2,156 research outputs found

    Central Europe – Modernism and the modern movement as viewed through the lens of town planning and building 1895 - 1939

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    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This thesis sets out to re-locate and redefine the historical arguments around the development of the Modern Movement in architecture. It investigates the development of architectural modernism in Central Europe from 1895-1939 in the towns and cities of the multinational Habsburg Empire, in a creative milieu in which opposition, contrast and difference were the norm. It argues that the evolution of the Modern Movement through the independent nations that arose from the Empire constituted an early and significant engagement with urbanisation, planning and architectural modernism that has been largely overlooked by western scholarship. By reviewing the extant literature in discussion with Central European authorities and by drawing upon a little known range of sources, this thesis brings into focus the role of key individuals such as Plečnik, Fabiani and Kotěra and it explores the significance of developments in town planning in places like Zagreb and Ljubljana. In restoring some of this missing detail and revisiting some of the key sites, the thesis reveals how Central European individuals made early and significant contributions to the development of architectural modernism and the Modern Movement that have hitherto received little critical acknowledgement. What this research reveals is how these figures developed what can be seen as local solutions, rooted in the context and culture of individual towns and cities and their unique histories. However more significantly, this thesis also demonstrates that these independent initiatives were formed with an understanding of - and in response to - wider national and international developments in the field of architectural modernism. In this connection, the thesis can be regarded as part of an emerging academic effort to redress the history of the Modern Movement and an attempt to set in motion a raft of suggestion for further research into this rich field of cultural endeavour

    Asymptomatic cardiac ischemia pilot (ACIP) study: Effects of coronary angioplasty and coronary artery bypass graft surgery on recurrent angina and ischemia

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    ObjectivesThe Asymptomatic Cardiac Ischemia Pilot (ACIP) study showed that revascularization is more effective than medical therapy in suppressing cardiac ischemia at 12 weeks. This report compares the relative efficacy of coronary angioplasty or coronary artery bypass graft surgery in suppressing ambulatory electrocardiographic (ECG) and treadmill exercise cardiac ischemia between 2 and 3 months after revascularization in the ACIP study.BackgroundPrevious studies have shown that coronary angioplasty and bypass surgery relieve angina early after the procedure in a high proportion of selected patients. However, alleviation of ischemia on the ambulatory ECG and treadmill exercise test have not been adequately studied prospectively after revascularization.MethodsIn patients randomly assigned to revascularization in the ACIP study, the choice of coronary angioplasty or bypass surgery was made by the clinical unit staff and the patient.ResultsPatients assigned to bypass surgery (n = 78) had more severe coronary disease (p = 0.001) and more ischemic episodes (p = 0.01) at baseline than those assigned to angioplasty (n = 92). Ambulatory ECG ischemia was no longer present 8 weeks after revascularization (12 weeks after enrollment) in 70% of the bypass surgery group versus 46% of the angioplasty group (p = 0.002). ST segment depression on the exercise ECG was no longer present in 46% of the bypass surgery group versus 23% of the angioplasty group (p = 0.005). Total exercise time in minutes on the treadmill exercise test increased by 2.4 min after bypass surgery and by 1.4 min after angioplasty (p = 0.02). Only 10% of the bypass surgery group versus 32% of the angioplasty group still reported angina in the 4 weeks before the 12-week visit (p = 0.001).ConclusionsAngina and ambulatory ECG ischemia are relieved in a high proportion of patients early after revascularization. However, ischemia can still be induced on the treadmill exercise test, albeit at higher levels of exercise, in many patients. Bypass surgery was superior to coronary angioplasty in suppressing cardiac ischemia despite the finding that patients who underwent bypass surgery had more severe coronary artery disease

    Factors influencing referral to and uptake and attendance of pulmonary rehabilitation for chronic obstructive pulmonary disease: a qualitative evidence synthesis of the experiences of service users, their families, and healthcare providers (Protocol)

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    This is a protocol for a Cochrane Review (Qualitative). The object ives are as follows: • To identify factors that influence referral to pulmonary rehab ilitation for COPD from the perspective of service users, thei r family/carers, and healthcare providers. • To identify factors that influence uptake of pulmonary rehabil itation for COPD (i.e. at least one attendance of an assessment or first programme session) from the perspective of service users , their family/carers, and healthcare providers. • To identify factors that influence attendance at pulmonary reha bilitation programmes for COPD from the perspective of servi ce users, their family/carers, and healthcare providers. • To develop an inductive explanatory framework for how these f actors may interact to contribute to better or poorer uptake or completion of pulmonary rehabilitation in order to guide acti ons of healthcare decision-makers to improve opportunities fo r people with COPD to benefit from pulmonary rehabilitation

    Spatial variations of dust abundances across the Large Magellanic Cloud

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    Using the data obtained with the Spitzer Space telescope as part of the Surveying the Agents of a Galaxy's Evolution (SAGE) legacy survey, we have studied the variations of the dust composition and abundance across the Large Magellanic Cloud (LMC). Such variations are expected, as the explosive events which have lead to the formation of the many HI shells observed should have affected the dust properties. Using a model and comparing with a reference spectral energy distribution from our Galaxy, we deduce the relative abundance variations of small dust grains across the LMC. We examined the infrared color ratios as well as the relative abundances of very small grains (VSGs) and polycyclic aromatic hydrocarbons (PAHs) relative to the big grain (BG) abundance. Results show that each dust component could have different origins or evolution in the interstellar medium (ISM). The VSG abundance traces the star formation activity and could result from shattering of larger grains, whereas the PAH abundance increases around molecular clouds as well as in the stellar bar, where they could have been injected into the ISM during mass loss from old stars.Comment: Received 2009 February 13; Accepted 2009 April 2

    A Two-cohort Phase I Study of Weekly Oxaliplatin and Gemcitabine, Then Oxaliplatin, Gemcitabine, and Erlotinib During Radiotherapy for Unresectable Pancreatic Carcinoma

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    Gemcitabine is a potent radiosensitizer. When combined with standard radiotherapy (XRT) the gemcitabine dose must be reduced to about 10% of its conventional dose. Oxaliplatin and erlotinib also have radiosensitizing properties. In vitro, oxaliplatin and gemcitabine have demonstrated synergy. We aimed to determine the maximum tolerated dose of oxaliplatin and gemcitabine with concurrent XRT, then oxaliplatin, gemcitaibine and erlotinib with XRT in the treatment of locally advanced and low volume metastatic pancreatic or biliary cancer

    An interdisciplinary cruise dedicated to understanding ocean eddies upstream of the Prince Edward Islands

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    A detailed hydrographic and biological survey was carried out in the region of the South-West Indian Ridge during April 2004. Altimetry and hydrographic data have identified this region as an area of high flow variability. Hydrographic data revealed that here the Subantarctic Polar Front (SAF) and Antarctic Polar Front (APF) converge to form a highly intense frontal system. Water masses identified during the survey showed a distinct separation in properties between the northwestern and southeastern corners. In the north-west, water masses were distinctly Subantarctic (>8.5°C, salinity >34.2), suggesting that the SAF lay extremely far to the south. In the southeast corner water masses were typical of the Antarctic zone, showing a distinct subsurface temperature minimum of <2.5°C. Total integrated chl-a concentration during the survey ranged from 4.15 to 22.81 mg chl-a m[superscript (-2)], with the highest concentrations recorded at stations occupied in the frontal region. These data suggest that the region of the South-West Indian Ridge represents not only an area of elevated biological activity but also acts as a strong biogeographic barrier to the spatial distribution of zooplankton

    A phase I trial of sorafenib combined with cisplatin/etoposide or carboplatin/pemetrexed in refractory solid tumor patients

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    Sorafenib has demonstrated single agent activity in non-small cell (NSCLC) and small cell lung cancer (SCLC). Carboplatin/pemetrexed (CbP) and cisplatin/etoposide (PE) are commonly used in the treatment of these diseases

    Broad targeting of resistance to apoptosis in cancer

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    Apoptosis or programmed cell death is natural way of removing aged cells from the body. Most of the anti-cancer therapies trigger apoptosis induction and related cell death networks to eliminate malignant cells. However, in cancer, de-regulated apoptotic signaling, particularly the activation of an anti-apoptotic systems, allows cancer cells to escape this program leading to uncontrolled proliferation resulting in tumor survival, therapeutic resistance and recurrence of cancer. This resistance is a complicated phenomenon that emanates from the interactions of various molecules and signaling pathways. In this comprehensive review we discuss the various factors contributing to apoptosis resistance in cancers. The key resistance targets that are discussed include (1) Bcl-2 and Mcl-1 proteins; (2) autophagy processes; (3) necrosis and necroptosis; (4) heat shock protein signaling; (5) the proteasome pathway; (6) epigenetic mechanisms; and (7) aberrant nuclear export signaling. The shortcomings of current therapeutic modalities are highlighted and a broad spectrum strategy using approaches including (a) gossypol; (b) epigallocatechin-3-gallate; (c) UMI-77 (d) triptolide and (e) selinexor that can be used to overcome cell death resistance is presented. This review provides a roadmap for the design of successful anti-cancer strategies that overcome resistance to apoptosis for better therapeutic outcome in patients with cancer

    Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

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    Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
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