327 research outputs found
Outcome after steroid withdrawal in adult renal transplant patients receiving tacrolimus-based immunosuppression
Outcome after steroid withdrawal in renal transplant patients receiving tacrolimus-based immunosuppression
What are communities of practice? A comparative review of four seminal works
This paper is a comparative review of four seminal works on communities of practice. It is argued that the ambiguities of the terms community and practice are a source of the concept's reusability allowing it to be reappropriated for different purposes, academic and practical. However, it is potentially confusing that the works differ so markedly in their conceptualizations of community, learning, power and change, diversity and informality. The three earlier works are underpinned by a common epistemological view, but Lave and Wenger's 1991 short monograph is often read as primarily about the socialization of newcomers into knowledge by a form of apprenticeship, while the focus in Brown and Duguid's article of the same year is, in contrast, on improvising new knowledge in an interstitial group that forms in resistance to management. Wenger's 1998 book treats communities of practice as the informal relations and understandings that develop in mutual engagement on an appropriated joint enterprise, but his focus is the impact on individual identity. The applicability of the concept to the heavily individualized and tightly managed work of the twenty-first century is questionable. The most recent work by Wenger – this time with McDermott and Snyder as coauthors – marks a distinct shift towards a managerialist stance. The proposition that managers should foster informal horizontal groups across organizational boundaries is in fact a fundamental redefinition of the concept. However it does identify a plausible, if limited, knowledge management (KM) tool. This paper discusses different interpretations of the idea of 'co-ordinating' communities of practice as a management ideology of empowerment
Ergodic properties of a generic non-integrable quantum many-body system in thermodynamic limit
We study a generic but simple non-integrable quantum {\em many-body} system
of {\em locally} interacting particles, namely a kicked model of spinless
fermions on 1-dim lattice (equivalent to a kicked Heisenberg XX-Z chain of 1/2
spins). Statistical properties of dynamics (quantum ergodicity and quantum
mixing) and the nature of quantum transport in {\em thermodynamic limit} are
considered as the kick parameters (which control the degree of
non-integrability) are varied. We find and demonstrate {\em ballistic}
transport and non-ergodic, non-mixing dynamics (implying infinite conductivity
at all temperatures) in the {\em integrable} regime of zero or very small kick
parameters, and more generally and important, also in {\em non-integrable}
regime of {\em intermediate} values of kicked parameters, whereas only for
sufficiently large kick parameters we recover quantum ergodicity and mixing
implying normal (diffusive) transport. We propose an order parameter (charge
stiffness ) which controls the phase transition from non-mixing/non-ergodic
dynamics (ordered phase, ) to mixing/ergodic dynamics (disordered phase,
D=0) in the thermodynamic limit. Furthermore, we find {\em exponential decay of
time-correlation function} in the regime of mixing dynamics.
The results are obtained consistently within three different numerical and
analytical approaches: (i) time evolution of a finite system and direct
computation of time correlation functions, (ii) full diagonalization of finite
systems and statistical analysis of stationary data, and (iii) algebraic
construction of quantum invariants of motion of an infinite system, in
particular the time averaged observables.Comment: 18 pages in REVTeX with 14 eps figures included, Submitted to
Physical Review
fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients
Background
MR Tractography enables non-invasive preoperative depiction of language subcortical tracts, which is crucial for the presurgical work-up of brain tumors; however, it cannot evaluate the exact function of the fibers.
Purpose
A systematic pipeline was developed to combine tractography reconstruction of language fiber bundles, based on anatomical landmarks (Anatomical-T), with language fMRI cortical activations. A fMRI-targeted Tractography (fMRI-T) was thus obtained, depicting the subsets of the anatomical tracts whose endpoints are located inside a fMRI activation. We hypothesized that fMRI-T could provide additional functional information regarding the subcortical structures, better reflecting the eloquent white matter structures identified intraoperatively.
Methods
Both Anatomical-T and fMRI-T of language fiber tracts were performed on 16 controls and preoperatively on 16 patients with left-hemisphere brain tumors, using a q-ball residual bootstrap algorithm based on High Angular Resolution Diffusion Imaging (HARDI) datasets (b = 3000 s/mm(2); 60 directions); fMRI ROIs were obtained using picture naming, verbal fluency, and auditory verb generation tasks. In healthy controls, normalized MNI atlases of fMRI-T and Anatomical-T were obtained. In patients, the surgical resection of the tumor was pursued by identifying eloquent structures with intraoperative direct electrical stimulation mapping and extending surgery to the functional boundaries. Post-surgical MRI allowed to identify Anatomical-T and fMRI-T non-eloquent portions removed during the procedure.
Results
MNI Atlases showed that fMRI-T is a subset of Anatomical-T, and that different task-specific fMRI-T involve both shared subsets and task-specific subsets - e.g., verbal fluency fMRI-T strongly involves dorsal frontal tracts, consistently with the phonogical-articulatory features of this task. A quantitative analysis in patients revealed that Anatomical-T removed portions of AF-SLF and IFOF were significantly greater than verbal fluency fMRI-T ones, suggesting that fMRI-T is a more specific approach. In addition, qualitative analyses showed that fMRI-T AF-SLF and IFOF predict the exact functional limits of resection with increased specificity when compared to Anatomical-T counterparts, especially the superior frontal portion of IFOF, in a subcohort of patients.
Conclusion
These results suggest that performing fMRI-T in addition to the 'classic' Anatomical-T may be useful in a preoperative setting to identify the 'high-risk subsets' that should be spared during the surgical procedure
Tacrolimus without antilymphocyte induction therapy prevents pancreas loss from rejection in 123 consecutive patients
In this series, antilymphoid induction therapy did not appear to be necessary to prevent early graft loss from rejection. In addition, we have followed cytomegalovirus (CMV) antigenemia (pp65) for CMV infection. Although some patients developed a positive antigenemia in the seropositive to negative donor-recipient combinations, only one patient had a prolonged febrile course for 1 week
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