357 research outputs found
Стиль поезії Шевченка
The respect for human rights follows strong spatial patterns among countries. However, to understand and predict the spatial effects of policies and interventions, it is imperative to know whether these spatial patterns stem from countries’ interactions and spillovers, or from common deep determinants, such as history and physical geography. This paper makes an effort to disentangle the two. The lion’s share of spatial patterns is accounted for by time-invariant factors, while the evidence of contemporaneous spillovers is very marginal. This limits the scope of regional effects when individual countries change their human rights situations
The impact of terrorism on international mergers and acquisitions: Evidence from firm-level decisi
Does terrorism inhibit a country’s ability to attract international direct investment? If so, terrorism may have large costs in terms of employment losses, macroeconomic instability, and missed development opportunities. However, do investors fear terrorism because of direct risks to their assets, or because the opportunities in the host country deteriorate? And how do they adjust investments? We study the impact of terrorism on merger and acquisition decisions of 8,872 firms over 116 countries over 16 years. The firm-level perspective allows the isolation of host-country terrorism from firm-level characteristics such as size or experience as an explanation, by comparing decisions for the same firm across destinations. It also allows separation of investment responses into reductions or entire withholding of investment. A sample standard deviation increase in terrorism reduces merger and acquisition investment by around 30%. Firms do not generally reduce the size of their investment in the face of terrorism – instead, they decide not to enter the country altogether. We find no evidence to suggest that multinational firms are more sensitive to attacks on local business assets. A country-level analysis, which necessarily does not control for firm-level characteristics, yields materially different conclusions
Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service
<p>Abstract</p> <p>Background</p> <p>To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS.</p> <p>Methods</p> <p>Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed.</p> <p>Results</p> <p>Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS.</p> <p>Conclusions</p> <p>The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.</p
Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy
AIMS: Fluctuations in left ventricular (LV) thresholds with cardiac resynchronization therapy (CRT) are unknown. The LV capture management (LVCM) algorithm automatically measures LV thresholds on a daily basis and offers the opportunity to analyse threshold fluctuations. METHODS AND RESULTS: A total of 282 patients implanted with a Medtronic Concerto CRT-D device were prospectively studied. Device data were collected at periodic visits, including daily thresholds from the preceding 14 days and weekly threshold ranges since implantation, acquired by the LVCM algorithm up to 12 months' follow-up. Overall, LV thresholds remained relatively stable, with 189/208 (91%) patients having a maximum increase in threshold of > or = 1.0 V at any time between their 1 and 6 month visits and 127/135 (94%) between the 6 and 12 month visits. However, increase in threshold was significantly affected by LV threshold amplitude. Of the 170 patients with a 1 month threshold of > or = 2.0 V, 159 (94%) had increases of >1.0 V up to their 6 month visit, whereas 8/38 (21%) patients with or = 2.0 V) LV thresholds, a safety margin of 1.0 V is sufficient to ensure LV capture if phrenic nerve stimulation is an issue, and may be even lower in devices with auto-adaptive capture management algorithms. However, the margin should be greater in patients with higher thresholds because of larger fluctuations. Left ventricular capture management may be particularly useful in these patients to ensure LV capture without sacrificing device longevity
The value of routine chest radiographs after minimally invasive cardiac surgery: an observational cohort study
BACKGROUND: Chest radiographs (CXRs) are obtained frequently in postoperative cardiac surgery patients. The diagnostic and therapeutic efficacy of routine CXRs is known to be low and the discussion regarding the safety of abandoning these CXRs after cardiac surgery is still ongoing. We investigated the value of routine CXRs directly after minimally invasive cardiac surgery. METHODS: We prospectively included all patients who underwent minimally invasive cardiac surgery by port access, ministernotomy or bilateral video-assisted thoracoscopy (VATS) in the year 2012. A direct postoperative CXR was performed on all patients at ICU arrival. All CXR findings were noted, including whether they led to an intervention or not. The results were compared to the postoperative CXR results in patients who underwent conventional cardiac surgery by full median sternotomy over the same period. MAIN RESULTS: A total of 249 consecutive patients were included. Most of these patients underwent valve surgery, rhythm surgery or a combination of both. The diagnostic efficacy for minor findings was highest in the port access and bilateral VATS groups (56% and 63% versus 28% and 45%) (p < 0.005). The diagnostic efficacy for major findings was also higher in these groups (8.9% and 11% versus 4.3% and 3.8%) (p = 0.010). The need for an intervention was most common after minimally invasive surgery by port access, although this difference was not statistically significant (p = 0.056). CONCLUSIONS: The diagnostic efficacy of routine CXRs performed after minimally invasive cardiac surgery by port access or bilateral VATS is higher than the efficacy of CXRs performed after conventional cardiac surgery. A routine CXR after these procedures should still be considered
Benzene degradation in a denitrifying biofilm reactor: activity and microbial community composition
Benzene is an aromatic compound and harmful for the environment. Biodegradation of benzene can reduce the toxicological risk after accidental or controlled release of this chemical in the environment. In this study, we further characterized an anaerobic continuous biofilm culture grown for more than 14 years on benzene with nitrate as electron acceptor. We determined steady state degradation rates, microbial community composition dynamics in the biofilm, and the initial anaerobic benzene degradation reactions. Benzene was degraded at a rate of 0.15 μmol/mg protein/day and a first-order rate constant of 3.04/day which was fourfold higher than rates reported previously. Bacteria belonging to the Peptococcaceae were found to play an important role in this anaerobic benzene-degrading biofilm culture, but also members of the Anaerolineaceae were predicted to be involved in benzene degradation or benzene metabolite degradation based on Illumina MiSeq analysis of 16S ribosomal RNA genes. Biomass retention in the reactor using a filtration finger resulted in reduction of benzene degradation capacity. Detection of the benzene carboxylase encoding gene, abcA, and benzoic acid in the culture vessel indicated that benzene degradation proceeds through an initial carboxylation step.</p
CD40-CD40 ligand interactions in experimental allergic encephalomyelitis and multiple sclerosis
We investigated the role of CD40-CD40 ligand (CD40L) interactions in multiple sclerosis (MS) and experimental allergic encephalomyelitis (EAE). Activated helper T cells expressing CD40L (gp39) surface protein were found in MS patient brain sections, but not in brain tissue sections of normal controls or patients with other neurological diseases. CD40L-positive cells were co-localized with CD40-bearing cells in active lesions (perivascular infiltrates). Most of these CD40 bearing cells proved to be of the monocytic lineage (macrophages or microglial cells), and relatively few were B cells. To functionally evaluate CD40-CD40L interactions, EAE was elicited in mice by means of proteolipid-peptide immunization. Treatment with anti-CD40L monoclonal antibody completely prevented the development of disease. Furthermore, administration of anti-CD40L monoclonal antibody, even after disease onset, shortly before maximum disability score was reached led to dramatic disease reduction. The presence of helper T cells expressing CD40L in brain tissue of MS patients and EAE animals, together with the functional evidence provided by successful experimental prevention and therapy in an animal model, indicates that blockade of CD40-CD40L-mediated cellular interactions may be a method for interference in active MS
The dissolution and microbial degradation of mobile aromatic hydrocarbons from a Pintsch gas tar DNAPL source zone
Source zones containing tar, a dense non-aqueous phase liquid (DNAPL), can contaminate groundwater for centuries. A common occurrence of tar is at former Pintsch gas factories. Little is known about the composition and fate of contaminants dissolving from Pintsch gas tar DNAPL. In this study, we determined the composition and water-soluble characteristics of mobile aromatic hydrocarbons and their biodegradation metabolites in the DNAPL contaminated groundwater at a former Pintsch gas tar plant. We assessed the factors that determine the fate of observed groundwater contaminants. Measured values of density (1.03–1.06 kg/m3) and viscosity (18.6–39.4 cP) were found to be relatively low compared to common coal tars. Analysis showed that unlike common coal tars phenanthrene is the primary component rather than naphthalene. Moreover, it was found that Pintsch gas tar contains a relatively high amount of light molecular aromatic hydrocarbon compounds, such as benzene, toluene, ethylbenzene and xylenes (BTEX). Less commonly reported components, such as styrene, ethyltoluenes, di-ethylbenzene, 1,2,4,5-tetramethylbenzene, were also detected in water extracts from Pintsch gas tar. Moreover, 46 relatively hydrophilic metabolites were found within the tar samples. Metabolites present within the tar suggest biodegradation of mobile aromatic Pintsch gas tar compounds occurred near the DNAPL. Based on eleven detected suspect metabolites, a novel anaerobic biodegradation pathway is proposed for indene. Overall, our findings indicate that Pintsch gas tar has higher invasive and higher flux properties than most coal tars due to its relatively low density, low viscosity and, high content of water-soluble compounds. The partitioning of contaminants from multi-component DNAPL into the aqueous phase and re-dissolution of their slightly less hydrophobic metabolites back from the aqueous phase into the DNAPL is feasible and demonstrates the complexity of assessing degradation processes within a source zone
Sorption and fractionation of dissolved organic matter and associated phosphorus in agricultural soil
Molibility of dissolved organic matter (DOM) strongly affects the export of nitrogen (N) and phosphorus (P) from oils to surface waters. To study the sorption an mobility of dissolved organic C and P (DOC, DOP) in soil, the pH-dependent sorption of DOM to samples from Ap, EB, and Bt horizons from a Danish agircultural Humic Hapludult was investigated and a kinetic model applicable in field-scale model tested. Sorption experiments of 1 to 72 h duration were conducted at two pH levels (pH 5.0 and 7.0) and six initial DOC concentrtions (0-4.7 mmol L-1). Most sorption/desorption occurred during the first few hours. Dissolved organic carbon and DOP sorption decreased strongly with increased pH and desorption dominated at pH 7, especially for DOC. Due to fractionation during DOM sorption/desorption at DOC concentrations up to 2 mmol L-1, the solution fraction of DOM was enriched in P indicating preferred leaching of DOP. The kinetics of sorption was expressed as a function of how far the solution DOC or DOP concentrations deviate from "equilibrium". The model was able to simulate the kinetics of DOC and DOP sorption/desorption at all concentrations investigated and at both pH levels making it useful for incorporation in field-scale models for quantifying DOC and DOP dynamics
A web-based decision aid for shared decision making in pelvic organ prolapse:the SHADE-POP trial
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