25 research outputs found

    GONADOTROPHIN RESPONSES TO GnRH PULSES IN HYPOGONADOTROPHIC HYPOGONADISM: LH RESPONSIVENESS IS MAINTAINED IN THE PRESENCE OF LUTEAL PHASE CONCENTRATIONS OF OESTROGEN AND PROGESTERONE

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    LH pulse secretion changes during the menstrual cycle from a rapid regular pattern in the follicular phase to a slower and irregular pattern in the luteal phase. To determine whether the irregular LH pulse pattern in the luteal phase reflects altered GnRH secretion or altered pituitary responsiveness to GnRH, we gave low dose GnRH pulses (25 ng/kg i.v.) every 2 h or every hour for 10 or 12 d to three women with isolated GnRH deficiency. After 4 d of GnRH alone, oestradiol (E 2 ) was given and after 6 d progesterone (P) was added to mimic the hormonal milieu of the luteal phase. LH and FSH were measured every 4 h throughout and also every 20 min for 6 or 12 h, before and after GnRH alone (day 0 and day 4), after E 2 (day 6), and after E 2 + P (day 10 and day 12). Both GnRH pulse frequencies resulted in a rapid increase in plasma FSH to peaks on day 4 (every 2 h) and day 2 and 3 (every hour). FSH concentrations then declined as plasma E 2 rose to 50–80 pg/ml reflecting the selective inhibitory effect of E 2 on FSH release. Plasma LH was also increased after the hourly GnRH injections and this regimen was associated with a more rapid rise in E 2 reflecting follicular maturation. In contrast to the differences in mean hormone concentrations, administration of GnRH at both frequencies resulted in sustained one-on-one responsiveness of LH that was maintained in the presence of both oestrogen and progesterone at mid-luteal phase concentrations. We conclude that the slow frequency of LH pulses observed during the luteal phase reflects decreased GnRH pulse frequency rather than impaired pituitary responsiveness to GnRH.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74947/1/j.1365-2265.1987.tb00786.x.pd

    The non-adoption of supply chain management

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    This is an Accepted Manuscript of an article published by Taylor & Francis in Construction Management and Economics on 10th October 2013, available online: http://wwww.tandfonline.com/10.1080/01446193.2013.830186.Largely taken for granted within the UK construction sector has been a view that supply chain management theory is robust, relevant and reliable. As such it has formed a substantial aspect of previous and contemporary policy and government funded research. Despite this, the general view of its development and diffusion over the last 15 years within the construction industry has been problematic. Coincidentally, prevailing debates within the supply chain management academic community point to the lack of unified theory, models of diffusion and strong connections to organization theory. Using Straussian grounded theory, iterations between data and organization theory provided a fresh perspective on the development and diffusion of supply chain management in construction. This inductive research provided contextually rich explanations for development and diffusion that explicitly connected with and drew upon robust, relevant and reliable theories of institutions, innovation diffusion, triads, quasifirms and mechanisms of organizational governance. These explanations challenge the simplistic assumption that chains and networks of organizations are holistically managed and controlled by any single organization or institution in the construction industry. The debate therefore shifts away from proselytizing supply chain management towards research that explores the rigour, relevance and reliability of supply chain management assumptions in construction. The gap between industry practice and policy is exposed and the question is posed: to what extent policy and practice do, or should, constitute a recursive relationship.© 2013 Taylor & Francis

    Blood pressure-lowering effects of nifedipine/candesartan combinations in high-risk individuals: Subgroup analysis of the DISTINCT randomised trial

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    The DISTINCT study (reDefining Intervention with Studies Testing Innovative Nifedipine GITS - Candesartan Therapy) investigated the efficacy and safety of nifedipine GITS/candesartan cilexetil combinations vs respective monotherapies and placebo in patients with hypertension. This descriptive sub-analysis examined blood pressure (BP)-lowering effects in high-risk participants, including those with renal impairment (estimated glomerular filtration rate<90 ml min-1, n=422), type 2 diabetes mellitus (n=202), hypercholesterolaemia (n=206) and cardiovascular (CV) risk factors (n=971), as well as the impact of gender, age and body mass index (BMI). Participants with grade I/II hypertension were randomised to treatment with nifedipine GITS (N) 20, 30, 60 mg and/or candesartan cilexetil (C) 4, 8, 16, 32 mg or placebo for 8 weeks. Mean systolic BP and diastolic BP reductions after treatment in high-risk participants were greater, overall, with N/C combinations vs respective monotherapies or placebo, with indicators of a dose-response effect. Highest rates of BP control (ESH/ESC 2013 guideline criteria) were also achieved with highest doses of N/C combinations in each high-risk subgroup. The benefits of combination therapy vs monotherapy were additionally observed in patient subgroups categorised by gender, age or BMI. All high-risk participants reported fewer vasodilatory adverse events in the pooled N/C combination therapy than the N monotherapy group. In conclusion, consistent with the DISTINCT main study outcomes, high-risk participants showed greater reductions in BP and higher control rates with N/C combinations compared with respective monotherapies and lesser vasodilatory side-effects compared with N monotherapy

    Intelligent and interactive web-based tutoring system in engineering education : reviews, perspectives and development

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    Due to the rapid growth of the use of computers and increasing use of the Internet in education a large number of Web-based educational applications have been developed and implemented. However, very few of them are pedagogically intelligent and interactive for learning purposes. The Web-based intelligent learning has become more effective in the past decade due to increasing use of the Internet ineducation. A literature search indicates that there is a lack of relevant comprehensive research concerning the efficiency of computer-assisted instructions used in engineering education. The main focus of the research described in this chapter is on the comprehensive review of design and development of the Web-based authoring tool for an Intelligent Tutoring System in engineering education. The chapter outlines and discusses important issues of the development of intelligent Tutoring System (ITS) in engineering education with an example of the development of a Web-Based Computer-Assisted Tutorials and Laboratory Procedures (WCALP)
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