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      • HBV : No Detectable Tenofovir Resistance with Tenofovir Disoproxil Fumarate (TDF) or Emtricitabine+TDF (FTC/TDF) through 96 Weeks in Lamivudine Resistance CHB Patients

        ( Edward Gane ),( Amoreena C Corsa ),( Yang Liu ),( Ben C Mitchell2 ),( John F Flaherty ),( Michael D Miller ),( Kathryn M Kitrinos ),( Scott Fung ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

        Background/Aim: To evaluate amino acid changes within HBV pol/RT after 96 weeks of treatment with TDF or FTC/ TDF and determine their potential association with TDF resistance. Methods: In Study GS-US-174-0121, 280 patients receiving lamivudine (LAM) with detectable LAM-resistance mutations in HBV pol/RT (LAM-R: rtM204V/I±rtL180M) were randomized 1:1 to receive blinded treatment with TDF or FTC/TDF for 96 weeks. Virologic breakthrough (VB) was defined as confirmed HBV DNA >1 log10 increase from nadir or HBV DNA ≥400 copies/mL (69 IU/mL) after <400 copies/mL. Resistance genotyping by HBV pol/RT sequencing was attempted for all patients at baseline and if viremic (HBV DNA ≥400 copies/ mL) at Week 96/study discontinuation. Results: Overall, 18 patients (9 TDF, 9 FTC/TDF) were viremic viremic at Week 96/last visit. The mean baseline HBV DNA was significantly higher for viremic patients (8.04 log10 copies/mL) compared to patients who did not qualify for genotyping (6.39 log10 copies/mL). In the TDF arm, 3 patients had conserved site changes/reversions (1 with VB), 1 had unique polymorphic site changes, 2 had no change, and 3 were unable to be genotyped. In the FTC/TDF arm, 2 patients had conserved site changes/reversions, 1 had unique polymorphic site changes, 4 had no change, and 2 were unable to be genotyped. No phenotypic resistance to TDF was observed. Four of eight (50%) patients had LAM-R reversions (rtV/I204M±rtM180L) on TDF while 1/8 (12.5%) patients on FTC/TDF had LAM-R reversions. Thirteen patients (4.6%) with prior entecavir (ETV) exposure and 25 patients (8.9%) with baseline ETV-R were enrolled; neither had an impact on viral kinetics. Conclusions: No TDF resistance has been detected through 96 weeks of treatment with either TDF or FTC/TDF in LAM-R patients. The presence of ETV-R or ETV exposure did not impact viral kinetics through 96 weeks. Resistance surveillance in this population will continue through Year 5.

      • Special Education Assessment in the United States : Issues in law and Policy

        Mitchell L. Yell 국립특수교육원 2009 특수교육대상학생의 학업성취도 평가에 관한 국제적 동향 Vol. No.

        학생의 사정은 최소 3개의 이유에서 특수교육에서 가장 중요한 단계일 수 있다. 첫째, 학생의 부모를 포함하여 사정에 대해 지식을 가지고 있는 인원으로 이루어진 팀이 한 학생에 대해 특수교육에 대한 적격성을 가지고 있다고 결정하지 않는다면, 그 학생은 특수교육 프로그램에 배치될 수 없다. 둘째, 특수교육 프로그램의 모든 측면(학업성취와 기능적 수행능력에 대한 현재 수준, 목표, 특수교육 서비스 등)은 학생의 사정 자료에 기초한다. 만약 사정 자료가 완벽하지 않거나 혹은 부정확하다면, IEP의 나머지 역시 쓸모없게 된다. 세 번째로 IDEIA는 학생이 학습하고 있는지를 결정하기 위하여 특수교육 프로그램 내에서 학생의 진전도를 지속적으로 사정하도록 요구하고 있다. 사정은 단순히 적격성을 결정하기 위해 의례적으로 따라야 하는 것이 아니다; 이보다는 의미있고 측정가능하도록 의도된 특수교육 프로그램을 개발하기 위함이다. IEP의 일차적인 목적은 (a) 학생의 독특한 교육적 요구에 기초한 개별화된 특수교육 프로그램을 개발하고, (b) 프로그램을 실시하고, (c) 그 프로그램이 제대로 작동하는지 혹은 그렇지 않다면 수정해야 하는지 알아보기 위함이다. 사실 무상의 적절한 공교육을 평가하는데 가장 중대한 결정 요인은 학생의 진전도이다. 따라서 사정절차는 각 학생의 FAPE를 위한 기초가 된다. 특수교육 관련자가 IDEA에 따른 그들의 사정 관련 의무를 이해하고, 최선을 다해 이러한 책임을 순행하려고 노력하는 것은 매우 중요하다. The assessment of a student is perhaps the most crucial step in the special education process for at least three reasons. First, a student cannot be placed in a special, education program unless a team of knowledgeable persons, including a student‘s parents, determine that he or she meets the eligibility criteria. Second, every aspect of a student’s special education program (e.g., present levels of academic achievement and functional performance, goals, special education services) is based on his or her assessment data. If the assessment data are not complete or are inappropriate, the rest of the IEP will be flawed. Third, the IDEIA requires continuous assessment of a student‘s progress in his or her special education program to determine if the student is learning. The assessment process is not just about following procedures to determine eligibility; rather it is about developing special education programs that lead to meaningful and measurable educational progress. The primary purpose of the IEP process is to (a) develop an individualized special education program based on a student‘s unique educational needs, (b) implement the program, and (c) see if it works and change it if it is not working. Indeed, it is a student’s progress that is the critical determinant of a free appropriate public education. The assessment process, therefore, is the basis of each student‘s FAPE. It is crucial that special education personnel understand their assessment duties under the IDEA and discharge these responsibilities to the best of their abilities.

      • KCI등재

        CORIUM COOLABILITY UNDER EX-VESSEL ACCIDENT CONDITIONS FOR LWRs

        MITCHELL T. FARMER,DENNIS J. KILSDONK,ROBERT W. AESCHLIMANN 한국원자력학회 2009 Nuclear Engineering and Technology Vol.41 No.5

        In the wake of the Three Mile Island accident, vigorous research efforts were initiated to acquire a basic knowledge of the progression and consequences of accidents that involve a substantial degree of core degradation and melting. The primary emphasis of this research was placed on containment integrity, with: i) hydrogen combustion-detonation, ii) steam explosion, iii) direct containment heating (DCH), and iv) melt attack on the BWR Mark-I containment shell identified as energetic processes that could lead to early containment failure (i.e., within the first 24 hours of the accident). Should the core melt fail the reactor vessel, then non-condensable gas production from Molten Core-Concrete Interaction (MCCI) was identified as a mechanism that could fail the containment by pressurization over the long term. One signification question that arose as part of this investigation was the effectiveness of water in terminating an MCCI by flooding the interacting masses from above, thereby quenching the molten core debris and rendering it permanently coolable. Successful quenching of the core melt would prevent basemat melt through, as well as continued containment pressurization by non-condensable gas production, and so the accident progression would be successfully terminated without release of radioactivity to the environment. Based on these potential merits, ex-vessel corium coolability has been the focus of extensive research over the last 20 years as a potential accident management strategy for current plants. In addition, outcomes from this research have impacted the accident management strategies for the Gen III+ LWR plant designs that are currently being deployed around the world. This paper provides: i) an historical overview of corium coolability research, ii) summarizes the current status of research in this area, and iii) highlights trends in severe accident management strategies that have evolved based on the findings from this work.

      • SCISCIE
      • KCI등재

        The Domestic Origins of the Second Korean War: New Evidence from Communist Bloc Archives

        ( Mitchell Lerner ) 서울대학교 규장각한국학연구원 2018 Seoul journal of Korean studies Vol.31 No.1

        In the late 1960s, the Korean Peninsula suddenly exploded with a violence not seen since the end of the Korean War, driven by a sudden wave of North Korea aggression that culminated in January 1968 with the attempted assassination of Park Chung Hee and the capture of the USS Pueblo. For decades, scholars have struggled to understand this crisis, as they lacked access to materials that could open a window into DPRK policy. Only now, with the recent release of new materials collected from the archives of the Communist bloc nations, can we begin to understand the critical events of the Second Korean War and the larger environment that surrounded it. This paper integrates the most recent materials from former Communist bloc states to revisit our understanding of this dangerous situation, and to suggest that it was driven above all else by domestic political and economic circumstances inside North Korea.

      • KCI등재

        Identifying with the L2 Self : Study Abroad Experiences of Japanese English Language Learners

        Mitchell Fryer,Peter Roger 아시아영어교육학회 2017 The Journal of Asia TEFL Vol.14 No.3

        A possible self is a combination of the self knowledge, thoughts and beliefs that we have regarding our future potential (Markus & Nurius, 1986). This study investigated the possible selves of eight Japanese niversity study abroad (SA) students. Dörnyei (2005) posited the L2 motivational self-system, comprised of the L2 ideal self as a construct for better understanding and predicting L2 motivation. Several studies and theoretical accounts indicate that discrepancies between current and ideal states can help predict motivation, as the possible self acts as a future self-guide (Dörnyei & Chan, 2013; Higgins, 1987; Ushioda & Dörnyei, 2012). The study identified several key contextual elements that contributed to changes in the participants’ L2 motivational self systems. These included ‘thrown in the deep end’ type interactions, good timing of interactions, conscious moves by the conversation partner to assist the participants, relaxed and positive atmosphere, opportunities to initiate and sustain interactions and one on one interactions that were in line with the participants’ own cultural identity. The findings suggest the contextual elements shaped the participants’ L2 ideal and feared self images and contributed to the identification of discrepancies between current and desired states which influenced study behaviours, goals and motivation over time.

      • Strain analysis of protein structures and low dimensionality of mechanical allosteric couplings

        Mitchell, Michael R.,Tlusty, Tsvi,Leibler, Stanislas National Academy of Sciences 2016 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.113 No.40

        <P>In many proteins, especially allosteric proteins that communicate regulatory states from allosteric to active sites, structural deformations are functionally important. To understand these deformations, dynamical experiments are ideal but challenging. Using static structural information, although more limited than dynamical analysis, is much more accessible. Underused for protein analysis, strain is the natural quantity for studying local deformations. We calculate strain tensor fields for proteins deformed by ligands or thermal fluctuations using crystal and NMR structure ensembles. Strains-primarily shears-show deformations around binding sites. These deformations can be induced solely by ligand binding at distant allosteric sites. Shears reveal quasi-2D paths of mechanical coupling between allosteric and active sites that may constitute a widespread mechanism of allostery. We argue that strain-particularly shear-is the most appropriate quantity for analysis of local protein deformations. This analysis can reveal mechanical and biological properties of many proteins.</P>

      • KCI등재

        Acute kidney injury in the patient with cancer

        Mitchell H. Rosner,Mark A. Perazella 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.3

        Dramatic advances in the care of patients with cancer have led to significant improvement in outcomes and survival. However, renal manifestations of the underlying cancer as well as the effects of anti-neoplastic therapies leave patients with significant morbidity and chronic kidney disease risks. The most common renal manifestations associated with cancer include acute kidney injury (AKI) in the setting of multiple myeloma, tumor lysis syndrome, post-hematopoietic stem cell therapy, and AKI associated with chemotherapy. Knowledge of specific risk factors, modification of risk and careful attention to rapid AKI diagnosis are critical for improving outcomes.

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