4,363 research outputs found
Assessing Devolution in the Canadian North: A Case Study of the Yukon Territory
Despite a rich literature on the political and constitutional development of the Canadian territorial North, few scholars have examined the post-devolution environment in Yukon. This lacuna is surprising since devolution is frequently cited as being crucial to the well-being of Northerners, leading both the Government of Nunavut and the Government of the Northwest Territories to lobby the federal government to devolve lands and resources to them. This paper provides an updated historical account of devolution in Yukon and assesses its impact on the territory since 2003. Relying mainly on written resources and 16 interviews with Aboriginal, government, and industry officials in the territory, it highlights some broad effects of devolution and specifically analyzes the processes of obtaining permits for land use and mining. Our findings suggest that devolution has generally had a positive effect on the territory, and in particular has led to more efficient and responsive land use and mining permit processes
Professional guideline versus product label selection for treatment with IV thrombolysis: an analysis from SITS registry
Introduction:
Thrombolysis usage in ischaemic stroke varies across sites. Divergent advice from professional guidelines and product labels may contribute.
Patients and methods:
We analysed SITS-International registry patients enrolled January 2010 through June 2016. We grouped sites into organisational tertiles by number of patients arriving â€2.5âh and treated â€3âh, percentage arriving â€2.5âh and treated â€3âh, and numbers treated â€3âh. We assigned scores of 1â3 (lower/middle/upper) per variable and 2 for onsite thrombectomy. We classified sites as lower efficiency (summed scores 3â5), medium efficiency (6â8) or higher efficiency (9â11). Sites were also grouped by adherence with European product label and ESO guideline: âlabel adherentâ (>95% on-label), âguideline adherentâ (â„5% off-label, â„95% on-guideline) or âguideline non-adherentâ (>5% off-guideline). We cross-tabulated site-efficiency and adherence. We estimated the potential benefit of universally selecting by ESO guidance, using onset-to-treatment time-specific numbers needed to treat for day 90 mRS 0â1.
Results:
A total of 56,689 patients at 597 sites were included: 163 sites were higher efficiency, 204 medium efficiency and 230 lower efficiency. Fifty-six sites were âlabel adherentâ, 204 âguideline adherentâ and 337 âguideline non-adherentâ. There were strong associations between site-efficiency and adherence (Pâ<â0.001). Almost all âlabel adherentâ sites (55, 98%) were lower efficiency. If all patients were treated by ESO guidelines, an additional 17,031 would receive alteplase, which translates into 1922 more patients with favourable three-month outcomes.
Discussion:
Adherence with product labels is highest in lower efficiency sites. Closer alignment with professional guidelines would increase patients treated and favourable outcomes.
Conclusion:
Product labels should be revised to allow treatment of patients â€4.5âh from onset and aged â„80 years
Robust Estimation for Linear Panel Data Models
In different fields of applications including, but not limited to,
behavioral, environmental, medical sciences and econometrics, the use of panel
data regression models has become increasingly popular as a general framework
for making meaningful statistical inferences. However, when the ordinary least
squares (OLS) method is used to estimate the model parameters, presence of
outliers may significantly alter the adequacy of such models by producing
biased and inefficient estimates. In this work we propose a new, weighted
likelihood based robust estimation procedure for linear panel data models with
fixed and random effects. The finite sample performances of the proposed
estimators have been illustrated through an extensive simulation study as well
as with an application to blood pressure data set. Our thorough study
demonstrates that the proposed estimators show significantly better
performances over the traditional methods in the presence of outliers and
produce competitive results to the OLS based estimates when no outliers are
present in the data set
The shifting nature of womenâs experiences and perceptions of ductal carcinoma in situ
Aim: This paper is a report of a descriptive qualitative study of the evolution of womenâs perceptions and experiences of ductal carcinoma in situ from the period near to diagnosis to one year later.
Background: Ductal carcinoma in situ is a non-invasive breast condition where cancer cells are detected but confined to the ducts of the breast. With treatment, the condition has a positive prognosis but ironically patients undergo treatment similar to that for invasive breast cancer. There is a lack of longitudinal qualitative research studying womenâs experiences of ductal carcinoma in situ, especially amongst newly diagnosed patients and how experiences change over time.
Methods: Forty-five women took part in an initial interview following a diagnosis of ductal carcinoma in situ and twenty-seven took part in a follow-up interview 9-13 months later. Data were collected between January 2007 and October 2008. Transcripts were analysed using a hybrid approach to thematic analysis.
Findings: Womenâs early perceptions of ductal carcinoma in situ merged and sometimes conflicted with their lay beliefs of breast cancer. Perceptions and experiences of the condition shifted over time. These overriding aspects were evident within four themes identified across the interviews: 1) perceptions of DCIS versus breast cancer, 2) from paradox to acceptance, 3) personal impact, and 4) support and interactions with others.
Conclusion: This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing womenâs initial and shifting experiences and perceptions of the condition. The issues identified need to be recognised in clinical practice and supported appropriately
Foam nest components of the tĂșngara frog: a cocktail of proteins conferring physical and biological resilience
The foam nests of the tĂșngara frog (Engystomops pustulosus) form a biocompatible incubation medium for eggs and sperm while resisting considerable environmental and microbiological assault. We have shown that much of this behaviour can be attributed to a cocktail of six proteins, designated ranaspumins (Rsn-1 to Rsn-6), which predominate in the foam. These fall into two discernable classes based on sequence analysis and biophysical properties. Rsn-2, with an amphiphilic amino acid sequence unlike any hitherto reported, exhibits substantial detergent-like surfactant activity necessary for production of foam, yet is harmless to the membranes of eggs and spermatozoa. A further four (Rsn-3 to Rsn-6) are lectins, three of which are similar to fucolectins found in teleosts but not previously identified in a land vertebrate, though with a carbohydrate binding specificity different from previously described fucolectins. The sixth, Rsn-1, is structurally similar to proteinase inhibitors of the cystatin class, but does not itself appear to exhibit any such activity. The nest foam itself, however, does exhibit potent cystatin activity. Rsn-encoding genes are transcribed in many tissues of the adult frogs, but the full cocktail is present only in oviduct glands. Combinations of lectins and cystatins have known roles in plants and animals for defence against microbial colonization and insect attack. TĂșngara nest foam displays a novel synergy of selected elements of innate defence plus a specialized surfactant protein, comprising a previously unreported strategy for protection of unattended reproductive stages of animals
The Mechanism behind Erosive Bursts in Porous Media
Erosion and deposition during flow through porous media can lead to large
erosive bursts that manifest as jumps in permeability and pressure loss. Here
we reveal that the cause of these bursts is the re-opening of clogged pores
when the pressure difference between two opposite sites of the pore surpasses a
certain threshold. We perform numerical simulations of flow through porous
media and compare our predictions to experimental results, recovering with
excellent agreement shape and power-law distribution of pressure loss jumps,
and the behavior of the permeability jumps as function of particle
concentration. Furthermore, we find that erosive bursts only occur for pressure
gradient thresholds within the range of two critical values, independent on how
the flow is driven. Our findings provide a better understanding of sudden sand
production in oil wells and breakthrough in filtration.Comment: 7 pages, 8 figure
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