BackgroundAlthough immunosuppression is commonly used in HP, there are no studies that compare treatment regimes.Aims and objectivesThe aim of this study was to survey specialist ILD consultants to ...determine how HP is treated in Britain.MethodsBritish ILD consultants were provided with clinical scenarios, and asked how they would treat patients with HP. They were also asked to rate their level of agreement with a series of statements. A priori ‘consensus agreement’ and ‘majority agreement’ were defined as at least 70% and 50% respectively of participants replying that they ‘Strongly agree’ or ‘Tend to agree’.Results54 consultants took part in the survey from 27 centres. The choice of first line immunosuppression in progressive HP was relatively evenly split between dual therapy with corticosteroids plus a ‘steroid-sparing’ immunosuppressant (46%) and monotherapy with oral corticosteroids (39%). On average, the initial starting dose of oral prednisolone (for an 80 kg patient) was 40 mg continued for 6 weeks prior to weaning, aiming for a maintenance of 10 mg. 75% of participants reported that mycophenolate mofetil was their first choice ‘non-corticosteroid immunosuppressant’ for the long-term management of HP. A number of statements relating to the treatment of HP reached consensus or majority agreement (table 1).ConclusionsThis survey has demonstrated a degree of variation in the treatment of patients with suspected HP in Britain, but has found consensus and majority agreement for some key areas.Abstract S82 Table 1Consensus (C) and majority (M) statements with level of agreement Statement % agree HP patients with an acute onset of severe symptoms (often with hypoxia) should be treated with short courses of oral corticosteroids, to speed up the rate of clinical improvement (C). 91% In some cases of biopsy confirmed HP, fibrosis progresses despite cessation of exposure and treatment with immunosuppression (C). 96% I have had patients with progressive fibrotic HP unresponsive to immunosuppression, whom I would have treated with antifibrotic agents, had they been routinely available as standard NHS care (C). 81% In HP that progresses (despite cessation of exposure) immunosuppression should be considered (where not contraindicated):- only if there is evidence of active inflammation- in all cases irrespective of the radiological diagnosis or histological pattern (M)- in all cases unless there is a definite UIP pattern of fibrosis- other (please specify) 19%50%13%4% In HP with a predominantly fibrotic picture, immunosuppression should be stopped after a three-month trial unless there is a clear improvement or stabilisation of lung function (M). 67% In HP with a predominantly fibrotic picture, I have concerns that treating patients long-term with immunosuppression may increase mortality as in IPF (M). 61%
Damage to these airways may be present in both asthma , COPD and other bronchiolar diseases with potential limitation of exercise capacity early in the disease course. Conclusions: Lung function ...tests commonly used to identify isolated small airway disease are positive in 3.5-55.9% of patients with respiratory symptoms and normal spirometry.
AimVertical jump represents an important skill in many sports and its evaluation is proposed to assess lower limb strength. The Jumpand-Reach test is the most commonly used fieldtest. It measures, ...on a vertical surface, the difference between the heights reached by the fingers with the arm extended standing flatfooted and at the highest point of the flight phase. It is simple, no equipment is required, but unilateral swing of the arm, involvement of muscles beyond the lower limb and coordination are needed. The Squat Jump and the Countermovement Jump, with hands to the hips, are adopted to obtain a specific measure of lower limb strength. The Countermovement Jump with arm swing is proposed to assess a more natural jump performance. Unfortunately, it is impossible to measure the height of these jumps without devices, such as accelerometers, contact mats, force platforms and video-analysis. The Optojump (Microgate, Bolzano-Italy), an optical transmitting-receiving bars measurement system, is proposed to measure these jumps. The aim of this study is to assess the testretest reliability of Squat Jump, Countermovement Jump and Countermovement Jump with arm swing measured by Optojump system. Moreover, the reliability of JumpandReach test measured both by vertical surface and by Optojump and the agreement between these two methods are analysed.Methods31 healthy volunteers were recruited (16 F15M). Inclusion criteria: age 2029 years, absence of painful conditions in the last three months. Subjects with orthopaedic, vascular, rheumatological and/or neurological diseases affecting lower limb were excluded. Each subject performed squat jump, countermovement jump and countermovement jump with arm swing using Optojump. Furthermore, each participant performed jumpandreach test and data were recorded by vertical surface (fieldtest) and by Optojump, simultaneously. Each jump was repeated three times during a single session (4 sessions in 2 days), with 20’’ rest between jumps and 5’ rest between different jumps’ test. The sequence of test was modified in each session. The interclass correlation coefficients and the standard error of measurement were calculated. The Bland-Altman method was used to assess the agreement between the two methods of measurement adopted for jumpandreach.ResultsInterclass correlation coefficients were Squat Jump = 0.969 (CI: 95% = 0.946–0.984, SEM = 1.91), Countermovement Jump = 0.969 (CI: 95% = 0.947–0.984, SEM = 1.7), Countermovement Jump with arm swing = 0.985 (CI: 95% = 0.973–0.992, SEM = 1.69), JumpandReach (Optojump) = 0.989 (CI: 95% = 0.981–0.994,SEM = 1.56), JumpandReach (vertical surface) = 0.982 (CI: 95% = 0.968–0.990, SEM = 2.91). JumpandReach scores obtained by vertical surface were significantly higher than scores recorded by Optojump (p < 0.001). The correlation coefficient was very high (r = 0.92) but BlandAltman analysis (Figure 1) showed a significant bias between two methods (mean = 12.36 cm, limits of agreement 2.6322.09 cm +42,04%, limits of agreement 17.46%, 66.62%).ConclusionsThe Optojump is a reliable device to measure Squat Jump, Countermovement Jump, Counter-movement Jump with arm swings and JumpandReach. Also the JumpandReach test measured by vertical surface showed a significant reliability but with scores higher than Optojump. A significative bias in the agreement between the two methods of JumpandReach measurement was detected. This difference is probably due to some biomechanical aspects that require further investigations to better understand the impact of upper body structures on jump performance.Abstract O-32 Figure 1Bland-Altman AnalysisFigure omitted. See PDF
There have also been more specific studies about synergistic factors affecting these costs and benefits 4,5. ...if this is the basis for NTW's claim that relatedness is not causal, then we have shown ...that NTW's other parameters are also not causal, because when we force them to be constant, only variation in relatedness matters 1. ...this apparent concession about the importance of relatedness is perplexing, given that Nowak and Allen expend significant effort questioning the details of exactly how we modeled lower relatedness, while continuing to equivocate about the real issue of how relatedness matters.
This article is devoted to the study of some theoretical and practical problems of concluding a conditional agreement in the form of a smart contract. The article defines and characterizes a ...conditional agreement and describes its differences from ordinary transactions. The author analyzes the possibility of expressing conditional agreements in the form of a smart contract, taking into account the features of setting program code, as well as features of the agreement (a condition that the special nature of the rights and obligations of the parties activity). As a result of the research, it was concluded that the conditional transaction structure is ideally suited to the elementary program code for creating a smart contract. However, the condition contained in the transaction must be strictly formalized and expressed in clear values, such as numbers. The main problems that arise when creating a smart contract are also identified: the complexity of getting data from the real world by the system, weak state control, and possible data leakage from the system. Thus, the use of digital technologies is a prospective direction for the development of conditional agreements, but this requires solving both legal and some technical problems.
U članku se daje prilog poznavanju povijesti Balkanske banke d.d. Zagreb od njezina osnutka (1922.) pa sve do formalnoga završetka njezine likvidacije (1948.). Poslovanje banke razvijalo se je u ...početku izuzetno povoljno. U kolovozu 1922. predsjednik banke Dušan Plavšić pozvan je na dužnost pomoćnika ministra financija. Kako je vlada kojoj je Plavšić pripadao u prosincu 1922. dala ostavku, uslijed tadašnjih političkih prilika nastala je novinska kampanja koja je bila uperena i protiv Balkanske banke. Time je taj slučaj dobio i čisto političku konotaciju. Tada je počela propast Balkanske banke. Kontinuiranim napadima novoga ministra financija, radikala Milana Stojadinovića, na Dušana Plavšića, novinskom kampanjom protiv Plavšića i Balkanske banke te katastrofalno izvedenim devizno-čekovnim transakcijama, cjelokupno poslovanje Balkanske banke došlo je u vrlo tešku financijsku situaciju. Krajem 1924. banci je odobrena prinudna nagodba. Na temelju te nagodbe banka je na svojoj izvanrednoj glavnoj skupštini 1925. zaključila likvidaciju. Banka je pravno postojala sve do 1948., kada je nakon praktično formalizirane likvidacije brisana iz trgovačkoga registra Okružnoga suda za grad Zagreb.
Long range forecasts for a period of thirty days ahead have been published twice a month for the past three years ... the Meteorological Office says that results have been slightly better than ...expected ... forecasts are assessed after the event ... and "marks are given for the accuracy of forecasts of temperature, rainfall and additional information".
Esta investigación tiene como principal propósito llevar a cabo un análisis exhaustivo de la impugnación de acuerdos sociales. Esta materia, recurrente en la práctica mercantil, se ha mantenido en ...nuestro Derecho sin demasiados cambios durante mucho tiempo. Sin embargo, en 2014 se llevó a cabo la reforma de la Ley de Sociedades de Capital siendo uno de los puntos más tratados la impugnación de acuerdos sociales. Con la reforma se han introducido múltiples novedades que han unificado y mejorado la situación que existía con anterioridad en lo respectivo a la impugnación de los acuerdos societarios. Se han introducido, así mismo, nuevos límites a la acción de impugnación puesto que lo que busca el legislador es mantener la voluntad común de todos los socios que es el fundamento último por el que se creó la sociedad inicialmente. Así, a lo largo de este proyecto de investigación vemos cuáles son las diferentes novedades y mejoras que aparecen con la reforma operada en 2014 que se encuentran vigentes en la actualidad
Never Ask Why Garvey, Ed; Cascio, Chuck; Page, Judge Alan ...
2023, 2023-01-13
eBook
When pro football players formed a union to stand up against the NFL for their own interests, they chose lawyer Ed Garvey as their Executive Director. The NFL Players Association (NFLPA), would take ...on the NFL over player contracts, collective bargaining agreements, and antitrust suits. It lobbied for players' free agency, contract rights, and impartial arbitration of disciplinary disputes. Garvey navigated strikes, lockouts, scabs, stooges, lies, as well as the sports media complex-to maintain players' dignity. According to the league, the players were to take what they were given and "never ask why." In Never Ask "Why," journalist Chuck Cascio presents the late Garvey's rich account of the early years of the NFLPA, taking readers among the players as they held the league accountable to play fair. Learning from their mistakes, the NFLPA would succeed in curbing commissioner Pete Rozelle's disciplinary power and striking down the Rozelle Rule's absolute control over free agency.Garvey tells the intimate stories of how pro football players, rivals on the field, rallied together to stand up for themselves. He worked tirelessly to change a system that exploited players and even controlled the media. In the end, Garvey shows how the NFLPA transformed the state of pro sports leagues today and how, even still, they work to keep down the players on whose backs they profit.
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