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Epidemiological studies have demonstrated an increased risk of developing non-transmittable diseases in adults subjected to adverse early developmental conditions. Metabolic and cardiovascular diseases have been the focus of most studies. Nevertheless, data from animal models also suggest early programming of fertility. In humans, it is difficult to assess the impact of the in utero environment retrospectively. Birthweight is commonly used as an indirect indicator of intrauterine development. This research is part of the ALIFERT study. We investigated a potential link between ponderal index at birth and female fertility in adulthood. Data from 51 infertile and 74 fertile women were analysed. BW was on average higher in infertile women, whereas birth length did not differ between the two groups; thus, resulting in a significantly higher ponderal index at birth in infertile women. Ponderal index at birth has been identified as a risk factor for infertility. These results suggest the importance of the intra-uterine environment, not only for long-term metabolic health but also for fertility.
The objective of this research is to support DfX considerations in the early phases of design. In order to do conduct DfX, designers need access to pertinent downstream knowledge that is keyed to early stage design activities and problem knowledge. Product functionality is one such “key” connection between early understanding of the design problem and component choices which dictate product performance and impact, and repositories of design knowledge are one way to archive such design knowledge. However, curation of design knowledge is often a time-consuming activity requiring expertise in product modeling. In this paper, we explore a method to automate the populating of design repositories to support the overall goal of having up-to-date repositories of product design knowledge. To do this, we mine information from an existing repository to better understand the relationships between the components, functions, and flows of products. The resulting knowledge can be applied to automate functional decompositions once a product's components have been entered and thus reliably provide that “key” between early design activities and the later, component dependent characteristics.
Improvement of the performance of renewable electronic devices is a crucial point for the consolidation of this emerging technology. Herein, we develop a supercapacitor based on cellulose, carbon nanotubes, and ionic liquids. A conductive paper prepared by simple acid hydrolysis of cellulose and carboxylated carbon nanotubes was used as an electrode. A cellulose sponge impregnated with 1-n-butyl-3-methylimidazolium bis(trifluoromethane sulfonyl)imide was used as a separator/electrolyte. Electrochemical tests were performed in a two-electrode cell that presented a specific capacitance of 34.37 F/g when considered the active mass and 97.9% of capacitance retention after 5000 charge/discharge cycles.
Unsteadiness in separated shock–boundary layer interactions have been previously analysed in order to propose a scenario of entrainment–discharge as the origin of unsteadiness. It was assumed that the fluid in the separated zone is entrained by the free shear layer formed at its edge, and that this layer follows the properties of the canonical mixing layer. This last point is addressed by reanalysing the velocity measurements in an oblique shock reflection at a nominal Mach number of 2.3 and for two cases of flow deviation (
). The rate of spatial growth of this layer is evaluated from the spatial growth of the turbulent stress profiles. Moreover, the entrainment velocity at the edge of the layer is determined from the mean velocity profiles. It is shown that the values of turbulent shear stress, spreading rate and entrainment velocity are consistent, and that they follow the classical laws for turbulent transport in compressible shear layers. Moreover, the measurements suggest that the vertical normal stress is sensitive to compressibility, so that the anisotropy of turbulence is affected by high Mach numbers. Dimensional considerations proposed by Brown & Roshko (J. Fluid Mech., vol. 64, 1974, 775–781) are reformulated to explain this observed trend.
be a holomorphic endomorphism of
. We estimate the local directional dimensions of closed positive currents
with respect to ergodic dilating measures
. We infer several applications. The first one is an upper bound for the lower pointwise dimension of the equilibrium measure, towards a Binder–DeMarco’s formula for this dimension. The second one shows that every current
containing a measure of entropy
has a directional dimension
, which answers a question of de Thélin–Vigny in a directional way. The last one estimates the dimensions of the Green current of Dujardin’s semi-extremal endomorphisms.
The aim of this study is to review evidence on the cost-effectiveness of exercise-based interventions in the treatment of chronic conditions a decade after the publication of Roine et al. in 2009 (Roine E, Roine RP, Räsänen P, et al. Int J Technol Assess Health Care. 2009;25:427–454).
We carried out a review of published articles in PUBMED and JSTOR between January 1, 2008, and December 31, 2016. Full economic evaluations of exercise programs targeting patients with a chronic condition were eligible for inclusion. Data on program, design, and economic characteristics were extracted using a predefined extraction form. The quality of the economic evaluations was appraised using the adjusted Consensus Health Economic Criteria List.
A total of 426 articles were identified and thirty-seven studies were selected. Eleven studies dealt with musculoskeletal and rheumatologic disorders, ten with cardiovascular diseases, six with neurological disorders, three with mental illnesses, three with cancers, and four with diabetes, respiratory diseases, or pelvic organ prolapse. In total, 60 percent of exercise programs were dominant or cost-effective. For musculoskeletal and rheumatologic disorders, 72 percent of programs were dominant or cost-effective while this was the case for 57 percent of programs for cardiovascular diseases using a nonsurgical comparator.
There is clear evidence in favor of exercise-based programs for the treatment of musculoskeletal and rheumatologic disorders and, to a lesser extent, for the treatment of cardiovascular diseases. More research is needed to evaluate the cost-effectiveness of physical activity in the treatment of neurological disorders, mental illnesses, cancers, respiratory diseases, and diabetes/obesity.
The Collectio ex opusculis sancti Augustini in epistulas Pauli apostoli is an exegetical commentary on the Pauline letters that consists of 457 fragments from the works of Augustine of Hippo. The Collectio was compiled by the Northumbrian scholar Beda Venerabilis (672/73–735), whose biblical commentaries heavily rely on patristic exegesis and theology, and, as such, function as an important mediator between patristic and medieval exegesis and theology. Though many scholars have stressed the importance of the Collectio for the study of the transmission and reception of Augustine's writings and thinking in Anglo-Saxon England, the commentary has never been edited nor have its contents been thoroughly studied. The following contribution offers the first detailed study of the Collectio’s contents by analysing the ways in which Bede presents Augustine's Pauline exegesis in his own commentary on Paul's letters. Specifically, this article will study Bede's compilation methods by means of a close analysis of one of the Collectio’s fragments, fr. 315, which offers an exegetical commentary of Eph. 3:17–18. By studying the textual channels through which Bede had access to Augustine's writings as well as by considering other passages in Bede's biblical commentaries that discuss Eph. 3:17–18, this contribution seeks to demonstrate how Bede uses, adapts, and presents Augustine's exegesis of this pericope.
Using individual balance sheet data from the state banks in one state that was deeply impacted by the 1893 crisis, this article presents evidence that correspondent networks played an important role in transmitting the crisis. In particular, the unexpected closure of a single large national bank in Kansas City considerably increased the probability of suspension among the state banks that were connected to it through the correspondent networks. This episode thus illustrates how contagion can spread through interbank networks and sheds new light on the nature of the 1893 crisis.
We study a family of mixed Tate motives over
whose periods are linear forms in the zeta values
. They naturally include the Beukers–Rhin–Viola integrals for
and the Ball–Rivoal linear forms in odd zeta values. We give a general integral formula for the coefficients of the linear forms and a geometric interpretation of the vanishing of the coefficients of a given parity. The main underlying result is a geometric construction of a minimal ind-object in the category of mixed Tate motives over
which contains all the non-trivial extensions between simple objects. In a joint appendix with Don Zagier, we prove the compatibility between the structure of the motives considered here and the representations of their periods as sums of series.
Recent satellite investigations revealed that in the 1990s the grounding line of Pine Island and Thwaites Glaciers, West Antarctica, retreated several km, the ice surface on the interior of the basins lowered 10 cm a–1, and Pine Island Glacier thinned 1.6 ma–1. These observations, however, were not sufficient to determine the cause of the changes. Here, we present satellite radar interferometry data that show the thinning and retreat of Pine Island Glacier are caused by an acceleration of ice flow of about 18 ± 2% in 8 years. Thwaites Glacier maintained a nearly constant flow regime at its center, but widened along the sides, and increased its 30 ± 15% mass deficit by another 4% in 4 years. The combined mass loss from both glaciers, if correct, contributes an estimated 0.08 ± 0.03 mma–1 global sea-level rise in 2000.
Sufficiently deep water-filled fractures can penetrate even cold ice-sheet ice, but glaciogenic stresses are typically smaller than needed to propagate water-filled fractures that are less than a few tens of meters deep, as shown by our simplified analytical treatment based on analogous models of magmatic processes. However, water-filled fractures are inferred to reach the bed of Greenland through >1 km of ice and then collapse to form moulins, which are observed. Supraglacial lakes appear especially important among possible crack ‘nucleation’ mechanisms, because lakes can warm ice, supply water, and increase the pressure driving water flow and ice cracking.
Reversals in the ice/air surface slope are important in geomorphic and glaciological contexts, thus motivating consideration of the conditions under which they form. Surface slope reversals are seen in numerous places, such as ice rumples on ice shelves, as surficial lakes, and at the down-glacier end of Vostok lake, Antarctica. Such slope reversals can reduce or reverse the subglacial hydrological gradient, thereby rerouting subglacial water transport and possibly leading to the creation of subglacial lakes. Supraglacial lakes produced by slope reversals in ablation zones may aid in driving water-filled cracks that allow surface water access to the bed. Surface slope reversals, in the absence of a concomitant reversal in ice flow, indicate a local violation of the so-called ‘shallow-ice’ approximation, and in this circumstance the longitudinal deviatoric stress becomes critical in the stress equilibrium. Using a simple numerical model, we have explored the conditions under which surface slope reversals form for certain simple scenarios. The results indicate that ice which initially possesses a normal slope will tend toward a reversed slope if the ice is thinned, the bed is strengthened or the downstream buttressing is increased.
We use a finite-element model of coupled ice-stream/ice-shelf flow to study the sensitivity of Pine Island Glacier, West Antarctica, to changes in ice-shelf and basal conditions. By tuning a softening coefficient of the ice along the glacier margins, and a basal friction coefficient controlling the distribution of basal shear stress underneath the ice stream, we are able to match model velocity to that observed with interferometric synthetic aperture radar (InSAR). We use the model to investigate the effect of small perturbations on ice flow. We find that a 5.5–13% reduction in our initial ice-shelf area increases the glacier velocity by 3.5–10% at the grounding line. The removal of the entire ice shelf increases the grounding-line velocity by > 70%. The changes in velocity associated with ice-shelf reduction are felt several tens of km inland. Alternatively, a 5% reduction in basal shear stress increases the glacier velocity by 13% at the grounding line. By contrast, softening of the glacier side margins would have to be increased a lot more to produce a comparable change in ice velocity. Hence, both the ice-shelf buttressing and the basal shear stress contribute significant resistance to the flow of Pine Island Glacier.
Introduction: Poor physicians’ knowledge of health care costs has been identified as an important barrier to improving efficiency and reducing overuse in care delivery. Moreover, costs of tests and treatments estimated with traditional costing methods have been shown to be imprecise and unreliable. We estimated the cost of frequent care activities in the emergency department (ED) using the time-driven activity-based costing (TDABC) method. Methods: We conducted a TDABC study in the ED of the CHUL, Québec city (77000 visits/year). We estimated the cost of all potential care activities (e.g. triage) provided to adult patients with selected urgent (e.g. pulmonary sepsis) and non urgent (e.g. urinary tract infection) conditions frequently encountered in the ED. Following Lean management principles, process maps were developed by a group of ED care providers for each care activity to identify human resources, supplies and equipment involved, and to estimate the time required to complete each process. Resource unit cost (e.g. cost per minute of a nurse) and overhead rate were calculated using financial information from fiscal year 2015-16. Estimated cost of each care activity (e.g. chest X-ray) including physicians’ charges was calculated by summing overhead allocation and the cost of each process (e.g. disinfection of the X-ray machine) as obtained by multiplying the resource unit cost by the time for process completion. Results: Process maps were developed for 14 conditions and 68 ED care activities. We estimated the costs of activities (CAN$) related to nursing (e.g. urinalysis and culture triage ordering $14.70), clerk tasks (e.g. patient registration $3.40), physicians (e.g. FAST scan $20.90), laboratory testing (e.g. CBC $6.30), diagnostic imaging (e.g. abdominal CT scan $146.50), therapy (e.g. 5 mg of iv morphine $20.40), and resuscitation (rapid sequence intubation with ketamine and succinylcholine $146.40). Overall, emergency physicians’ charges, personnel salaries and overheads accounted for 38%, 22% and 16% of all ED care costs, respectively. Conclusion: Our results represent an important step toward increasing emergency physicians’ awareness on the real cost of their interventions and empowering them to adopt more cost-effective practice patterns.