pain (intermittent claudication) and have to stop. They are also at risk in the future of needing amputation of one of their limbs. Allopurinol is a new possible treatment for this condition as it has been shown in coronary arterial disease to prolong exercise before angina pain occurs. This is thought to be because allopurinol can both prevent oxygen wastage in tissues and prevent the formation of harmful oxidative stress. We hypothesised that allopurinol could prolong the time to leg pain in participants with PAD. In a double-blind, randomised controlled clinical trial 50 participants with PAD were randomised to receive either allopurinol 300mg twice daily or placebo for six months. The primary outcome was change in exercise capacity on treadmill testing at six months. Secondary outcomes were six-minute walking distance, Walking Impairment Questionnaire, SF-36 QoL questionnaire, flow-mediated dilatation and oxidised LDL. Outcome measures were repeated mid-study and at end of study. The mean age of participants was 68.4 years (SD 1.2) with 39/50 (78%) male. Only five participants withdrew in the course of the study, two in the active group and three in the placebo group. There was a significant reduction in uric acid levels in those on active treatment of 52.1% (p<0.001), but no significant change in either the pain-free or the maximum distance they were able to walk. Other measures of exercise capacity, blood vessel function and the participants’ own assessment of their health and walking ability also did not change during the course of the study. In summary, although allopurinol has been shown to be of benefit in a number of other diseases, in this study there was no evidence of any improvement following treatment in patients with peripheral arterial disease.
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Nguyen, Nam, Siyoung Jang, Jacqueline Vock, Vincent Vinh-Hung, Alexander Chi, Paul Vos, Judith Pugh, et al. "Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer." BioMed Central, 2014. http://hdl.handle.net/10150/610350.
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BACKGROUND:In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed.METHODS:A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70Gy (62.4-75Gy).RESULTS:At a median follow-up of 14months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications.CONCLUSIONS:IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.
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Nguyen, Nam, Paul Vos, Vincent Vinh-Hung, Misty Ceizyk, Lexie Smith-Raymond, Michelle Stevie, Benjamin Slane, et al. "Feasibility of image-guided radiotherapy based on helical tomotherapy to reduce contralateral parotid dose in head and neck cancer." BioMed Central, 2012. http://hdl.handle.net/10150/610349.
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BACKGROUND:To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases.METHODS:A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.RESULTS:Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1Gy and 24.7Gy for the SC and CC plans (p<0.0001). The volume of contralateral parotid receiving 40Gy or more was respectively 5.3% and 18.2% (p<0.0001)CONCLUSION:Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.
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Porter, David A. "Glucose feeding during exercise : the mechanism for muscle and liver glycogen sparing in untrained rats." Virtual Press, 1985. http://liblink.bsu.edu/uhtbin/catkey/421992.
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The purpose of this study was to examine the effect of glucose ingestion on glycogen use andresynthesis during moderate exercise in untrained rats. Female Wistar rats (avg. wt.= 262 g) were assigned to either a control (C), control exercise (CE) or experimental exercise (EE) group. To examine glycogen resynthesis during exercise from a carbohydrate feeding, the EE animals were given 1 ml of a 10% glucose solution enriched with U-14C-glucose via stomach tube and run for 1h at 20.6 m/min. To distinguish between glycogen synthesis from endogenous versus exogenous sources, the CE animals were given a 0.1 ml tail-vein injection of U-14C-glucose tracer and run for 1h at 20.6 m/min. The C animals served as resting controls. Immediately after sacrifice, samples of the liver, soleus m., plantaris m., gastrocnemius m. and w. vastus m. were removed and analyzed for glycogen concentration and 14C activity in a glycogen pellet. Muscle and liver glycogen was 4.72 umol/g and 5.16 umol/g, respectively, higher (p<0.05) in the EE animals than in the CE animals. The average 14C activity of the muscle glycogen (mean ± SE) (182.85+ 31.79 cpm/g) was greater (p<0.05) than that of the liver (47.44 + 8.10 cpm/g), indicating a greater exogenous glucose incorporation into muscle glycogen than liver glycogen during exercise. However, this activity represented less than 2% of the remaining glycogen found in each tissue. Thus, it appears that the glycogen sparing observed with the glucose feeding in untrained rats was the result of an increased contribution of blood glucose to muscle metabolism.Ball State UniversityMuncie, IN 47306
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Thiele, Sylvia. "Bone-sparing and anti-inflammatory potential of the novel selective glucocorticoid receptor modulator, compound A." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-114824.
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Rheumatoid arthritis (RA) is a common chronic inflammatory disease that affects about 1% of the Western population. Glucocorticoids (GC) are widely used for the treatment of RA and other immune-mediated diseases, such as asthma, but their use is associated with adverse effects on bone metabolism. Because of that, new selective GC receptor (GR) agonists (SEGRAs) with the potential for an improved risk/benefit profile have been developed. Compound A (CpdA) is a novel SEGRA, which showed an improved risk/benefit profile concerning glucose metabolism, however the effects on bone are not well investigated yet. Initial in vitro studies of our group showed bone-sparing potential of CpdA. The aim of this study was to investigate whether CpdA also possesses beneficial effects on bone in vivo. Therefore, the first step was to explore the effects of CpdA on healthy bone metabolism, followed by the analysis of the anti-inflammatory potential in a murine model of RA. To mimic the effects of continuous therapy, bone loss was induced in FVB/N mice by implanting slow-release pellets containing placebo, prednisolone (PRED; 3.5 mg), or CpdA (3.5 mg). After four weeks, mice were killed and the effects on the skeleton were examined. By performing in vitro studies with human bone marrow stromal cells (BMSC) and murine osteocyte-like cells (MLO-Y4 cells), the underlying mechanisms were assessed. Here, we focused on the RANKL/OPG ratio as a marker for the osteoclastogenic potential as well as on the Wnt signaling pathway. Whereas PRED reduced the total and trabecular bone density in the femur and in the spine, CpdA did not influence these parameters. These results were confirmed by histomorphometry as the mineral apposition rate was decreased by PRED whereas the number of osteoclasts was increased. Reduced bone formation was furthermore paralleled by a decline in the serum bone formation marker pro-collagen type 1 N-terminal peptide (P1NP) and decreased skeletal expression of osteoblast markers, as well as increased serum levels of the osteoblast inhibitor dickkopf-1 (Dkk-1). Additionally, serum CTX-1 and the RANKL/OPG ratio in the bone tissue were increased by PRED. None of these effects were observed with CpdA. Moreover, CpdA did not increase the RANKL/OPG ratio in MLO-Y4 cells and failed to transactivate Dkk-1 expression in bone tissue, BMSC, and osteocytes. To analyze the anti-inflammatory properties of CpdA, arthritis was induced in DBA/1 mice by injection of type II collagen. After disease onset, mice were treated for ten days with PBS (placebo), dexamethasone (DEX; 100 µg/mouse), or CpdA (300 µg/mouse). The latter was able to decrease disease activity, paw swelling, and paw temperature, but was less potent compared to DEX. In addition, T cells isolated from CpdA- and DEX-treated animals were less active based on proliferation rates after stimulation with type II collagen and produced smaller amounts of interferon-γ as compared to T cells from PBS-treated mice. The weaker potency of CpdA as compared to DEX in preventing infiltration of inflammatory cells, induction of osteoclastogenesis, and destruction of articular cartilage was confirmed by histological assessment of the joints. While CpdA was unable to prevent inflammation-induced bone loss, it did not aggravate bone loss or alter bone density in healthy control mice. In conclusion, this study underlines the bone-sparing potential of CpdA compared to conventional GC in a murine model of GC-induced bone loss. Even though a moderate anti-inflammatory potential of CpdA was demonstrated, it was unable to prevent inflammation-induced bone loss. Despite the bone-sparing effects of CpdA in healthy mice, its narrow therapeutic window limits its use in clinical practice. Nevertheless, this study highlights important molecular mechanisms of GC-induced bone loss showing that by avoiding increases in the RANKL/OPG ratio or Dkk-1 in osteoblast lineage cells, GC-induced bone loss may be improvedRund 1% der westlichen Bevölkerung leidet an rheumatoider Arthritis, einer chronischen Entzündung der Gelenke. Für deren Behandlung werden häufig Glukokortikoide (GC) eingesetzt. Trotz ihrer potenten entzündungshemmenden Wirkung ist ihr Einsatz aufgrund der negativen Auswirkungen auf den Knochenstoffwechsel eingeschränkt. Um ein besseres Risiko/Nutzen-Profil zu erzielen, wurden selektive GC-Rezeptoragonisten (SEGRAs) entwickelt, die weiterhin potent anti-inflammatorisch wirken, während negative metabolische Effekte ausbleiben. Compound A (CpdA) ist ein Vertreter dieser Gruppe, der in Mäusen ein verbessertes Behandlungsprofil hinsichtlich des Glukosestoffwechsels zeigte. Die Wirkung auf den Knochen wurde bisher nur unzureichend untersucht. Erste in vitro Ergebnisse unserer Gruppe zeigten knochenfördernde Eigenschaften von CpdA. Ziel dieser Arbeit war es zu untersuchen, ob CpdA auch in vivo ein knochenschonendes Potenzial besitzt. Dafür wurden zunächst die Effekte von CpdA auf den gesunden Knochenstoffwechsel untersucht, um anschließend seine Wirkung in einem Mausmodell der rheumatoiden Arthritis zu testen. Um die Effekte einer Dauertherapie mit CpdA nachzustellen, wurden Slow-release-Pellets mit Plazebo, Prednisolon (PRED; 3,5 mg) beziehungsweise CpdA (3,5 mg) in FVB/N-Mäuse implantiert. Nach vier Wochen wurden die Effekte der Substanzen auf den Knochen untersucht. Um mögliche zugrundeliegende Mechanismen zu eruieren, wurden humane Knochenmarkszellen und murine Osteozyten-ähnliche Zellen (MLO-Y4-Zellen) genutzt. In diesen wurde der Einfluss der Substanzen auf das RANKL/OPG-Verhältnis, als einen Marker der Osteoklastenfunktion, sowie auf Dickkopf-1, einen Inhibitor des Wnt-Signalwegs, getestet. Während PRED die totale und trabekuläre Knochendichte im Femur und der Wirbelsäule verminderte, zeigte CpdA keinen Einfluss auf diese Parameter. Diese Ergebnisse wurden durch die histomorphometrische Analyse bestätigt und zeigten des Weiteren, dass PRED die Mineralanbaurate reduzierte während es die Anzahl der Osteoklasten erhöhte. Die verminderte Osteoblastenfunktion ging mit einer Abnahme der Knochenformationsmarker im Serum und im Knochengewebe einher. Außerdem wurden der Resorptionsmarker im Serum und das RANKL/OPG-Verhältnis im Knochengewebe von PRED erhöht. Bei CpdA-behandelten Tieren wurden keine dieser Effekte beobachtet. Zudem wurde das RANKL/OPG-Verhältnis in vitro in MLO-Y4-Zellen durch CpdA nicht beeinflusst und auch die Transaktivierung von Dkk-1 im Knochengewebe, in Knochenmarkszellen und Osteozyten blieb aus, was somit eine mögliche Erklärung für die knochenschonende Wirkung von CpdA darstellen könnte. Um die entzündungshemmenden Eigenschaften von CpdA zu untersuchen, wurde mittels einer Kollageninjektion Arthritis in DBA/1-Mäusen induziert. Nachdem die Mäuse eine Arthritis entwickelt hatten, wurden sie jeden zweiten Tag über eine Dauer von zehn Tagen mit PBS (Vehikel), Dexamethason (DEX; 100 µg/Maus) oder CpdA (300 µg/Maus) behandelt. CpdA war in der Lage die Krankheitsaktivität, die Pfotendicke und die Pfotentemperatur zu senken. Dabei war es aber nicht so effektiv wie DEX. Außerdem konnte gezeigt werden, dass T-Zellen, die aus CpdA- und DEX- behandelten Tieren isoliert und mit Kollagen stimuliert wurden, basierend auf ihrer Proliferationsrate weniger aktiv waren und geringere Mengen an Interferon-γ produzierten, als T-Zellen, die aus PBS-behandelten Tieren entnommen wurden. Das schwächere entzündungshemmende Potenzial von CpdA, verglichen mit DEX, wurde mittels der histologischen Analyse der Gelenke bestätigt. Es konnte eine höhere Infiltration von Entzündungszellen, sowie eine erhöhte Osteoklastogenese und Knorpelzerstörung in CpdA-behandelten Tieren beobachtet werden. Obwohl CpdA nicht in der Lage war, vor dem entzündungsbedingten Knochenverlust zu schützen, verschlimmerte es weder den Knochenverlust, noch veränderte es die Knochendichte in gesunden Kontrollmäusen. Diese Studie zeigt das knochenschonende Potenzial von CpdA in einem Mausmodell des GC-induzierten Knochenverlustes und bestätigt die moderaten entzündungshemmenden Eigenschaften von CpdA in vivo. Trotz der knochenschonenden Effekte von CpdA in gesunden Mäusen wird sein Einsatz in der klinischen Praxis durch die schmale therapeutische Breite erschwert. Trotz alledem deutet unsere Studie mit CpdA auf wichtige molekulare Mechanismen hin. Somit könnte durch das Verhindern der Erhöhung des RANKL/OPG-Quotienten oder von Dkk-1 in osteogenen Zellen, der durch GC verursachte Knochenverlust möglicherweise verhindert werden
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Civale, John. "Aspects of High Intensity Focused Ultrasound Treatment Planning : Rib Sparing, Attenuation, Thermometry and Exposure Determination." Thesis, Institute of Cancer Research (University Of London), 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.487294.
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High Intensity Focused Ultrasound (HIFU) is rapidly emerging as a non-invasive treatment for soft tissue tumours. HIFU is used to generate small regions of high intensity sound at the focus of geometrically or electronically focused transducers. These intensities are used to raise the tissue temperature rapidly to form a region of coagulative necrosis, known as a lesion. Clinical use of HIFU has shown that the technique is safe and is capable of ablating tumours. However, the technique is still in its infancy and, consequently, appropriate methods of treatment delivery, planning and monitoring are under development. In this thesis, ways ofimproving clinical treatment delivery are investigated. During HIFU treatments of the liver, it is desirable to avoid rib exposure. The high ultrasound absorption in bone means that it can heat up, leading to damage of the periosteum and overlying skin. A solution to this problem has been identified as the use a linearly segmented transducer with 10 independent elements. The acoustic field from a number of active drive element configurations of the transducer was investigated with theoretical modelling. In corresponding experiments, the acoustic field and the temperature rise on a rib phantom were measured. A novel method of visualising the heating pattern i~ the beam, namely using a temperature sensitive thermo-chromic liquid crystal, was investigated. The ability to shape the HIFU beam to spare the ribs was demonstrated, allowing the sound axis to be directed approximately a centimetre closer to the rib edge. The use of a diagnostic ultrasound scanner for measurements of ultrasound attenuation of tissue (BAE) and for thermometry (BTl) in HIFU using ultrasound backscatter is investigated. Methods of data acquisition and processing for both techniques are described together with their limitations. These techniques were used to determine the correct HIFU drive power in a lesioning experiment aiming to improve reproducibility of single lesion formation in an ex-vivo liver tissue model. Some evidence that BAE and BTl can be used as tools to improve the reproducibility of single lesion formation has been obtainedwith a reduction in the variance oflesion size and shape. In conclusion, a number of potential ways of improving HIFU treatment delivery have been demonstrated. The techniques for rib sparing, BAE and BTl are ready to be tested in a situation more representative of the clinical scenario, where multiple tissue layers, backscatter inhomogeneity and tissue motion are likely to pose more significant limits on their application.
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Triki, Abdelfattah. "Role orientations and family purchasing behaviour : modelling the relationships for time saving and effort-sparing durables." Thesis, Northumbria University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367421.
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Jeffery, Casey Miles. "Performance analysis of dynamic sparing and error correction techniques for fault tolerance in nanoscale memory structures." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0007163.
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zu, Ermgassen Erasmus Klaus Helge Justus. "Strategies for sustainable livestock production in Brazil and the European Union." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/274541.
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Livestock provide as much as one-third of all protein consumed by humans, but have a disproportionate and growing environmental impact. Livestock production occupies 50-75% of agricultural land, contributes 15% of anthropogenic greenhouse gas emissions, and drives agricultural expansion in the tropics through the global trade in animal feed. This thesis therefore evaluates two strategies for shrinking the environmental impact of the livestock sector. First, I evaluate the potential for food losses (i.e. foods which were intended for human consumption, but which ultimately are not directly eaten by people) to replace grain- and soybean-based pig feeds in Europe. While food losses have been included in animal feed for millennia, the practice is all but banned in the European Union, because of disease control concerns. Several East Asian states have in the last 20 years, however, introduced regulated systems for safely recycling food losses into animal feed. I combine data from multiple sources (including government reports, the animal science literature, and factory-floor data from South Korean swill-feed factories), and find that the introduction of East Asian practices for recycling food losses as animal feed could reduce the land use of EU pork (20% of world production) by one fifth, potentially saving 1.8 million hectares of agricultural land. This would also reduce 12/14 other assessed environmental impacts and deliver economic savings for pig farmers, as swill (cooked food losses) costs 40-60% less than conventional grain-based feeds. In a survey of pig farmers (n=82) and other agricultural stakeholders (n=81) at a UK agricultural trade fair, we found high support (>75%) for the relegalisation of swill. Support for swill feeding arose in part because respondents thought that swill would lower costs, increase profitability, and be better for the environment. Our results also confirmed the critical importance of disease control and consumer communication when considering relegalisation, as respondents who thought that swill would increase disease risks and be unpalatable to consumers were less supportive of relegalisation. Any new system for the use of swill will require careful design of regulation to ensure that heat-treatment is sufficient, and to reduce to a negligible level the risk of uncooked animal by-products entering feed. Our results suggest, however, that if such a system can be established, there would be multiple benefits and widespread support for its relegalisation. Second, I evaluated the potential to increase the productivity of cattle ranching in the Brazilian Amazon. While high hopes have been placed on the potential for intensification of low-productivity cattle ranching to spare land for other agricultural uses, cattle productivity in the Amazon biome (29% of the Brazilian cattle herd) remains stubbornly low, and it is not clear how to realize theoretical productivity gains in practice. I therefore (a) surveyed six on-the-ground initiatives which have been working with local farmers to improve cattle ranching, quantifying their farm practices, animal performance, and economic results; and (b) analysed the progress that has already been made in reconciling agriculture and forest conservation, by evaluating the impact of the flagship anti-deforestation policy, the priority list (Municípios Prioritários). The survey showed that cattle intensification initiatives operating in four states have used a wide range of technologies to improve productivity by 30-490%, while supporting compliance with the Brazilian Forest Code. Using two complementary difference-in-difference estimators, I then found no evidence for trade-offs between agriculture and forest conservation under the priority list; instead, reductions in deforestation in priority list municipalities were paired with increases in cattle production and productivity (cattle/hectare). The policy had no effect on dairy or crop production. Together, these results provide real-world evidence that increases in cattle production in Brazil do not need to come at the expense of the country’s remaining native vegetation.
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Widman, Lars. "Skeletal muscle potassium and magnesium in diuretic treated patients : effects of potassium - sparing diuretics of magnesium supplementation." Doctoral thesis, Umeå universitet, Medicin, 1988. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100556.
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Hamid, Rezaei. "EFFECT OF MOLECULAR WEIGHT OF POLYETHYLENE GLYCOLS ON THEIR FUNCTION AS LUBRICANT SPARING BINDERS IN TABLET TECHNOLOGY." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin984508148.
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Dross, Camille. "Stratégies d’utilisation des sols agricoles pour concilier production et oiseaux spécialistes des milieux agricoles." Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLA028/document.
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L’expansion et l’intensification agricole ont d’énormes conséquences sur la biodiversité. L’étude des compromis entre production et biodiversité peut aider au ciblage de mesures en faveur de la biodiversité.L’objectif de la thèse était de révéler des stratégies d’utilisation des sols agricoles qui permettraient d’enrayer le déclin des oiseaux agricoles tout en maintenant la production dans un territoire partagé entre grandes cultures et élevage de ruminants.Notre travail s’est basé sur l’étude de corrélations entre des variables décrivant l’utilisation des sols agricoles, la production agricole et plusieurs descripteurs des communautés d’oiseaux dans les milieux agricoles français.Nous avons observé des communautés d’oiseaux très spécialisées et pauvres en espèces dans les régions à haute production végétale ; et des communautés dominées par des oiseaux généralistes dans les régions à haute production animale. La stratégie qui maximise le FBI (un indice d’abondance des oiseaux agricoles) en maintenant la production dans ses composantes animale et végétale combinait une légère extensification des grandes cultures, le renforcement des régions d’élevage extensif et l’intensification des régions d’élevage déjà intensives.Nos résultats soulignent la nécessité d’adopter des solutions différenciées à la production animale et à la production végétale, au-delà de la dichotomie land sparing/land sharingAgricultural expansion and intensification have disastrous consequences on biodiversity. Studying the relationship between biodiversity and food production can help devise appropriate measures.The objective of this work was to reveal land use strategies to halt the decline of farmland birds while maintaining agricultural production.Our work was based on the study of correlations between agricultural land use, food production, and various bird community descriptors across French agroecosystems.In high crop production regions, we observed low-diversity communities dominated by few arable specialist species. In high livestock production regions, we observed communities dominated by generalist bird species. The land-use strategy that maximized the Farmland Bird Index under crop and livestock production constraints involved a decrease of crop intensity in the most intensive crop regions and an increase of livestock intensity in the most intensive livestock regions. Extensive livestock production was reinforced in current extensive areas.Our results have shown that different strategies are needed in crop-dominated and in livestock dominated regions
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Woitel, Franklin. "Impact of alternative, non-fish oil dietary lipid sources and subsequent 'finishing' on growth and tissue long-chain polyunsaturated retention in cobia, Rachycentron canadum." OpenSIUC, 2013. https://opensiuc.lib.siu.edu/theses/1283.
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Cobia (Rachycentron canadum) aquaculture is poised for expansion, due in part to rapid growth rate, tolerance of culture conditions, and high market value of this species. Similar to other carnivorous marine fishes, the high monetary cost and long-range unsustainability of reliance on fish oil as the principle lipid source for cobia feeds necessitates evaluation of alternative lipid sources to spare or replace fish oil. Unfortunately, alternative lipid-based feeds may affect production performance, and typically yield fillets with reduced levels of long-chain polyunsaturated fatty acids (LC-PUFAs) such as docosahexaenoic acid (DHA, 22:6n-3). Recent research has indicated that diets rich in saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs), coupled with the application of so-called "finishing feeds" (feeds containing elevated levels of fish oil relative to grow-out feeds) at the end of the production cycle, may limit or attenuate these effects of fish oil sparing. Accordingly, I conducted two trials to evaluate the usefulness of alternative lipids and finishing in cobia culture. In the first trial, I assessed growth performance and tissue fatty acid composition of juvenile cobia fed diets (~11% lipid, ~48% protein) containing fish oil (control), or 50/50 blends of fish oil and alternative lipids (beef tallow, pork lard, partially and fully hydrogenated soy oils, and traditional soy oil) supplemented with an algal meal (to meet the 22:6n-3 requirement of cobia) for 8 weeks. Although minor differences were observed in feed intake, growth performance was otherwise equivalent among the dietary groups. Tissue fatty acid composition varied significantly among treatments, however, with alternative lipids containing higher levels of saturated (SFAs) and monounsaturated fatty acids (MUFAs) yielding tissue profiles that were most similar to those associated with the fish oil-based control feed. Although beef tallow and hydrogenated soybean oil were largely equivalent in terms of growth performance and fatty acid profile change, beef tallow was selected for further evaluation because of its low cost. In the second trial, beef tallow replaced fish oil in feeds at one of four substitution levels: 0% (100% fish oil), 33%, 67%, or 100% tallow (with algal 22:6n-3 meal included in all feeds as before). Juvenile cobia were raised on these feeds for 8 weeks, then switched to the 100% fish oil-based control feed for an 8-week finishing period. During finishing, subsamples of fish were collected every 2 weeks to quantify changes in tissue fatty acid profile over time as a result of finishing. In the second trial, the overall similarity of tissue fatty profiles to those in the 100% fish oil control treatment increased over the course of finishing, mostly as a result of declines in SFAs and MUFAs. These results suggest that SFA and MUFA-rich lipids, such as fully hydrogenated soy oil and beef tallow, are effective and strategically valuable as partial substitutes for fish oil in cobia feeds, and that finishing is at least partially effective in restoring cobia tissue fatty acid composition to a state approximating that of cobia fed only fish oil as dietary lipid.
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Spignesi, Nicholas A. "Implementing readiness based sparing in the United States Marine Corps by analyzing the United States Army's implementation process." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1998. http://handle.dtic.mil/100.2/ADA358984.
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Thesis (M.S. in Management) Naval Postgraduate School, December 1998."December 1998." Thesis advisor(s): Jane Feitler, James Suchan. Includes bibliographical references (p. 79-81). Also available online.
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Zumbaugh, Charles Arthur III. "Evaluation of a phytogenic feed additive on performance, nutrient digestion, and absorption in turkey poults." Thesis, Virginia Tech, 2018. http://hdl.handle.net/10919/81914.
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In recent years, there has been a growing interest in feeding phytogenic products to poultry for their growth and health benefits. The objective of this experiment was to determine the effects of a phytogenic feed additive on turkey poult performance and digestive physiology over a 6-week brooding period. In total, 864 male Hybrid Converter turkey poults were obtained from a local commercial hatchery on day-of-hatch and placed into floor pens with clean pine shavings. The treatments were randomly assigned including an industry-type corn-soybean meal positive control (PC), a similar diet with a 1.5% reduction in crude protein and key amino acids (NC), or the NC with the addition of Digestarom® (PFA) included at a rate of 1 g/kg. Body weight gain (BWG), feed intake (FI), feed efficiency (FE), and mortality were recorded throughout the experiment. On day 14 poults fed the PFA had significantly higher BWG compared to the PC and NC fed birds. By day 42 birds fed the PC and PFA diets had significantly higher BWG compared to the NC, and the PC had significantly higher FE compared to the NC and PFA fed birds. No differences in FI or mortality were observed throughout the experiment. There were no significant differences in AMEn, crude protein digestibility, or nutrient transporter or pancreatic enzyme mRNA expression among treatments. However, aminopeptidase activity tended to be lower in the ileum of poults fed the PC or PFA diets compared to the NC, suggesting that the PFA may be improving protein utilization.Master of Science
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Fresser, Patrizia [Verfasser], and Don C. [Akademischer Betreuer] Lamb. "Pathological Notch3 aggregation : role of cysteine-sparing mutations and antiaggregatory strategies in CADASIL / Patrizia Fresser ; Betreuer: Don C. Lamb." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2016. http://d-nb.info/1137835184/34.
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Schoch, Eric J. "A simulation of the I3 to D repair process and sparing of the F414-GE-400 jet aircraft engine." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2003. http://library.nps.navy.mil/uhtbin/hyperion-image/03sep%5FSchoch.pdf.
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Thesis (M.S. in Operations Research)--Naval Postgraduate School, September 2003.Thesis advisor(s): Arnold H. Buss, Kevin J. Maher. Includes bibliographical references (p. 147-148). Also available online.
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Brem, Robert D. "Army inventory policy, the need for strategic change : an examination of Readiness Based Sparing for retail repair parts supply support /." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1997. http://handle.dtic.mil/100.2/ADA341433.
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Thesis (M.S. in Management) Naval Postgraduate School, December 1997."December 1997." Thesis advisor(s): Kevin R. Gue, Mike Boudreau. Includes bibliographical references (p. 79-82). Also available online.
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Bergman, Alexis M. "FISH OIL SPARING IN FEEDS FOR CALIFORNIA YELLOWTAIL SERIOLA DORSALIS: ADDRESSING DIGESTIBILITY LIMITATIONS AND EFFECTS ON TISSUE FATTY ACID PROFILES." OpenSIUC, 2017. https://opensiuc.lib.siu.edu/theses/2085.
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Sparing fish oil (FO) in aquafeeds, especially diets intended for marine carnivores, is essential for the continued economic and environmental sustainability of aquaculture. Plant- and animal-derived lipids may successfully replace FO so long as diets are otherwise formulated to contain adequate amounts of essential fatty acids, including the long-chain polyunsaturated fatty acids (LC-PUFAs) required by many marine carnivorous species. Whereas growth performance may not be affected by these alternative lipids, tissue fatty acid profiles, including that of the edible fillet products, are often distorted and contain less of the LC-PUFAs many seafood consumers desire. Saturated fatty acid (SFA)-rich lipids, such as fully hydrogenated soybean oil (SO), tend to have a less overt effect on fillet composition and LC-PUFA loss in comparison with alternative lipids rich in C18 polyunsaturated fatty acids (C18 PUFAs). However, SFA-rich lipids may be somewhat less digestible. To address this digestibility limitation, two studies were conducted to evaluate 1) increasing inclusion levels of partially hydrogenated SO (a monounsaturated fatty acid [MUFA]-rich lipid with presumably higher digestibility) in place of fully hydrogenated SO, and 2) supplementing fully hydrogenated SO-based feeds with emulsifiers as a means of enhancing diet utilization, growth performance, and fillet LC-PUFA retention in California Yellowtail (Seriola dorsalis). In both studies, diets containing only fully hydrogenated SO yielded tissues with equivalent levels of LC-PUFAs in comparison to diets containing menhaden FO. Replacing 60% of fully hydrogenated SO with partially hydrogenated SO resulted in numeric increases in production performance (weight gain and specific growth rate [SGR]), with minimal accumulations of trans fats in edible tissues. Whereas emulsifiers including casein, whey protein, and monoglycerides can be added to SFA-rich fully hydrogenated SO diets to potentially improve digestibility, no production performance benefit was realized in California Yellowtail; the addition of mixed bile acids, however, significantly impaired performance. In summary, the use of SFA-rich fully hydrogenated SO is an effective strategy for minimizing the negative effects of FO sparing on California Yellowtail fillet composition, but limitations associated with reduced SFA digestibility must be addressed in order to optimize utilization and effectiveness of SFA-rich aquafeeds.
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Kopp, Lugli Andrea. "Perioperative protein sparing in diabetes mellitus type 2 patients : an integrated analysis of perioperative protein and glucose metabolism using stable isotope kinetics." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=101152.
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The potential effects of nutritional support with amino acids or dextrose and epidural blockade on the catabolic response to surgery were investigated in diabetic patients undergoing colorectal surgery. Protein and glucose metabolism were assessed with a stable isotope infusion technique using the two stable isotopes L-[1-13C]leucine and [6,6-2H2 ]glucose.1. The first intervention of a postoperative infusion of amino acids avoided pronounced hyperglycaemia in diabetic patients after colorectal surgery and achieved a positive protein balance compared to dextrose.
2. The second intervention of a short term infusion of amino acids postoperatively blunted protein breakdown and stimulated protein synthesis. This resulted in a positive protein balance in patients with epidural blockade compared to patient controlled analgesia with intravenous morphine. With regard to glucose metabolism, amino acid supply after surgery decreased glucose clearance and endogenous glucose production independent from type of analgesia.
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Desai, Vibha CA. "Comparative Effectiveness of Tacrolimus-Based Steroid Sparing versus Steroid Withdrawal Regimens in Patients with Kidney Transplantation: Results from Discrete Event Simulation Modeling." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1416579177.
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Mugoya, Isaac. "Retrospective descriptive evaluation of empiric carbapenem-sparing regimens versus carbapenem use in non-intensive care patients at a district hospital in South Africa." University of Western Cape, 2021. http://hdl.handle.net/11394/8228.
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Magister Pharmaceuticae - MPharmAntimicrobial resistance is a global concern associated with increased morbidity and mortality. It has been estimated that, by 2050, the continuous escalation of antimicrobial resistance, globally, will result in more deaths per year, compared to cancer and diabetes. The direct and indirect impact of ineffective antibiotics, and therefore, antimicrobial resistance, will be hardest felt by low and middle-income countries, as the financial burden will be too great to manage. Carbapenems are considered the last line of antimicrobials to treat multidrug-resistant bacterial infections. They are the preferred choice to treat infections, presenting with extended-spectrum beta-lactamases (ESBL) producing Enterobacteriacea. Various strains of bacteria that have become resistant, due to the selective pressure, as a result of carbapenem over use, are referred to as Carbapenem-resistant Enterobacteriaceae (CRE).
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Tamimi, Noor Nihad [Verfasser], and Matthias [Akademischer Betreuer] Schwarzbach. "Results of Limb-Sparing Surgery of Soft Tissue Sarcoma of the Lower Extremity with Sciatic Nerve Involvement. / Noor Nihad Tamimi ; Betreuer: Matthias Schwarzbach." Heidelberg : Universitätsbibliothek Heidelberg, 2020. http://d-nb.info/1205976744/34.
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Muranyi, Andrew L. "Inhibition of the phosphatidylinositol-3-kinase pathway is selectively cytotoxic to primitive and mature acute myeloid leukemia progenitor cells while sparing their normal counterparts." Thesis, University of British Columbia, 2009. http://hdl.handle.net/2429/16327.
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Acute myeloid leukemia (AML) is a disorder of the hematopoietic system in which there is an overproduction of immature myeloblast (blast) cells in the bone marrow and suppression of normal hematopoiesis. Like normal hematopoiesis, AML is structured hierarchically and is maintained by rare progenitor cells capable of self-renewal and production of large numbers of leukemic blasts. These rare cells, leukemia-initiating cells (L-IC), are capable of engraftment and proliferation in immunocompromised mice. Dysregulation of signal transduction pathways are frequent occurrences in AML, leading to enhanced cell proliferation and resistance to apoptosis. Pathways which are frequently constitutively active in AML blasts include the phosphatidylinosityl-3-kinase (PI3K) and FMS-like tyrosine kinase 3 (FLT3) receptor signalling pathways.
Constitutive PI3K activation, as measured by Akt phosphorylation, was detected in the majority of the 36 AML patient samples tested. The PI3K signalling intermediate integrin linked kinase (ILK) was ubiquitously expressed, and FLT3 abundantly expressed although at variable levels. Furthermore, in the five samples tested, ILK and FLT3, as well as PI3K pathway activation, were also detected in CD34+CD38- sorted and quiescent AML cells, populations enriched for L-IC.
siRNA inhibition of ILK caused a decrease in AML colony forming cell (CFC) production. To further test the effects of ILK inhibition on AML, the small molecule inhibitor QLT0267 was used. In vitro kinase assays showed that QLT0267 inhibits both ILK and FLT3 kinases to a similar degree. Treatment of AML blasts with QLT0267 caused dose-dependent killing of AML-CFC, with AML samples containing FLT3 mutations being more sensitive to the inhibitor, although some samples with wildtype FLT3 were also effectively killed. Treatment of AML cells with QLT0267 also decreased survival of both primitive leukemic progenitor cells and L-IC in a dose-dependent fashion. In contrast, QLT0267 showed little toxicity toward normal bone marrow progenitors detected in the same assays. When combined with cytarabine or daunorubicin, QLT0267 worked synergistically to kill AML-CFC from a proportion of AML samples tested. Thus, FLT3, ILK, and constitutive PI3K activation are present in L-ICs, and these candidate leukemic stem cells can be eliminated by inhibition of these pathways, while their normal hematopoietic counterparts are spared.
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Yin, Lingshu. "Dose painting to combat tumor hypoxia while sparing urethra in prostate IMRT: a biologically based adaptive approach accounting for setup uncertainties and organ motion." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2524.
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Enhanced resistance to radiation could be caused by both chronic hypoxia and acute hypoxic which has been reported in prostate cancer in various studies. Therefore currently used dose prescriptions (70Gy in 35 fractions) for external beam radiation therapy (EBRT) of prostate cancer has been suggested insufficient to provide optimum clinical outcome. In this study, we propose a Biologically Guided Radiation Therapy approach to boost dose in hypoxic prostate tumor regions while sparing the urethra. A previously proposed hypoxia model was modified for prostate cancer and incorporated into treatment plan optimization. The concept of equivalent uniform dose (EUD) was used in the optimization and evaluation of results. CT data from 25 prostate cancer patients who recently received EBRT at the British Columbia Cancer Agency (BCCA) and hypothetical hypoxic regions manually drawn on these CT scans were selected for this study. The results show that our methods could boost dose in target volume to substantially higher levels. EUD of planning target volume increased to more than 80Gy, despite accounting for effects of hypoxia. This increase was achieved with only minor changes in dose in normal tissues, typically less than 5Gy. Notably, urethra sparing was excellent with a EUD around 64Gy. Robustness of the proposed approach is verified against various hypoxic settings. EUD comparison between RT plans in biological guided and conventional approaches using the same RT technique (Volumetric Modulated Arc Therapy) also suggests that biologically guided radiation therapy (BGRT) approach is more suitable for dose painting purposes with the advantage of delivering sufficient dose to hypoxia region in different scenarios and sparing normal tissue better. Furthermore, we also investigated the impact of inter-fraction patient set-up error and intra-fraction organ motion on the high dose gradients achieved with this proposed dose painting method and explored the feasibility of adapting geometrical uncertainties (represented as systematic error and random error) into treatment planning. Image error obtained from EPID images are used to derive systematic uncertainty and random uncertainty. During the geometrical uncertainty adapted optimization, dose matrix in PTV is shifted based on systematic error and convolved with a Gaussian kernel which is pre-calculated using random error. CT sets and organ contours from five patients who enrolled in the previous dose painting
i
study are selected. For each of them, seven plans are generated using cumulated uncertainty data which was collected after every five fractions. We also present the outcome in terms of equivalent uniform dose (EUD). For four of the patients, EUD history of all seven plans suggests using the proposed optimization method with uncertainty data from the first five fractions, it is possible to achieve the same target coverage of static treatment plans (difference in EUD less than 1Gy). Meanwhile, the elimination of PTV margin also leads to a significant dose reduction (more than 15Gy) in rectum.
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Kärrvall, Sofie, and Isaksson Anette Guerrieri. "Opioidfri anestesi : En litteraturöversikt om alternativ för analgesi." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-385497.
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Bakgrund: Användningen av höga doser av opioider under generell anestesi är numera mycket vanligt. Biverkningar orsakade av opioider är väl känt inom anestesin och sjukvården och senare evidens tyder på att opioider även kan bidra till smärtutveckling. Av denna anledning har studier de senaste 20 åren ifrågasatt användningen av opioider och intresset för att minska opioidbehovet och utveckla opioidfria metoder för anestesi har växt. Syfte: Att beskriva opioidfri analgesi i generell anestesi, och hur detta påverkar den perioperativa smärtupplevelsen, jämfört med patienter i generell anestesi som fått traditionell smärtlindring med opioider. Metod: En litteraturöversikt med systematisk ansats. Artikelsökningen genomfördes i PubMed, Cinahl och Scopus. Resultatet sammanställdes utifrån 15 granskade artiklar med kvantitativ design. Resultat: Litteraturöversikten visar att det finns ett stort antal läkemedel som kan användas inom opioidfri anestesi, samt deras för- och nackdelar för smärtupplevelsen jämfört opioider. De protokoll som användes vid opioidbaserad anestesi eller för opioidsparande anestesi är inte standardiserade och därför är det inte möjligt att syntetisera resultatet och ställa olika metoder mot varandra i denna litteraturöversikt. De flesta artiklar visade att det går att minska intraoperativt och postoperativt opioidbehov för patienter och ändå erbjuda likvärdig smärtlindring. De patienter som fick en opioidfri eller opioidsparande anestesi hade inte en försämrad perioperativ smärtupplevelse. Den mängd metoder som beskrevs indikerar att analgesi kan anpassas efter patientens individuella förutsättningar. Slutsats: Litteraturöversikten visade att olika läkemedel och metoder kan användas för att ge analgesi till patienten vid opioidfri anestesi samt dess effekt på smärtupplevelsen kontra opioider. De flesta alternativa läkemedel som används i artiklarna gav ett mer gynnsamt eller likvärdigt utfall för patienten. Genom utveckling av fler metoder för analgesi under anestesi kan anestesin i större omfattning utgå från individens behov och förutsättningar, vilket bidrar till en mer personcentrerad vård. Litteraturöversiktens resultat visar på en stor spridning och det är därför svårt att bedöma vilka läkemedel som är bäst lämpade. Det krävs således mer forskning inom detta ämne för att möjliggöra jämförelser och utarbeta protokoll som gör opioidfri anestesi till etablerad och säker metod för patienten.Background: High dose opioids during general anesthesia are frequently used. The side effects caused by opioids are well known in anesthesia and healthcare and recent evidence implies opioides can contribute to the development of pain. For this reason, studies over the past 20 years have questioned the use of opioids and an interest has grown in reducing the need of opioids and developing opioid-free methods for anesthesia. Aim: To describe opioid-free analgesia in general anesthesia, and how this affects the perioperative pain experience, compared to patients in general anesthesia who have received traditional opioid-based pain relief. Method: A literature study with systematic approach. The article search was performed in PubMed, Cinahl and Scopus. The result was compiled based on 15 reviewed articles with quantitative design. Result: The literature review shows that there are a large number of drugs that can be used in opioid-free anesthesia and the advantages and disadvantages of these drugs versus opioids. The protocols used for opioid-based anesthesia or for opioid-saving anesthesia are not standardized and therefore it is not possible to synthesize the results or set different methods against each other in this review. Most articles found that it is possible to reduce the intraoperative and postoperative need of opioid for patients and still offer equivalent pain relief. The patients receiving opioid-free or opioid-sparing anesthesia did not suffer a worsened pain-related experience. The amount of methods described indicates that the analgesia can be customized accordingly to the patient's individual circumstances. Conclusion: The literature review described various drugs and methods that can be used to give analgesia to the patient during opioid-free anesthesia and the effect on the pain-related experience. Most of the alternative drugs used in the articles gave a more favorable or equivalent outcome for the patient. By developing more methods for analgesia during anesthesia, it is in a greater extent possible to adjust the anesthesia depending on the individuals needs, which contributes to a more person-centered care. The result shows a wide spread and it is therefore difficult to assess which drugs are best suited. Thus, more research is required in this subject to prepare protocols that make opioid-free anesthesia an established and safe method for the patient.
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Camões, Ana Filipa Bizarro. "Protocolo terapêutico alternativo com oclacitinib para dermatite atópica canina : uma solução capaz de reduzir custos?" Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2021. http://hdl.handle.net/10400.5/21124.
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Dissertação de Mestrado Integrado em Medicina VeterináriaO oclacitinib é um inibidor seletivo da enzima Janus cinase que tem como alvo a interleucina-31, principal mediadora do prurido, sendo considerado um fármaco de espectro de ação moderado, de grande eficácia em termos do alívio sintomático da dermatite atópica (DA) canina, aquando da sua utilização diária. No entanto, apesar de 92,5% dos tutores de cães com DA estarem satisfeitos ou muito satisfeitos com o tratamento com oclacitinib, o seu custo constituí um foco de preocupação para 75% deles, sendo que 42,5% referiram ter de limitar outras despesas para poderem pagar o tratamento do seu cão. No presente estudo pretendeu-se avaliar a possibilidade de adotar um protocolo terapêutico alternativo administrando oclacitinib em dias alternados, o que reduziria para metade os custos da terapêutica. Secundariamente, pretendeu-se ainda avaliar se existe vantagem em associar glucocorticóides por via oral (G), fármacos pouco dispendiosos e de uma maior abrangência de ação, no início deste novo protocolo com oclacitinib. Foi realizado um estudo prospetivo, aleatório, emparelhado, duplamente cego e controlado com placebo, onde foram incluídos 16 cães com diagnóstico de DA, alocados nos grupos P (n=7; placebo) e G (n=9). Os animais foram periodicamente avaliados quanto à gravidade lesional (CADESI-04) e grau de prurido (VAS) no D-30, no D0 e no end-point. O estudo comportou duas fases distintas e sucessivas. Na primeira fase, foi administrado oclacitinib (0,4-0,6 mg/kg, 14 dias BID, depois 16 dias SID) por via oral em ambos os grupos de acordo com o protocolo padrão. No entanto, nos primeiros 7 dias, foi administrada prednisolona (1 mg/kg SID) por via oral ao grupo G e um placebo ao grupo P no mesmo regime. Na segunda fase, todos os animais que responderam satisfatoriamente ao tratamento anterior realizaram o mesmo tratamento, mantendo o oclacitinib, administrado apenas em dias alternados. Os animais mantiveram o protocolo descrito até à recidiva do seu quadro clínico (end-point). Foi possível adotar o protocolo em dias alternados num período de tempo de pelo menos 30 dias em 71,43% dos animais. Não foram encontradas diferenças estatisticamente significativas quer entre as médias de CADESI-04 dos 2 grupos no D0 (p=0,874) e no end-point (p=0,332), quer nos valores de prurido no D0 (p=0,714) e no end-point (p=0,267). Também não foram encontradas diferenças significativas entre os períodos de tempo médios de tratamento em dias alternados dos animais dos 2 grupos (p=0,467). Este protocolo em dias alternados apresenta um potencial que permite reduzir custos mensais a metade, possibilitando um maior acesso a esta ferramenta terapêutica inovadora, segura e muito eficaz, mas também dispendiosa. Não parece existir benefício, para a redução da dose de oclacitinib, pela administração de prednisolona no início do tratamento.
ABSTRACT - Oclacitinib is a Janus kinase inhibitor with activity against IL-31, one of the main pruritus mediators. This drug is considered to have a semi-broad targeting capacity, but with great efficacy in terms of resolution of clinical symptoms of canine atopic dermatitis (AD), when used daily. However, despite 92,5% of the owners of dogs with AD being satisfied or very satisfied with the treatment with oclacitinib, the cost of the drug is a concern for 75%, with 42,5% mentioning that they had to limit other expenses to afford the treatment of their dog. Therefore, its cost may limit its use. This study’s goal is to evaluate the possibility of adopting an alternative therapeutic protocol with oclacitinib on alternate days, which would reduce maintenance costs to half, and to evaluate whether there is an advantage in administering oral glucocorticoids (G), inexpensive drugs with a broader spectrum, at the beginning of this protocol with oclacitinib. This prospective study was conducted as a paired, randomised, placebo-controlled, double-blinded clinical trial. For this study, private-owned dogs diagnosed with AD were randomly allocated in two groups, group P (n=7; placebo) and group G (n=9). Dogs were periodically evaluated for skin lesions CADESI-04 and pruritus (VAS) at D-30, D0 and end-point. This study comprised two distinct and successive phases. In the first phase of the study, oclacitinib was given orally to both groups according to the standard protocol (0,4 mg/kg, BID for 14 days and SID thereafter 16 days). However, in the first 7 days, group G was given oral prednisolone (1 mg/kg SID) and group P was given a placebo following the same regimen. In the second phase of the study, all the animals that had succeeded on the first phase underwent the same protocol with oclacitinib, now given every other day until complete relapse of the disease (end-point) It was possible to adopt the protocol in which oclacitinib was given every other day over a period of time of at least 30 days in 71,43% of the animals. There were no significant differences either between the mean values of CADESI-04 of the two groups at D0 (p=0,874) and the end-point (p=0,332), and between the mean values of pruritus at D0 (p=0,714) and the end-point (p=0,267). There were also no statistically significant differences between the average alternate days treatment times between the animals in the two groups (p=0,467). The alternate days treatment protocol has potential in allowing monthly costs to be reduced by half, giving greater access to this innovative, safe and very effective, but also expensive, therapeutic tool. There seems to be no benefit, in matters of reducing the oclacitinib dose, in adding prednisolone at the beginning of the treatment.
CEVA Saúde Animal (Algés, Portugal)
N/A
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Phalan, Benjamin Timothy. "Land use, food production, and the future of tropical forest species in Ghana." Thesis, University of Cambridge, 2010. https://www.repository.cam.ac.uk/handle/1810/245197.
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Agriculture is arguably the greatest threat to tropical forest species. Conservation scientists disagree over the relative importance of two opposing strategies for minimising this threat: enhancing on-farm biodiversity, through wildlife-friendly farming practices, or sparing land for nature by using high-yielding farming methods on the smallest possible area to reduce the need to convert natural habitats. Previous theoretical work shows that understanding the relationship between population density and yield for individual species is crucial for determining whether one of these strategies, or a mixed strategy, will maximise their populations for a given food production target. In this thesis, I aim to identify what land-use strategy will permit increases in food production with least impact on species in the forest zone of Ghana. Farm-fallow mosaic landscapes with shifting cultivation and native canopy trees produced only around 15% as much food energy per hectare as the highest-yielding oil palm plantations. In farm mosaics where perennial tree crops dominate, food production and profits were higher, but did not reach those of oil palm plantations. I surveyed birds and trees in forest, farm mosaic, and oil palm plantation, and combined these data with information on yields to assess the likely consequences of plausible future scenarios of land-use change. My results provide evidence of a strong trade-off between wildlife value and agricultural yield. Species richness was high in low-yielding farming systems, but there was considerable turnover between these systems and forests, with widespread generalists replacing narrowly endemic forest-dependent species. Species most dependent on forest as a natural habitat, those with smaller global ranges and those of conservation concern showed least tolerance of habitat modification. For virtually all species, including even widespread generalists, future land-use strategies based on land sparing are likely to support higher populations of most species and minimise their risk of extinction compared to land-use strategies based on wildlife-friendly farming. If food production is to increase in line with Ghana‘s population growth, a combination of efforts to improve forest protection and to increase yields on current farmed land is likely to achieve this at least cost to forest species. Efforts to better protect forests, which require further restrictions on human use, might be most effective if they can be closely linked to support for farmers to improve their yields. In the long term however, this strategy will only delay and not avert biodiversity loss, unless global society can limit its consumption.
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Thiele, Sylvia [Verfasser], Lorenz C. [Akademischer Betreuer] Hofbauer, Günter [Akademischer Betreuer] Vollmer, and Lorenz [Akademischer Betreuer] Hofbauer. "Bone-sparing and anti-inflammatory potential of the novel selective glucocorticoid receptor modulator, compound A / Sylvia Thiele. Gutachter: Günter Vollmer ; Lorenz Hofbauer. Betreuer: Lorenz C. Hofbauer." Dresden : Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://d-nb.info/1068152702/34.
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Martino, González Juan. "Estudio de la conectividad cerebral en humanos mediante la técnica de disección de fibras con preservación cortical (Analysis of human brain connectivity with cortex-sparing fiber dissection)." Doctoral thesis, Universidad de Cantabria, 2011. http://hdl.handle.net/10803/131458.
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Introducción: nuestro conocimiento actual de la anatomía de la sustancia blanca cerebral es muy limitado.
Material y Métodos: se estudiaron 15 especímenes de autopsias frescas. Se realizó disección de fibras con preservación cortical. Se estudiaron 4 voluntarios sanos mediante tractografía por tensor de difusión (DTI) con un escáner de RM de 3.0 Teslas.
Resultados: en este trabajo se evidenció que el fascículo uncinado atraviesa el tercio anterior del istmo temporal, mientras que el fascículo fronto-occipital inferior (FFOI) atraviesa los dos tercios posteriores del istmo temporal. Se identificaron dos componentes del FFOI: (i) porción superficial y dorsal, y (ii) porción profunda y ventral. Por último, se aislaron tres segmentos del componente perisilviano del fascículo longitudinal superior (FLS): (A) porción horizontal, (B) porción vertical, y (C) el fascículo arcuato.
Conclusiones: en este trabajo se presenta una nueva técnica de disección de fibras, esta técnica permite aislar los tractos de sustancia blanca, respetando al mismo tiempo la estructura cerebral durante todas las etapas de la disección.
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Williamson, Allan John. "Cardiovascular effects of a low and a high dose of fentanyl in the isoflurane anesthetized dog: the influence of the anesthetic-sparing effect and the correction of bradycardia." Thesis, Virginia Tech, 2017. http://hdl.handle.net/10919/86614.
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Fentanyl has historically been used to reduce inhalant anesthetic requirements in the dog, with the end goal of reducing detrimental cardiovascular effects seen with their use. While fentanyl has been investigated in this context with the older agent enflurane, this agent is no longer in common use. In the current literature, no studies exist that compare the effects of low and high doses of fentanyl on cardiovascular function in dogs anesthetized with isoflurane. In previous literature, a high dose of fentanyl improved cardiovascular function in enflurane anesthetized dogs only following correction of bradycardia associated with its use.
The objective of this study was to evaluate the effect of two doses of fentanyl on isoflurane requirement in the dog, followed by an evaluation of cardiovascular function in the isoflurane-anesthetized dog at equivalent depth of anesthesia. The hypothesis was that fentanyl would reduce inhalant requirements in a dose dependent fashion, and that cardiovascular function would increase with fentanyl administration only following correction of bradycardia.
A total of 8 healthy adult male beagle dogs were enrolled in this study, which was performed in a randomized cross-over design. Minimum Alveolar Concentration (MAC) was determined in these dogs via a 30 mA electric stimulation both before and after administration of a low (loading dose 30 µg/kg, continuous rate infusion (CRI) of 0.2 µg/kg/minute) or high (loading dose 90 µg/kg, CRI 0.8 µg/kg/min) dose of fentanyl. A 7-day washout was observed between experimental days. Following MAC determination, in a subsequent anesthetic episode animals were placed at a MAC multiple of 1.3 and cardiovascular and blood gas parameters were evaluated before and after each fentanyl dose in the presence and absence of bradycardia.
Fentanyl decreased MAC in a dose-dependent fashion (p < 0.001), with the low dose reducing MAC by about 42% and the high dose by about 77%. MAC reduction, however, did not translate into improvement in cardiovascular function, with a significant reduction in cardiac index and oxygen delivery noted with both doses (p < 0.01) that was not different between treatments. Normal mean arterial pressures were maintained with both treatments despite these effects. Only with the high dose, however, correction of bradycardia caused an increase in both cardiac index and oxygen delivery (p < 0.02) when compared to isoflurane alone.
In clinically healthy dogs, administration of a high dose of fentanyl increased cardiac function following correction of bradycardia, but a decrease was observed when bradycardia went uncorrected. Further studies are needed in order to evaluate these effects in clinical patients.Master of Science
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Nordbrøden, Mats. "Optimization of Magnetic Resonance Diffusion Tensor Imaging for Visualization and Quantification of Periprostatic Nerve Fibers." Thesis, KTH, Skolan för teknik och hälsa (STH), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-179658.
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Prostatectomy, surgical resection of the whole prostate is a common treatment for high- risk prostate cancer. Common side effects include long-time urinary and or erectile dysfunction due to damage inflicted to periprostatic nerves. The aim of this study was to identify an optimal magnetic resonance diffusion tensor imaging protocol for visualization and quantification of these nerves, as pre-surgery visualization may help nerve-sparing surgery. Both scanner filter, parameters for accelerated scan techniques, diffusion-related acquisition parameters and post- processing tractography parameters were investigated. Seven healthy volunteers were scanned with a state-of-art 3 T MRI scanner with varying protocol parameters. Diffusion data were processed and analysed using Matlab and Explore DTI. The resulting protocol recommendation included a normalized scanner filter, a parallel imaging acceleration factor of 2, partial Fourier sampling of 6/8, a right-left phase encoding direction, a b-value of 600 s/mm2, monopolar gradient polarity with applied eddy current correction, four acquisitions of 12 diffusion- sensitizing gradient directions, and a reverse phase encoding approach for correction of geometrical image distortions induced by static field inhomogeneity. For post-processing tractography, the recommended parameters were a lower limit for fractional anisotropy of 0.05, a minimum tract length of 3 centimetres and a maximum turning angle between voxels of 60 degrees. The limited parameter range that was tested and the low number of volunteers can be regarded as limitations to this study. Future work should address these issues. Furthermore, feasibility of periprostatic nerve tracking with the optimized protocol should be tested in a patient study.
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Reddy, Bhiskar. "Dosimetric comparison of volumetric modulated arc therapy and three dimensional conformal radiotherapy in the adjuvant setting for the management of gastric cancer : target volume coverage and normal tissue sparing." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/12943.
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Includes bibliographical references.Whilst the benefit of adjuvant radiotherapy in gastric cancer is known, the optimal means of delivery, including two dimensional conventional, three dimensional conformal radiotherapy, intensity modulated radiotherapy and volumetric modulated arc therapy is less certain. The purpose of this study is to assess and compare volumetric modulated arc therapy (VMAT) and three dimensional conformal radiotherapy (3DCRT) plans in adjuvant radiation of gastric cancer.
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Szeterlak, Nina Tatjana [Verfasser], Markus [Akademischer Betreuer] [Gutachter] Niemeyer, and Stephanie E. [Gutachter] Combs. "Adjuvante Radiatio nach Skin-Sparing Mastektomie und autologer Sofortrekonstruktion bei invasivem Mammakarzinom - Eine Machbarkeitsstudie zum Vergleich strahlentherapeutischer Zielvolumina / Nina Tatjana Szeterlak ; Gutachter: Stephanie E. Combs, Markus Niemeyer ; Betreuer: Markus Niemeyer." München : Universitätsbibliothek der TU München, 2016. http://d-nb.info/1114885010/34.
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Hession, Michelle. "Different dietary approaches for the treatment of obesity and the phenotypic responses to these diets." Thesis, Robert Gordon University, 2009. http://hdl.handle.net/10059/415.
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Current treatments for obesity have been unsuccessful. It is essential that a patient-centred approach for obesity management is developed and for this to be successful other diet and lifestyle approaches need to be considered. A systematic review comparing low carbohydrate vs. low fat diets for the treatment of obesity was carried out. It found that low carbohydrate/high protein diets are as effective as, if not better, for treating obesity and cardiovascular disease risk factors. A randomised controlled trial investigating dietary approaches for the treatment of obesity and its co morbidities was carried out. Variables including weight and body composition, cardiovascular risk factors, adipokines, liver and kidney function, and health and lifestyle factors were measured. Those with metabolic syndrome were also examined. It was hypothesised that there are alternative ways of treating obese subjects depending on their phenotype. Those with a higher BMI tend to have a higher carbohydrate intake rather that a higher fat intake so may be better suited to a low carbohydrate/high protein diet rather than the conventional low fat/energy reduced diet. Subjects were initially treated with the standard dietary approach for obesity (health eating, HE) and if not successful after 3 months were randomised to either a very low calorie diet (Lighterlife, LL) or a protein sparing modified fast (PSMF). All three groups showed a significant weight loss and reduced risk for CVD at 12 months. Significant improvements were seen for plasminogen-activated receptor-1, adiponectin, leptin and IL-6 on HE and LL, but only adiponectin significantly improved on the PSMF. Neither diet showed any detrimental effects for those with a healthy liver and kidney function. Quality of life and levels of depression improved at 12 months. Of the 54 subjects with metabolic syndrome at baseline, 12 remained on HE and 32 were randomised to LL and PSMF. This indicates that most subjects did not suit a low fat dietary approach. They were successful at losing weight on LL and PSMF and showed improvement in MS risk factors, and adipokine levels at 12 months. In conclusion, the study demonstrates that a low fat diet may not necessarily be the first line of approach to treat obese subjects with a BMI over 35 kg/m2, including those with MS. A very low calorie diet such as LL or a PSMF may be better suited to the subject.
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B, Pettersson Emira. "Dubbelbeskattningsavtal mellan Sverige och Afrika : En rättslig analys om varför Sverige bör ingå skatteavtal med afrikanska stater - särskilt fokus på Sveriges skatteavtal med Sydafrika, Nigeria och Tunisien." Thesis, Uppsala universitet, Juridiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-252364.
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Syftet med uppsatsen är att undersöka om och varför Sverige bör ingå skatteavtal med afrikanska utvecklingsländer. Sverige är medlem i OECD och har en lång tradition av skatteavtal framför allt gentemot andra industrialiserade länder. Afrikanska utvecklingsländer däremot har inte ett lika utvecklat skattesystem eller konkurrenskraftigt skatteavtalsnät och har andra förutsättningar än Sverige på den globala marknaden. Frågan om varför skatteavtal behövs mellan Sverige och afrikanska u-länder ska belysas genom dessa två vitt skilda perspektiv och utgångspunkter. Jag ifrågasätter även vilka incitament afrikanska stater har för att ingå skatteavtal med Sverige. För ytterligare vetenskaplig förankring har jag valt att granska tre av Sveriges skatteavtal med afrikanska länder. Hur förhåller sig de utvalda skatteavtalen i förhållande till FN:s modellavtal och vilka konsekvenser innebär detta för avtalen mellan Sverige och de utvalda afrikanska länderna? Förhoppningen är att uppsatsen ska bidra till att ge handlingsdirektiv för hur Sverige borde agera i frågan om skatteavtal gentemot afrikanska utvecklingsländer.
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Ander, Fredrik. "Perioperative complications in obese patients : A thesis on risk reducing strategies." Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-59411.
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Aspiration of gastric content and delayed or failed intubation are the leading causes of anesthesia-related mortality and morbidity. In the recovery period, airway obstruction with subsequent hypoxia is a relatively common cause of morbidity, and is highly associated to the amount of opioids administered, especially in obese patients. The overall aim of this thesis was to study these risk factors for airway complications and postoperative hypoxia in obese patients, and to evaluate possible strategies for their prevention. In Study I, intubation times and incidence of failed intubation in obese patients were compared between direct laryngoscopy and videolaryngoscopy with the Stortz® C-MAC™. In Studies II and III, the effect of esmolol vs. remifentanil on the esophageal junction, and the possible analgesic properties of low-dose esmolol vs. placebo were evaluated using high-resolution manometry and the cold pressor test, respectively. Finally, in Study IV, the possible opioid-sparing effect of esmolol after laparoscopic gastric bypass surgery was evaluated. The use of videlaryngoscopy did not shorten intubation times, however appeared to reduce the incidence of failed intubation. Our results also show that esmolol has a favorable profile, compared to remifentanil, with regard to the protection against passive regurgitation and aspiration of gastric content. No analgesic effect of low-dose esmolol was however demonstrated. The intraoperative administration of esmolol instead of remifentanil also did not reduce the requirement of morphine for treatment of post-operative pain. The use of Stortz® C-MAC™ may be recommended for intubation of obese patients. Further studies are however required to clarify the possible role of esmolol in anesthesia.