To assess the association between ketonuria and hyperemesis gravidarum (HG) disease severity.
We included pregnant women hospitalised for HG who participated in the Maternal and Offspring outcomes ...after Treatment of HyperEmesis by Refeeding (MOTHER) trial and women who were eligible, chose not to be randomised and agreed to participate in the observational cohort. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation. The presence of ketonuria was not required for study entry. Ketonuria was measured at hospital admission with a dipstick, which distinguishes 5 categories: negative and 1+ through 4 + . The outcome measures were multiple measures of HG disease severity at different time points: 1) At hospital admission (study entry): severity of nausea and vomiting, quality of life and weight change compared to pre-pregnancy weight, 2) One week after hospital admission: severity of nausea and vomiting, quality of life and weight change compared to admission, 3) Duration of index hospital admission and readmission for HG at any time point
215 women where included. Ketonuria was not associated with severity of nausea and vomiting, quality of life or weight loss at hospital admission, nor was the degree of ketonuria at admission associated with any of the outcomes 1 week after hospital admission. The degree of ketonuria was also not associated with the number of readmissions. However, women with a higher degree of ketonuria had a statistically significant longer duration of hospital stay (per 1+ ketonuria, difference: 0.27 days, 95 % CI: 0.05 to 0.48).
There was no association between the degree of ketonuria at admission and severity of symptoms, quality of life, maternal weight loss, or number of readmissions, suggesting that ketonuria provides no information about disease severity or disease course. Despite this, women with a higher degree of ketonuria at admission were hospitalised for longer. This could suggest that health care professionals base length of hospital stay on the degree of ketonuria. Based on the lack of association between ketonuria and disease severity, we suggest it has no additional value in the clinical management of HG.
Although statistical evidence seems to be lacking. it is at present widely acknowledged that organisational culture has the potential of having a significant effect on organisational performance. An ...analysis of sustained superior financial performance of certain American organisations has attributed their success to the culture that each of them had developed. It has been proposed that these organisations are characterised by a strong set of core managerial values that define the ways in which they conduct business. how they treat employees, customers, suppliers and others. Culture is to the organisation what personality is to the individual. It is a hidden but unifying force that provides meaning and direction and has been defined as the prevailing background fabric of prescriptions and proscriptions for behaviour, the system of beliefs and values and the technology and task of the organisation together with the accepted approaches to these. Recent studies have indicated that corporate culture has an impact on a firm's long-term financial performance: that corporate culture will probably be an even more important factor in determining the success or failure of firms in the next decade; that corporate cultures that inhibit long-term financial performance are not rare and that they develop easily. even in firms that are staffed by reasonable and intelligent people; and that corporate cultures, although difficult to change, can be made more performance enhancing. The purpose of this study, therefore, was to establish the statistical relationship between organisational culture and financial performance.
An instrument to measure organizational culture Van Der Post, W. Z; De Coning, T. J; Smit, E. V.D.M
South African journal of business management,
12/1997, Letnik:
28, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Although statistical evidence seems to be lacking, it is at present widely acknowledged that organizational culture has the potential of having a significant effect on organizational performance. An ...analysis of sustained superior financial performance of certain American organizations has attributed their success to the culture that each of them had developed. It has been proposed that these organizations are characterized by a strong set of core managerial values that define the ways in which they conduct business, how they treat employees, customers, suppliers and others. Culture is to the organization what personality is to the individual. It is a hidden but unifying force that provides meaning and direction and has been defined as the prevailing background fabric of prescriptions and proscriptions for behaviour, the system of beliefs and values and the technology and task of the organization together with the accepted approaches to these. From the literature, a vast number of dimensions of organizational culture were observed. These dimensions were synthetized and 15 constructs of culture emerged. By means of conventional item construction, item analysis and factor analysis, a questionnaire with acceptable reliability and construct validity was developed to measure organizational culture.
It is unclear which patients with multiple sclerosis (MS) are most susceptible for omicron breakthrough infections.
We assessed omicron breakthrough infections in vaccinated patients with MS with and ...without disease-modifying therapies enrolled in an ongoing large prospective study. We longitudinally studied humoral responses after primary and booster vaccinations and breakthrough infections.
Omicron breakthrough infections were reported in 110/312 (36%) patients with MS, and in 105/110 (96%) infections were mild. Omicron breakthrough infections occurred more frequently in patients treated with anti-CD20 therapies and sphingosine-1 phosphate receptor (S1PR) modulators, patients with impaired humoral responses after primary immunisation (regardless of treatment) and patients without prior SARS-CoV-2 infections. After infection, antibody titres increased in patients on S1PR modulator treatment while anti-CD20 treated patients did not show an increase.
SARS-COV-2 omicron breakthrough infections are more prevalent in patients with MS on anti-CD20 therapies and S1PR modulators compared with other patients with MS, which correlated with decreased humoral responses after vaccination. Humoral responses after infection were higher in S1PR modulator-treated patients in comparison to patients on anti-CD20 therapies, suggesting that immunological protection from contracting infection or repeated exposures may differ between these therapies.
Objectives The primary aim was to demonstrate that moxonidine, given in an experimental sustained release (SR) formulation, had no clinically relevant central nervous system (CNS) effects after 4 ...weeks of treatment. A clinically relevant CNS effect was predefined as more than 45° s−1 reduction in saccadic peak velocity (SPV), corresponding to the effects of one night's sleep deprivation.
Methods In a randomized, double‐blind fashion, 35 patients with mild to moderate essential hypertension received placebo run‐in medication for 2 weeks, followed by 4 weeks’ moxonidine sustained release (1.5 mg o.d.) or placebo. On the first day and 1 and 4 weeks following the start of treatment, blood pressure was measured and CNS effects were assessed using SPV, visual analogue scales and EEG.
Results On day 1 there was a significant, but not clinically relevant, reduction in the time‐corrected area under the effect curve (AUEC) for SPV in the moxonidine group compared with placebo difference of 38° s−1; 95% confidence interval (CI) 23, 52. This difference was no longer significant after one (9° s−1; 95% CI −17, 35) and 4 weeks (6.9° s−1; 95% CI −16, 30). Visual analogue scales for alertness showed similar results. A decrease in EEG α‐ and β‐power and an increase in δ‐power were only found on day 1 of moxonidine treatment. The AUEC for systolic/diastolic blood pressure relative to placebo was 23 (95% CI 17, 29)/13 (9, 16) mmHg lower on day 1 and remained reduced by 20 (11, 30)/12 (6, 17) and 15 (6, 25)/9 (3, 15) mmHg after 1 and 4 weeks’ moxonidine treatment.
Conclusions Four weeks’ treatment with an experimental SR formulation resulted in tolerance to CNS effects (equivalence to placebo) while blood pressure‐lowering effects remained adequate. The tolerance to CNS effects was already observed after 1 week of treatment.
Overview of the Compact Ignition Tokamak Flanagan, C. A.; Brown, T. G.; Hamilton, W. R. ...
Fusion technology,
11/1986, Letnik:
10, Številka:
3P2A
Journal Article, Conference Proceeding
Odprti dostop
The Compact Ignition Tokamak (CIT) mission is to achieve ignition and provide the capability to experimentally study burning plasma behavior. A national team has developed a baseline concept ...including definition of the necessary research and development. The baseline concept satisfies the physics performance objectives established for the project and complies with defined design specifications. To ensure that the mission is achieved, the design requires large magnetic fields on axis (∼ 10 T) and use of large plasma currents (∼ 10 MA). The design is capable of accommodating significant auxiliary heating to enter the ignited regime. The CIT is designed to operate in plasma parameter regimes that are directly relevant to future fusion power reactors. The CIT uses a high-strength copper-Inconel composite plate toroidal magnet design and relies on inertial cooling starting from a liquid nitrogen temperature at the beginning of each pulse. The design is capable of both limiter and divertor operation. The design is compact (1.22 m major radius, 0.45 m plasma radius), has 20 toroidal field (TF) magnets, and has ten major horizontal access ports, about 20 cm by 80 cm, located between alternate TF coils. A total of 3000 full parameter deuterium-tritium (D-T) pulses and 50,000 partial parameter pulses are planned; each full parameter pulse is about 3-5 s. Significant fusion power (300-400 MW depending on ignition assumptions) will be generated; corresponding neutron wall loadings will be in the range 5-10 MW/m
2
. The current schedule is for a construction project to be authorized for the period FY 1988-93.
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