324 research outputs found

    Numerische Analyse des Langzeitverhaltens hochbeanspruchter Druckglieder unter Berücksichtigung des nichtlinearen Kriechens mit Hilfe der quadratischen Optimierung

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    Bei der Berechnung von Stahlbeton- bzw. Spannbetonkonstruktionen müssen die Zusatzverformungen infolge Kriechen und Schwinden des Betons unter anderem dann berücksichtigt werden, wenn durch sie der Schnittgrößenzustand des Gesamttragwerks bzw. einzelner Tragwerksteile ungünstig verändert wird. Das trifft vor allem auf schlanke Druckglieder zu. Die Ermittlung der Kriechausmitte erfolgt im allgemeinen unter Zugrundelegung einer Kriechzahl, die vom Beanspruchungsniveau des Betons unabhängig ist. Diese Annahme ist unzulässig, wenn die Betonspannungen oberhalb des Gebrauchslastniveaus (>30..50% der Druckfestigkeit) liegen, da in diesem Bereich die Kriechdehnungen überproportional zu den kriecherzeugenden Spannungen anwachsen (nichtlineares Kriechen). Theoretische Untersuchungen zum Tragverhalten hochbeanspruchter Stahlbetonstützen unter Berücksichtigung des nichtlinearen Kriechens sind aufgrund der Komplexität des Problems und dem damit verbundenen Berechnungsaufwand gegenwärtig in nur geringem Umfang vorhanden. Im vorliegenden Beitrag wird ein Algorithmus vorgestellt, bei dem die Ermittlung der Schnittgrößen und Deformationen auf die sukzessive Lösung quadratischer Optimierungsaufgaben für im voraus festgelegte Betrachtungszeitpunkte zurückgeführt wird, wobei die Ergebnisse der vorangegangenen Zeitpunkte Eingangswerte für die Berechnung darstellen. Die Berücksichtigung der Nichtlinearität des Kriechens unter hoher Spannung sowie geometrisch nichtlinearer Effekte erfolgt iterativ innerhalb jedes Betrachtungszeitpunkts. Mit der Einführung von Spannungsbegrenzungen als zusätzliche Nebenbedingungen können in jeder Iteration Materialplastizierungen, Rißbildungen des Betons bzw. >tension stiffening<-Effekte ohne prinzipielle Veränderung des mathematischen Modells berücksichtigt werden. Durch Nachrechnung von Langzeitversuchen an Stahlbetonstützen erfolgt die Verifikation des Berechnungsmodell

    Incidence of ocular complications in patients with multibacillary leprosy after completion of a 2 year course of multidrug therapy

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    Aim: To evaluate the incidence of and risk factors for ocular complications in multibacillary (MB) leprosy patients following completion of 2 year, fixed duration, multidrug therapy (MDT). Methods: Biannual eye examinations were conducted prospectively on a cohort of MB patients who had completed MDT and followed up for 5 years. The incidence of ocular pathology was calculated as the number of events per person year of event free follow up of patients who did not have the specific finding before completion of MDT. Results: 278 patients had one or more follow up visits after completion of MDT. The incidence of lagophthalmos was 0.24%/patient year (95% CI 0.10% to 0.37%); corneal opacity, 5.35%/patient year (95% CI 4.27% to 6.70%); uveal involvement, 3.78%/patient year (95% CI 2.96% to 4.83%); and cataract that reduced vision to 6/18 or less, 2.4%/patient year (95% CI 1.77% to 3.26%). Overall, 5.65%/patient year (95% CI 4.51% to 7.09%) developed leprosy related ocular disease and 3.86%/patient year (95% CI 3.00% to 4.95%) developed leprosy related, potentially blinding ocular pathology during the period following MDT. Age and other disability also predicted incident eye disease. Conclusions: Every year, approximately 5.6% of patients with MB who have completed MDT can be expected to develop new ocular complications of leprosy, which often (3.9%) are potentially vision threatening. Because many of these complications cannot be detected without slit lamp examination, periodic monitoring, particularly of older patients and those with other disability, is recommended, in order to detect and treat ocular complications satisfactorily. I t is estimated that by the end of the year 2005, more than 14 million leprosy patients will have completed a standard course of anti-leprosy multidrug therapy (MDT). 1 Although the incidence of leprosy is declining in some areas, approximately half a million new patients are diagnosed with leprosy each year. Recent changes in the epidemiology of leprosy include a gradual shift in the proportion of the type of leprosy from the paucibacillary to the multibacillary (MB) form, as well as a shift to an older age at diagnosis of disease. 2 Improving health care and socioeconomic conditions predict increasing survival, with the fortunate result that there will be an ever increasing number of antimicrobially &apos;&apos;cured&apos;&apos; leprosy patients than ever existed in history. There is evidence that even after adequate treatment with MDT, a sizeable proportion of cured leprosy patients continue to manifest progressive impairment of nerve function. Although the pathophysiology of this process is not fully understood, it is thought to be related to continuing immunological reactions and slow evolution of pre-existing nerve damage. Ocular complications are frequently observed in newly diagnosed leprosy patients and in patients who are undergoing MDT. 7-9 However, little information exists on the incidence of ocular complications after completion of MDT in MB patients who have completed the recommended course of MDT. Knowledge of the risk and nature of ocular morbidity in leprosy patients after treatment with MDT is needed to prevent and/or manage such complications promptly and effectively in programmes worldwide. Such information potentially could identify risk factors that may be amenable to intervention and help prioritise groups for more active follow up. In our previous reports, we have described a cohort of newly diagnosed MB leprosy patients who were followed for ocular complications during 2 year fixed MDT. 8 10 These patients were followed up for a further 5 years. In this paper, we report information on ocular complications that were incident during the post-MDT period. MATERIAL AND METHODS All new clinically diagnosed MB patients starting on a 2 year MDT and living within the leprosy control area of the Schieffelin Leprosy Research and Training Centre in southern India were invited to participate. Recruitment began in 1991 and was completed in 1997. Consenting patients received a baseline ocular examination followed by biannual examinations during MDT and for a period of at least 5 years after completion of MDT. Based on sample size calculations taking into account possible losses to follow up resulting from migration and mortality, 301 MB leprosy patients were enrolled over a period of 6 years. Research methods and protocols were approved by the institutional review board of the Schieffelin Leprosy Research and Training Centre. All patients were examined and given treatment free of charge. At enrolment the following leprosy characteristics were recorded; the type of MB leprosy, based on the clinical classification of Ridley and Jopling 11 ; deformity grading of hands and legs, based on the WHO classification 12 ; the bacterial index, calculated from the results of the acid fast staining of smears from specific skin sites 13 ; presence or Abbreviations: LROP, leprosy related ocular pathology; MB, multibacillary; MDT, multidrug therapy; PBLROP, potentially blinding leprosy related ocular pathology 949 www.bjophthalmol.co

    Stroke genetics: prospects for personalized medicine.

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    Epidemiologic evidence supports a genetic predisposition to stroke. Recent advances, primarily using the genome-wide association study approach, are transforming what we know about the genetics of multifactorial stroke, and are identifying novel stroke genes. The current findings are consistent with different stroke subtypes having different genetic architecture. These discoveries may identify novel pathways involved in stroke pathogenesis, and suggest new treatment approaches. However, the already identified genetic variants explain only a small proportion of overall stroke risk, and therefore are not currently useful in predicting risk for the individual patient. Such risk prediction may become a reality as identification of a greater number of stroke risk variants that explain the majority of genetic risk proceeds, and perhaps when information on rare variants, identified by whole-genome sequencing, is also incorporated into risk algorithms. Pharmacogenomics may offer the potential for earlier implementation of 'personalized genetic' medicine. Genetic variants affecting clopidogrel and warfarin metabolism may identify non-responders and reduce side-effects, but these approaches have not yet been widely adopted in clinical practice

    Проблема ада как компонент проблемы зла в христианской религиозно-философской парадигме

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    Целью данной работы выступает религиоведческое исследование темы получившей название проблема ада в ее философско-теологическом измерении. Соответственно цели автор ставит перед собой такие задания как: проследить становление традиционной концепции ада, выявить богословские и философские предпосылки формирования данного учения, провести религиоведческий и философский анализ альтернативных учений относительно загробного воздаяния

    Chronic pancreatitis of the pancreatic remnant is an independent risk factor for pancreatic fistula after distal pancreatectomy

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    Background: There is an ongoing debate about the best closure technique after distal pancreatectomy (DP). The aim of the closure is to prevent the formation of a clinically relevant post-operative pancreatic fistula (POPF). Stapler technique seems to be equal compared with hand-sewn closure of the remnant. For both techniques, a fistula rate of approximately 30% has been reported. Methods: We retrospectively analyzed our DPs between 01/2000 and 12/2010. In all cases, the pancreatic duct was over sewn with a separately stitched ligation of the pancreatic duct (5*0 PDS) followed by a single-stitched hand-sewn closure of the residual pancreatic gland. The POPF was classified according to the criteria of the International Study Group for Pancreatic Fistula (ISGPF). Univariate and multivariate analyses of potential risk factors for the formation of POPF were performed. Indications for operations included cystic tumors (n = 53), neuroendocrine tumors (n = 27), adenocarcinoma (n = 22), chronic pancreatitis (n = 9), metastasis (n = 6), and others (n = 7). Results: During the period, we performed 124 DPs (♀ = 74, ♂ = 50). The mean age was 57.5 years (18–82). The POPF rates according to the ISGPF criteria were: no fistula, 54.8% (n = 68); grade A, 24.2% (n = 30); grade B, 19.3% (n = 24); and grade C, 1.7% (n = 2). Therefore, in 21.0% (n = 26) of the cases, a clinically relevant pancreatic fistula occurred. The mean postoperative stay was significantly higher after grade B/C fistula (26.3 days) compared with no fistula/grade A fistula (13.7 days) (p < 0.05). The uni- and multivariate analyses showed chronic pancreatitis of the pancreatic remnant to be an independent risk factor for the development of POPF (p = 0.004 OR 7.09). Conclusion: By using a standardized hand-sewn closure technique of the pancreatic remnant after DP with separately stitched ligation of the pancreatic duct, a comparably low fistula rate can be achieved. Signs of chronic pancreatitis of the pancreatic remnant may represent a risk factor for the development of a pancreatic fistula after DP and therefore an anastomosis of the remnant to the intestine should be considered

    Cardiovascular care of patients with stroke and high risk of stroke: The need for interdisciplinary action: A consensus report from the European Society of Cardiology Cardiovascular Round Table.

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    Comprehensive stroke care is an interdisciplinary challenge. Close collaboration of cardiologists and stroke physicians is critical to ensure optimum utilisation of short- and long-term care and preventive measures in patients with stroke. Risk factor management is an important strategy that requires cardiologic involvement for primary and secondary stroke prevention. Treatment of stroke generally is led by stroke physicians, yet cardiologists need to be integrated care providers in stroke units to address all cardiovascular aspects of acute stroke care, including arrhythmia management, blood pressure control, elevated levels of cardiac troponins, valvular disease/endocarditis, and the general management of cardiovascular comorbidities. Despite substantial progress in stroke research and clinical care has been achieved, relevant gaps in clinical evidence remain and cause uncertainties in best practice for treatment and prevention of stroke. The Cardiovascular Round Table of the European Society of Cardiology together with the European Society of Cardiology Council on Stroke in cooperation with the European Stroke Organisation and partners from related scientific societies, regulatory authorities and industry conveyed a two-day workshop to discuss current and emerging concepts and apparent gaps in stroke care, including risk factor management, acute diagnostics, treatments and complications, and operational/logistic issues for health care systems and integrated networks. Joint initiatives of cardiologists and stroke physicians are needed in research and clinical care to target unresolved interdisciplinary problems and to promote the best possible outcomes for patients with stroke

    Isolated and dynamical horizons and their applications

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    Over the past three decades, black holes have played an important role in quantum gravity, mathematical physics, numerical relativity and gravitational wave phenomenology. However, conceptual settings and mathematical models used to discuss them have varied considerably from one area to another. Over the last five years a new, quasi-local framework was introduced to analyze diverse facets of black holes in a unified manner. In this framework, evolving black holes are modeled by dynamical horizons and black holes in equilibrium by isolated horizons. We review basic properties of these horizons and summarize applications to mathematical physics, numerical relativity and quantum gravity. This paradigm has led to significant generalizations of several results in black hole physics. Specifically, it has introduced a more physical setting for black hole thermodynamics and for black hole entropy calculations in quantum gravity; suggested a phenomenological model for hairy black holes; provided novel techniques to extract physics from numerical simulations; and led to new laws governing the dynamics of black holes in exact general relativity.Comment: 77 pages, 12 figures. Typos and references correcte

    The Maternal Personhood of Cattle and Plants at a Hindu Center in the United States

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    Religious experiences with sacred nonhuman natural beings considered to be “persons” remain only vaguely understood. This essay provides a measure of clarification by engendering a dialogue between psychoanalytic self psychology on one side and, on the other, religious experiences of cattle and Tulsi plants as holy mothers at a Hindu cattle sanctuary in the United States. Ethnographic data from the Hindu center uncover experiences of sacred maternal natural beings that are tensive, liminal, and colored with affective themes of nurturance, respect, and intimacy, much like psychoanalytic maternal selfobjects. Devotees protect cattle and ritually venerate plants because these actions facilitate a limited experiential grounding of religiosity on what is perhaps the most fundamental of all relationships, the relationship with the mother, within a theological worldview that somewhat embraces nonhuman natural beings in both doctrine and practice

    Features of home and neighbourhood and the liveability of older South Africans

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    While older people live in developing countries, little is known about the relative importance of features of their communities in influencing their liveability. We examinecomponents of home and neighbourhood among older South Africans. Linear regression analyses revealed that features of home (basic amenities, household composition, financial status and safety) and neighbourhood (ability to shop for groceries, participate in organizations and feel safe from crime) are significantly associated with life satisfaction. Approaches to liveability that are person-centred and also set within contexts beyond home and neighbourhood are needed to addressboundaries between home and neighbourhood; incorporate personal resources into liveability models and import broader environmental contexts such as health and social policy

    Biodegradation of Pig Manure by the Housefly, Musca domestica: A Viable Ecological Strategy for Pig Manure Management

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    The technology for biodegradation of pig manure by using houseflies in a pilot plant capable of processing 500–700 kg of pig manure per week is described. A single adult cage loaded with 25,000 pupae produced 177.7±32.0 ml of eggs in a 15-day egg-collection period. With an inoculation ratio of 0.4–1.0 ml eggs/kg of manure, the amount of eggs produced by a single cage can suffice for the biodegradation of 178–444 kg of manure. Larval development varied among four different types of pig manure (centrifuged slurry, fresh manure, manure with sawdust, manure without sawdust). Larval survival ranged from 46.9±2.1%, in manure without sawdust, to 76.8±11.9% in centrifuged slurry. Larval development took 6–11 days, depending on the manure type. Processing of 1 kg of wet manure produced 43.9–74.3 g of housefly pupae and the weight of the residue after biodegradation decreased to 0.18–0.65 kg, with marked differences among manure types. Recommendations for the operation of industrial-scale biodegradation facilities are presented and discussed
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