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1
Gandhi, Ajay. "State (under)development, transnational activism, and tribal resistance in India's Narmada valley." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33895.
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This thesis examines how the Narmada damming project in India is constituted and contested by the state, affected tribal peoples ( adivasis), and a transnational advocacy network led by the Narmada Bachao Andolan (Save the Narmada Movement). Based on ethnographic fieldwork, and employing critical anthropological perspectives on development and globalization, the power relations underlying dominance and resistance are mapped out. The conflicting discourses, strategies and practices of Narmada proponents and opponents are conceptualized within local, regional, national, and transnational sites and modalities. Further, the negotiation of state dominance and adivasi resistance is analyzed through contradictory practice and shifting political alignments. Lastly, this thesis delineates how the Narmada conflict is permeated by complex symbolic and moral mechanisms activated by both state authorities and activist resistors.
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Ozcan, Ali Kemal. "The mobilisation of the tribal Kurds under the PKK : how the Kurds of Turkey were revitalised." Thesis, University of Kent, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270815.
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This study attempts to analyse the internal dynamics of the most recent Kurdish resistance movement in Turkey. The main focus of analysis is the PKK's organisational existence - its ideational and material structure. As the leading entity of the Kurdish movement, the research focuses on the PKK's recent growth - asking how it became capable of revitalising the "buried" body of Kurdishness in Anatolia that has been incorporated (in both demographic and geographical terms) into the Turkicized Republic. Within the framework of the case study method, much of the research is devoted to answering an indirect question: why wasn't it the other Kurdish "national" configurations that came to prominence? To this end, the study tries to appraise the extent of national and non-national ingredients in the make-up of the movement - the leadership, the grassroots and the masses that give their support. The conclusion reached is that the successes and failures of the PKK in bringing about Kurdish opposition in Turkey are fundamentally related to its philosophy of recruitment and organisational diligence, rather than to its scrupulous use of arms or other contextual factors. The form, content and intensity of educational activities give the organisation its strength. This "education war" - concomitant with the contextual tension of Turkey's Kurdish question - produced a "sparking" Apo charisma. In its originating period, the "pure form" of this charisma contributed much to the PKK's ability to mobilise the Kurds. The later "routinised" form of the very charisma has become one of principal determinants in what is known as the movement's "shrinkage process". It was also found that the substance of the party education - mainly involving Öcalan's talks - embodies a philosophy of human nature (rather than a strictly nationalistic content) in search of the re-appropriation of "human naturalness". In the party leadership's view, this human naturalness has to be extricated from the plague of civilisation's property mechanisms, which apparently have degenerated the humane faculties of man's spiritual structure. However, it ought not to be understood that the intensively worded philosophy depicts the extent of such extrication in the personalities of the cadre body of the Organisation. And the field research indicates that this is the Party's greatest internal contradiction.
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McClure, Rosemary O. ""These Are Preying Grounds" - How the Tulalip Tribes of Washington State are Fighting Violence Against Native American Women." Scholarship @ Claremont, 2013. http://scholarship.claremont.edu/scripps_theses/204.
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Domestic violence and sexual assault rates are higher on Indian reservations than anywhere else in the country. This text works toward an understanding of sexual violence as a legacy of colonialism. Rather than being rooted in inherent racial or cultural differences, current rates of sexual violence on Indian reservations are a continuation of a historical pattern in which colonizers used rape as a weapon to control, contain, and conquer the Indians. The unique history of racist and sexist oppression inflicted on Native Americans through the institutionalized denial of kinship, culture, sovereignty, and body autonomy has exacerbated the violence while frustrating the healing process. This paper describes how the boarding schools, Indian child removal, PL 280, the Oliphant decision, cultural appropriation, and the sexualized stereotyping of Indian women led to high rates of sexual violence on Indian reservations. It then explores how the Tulalip Tribes of Washington State have been proactive in fighting to end sexual assault and violence on their reservation, through retrocession, a holistic approach to batterer reform, and victim advocacy, while simultaneously lobbying in support of legislation such as the Violence Against Women Act, which would allow the Tribes to acquire criminal jurisdiction over non-Indians.
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Kendall, Deborah. "Metformin in obese children and adolescents : the MOCA Trial." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/metformin-in-obese-children-and-adolescents-the-moca-trial(7f93bf01-19ee-47b0-b5b1-7c354a1da016).html.
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Background and objective: Childhood obesity is a serious global health problem and it is associated with insulin resistance and significantly increased risk for development of type 2 diabetes and cardiovascular disease. Metformin reduces the risk of developing T2D in adult patients with obesity and insulin resistance. However there is limited and inconclusive data in obese non diabetic children and adolescents. The objective of the Metformin in Obese Children and Adolescents (MOCA trial) was to assess the effect of metformin on body composition, metabolic risk factors and adipokines. Design and methods: The MOCA trial was a six month multi-centre randomized, double-blind placebo-controlled trial of metformin (1.5g daily) in children and adolescents (8-18 years) with insulin resistance and/or impaired glucose tolerance. Auxology, blood pressure measurement and fasting blood tests (insulin, glucose, fasting lipids, ALT, bilirubin, CRP, lactate, resistin, adiponectin, leptin) were performed at baseline, three and six months. A prolonged oral glucose tolerance test was performed at baseline and after six months. Measures of insulin resistance/sensitivity were calculated including HOMA-IR and the adiponectin: leptin (A/L) ratio. Results: 151 obese children participated in the trial (metformin:77, placebo:78). 102 (67.5%) female, 99 (65.6%) post-pubertal, 115 (76.2%) White British and 36 (23.8%) British Asian or Afro-Caribbean. Mean age of participants was 13.7 ±2.3 year and mean BMI-SDS 3.4 (0.5). In regression analysis, controlling for baseline values, sex, ethnicity and pubertal status, metformin had a greater treatment effect over placebo for BMI at three months, that was sustained at six months (-0.25 kg/m2, p=0.01, 95% CI 0.29 to 1.86) and BMI-SDS (-0.1, p=0.01, 95% CI 0.02 to 0.19). Fasting glucose reduced (-0.03 mmol/l, p=0.03) and A/L ratio increased at three months (+0.04, p=0.03), but the improvements were lost at six months. The other measures of insulin sensitivity, metabolic risk factors and concentrations of adipokines did not change with metformin treatment. Conclusions: Metformin therapy for obese children with abnormal insulin glucose status is safe, well tolerated and has a small beneficial treatment effect over placebo for BMI, BMI-SDS, fasting glucose and A/L ratio at three months, with the changes in body composition sustained at six months. A three month course of metformin should be considered by Paediatricians to halt the inexorable rise in BMI-SDS in these children, improve insulin glucose status and act as catalyst and support for more radical change in lifestyle in the individual. Trial register number: ISRCTN 19517475.
5
Liu, Gengshen. "Measurement of ship resistance coefficient from simple trials during a regular voyage." Thesis, Massachusetts Institute of Technology, 1988. http://hdl.handle.net/1721.1/14391.
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Bhardwaj, Kalpana. "A Meta-analytic Approach for Testing Evolutionary Hypotheses of Acquired Resistance in Metastatic Cancer." Thèse, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30657.
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Nowell (1976) first proposed that unless cytotoxic cancer therapy eradicates all tumor cells, genetic or heritable variation within heterogeneous tumors will inevitably lead to the evolution of chemotherapeutic resistance through clonal selection. This evolutionary hypothesis was formalized by Goldie and Coldman (1979), who developed one of the earliest mathematical kinetic models of resistance evolution in neoplasms. Their model predicted that the likelihood of response and cure would be increased in combination vs single agent cytotoxic therapies. In a later study, Gardner (2002) developed a computational kinetic model to predict chemotherapeutic combinations, doses, and schedules most likely to result in patient response and prolonged life. This model predicts that combination therapy involving both cytotoxic and cytostatic drugs will be more effective than combination therapy involving only cytotoxic drugs. Thus far, no systematic evaluation of the Goldie and Coldman and Gardner hypotheses have been conducted in the metastatic clinical trial setting. Here I test these hypotheses using the results of over 700 phase II, III and II/III clinical trials. I show that, as predicted by Goldie and Coldman, both overall response rate and overall survival were greater in combination arms. Moreover, median duration of response – the key indicator of the rate of resistance evolution - was also greater in combination vs single agent arms. These results suggest that generally combination chemotherapy is more effective than single agent therapy for advanced solid tumors as predicted by Goldie and Coldman (1979) hypothesis and that, at least in the metastatic setting, the potential disadvantages of combination therapy with respect to accelerated resistance evolution are outweighed by the greater waiting times for resistance mutations to arise. By contrast, although combination cytotoxic and cytostatic therapy is associated with a greater average overall response rate than multi agent cytotoxic therapy, this is not the case for both median duration of response and overall survival. Hence, there is no evidence that, in contrast to the predictions of the Gardner (2002) model, combination cytotoxic and cytostatic therapy decreases the rate of resistance evolution relative to that obtaining under combination cytotoxic therapy.
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Lobacheva, Tatiana. "Pulmonary tuberculosis in pre-trial detentions in St. Petersburg, Russia /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-638-7/.
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Klein, Julie A. "Faith on Trial| Persecution and Resistance of Jehovah's Witnesses in North Rhine-Westphalia during the Third Reich." Thesis, Southern Illinois University at Edwardsville, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10127208.
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<p> In the study of the Holocaust and the genocidal policies of the Nazi regime, emphasis is most frequently placed on the attempted extermination of the Jewish population of Europe. While this focus is not misplaced, the result of this focus often forces other persecuted groups into the background. The persecution of the Jehovah’s Witnesses of Germany is often given limited attention in Holocaust historiography. Although not designated for extermination like the Jews, the Nazi regime sought to bring about an end to the presence of this religious sect, viewing the Witnesses as a threat to the unity of the German Reich. This paper draws on the theories of Benedict Anderson and Hannah Arendt and uses the region of present-day North Rhine-Westphalia as a case study in an effort to explain how and why the Jehovah’s Witnesses (unlike other sectarian religions) came to be seen as enemies of the Reich. It is estimated that there were 2,500 documented cases of state-sponsored persecution inflicted upon Witnesses living in North Rhine-Westphalia. The types of persecution varied from trial and imprisonment in concentration camps, to the removal of children from the care of their parents, to execution. Although the numbers of individuals targeted do not rival those of the Jews, their marginalization in the study of the Holocaust and genocide limits our understanding of the scope of this crime against humanity. This paper is an attempt to correct this deficiency.</p>
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Soko, Misheck Mica Mafeni. "Evaluation of transgenic RNAi banana and plantain lines for resistance to banana bunchy top disease." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/228515/1/Misheck%20Mica%20Mafeni_Soko_Thesis.pdf.
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This project evaluated genetically modified Cavendish bananas and plantains for field and glasshouse resistance to banana bunchy top virus in Malawi in Africa, over a three-and-a-half-year period. The study identified several GM lines with significant resistance to the virus and provided a rare insight into virus-vector relations and the climate. The research showed that rigorous field assessment of GM plants for disease resistance is critical and that immunity to this virus will likely only be achieved using a multi-faceted resistance strategy.
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Schwenk, Michael, Tania Zieschang, Stefan Englert, Gurtej Grewal, Bijan Najafi, and Klaus Hauer. "Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial." BioMed Central, 2014. http://hdl.handle.net/10150/610031.
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BACKGROUND:Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely. However, the evidence gathered in randomized controlled trials (RCTs) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce. The aim of the present study was to determine whether a specific, standardized training regimen can improve gait characteristics in people with dementia.METHODS:Sixty-one individuals (mean age: 81.9years) with confirmed mild to moderate stage dementia took part in a 3-month double-blinded outpatient RCT. Subjects in the intervention group (IG) received supervised, progressive resistance and functional group training for 3months (2 times per week for two hours) specifically developed for people with dementia. Subjects in the control group (CG) conducted a low-intensity motor placebo activity program. Gait characteristics were measured before and after the intervention period using a computerized gait analysis system (GAITRite(R)).RESULTS:Adherence to the intervention was excellent, averaging 91.9% in the IG and 94.4% in the CG. The exercise training significantly improved gait speed (P < 0.001), cadence (P = 0.002), stride length (P = 0.008), stride time (P = 0.001), and double support (P = 0.001) in the IG compared to the CG. Effect sizes were large for all gait parameters that improved significantly (Cohen's d: 0.80-1.27). No improvements were found for step width (P = 0.999), step time variability (P = 0.425) and Walk-Ratio (P = 0.554). Interestingly, low baseline motor status, but not cognitive status, predicted positive training response (relative change in gait speed from baseline).CONCLUSION:The intensive, dementia-adjusted training was feasible and improved clinically meaningful gait variables in people with dementia. The exercise program may represent a model for preventing and rehabilitating gait deficits in the target group. Further research is required for improving specific gait characteristics such as gait variability in people with dementia.TRIAL REGISTRATION:ISRCTN49243245
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Ljunggren, Stefan, and Robert G. Hahn. "Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial." Linköpings universitet, Anestesiologi med intensivvård, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-84540.
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Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery.<br><p>Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|</p>
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Grace, Brian. "Apparent Total Evaporative Resistance Values from Human Trials Over a Range of Heat Stress Levels." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3125.
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Clothing can influence heat stress depending on the design and its ability to act as a barrier. The progressive heat stress protocol permitted the collection of data to empirically estimate the apparent total evaporative resistance (Re,T,a). Five different clothing ensembles were evaluated, which included work clothes, cotton coveralls, and three limited-use protective clothing ensembles including a pthesis-barrier ensemble, (Tyvek® 1424), water-barrier, vapor-permeable ensemble (NexGen® LS 417), and a vapor-barrier ensemble (Tychem QC®). The study design called for three metabolic level's: low, moderate, and high (L, M, & H) and three heat stages: compensable, transitional, uncompensable (C, T, U). The purpose of this study was to determine if Re,T,a values remained constant over a range of metabolic and heat stage levels. Calculated Re,T,a values were compared using a four-way mixed model analysis of variance. Significant differences for Re,T,a were found among ensembles, metabolic levels, heat stress stages, as well as interactions among ensembles and metabolic levels along with ensembles and heat stress stages (p < 0.0001). A Tukey's Honestly Significant Difference multiple comparison test identified where significant differences occurred (p < 0.05). Results show Re,T,a values differ over a range of metabolic levels and stages of heat stress. Additionally, convection is more supportive of evaporative cooling than diffusion.
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Wehbe, Rabih. "Islam et Chiisme politique." Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE2013.
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Dans un essai qui aurait tout aussi bien pu s'intituler « L'islam chiite entre la politique et la religion, le cas du Liban », une analyse de l'islam politique demeure nécessaire pour mettre la lumière sur la différence entre islamisme et religion musulmane. Avec un peu moins de deux milliards de musulmans dans le monde, la religion musulmane est devenue la première religion pratiquée dans le monde actuel. Le dynamique de cette religion a permis la création d'un immense empire aux populations hétérogènes. Ainsi que, la coexistence entre religion et régime politique a provoquée de véritables luttes armées entre les grandes familles politico-religieuses, notamment le sunnisme et le chiisme. Le sunnisme ayant souvent l'étiquette d'orthodoxie a gardé cette aspect alors que le chiisme devint autres chose ce qu'il était à l'origine, lorsqu'on y voyait seulement le parti qui s'était rassemblé autour d'Ali ibn Abî Tâlib, cousin et gendre du prophète Mohammad. Dans ses quelques traitements de la doctrine islamique nous constatons que ces familles politico-religieuses, tant sunnites que chiites, proliférèrent les unes à côté des autres en même temps qu'elles se combattirent et souvent se condamnèrent réciproquement. Ceci est dû au fait qu'en l'islam, il n'y a jamais eu de pouvoir interprétatif qualifié, individuel ou collégial capable de s'imposer sans conteste.L'effondrement de l'Empire Ottoman donna l'occasion à la France et la Grande-Bretagne de partager le monde arabe sur la base des fameux accords Sykes-picot. La France va restructurer les territoires syrien et libanais, elle établit la structure constitutionnelle confessionnelle complexe du Liban, faisant du pays de Cèdre le plus grand laboratoire du communautarisme. Dans le Liban d'après-guerre, le communautarisme va de soi, il reflète l'état de la société et celle de la conciliation entre spécificités confessionnelle et principe fondamental de l'Etat nation. Le communautarisme libanais va évoluer à travers des mutations économiques, sociales et politiques, notamment chez la communauté chiite. Nous présenterons l'évolution de la communauté chiite dans cet environnement, ainsi que le rôle fondamental joué par Moussa el-Sadr dans la libération de la communauté chiite. Son objectif étant une réaction à la conscience politique du «Metwali». Sa première action était la lutte contre les inégalités sociales et devait s'engager avec l'Etat libanais dans une série d'affrontements qui couvraient souvent un aspect spectaculaire: grève générale en 1970, avertissement au gouvernement et à la réunion de 1974 à Baalbeck que Moussa-El -Sadr a annoncé la naissance du mouvement AMAL. Ce mouvement joue un rôle essentiel dans la vie politique libanaise. Enfin, nous consacrons une partie de ce travail à l'émergence d'une milice radicale pro-iranienne chiite, le Hezbollah, qui a pénétré le système politique libanais. Sa place est privilégiée à cause de ses succès dans la résistance contre Israël, de ses actions sociales et humaines et de ses organisations. La timide participation du « parti de Dieu » au parlement libanais constituait un premier pas vers la « libanisation » du parti. En 2012, le parti chiite annonce sa participation aux combats en Syrie à côté de l'armée de Bachar el-Assad, freinant ainsi le processus de libanisation. Le Hezbollah devient un des acteurs incontournables de la géopolitique du Moyen Orient et retourne en force sur la scène politique libanaise pour s'inscrire dans le cadre d'un chiisme politique international<br>In an essay that might as well have been entitled "Shia Islam between politics and religion, the case of Lebanon", an analysis of political Islam remains necessary to shed light on the difference between Islamism and religion Muslim. With just under two billion Muslims in the world, the Muslim religion has become the first religion practiced in the world today.The dynamics of this religion allowed the creation of an immense empire with heterogeneous populations. As well as, the coexistence between religion and political regime provoked real armed struggles between the big politico-religious families, notably Sunnism and Shiism.Sunnism often had the label of orthodoxy, but Shiism became something else that it was originally when one saw only the party that had gathered around Ali ibn Abi. Tâlib, cousin and son-in-law of the prophet Mohammad. In his few treatments of Islamic doctrine we find that these politico-religious families, both Sunni and Shiite, proliferated alongside each other at the same time that they fought each other and often condemned each other. This is due to the fact that in Islam there has never been a qualified, individual or collegiate interpretative power capable of imposing itself unquestionably.The collapse of the Ottoman Empire gave France and Britain the opportunity to share the Arab world on the basis of the famous Sykes-picot agreements. France will restructure the Syrian and Lebanese territories, it establishes the complex confessional constitutional structure of Lebanon, making the country of Cedar the largest laboratory of communitarianism. In post-war Lebanon, communitarianism is self-evident, reflecting the state of society and the reconciliation of confessional specificities with the fundamental principle of the nation-state. Lebanese communitarianism will evolve through economic, social and political changes, especially among the Shia community.We will present the evolution of the Shiite community in this environment, as well as the fundamental role played by Moussa el-Sadr in the liberation of the Shia community. His goal is a reaction to the political conscience of "Metwali". Its first action was the fight against social inequalities and was to engage with the Lebanese State in a series of clashes that often covered a spectacular aspect: general strike in 1970, warning to the government and to the 1974 meeting in Baalbeck that Moussa-El -Sadr announced the birth of the AMAL movement. This movement plays a vital role in Lebanese politics. Finally, we devote part of this work to the emergence of a radical pro-Iranian Shiite militia, Hezbollah, which has penetrated the Lebanese political system. His place is privileged because of his successes in the resistance against Israel, his social and human actions and his organizations. The timid participation of the "party of God" in the Lebanese parliament was a first step towards the "libanization" of the party. In 2012, the Shiite party announced its participation in the fighting in Syria next to the army of Bashar al-Assad, thus curbing the process of Lebanization. Hezbollah becomes one of the key players in the geopolitics of the Middle East and returns in force on the Lebanese political scene to be part of an international political Shiism
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Jadhav, Sachin. "Cardiac syndrome X, insulin resistance and microvascular dysfunction : the use of metformin in a double-blind randomised controlled trial." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/29177.
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I performed a randomised double-blinded placebo-controlled trial in which women with cardiac ‘Syndrome X’ were compared with a healthy control group to examine differences in their metabolic measures, anthropometric measures and peripheral microvascular function. I went on to administer metformin or placebo for 8 weeks to women with cardiac ‘Syndrome X’. The recruitment protocol and methods used are described in chapter 3. The differences between women with cardiac ‘Syndrome X’ and healthy controls are discussed in chapter 4. I show that after correction for age and body mass index, there exists significant differences between the groups in terms of indices of insulin resistance, some lipid parameters, some serum markers of endothelial function and serum leptin. The process of laser Doppler imaging in conjunction with iontophoretically-applied acetyl-choline and sodium nitroprusside is used to assess peripheral microvascular function, and this is discussed in chapter 5. In particular, the reproducibility of these measurements both between arms, and several weeks apart is validated. I go on to show that there is a significant difference both in the endothelium-dependent and independent peripheral microvascular vasodilating response, between women with cardiac ‘Syndrome X’ and controls, in chapter 6. I demonstrate in chapter 7 that administration of metformin to women with cardiac ‘Syndrome X’ results in significant improvement in some indices of insulin resistance, some lipid measures, some serum markers of endothelial function and body mass. Furthermore, in chapter 8, improvement in endothelium-dependent microvascular function and in some ischaemic-measures is shown following metformin administration. Finally, the potential use of these techniques in clinical practice is discussed.
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CORREALE, LUCA. "Combined endurance and resistance training in women with multiple sclerosis, strength, fatigue and psychological responses: a randomized controlled trial." Doctoral thesis, Università degli studi di Pavia, 2020. http://hdl.handle.net/11571/1329167.
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Background and Purpose
Persons with multiple sclerosis (MS) suffer from strength deficit and muscle mass reduction as expression of central motor areas/pathways demyelization lesions that are implicated in motor function. The loss of function and inactivity lead to a reduction of the work and daily activity, which is frequently associated with depression and other psychological diseases leading to a decline of the quality of life.
First aim of this study was to evaluate the effects of a 12-week endurance and strength combined program training on maximal strength, functional capacities and fatigue in women with multiple sclerosis. Therefore, secondary aim was to study the quality of life and psychological outcomes of the participants after the training.
Methods
Sixteen women with MS (mean age 46±7.2; EDSS 2.25±0.85) were randomized to either a combined training (COM) or waitlist group (WTL). All the participants performed 8 physical tests: body composition with bioelectrical impedance analysis, flexibility with Sit and Reach test (S&R), isometric strength with Handgrip test (HG), maximum dynamic strength with 1 Repetition Max test (1RM) for Legs, Chest and Back, Maximal Voluntary Isometric Contraction (MVIC) with Muscle Lab© force sensor for legs and VO2peak with an incremental test on a cycle-ergometer. Fatigue was measured with MFIS-21 questionnaire, Quality of life (QoL) with MSQOL-54, psychological condition with SCL-90 and depression with BDI-2. The tests were performed at baseline (T0), after 12 weeks (T1), at the end of the combined protocol for WTL and follow-up for COM (T2) and after 12 weeks from the end of intervention for WTL (T3).
The COM group performed 2 times a week for 12 weeks a protocol of supervised combined training. The WTL group began the same combined training intervention, after a 12-week period of habitual lifestyle. Every session lasted 60 minutes and was structured by 3 resistance exercises for body portions (lower, high portion and torso) and 20 minutes of High Intensity Interval Training (HIIT) endurance training.
Results
At the end of the training MVIC improved (+113.4; p=.002; Nm), similarly 1RM increased significantly in Leg Extension and Chest Press (+13.8; p=.001; +6.6; p=.002; Kg). VO2peak increased from 17.5±4.67 to 22±5.93 (p=.02; ml/kg/min). Fatigue decreased significantly in all subscales (Physical -9; p=.003, Cognitive -5; p=.02, Psychosocial -2; p=.005) and depression symptom enhanced from 15.6 to 10.3 points (p<.001) and Quality of life improved significantly in cognitive function (p=.01) and physical health (p=.005).
Discussion and Conclusion
12 weeks of combined endurance and resistance training increased strength and oxygen consumption in people with MS. The training was also effective to reduce fatigue and depression and to enhance quality of life. A tailored and supervised training should be recommended to people with MS because is safe and effective way of improving fitness in people with MS.
Keywords: Multiple Sclerosis, Combined Training, Strength, Fatigue, Depression.<br>Background and Purpose
Persons with multiple sclerosis (MS) suffer from strength deficit and muscle mass reduction as expression of central motor areas/pathways demyelization lesions that are implicated in motor function. The loss of function and inactivity lead to a reduction of the work and daily activity, which is frequently associated with depression and other psychological diseases leading to a decline of the quality of life.
First aim of this study was to evaluate the effects of a 12-week endurance and strength combined program training on maximal strength, functional capacities and fatigue in women with multiple sclerosis. Therefore, secondary aim was to study the quality of life and psychological outcomes of the participants after the training.
Methods
Sixteen women with MS (mean age 46±7.2; EDSS 2.25±0.85) were randomized to either a combined training (COM) or waitlist group (WTL). All the participants performed 8 physical tests: body composition with bioelectrical impedance analysis, flexibility with Sit and Reach test (S&R), isometric strength with Handgrip test (HG), maximum dynamic strength with 1 Repetition Max test (1RM) for Legs, Chest and Back, Maximal Voluntary Isometric Contraction (MVIC) with Muscle Lab© force sensor for legs and VO2peak with an incremental test on a cycle-ergometer. Fatigue was measured with MFIS-21 questionnaire, Quality of life (QoL) with MSQOL-54, psychological condition with SCL-90 and depression with BDI-2. The tests were performed at baseline (T0), after 12 weeks (T1), at the end of the combined protocol for WTL and follow-up for COM (T2) and after 12 weeks from the end of intervention for WTL (T3).
The COM group performed 2 times a week for 12 weeks a protocol of supervised combined training. The WTL group began the same combined training intervention, after a 12-week period of habitual lifestyle. Every session lasted 60 minutes and was structured by 3 resistance exercises for body portions (lower, high portion and torso) and 20 minutes of High Intensity Interval Training (HIIT) endurance training.
Results
At the end of the training MVIC improved (+113.4; p=.002; Nm), similarly 1RM increased significantly in Leg Extension and Chest Press (+13.8; p=.001; +6.6; p=.002; Kg). VO2peak increased from 17.5±4.67 to 22±5.93 (p=.02; ml/kg/min). Fatigue decreased significantly in all subscales (Physical -9; p=.003, Cognitive -5; p=.02, Psychosocial -2; p=.005) and depression symptom enhanced from 15.6 to 10.3 points (p<.001) and Quality of life improved significantly in cognitive function (p=.01) and physical health (p=.005).
Discussion and Conclusion
12 weeks of combined endurance and resistance training increased strength and oxygen consumption in people with MS. The training was also effective to reduce fatigue and depression and to enhance quality of life. A tailored and supervised training should be recommended to people with MS because is safe and effective way of improving fitness in people with MS.
Keywords: Multiple Sclerosis, Combined Training, Strength, Fatigue, Depression.
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Stockler, Martin Richard. "Validation of the PROSQOLI as an outcome measure for clinical trials in advanced hormone-resistant prostate cancer, assessment of convergent, discriminative and predictive validity with baseline data from a randomised trial." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ51552.pdf.
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Brenninger, Vanessa. "Establishing evidence for practice in medical nutrition therapy a case study of the impact of a high amylose resistant starch diet on clinical indicators of the insulin resistant syndrome /." Access electronically, 2005. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060712.103548/index.html.
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Lambert, Conor. "A comparison of the bone response to impact loading and resistance training in young adult women: The OPTIMA-Ex trial." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/389686.
Full textAbstract:
Many factors are linked to developing osteoporosis; however, the inadequate accumulation of peak bone mass prior to skeletal maturity is considered an important factor. As peak bone mass is often achieved by the end of the third decade, young adulthood provides an important and possibly final opportunity for its augmentation. Physical activity has been proposed as one of the most effective strategies to improve bone mass, however, the bone response to physical activity is highly dependent on the nature of the loads imposed. The most osteogenic loads are those that induce high magnitude bone strains at high loading rates. As most mechanical forces acting on the skeleton are generated through either gravitational-derived loads or muscle-derived loads, debate exists as to the predominant source of the adaptive stimulus. Despite this, few direct comparisons of the effect of gravitationally-derived (impact) loading and muscle-derived (resistance training) loading on bone have been undertaken, with none examined under true high-intensity training conditions. Consequently, the primary goal of the current work was to compare the bone response to two known osteogenic loading methods, impact loading exercise versus resistance training exercise in young women with below average bone mass.
The thesis comprises six manuscripts, presented as three published papers, two under review and one submitted. The first paper (Chapter 3) details the protocol for the Osteoporosis Prevention Through Impact and Muscle-loading Approaches to Exercise (OPTIMA-Ex) trial. Therein, the methods of the three-arm randomised controlled trial, comparing the bone responses of 10-month, twice-weekly, either supervised high-intensity impact training, high-intensity resistance training, or unsupervised home-based low intensity exercise (active control) in young adult women with lower than average bone mass have been described. The two subsequent papers describe the outcomes of methodological studies related to the measurement of forces associated with the exercise interventions, specifically the impact training intervention. The first study (Chapter 4), determined the validity and reliability of a Gym-aware linear positional transducer to track the progression of the novel punching exercise of the impact training arm of the OPTIMA-Ex trial. The second (Chapter 5) quantified the intensity of mechanical loading associated with the lower limb exercises of the impact training exercise program. We found that vertical ground reaction forces generated were greater than four times body weight for all seven training stages and increased over time, suggesting that the impact intervention arm of the OPTIMA-Ex trial achieved its goal of being both high-intensity and progressive in nature.
The fourth manuscript (Chapter 6) comprises the overall findings of the between-group comparisons of the OPTIMA-Ex trial. We found that high-intensity resistance training may provide a broader osteogenic loading stimulus than high-intensity impact training for young adult women with lower than average bone mass, although findings were site-specific. More specifically, high-intensity resistance training had a greater osteogenic effect for cortical bone than impact training, while impact training provided a greater stimulus for trabecular bone. Furthermore, resistance training evoked greater improvements in both body composition and physical performance measures. Manuscript five (Chapter 7), presents a comparison of upper and lower limb responses to high-intensity impact training and high-intensity resistance training on indices of bone strength. Only those who completed the intervention arms of the OPTIMA-Ex trial were included in this analysis. Similar site-specific responses were observed from these analyses, irrespective of upper or lower extremity. Resistance training elicited greater effects at the proximal femur and along the shaft of long bones, while the effects of impact training were greater in the distal segments of long bones nearest to the points of impact.
The final manuscript (Chapter 8) describes a mixed-methods study to explore participant experiences during the OPTIMA-Ex trial, determine enjoyment and acceptability of each exercise mode, and identify barriers and facilitators to bone-targeted exercise in young adult women. Overall, the program was well received, with all groups demonstrating an improvement in the ‘mental health’ domain of the quality of life measure, however, the two supervised exercise groups reported greater levels of physical activity enjoyment. Qualitative analysis revealed the impact and resistance training groups had ‘richer’ exercise experiences than controls, through perceived improvements in emotional and mental well-being along with the an overall sense of achievement through progression and skill acquisition. Furthermore, clear group differences were observed in terms of willingness to recommend their training mode to a friend and intention to continue the program after the trial period, with resistance training participants appearing most positive for both outcomes.
Overall, the current work demonstrates site-specific effects of high-intensity impact training and high-intensity resistance training in young adult women with lower than average bone mass. Within the limits of the modest sample size, we conclude that both impact training and resistance training have important beneficial effects on bone in the participant demographic and are safe, enjoyable and well received. High-intensity resistance training, however, may have a slightly broader effect on bone outcomes than impact training, as well as on body composition, strength and acceptability in young adult women.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School Allied Health Sciences<br>Griffith Health<br>Full Text
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Dooris, Matthew David. "Apparent Total Evaporative Resistance Values From Human Trials Over a Range of Metabolic and Heat Stress Levels." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3078.
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Failure to maintain thermal equilibrium can cause uncontrollable increases in body core temperature beyond critical upper limits. In selecting clothing, consideration must be given to the heat transfer properties of clothing that may restrict the cooling capacity of the human body under heat stress conditions, most importantly, apparent total evaporative resistance (Re,T,a). This study calculated and compared Re,T,a for five clothing ensembles under varying heat stress conditions, including three relative humidity (RH) levels and three stages of heat stress to determine if Re,T,a values varied or remained the same with changes in heat stress conditions. A four-way mixed model analysis of variance demonstrated significant differences for estimated Re,T,a values among ensembles, RH levels, heat stress stages, and interactions among ensembles and RH levels and ensembles and heat stress stages (p < 0.0001). No significant interaction among RH levels and heat stress stages was found (p = 0.67). A Tukey's Honestly Significant Difference multiple comparison test was used to identify where significant differences occurred (p < 0.05). The results of the study indicated that Re,T,a values do change with RH levels and stages of heat stress and that the theoretical framework for explaining heat-exchange in hot environments is not yet well-established. Also confirmed was the dominance of the convection pathway over the diffusion pathway in hot environments.
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Gloster, Andrew T., Rainer Sonntag, Jürgen Hoyer, et al. "Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial." Karger, 2015. https://tud.qucosa.de/id/qucosa%3A71640.
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Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-ofprinciple data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed.
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Brassey, Christina. "Analysis of a Pinus radiata Seed Stock Field in the Native Año Nuevo Stand in California." DigitalCommons@CalPoly, 2009. https://digitalcommons.calpoly.edu/theses/219.
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This study was a part of the international collaborative IMPACT project, which aims to address the potential threat that the pitch canker disease poses to the use of Pinus radiata D. Don in plantations in New Zealand, Australia, and Chile. A field trial of 264 seedstocks was planted adjacent to a native stand of pitch canker infected P. radiata on the central coast of California, and disease symptom development was recorded over a period of 3 years. The results did not correlate with a greenhouse study of the same seedstocks inoculated with Fusarium circinatum Nirenberg & O'Donnell, the causal agent of pitch canker. Three main types of symptoms were identified (branch flagging, pitchy buds, and chlorotic tips), and preliminary isolation analyses suggest that the disease observed is actually caused by Diplodia pinea (Desm.) Kickx. Survival analysis showed that the effect of tree genetic origin was significant to its time to disease, and that spatial location in the plantation was also significant. Average nearest neighbor analysis showed disease distribution to be significantly clustered, which also suggests that the disease is not pitch canker, but diplodia blight. This experiment illustrates the difficulty in performing naturally infected field trials when another similar-looking fungal disease is also present. It also provides data on seedstock resistance to diplodia blight, another fungal disease important to P. radiata forest managers.
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Hurl, Jennine. "Voices of litigation; voices of resistance constructions of gender in the records of assault in London, 1680-1720 /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ66350.pdf.
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Stites, Aaron W. "A Comparison of the Effects of High-Resistance Cycle Training and Leg Press on the Wingate Anaerobic Test, Strength, and Time-Trial Performance." Diss., CLICK HERE for online access, 2009. http://contentdm.lib.byu.edu/ETD/image/etd2844.pdf.
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Kim, Jiyoung. "The impact of physical activity and resistant starch on gut fermentation." Thesis, Kansas State University, 2016. http://hdl.handle.net/2097/32841.
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Master of Science<br>Department of Human Nutrition<br>Mark D. Haub<br>Purpose: Physical activity (PA) and resistant starch (RS) beneficially affect metabolic health. However, their combined effects on gut health are poorly understood. The purpose of this thesis was to investigate the combined effects of PA and RS via breath hydrogen production and blood glucose responses and directly learn about the research process. Methods: Twenty subjects with no reported symptoms of metabolic diseases participated in this thesis project. Subjects wore accelerometers to determine PA status, and were then stratified into two groups: less active or more active. Once enrolled and stratified into groups based on PA assessment, subjects came to the laboratory on two more occasions to eat a standardized energy dense test meal with a lemonade beverage. The beverage contained different doses (5 g or 25 g) of RS type 4. On each test day, breath hydrogen was collected at baseline through the sixth hour at hour intervals through the fourth hour. Between hours four and six, the breath samples were collected every 30 minutes. Blood glucose samples were collected at baseline before the meal and then 15, 30, 45, 60, 90, and 120 minutes after beginning to eat the meal. Results: The incremental areas under the curve for glucose were not different between PA groups or RS dose (p>0.05). The area under the curve values for breath hydrogen were not different (p>0.05) between groups or doses of PA and RS, respectively. Conclusion: These results indicate that acute assessments of gut fermentation in generally healthy participants, as assessed by postprandial breath hydrogen production, requires more than six hours of assessment to determine differences between treatments and levels of physical activity.
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Nanzer, Alexandra M. "The Calcitriol Study : a randomised placebo controlled clinical trial to test the effects of calcitriol in steroid resistant asthma." Thesis, Queen Mary, University of London, 2015. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8956.
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Background: Over five million people in the UK are receiving treatment for asthma. Corticosteroids (steroids) are the mainstay of asthma therapy but some patients do not respond fully to steroid treatment; they are characterised as being steroid resistant (SR) and are at high risk of morbidity and mortality. Earlier data from our laboratory has shown evidence that in vitro treatment with the active form of vitamin D, - 1α, 25-dihydroxyvitamin D3 or calcitriol - enhanced responsiveness to steroids for induction of the anti inflammatory cytokine IL-10. This thesis discusses the results of a proof of concept clinic trial - ‘The Calcitriol Study’ - which hypothesized that concomitant in vivo treatment with oral calcitriol improves the clinical responsiveness to systemic steroid (prednisolone) therapy. The study further allowed investigation of the in vitro cytokine profile of patients with SR and steroid sensitive (SS) asthma. Th17 cells and their hallmark cytokine IL-17A are proposed to play a role in the pathology of severe asthma, including SR asthma, and this work tested the susceptibility of IL-17A and other pro inflammatory cytokines important in asthma to inhibition by steroids and calcitriol in vivo and in culture. Methods: Adult patients with moderate/severe asthma (FEV1 <80% predicted) with demonstrable reversibility of airways obstruction underwent a two-week, pharmacodynamically standardised course of oral prednisolone (screening phase) to delineate steroid resistance a <10% improvement in FEV₁. Patients were then randomly assigned to receive calcitriol (n=12) or indistinguishable placebo (n=11) for four weeks, with a repeat course of prednisolone during the final two weeks (treatment phase). Changes in lung function (ΔFEV₁) in response to prednisolone were compared between the placebo and calcitriol groups in the treatment phase, and within groups between the screening and treatment phases. Asthma Control Questionnaires and fractional exhaled nitric oxide (FeNo) were scored and analysed as secondary endpoints. All participants had serum 25(OH)D levels measured at baseline. CD8-depleted PBMCs were isolated from SS and SR asthmatics and healthy controls and cultured with or without dexamethasone and/or calcitriol. Cytometric bead array, ELISA, qPCR and intracellular cytokine staining were used to assess cytokine production. Results: 5 Treatment with calcitriol improved the clinical response to steroids in patients classified as clinically steroid resistant (SR) in a within group comparison of changes in FEV1. However, there was no significant difference seen between the two groups from screening to the end of the trial. A striking dichotomy was observed between SR and SS asthma patients in terms of their cytokine profiles; SS patients, who showed the biggest improvement in lung function after a course of prednisolone had the highest levels of IL-10 in culture in response to dexamethasone, whereas SR patients, whose lung function failed to improve, had significantly greater levels of IL-17A. Treatment with steroids appeared to aggravate production of this pro-inflammatory cytokine but in vitro and in vivo calcitriol not only resulted in a significant reduction of IL-17A levels but also restored the impaired, steroid-induced anti-inflammatory IL-10 response in SR patients. Serum 25(OH)D levels at baseline correlated positively with IL-13 in culture, a Th2 cytokine known to be associated with steroid responsive asthma. Conclusion: Calcitriol may have the potential to improve the clinical responsiveness of asthma patients to systemic steroid therapy in SR asthma. These data identify immunological pathways that likely underpin the beneficial clinical effects of calcitriol in SR asthma, by directing the SR cytokine profile towards a more SS type, suggesting strategies to characterise vitamin D responder immune phenotypes.
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Wang, Yi. "A randomised controlled trial of power training in older adults with type 2 diabetes: Adaptations in muscle and subcutaneous adipose tissues." Thesis, The University of Sydney, 2010. https://hdl.handle.net/2123/29217.
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The GREAT2DO study (Graded Resistive Exercise And Type 2 Diabetes in Older
Adults) was a randomised double-blind, sham-exercise controlled trial assessing the
efficacy of 1 year of power training (high velocity, high intensity anabolic exercise)
on glucose homeostasis and associated co-morbidities in older adults with type 2
diabetes. The aims of this GREATZDO sub-study were to assess the efficacy of 1 year
power training on insulin signalling pathways components and inflammatory factors
in thigh skeletal muscle and subcutaneous adipose tissues in older adults with type 2
diabetes.
Chapter Two is a systematic review that outlines the current level of morphological
and metabolic adaptations within skeletal muscle to exercise training in adults with
type 2 diabetes or impaired glucose tolerance.
Chapter Three describes the methodology of this GREATZDO sub-study. This
includes an overview of the study design, and focuses in particular on the method of
muscle and adipose tissue biopsy performed in this study, and the methods of
investigating the factors in muscle and adipose tissues we hypothesised would be
related to exercise adaptation and insulin sensitivity.
Chapter Four describes the baseline characteristics of the enrolled cohort in this
GREATZDO sub-study. This chapter also investigates any relationships between
these baseline characteristics. Factors investigated included insulin resistance,
selected insulin signalling pathway components, glucose homeostasis, inflammatory
factors, health status, body composition, muscle function, quality of life and physical
performance in this cohort.
Chapter Five describes the effects of power training on insulin signalling pathways
components and inflammatory factors in thigh skeletal muscle and subcutaneous
adipose tissues in study participants, as well as their whole body composition and
glucose homeostasis.
1n the discussion chapter, we summarise our findings and place our results in the
context of the existing published literature in this field. In addition, we discuss
limitations relevant to the interpretation of our findings, suggest areas for future
investigation, and propose how to use our analysis of previous studies and the
GREATZDO trial to inform clinical practice in patients with type 2 diabetes.
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Oliver, Charlotte. "Phylogeny, histological observation, and in vitro fungicide screening and field trials of multiple Colletotrichum species, the causal agents of grape ripe rot." Diss., Virginia Tech, 2019. http://hdl.handle.net/10919/99418.
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Colletotrichum acutatum and C. gloeosporioides are fungal plant pathogens that have a global distribution, extensive host range, and convoluted taxonomy. Both species can cause grape ripe rot and are considered endemic to Virginia US. In 2012, C. acutatum and C. gloeosporioides were reclassified into species complexes that consist of 31 and 22 accepted species, respectively. The objectives of this study were to: 1) survey Virginia vineyards for grape ripe rot, and morphologically and phylogenetically identify isolates to the species within the complexes, 2) conduct an in vitro fungicide assay to screen fifteen commercial fungicides and combinations of two fungicides for efficacy to control isolates from seven Colletotrichum species from Virginia vineyards, 3) sequence gene fragments from three subunits of the SDH enzyme in the fungicide-screened isolates to observe potential resistance mutations, 4) investigate the susceptibility of three grapevine tissues to Colletotrichum species, 5) observe potential infection structures before and after the application of fungicides, 6) evaluate the efficacy of commercial fungicide controls of grape ripe rot in the field, and determine the most advantageous timing of applications. In my studies, I identified six Colletotrichum species: C. aenigma, C. conoides, C. fioriniae, C. gloeosporioides, C. kahawae, and C. nymphaeae. I also found two additional groups; an isolate similar to C. limetticola and C. melonis and a group of isolates that are similar to C. alienum, C. fructicola, and C. nupharicola. I also identified captan, and mancozeb as two potential active ingredients for control of grape ripe rot isolates from Virginia via the in vitro fungicide assay. Additionally, I found that combinations of two active ingredients could increase the efficacy of benzovindiflupyr, copper, and polyoxin-D. C. fioriniae germination and production of melanized appressoria was documented on leaves. I observed appressorium formation with isolates of two C. fructicola-like genotypes and C. nymphaeae, as well as secondary conidiation with isolates of C. aenigma, C. fructicola-like genotype 3, and C. nymphaeae on blooms. And finally, benzovindiflupyr, cyprodinil + fludioxonil pre-mix, and potassium phosphite + tebuconazole were identified as candidates for chemical control for grape ripe rot in the field.<br>PHD
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Fox, Z. V. "Analyses of observational studies and randomised trials to increase understanding of the occurrence and role of drug resistance in HIV infection." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1443956/.
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This thesis explores the relationship between the use of antiretroviral therapy (ARVs) and drug resistance emergence in HIV-1 infected individuals. It also describes the combined impact of treatment use and resistance mutations on virological and immunological response in individuals who are under follow-up in one of four trials: MaxCminl, MaxCmin2, COLATE or SMART and three observational studies: EuroSIDA, the UK CHIC study and the UK drug resistance database. The emergence of resistance to an ARV that an individual is receiving may influence viral replication rates, which could increase the risk of CD4+T cell count deterioration, clinical progression and death, unless changes are made to the treatment regimen. Individuals may exhaust all treatment options if large amounts of resistance mutations are detected in their viral sub-populations. In the current era, new ARVs are still arriving on the market, but resistance to these ARVs is only partially understood. Understanding what mutations emerge in individuals who are failing treatment and the impact of specific mutations and combinations of mutations on the likelihood of responding to future regimens is still essential for being able to administer long-term therapy successfully. Research for this thesis started just after the introduction of ritonavir boosted protease inhibitors (Pl/rs). Drug resistance emergence among individuals who experienced virological failure on a Pl/r containing regimen is described in detail, and the relationship between resistance at baseline and virological response is also quantified. Other aspects of drug resistance are investigated, including: the potential benefit of harbouring the M184IA/ mutation, the impact of resistance on immunological response and the relationship between resistance and viral re-suppression rates amongst patients who interrupt an NNRTI containing regimen. This thesis outlines the benefits of resistance testing and highlights some of the key issues with interpreting resistance data. Resistance tests are generally performed on a selective group of individuals so caution needs to be used when extending the results to all HIV-1 infected individuals. Further, consensus sequences are useful for indicating resistance that is present in the predominant virus however, more minor, archived, species are not usually identified through this method and these may also be an important determinant of therapy response.
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Juopperi, Tarja Alison. "Retroviral-mediated gene transfer and expression of the multidrug resistance-associated protein 1 for hematopoietic chemoprotection, preclinical trials in a canine model." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0015/MQ54076.pdf.
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Feng, Xuewen. "Characterization of fungicide resistance in grape powdery and downy mildew using field trials, bioassays, genomic, and transcriptomic approaches: quinoxyfen, phosphite, and mandipropamid." Diss., Virginia Tech, 2018. http://hdl.handle.net/10919/92588.
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Development of fungicide resistance in fungal and oomycete pathogens is a serious problem in grape production. Quinoxyfen is a fungicide widely used against grape powdery mildew (Erysiphe necator). In 2013, E. necator isolates with reduced quinoxyfen sensitivity (designated as quinoxyfen lab resistance or QLR) were detected in Virginia. Field trials were conducted in 2014, 2015, and 2016 at the affected vineyard to determine to what extent quinoxyfen might still contribute to disease control. Powdery mildew control by quinoxyfen was good, similar to, or only slightly less, than that provided by myclobutanil and boscalid in all three years. The frequency of QLR in vines not treated with quinoxyfen declined only slowly over the three years, from 65% to 46%. Information about the mode of action of quinoxyfen is limited; previous research suggests that quinoxyfen interferes with the signal transduction process. We profiled the transcriptomes of QLR and sensitive isolates in response to quinoxyfen treatment, providing support for this hypothesis. Additional transcriptional targets of quinoxyfen were revealed to be involved in the positive regulation of the MAPK signaling cascade, pathogenesis, and sporulation activity. Grape downy mildew (Plasmopara viticola), another important grape pathogen, is commonly controlled by phosphite fungicides. A field trial and laboratory bioassays were conducted to determine whether P. viticola isolates from vineyards with suspected control failures showed reduced sensitivity against phosphite fungicides. Prophyt applied at 14-day intervals under high disease pressure provided poor downy mildew control in the field. Next-generation sequencing technologies were utilized to identify 391,930 single nucleotide polymorphisms (SNPs) and generated a draft P. viticola genome assembly at ~130 megabase (Mb). Finally, field isolates of P. viticola collected from a Virginia vineyard with suspected mandipropamid control failure were bioassayed. The EC50 values of the isolates were >240 μg.ml-1 for mandipropamid, well above the field rate. The PvCesA3 gene of two resistant isolates was sequenced revealing that these isolates had a GGC-to-AGC substitution at codon 1105, the same mutation that has been found associated with CAA resistance elsewhere.<br>PHD
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Falgin, Hultgren Jonas. "The Acute Metabolic Response of Intermittent Hypoxic Resistance Exercise : A Cross-Over RCT." Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-5791.
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Aim The aim for this present study was to investigate the acute metabolic response from intermittent resistance exercise during hypoxia, with the following research questions: (1) Are blood levels of lactate and glucose different between hypoxia and normoxia? (2) Does hypoxia induce higher lactate accumulation and pH reduction in the human skeletal muscle? (3) Is there a relationship between plasma-, blood- and muscle lactate? Method Eight healthy males (30 ± 2 years) performed 6 sets of unilateral leg extension on each leg (75% of 1RM) with randomized normoxic (20,9% inspired 𝑂2) and normobaric hypoxic (12% inspired 𝑂2) conditions. A total of 5 muscle biopsies was extracted from m. Vastus Lateralis (pre-, post exercise, 90-, 180min and 24h post exercise) during both normoxia and hypoxia trials, separated by one week for all participants. Blood samples were repeatedly taken with 20 min intervals. Heart Rate (HR) and saturation (𝑆𝑝𝑂2) were measured by a pulsoximeter during resistance exercise. Results No significant main effect was observed for blood lactate and glucose levels as well as the muscle lactate accumulation and pH between normoxia and hypoxia. However, pH in muscle showed a trend between the conditions post exercise where hypoxia reached lower levels in total (P=0.08). Significant correlations were observed for blood- and plasma lactate, where hypoxia showed a stronger relationship than normoxia (r=0.98 compared to r=0.87). Equal findings for the correlation of muscle- and plasma lactate showed an even greater coefficient value for hypoxia compared to normoxia (r=0.860 compared to r=0.59). Conclusion Summarized data indicated that no significant difference between hypoxia and normoxia was evident. Nonetheless, tendencies illustrate that hypoxia may alter the metabolic response slightly. However, further research is needed to draw a conclusion between the conditions.<br>Syftet med denna studie är att undersöka kroppens akuta metabola svar från intermittent styrketräning under hypoxi, med följande frågeställningar: (1) Skiljer sig nivåerna av laktat och glukos i blodet mellan hypoxi och normoxi? (2) Skapar hypoxi större laktatansamling och pH reduktion i människoskelettmuskeln? (3) Finns det en relation mellan plasma-, blod- och muskellaktat? Metod Åtta friska män (30 ± 2 år) deltog där deltagarna utförde 6 set unilateral benextension för varje ben (75% 1RM). Intermittent styrketräning randomiserades med hypoxi som utfördes med 12% syrgas och normoxi som bibehöll normal syrgasnivå (20,9% syrgas). Under två testdagar togs 5 muskelbiopsier från m. Vastus Lateralis (före-, efter träning, 90-, 180min och 24h efter träning) på vartannat ben per testdag. Hjärtfrekvensen och 𝑆𝑝𝑂2 mättes via pulsoximeter under träningen. Resultat Ingen signifikant huvudeffekt påvisades mellan hypoxi och normoxi för blodlaktat samt glukos, såväl som laktatackumulationen och pH värdet i muskeln. Muskel pH visade en trend där hypoxi efter styrketräning nådde lägre totalnivå än normoxi (P=0,08). Vidare observerades hypoxi att ha starka relationer mellan blod- och plasmalaktat jämfört med normoxi (r=0,98 vs. r=0,87). Större skillnad framgick för korrelationen mellan muskel- och plasmalaktat där hypoxi-försöket utgav starkare koefficient jämfört med normoxi (r=0,86 vs. r=0,59). Konklusion Sammanfattad data visar att hypoxi inte skapar större metabolisk respons vid intermittent styrketräning. Trots detta framkom tendenser som illustrerar att hypoxi kan påverka den metabola stressen under styrketräning. Däremot krävs vidare forskning för att kunna säkerställa effekten av hypoxi på kroppens metabola svar.<br>Ingår i Marcus Mobergs projekt: ”Resistance exercise under hypoxia and the acute molecular effects in human skeletal muscle
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Merolla, Aneliya B. "A study of the relationship between borderline-dysregulated personality and treatment-resistant depression in the course of the TADS randomised controlled trial." Thesis, University of Essex, 2017. http://repository.essex.ac.uk/19360/.
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Aim: This research project explored the relationship between borderline personality disorder, difficult to treat depression and treatment outcome. Method: The study used data collected in the course of the Tavistock Adult Depression Study (TADS). The TADS was a randomised controlled trial comparing Long Term Psychodynamic Psychotherapy (LTPP) to Treatment as Usual (TAU) for 129 patients whose depression has not been successfully treated by at least two previous interventions. The author of this project took part in rating all patients with the Shedler-Westen Assessment Profile (SWAP-II) – a 200-item personality measure – at the beginning and end of treatment. Statistical analysis explored the relationship between patients’ borderline personality scores at the beginning and end of treatment, and their progress in treatment in terms of decrease in depression severity, and psychological distress, and increase in general functioning. In addition, changes in borderline personality features were also explored in relation to changes on the three main outcome measures. The author included the rest of the SWAP-II personality scales in the analysis, too, as the SWAP-II generates an overall personality profile. Results: Only a small number of patients reached cut-off scores for borderline personality disorder or features. When the SWAP-II borderline scale was entered in analysis as a continuous variable, no significant link was found between borderline personality scores at the beginning of treatment, and treatment outcome. The way borderline features changed in the course of treatment, however, was significantly related to the outcome measures. This was particularly the case for SWAP-II items indicating insecure attachment and affect dysregulation. In addition, patients in the LTPP group who presented with borderline personality features or disorder at the end of treatment were more likely to still experience severe or very severe depression at the end of therapy.
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Mesa, Castrillón Carlos Iván. "Effects of two periodized training programs : aerobic interval and functional resistance on isokinetic muscle strength, physical fitness and clinical parameters in metabolic syndrome. Non-randomized controlled clinical trial /." Presidente Prudente, 2017. http://hdl.handle.net/11449/149926.
Full textAbstract:
Orientador: Jayme Netto Júnior<br>Banca: Fabio do Nascimento Bastos<br>Banca: Fabio Santos de Lira<br>Resumo: Introdução: A Síndrome Metabólica é uma condição sistêmica relacionada com transtornos musculoesqueléticos. O treinamento aeróbio intervalado é amplamente utilizado como tratamento mas seus efeitos sobre a força muscular e aptidão física, ainda são pouco descritos. Objetivo: Analisar e comparar os efeitos de dois programas periodizados: treinamento aeróbio intervalado e treinamento funcional resistido na força muscular isocinética, aptidão física, e parâmetros clínicos em sujeitos com Síndrome Metabólica. Métodos: 68 participantes com idade entre 35 e 60 anos e diagnóstico de Síndrome Metabólica, foram divididos em três grupos, controle sem intervenção, treinamento aeróbio intervalado e resistido funcional, os quais foram submetidos a programas de exercício periodizado, totalizando 39 sessões. Análise estatística: Utilizou-se análise de covariância (ANCOVA) e Kruskal-Wallis para dados paramétricos e não paramétricos, respectivamente. Resultados: Os grupos aeróbio e resistido melhoraram a força de flexão de joelho. Houve diferenças significativas na agilidade e resistência aeróbia geral incluindo um tamanho de efeito grande que favorece ao grupo aeróbio intervalado. Conclusão: Ambos treinamentos tiveram um tamanho de efeito médio na força de flexão de joelho e efeito baixo na força de extensão. Além disso tiveram grande efeito na agilidade, mas só exercício aeróbio intervalado foi efetivo na melhora da resistência aeróbia geral com tamanho de efeito grande<br>Abstract: Introduction: Metabolic Syndrome is a systemic condition related to musculoskeletal disorders. Aerobic interval training is widely used as treatment but its effects on muscular strength and musculoskeletal symptoms are still modestly described. Objective: to analyze and to compare the effects of two periodized programs, aerobic interval and functional resistance training on isokinetic muscular strength, physical fitness, and clinical parameters in participants with Metabolic Syndrome. Methods: 68 participants aged 35 and 60 years old, with Metabolic Syndrome diagnostic, were divided in three groups: control with no intervention, aerobic interval and functional resistance training, who were submitted in exercise programs, totalizing 39 sessions. Statistical analysis: We used covariance (ANCOVA) and Kruskal-Wallis analysis for parametric and non-parametric data, respectively. Results: Aerobic and resistance training improved knee flexion muscle strength. There were significant differences in agility and overall aerobic endurance, including a large effect size that favors the interval aerobic group. Conclusion: 16 weeks of either aerobic interval or functional resistance training had a medium effect on knee flexion strength and a low effect on knee extension strength. Both training program had a large effect on agility, but only aerobic interval training was effective to improve general aerobic resistance with a large effect size<br>Mestre
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Vogler, Constance. "Reducing fall risk in older people discharged from hospital: a randomised controlled trial comparing (i) seated lower limb resistance training, (ii) functional weight-bearing exercises and (iii) social visits." Thesis, The University of Sydney, 2007. https://hdl.handle.net/2123/28062.
Full textAbstract:
Whilst exercise therapy has been found in trials to reduce fall rates in older
people, not all exercise interventions have been found to be equally effective in
preventing falls or reducing fall risk factors. Older people who have recently been
discharged from hospital are at an increased risk of falling, but they are a
population that has not been well studied in interventional trials.
This study aimed to investigate the effects of different types of exercise therapy
on fall risk factors in older people recently discharged from hospital, using a
randomised controlled trial. It also aimed to determine the extent to which gains in
physical performance and functional ability were maintained or lost following the
completion of the 12-week trial.
Firstly a reliability study of outcome factors for risk of falling was tested in the
home setting, using portable equipment, to determine intra-rater reliability.
Secondly, the main randomised controlled trial of subjects recently discharged
from two hospitals in Sydney’s northern suburbs was performed, comparing the
impact of seated resistance, fimctional weight-bearing exercises and social visits
on fall risk factors. After the interventions at 12 weeks, there were significant
improvements in composite fall risk (measured by the Physiological Profile
assessment), coordinated stability, maximal balance range, body sway and fingerpress
reaction time when comparing the functional weight-bearing exercises with
control. There was a significant improvement in composite fall risk for the seated
resistance group when compared with control. There was evidence of detraining
(complete or partial) for all of the above measures that had improved at 12 weeks.
Seated resistance exercises had the highest rate of musculoskeletal injury.
It can be concluded that in people recently discharged from hospital, functional
weight-bearing exercises had a greater impact on improving fall risk factors than
seated resistance exercises. Twelve weeks after the cessation of exercises,
detraining had occurred, highlighting the importance of longer-term exercises to
maintain improvements in this population.
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Atkin, Marc. "The effects of garlic upon endothelial function, vascular inflammation, oxidative stress and insulin resistance in patients with type 2 diabetes at high cardiovascular risk : a double blind randomised placebo controlled trial." Thesis, University of Portsmouth, 2011. https://researchportal.port.ac.uk/portal/en/theses/the-effects-of-garlic-upon-endothelial-function-vascular-inflammation-oxidative-stress-and-insulin-resistance-in-patients-with-type-2-diabetes-at-high-cardiovascular-risk(929aa70d-7be1-4c36-87ba-f37eaf60d748).html.
Full textAbstract:
Background and aims: Endothelial dysfunction, vascular inflammation and oxidative stress have been integrally linked to the pathogenesis of both type 2 diabetes and cardiovascular disease. Aged Garlic Extract (AGE), a potent antioxidant, has been shown in previous studies to attenuate these novel risk factors in a non-diabetic population. Aims: This study tested the hypothesis that AGE may improve endothelial function , oxidative stress, vascular inflammation and insulin resistance in high risk cardiovascular subjects with type 2 diabetes (defined as >30% Cardiovascular risk over 10 yrs). Methods: A double blind, placebo controlled cross-over study was performed in 26 type 2 diabetic patients who received 1200mg of AGE or placebo daily for 4 weeks with a 4 week washout period. Plasma HsCRP was measured as a marker of inflammation. TAOS,GSH/GSSG and LHP were measured as markers of oxidative stress/anti-oxidant defence. Insulin resistance was measured using the HOMA-IR method. Endothelial function was measured using change in the reflective index (RI) post salbutamol using digital photoplethysmography and urinary albumin/creatinine ratio was measured as a biochemical surrogate. Measurements were taken at baseline and after intervention with AGE or placebo. Results: Of the 26 patients studied (Male 17, Female 9), mean age was 61 ± 8 yrs, HbA1c 7.2 ± 1.1%, BP 130/75 ± 15.9/9.8 mmHg, total cholesterol 4.2 ± 0.81 mmol/l, triglyceride 2.11 ± 1.51 mmol/l, HDL-cholesterol 1.04 ± 0.29 mmol/l. The majority of patients were being treated with metformin (59%), aspirin (50%) and statin (96%) therapy. 36% were treated with an ACEI. There were no changes in these therapies throughout the study. Treatment with AGE had no significant effect upon the above metabolic parameters including insulin resistance. Systolic blood pressure pre AGE 130 ± 15mmHg vs post AGE 130± 14mmHg. Total cholesterol pre AGE 4.2 ± 0.9 mmol/l vs post AGE 4.2 ± 0.8 mmol/l. Triglycerides pre AGE 1.4 IQ range 0.7 mmol/l vs post AGE 1.4 IQ range 0.8 mmol/l. HDL cholesterol pre AGE 1.0 ± 0.3 mmol/l vs post AGE 1.0 ± 0.3mmol/l. In addition, no statistically significant difference was found in plasma HsCRP (pre AGE: median 2.0mg/l, IQ range 0.8-2.7 vs post AGE: median 1.83mg/l, IQ range 1.1-3.2, p = 0.89) or urinary albumin/creatinine ratio (pre AGE: 0.55, IQ range 0.4-1.65 vs post AGE: 0.6, IQ range 0.47-1.5, p = 0.43) endothelial function (change in RI pre AGE: 6.5%, IQ range 2.75-11 vs post AGE: 6.5%, IQ range 2.75-13, p = 0.95) with AGE or placebo. Conclusion: In this group of type 2 diabetic patients at high cardiovascular risk, 4 weeks treatment with AGE did not significantly improve endothelial function, vascular inflammation, oxidative stress or insulin resistance.
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Rudolfsson, Thomas. "Sensorimotor control and cervical range of motion in women with chronic neck pain : Kinematic assessments and effects of neck coordination exercise." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96172.
Full textAbstract:
Introduction: Neck pain is a common problem in society and is more prevalent among women. The consequences of neck pain for the individual often include activity and participation limitations, thus affecting many dimensions of life. There is still a lack of understanding of the underlying mechanisms of the disorder and likewise of efficient rehabilitation for people with neck pain. However, coordination exercises have shown promising short-term effects. To carry this line of research forward, there is a need to improve methods for objective characterization of impairments and to investigate novel methods of rehabilitation. Aims: To characterize impairments of active cervical range of motion of the upper and lower cervical levels in women with chronic neck pain with a novel method (Study I and II) and identify the influence of head posture and movement strategies (Study II). Further, to investigate the effects of a novel method for neck coordination exercise on sensorimotor function and neck pain (study III) and the consistencies of motor variability metrics in a goal directed arm movement task to aid the design of future clinical research (Study IV). Methods: All studies were laboratory based with kinematic assessments of neck movements (Study I-III), balance (Study III) and goal directed arm movements (Study III, IV). The studies had designs that were: cross-sectional (I and II), randomized controlled trial (III) or test-retest reliability study (IV). Participants in Study I (n=135) and II (n=160) were women with chronic non-specific neck pain and healthy controls. In Study III, women with chronic non-specific neck pain (n=108) were randomized into three different individually supervised 11 week interventions. Study IV included healthy women (n=14). Results: It was found that cervical range of motion impairments in women with non-specific neck pain were direction- and level-specific; impairments were greater in extension in the upper and flexion in the lower levels of the cervical spine. The magnitude of impairments in range of motion was associated to self-ratings of functioning and health. Possible group differences in natural head posture were rejected as a cause for the direction specific effects. Neither could the effects be explained by a strategy to minimize torque in the cervical spine during movement execution. The neck coordination training was not superior to strength training (best-available) and massage treatment (sham) in improving sensorimotor functions or pain according to short-term and 6 months follow ups. The results from the study of the goal directed movement task showed that between and within-subject sizes of most motor variability metrics were too large to make the test suitable for application in clinical research. Conclusions: Women with chronic non-specific neck pain have direction- and level-specific impairments in cervical sagittal range of motion. The underlying causes of these specific impairments remains unresolved, but the direction specific impairments are not related to natural head posture. The clinical validity of the method of characterization of cervical range of motion was supported and it can be useful in future clinical research. The novel method of neck coordination exercise showed no advantages on sensorimotor functions or pain compared with best-available treatment in women with chronic non-specific neck pain.<br>Långvarig smärta i nacken är vanligt förekommande och orsakar både personligt lidande och stora kostnader för samhället. Långvariga nackbesvär är vanligare hos kvinnor än hos män. Det saknas kunskap om effektiva rehabiliteringsmetoder, men forskning har indikerat att träning som förbättrar nackens koordination kan vara effektivt. För att uppnå bättre rehabiliteringsresultat är det viktigt att utveckla metoder för att objektivt mäta funktionsnedsättningar och att utveckla samt utvärdera nya rehabiliteringsmetoder. Syftet med avhandlingen kan sammanfattas i tre delar: Att detaljerat mäta nedsättningar i nackens rörelseomfång hos kvinnor med långvarig nacksmärta; att utvärdera effekten av en ny metod för nackkoordinationsträning på rörelsefunktion och smärta hos kvinnor med långvarig nacksmärta; samt att utvärdera ett nytt test för att mäta precision och koordination vid målriktade armrörelser och ämnat för framtida klinisk forskning. Resultaten visade att kvinnor med långvarig nacksmärta hade specifika nedsättningar i nacken rörelseomfång; i övre nackregionen var bakåtböjning mer begränsad medan i nedre nackregionen var framåtböjning mer begränsad. Vi kunde utesluta att resultaten berodde på skillnader i huvudets normala hållning. Graden av rörelsebegränsning i nacken uppvisade samband med personernas självskattade funktion, symtom och hälsa. Nackkoordinationsträningen var inte var bättre än styrketräning eller massage för att förbättra rörelsefunktion eller för att minska smärta. Det nya testet för armrörelser var inte lämpat för kliniska studier av rörelseprecision. Slutsatserna från avhandlingsarbetet är att kvinnor med långvarig nacksmärta har begränsningar i nackens rörelseomfång vid framåt- och bakåtböjning av huvudet som är specifika vad gäller nivå i halsryggen och riktning. Att graden av rörelsebegränsning uppvisade samband med självskattad funktion, symtom och hälsa styrker testets kliniska validitet. Ytterligare forskning behövs för att förstå orsakerna bakom de specifika nedsättningarna. Nackkoordinationsträningen som utvärderades kan inte rekommenderas för kvinnor med långvarig nacksmärta eftersom korttidsuppföljning och 6-månadersuppföljning visade att träningsformen inte var bättre än styrketräning eller massage, vare sig när det gällde att förbättra sensomotorisk funktion eller att minska smärta.
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Guimarães, Marília Mendonça. "Efeito do nicotinato de cromo na sensibilidade à insulina e antropometria em indivíduos com diabetes mellitus tipo 2." Universidade Federal de Goiás, 2012. http://repositorio.bc.ufg.br/tede/handle/tde/2903.
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Previous issue date: 2012-02-02<br>Chromium dietary interventions have been used to investigate the improvement
in insulin sensitivity due to the role of chromium as a central component of the
glucose tolerance factor. This study aims investigate the effect of chromium
nicotinate supplementation on insulin sensitivity and anthropometry in type 2
diabetic subjects. In double-blind trial, fifty-six type 2 diabetic subjects with Body
Mass Index 25 kg/m2 and increased waist circumference were randomized
into three groups: placebo (NC0), 50μg (NC50) and 200μg (NC200) of chromium
nicotinate. Status of chromium, insulin resistance, cell function, glycemic
control, lipid profile, anthropometry, intensity and energy expenditure in physical
activity were assessed at the beginning, 45 and 90 days of intervention. Energy
consumption was assessed at the beginning, between the beginning and 45
days and between 45 and 90 days of study. Most subjects had low serum levels
of chromium (71.88%), normal levels of urinary chromium (80.65%) and insulin
resistance (73.80%). Chromium serum concentrations did not differ between
groups over time (p = 0.2549). Changes in concentrations of serum and urinary
chromium were not related to changes in fasting glucose (p> 0.05). At 90 days,
there was no significant intra-group difference in fasting plasma glucose,
glycosylated hemoglobin, HOMA-IR, total cholesterol, LDL cholesterol, waist
circumference, % body fat and % lean mass. There was an increase in HOMA-
(p = 0.0349) and HDL cholesterol (p = 0.0425) in the group NC0, reduction in
triglycerides in NC0 group (p = 0.0177) and NC50 (p = 0.0336) and reduced of
1.08 kg in the NC50 group (p = 0.0048). No difference was found at intra-group
physical activity intensity and between supplemented groups (NC50 and NC200)
and placebo (NC0) at 90 days (p>0.05). There was an increase in physical
activity energy expenditure in NC50 group at 90 days (p = 0.0371). As for total
energy intake, there was no difference within and between groups during the
study (p> 0.05). Supplementation with 50 μg and 200 μg chromium nicotinate for
90 days did not promote improvements in glucose homeostasis, lipid profile and
anthropometry in individuals with type 2 diabetes mellitus.<br>Intervenções dietéticas com cromo têm sido utilizadas para investigar a melhora
na sensibilidade à insulina, devido à função do cromo como componente central
do fator de tolerância à glicose. O objetivo deste estudo foi investigar o efeito da
suplementação com nicotinato de cromo na sensibilidade à insulina e na
antropometria de indivíduos diabéticos tipo 2. Em ensaio clínico duplo-cego,
cinqüenta e seis indivíduos diabéticos tipo 2, com Índice de Massa Corporal
25 kg/m2 e circunferência da cintura aumentada foram randomizados em três
grupos: placebo (NC0), 50μg (NC50) e 200μg (NC200) de nicotinato de cromo. O
status de cromo, resistência à insulina, função das células , controle glicêmico,
perfil lipídico, antropometria, intensidade e gasto energético em atividade física
foram avaliados ao início, aos 45 e 90 dias de intervenção. A ingestão
energética foi avaliada ao início, entre o início e 45 dias e entre 45 e 90 dias de
estudo. A maioria dos indivíduos apresentou, ao início, baixas concentrações de
cromo sérico (71,88%), concentrações normais de cromo urinário (80,65%) e
resistência à insulina (73,80%). As concentrações de cromo sérico não diferiram
entre os grupos ao longo do tempo (p = 0,2549). As mudanças nas
concentrações de cromo sérico e urinário não se relacionaram às mudanças na
glicemia de jejum (p>0,05). Aos 90 dias, não houve diferença significativa intragrupo
na glicemia de jejum, hemoglobina glicada, HOMA-IR, colesterol total,
LDL, circunferência da cintura, % gordura corporal e % massa magra. Houve
aumento no HOMA- (p=0,0349) e HDL (p=0,0425) no grupo NC0, redução no
triglicérides no grupo NC0 (p = 0,0177) e NC50 (p = 0,0336) e redução de 1,08
kg no grupo NC50 (p = 0,0048). Não se observou diferença na intensidade de
atividade física intra-grupo e na comparação entre os grupos suplementados
(NC50 e NC200) e placebo (NC0) aos 90 dias (p>0,05). Houve aumento no gasto
energético em atividade física aos 90 dias de intervenção nos indivíduos do
grupo NC50 (p = 0,0371). Quanto à ingestão energética total, não houve
diferença intra e entre grupos no decorrer do estudo (p>0,05). A suplementação
com 50 μg e 200 μg de nicotinato de cromo durante 90 dias não promoveu
melhorias na homeostase glicêmica, perfil lipídico e antropometria em
indivíduos com diabetes mellitus tipo 2.
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Patala, Anne Havilah. "Discordance of Drug Susceptibility Test Data between the CDC Mycobacteriology Laboratory and Local Public Health Laboratories Participating in Tuberculosis Clinical Trials, TBTC, CDC." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/iph_theses/171.
Full textAbstract:
BACKGROUND: Multi drug resistant Tuberculosis (MDR-TB) is a serious public health concern in many parts of the world. As per the WHO- 2010 global report on
Surveillance and response 3.6% of all incident TB cases globally are multidrug resistant. In this regard, there is an increasing demand for timely, reliable and comprehensive drug susceptibility testing (DST) as MDR-TB surveillance is being geared up. The intent of this analysis is to determine whether there is a need to continue routine confirmatory DST testing at CDC in addition to just sending the isolates for genotyping. Analysis is done by measuring the discordance between the results of laboratory DST at CDC and the local labs drug type, drug testing concentrations, and study sites.
METHODS: The data for this analysis was provided by the Tuberculosis Trials Consortium (TBTC), CDC. Data for this analysis was collected over nearly two decades (1993-2011), gathered from 7 clinical trials. Discordance between the local and CDC lab DST results was measured using Kappa statistic. Sensitivity and specificity analysis was done by taking the CDC DST lab results as the gold standard. Discordance levels were calculated by local sites and baseline drug resistance for each antibiotic in each study was measured.
RESULTS: Average Kappa values for inter rater agreement for all the studies was 0.6444 whereas the overall level of discordance across all studies is 7.786%. Drug resistance at baseline was highest for Isoniazid and Streptomycin (except Study 23 and 22).
CONCLUSION: Though the current results show few DST result discordances between local and CDC labs, it is better to continue to send isolates to the centralized lab (CDC) in view of the worldwide threat of drug resistant TB epidemic, the recommendations of the current literature and the benefits of reliable confirmatory testing services and availability of other molecular diagnostic methods.
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Jovine, Marcia Salazar. "Efeito do treinamento resistido sobre a osteoporose após a menopausa: estudo de atualização." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-20102006-150550/.
Full textAbstract:
Objetivo: investigar o efeito de intervenções com treinamento resistido sobre a força muscular e densidade mineral óssea nos sítios de maior ocorrência de fraturas relacionadas a osteoporose em mulheres no estágio de vida após a menopausa. Metodologia: estudo de atualização por meio de revisão sistemática de ensaios controlados randomizados e meta-análise nas bases de dados do Colégio Americano de Medicina Esportiva e da Biblioteca Cochrane no período compreendido entre os anos de 1985 e fevereiro de 2005. Resultados: foram encontrados vinte e seis estudos que atenderam os critérios de inclusão, realizados nos países Alemanha, Austrália, Áustria, Canadá, China, Estados Unidos, França, e Japão, com um total de 2300 mulheres com idades entre os 40 e 92 anos. Intervenções com treinamento resistido apresentaram resultados estatisticamente significantes sobre a força muscular e a densidade mineral óssea nos sítios vértebras lombares, fêmur (triângulo de Ward/trocanter) e quadril total. Conclusão: treinamento resistido mostrou ser capaz de prover estímulo para aumentar força muscular e formação óssea, influenciando os fatores de risco relacionados com osteoporose e quedas seguidas de fratura em mulheres no estágio de vida após a menopausa.<br>Objective: to investigate the effect of interventions with resistance training on muscular strength and bone mineral density in the sites of larger occurrence of osteoporotic fractures in postmenopausal women. Methodology: updating study through systematic review of randomized controlled trials and meta-analysis in the databases of the American College of Sports Medicine and the Cochrane Library was conducted from 1985 up to and including February 2005. Results: twenty-six studies met the inclusion criteria from the Germany, Australia, Austria, Canada, China, United States, France and Japan, with a total of 2300 women aged 40 and 92 yrs. Interventions with resistance training showed results statistically significant on the muscular strength and bone mineral density of the lumbar spine, femur (Ward/ trochanter) and total hip. Conclusion: resistance training markedly influences osteoporotic risk factors concerning falls (muscular strength) and bone mineral density in postmenopausal women.
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Arjyal, Amit. "Clinical studies on enteric fever." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:7b82ceef-96de-4159-adcf-a06dc14c581a.
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I performed two randomised controlled trials (RCTs) to determine the best treatments for enteric fever in Kathmandu, Nepal, an area with a high proportion of nalidixic acid resistant S. Typhi and S. Paratyphi A isolates. I recruited 844 patients with suspected enteric fever to compare chloramphenicol versus gatifloxacin. 352 patients were culture confirmed. 14/175 patients treated with chloramphenicol and 12/177 patients treated with gatifloxacin experienced treatment failure (HR=0.86 (95% CI 0.40 to 1.86), p=0.70). The median times to fever clearance were 3.95 and 3.90 days, respectively (HR=1.06 [CI 0.86 to 1.32], p=0.59). The second RCT compared ofloxacin versus gatifloxacin and recruited 627 patients. Of the 170 patients infected with nalidixic acid resistant strains, the number of patients with treatment failure was 6/83 in the ofloxacin group and 5/87 in the gatifloxacin group (Hazard Ratio, HR=0.81, 95% CI 0.25 to 2.65; p=0.73); the median times to fever clearance were 4.7 and 3.3 days respectively (HR=1.59 [CI 1.16 to 2.18], p=0.004). I compared conventional blood culture against an electricity free culture approach. 66 of 304 patients with suspected enteric fever were positive for S. Typhi or S. Paratyphi A, 55 (85%) isolates were identified by the conventional blood culture and 60 (92%) isolates were identified by the experimental method. The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% and 96.0%, respectively. This electricity free blood culture system may have utility in resource-limited settings or potentially in disaster relief and refugee camps. I performed a literature review of RCTs of enteric fever which showed that trial design varied greatly. I was interested in the perspective of patients and what they regarded as cure. 1,481 patients were interviewed at the start of treatment, 860 (58%) reported that the resolution of fever would mean cure to them. At the completion of treatment, 877/1,448 (60.6%) reported that they felt cured when fever was completely gone. We suggest that fever clearance time is the best surrogate for clinical cure in patients with enteric fever and should be used as the primary outcome in future RCTs for the treatment of enteric fever.
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Rodrigues, Mariana Del Bosco. "Efeito do consumo de cálcio no tratamento de crianças e adolescentes obesas." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5135/tde-04042008-155033/.
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INTRODUÇÃO: Estudos evidenciam a relação da baixa ingestão de cálcio e osteoporose, câncer colo-retal e hipertensão. Mais recentemente, estudos epidemiológicos vêm apontando que pode haver uma diminuição do risco de obesidade e de suas comorbidades com um maior consumo de cálcio e/ou derivados de leite. Ensaios em humanos apresentam resultados conflitantes com relação à perda de peso e alteração dos parâmetros metabólicos. Pretendemos avaliar a interferência da restrição calórica e do consumo de cálcio sobre a evolução dos parâmetros antropométricos e de composição corporal e parâmetros bioquímicos de 42 meninas (11,1 + 1,4 anos) obesas (2,2 + 0,3 escore Z de IMC) em 5 meses de tratamento no ambulatório de obesidade do HCFMUSP. MÉTODOS: Nesse ensaio clínico não controlado, realizado entre agosto de 2005 a agosto de 2006, orientamos o seguimento de uma dieta hipocalórica balanceada, composta por 3 porções de derivados de leite e complementada com 4 c. sopa de leite em pó desnatado com carbonato de cálcio (adicional de 800mg cálcio). As crianças apresentaram diferentes níveis de adesão, tanto com relação ao consumo energético, quanto com relação ao consumo de cálcio e, a partir desta variação no consumo, investigamos o efeito da dieta sobre a evolução das variáveis. RESULTADOS: Após a intervenção observamos perda de peso, perda de gordura e melhora da maioria dos parâmetros metabólicos (glicose, insulina, HOMA, Colesterol e frações LDL e HDL). Não houve diferença significante na diminuição dos triacilgliceróis e VLDL-C, nem da leptina e da adiponectina. Por meio da regressão linear múltipla identificamos que o consumo de cálcio não explicou a variação do peso nem do perfil lipídico, mas interferiu na melhora da resistência insulínica. Estimamos que com um déficit de 390 kcal e um incremento de mais de 400mg de cálcio por dia seria possível, em 5 meses, diminuir a insulinemia em 9,2 ?U/ml e o HOMA em 2,6%. CONCLUSÃO: O incremento do consumo de cálcio parece não interferir na evolução das variáveis antropométricas e de composição corporal de crianças obesas submetidas à dieta hipocalórica balanceada. Sugerimos que o cálcio interfira na resistência insulínica, pois observamos que, sob a mesma restrição calórica, a diminuição da insulinemia e a melhora do HOMA é mais relevante quanto maior o consumo de cálcio. São necessários estudos clínicos controlados e a elucidação de um possível mecanismo de ação para entender o papel do cálcio no controle do metabolismo glicídico.<br>INTODUCTION: It has been shown a relationship between a low calcium intake and osteoporosis, colorectal cancer, and hypertension. Recently, epidemiological studies are pointing that there may be a decreased risk of obesity and its co-morbidities with a higher intakes of calcium and/or dairy. Clinical trials have been showing conflicting results related to weight loss and change in metabolic parameters. We intend to evaluate the interference of caloric restriction and calcium intake on anthropometric and body composition, metabolic and hormonal parameters of 42 obese (2,2 + 0,3 score Z of IMC) girls in 5 months of outpatient treatment at HCFMUSP. METHODS: In an uncontrolled clinical trial launched between August 2005 to August 2006, they`re counseled to include 3 portions of dairy and 40g of nonfat powdered milk with calcium carbonate per day (additional 800mg calcium). Children presented different levels of caloric and calcium intake and so we investigate the effect of these components of diet in several levels. RESULTS: Loss of weight, fat mass and lipid profile were improved independently of calcium intake. There was no significant difference in the decrease of triglycerides and VLDL-C, neither to leptin and adiponectin. Through multiple linear regressions, we identified that calcium intake did not explain the variation of weight or lipid profile, but seems to improve insulin resistance. We estimate that a deficit of 390 kcal and an increase of more than 400mg of calcium per day should decrease insulin levels in 9.2 ? U / ml and the HOMA at 2.6%, after 5 months. CONCLUSION: The increase calcium intake does not seem to interfere in the evolution of the anthropometric variables and body composition in obese children under a balanced hypocaloric diet. We suggest that under the same caloric restriction, calcium intake shold be relevant to improve insulin resistance. In order to understand the role of calcium in the control of glycolic metabolism. Controlled clinical trials are necessary and so the elucidation of a possible mechanism of action.
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Pradat, Yoann. "Analyses of genomic and transcriptomic profiles of metastatic tumors from precision medicine clinical trials". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASL010.
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À l’ère de l’analyse des données, les connaissances sur l’apparition et la progression du cancer se sont approfondies grâce à l’analyse moléculaire de nombreuses tumeurs dans le monde. Le séquençage de nouvelle génération, apparu dans les années 2000, a transformé la recherche sur les cellules cancéreuses en permettant le profilage complet de l’exome, du transcriptome et même du génome entier. Bien que le séquençage à haut débit ne soit pas systématique dans la pratique clinique, il est couramment utilisé dans les essais thérapeutiques. Le vaste réservoir de données ainsi généré alimente de nombreuses recherches qui contribuent aux progrès de l’oncologie de précision. Cette thèse explore l’analyse de cohortes de patients atteints de cancer et les outils modernes d’oncologie. Le premier chapitre couvre les principes essentiels de la biologie du cancer, en mettant l'accent sur le rôle évolutif du profilage moléculaire dans le traitement et la recherche. Le deuxième chapitre passe en revue les outils informatiques et les bases de données employés pour l’analyse des données de séquençage. Ces chapitres donnent les clés pour le troisième chapitre, axé sur la cohorte META- PRISM, comprenant 1 031 patients issus d’essais de médecine de précision à Gustave Roussy. Il met en évidence les spécificités génétiques des patients réfractaires et les possibilités de modélisation prédictive sur les données du séquençage haut débit. Le quatrième chapitre examine les marqueurs de résistance aux traitements connus et émergents dans la cohorte META-PRISM et dans deux études cliniques récentes, révélant des altérations de cibles et des activations de voies alternatives comme facteurs de résistance clés<br>In the era of extensive data analysis, insights into cancer onset and progression have deepened through molecular analysis of numerous tumors globally. Next-generation sequencing, emerging in the 2000s, transformed cancer cell investigation by enabling exome, transcriptome, and now whole genome profiling. While high-throughput sequencing has not yet entered clinical pratice for all, it is commonly used in trials. The vast data pool thus generated fuels many research areas which contribute to precision oncology advancements. This thesis explores cancer patient cohort analysis and modern oncology tools. The first chapter covers cancer biology fundamentals, emphasizing molecular profiling's evolving role in treatment and research. The second chapter reviews computing tools and databases for sequencing data analysis. These chapters set the stage for the third chapter, focusing on the META-PRISM cohort, comprising 1,031 patients from precision medicine trials at Gustave Roussy. It highlights the molecular specificities of refractory and the promises of predictive modeling based on high-throughput sequencing data. The fourth chapter delves into known and emerging treatment resistance markers in the META-PRISM cohort and two recent clinical studies, revealing target alterations and alternative pathway activations as key resistance factors
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Thompson, Gillian Ann. "A randomised control trial of tea tree oil 5% body wash versus standard care body wash to prevent colonisation with meticillin resistant Staphylococcus aureus (MRSA) in critically ill adults." Thesis, Queen's University Belfast, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.580124.
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Background To determine effectiveness of 5% tea tree oil (TTO) body wash in preventing colonisation with methicillin resistant Staphylococcus aureus (MRSA) in critically ill adults. A systematic review of the literature found that tea tree oil was effective in killing MRSA in the laboratory setting, and it was a promising intervention to treating MRSA colonisation in the clinical setting. However, there was no evidence of its effectiveness in preventing MRSA colonization. Methods To investigate this further, a prospective, randomized controlled trial was undertaken in a large intensive care unit in the United Kingdom (UK). Patients were assigned to one of two groups, to be washed daily with one of the following interventions: 5% TTO body wash or standard care body wash for the duration of their stay in Intensive Care. Nasal and groin swabs were taken on admission and discharge from the unit and the primary outcome measure was new MRSA colonization. Results There were 391 patients that completed the trail. The trial was terminated early due to low accrual and therefore the study was underpowered to detect a statistical difference. The results showed a 2.5% difference in colonization rates in favour of TTC but the difference was not statistically significant (95% Cl -8.95 to 3.94, p=O.50) nor clinically significant. Although TTO cannot be recommended for preventing MRSA colonization, this study adds to the body of nursing research in many ways. First, it is a useful pilot study that provides important insights for further research in this area. Second, it highlights that tea tree oil is safe to use and well tolerated.
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Trocchia-Balkits, Lisa. "A Hipstory of Food, Love, and Chaosmos at the Rainbow Gathering of the Tribes." Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1499825960234156.
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Berssaneti, Ana Assumpção. "Exercícios de alongamento e fortalecimento muscular no tratamento de pacientes com fibromialgia: um ensaio clínico randomizado." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-11052010-144342/.
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Introdução: Exercícios físicos são descritos como uma das formas mais eficazes de controle da Fibromialgia (FM). No entanto, os exercícios de fortalecimento e alongamento muscular ainda permanecem pouco avaliados. Objetivos: Avaliar e comparar a eficácia dos exercícios de alongamento e fortalecimento muscular, isolados, na melhora da força muscular, flexibilidade, dor, sintomas e qualidade de vida de pacientes com FM, comparando com um grupo controle. Casuística e métodos: A amostra foi composta por 79 mulheres elegíveis das quais 16 foram excluídas e 63 iniciam o estudo, sendo alocadas aleatoriamente em três grupos: alongamento (GA), fortalecimento (GF) e controle (GC). Ao final, 14 finalizaram o tratamento no GA, 16 no GF e 14 no GC. Todos os sujeitos foram avaliados antes e após 12 semanas, da seguinte forma: força muscular de flexores e extensores de joelho pela contração isométrica voluntária máxima (CIVM) com célula de carga (EMG System do Brasil); flexibilidade pelo teste do 3º dedo-solo (3DS); dor pela escala visual analógica (EVA); limiar de dor nos tender points (LD) e número de tender points positivos (TP+) com dolorímetro de Fischer; sintomas da FM pelo Questionário de Impacto da FM (QIF) e qualidade de vida pelo Medical Outcomes Study 36-item Short-Form Health Survey (SF- 36). O GA e o GF realizaram exercícios gerais, envolvendo a musculatura de membros superiores, inferiores e tronco, com freqüência de bissemanal. Os dados foram analisados pelos testes estatísticos: t-Student, Wilcoxon, Anova um fator e Kruskal- Wallis, com nível de significância de 5%. Resultados: O GA teve melhora estatisticamente significante nas variáveis: LD, 3DS; fadiga, sono e rigidez do QIF; capacidade funcional, Vitalidade, saúde mental, dor e total físico e emocional do SF-36 (p=0,05) e, o GF nos itens: LD, TP+, 3DS, CIVM flexão de joelho; fadiga, sono, rigidez, ansiedade, depressão e escore total do QIF; capacidade funcional, vitalidade, saúde mental e total emocional do SF-36 (p=0,05). O GC não apresentou melhora em nenhuma das variáveis (p=0,05). Na comparação entre os grupos, o GA foi estatisticamente diferente nos itens CF, Dor, e Total Físico do SF-36; o GF na Depressão do QIF (p=0,05) e o GC foi pior na capacidade funcional, sono e rigidez do QIF e vitalidade do SF-36 (p=0,05). Conclusões: Os exercícios de alongamento e fortalecimento muscular melhoram de forma significativa a dor, sintomas da FM e qualidade de vida podendo ser considerados complementares já que apresentam melhora em aspectos distintos<br>Background: Exercises have been reported as one of the most effective management of Fibromyalgia (FM), however stretching and strengthening training remain under evaluated. Objectives: To assess and compare the effects of stretching and strengthening exercises on muscle strength, flexibility, pain, symptoms and quality of life of FM patients, comparing to a control group. Methods: The sample was composed by 79 eligible women of whom 16 were excluded, and 63 entered the study and were randomly assign in to one of three groups: flexibility group (FG), strength group (SG) and control (CG). At the end, 14 finished the study on FG, 16 on ST and 14 on CG. All subjects were evaluated before and after 12 weeks according to the following procedures: maximum isometric muscle contraction for knee flexion and extension (MIMC) using the EMG System do Brasil dynamometer, flexibility by finger-to-tip floor test (FTF), pain by visual analogue scale (VAS), pain threshold (PT) and tender points count (TP+) by a Fischer dolorimeter, symptoms by Fibromyalgia Impact Questionnaire (FIQ) and quality of life by Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). FG and SG underwent in a stretching and strengthening program, respectively, including exercises for upper and lower body and trunk, twice a week. Data were statistically analyzed by: t-Student test, Wilcoxon test, Anova one-way and Kruskall- Wallis Anova, with significance level of 5%. Main Results: FG had statistically improvements after treatment in: PT, FTF, fatigue, sleep and stiffness of FIQ; functional capacity, vitality, mental health, pain and role physical of SF-36 (p=0,05). SG had statistically improvements after treatment in: PT, TP+, FTF, MIMC of knee flexion, fatigue, sleep, stiffness, anxiety, depression and total score of FIQ and functional capacity, vitality, mental health and role emotional (p=0,05). No significant difference was observed in CG after 12 weeks (p=0,05). Comparing three groups, the FG was statistically better after treatment for functional capacity, pain and role physical of SF-36. The SG was statistically better for depression of FIQ and CG was statistically worse for functional capacity, sleep and stiffness of FIQ and vitality of SF -36. Conclusions: Stretching and strengthening exercise had statistically improvements in pain, symptoms and quality of life of FM patients. Considering the positive effects on different aspects, they could be used as complementary exercises
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Rodrigues, Arthur Valbon. "S?ntese e avalia??o anticorrosiva experimental e te?rica de tioureias assim?tricas derivadas da benzil e fenetilamina." Universidade Federal Rural do Rio de Janeiro, 2015. https://tede.ufrrj.br/jspui/handle/jspui/1470.
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Previous issue date: 2015-08-04<br>Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES<br>In this work six asymmetric thyourea, derived from benzylamine and phenethylamine, were synthesized by reaction of p-substituted phenyl isothiocyanates in the presence of benzylamine and phenethylamine in toluene as solvent by irradiation in ultrasonic bath, featuring the first report in the literature of the adoption of this method for such molecules. The compounds were obtained in high purity, requiring only one recrystallization from hexane/dichloromethane. Yields were very satisfactory, ranging from 89 to 98%. The compounds were characterized by spectroscopic techniques such as 1H, 13C Nuclear Magnetic Resonance and IR.
The synthesized compounds were evaluated by electrochemical potentiodynamic polarization techniques, Electrochemical Impedance Spectroscopy and Linear Polarization Resistance as inhibitors to the corrosion AISI 1020 carbon steel in 1M HCl media.
Molecular modeling was used for better visualization of the thiourea structures and to correlate theoretical parameters such as the energy of the symmetrical frontier orbital, Mulliken charge on the sulfur atom and dipole moment with the experimental results for corrosion efficiency.
In general, all compounds showed corrosion inhibition efficiency with characteristics of mixed inhibitors with anodic trend, however compounds with nitro substituent showed less efficiency, a fact that may be related to their electrons withdrawing potential, which consequently decreases the electron density at the possible center of chemical adsorption, the sulfur atom. However, compounds which showed no substituent and those that contain electron donating group (OCH3) stood out as inhibitors, highlighting N- (p-methoxyphenyl) -N'-phenetylthiourea, which showed 95% efficiency corrosion inhibition, from Electrochemical Impedance spectroscopy.
Thus, the asymmetric thiourea benzyl and phenethyl-substituted, especially methoxy-substituted phenyl, can be considered as promising corrosion inhibitors for carbon steel in acid.<br>Nesse trabalho de disserta??o foram sintetizadas seis tioureias assim?tricas, derivadas da benzilamina e fenetilamina. A obten??o ocorreu atrav?s da rea??o dos isotiocianatos de fenila p-substituidos na presen?a da benzilamina e fenetilamina em tolueno como solvente atrav?s de irradia??o em banho de ultrassom, sendo o primeiro relato na literatura dessa metodologia para tais mol?culas. Os compostos foram obtidos em alto grau de pureza, sendo necess?ria apenas uma recristaliza??o em hexano/diclorometano. Os rendimentos foram muitos satisfat?rios, variando de 89 ? 98%. Os compostos foram caracterizados por t?cnicas espectrosc?picas como Resson?ncia Magn?tica Nuclear 1H,13C e Infravermelho.
Os compostos sintetizados foram avaliados atrav?s das t?cnicas eletroqu?micas de Polariza??o Potenciodin?mica, Espectroscopia de Imped?ncia Eletroqu?mica e Resist?ncia a Polariza??o Linear quanto ? a??o como inibidores de corros?o frente a a?o carbono AISI 1020 em HCl 1 mol.L-1.
A Modelagem Molecular foi utilizada para melhor visualiza??o das estruturas das tioureias e correlacionar os par?metros te?ricos como a energia dos orbitais de fronteiras sim?tricos, carga de Mulliken no ?tomo de enxofre e momento dipolar com os resultados experimentais da efici?ncia anticorrosiva.
De forma geral, todos apresentaram efici?ncia de inibi??o ? corros?o com caracter?sticas de inibidores mistos com tend?ncia an?dica, por?m os compostos com substituinte nitro apresentaram menor efici?ncia, fato esse que pode estar relacionado ao seu poder retirador de el?trons, que consequentemente, diminui a densidade eletr?nica no poss?vel centro de adsor??o qu?mica, o enxofre.
Por?m, os compostos que n?o apresentaram substituintes e os que cont?m grupo doador de el?trons (OCH3) se destacaram como inibidores, dando destaque a N-(p-metoxi-fenil)-N?-fenetiltioureia, que apresentou efici?ncia de 95% de inibi??o da corros?o, pela t?cnica de Espectroscopia de Imped?ncia Eletroqu?mica.
Assim, as tioureias assim?tricas benzil e fenetil-substitu?das, especialmente met?xi-fenil substitu?das, podem ser consideradas como promissores agentes inibidores da corros?o para o a?o-carbono em meio ?cido.
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Santos, Douglas Xavier dos. "Synbiotic aerated dessert: diet product development and evaluation of the intake effects in individuals with metabolic syndrome." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/9/9133/tde-22012018-101115/.
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The objective of this work was to adapt a synbiotic aerated diet dessert, produced with the addition of a probiotic culture of Lactobacillus acidophilus La-5 and prebiotic ingredients (fructooligosaccharides and inulin), from the previously developed sucrose-containing formulation, and to evaluate the effects of its ingestion on adult volunteers with metabolic syndrome (MetS) during a period of 8 weeks of intervention. In addition, to improve the resistance of the probiotic to simulated gastrointestinal conditions, a microencapsulation process was optimized. For the development of the product, the formulations were produced in triplicates, in which probiotic culture survival, instrumental texture and sensory acceptability were evaluated up to 112 days of storage under freezing (-18 °C). Subsequently, a randomized, double-blind, placebo-controlled trial was carried out in which the product developed was administered to forty-five volunteers with MetS assigned into two groups, each receiving 40 g/day of: synbiotic diet mousse (SDM) (n=23) and placebo diet mousse (PDM) without pro- and prebiotics (n=22). Fasting blood samples were collected at the beginning and after 8 weeks of daily consumption of both mousses to determine the anthropometric, biochemical, haematological, inflammatory, and immunological parameters. Afterward, with the goal of improving the survival of L. acidophilus La-5 to in vitro simulated gastrointestinal conditions, the microencapsulation process conditions of the probiotic strain via spray drying were optimized using inulin as the encapsulating agent. The viability of L. acidophilus La-5 incorporated into SDM was above 7.8 log CFU/g and remained stable throughout storage. PDM showed lower acceptability (5.77-6.50) after storage than SDM (6.67-7.03). The texture was the most appreciated attribute and hardness of the SDM increased during storage, but remained stable for PDM. The clinical trial revealed significant reductions of total cholesterol and HDL-cholesterol, as well as of immunoglobulins (A and M), and interleukin-1β in both groups during the intervention period. However, regarding intergroup changes, there were not any significant differences for all parameters evaluated (p>0.05). After the optimization of the microencapsulation process of the probiotic culture (80 mL/min, 82% and 10%, respectively for feed flow, aspiration rate, and inulin concentration), the microencapsulated probiotic strain incorporated in the SDM mousse showed the highest in vitro gastrointestinal survival (p<0.05) in the different stages of the assay, as follows: after the gastric phase: 5.68 log CFU/g (83.3%), the enteral phase I: 5.61 log CFU/g (82.3%), the enteral phase II: 5.56 log CFU/g (81.4%). Therefore, these results suggest that the presence of probiotic and prebiotics in SDM did not provide an additional effect on the health of volunteers with MetS. Additionally, the results confirm the appropriateness of the spray drying process to microencapsulate L. acidophilus La-5 using inulin as coating agent, providing increased resistance to the microencapsulated probiotic strain under in vitro gastrointestinal stress.<br>O objetivo deste trabalho foi adaptar uma sobremesa aerada simbiótica diet do tipo musse, processada com a adição de uma cultura probiótica de Lactobacillus acidophilus La-5 e de ingredientes prebióticos (fruto-oligossacarídeos e inulina), a partir da formulação contendo sacarose desenvolvida anteriormente, e avaliar os efeitos de sua ingestão em voluntários adultos com síndrome metabólica (MetS) durante um período de 8 semanas de intervenção. Adicionalmente, para melhorar a resistência do probiótico frente às condições gastrintestinais simuladas, otimizou-se um processo de microencapsulação da cepa probiótica. Para o desenvolvimento do produto, as formulações foram produzidas em triplicata, em que se avaliou a sobrevivência da cultura probiótica, a textura instrumental e a aceitabilidade sensorial até 112 dias de armazenamento sob congelamento (-18 oC). Em seguida, foi realizado um estudo randomizado, duplo-cego e controlado por placebo, no qual o produto desenvolvido foi administrado a quarenta e cinco indivíduos com MetS divididos em dois grupos, cada um recebendo 40 g/dia de: mousse simbiótica diet (SDM) (n=23) e musse placebo diet (PDM) sem componentes pro- e prebióticos (n=22). As amostras sanguíneas foram coletadas em jejum no início e após 8 semanas de consumo diário de ambas as musses para a determinação dos parâmetros antropométricos, bioquímicos, hematológicos, inflamatórios e imunológicos. Posteriormente, com o intuito de melhorar a sobrevivência do L. acidophilus La-5 em condições gastrointestinais simuladas in vitro, as condições de processo de microencapsulação da cepa probiótica via spray drying foram otimizadas, utilizando inulina como agente encapsulante. A viabilidade de L. acidophilus La-5 incorporados na SDM foi superior a 7,8 log UFC/g e se manteve estável ao longo do armazenamento. A PDM mostrou menor aceitabilidade (5.77-6.50) após o armazenamento do que a SDM (6.67-7.03). A textura foi o atributo mais apreciado, sendo que a dureza da SDM apresentou elevação, enquanto a da PDM manteve-se estável. O ensaio clínico revelou reduções significativas de colesterol total, colesterol-HDL, imunoglobulinas (A e M) e interleucina1β em ambos os grupos durante o período de intervenção. Entretanto, no que se refere às mudanças intergrupos, não se observou diferenças significativas para todos os parâmetros avaliados (p>0,05). Após a otimização do processo de microencapsulação da cultura probiótica (80 mL/min, 82% e 10%, respectivamente para o fluxo de alimentação, taxa de aspiração e concentração de inulina), a cepa probiótica microencapsulada incorporada a amostra SDM apresentou a maior sobrevivência gastrointestinal in vitro (p<0,05) nas diferentes etapas do ensaio, a saber: após a fase gástrica: 5,68 log UFC/g (83,3%); fase entérica I: 5,61 log UFC/g (82,3%); fase entérica II: 5,56 log UFC/g (81,4%). Portanto, esses resultados sugerem que a presença de probiótico e prebiótico na SDM não apresentou efeitos adicionais na saúde dos voluntários com MetS. Adicionalmente, os resultados confirmaram a adequação do processo de spray drying para a microencapsulação de L. acidophilus La-5 utilizando inulina como agente de revestimento, proporcionando uma maior resistência da cepa probiótica microencapsulada às condições gastrintestinais simuladas in vitro.
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Hamy, Anne-Sophie. "Identification of Factors Predicting Sensitivity or Resistance to Neoadjuvant Chemotherapy in Breast Cancer Neoadjuvant treatment : the future of patients with breast cancer Neoadjuvant treatment for intermediate/high-risk HER2-positive and triple-negative breast cancers: no longer an “option” but an ethical obligation Long-term outcome of the REMAGUS 02 trial, a multicenter randomised phase II trial in locally advanced breast cancer patients treated with neoadjuvant chemotherapy with or without celecoxib or trastuzumab according to HER2 status BIRC5 (survivin) : a pejorative prognostic marker in stage II/III breast cancer with no response to neoadjuvant chemotherapy Beyond Axillary Lymph Node Metastasis, BMI and Menopausal Status Are Prognostic Determinants for Triple-Negative Breast Cancer Treated by Neoadjuvant Chemotherapy Pathological complete response and prognosis after neoadjuvant chemotherapy for HER2-positive breast cancers before and after trastuzumab era: results from a real-life cohort The presence of an in situ component on pre-treatment biopsy is not associated with response to neoadjuvant chemotherapy for breast cancer Chemosensitivity, tumor infiltrating lymphocytes (TILs), and survival of postpartum PABC patients treated by neoadjuvant chemotherapy Lymphovascular invasion after neoadjuvant chemotherapy is strongly associated with poor prognosis in breast carcinoma New insight for pharmacogenomics studies from the transcriptional analysis of two large-scale cancer cell line panels Biological network-driven gene selection identifies a stromal immune module as a key determinant of triple-negative breast carcinoma prognosis A Stromal Immune Module Correlated with the Response to Neoadjuvant Chemotherapy, Prognosis and Lymphocyte Infiltration in HER2-Positive Breast Carcinoma Is Inversely Correlated with Hormonal Pathways Stromal lymphocyte infiltration after neoadjuvant chemotherapy is associated with aggressive residual disease and lower disease-free survival in HER2-positive breast cancer Interaction between molecular subtypes, stromal immune infiltration before and after treatment in breast cancer patients treated with neoadjuvant chemotherapy COX2/PTGS2 Expression Is Predictive of Response to Neoadjuvant Celecoxib in HER2-negative Breast Cancer Patients Celecoxib With Neoadjuvant Chemotherapy for Breast Cancer Might Worsen Outcomes Differentially by COX-2 Expression and ER Status: Exploratory Analysis of the REMAGUS02 Trial Comedications influence immune infiltration and pathological response to neoadjuvant chemotherapy in breast cancer." Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLS129.
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La chimiothérapie néoadjuvante (CNA) est utilisée dans les cancers du sein agressifs ou localement avancés (CS). Au delà des bénéfices cliniques, elle représente une opportunité pour monitorer in vivo la sensibilité d’une tumeur à un traitement.A partir de l’analyse de sets de données de patients traités par CNA, nous souhaitons identifier des mécanismes associes à la résistance ou sensibilité au traitement. Dans la première partie, nous avons évalué des paramètres, cliniques, anatomopathologiques et transcriptomiques. Nous avons démontré que des éléments non explorés comme la présence d’embols après CNA revêtaient une information pronostique importante. Dans une 2ème partie, nous avons analysé l’impact de l’infiltrat immunitaire dans le cancer du sein, et avons décrit les changements observés entre des échantillons avant et après CNA. Nous avons montré que l’impact pronostique des TILs était différent avant et après CNA, et était opposé dans les CS triple négatif ou HER2-positif. Finalement, nous avons analysé l’impact des comédications pendant la CNA. Nous avons trouvé des effets positifs – via l’augmentation de l’infiltrat immunitaire et la réponse au traitement – et des effets négatifs avec des effets délétères dans certains sous groupes de patients. En conclusion, la situation néoadjuvante représente une plateforme pour générer et potentiellement valider des hypothèses de recherche. La mise à disposition de jeux de données de patients traités par chimiothérapie néoadjuvante constituerait une ressource majeure pour accélérer la recherche contre le cancer du sein<br>Neoadjuvant chemotherapy (NAC i.e. chemotherapy before surgery) is increasingly being used for aggressive or locally advanced breast cancer (BCs). Beyond clinical benefits, it represents an opportunity to monitor in vivo sensitivity to treatment. Based on the analysis of datasets of BCs patients treated with NAC, we aimed at identifying mechanisms associated with resistance or sensitivity to treatment.In the first part, we evaluated biological, clinical, pathological and transcriptomic patterns. We demonstrated that unexplored pathological features such as post-NAC lymphovascular invasion may carried an important prognostic information.In a second part, we analyzed impact of imune infiltration in BC and we described extensively the changes of tumor infiltrating lymphocytes (TILs) between pre and post-NAC samples. We showed that the prognostic impact of TILs was different before and after NAC, and was opposite in TNBC and HER2-positive BCs. Finally, we investigated the impact of comedications use during NAC. We found both positive effects - while enhancing immune infiltration and response to treatment - and negative effects with deleterisous oncologic outcomes in specific patients subgroups. In conclusion, the neoadjuvant setting represents a platform to both generate and potentially validate research hypotheses aiming at increasing the efficacy of treatment. The public release of real-life datasets of BC patients treated with NAC would represent a major resource to accelerate BC research
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Jansen, Kirstin. "Stable Isotopes and Metabolite Profiles as Physiological Markers for the Drought Stress Sensitivity in Douglas-Fir Provenances (Pseudotsuga menziesii (MIRB.) FRANCO)." Doctoral thesis, Humboldt-Universität zu Berlin, 2018. http://dx.doi.org/10.18452/19617.
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In Mitteleuropa werden zukünftig häufigere Trocken- und Hitzeperioden mit wirtschaftlichen Einbußen in der Waldwirtschaft erwartet. Die Douglasie (Pseudotsuga menziesii (Mirb.) Franco) wird als Alternative für die wirtschaftlich bedeutsame, jedoch trockenheitsempfindliche Fichte diskutiert (Picea abies (L.) H.Karst.). Zwei Unterarten, die Küsten- (FDC) und die Inlandsdouglasie (FDI), sind im ausgedehnten natürlichen Verbreitungsgebiet in Nordamerika beheimatet, welches ein großes Potenzial für die Auswahl produktiver und trockenresistenter Herkünfte bietet. Unser Ziel war, die Trockenreaktion verschiedener Douglasienherkünfte unter Verknüpfung morphologischer und physiologischer Parameter und die der Trockenheitsresistenz bzw. -empfindlichkeit zugrundeliegenden Mechanismen zu erforschen. Ein Herkunftsversuch in Südwestdeutschland ermöglichte die Untersuchung 50-jähriger Douglasien verschiedener Herkünfte entlang eines Höhengradienten. Unter kontrollierten Bedingungen simulierten wir die Effekte einer Hitzewelle auf Jungbäume zweier Provenienzen. Wir analysierten die Kohlenstoff- und Sauerstoff-Stabilisotopenzusammensetzung, den Gaswechsel der Blätter, Veränderungen im Stoffwechsel und das Baumwachstum.
Unsere Ergebnisse zeigen bei FDC aus humiden Regionen hohe Wachstumseinbußen unter Trockenheit und moderat bis stark verringerte stomatäre Leitfähigkeit, unterstützt durch Photoprotektion. FDC aus Regionen mit starker Sommertrockenheit reagierten kaum mit Stomataschluss und Wachstumseinbußen auf Trockenheit, jedoch mit starker Osmoregulation und Monoterpen-Emissionen, welche zur Trockenresistenz beitragen könnten. FDI aus einer ariden Region zeigten hohe An, geringes Wachstum und stark antioxidative und photoprotektive Mechanismen.
Die Herkünfte unterscheiden sich stark in ihrer Trockenreaktion und ihren Schutzmechanismen. Der Anbau trockenresistenter Herkünfte wird an Standorten von Vorteil sein, für die eine Häufung von ariden Sommerperioden vorhergesagt wird.<br>In Central Europe, more frequent periods of dry and hot weather are expected in the future with economic losses in the forestry sector. Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) is discussed as a timber species alternative to the economically important but drought-sensitive spruce (Picea abies (L.) H. Karst.). Two subspecies, the coastal (FDC) and the interior Douglas-fir (FDI), are native to an extensive natural range in North America, offering a great potential for the selection of productive and drought tolerant provenances. Our goal was to investigate the drought response of different Douglas-fir provenances on the morphological and physiological level, as well as the mechanisms underlying drought resistance or susceptibility. A provenance trial in southwestern Germany established in 1958 allowed the study of 50-year-old Douglas-fir trees of diverse provenances along a height gradient. Under controlled conditions, we simulated the effects of a heat wave on young trees of two provenances. We analyzed carbon and oxygen stable isotopic composition, leaf gas exchange, changes in metabolism and tree growth.
FDC from humid regions responded to drought with strong growth decline and a medium to strong stomatal closure, supported by enhanced instantaneous photoprotection. FDC from regions with very dry summer conditions showed a small growth decline and anisohydric regulation of stomatal conductance under drought, supported by high levels of osmotic adjustment. High monoterpene emissions might contribute to the drought resistance. FDI from an arid region showed high assimilation rates, low growth potential and a high antioxidant, photoprotective, drought and heat protective potential.
The provenances differ greatly in their dry reaction and their protective mechanisms. The cultivation of drought resistant crops will be beneficial at sites predicted to accumulate arid summer periods.
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Christle, Jeffrey Wilcox [Verfasser], Martin [Akademischer Betreuer] [Gutachter] Halle, and Henning [Gutachter] Wackerhage. "Individualized combined exercise in patients with cardiac disease and low fitness. A comparison of individualized combined endurance-resistance exercise with a cardiac rehabilitation maintenance program on peak and submaximal exercise performance, risk status, health-related quality of life and physical activity levels in elderly patients with cardiac disease and low physical fitness: A randomized controlled trial / Jeffrey Wilcox Christle ; Gutachter: Martin Halle, Henning Wackerhage ; Betreuer: Martin Halle." München : Universitätsbibliothek der TU München, 2016. http://d-nb.info/1132773997/34.
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