Randomised clinical trial

DEFF Research Database (Denmark)

Reimer, C; Lødrup, A; Smith, G

2016-01-01

of an alginate (Gaviscon Advance, Reckitt Benckiser, Slough, UK) on reflux symptoms in patients with persistent symptoms despite once daily PPI. MethodsThis was a multicentre, randomised, placebo-controlled, 7-day double-blind trial preceded by a 7-day run-in period. Reflux symptoms were assessed using...

Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: A double-blind, randomised, placebo-controlled trial

OpenAIRE

Villar-Garc?a, Judit; G?erri-Fern?ndez, Robert; Moya, Andr?s; Gonz?lez, Alicia; Hern?ndez, Juan J.; Lerma, Elisabet; Guelar, Ana; Sorli, Luisa; Horcajada, Juan P.; Artacho, Alejandro; D?Auria, Giuseppe; Knobel, Hernando

2017-01-01

Dysbalance in gut microbiota has been linked to increased microbial translocation, leading to chronic inflammation in HIV-patients, even under effective HAART. Moreover, microbial translocation is associated with insufficient reconstitution of CD4+T cells, and contributes to the pathogenesis of immunologic non-response. In a double-blind, randomised, placebo-controlled trial, we recently showed that, compared to placebo, 12 weeks treatment with probiotic Saccharomyces boulardii significantly ...

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Harris, Deborah L; Weston, Philip J; Signal, Matthew; Chase, J Geoffrey; Harding, Jane E

2013-12-21

Neonatal hypoglycaemia is common, and a preventable cause of brain damage. Dextrose gel is used to reverse hypoglycaemia in individuals with diabetes; however, little evidence exists for its use in babies. We aimed to assess whether treatment with dextrose gel was more effective than feeding alone for reversal of neonatal hypoglycaemia in at-risk babies. We undertook a randomised, double-blind, placebo-controlled trial at a tertiary centre in New Zealand between Dec 1, 2008, and Nov 31, 2010. Babies aged 35-42 weeks' gestation, younger than 48-h-old, and at risk of hypoglycaemia were randomly assigned (1:1), via computer-generated blocked randomisation, to 40% dextrose gel 200 mg/kg or placebo gel. Randomisation was stratified by maternal diabetes and birthweight. Group allocation was concealed from clinicians, families, and all study investigators. The primary outcome was treatment failure, defined as a blood glucose concentration of less than 2·6 mmol/L after two treatment attempts. Analysis was by intention to treat. The trial is registered with Australian New Zealand Clinical Trials Registry, number ACTRN12608000623392. Of 514 enrolled babies, 242 (47%) became hypoglycaemic and were randomised. Five babies were randomised in error, leaving 237 for analysis: 118 (50%) in the dextrose group and 119 (50%) in the placebo group. Dextrose gel reduced the frequency of treatment failure compared with placebo (16 [14%] vs 29 [24%]; relative risk 0·57, 95% CI 0·33-0·98; p=0·04). We noted no serious adverse events. Three (3%) babies in the placebo group each had one blood glucose concentration of 0·9 mmol/L. No other adverse events took place. Treatment with dextrose gel is inexpensive and simple to administer. Dextrose gel should be considered for first-line treatment to manage hypoglycaemia in late preterm and term babies in the first 48 h after birth. Waikato Medical Research Foundation, the Auckland Medical Research Foundation, the Maurice and Phyllis Paykel

Randomised, Double Blind, Placebo-Controlled Trial of Echinacea Supplementation in Air Travellers

Directory of Open Access Journals (Sweden)

E. Tiralongo

2012-01-01

Full Text Available Objective. To identify whether a standardised Echinacea formulation is effective in the prevention of respiratory and other symptoms associated with long-haul flights. Methods. 175 adults participated in a randomised, double-blind placebo-controlled trial travelling back from Australia to America, Europe, or Africa for a period of 1–5 weeks on commercial flights via economy class. Participants took Echinacea (root extract, standardised to 4.4 mg alkylamides or placebo tablets. Participants were surveyed before, immediately after travel, and at 4 weeks after travel regarding upper respiratory symptoms and travel-related quality of life. Results. Respiratory symptoms for both groups increased significantly during travel (P<0.0005. However, the Echinacea group had borderline significantly lower respiratory symptom scores compared to placebo (P=0.05 during travel. Conclusions. Supplementation with standardised Echinacea tablets, if taken before and during travel, may have preventive effects against the development of respiratory symptoms during travel involving long-haul flights.

Randomised clinical trial

DEFF Research Database (Denmark)

Coyle, C; Crawford, G; Wilkinson, J

2017-01-01

BACKGROUND: Symptomatic breakthrough in proton pump inhibitor (PPI)-treated gastro-oesophageal reflux disease (GERD) patients is a common problem with a range of underlying causes. The nonsystemic, raft-forming action of alginates may help resolve symptoms. AIM: To assess alginate-antacid (Gaviscon...... Double Action, RB, Slough, UK) as add-on therapy to once-daily PPI for suppression of breakthrough reflux symptoms. METHODS: In two randomised, double-blind studies (exploratory, n=52; confirmatory, n=262), patients taking standard-dose PPI who had breakthrough symptoms, assessed by Heartburn Reflux...

Amazon`s strategic analysis approaching the Spanish market

OpenAIRE

Rúa de la Plaza, José

2018-01-01

Amazon.com has not stopped growing since its foundation in 1994, and has become the leading company in the world of e-commerce. Amazon emerged from a great idea of its founder Jeff Bezos, who has managed to turn an online books store into a company that is constantly thinking about its customers and trying to innovate, either improving existing products and services, developing new ones or entering new markets. Amazon takes advantage of economies of scale that derive from its excellent dis...

Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study.

Science.gov (United States)

Wade, C; Wang, L; Zhao, W J; Cardini, F; Kronenberg, F; Gui, S Q; Ying, Z; Zhao, N Q; Chao, M T; Yu, J

2016-01-05

To determine if injection of vitamin K3 in an acupuncture point is optimal for the treatment of primary dysmenorrhoea, when compared with 2 other injection treatments. A Menstrual Disorder Centre at a public hospital in Shanghai, China. Chinese women aged 14-25 years with severe primary dysmenorrhoea for at least 6 months not relieved by any other treatment were recruited. Exclusion criteria were the use of oral contraceptives, intrauterine devices or anticoagulant drugs, pregnancy, history of abdominal surgery, participation in other therapies for pain and diagnosis of secondary dysmenorrhoea. Eighty patients with primary dysmenorrhoea, as defined on a 4-grade scale, completed the study. Two patients withdrew after randomisation. A double-blind, double-dummy, randomised controlled trial compared vitamin K3 acupuncture point injection to saline acupuncture point injection and vitamin K3 deep muscle injection. Patients in each group received 3 injections at a single treatment visit. The primary outcome was the difference in subjective perception of pain as measured by an 11 unit Numeric Rating Scale (NRS). Secondary measurements were Cox Pain Intensity and Duration scales and the consumption of analgesic tablets before and after treatment and during 6 following cycles. Patients in all 3 groups experienced pain relief from the injection treatments. Differences in NRS measured mean pain scores between the 2 active control groups were less than 1 unit (-0.71, CI -1.37 to -0.05) and not significant, but the differences in average scores between the treatment hypothesised to be optimal and both active control groups (1.11, CI 0.45 to 1.78) and (1.82, CI 1.45 to 2.49) were statistically significant in adjusted mixed-effects models. Menstrual distress and use of analgesics were diminished for 6 months post-treatment. Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic. NCT00104546; Results

3g mesalazine granules are superior to 9mg budesonide for achieving remission in active ulcerative colitis: a double-blind, double-dummy, randomised trial.

Science.gov (United States)

Gross, Volker; Bunganic, Ivan; Belousova, Elena A; Mikhailova, Tatyana L; Kupcinskas, Limas; Kiudelis, Gediminas; Tulassay, Zsolt; Gabalec, Libor; Dorofeyev, Andrey E; Derova, Jelena; Dilger, Karin; Greinwald, Roland; Mueller, Ralph

2011-04-01

Budesonide may be an effective therapy for mild-to-moderately active ulcerative colitis (UC). This study aimed to demonstrate non-inferiority for oral 9mg budesonide once daily (OD) versus 3g mesalazine granules OD. This was an eight-week randomised, double-blind, double-dummy, multicentre study in which patients with mild-to-moderately active UC, defined as Clinical Activity Index (CAI) ≥6 and Endoscopic Index (EI) ≥4, received budesonide (Budenofalk® 3mg capsules×3) or mesalazine (Salofalk® 1000mg granules×3). The primary endpoint was clinical remission at week 8 (CAI ≤4 with stool frequency and rectal bleeding subscores of "0"). 343 patients were randomised (177 budesonide, 166 mesalazine). Fewer patients achieved the primary endpoint with budesonide versus mesalazine (70/177 [39.5%] versus 91/166 [54.8%]) with a difference in proportions of -15.3% (95% CI [-25.7%, -4.8%]; p=0.520 for non-inferiority). The median time to first resolution of symptoms was 14.0 days (budesonide) and 11.0 days (mesalazine) (hazard ratio 1.19; 95% CI [0.94, 1.51]). Mucosal healing was observed in 54/177 (30.5%) budesonide patients versus 65/166 (39.2%) mesalazine patients, a difference of -8.6% (95% CI [-18.7%, 1.4%]; p=0.093). The incidences of adverse events (budesonide 26.6%, mesalazine 25.3%) and serious adverse events (budesonide 1.7%, mesalazine 1.2%) were similar. Once-daily 3g mesalazine administered as granules is superior to 9mg budesonide OD administered as capsules for achieving remission in mild-to-moderately active UC. However, it is noteworthy that remission of UC was attained in about 40% of budesonide-treated patients with a rapid onset of resolution. Copyright © 2010. Published by Elsevier B.V.

Dexketoprofen/tramadol: randomised double-blind trial and confirmation of empirical theory of combination analgesics in acute pain.

Science.gov (United States)

Moore, R Andrew; Gay-Escoda, C; Figueiredo, R; Tóth-Bagi, Z; Dietrich, T; Milleri, S; Torres-Lagares, D; Hill, C M; García-García, A; Coulthard, P; Wojtowicz, A; Matenko, D; Peñarrocha-Diago, M; Cuadripani, S; Pizà-Vallespir, B; Guerrero-Bayón, C; Bertolotti, M; Contini, M P; Scartoni, S; Nizzardo, A; Capriati, A; Maggi, C A

2015-01-01

Combination analgesics are effective in acute pain, and a theoretical framework predicts efficacy for combinations. The combination of dexketoprofen and tramadol is untested, but predicted to be highly effective. This was a randomised, double-blind, double-dummy, parallel-group, placebo-controlled, single-dose trial in patients with moderate or severe pain following third molar extraction. There were ten treatment arms, including dexketoprofen trometamol (12.5 mg and 25 mg) and tramadol hydrochloride (37.5 mg and 75 mg), given as four different fixed combinations and single components, with ibuprofen 400 mg as active control as well as a placebo control. The study objective was to evaluate the superior analgesic efficacy and safety of each combination and each single agent versus placebo. The primary outcome was the proportion of patients with at least 50 % max TOTPAR over six hours. 606 patients were randomised and provided at least one post-dose assessment. All combinations were significantly better than placebo. The highest percentage of responders (72%) was achieved in the dexketoprofen trometamol 25 mg plus tramadol hydrochloride 75 mg group (NNT 1.6, 95% confidence interval 1.3 to 2.1). Addition of tramadol to dexketoprofen resulted in greater peak pain relief and greater pain relief over the longer term, particularly at times longer than six hours (median duration of 8.1 h). Adverse events were unremarkable. Dexketoprofen trometamol 25 mg combined with tramadol hydrochloride 75 mg provided good analgesia with rapid onset and long duration in a model of moderate to severe pain. The results of the dose finding study are consistent with pre-trial calculations based on empirical formulae. EudraCT (2010-022798-32); Clinicaltrials.gov (NCT01307020).

A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin

OpenAIRE

Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

2017-01-01

Introduction Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve? gel (DELP) and a cheaper alternative, Zerobase Emollient? cream (ZBC). Methods This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) com...

Effects of tonabersat on migraine with aura: a randomised, double-blind, placebo-controlled crossover study

DEFF Research Database (Denmark)

Hauge, Anne W; Asghar, Mohammed S; Schytz, Henrik W

2009-01-01

BACKGROUND: Migraine with aura is thought likely to be caused by cortical spreading depression (CSD). Tonabersat inhibits CSD, and we therefore investigated whether tonabersat has a preventive effect in migraine with aura. METHODS: In this randomised, double-blind, placebo-controlled crossover......, of whom 31 were included in the statistical analysis of efficacy. Median (IQR) attacks of aura were reduced from 3.2 (1.0-5.0) per 12 weeks on placebo to 1.0 (0-3.0) on tonabersat (p=0.01), whereas the other primary outcome measure, median migraine headache days with or without aura, was not significantly...... inhibitory effect on CSD. The results support the theory that auras are caused by CSD and that this phenomenon is not involved in attacks without aura. FUNDING: Minster Pharmaceuticals; Lundbeck Foundation....

Reduction of fatigue in Sjögren syndrome with rituximab: results of a randomised, double-blind, placebo-controlled pilot study.

Science.gov (United States)

Dass, S; Bowman, S J; Vital, E M; Ikeda, K; Pease, C T; Hamburger, J; Richards, A; Rauz, S; Emery, P

2008-11-01

Primary Sjögren syndrome (pSS) causes significant systemic symptoms including fatigue as well as glandular dysfunction. There are currently no effective systemic therapies; however, open label series have suggested that rituximab may be beneficial for systemic and glandular manifestations. Therefore, we performed a double blind, placebo-controlled, randomised pilot study of the efficacy of rituximab in reducing fatigue in pSS. A total of 17 patients with pSS and a score on fatigue visual analogue scale (VAS) >50 were randomised to receive either 2 infusions of rituximab 1 g or placebo; patients also received oral and intravenous steroids. Outcome measures included: the proportion of patients with >20% reduction in fatigue VAS, changes in pSS related symptoms, health related quality of life and immunological parameters of pSS. These were measured 6 months after therapy. There was significant improvement from baseline in fatigue VAS in the rituximab group (p<0.001) in contrast to the placebo group (p = 0.147). There was a significant difference between the groups at 6 months in the social functioning score of SF-36 (p = 0.01) and a trend to significant difference in the mental health domain score of SF-36 (p = 0.06). There was one episode of serum sickness in the rituximab treated group. This is the first double blind study of rituximab in pSS to show benefit; further studies are justified.

Double-blind, placebo-controlled, randomised phase II trial of IH636 grape seed proanthocyanidin extract (GSPE) in patients with radiation-induced breast induration

International Nuclear Information System (INIS)

Brooker, Sonja; Martin, Susan; Pearson, Ann; Bagchi, Debasis; Earl, Judith; Gothard, Lone; Hall, Emma; Porter, Lucy; Yarnold, John

2006-01-01

Background and purpose: Tissue hardness (induration), pain and tenderness are common late adverse effects of curative radiotherapy for early breast cancer. The purpose of this study was to test the efficacy of IH636 grape seed proanthocyanidin extract (GSPE) in patients with tissue induration after high-dose radiotherapy for early breast cancer in a double-blind placebo-controlled randomised phase II trial. Patients and methods: Sixty-six eligible research volunteers with moderate or marked breast induration at a mean 10.8 years since radiotherapy for early breast cancer were randomised to active drug (n=44) or placebo (n=22). All patients were given grape seed proanthocyanidin extract (GSPE) 100 mg three times a day orally, or corresponding placebo capsules, for 6 months. The primary endpoint was percentage change in surface area (cm 2 ) of palpable breast induration measured at the skin surface 12 months after randomisation. Secondary endpoints included change in photographic breast appearance and patient self-assessment of breast hardness, pain and tenderness. Results: At 12 months post-randomisation, ≥50% reduction in surface area (cm 2 ) of breast induration was recorded in13/44 (29.5%) GSPE and 6/22 (27%) placebo group patients (NS). At 12 months post-randomisation, there was no significant difference between treatment and control groups in terms of external assessments of tissue hardness, breast appearance or patient self-assessments of breast hardness, pain or tenderness. Conclusions: The study failed to show efficacy of orally-adminstered GSPE in patients with breast induration following radiotherapy for breast cancer

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Thwaites, Guy E; Scarborough, Matthew; Szubert, Alexander; Nsutebu, Emmanuel; Tilley, Robert; Greig, Julia; Wyllie, Sarah A; Wilson, Peter; Auckland, Cressida; Cairns, Janet; Ward, Denise; Lal, Pankaj; Guleri, Achyut; Jenkins, Neil; Sutton, Julian; Wiselka, Martin; Armando, Gonzalez-Ruiz; Graham, Clive; Chadwick, Paul R; Barlow, Gavin; Gordon, N Claire; Young, Bernadette; Meisner, Sarah; McWhinney, Paul; Price, David A; Harvey, David; Nayar, Deepa; Jeyaratnam, Dakshika; Planche, Tim; Minton, Jane; Hudson, Fleur; Hopkins, Susan; Williams, John; Török, M Estee; Llewelyn, Martin J; Edgeworth, Jonathan D; Walker, A Sarah

2018-02-17

Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute

A randomised, double-masked comparison study of diquafosol versus sodium hyaluronate ophthalmic solutions in dry eye patients.

Science.gov (United States)

Takamura, Etsuko; Tsubota, Kazuo; Watanabe, Hitoshi; Ohashi, Yuichi

2012-10-01

To compare the efficacy and safety of 3% diquafosol ophthalmic solution with those of 0.1% sodium hyaluronate ophthalmic solution in dry eye patients, using mean changes in fluorescein and rose bengal staining scores as endpoints. TRIAL DESIGN AND METHODS: In this multicenter, randomised, double-masked, parallel study of 286 dry eye patients with fluorescein and rose bengal staining scores of ≥3 were randomised to the treatment groups in a 1 : 1 ratio. Efficacy and safety were evaluated after drop-wise instillation of the study drug, six times daily for 4 weeks. After 4 weeks, the intergroup difference in the mean change from baseline in fluorescein staining score was -0.03; this verified the non-inferiority of diquafosol. The mean change from baseline in rose bengal staining score was significantly lower in the diquafosol group (p=0.010), thus verifying its superiority. The incidence of adverse events was 26.4% and 18.9% in the diquafosol and sodium hyaluronate groups, respectively, with no significant difference. Diquafosol (3%) and sodium hyaluronate (0.1%) exhibit similar efficacy in improving fluorescein staining scores of dry eye patients, whereas, diquafosol exhibits superior efficacy in improving rose bengal staining scores. Diquafosol has high clinical efficacy and is well tolerated with a good safety profile.

Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial.

Directory of Open Access Journals (Sweden)

Kevin K C Hung

Full Text Available Soft tissue injuries commonly present to the emergency department (ED, often with acute pain. They cause significant suffering and morbidity if not adequately treated. Paracetamol and ibuprofen are commonly used analgesics, but it remains unknown if either one or the combination of both is superior for pain control.To investigate the analgesic effect of paracetamol, ibuprofen and the combination of both in the treatment of soft tissue injury in an ED, and the side effect profile of these drugs.Double-blind, double dummy, placebo-controlled randomised controlled trial. 782 adult patients presenting with soft tissue injury without obvious fractures attending the ED of a university hospital in the New Territories of Hong Kong were recruited. Patients were randomised using a random number table into three parallel arms of paracetamol only, ibuprofen only and a combination of paracetamol and ibuprofen in a 1:1:1 ratio. The primary outcome measure was pain score at rest and on activity in the first 2 hours and first 3 days. Data was analysed on an intention to treat basis.There was no statistically significant difference in pain score in the initial two hours between the three groups, and no clinically significant difference in pain score in the first three days.There was no difference in analgesic effects or side effects observed using oral paracetamol, ibuprofen or a combination of both in patients with mild to moderate pain after soft tissue injuries attending the ED.The study is registered with ClinicalTrials.gov (no. NCT00528658.

Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial.

Science.gov (United States)

Hung, Kevin K C; Graham, Colin A; Lo, Ronson S L; Leung, Yuk Ki; Leung, Ling Yan; Man, S Y; Woo, W K; Cattermole, Giles N; Rainer, Timothy H

2018-01-01

Soft tissue injuries commonly present to the emergency department (ED), often with acute pain. They cause significant suffering and morbidity if not adequately treated. Paracetamol and ibuprofen are commonly used analgesics, but it remains unknown if either one or the combination of both is superior for pain control. To investigate the analgesic effect of paracetamol, ibuprofen and the combination of both in the treatment of soft tissue injury in an ED, and the side effect profile of these drugs. Double-blind, double dummy, placebo-controlled randomised controlled trial. 782 adult patients presenting with soft tissue injury without obvious fractures attending the ED of a university hospital in the New Territories of Hong Kong were recruited. Patients were randomised using a random number table into three parallel arms of paracetamol only, ibuprofen only and a combination of paracetamol and ibuprofen in a 1:1:1 ratio. The primary outcome measure was pain score at rest and on activity in the first 2 hours and first 3 days. Data was analysed on an intention to treat basis. There was no statistically significant difference in pain score in the initial two hours between the three groups, and no clinically significant difference in pain score in the first three days. There was no difference in analgesic effects or side effects observed using oral paracetamol, ibuprofen or a combination of both in patients with mild to moderate pain after soft tissue injuries attending the ED. The study is registered with ClinicalTrials.gov (no. NCT00528658).

GoAmazon – Scaling Amazon Carbon Water Couplings

Energy Technology Data Exchange (ETDEWEB)

Dubey, Manvendra Krishna [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-09-06

Forests soak up 25% of the carbon dioxide (CO₂) emitted by anthropogenic fossil energy use (10 Gt C y^-1) moderating its atmospheric accumulation. How this terrestrial CO₂ uptake will evolve with climate change in the 21st century is largely unknown. Rainforests are the most active ecosystems with the Amazon basin storing 120 Gt C as biomass and exchanging 18 Gt C y^-1 of CO₂ via photosynthesis and respiration and fixing carbon at 2-3 kg C m^-2 y^-1. Furthermore, the intense hydrologic and carbon cycles are tightly coupled in the Amazon where about half of the water is recycled by evapotranspiration and the other half imported from the ocean by Northeasterly trade winds. Climate models predict a drying in the Amazon with reduced carbon uptake while observationally guided assessments indicate sustained uptake. We will resolve this huge discrepancy in the size and sign of the future Amazon carbon cycle by performing the first simultaneous regional scale high frequency measurements of atmospheric CO₂, H₂O, HOD, CH₄, N₂O and CO at the T3 site in Manacupuru, Brazil as part of DOE's GoAmazon project. Our data will be used to inform and develop DOE's CLM on the tropical carbon-water couplings at the appropriate grid scale (10-50km). Our measurements will also validate the CO₂ data from Japan's GOSAT and NASA's imminent OCO-2 satellite (launch date July 2014).

Carbetocin versus oxytocin for the prevention of postpartum haemorrhage following caesarean section: the results of a double-blind randomised trial.

Science.gov (United States)

Attilakos, G; Psaroudakis, D; Ash, J; Buchanan, R; Winter, C; Donald, F; Hunt, L P; Draycott, T

2010-07-01

To compare the effectiveness of carbetocin and oxytocin when they are administered after caesarean section for prevention of postpartum haemorrhage (PPH). Double-blind randomised single centre study (1:1 ratio). Teaching hospital in Bristol, UK with 6000 deliveries per annum. Women at term undergoing elective or emergency caesarean section under regional anaesthesia, excluding women with placenta praevia, multiple gestation and placental abruption. Women were randomised to receive either carbetocin 100 microg or oxytocin 5 IU intravenously after the delivery of the baby. Perioperative care was otherwise normal and use of additional oxytocics was at the discretion of the operating obstetrician. Analysis was by intention to treat. The proportion of women in each arm of the trial that needed additional pharmacological oxytocic interventions. Significantly more women needed additional oxytocics in the oxytocin group (45.5% versus 33.5%, Relative risk 0.74, 95% CI 0.57-0.95). The majority of women had oxytocin infusions. There were no significant differences in the secondary outcomes, including major PPH, blood transfusions and fall in haemoglobin. Carbetocin is associated with a reduced use of additional oxytocics. It is unclear whether this may reduce rates of PPH and blood transfusions.

A double-blind, randomised, placebo-controlled trial of Ganoderma lucidum for the treatment of cardiovascular risk factors of metabolic syndrome

Science.gov (United States)

Klupp, Nerida L.; Kiat, Hosen; Bensoussan, Alan; Steiner, Genevieve Z.; Chang, Dennis H.

2016-01-01

This study aimed to evaluate the efficacy and safety of Ganoderma lucidum for the treatment of hyperglycaemia and other cardiovascular risk components of metabolic syndrome using a prospective, double-blind, randomised, placebo-controlled trial. Eighty-four participants with type 2 diabetes mellitus and metabolic syndrome were randomised to one of three intervention groups: Ganoderma lucidum, Ganoderma lucidum with Cordyceps sinensis, or placebo. The dosage was 3 g/day of Ganoderma lucidum, with or without Cordyceps sinensis, for 16 weeks. The primary outcome measure was blood glucose (glycosylated haemoglobin [HbA1c] and fasting plasma glucose [FPG]); a number of secondary outcome measures were also tested. Data from the two intervention groups were combined. The combined intervention had no effect on any of the primary (baseline-adjusted difference in means: HbA1c = 0.13%, 95% CI [−0.35, 0.60], p = 0.60; FPG = 0.03 mmol/L, 95% CI [−0.90, 0.96], p = 0.95) or secondary outcome measures over the course of the 16-week trial, and no overall increased risk of adverse events with either active treatment. Evidence from this randomised clinical trial does not support the use of Ganoderma lucidum for treatment of cardiovascular risk factors in people with diabetes mellitus or metabolic syndrome. This Clinical Trial was registered with the Australian New Zealand Clinical Trials Registry on November 23, 2006. Trial ID: ACTRN12606000485538 and can be accessed here: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=81705. PMID:27511742

A randomised, double-blind, placebo-controlled, multicentre study of the safety and efficacy of BIOBYPASS (AdGVVEGF121.10NH) gene therapy in patients with refractory advanced coronary artery disease: the NOVA trial

DEFF Research Database (Denmark)

Kastrup, Jens; Jørgensen, Erik; Fuchs, Shmuel

2011-01-01

Genes encoding vascular endothelial growth factor (VEGF) can potentially augment myocardial perfusion in patients with coronary artery disease (CAD). We conducted a randomised, double-blind, placebo-controlled gene therapy study with the adenovirus carrying VEGF121 (BIOBYPASS [AdGVVEGF121.10NH])....

Distribution and flux of 226Ra and 228Ra in the Amazon River estuary

International Nuclear Information System (INIS)

Key, R.M.; Sarmiento, J.L.; Stallard, R.F.; Moore, W.S.

1985-01-01

Measurements of 226 Ra and 228 Ra in the Amazon River estuary show that desorption from riverborne suspended particulate matter in the estuary increases the riverine flux of both isotopes to the ocean by a factor of approximately 5 over the flux attributable to radium dissolved in the river water alone. The total Amazon flux supplies approximately 0.20% of the 226 Ra and approximately 2.6% of the 228 Ra standing crops in the near-surface Atlantic (0-200 m). Diffusive flux from estuarine and shelf sediments and desorption from resuspended sediments in the region of the estuary approximately double the estuarine 226 Ra concentration and quadruple the estuarine 228 Ra concentration above that caused by the dissolved and desorbed river components alone

Repeat-Pass Multi-Temporal Interferometric SAR Coherence Variations with Amazon Floodplain and Lake Habitats

Science.gov (United States)

Jung, H.; Alsdorf, D.

2006-12-01

Monitoring discharge in the main channels of rivers and upland tributaries as well as storage changes in floodplain lakes is necessary for understanding flooding hazards, methane production, sediment transport, and nutrient exchange. Interferometric processing of synthetic aperture radar (SAR) data may enable hydrologists to detect environmental and ecological changes in hydrological systems over space and time. An aim of our experiments is to characterize interferometric SAR coherence variations that occur in Amazon aquatic habitats. We analyze coherence variations in JERS-1 data at three central Amazon sites; Lake Balbina, the Cabaliana floodplain, and the confluence of the Purus and Amazon rivers. Because radar pulse interactions with inundated vegetation typically follow a double-bounce travel path which returns energy to the antenna, coherence will vary with vegetation type, physical baseline, and temporal baseline. Balbina's vegetation consists mostly of forest and inundated trunks of dead, leafless trees as opposed to Cabaliana and Amazon- Purus (dominated by flooded forests), thus it serves to isolate the vegetation signal. Coherence variations with baselines were determined from 253 interferograms at Balbina, 210 at Calbaliana, and 153 at Purus. The average temporal and perpendicular baselines (mean std.) are 574 394 days and 1708 1159 m at Balbina, 637 435 days and 1381 981 m at Cabaliana, and 587 425 days and 1430 964 m at Purus. Balbina has a stronger coherence than either Cabaliana or Amazon-Purus. With results of Mann-Whitney statistical tests, Balbina has a difference between terre-firme and flooded coherence values plotted with perpendicular baseline but Cabaliana and Amazon-Purus do not show this difference. Balbina has a linearly decreasing trend in coherence plotted with temporal baseline whereas Cabaliana and Amazon-Purus have a steep drop-off, non- linear change. A strong annual periodicity is evident on power spectrums of the coherence values

Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

NARCIS (Netherlands)

Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

2000-01-01

Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with

Introduction: Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5)

Science.gov (United States)

Martin, S. T.; Artaxo, P.; Machado, L. A. T.; Manzi, A. O.; Souza, R. A. F.; Schumacher, C.; Wang, J.; Andreae, M. O.; Barbosa, H. M. J.; Fan, J.; Fisch, G.; Goldstein, A. H.; Guenther, A.; Jimenez, J. L.; Pöschl, U.; Silva Dias, M. A.; Smith, J. N.; Wendisch, M.

2016-04-01

The Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5) Experiment was carried out in the environs of Manaus, Brazil, in the central region of the Amazon basin for 2 years from 1 January 2014 through 31 December 2015. The experiment focused on the complex interactions among vegetation, atmospheric chemistry, and aerosol production on the one hand and their connections to aerosols, clouds, and precipitation on the other. The objective was to understand and quantify these linked processes, first under natural conditions to obtain a baseline and second when altered by the effects of human activities. To this end, the pollution plume from the Manaus metropolis, superimposed on the background conditions of the central Amazon basin, served as a natural laboratory. The present paper, as the introduction to the special issue of GoAmazon2014/5, presents the context and motivation of the GoAmazon2014/5 Experiment. The nine research sites, including the characteristics and instrumentation of each site, are presented. The sites range from time point zero (T0) upwind of the pollution, to T1 in the midst of the pollution, to T2 just downwind of the pollution, to T3 furthest downwind of the pollution (70 km). In addition to the ground sites, a low-altitude G-159 Gulfstream I (G-1) observed the atmospheric boundary layer and low clouds, and a high-altitude Gulfstream G550 (HALO) operated in the free troposphere. During the 2-year experiment, two Intensive Operating Periods (IOP1 and IOP2) also took place that included additional specialized research instrumentation at the ground sites as well as flights of the two aircraft. GoAmazon2014/5 IOP1 was carried out from 1 February to 31 March 2014 in the wet season. GoAmazon2014/5 IOP2 was conducted from 15 August to 15 October 2014 in the dry season. The G-1 aircraft flew during both IOP1 and IOP2, and the HALO aircraft flew during IOP2. In the context of the Amazon basin, the two IOPs also correspond to the clean and

An Atlantic influence on Amazon rainfall

Energy Technology Data Exchange (ETDEWEB)

Yoon, Jin-Ho [University of Maryland, Department of Atmospheric and Oceanic Science, College Park, MD (United States); Zeng, Ning [University of Maryland, Earth System Science Interdisciplinary Center, College Park, MD (United States); University of Maryland, Department of Atmospheric and Oceanic Science, College Park, MD (United States)

2010-02-15

Rainfall variability over the Amazon basin has often been linked to variations in Pacific sea surface temperature (SST), and in particular, to the El Nino/Southern Oscillation (ENSO). However, only a fraction of Amazon rainfall variability can be explained by ENSO. Building upon the recent work of Zeng (Environ Res Lett 3:014002, 2008), here we provide further evidence for an influence on Amazon rainfall from the tropical Atlantic Ocean. The strength of the North Atlantic influence is found to be comparable to the better-known Pacific ENSO connection. The tropical South Atlantic Ocean also shows some influence during the wet-to-dry season transition period. The Atlantic influence is through changes in the north-south divergent circulation and the movement of the ITCZ following warm SST. Therefore, it is strongest in the southern part of the Amazon basin during the Amazon's dry season (July-October). In contrast, the ENSO related teleconnection is through anomalous east-west Walker circulation with largely concentrated in the eastern (lower) Amazon. This ENSO connection is seasonally locked to boreal winter. A complication due to the influence of ENSO on Atlantic SST causes an apparent North Atlantic SST lag of Amazon rainfall. Removing ENSO from North Atlantic SST via linear regression resolves this causality problem in that the residual Atlantic variability correlates well and is in phase with the Amazon rainfall. A strong Atlantic influence during boreal summer and autumn is particularly significant in terms of the impact on the hydro-ecosystem which is most vulnerable during the dry season, as highlighted by the severe 2005 Amazon drought. Such findings have implications for both seasonal-interannual climate prediction and understanding the longer-term changes of the Amazon rainforest. (orig.)

Bronchodilator Efficacy of Single Doses of Indacaterol in Japanese Patients with COPD: A Randomised, Double-Blind, Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Motokazu Kato

Full Text Available ABSTRACT: Background: Indacaterol is an investigational, novel, inhaled once-daily ultra-long-acting beta-2 agonist for the treatment of chronic obstructive pulmonary disease (COPD. This study evaluated the 24-h bronchodilatory efficacy and safety of indacaterol in Japanese patients with COPD. Methods: This Phase-II, randomised, placebo-controlled, crossover study comprised four double-blind, single-dose treatment periods (washout between periods: 14-28 days. Japanese patients aged 40-75 years with moderate-to-severe COPD were randomised to receive single doses of indacaterol (150, 300, or 600 μg or placebo via a single-dose dry-powder inhaler. Efficacy (primary endpoint: standardised FEV1AUC22-24h and safety were assessed for 24 h post-dose in each treatment period. Results: Of the 50 patients randomised (92% male; mean age, 67.2 years, 45 completed the study. Standardised FEV1AUC22-24h was significantly higher for all indacaterol doses as compared with placebo, with clinically relevant differences of 130, 160, and 170 mL for 150, 300, and 600 μg, respectively (P < 0.001. The improvement in FEV1 was seen as early as 5 min post-dose with indacaterol and sustained for 24 h (P < 0.001 vs placebo at all time points. All indacaterol doses were well tolerated and showed no clinically meaningful effect on pulse rate, blood pressure, QTc interval, and laboratory parameters when compared with placebo. Conclusions: In the Japanese COPD population studied, single doses of indacaterol (150, 300, and 600 μg provided sustained 24-h bronchodilation, with onset of action within 5 min post-dose. All doses were well tolerated. These results are consistent with data from Caucasian populations. KEY WORDS: beta2-agonists, bronchodilator, COPD, efficacy, indacaterol

Efficacy of a microencapsulated iron pyrophosphate-fortified fruit juice: a randomised, double-blind, placebo-controlled study in Spanish iron-deficient women.

Science.gov (United States)

Blanco-Rojo, Ruth; Pérez-Granados, Ana M; Toxqui, Laura; González-Vizcayno, Carmen; Delgado, Marco A; Vaquero, M Pilar

2011-06-01

Fe-deficiency anaemia is a worldwide health problem. We studied the influence of consuming an Fe-fortified fruit juice on Fe status in menstruating women. A randomised, double-blind, placebo-controlled study of 16 weeks of duration was performed. Subjects were randomised into two groups: the P group (n 58) or the F group (n 64), and consumed, as a supplement to their usual diet, 500 ml/d of a placebo fruit juice or an Fe-fortified fruit juice, respectively. The Fe-fortified fruit juice, containing microencapsulated iron pyrophosphate, provided 18 mg Fe/d (100 % of the RDA). At baseline and monthly, dietary intake, body weight and Fe parameters were determined: total erythrocytes, haematocrit, mean corpuscular volume (MCV), red blood cell distribution width (RDW), Hb, serum Fe, serum ferritin, serum transferrin, transferrin saturation, soluble transferrin receptor (sTfR) and zinc protoporphyrin (ZnPP). The fruit juice consumption involved increased intake of carbohydrates and vitamin C, and increased BMI within normal limits. Ferritin was higher in the F group after week 4 (P juice improves Fe status and may be used to prevent Fe-deficiency anaemia.

Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial.

Science.gov (United States)

Santos, Jaqueline de O; de Oliveira, Sonia M J V; da Silva, Flora M B; Nobre, Moacyr R C; Osava, Ruth H; Riesco, Maria L G

2012-12-01

To evaluate the effectiveness of a low-level laser therapy for pain relief in the perineum following episiotomy during childbirth. Laser irradiation is a painless and non-invasive therapy for perineal pain treatment and its effects have been investigated in several studies, with no clear conclusion on its effectiveness. A double-blind randomised controlled clinical trial. One hundred and fourteen women who underwent right mediolateral episiotomies during vaginal birth in an in-hospital birthing centre in São Paulo, Brazil and reported pain ≥ 3 on a numeric scale (0-10) were randomised into three groups of 38 women each: two experimental groups (treated with red and infrared laser) and a control group. The experimental groups were treated with laser applied at three points directly on the episiotomy after suturing in a single session between 6-56 hours postpartum. We used a diode laser with wavelengths of 660 nm (red laser) and 780 nm (infrared laser). The control group participants underwent all laser procedures, excluding the emission of irradiation. The participants and the pain scores evaluator were blinded to the type of intervention. The perineal pain scores were assessed at three time points: before, immediately after and 30 minutes after low-level laser therapy. The comparison of perineal pain between the three groups showed no significant differences in the three evaluations (p = 0.445), indicating that the results obtained in the groups treated with low-level laser therapy were equivalent to the control group. Low-level laser therapy did not decrease the intensity of perineal pain reported by women who underwent right mediolateral episiotomy. The effect of laser in perineal pain relief was not demonstrated in this study. The dosage may not have been sufficient to provide relief from perineal pain after episiotomy during a vaginal birth. © 2012 Blackwell Publishing Ltd.

Prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin: a double-blind randomised controlled trial.

Science.gov (United States)

Bellad, M B; Tara, D; Ganachari, M S; Mallapur, M D; Goudar, S S; Kodkany, B S; Sloan, N L; Derman, R

2012-07-01

Sublingual misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum measured blood loss with 400 μg powdered sublingual misoprostol and after standard care using 10 iu intramuscular (IM) oxytocin. Double-blind randomised controlled trial. A teaching hospital: J N Medical College, Belgaum, India. A cohort of 652 consenting eligible pregnant women admitted to the labour room. Subjects were assigned to receive the study medications and placebos within 1 minute of clamping and cutting the cord by computer-generated randomisation. Chi-square and bootstrapped Student's t-tests were used to test categorical and continuous outcomes, respectively. Measured mean postpartum blood loss and haemorrhage (PPH, loss ≥ 500 ml), >10% pre- to post-partum decline in haemoglobin, and reported side effects. The mean blood loss with sublingual misoprostol was 192 ± 124 ml (n=321) and 366 ± 136 ml with oxytocin IM (n=331, P ≤ 0.001). The incidence of PPH was 3.1% with misoprostol and 9.1% with oxytocin (P=0.002). No woman lost ≥ 1000 ml of blood. We observed that 9.7% and 45.6% of women experienced a haemoglobin decline of >10% after receiving misoprostol and oxytocin, respectively (P ≤ 0.001). Side effects were significantly greater in the misoprostol group than in the oxytocin group. Unlike other studies, this trial found sublingual misoprostol more effective than intramuscular oxytocin in reducing PPH, with only transient side effects being greater in the misoprostol group. The sublingual mode and/or powdered formulation may increase the effectiveness of misoprostol, and render it superior to injectable oxytocin for the prevention of PPH. Further research is needed to confirm these results. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Introduction: Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5

Directory of Open Access Journals (Sweden)

S. T. Martin

2016-04-01

Full Text Available The Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5 Experiment was carried out in the environs of Manaus, Brazil, in the central region of the Amazon basin for 2 years from 1 January 2014 through 31 December 2015. The experiment focused on the complex interactions among vegetation, atmospheric chemistry, and aerosol production on the one hand and their connections to aerosols, clouds, and precipitation on the other. The objective was to understand and quantify these linked processes, first under natural conditions to obtain a baseline and second when altered by the effects of human activities. To this end, the pollution plume from the Manaus metropolis, superimposed on the background conditions of the central Amazon basin, served as a natural laboratory. The present paper, as the introduction to the special issue of GoAmazon2014/5, presents the context and motivation of the GoAmazon2014/5 Experiment. The nine research sites, including the characteristics and instrumentation of each site, are presented. The sites range from time point zero (T0 upwind of the pollution, to T1 in the midst of the pollution, to T2 just downwind of the pollution, to T3 furthest downwind of the pollution (70 km. In addition to the ground sites, a low-altitude G-159 Gulfstream I (G-1 observed the atmospheric boundary layer and low clouds, and a high-altitude Gulfstream G550 (HALO operated in the free troposphere. During the 2-year experiment, two Intensive Operating Periods (IOP1 and IOP2 also took place that included additional specialized research instrumentation at the ground sites as well as flights of the two aircraft. GoAmazon2014/5 IOP1 was carried out from 1 February to 31 March 2014 in the wet season. GoAmazon2014/5 IOP2 was conducted from 15 August to 15 October 2014 in the dry season. The G-1 aircraft flew during both IOP1 and IOP2, and the HALO aircraft flew during IOP2. In the context of the Amazon basin, the two IOPs also

Double oral esomeprazole after a 3-day intravenous esomeprazole infusion reduces recurrent peptic ulcer bleeding in high-risk patients: a randomised controlled study.

Science.gov (United States)

Cheng, Hsiu-Chi; Wu, Chung-Tai; Chang, Wei-Lun; Cheng, Wei-Chun; Chen, Wei-Ying; Sheu, Bor-Shyang

2014-12-01

Patients with high Rockall scores have increased risk of ulcer rebleeding after 3-day esomeprazole infusions. To investigate whether double oral esomeprazole given after a 3-day esomeprazole infusion decreases ulcer rebleeding for patients with high Rockall scores. We prospectively enrolled 293 patients with peptic ulcer bleeding who had achieved endoscopic haemostasis. After a 3-day esomeprazole infusion, patients with Rockall scores ≥6 were randomised into the oral double-dose group (n=93) or the oral standard-dose group (n=94) to receive 11 days of oral esomeprazole 40 mg twice daily or once daily, respectively. The patients with Rockall scores peptic ulcer rebleeding. Among patients with Rockall scores ≥6, the oral double-dose group had a higher cumulative rebleeding-free proportion than the oral standard-dose group (p=0.02, log-rank test). The proportion of patients free from recurrent bleeding during the 4th-28th day in the oral double-dose group remained lower than that of the group with Rockall scores peptic ulcer bleeding in high-risk patients with Rockall scores ≥6. NCT01591083. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Programming Amazon EC2

CERN Document Server

Vliet, Jurg

2011-01-01

If you plan to use Amazon Web Services to run applications in the cloud, the end-to-end approach in this book will save you needless trial and error. You'll find practical guidelines for designing and building applications with Amazon Elastic Compute Cloud (EC2) and a host of supporting AWS tools, with a focus on critical issues such as load balancing, monitoring, and automation. How do you move an existing application to AWS, or design your application so that it scales effectively? How much storage will you require? Programming Amazon EC2 not only helps you get started, it will also keep y

The Vine Trust's Amazon Hope boats--providing a dental service on the Amazon.

Science.gov (United States)

Mason, Shona M C

2013-01-01

The Vine Trust's Amazon Hope Project is a medical and dental programme providing healthcare to communities along the Amazon River in Peru. Volunteers from the UK and other countries work alongside Peruvian staff employed by their partner organization, Union Biblica del Peru, to provide a health service from a boat which serves communities on several tributaries who otherwise would have no other access to care. The dental programme involves a basic restorative and extraction service, with scope to develop a preventive programme. Dentists'and DCPs' skills are transferable globally: this article illustrates how one volunteer dental project is working to provide relevant and sustainable dental health care in the Amazon jungle.

Golimumab in patients with active rheumatoid arthritis who have previous experience with tumour necrosis factor inhibitors: results of a long-term extension of the randomised, double-blind, placebo-controlled GO-AFTER study through week 160

NARCIS (Netherlands)

Smolen, Josef S.; Kay, Jonathan; Landewé, Robert B. M.; Matteson, Eric L.; Gaylis, Norman; Wollenhaupt, Jurgen; Murphy, Frederick T.; Zhou, Yiying; Hsia, Elizabeth C.; Doyle, Mittie K.

2012-01-01

The aim of this study was to assess long-term golimumab therapy in patients with rheumatoid arthritis (RA) who discontinued previous tumour necrosis factor alpha (TNFα) inhibitor(s) for any reason. Results through week 24 of this multicentre, randomised, double-blind, placebo-controlled study of

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial.

Science.gov (United States)

le Roux, Carel W; Astrup, Arne; Fujioka, Ken; Greenway, Frank; Lau, David C W; Van Gaal, Luc; Ortiz, Rafael Violante; Wilding, John P H; Skjøth, Trine V; Manning, Linda Shapiro; Pi-Sunyer, Xavier

2017-04-08

Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m 2 , or at least 27 kg/m 2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2·7 times longer with liraglutide than with placebo (95% CI 1·9 to 3·9, pprediabetes. Novo Nordisk, Denmark. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modelling sustainable international tourism demand to the Brazilian Amazon

OpenAIRE

Divino, Jose Angelo; McAleer, Michael

2008-01-01

The Amazon rainforest is one of the world's greatest natural wonders and holds great importance and significance for the world's environmental balance. Around 60% of the Amazon rainforest is located in the Brazilian territory. The two biggest states of the Amazon region are Amazonas (the upper Amazon) and Para (the lower Amazon), which together account for around 73% of the Brazilian Legal Amazon, and are the only states that are serviced by international airports in Brazil's North region. Th...

Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea.

Science.gov (United States)

Money, Mary E; Walkowiak, Jaroslaw; Virgilio, Chris; Talley, Nicholas J

2011-01-01

OBJECTIVE: To evaluate the efficacy of pancrealipase (PEZ) compared with placebo in the reduction of postprandial irritable bowel syndrome-diarrhoea (IBS-D). DESIGN: An intention to treat, double blind, randomised, crossover trial comparing PEZ to placebo for reduction of postprandial IBS-D. Patients had to recognise at least two different triggering foods, be willing to consume six baseline 'trigger meals' and again blinded with PEZ and placebo. Patients then chose which drug they preferred for another 25 meals. SETTING: Outpatient internal medicine practice clinic. PATIENTS: 255 patients were screened; 83 met the criteria, including 5 years of symptoms, recognised 'food triggers', no other identifiable cause for the symptoms, either a normal colonoscopy or barium enema while symptomatic and able to discontinue all anticholinergic medications. 69 patients were enrolled, 20 withdrew before randomisation, leaving 49 patients: 14 men, 35 women, mean age 52 years (SD 15.3). Over 60% had experienced symptoms for 11-30 years and 16% for more than 40 years. INTERVENTIONS: After completing six baseline meals, patients were randomised in blocks of four to receive either identical PEZ or a placebo for another six meals, and after a washout period of time received the alternative drug. MAIN OUTCOME MEASURES: The primary analysis was number of patients who chose PEZ over placebo for the extended use. RESULTS: Overall, 30/49 (61%) would have chosen PEZ (p=0.078), with first drug preference for PEZ at 0.002. Among the PEZ subgroup, PEZ use compared with placebo, demonstrated improvement in all symptoms (p≤0.001) for cramping, bloating, borborygami, urge to defecate, global pain and decrease stooling with increase in stool firmness. CONCLUSIONS: PEZ was found in a small group of patients to reduce postprandial IBS-D symptoms and deserves further evaluation.

Hydrologic resilience and Amazon productivity.

Science.gov (United States)

Ahlström, Anders; Canadell, Josep G; Schurgers, Guy; Wu, Minchao; Berry, Joseph A; Guan, Kaiyu; Jackson, Robert B

2017-08-30

The Amazon rainforest is disproportionately important for global carbon storage and biodiversity. The system couples the atmosphere and land, with moist forest that depends on convection to sustain gross primary productivity and growth. Earth system models that estimate future climate and vegetation show little agreement in Amazon simulations. Here we show that biases in internally generated climate, primarily precipitation, explain most of the uncertainty in Earth system model results; models, empirical data and theory converge when precipitation biases are accounted for. Gross primary productivity, above-ground biomass and tree cover align on a hydrological relationship with a breakpoint at ~2000 mm annual precipitation, where the system transitions between water and radiation limitation of evapotranspiration. The breakpoint appears to be fairly stable in the future, suggesting resilience of the Amazon to climate change. Changes in precipitation and land use are therefore more likely to govern biomass and vegetation structure in Amazonia.Earth system model simulations of future climate in the Amazon show little agreement. Here, the authors show that biases in internally generated climate explain most of this uncertainty and that the balance between water-saturated and water-limited evapotranspiration controls the Amazon resilience to climate change.

Skeletal effects and functional outcome with olpadronate in children with osteogenesis imperfecta: a 2-year randomised placebo-controlled study

NARCIS (Netherlands)

Sakkers, Ralph; Kok, Dieke; Engelbert, Raoul; van Dongen, Alice; Jansen, Maarten; Pruijs, Hans; Verbout, Ab; Schweitzer, Dave; Uiterwaal, Cuno

2004-01-01

Non-randomised studies have suggested beneficial effects of bisphosphonates in osteogenesis imperfecta. We assessed the effects of oral olpadronate in children with this disorder in a randomised double-blind placebo-controlled trial. 34 children recruited from the Dutch national centre for

Recovery of Methane Consumption by Secondary Forests in the Amazon River Basin

Science.gov (United States)

Webster, K. D.; Meredith, L. K.; Piccini, W.; Pedrinho, A.; Nüsslein, K.; Van Haren, J. L. M.; Camargo, P. B. D.; Mui, T. S.; Saleska, S. R.

2017-12-01

Methane (CH4) is a major greenhouse gas in Earth's atmosphere and its atmospheric global mole fraction has roughly doubled since the start of the industrial revolution. The tropics are thought to be a major CH4 emitter, with the Amazon River Basin estimated to contribute 7 % of the annual flux to the atmosphere. The Amazon has experienced extensive land use change during the past 30 years, but we lack an understanding of the qualitative and quantitative effects of land use change on CH4 flux from the Amazon and the associated reasons. To illuminate the factors controlling CH4 flux across land use gradients in the Amazon we measured the CH4 fluxes and will measure the associated stable isotopic composition from pastures, primary forests, and secondary forests, at Ariquemes (Western Amazon, more deforested), and Santarem (Eastern Amazon, less deforested), Brazil. The sites near Santarem were sampled in June of 2016 and the sites near Ariquemes were sampled in March and April of 2017, both at the end of the wet season. Little difference was observed between land use types in Santarem with each land use type slightly consuming atmospheric CH4. However, pasture fluxes at Ariquemes were higher (+520 μg-C m-2 hr-1) than in primary (0 μg-C m-2 hr-1) and secondary forests (-20 μg-C m-2 hr-1; p = 6*10-4). CH4 flux from individual Santarem sites was not correlated with environmental variables. CH4 flux from Airquemes was correlated with several parameters across all samples including soil temperature (p = 7*10-4), and soil humidity (p = 0.02). Despite the fact that pastures experienced higher soil temperatures than forest soils this appears to be a low predictor of CH4 flux from these environments as it was seen at both Santarem and Ariquemes. The analysis of the stable isotopic composition of CH4 from these chambers will aid in understanding the competing processes of microbial CH4 consumption and production in these soils and why pastures may become CH4 sources and

Carbon uptake by mature Amazon forests has mitigated Amazon nations' carbon emissions.

Science.gov (United States)

Phillips, Oliver L; Brienen, Roel J W

2017-12-01

Several independent lines of evidence suggest that Amazon forests have provided a significant carbon sink service, and also that the Amazon carbon sink in intact, mature forests may now be threatened as a result of different processes. There has however been no work done to quantify non-land-use-change forest carbon fluxes on a national basis within Amazonia, or to place these national fluxes and their possible changes in the context of the major anthropogenic carbon fluxes in the region. Here we present a first attempt to interpret results from ground-based monitoring of mature forest carbon fluxes in a biogeographically, politically, and temporally differentiated way. Specifically, using results from a large long-term network of forest plots, we estimate the Amazon biomass carbon balance over the last three decades for the different regions and nine nations of Amazonia, and evaluate the magnitude and trajectory of these differentiated balances in relation to major national anthropogenic carbon emissions. The sink of carbon into mature forests has been remarkably geographically ubiquitous across Amazonia, being substantial and persistent in each of the five biogeographic regions within Amazonia. Between 1980 and 2010, it has more than mitigated the fossil fuel emissions of every single national economy, except that of Venezuela. For most nations (Bolivia, Colombia, Ecuador, French Guiana, Guyana, Peru, Suriname) the sink has probably additionally mitigated all anthropogenic carbon emissions due to Amazon deforestation and other land use change. While the sink has weakened in some regions since 2000, our analysis suggests that Amazon nations which are able to conserve large areas of natural and semi-natural landscape still contribute globally-significant carbon sequestration. Mature forests across all of Amazonia have contributed significantly to mitigating climate change for decades. Yet Amazon nations have not directly benefited from providing this global scale

How many more dams in the Amazon?

International Nuclear Information System (INIS)

Tundisi, J.G.; Goldemberg, J.; Matsumura-Tundisi, T.; Saraiva, A.C.F.

2014-01-01

The Amazon watershed harbors a megadiversity of terrestrial and aquatic plants and animals. Mechanisms that sustain this biodiversity are the water level fluctuations the fluvial dynamics and the intense gene flux due to permanent integration of climatological, geomorphological and biological components of the system. The construction of hydroelectric reservoirs to support economic development of Brazil and other countries that share the Amazon basin will interfere with the ecological dynamics of this ecosystem changing the hydrological, hydrosocial and fundamental processes. Furthermore the construction of Andean reservoirs can disrupt the connectivity with the lower Amazon ecosystem. Principles of ecohydrologies, ecological engineering and preservation of key river basins, have to be applied in order to optimize energy production and promote conservation practices. Long term planning and integration of countries that share the Amazon basin is a strategic decision to control and develop the hydropower exploitation in the region. - Highlights: • The Amazon basin is an ecosystem of megadiversity. • The demand for energy threatens this ecosystem. • Climate, water, forests and floodplain interacts in the Amazon basin. • Dams in the Amazon basin will impact the hydrological and biological systems. • Ecohydrological principles and ecological engineering technology are necessary

DNA double-strand breaks as potential indicators for the biological effects of ionising radiation exposure from cardiac CT and conventional coronary angiography: a randomised, controlled study

Energy Technology Data Exchange (ETDEWEB)

Geisel, Dominik; Zimmermann, Elke; Rief, Matthias; Greupner, Johannes; Hamm, Bernd [Charite Medical School, Department of Radiology, Berlin (Germany); Laule, Michael; Knebel, Fabian [Charite Medical School, Department of Cardiology, Berlin (Germany); Dewey, Marc [Charite Medical School, Department of Radiology, Berlin (Germany); Charite, Institut fuer Radiologie, Berlin (Germany)

2012-08-15

To prospectively compare induced DNA double-strand breaks by cardiac computed tomography (CT) and conventional coronary angiography (CCA). 56 patients with suspected coronary artery disease were randomised to undergo either CCA or cardiac CT. DNA double-strand breaks were assessed in fluorescence microscopy of blood lymphocytes as indicators of the biological effects of radiation exposure. Radiation doses were estimated using dose-length product (DLP) and dose-area product (DAP) with conversion factors for CT and CCA, respectively. On average there were 0.12 {+-} 0.06 induced double-strand breaks per lymphocyte for CT and 0.29 {+-} 0.18 for diagnostic CCA (P < 0.001). This relative biological effect of ionising radiation from CCA was 1.9 times higher (P < 0.001) than the effective dose estimated by conversion factors would have suggested. The correlation between the biological effects and the estimated radiation doses was excellent for CT (r = 0.951, P < 0.001) and moderate to good for CCA (r = 0.862, P < 0.001). One day after radiation, a complete repair of double-strand breaks to background levels was found in both groups. Conversion factors may underestimate the relative biological effects of ionising radiation from CCA. DNA double-strand break assessment may provide a strategy for individualised assessments of radiation. (orig.)

Deforestation in the Brazilian Amazon

NARCIS (Netherlands)

Boekhout van Solinge, T.|info:eu-repo/dai/nl/156696207

2015-01-01

This essay takes a (green) criminological and multidisciplinary perspective on deforestation in the Brazilian Amazon, by focusing on the crimes and damages that are associated with Amazonian deforestation. The analysis and results are partly based on longer ethnographic stays in North Brazil (Amazon

Role of oral tramadol 50 mg in reducing pain associated with outpatient hysteroscopy: A randomised double-blind placebo-controlled trial.

Science.gov (United States)

Hassan, AbdelGany; Haggag, Hisham

2016-02-01

Several drugs have been used to reduce hysteroscopy-associated pain. Although the Royal College of Obstetricians and Gynaecologists has recommended against the use of opiates in outpatient hysteroscopy, we wished to investigate if opioids can be used if the appropriate opioid was given in the appropriate dose. To study the effectiveness of tramadol 50 mg in reducing pain associated with outpatient hysteroscopy. A prospective randomised double-blind placebo-controlled trial conducted in the outpatient hysteroscopy clinic at Cairo University Hospital. Main outcome measures were the severity of pain during the procedure, immediately after the procedure and 30 minutes later assessed by a visual analogue scale (VAS). VAS of 0 indicates no pain and VAS of 10 indicates the worst possible pain. A total of 140 women who had diagnostic outpatient hysteroscopy were randomised to receive oral tramadol 50 mg or placebo one h before performing outpatient hysteroscopy. There was no difference between the groups in the age, parity, duration of the procedures or indications of hysteroscopy. The median pain score was significantly lower in the tramadol group during the procedure (5 vs 6; P = 0.013), immediately after the procedure (3 vs 4; P pain evoked by the procedure and the drug was well tolerated by women. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Socio-ecological costs of Amazon nut and timber production at community household forests in the Bolivian Amazon.

Science.gov (United States)

Soriano, Marlene; Mohren, Frits; Ascarrunz, Nataly; Dressler, Wolfram; Peña-Claros, Marielos

2017-01-01

The Bolivian Amazon holds a complex configuration of people and forested landscapes in which communities hold secure tenure rights over a rich ecosystem offering a range of livelihood income opportunities. A large share of this income is derived from Amazon nut (Bertholletia excelsa). Many communities also have long-standing experience with community timber management plans. However, livelihood needs and desires for better living conditions may continue to place these resources under considerable stress as income needs and opportunities intensify and diversify. We aim to identify the socioeconomic and biophysical factors determining the income from forests, husbandry, off-farm and two keystone forest products (i.e., Amazon nut and timber) in the Bolivian Amazon region. We used structural equation modelling tools to account for the complex inter-relationships between socioeconomic and biophysical factors in predicting each source of income. The potential exists to increase incomes from existing livelihood activities in ways that reduce dependency upon forest resources. For example, changes in off-farm income sources can act to increase or decrease forest incomes. Market accessibility, social, financial, and natural and physical assets determined the amount of income community households could derive from Amazon nut and timber. Factors related to community households' local ecological knowledge, such as the number of non-timber forest products harvested and the number of management practices applied to enhance Amazon nut production, defined the amount of income these households could derive from Amazon nut and timber, respectively. The (inter) relationships found among socioeconomic and biophysical factors over income shed light on ways to improve forest-dependent livelihoods in the Bolivian Amazon. We believe that our analysis could be applicable to other contexts throughout the tropics as well.

AMAZON HADOOP FRAMEWORK USED IN BUSINESS FOR BIG DATA ANALYSIS

OpenAIRE

Ankush Verma*, Dr Neelesh Jain

2017-01-01

The Amazon MapReduce programming model, introduced by Amazon, a simple and efficient way of performing distributed computation over large data sets on the web especially for e-commerce. Amazon EMR work on Master/Slave Architecture using Amazon EMR for map and reduce big data. Amazon EC2 use cloud computing is a central part of designed web service that provides resizable compute capacity in the cloud. Here we also discuss about the Benefit and limitation of using Amazon EMR. Amazon S3 use eas...

Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomised, double blind, placebo-controlled clinical study.

Science.gov (United States)

Stracke, H; Gaus, W; Achenbach, U; Federlin, K; Bretzel, R G

2008-11-01

Efficacy and safety of benfotiamine in treatment of diabetic polyneuropathy. Double blind, placebo-controlled, phase-III-study. 181 patients were screened. 165 patients with symmetrical, distal diabetic polyneuropathy were randomised to one of three treatment groups entering the wash-out phase and 133/124 patients were analysed in the ITT/PP analysis: Benfotiamine 600 mg per day (n=47/43), benfotiamine 300 mg per day (n=45/42) or placebo (n=41/39). After 6 weeks of treatment, the primary outcome parameter NSS (Neuropathy Symptom Score) differed significantly between the treatment groups (p=0.033) in the PP (per protocol) population. In the ITT (intention to treat) population, the improvement of NSS was slightly above significance (p=0.055). The TSS (Total Symptom Score) showed no significant differences after 6 weeks of treatment. The improvement was more pronounced at the higher benfotiamine dose and increased with treatment duration. In the TSS, best results were obtained for the symptom "pain". Treatment was well tolerated in all groups. Benfotiamine may extend the treatment option for patients with diabetic polyneuropathy based on causal influence on impaired glucose metabolism. Further studies should confirm the positive experiences.

MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study.

Science.gov (United States)

Tourbah, Ayman; Lebrun-Frenay, Christine; Edan, Gilles; Clanet, Michel; Papeix, Caroline; Vukusic, Sandra; De Sèze, Jerome; Debouverie, Marc; Gout, Olivier; Clavelou, Pierre; Defer, Gilles; Laplaud, David-Axel; Moreau, Thibault; Labauge, Pierre; Brochet, Bruno; Sedel, Frédéric; Pelletier, Jean

2016-11-01

Treatment with MD1003 (high-dose biotin) showed promising results in progressive multiple sclerosis (MS) in a pilot open-label study. To confirm the efficacy and safety of MD1003 in progressive MS in a double-blind, placebo-controlled study. Patients (n = 154) with a baseline Expanded Disability Status Scale (EDSS) score of 4.5-7 and evidence of disease worsening within the previous 2 years were randomised to 12-month MD1003 (100 mg biotin) or placebo thrice daily, followed by 12-month MD1003 for all patients. The primary endpoint was the proportion of patients with disability reversal at month 9, confirmed at month 12, defined as an EDSS decrease of ⩾1 point (⩾0.5 for EDSS 6-7) or a ⩾20% decrease in timed 25-foot walk time compared with the best baseline among screening or randomisation visits. A total of 13 (12.6%) MD1003-treated patients achieved the primary endpoint versus none of the placebo-treated patients (p = 0.005). MD1003 treatment also reduced EDSS progression and improved clinical impression of change compared with placebo. Efficacy was maintained over follow-up, and the safety profile of MD1003 was similar to that of placebo. MD1003 achieves sustained reversal of MS-related disability in a subset of patients with progressive MS and is well tolerated. © The Author(s), 2016.

Amazon: Is Profitability a Possibility?

Directory of Open Access Journals (Sweden)

Brett DENNIS

2014-06-01

Full Text Available In today’s society, companies seem to all be following the same trend; growth in profitability at all cost. Higher profits, for the most part, leads to more investors and more potential financing. Amazon.com appears to be breaking that trend, however. Their strategy seems to be growth, but not in profits. We would like to look into how and why Amazon is growing at such a fast pace, while their profits are staying steady at a very low level. Is profitability a possibility for Amazon? We believe that a marginal increase in price could accomplish just that, with a minimal impact to consumers.

Amazon Web Services- a Case Study

OpenAIRE

Narendula, Rammohan

2012-01-01

The Amazon Web Services (AWS) is a set (more than 25) of proprietary web-based services owned by Amazon.com. All these services ranging from simple storage to sophisticated database services constitute the cloud platform oered by Amazon. An extensive list of customers for AWS include Dropbox, UniLever, Airbnb, Nasdaq, Netflix. As of 2007, there are more than 300K developers actively using AWS. It is one of the pioneers which brought the cloud computing closer to masses helping number of start...

Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

Science.gov (United States)

Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

2013-01-01

Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

Use of ChAd3-EBO-Z Ebola virus vaccine in Malian and US adults, and boosting of Malian adults with MVA-BN-Filo: a phase 1, single-blind, randomised trial, a phase 1b, open-label and double-blind, dose-escalation trial, and a nested, randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Tapia, Milagritos D; Sow, Samba O; Lyke, Kirsten E; Haidara, Fadima Cheick; Diallo, Fatoumata; Doumbia, Moussa; Traore, Awa; Coulibaly, Flanon; Kodio, Mamoudou; Onwuchekwa, Uma; Sztein, Marcelo B; Wahid, Rezwanul; Campbell, James D; Kieny, Marie-Paule; Moorthy, Vasee; Imoukhuede, Egeruan B; Rampling, Tommy; Roman, Francois; De Ryck, Iris; Bellamy, Abbie R; Dally, Len; Mbaya, Olivier Tshiani; Ploquin, Aurélie; Zhou, Yan; Stanley, Daphne A; Bailer, Robert; Koup, Richard A; Roederer, Mario; Ledgerwood, Julie; Hill, Adrian V S; Ballou, W Ripley; Sullivan, Nancy; Graham, Barney; Levine, Myron M

2016-01-01

The 2014 west African Zaire Ebola virus epidemic prompted worldwide partners to accelerate clinical development of replication-defective chimpanzee adenovirus 3 vector vaccine expressing Zaire Ebola virus glycoprotein (ChAd3-EBO-Z). We aimed to investigate the safety, tolerability, and immunogenicity of ChAd3-EBO-Z in Malian and US adults, and assess the effect of boosting of Malians with modified vaccinia Ankara expressing Zaire Ebola virus glycoprotein and other filovirus antigens (MVA-BN-Filo). In the phase 1, single-blind, randomised trial of ChAd3-EBO-Z in the USA, we recruited adults aged 18-65 years from the University of Maryland medical community and the Baltimore community. In the phase 1b, open-label and double-blind, dose-escalation trial of ChAd3-EBO-Z in Mali, we recruited adults 18-50 years of age from six hospitals and health centres in Bamako (Mali), some of whom were also eligible for a nested, randomised, double-blind, placebo-controlled trial of MVA-BN-Filo. For randomised segments of the Malian trial and for the US trial, we randomly allocated participants (1:1; block size of six [Malian] or four [US]; ARB produced computer-generated randomisation lists; clinical staff did randomisation) to different single doses of intramuscular immunisation with ChAd3-EBO-Z: Malians received 1 × 10(10) viral particle units (pu), 2·5 × 10(10) pu, 5 × 10(10) pu, or 1 × 10(11) pu; US participants received 1 × 10(10) pu or 1 × 10(11) pu. We randomly allocated Malians in the nested trial (1:1) to receive a single dose of 2 × 10(8) plaque-forming units of MVA-BN-Filo or saline placebo. In the double-blind segments of the Malian trial, investigators, clinical staff, participants, and immunology laboratory staff were masked, but the study pharmacist (MK), vaccine administrator, and study statistician (ARB) were unmasked. In the US trial, investigators were not masked, but participants were. Analyses were per protocol. The primary outcome was safety, measured

Amazon Fund: financing deforestation avoidance

Directory of Open Access Journals (Sweden)

Jacques Marcovitch

2014-06-01

Full Text Available The Amazon Fund, created in 2008 by the Brazilian Federal Government, is managed by Banco Nacional de Desenvolvimento Econômico e Social (BNDES. It is a pioneering initiative to fundraise and manage financial resources to cut back deforestation and support sustainable development for 30 million inhabitants in the Amazon Biome. The Amazon Fund has already received more than R$ 1.7 billion in grants (about USD 787 million. This essay analyzes the Amazon Fund's governance and management with focus on its operation and from its stakeholders' perspectives. A combination of research methods includes: documental research, in-depth interviews, and speech analysis. The study offers a comparative analysis of strengths and weaknesses related to its governance. Furthermore, it proposes ways to improve its management towards greater effectiveness. The essay also includes an assessment of the government of Norway, a major donor to the fund. The governments of Norway and Germany, in partnership with Brazil, reveal how important it is to experiment with new means of international cooperation to successfully reduce greenhouse gas emissions through rainforest preservation.

Effect of nitrous oxide on pain due to rocuronium injection: A randomised, double-blind, controlled clinical trial

Directory of Open Access Journals (Sweden)

Sonal Sharma

2010-01-01

Full Text Available A prospective, randomised, double-blind, placebo-controlled study was carried out to determine the effect of nitrous oxide (N 2 O on the frequency and severity of pain and withdrawal reactions after injection of rocuronium. Eighty ASA physical status I and II patients undergoing general anaesthesia for elective surgery were enrolled. The patients were randomised to receive 100% oxygen (O 2 , or 50% N 2 O in O 2 for 3 minutes followed by a subparalysing dose of rocuronium 0.06 mg/kg. After induction of anaesthesia with thiopentone 5 mg/kg, an intubating dose of rocuronium 0.6 mg/kg was given. The patients were observed after injection of rocuronium 0.06 mg/kg, and asked to rate pain in the arm on a 4-point (0-3 verbal rating scale (none, mild, moderate or severe. After the intubating dose of rocuronium, withdrawal reactions were recorded. Thirty-six patients (90% in the group N 2 O and 15 patients (37.5% in the group O 2 reported no pain (P < 0.001. The pain was mild in 1 (2.5% and 9 (22.5% patients in N 2 O and O 2 groups, respectively (P = 0.006. Moderate pain occurred in 2 (5% patients in group N 2 O and 15 (37.5% patients in group O 2 (P = 0.001. Severe pain was reported by one patient in each group (P = 0.47. Withdrawal response after an intubating dose of rocuronium was observed in 6 (15% and 18 (45% patients in the N 2 O and O 2 groups, respectively (P < 0.05. Inhalation of 50% N 2 O in O 2 reduces the incidence and severity of pain and the withdrawal reactions associated with rocuronium injection.

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial.

Science.gov (United States)

Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

2004-11-01

Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. After faecal disimpaction, patients PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.

Clonidine versus sufentanil as an adjuvant to ropivacaine in patient-controlled epidural labour analgesia: A randomised double-blind trial.

Science.gov (United States)

Roelants, Fabienne; Lavand'homme, Patricia

2015-11-01

Adjuvants to local anaesthetics for epidural labour analgesia are useful if they reduce side-effects or personnel requirements. Epidural clonidine improves analgesia and provides a significant local anaesthetic-sparing effect. To compare the number of rescue doses administered by the anaesthesiologist when clonidine or sufentanil is added to epidural ropivacaine. A randomised double-blind trial. Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, from June 2009 to June 2010. One hundred and ninety-five women in labour. Epidural analgesia initiated with 10 ml ropivacaine 0.1%, women randomised to receive patient-controlled epidural analgesia (5 ml demand bolus, 15 min lockout) with ropivacaine 0.1% and sufentanil 0.25 μg ml⁻¹ (RS group; n = 65), or ropivacaine 0.1% and clonidine 1.5 μg ml⁻¹ (RC1.5 group; n = 65) or ropivacaine 0.1% and clonidine 3 μg ml⁻¹ (RC3 group; n = 65). Rescue analgesia was available as needed – 10 ml ropivacaine 0.1% (numerical rating scale neonatal outcomes were similar among the groups. Compared with sufentanil 0.25 μg ml⁻¹, addition of clonidine (1.5 to 3 μg ml⁻¹) to patient-controlled epidural analgesia with ropivacaine 0.1% provided similar labour analgesia and a similar need for anaesthesiologist-administered rescue doses. Clonidine 3 μg ml⁻¹ did not offer any advantage over clonidine 1.5 μg ml⁻¹. The instrumentation rate was higher in both the clonidine groups.

Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Raman, Subha V; Hor, Kan N; Mazur, Wojciech; Halnon, Nancy J; Kissel, John T; He, Xin; Tran, Tam; Smart, Suzanne; McCarthy, Beth; Taylor, Michael D; Jefferies, John L; Rafael-Fortney, Jill A; Lowe, Jeovanna; Roble, Sharon L; Cripe, Linda H

2015-02-01

Cardiomyopathy is a leading cause of death in patients with Duchenne muscular dystrophy and myocardial damage precedes decline in left ventricular systolic function. We tested the efficacy of eplerenone on top of background therapy in patients with Duchenne muscular dystrophy with early myocardial disease. In this randomised, double-blind, placebo-controlled trial, boys from three centres in the USA aged 7 years or older with Duchenne muscular dystrophy, myocardial damage by late gadolinium enhancement cardiac MRI and preserved ejection fraction received either eplerenone 25 mg or placebo orally, every other day for the first month and once daily thereafter, in addition to background clinician-directed therapy with either angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB). Computer-generated randomisation was done centrally using block sizes of four and six, and only the study statistician and the investigational pharmacy had the preset randomisation assignments. The primary outcome was change in left ventricular circumferential strain (Ecc) at 12 months, a measure of contractile dysfunction. Safety was established through serial serum potassium levels and measurement of cystatin C, a non-creatinine measure of kidney function. This trial is registered with ClinicalTrials.gov, number NCT01521546. Between Jan 26, 2012, and July 3, 2013, 188 boys were screened and 42 were enrolled. 20 were randomly assigned to receive eplerenone and 22 to receive placebo, of whom 20 in the eplerenone group and 20 in the placebo group completed baseline, 6-month, and 12-month visits. After 12 months, decline in left ventricular circumferential strain was less in those who received eplerenone than in those who received placebo (median ΔEcc 1·0 [IQR 0·3-2·2] vs 2·2 [1·3-3·1]; p=0·020). Cystatin C concentrations remained normal in both groups, and all non-haemolysed blood samples showed normal potassium concentrations. One 23-year-old patient in

Total hip arthroplasty and perioperative oral carbohydrate treatment: a randomised, double-blind, controlled trial.

Science.gov (United States)

Harsten, Andreas; Hjartarson, Hjörtur; Toksvig-Larsen, Sören

2012-06-01

Perioperative oral carbohydrate intake is beneficial to general surgery patients. Total hip arthroplasty is a common surgical procedure, and even a moderate improvement in patient outcome could have a significant effect on the resources needed for these patients. However, few studies have focused on the effects of carbohydrate intake on orthopaedic patients. The purpose of this study was to investigate if perioperative oral carbohydrate intake alters the postoperative course for patients undergoing total hip arthroplasty. The primary hypothesis was that pain scores would be lower in patients treated with carbohydrate. A randomised, double-blind, controlled trial. This study was carried out between September 2009 and April 2011 at a district Swedish hospital that specialises in orthopaedic surgery. Sixty ASA physical status I-III patients scheduled for elective total hip arthroplasty were included. Exclusion criteria were obesity, diabetes, prior hip surgery to the same hip, ongoing infection, immunological deficiency or age less than 50 or more than 80 years. Patients were given 400 ml of either an oral 12.5% carbohydrate solution or a placebo beverage (flavoured water) 1.5 h before and 2 h after surgery. Visual analogue scales were used to score six discomfort parameters. Immediately prior to surgery, the carbohydrate-treated patients were less hungry (median score 9.5 vs. 22 mm) and experienced less nausea (0 vs. 1.5 mm) (Phip arthroplasty.

Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion

DEFF Research Database (Denmark)

Secher, Niels Jørgen; MaCormack, CD; Weber, Tom

2007-01-01

Kingdom, Spain, South Africa, Australia and India. This gives both a broad spectrum of diversity global and local. We expect a total of 242 women enrolled per year. POPULATION: Prophylactic study: 1. History of cervical incompetence/insufficiency. (Delivery 15 to ..., without the membranes being exposed to the vagina. 6. Tertiary cerclage: Short cervix, membranes exposed to the vagina. Observational study: Eligible women who refuse to be randomised will participate in an observational study. 7. Repeat/requested cervical occlusion. METHODS: The women will be randomised...... between a single (vaginal or abdominal) and a double cerclage. The cervical cerclage (McDonald or Shirodkar) as well as the abdominal suture will be performed with the same material and technique normally used by the participating department. Those randomised to the double cerclage will have...

Vulnerability of Amazon forests to storm-driven tree mortality

Science.gov (United States)

Negrón-Juárez, Robinson I.; Holm, Jennifer A.; Magnabosco Marra, Daniel; Rifai, Sami W.; Riley, William J.; Chambers, Jeffrey Q.; Koven, Charles D.; Knox, Ryan G.; McGroddy, Megan E.; Di Vittorio, Alan V.; Urquiza-Muñoz, Jose; Tello-Espinoza, Rodil; Alegria Muñoz, Waldemar; Ribeiro, Gabriel H. P. M.; Higuchi, Niro

2018-05-01

Tree mortality is a key driver of forest community composition and carbon dynamics. Strong winds associated with severe convective storms are dominant natural drivers of tree mortality in the Amazon. Why forests vary with respect to their vulnerability to wind events and how the predicted increase in storm events might affect forest ecosystems within the Amazon are not well understood. We found that windthrows are common in the Amazon region extending from northwest (Peru, Colombia, Venezuela, and west Brazil) to central Brazil, with the highest occurrence of windthrows in the northwest Amazon. More frequent winds, produced by more frequent severe convective systems, in combination with well-known processes that limit the anchoring of trees in the soil, help to explain the higher vulnerability of the northwest Amazon forests to winds. Projected increases in the frequency and intensity of convective storms in the Amazon have the potential to increase wind-related tree mortality. A forest demographic model calibrated for the northwestern and the central Amazon showed that northwestern forests are more resilient to increased wind-related tree mortality than forests in the central Amazon. Our study emphasizes the importance of including wind-related tree mortality in model simulations for reliable predictions of the future of tropical forests and their effects on the Earth’ system.

Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Page, Valerie J; Ely, E Wesley; Gates, Simon; Zhao, Xiao Bei; Alce, Timothy; Shintani, Ayumi; Jackson, Jim; Perkins, Gavin D; McAuley, Daniel F

2013-09-01

Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or coma. We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 h of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2.5 mg or 0.9% saline placebo intravenously every 8 h, irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days of treatment, whichever came first. Delirium was assessed using the confusion assessment method for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14 day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p=0

Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China.

Science.gov (United States)

Sun, J; Yang, C; Zhao, H; Zheng, P; Wilkinson, J; Ng, B; Yuan, Y

2015-10-01

There is a paucity of large-scale studies evaluating the clinical benefit of the Gaviscon Double Action (DA) alginate-antacid formulation for treating gastroesophageal reflux disease (GERD) symptoms. Randomised double-blind placebo-controlled parallel-group study to evaluate efficacy and safety of Gaviscon DA in reducing heartburn, regurgitation and dyspepsia symptoms in individuals with mild-to-moderate GERD in China. Participants with symptomatic GERD (n = 1107) were randomised to receive Gaviscon DA or placebo (two tablets four times daily) for seven consecutive days. The primary endpoint compared the change in Reflux Disease Questionnaire (RDQ) score for the GERD (heartburn + regurgitation) dimension between Gaviscon DA and placebo. Secondary endpoints compared the change in RDQ scores for individual heartburn, regurgitation and dyspepsia dimensions, overall treatment evaluation (OTE) scores and incidence of adverse events (AEs). Mean RDQ GERD scores: 2.51 for Gaviscon DA and 2.50 for placebo at baseline; 1.25 for Gaviscon DA and 1.46 for placebo post treatment. Gaviscon DA was statistically superior to placebo in reducing GERD and dyspepsia RDQ scores [least-squares mean (LSM) difference: GERD -0.21, P GERD symptoms was observed both in those with non-erosive and those with erosive reflux disease (LSM difference -0.14 [P = 0.038] and -0.29 [P GERD. ClinicalTrials.gov: NCT01869491. © 2015 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.

Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial.

Science.gov (United States)

Jacobs, Ian G; Finn, Judith C; Jelinek, George A; Oxer, Harry F; Thompson, Peter L

2011-09-01

There is little evidence from clinical trials that the use of adrenaline (epinephrine) in treating cardiac arrest improves survival, despite adrenaline being considered standard of care for many decades. The aim of our study was to determine the effect of adrenaline on patient survival to hospital discharge in out of hospital cardiac arrest. We conducted a double blind randomised placebo-controlled trial of adrenaline in out-of-hospital cardiac arrest. Identical study vials containing either adrenaline 1:1000 or placebo (sodium chloride 0.9%) were prepared. Patients were randomly allocated to receive 1 ml aliquots of the trial drug according to current advanced life support guidelines. Outcomes assessed included survival to hospital discharge (primary outcome), pre-hospital return of spontaneous circulation (ROSC) and neurological outcome (Cerebral Performance Category Score - CPC). A total of 4103 cardiac arrests were screened during the study period of which 601 underwent randomisation. Documentation was available for a total of 534 patients: 262 in the placebo group and 272 in the adrenaline group. Groups were well matched for baseline characteristics including age, gender and receiving bystander CPR. ROSC occurred in 22 (8.4%) of patients receiving placebo and 64 (23.5%) who received adrenaline (OR=3.4; 95% CI 2.0-5.6). Survival to hospital discharge occurred in 5 (1.9%) and 11 (4.0%) patients receiving placebo or adrenaline respectively (OR=2.2; 95% CI 0.7-6.3). All but two patients (both in the adrenaline group) had a CPC score of 1-2. Patients receiving adrenaline during cardiac arrest had no statistically significant improvement in the primary outcome of survival to hospital discharge although there was a significantly improved likelihood of achieving ROSC. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Causes and impacts of the 2005 Amazon drought

International Nuclear Information System (INIS)

Zeng Ning; Yoon, Jin-Ho; Marengo, Jose A; Nobre, Carlos A; Subramaniam, Ajit; Mariotti, Annarita; Neelin, J David

2008-01-01

A rare drought in the Amazon culminated in 2005, leading to near record-low streamflows, small Amazon river plume, and greatly enhanced fire frequency. This episode was caused by the combination of 2002-03 El Nino and a dry spell in 2005 attributable to a warm subtropical North Atlantic Ocean. Analysis for 1979-2005 reveals that the Atlantic influence is comparable to the better-known Pacific linkage. While the Pacific influence is typically locked to the wet season, the 2005 Atlantic impact concentrated in the Amazon dry season when its hydroecosystem is most vulnerable. Such mechanisms may have wide-ranging implications for the future of the Amazon rainforest

Amazon Forests Response to Droughts: A Perspective from the MAIAC Product

Science.gov (United States)

Bi, Jian; Myneni, Ranga; Lyapustin, Alexei; Wang, Yujie; Park, Taejin; Chi, Chen; Yan, Kai; Knyazikhin, Yuri

2016-01-01

Amazon forests experienced two severe droughts at the beginning of the 21st century: one in 2005 and the other in 2010. How Amazon forests responded to these droughts is critical for the future of the Earth's climate system. It is only possible to assess Amazon forests' response to the droughts in large areal extent through satellite remote sensing. Here, we used the Multi-Angle Implementation of Atmospheric Correction (MAIAC) Moderate Resolution Imaging Spectroradiometer (MODIS) vegetation index (VI) data to assess Amazon forests' response to droughts, and compared the results with those from the standard (Collection 5 and Collection 6) MODIS VI data. Overall, the MAIAC data reveal more realistic Amazon forests inter-annual greenness dynamics than the standard MODIS data. Our results from the MAIAC data suggest that: (1) the droughts decreased the greenness (i.e., photosynthetic activity) of Amazon forests; (2) the Amazon wet season precipitation reduction induced by El Niño events could also lead to reduced photosynthetic activity of Amazon forests; and (3) in the subsequent year after the water stresses, the greenness of Amazon forests recovered from the preceding decreases. However, as previous research shows droughts cause Amazon forests to reduce investment in tissue maintenance and defense, it is not clear whether the photosynthesis of Amazon forests will continue to recover after future water stresses, because of the accumulated damages caused by the droughts.

Axitinib with or without dose titration for first-line metastatic renal-cell carcinoma: a randomised double-blind phase 2 trial.

Science.gov (United States)

Rini, Brian I; Melichar, Bohuslav; Ueda, Takeshi; Grünwald, Viktor; Fishman, Mayer N; Arranz, José A; Bair, Angel H; Pithavala, Yazdi K; Andrews, Glen I; Pavlov, Dmitri; Kim, Sinil; Jonasch, Eric

2013-11-01

Population pharmacokinetic data suggest axitinib plasma exposure correlates with efficacy in metastatic renal-cell carcinoma. Axitinib dose titration might optimise exposure and improve outcomes. We prospectively assessed the efficacy and safety of axitinib dose titration in previously untreated patients with metastatic renal-cell carcinoma. In this randomised, double-blind, multicentre, phase 2 study, patients were enrolled from 49 hospitals and outpatient clinics in the Czech Republic, Germany, Japan, Russia, Spain, and USA. Patients with treatment-naive metastatic renal-cell carcinoma received axitinib 5 mg twice daily during a 4 week lead-in period. Those patients with blood pressure 150/90 mm Hg or lower, no grade 3 or 4 treatment-related toxic effects, no dose reductions, and no more than two antihypertensive drugs for 2 consecutive weeks were stratified by Eastern Cooperative Oncology Group performance status (0 vs 1), and then randomly assigned (1:1) to either masked titration with axitinib to total twice daily doses of 7 mg, and then 10 mg, if tolerated, or placebo titration. Patients who did not meet these criteria continued without titration. The primary objective was comparison of the proportion of patients achieving an objective response between randomised groups. Safety analyses were based on all patients who received at least one dose of axitinib. Between Sept 2, 2009, and Feb 28, 2011, we enrolled 213 patients, of whom 112 were randomly assigned to either the axitinib titration group (56 patients) or the placebo titration group (56 patients). 91 were not eligible for titration, and ten withdrew during the lead-in period. 30 patients (54%, 95% CI 40-67) in the axitinib titration group had an objective response, as did 19 patients (34%, 22-48]) in the placebo titration group (one-sided p=0·019). 54 (59%, 95% CI 49-70) of non-randomised patients achieved an objective response. Common grade 3 or worse, all-causality adverse events in treated patients

Axitinib with or without dose titration for first-line metastatic renal-cell carcinoma: a randomised double-blind phase 2 trial

Science.gov (United States)

Rini, Brian I; Melichar, Bohuslav; Ueda, Takeshi; GrÜnwald, Viktor; Fishman, Mayer N; Arranz, José A; Bair, Angel H; Pithavala, Yazdi K; Andrews, Glen I; Pavlov, Dmitri; Kim, Sinil; Jonasch, Eric

2014-01-01

Summary Background Population pharmacokinetic data suggest axitinib plasma exposure correlates with efficacy in metastatic renal-cell carcinoma. Axitinib dose titration might optimise exposure and improve outcomes. We prospectively assessed the efficacy and safety of axitinib dose titration in previously untreated patients with metastatic renal-cell carcinoma. Methods In this randomised, double-blind, multicentre, phase 2 study, patients were enrolled from 49 hospitals and outpatient clinics in the Czech Republic, Germany, Japan, Russia, Spain, and USA. Patients with treatment-naive metastatic renal-cell carcinoma received axitinib 5 mg twice daily during a 4 week lead-in period. Those patients with blood pressure 150/90 mm Hg or lower, no grade 3 or 4 treatment-related toxic effects, no dose reductions, and no more than two antihypertensive drugs for 2 consecutive weeks were stratified by Eastern Cooperative Oncology Group performance status (0 vs 1), and then randomly assigned (1:1) to either masked titration with axitinib to total twice daily doses of 7 mg, and then 10 mg, if tolerated, or placebo titration. Patients who did not meet these criteria continued without titration. The primary objective was comparison of the proportion of patients achieving an objective response between randomised groups. Safety analyses were based on all patients who received at least one dose of axitinib. This ongoing trial is registered with ClinicalTrials.gov, number NCT00835978. Findings Between Sept 2, 2009, and Feb 28, 2011, we enrolled 213 patients, of whom 112 were randomly assigned to either the axitinib titration group (56 patients) or the placebo titration group (56 patients). 91 were not eligible for titration, and ten withdrew during the lead-in period. 30 patients (54%, 95% CI 40–67) in the axitinib titration group had an objective response, as did 19 patients (34%, 22–48]) in the placebo titration group (one-sided p=0·019). 54 (59%, 95% CI 49–70) of non-randomised

Fragmentation of Andes-to-Amazon connectivity by hydropower dams.

Science.gov (United States)

Anderson, Elizabeth P; Jenkins, Clinton N; Heilpern, Sebastian; Maldonado-Ocampo, Javier A; Carvajal-Vallejos, Fernando M; Encalada, Andrea C; Rivadeneira, Juan Francisco; Hidalgo, Max; Cañas, Carlos M; Ortega, Hernan; Salcedo, Norma; Maldonado, Mabel; Tedesco, Pablo A

2018-01-01

Andes-to-Amazon river connectivity controls numerous natural and human systems in the greater Amazon. However, it is being rapidly altered by a wave of new hydropower development, the impacts of which have been previously underestimated. We document 142 dams existing or under construction and 160 proposed dams for rivers draining the Andean headwaters of the Amazon. Existing dams have fragmented the tributary networks of six of eight major Andean Amazon river basins. Proposed dams could result in significant losses in river connectivity in river mainstems of five of eight major systems-the Napo, Marañón, Ucayali, Beni, and Mamoré. With a newly reported 671 freshwater fish species inhabiting the Andean headwaters of the Amazon (>500 m), dams threaten previously unrecognized biodiversity, particularly among endemic and migratory species. Because Andean rivers contribute most of the sediment in the mainstem Amazon, losses in river connectivity translate to drastic alteration of river channel and floodplain geomorphology and associated ecosystem services.

Safety and efficacy of eculizumab in Guillain-Barré syndrome: a multicentre, double-blind, randomised phase 2 trial.

Science.gov (United States)

Misawa, Sonoko; Kuwabara, Satoshi; Sato, Yasunori; Yamaguchi, Nobuko; Nagashima, Kengo; Katayama, Kanako; Sekiguchi, Yukari; Iwai, Yuta; Amino, Hiroshi; Suichi, Tomoki; Yokota, Takanori; Nishida, Yoichiro; Kanouchi, Tadashi; Kohara, Nobuo; Kawamoto, Michi; Ishii, Junko; Kuwahara, Motoi; Suzuki, Hidekazu; Hirata, Koichi; Kokubun, Norito; Masuda, Ray; Kaneko, Juntaro; Yabe, Ichiro; Sasaki, Hidenao; Kaida, Ken-Ichi; Takazaki, Hiroshi; Suzuki, Norihiro; Suzuki, Shigeaki; Nodera, Hiroyuki; Matsui, Naoko; Tsuji, Shoji; Koike, Haruki; Yamasaki, Ryo; Kusunoki, Susumu

2018-06-01

Despite the introduction of plasmapheresis and immunoglobulin therapy, many patients with Guillain-Barré syndrome still have an incomplete recovery. Evidence from pathogenesis studies suggests the involvement of complement-mediated peripheral nerve damage. We aimed to investigate the safety and efficacy of eculizumab, a humanised monoclonal antibody against the complement protein C5, in patients with severe Guillain-Barré syndrome. This study was a 24 week, multicentre, double-blind, placebo-controlled, randomised phase 2 trial done at 13 hospitals in Japan. Eligible patients with Guillain-Barré syndrome were aged 18 years or older and could not walk independently (Guillain-Barré syndrome functional grade 3-5). Patients were randomly assigned (2:1) to receive 4 weeks of intravenous immunoglobulin plus either eculizumab (900 mg) or placebo; randomisation was done via a computer-generated process and web response system with minimisation for functional grade and age. The study had a parallel non-comparative single-arm outcome measure. The primary outcomes were efficacy (the proportion of patients with restored ability to walk independently [functional grade ≤2] at week 4) in the eculizumab group and safety in the full analysis set. For the efficacy endpoint, we predefined a response rate threshold of the lower 90% CI boundary exceeding 50%. This trial is registered with ClinicalTrials.gov, number, NCT02493725. Between Aug 10, 2015, and April 21, 2016, 34 patients were assigned to receive either eculizumab (n=23) or placebo (n=11). At week 4, the proportion of the patients able to walk independently (functional grade ≤2) was 61% (90% CI 42-78; n=14) in the eculizumab group, and 45% (20-73; n=5) in the placebo group. Adverse events occurred in all 34 patients. Three patients had serious adverse events: two in the eculizumab group (anaphylaxis in one patient and intracranial haemorrhage and abscess in another patient) and one in the placebo group (depression

Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial.

OpenAIRE

Rascol, O.; Brooks, D.J.; Melamed, E.; Oertel, W.; Poewe, W.; Stocchi, F.; Tolosa, E.; LARGO study group

2005-01-01

Lancet. 2005 Mar 12-18;365(9463):947-54. Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Rascol O, Brooks DJ, Melamed E, Oertel W, Poewe W, Stocchi F, Tolosa E; LARGO study group. Clinical Investigation Centre, Department of Clinical Pharmacology, University Hospital, Toulouse, France. ...

Safety and immunogenicity of RV3-BB human neonatal rotavirus vaccine administered at birth or in infancy: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Bines, Julie E; Danchin, Margaret; Jackson, Pamela; Handley, Amanda; Watts, Emma; Lee, Katherine J; West, Amanda; Cowley, Daniel; Chen, Mee-Yew; Barnes, Graeme L; Justice, Frances; Buttery, Jim P; Carlin, John B; Bishop, Ruth F; Taylor, Barry; Kirkwood, Carl D

2015-12-01

Despite the success of rotavirus vaccines, suboptimal vaccine efficacy in regions with a high burden of disease continues to present a challenge to worldwide implementation. A birth dose strategy with a vaccine developed from an asymptomatic neonatal rotavirus strain has the potential to address this challenge and provide protection from severe rotavirus disease from birth. This phase 2a randomised, double-blind, three-arm, placebo-controlled safety and immunogenicity trial was undertaken at a single centre in New Zealand between Jan 13, 2012, and April 17, 2014. Healthy, full-term (≥36 weeks gestation) babies, who weighed at least 2500 g, and were 0-5 days old at the time of randomisation were randomly assigned (1:1:1; computer-generated; telephone central allocation) according to a concealed block randomisation schedule to oral RV3-BB vaccine with the first dose given at 0-5 days after birth (neonatal schedule), to vaccine with the first dose given at about 8 weeks after birth (infant schedule), or to placebo. The primary endpoint was cumulative vaccine take (serum immune response or stool shedding of vaccine virus after any dose) after three doses. The immunogenicity analysis included all randomised participants with available outcome data. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611001212943. 95 eligible participants were randomised, of whom 89 were included in the primary analysis. A cumulative vaccine take was detected in 27 (90%) of 30 participants in the neonatal schedule group after three doses of RV3-BB vaccine compared with four (13%) of 32 participants in the placebo group (difference in proportions 0·78, 95% CI 0·55-0·88; pvaccine take after three doses compared with eight (25%) of 32 participants in the placebo group (difference in proportions 0·68, 0·44-0·81; pvaccine was not associated with an increased frequency of fever or gastrointestinal symptoms compared with placebo. RV3-BB vaccine was

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

Science.gov (United States)

Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

2004-01-01

Background: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. Aims: To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. Patients: One hundred patients (aged 6 months–15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. Methods: After faecal disimpaction, patients encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency ⩾3/week and encopresis ⩽1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. Results: A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. Conclusions: PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation. PMID:15479678

Green Ocean Amazon 2014/15 – Scaling Amazon Carbon Water Couplings Field Campaign Report

Energy Technology Data Exchange (ETDEWEB)

Dubey, Manvendra [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Parket, Harrison [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Myers, Katherine [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rahn, Thom [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Christoffersson, B. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wunch, Debra [California Inst. of Technology (CalTech), Pasadena, CA (United States); Wennberg, Paul [California Inst. of Technology (CalTech), Pasadena, CA (United States)

2016-08-01

Forests soak up 25% of the carbon dioxide (CO2) emitted by anthropogenic fossil energy use (10 Gt C y-1), moderating its atmospheric accumulation. How this terrestrial CO2 uptake will evolve with climate change in the 21st Century is largely unknown. Rainforests are the most active ecosystems, with the Amazon basin storing 120 Gt C as biomass and exchanging 18 Gt C y-1 of CO2 via photosynthesis and respiration and fixing carbon at 2-3 kg C m-2 y-1. Furthermore, the intense hydrologic and carbon cycles are tightly coupled in the Amazon where about half of the water is recycled by evapotranspiration and the other half imported from the ocean by Northeasterly trade winds. Climate models predict a drying in the Amazon with reduced carbon uptake while observationally guided assessments indicate sustained uptake. We set out to resolve this huge discrepancy in the size and sign of the future Amazon carbon cycle by performing the first simultaneous regional-scale high-frequency measurements of atmospheric CO2, H2O, HOD, CH4, N2O, and CO at the T3 site in Manacupuru, Brazil, as part of DOE's GoAmazon 2014/15 project. Our data will be used to inform and develop DOE's Community Land Model (CLM) on the tropical carbon-water couplings at the appropriate grid scale (10-50 km). Our measurements will also validate the CO2 data from Japan's Greenhouse gases Observing Satellite (GOSAT) and NASA's Orbiting Carbon Observatory (OCO)-2 satellite (launched in July, 2014). Our data addresses these science questions: 1. How does ecosystem heterogeneity and climate variability influence the rainforest carbon cycle? 2. How well do current tropical ecosystem models simulate the observed regional carbon cycle? 3. Does nitrogen deposition (from the Manaus, Brazil, plume) enhance rainforest carbon uptake?

Proliferation of hydroelectric dams in the Andean Amazon and implications for Andes-Amazon connectivity.

Science.gov (United States)

Finer, Matt; Jenkins, Clinton N

2012-01-01

Due to rising energy demands and abundant untapped potential, hydropower projects are rapidly increasing in the Neotropics. This is especially true in the wet and rugged Andean Amazon, where regional governments are prioritizing new hydroelectric dams as the centerpiece of long-term energy plans. However, the current planning for hydropower lacks adequate regional and basin-scale assessment of potential ecological impacts. This lack of strategic planning is particularly problematic given the intimate link between the Andes and Amazonian flood plain, together one of the most species rich zones on Earth. We examined the potential ecological impacts, in terms of river connectivity and forest loss, of the planned proliferation of hydroelectric dams across all Andean tributaries of the Amazon River. Considering data on the full portfolios of existing and planned dams, along with data on roads and transmission line systems, we developed a new conceptual framework to estimate the relative impacts of all planned dams. There are plans for 151 new dams greater than 2 MW over the next 20 years, more than a 300% increase. These dams would include five of the six major Andean tributaries of the Amazon. Our ecological impact analysis classified 47% of the potential new dams as high impact and just 19% as low impact. Sixty percent of the dams would cause the first major break in connectivity between protected Andean headwaters and the lowland Amazon. More than 80% would drive deforestation due to new roads, transmission lines, or inundation. We conclude with a discussion of three major policy implications of these findings. 1) There is a critical need for further strategic regional and basin scale evaluation of dams. 2) There is an urgent need for a strategic plan to maintain Andes-Amazon connectivity. 3) Reconsideration of hydropower as a low-impact energy source in the Neotropics.

Proliferation of hydroelectric dams in the Andean Amazon and implications for Andes-Amazon connectivity.

Directory of Open Access Journals (Sweden)

Matt Finer

Full Text Available Due to rising energy demands and abundant untapped potential, hydropower projects are rapidly increasing in the Neotropics. This is especially true in the wet and rugged Andean Amazon, where regional governments are prioritizing new hydroelectric dams as the centerpiece of long-term energy plans. However, the current planning for hydropower lacks adequate regional and basin-scale assessment of potential ecological impacts. This lack of strategic planning is particularly problematic given the intimate link between the Andes and Amazonian flood plain, together one of the most species rich zones on Earth. We examined the potential ecological impacts, in terms of river connectivity and forest loss, of the planned proliferation of hydroelectric dams across all Andean tributaries of the Amazon River. Considering data on the full portfolios of existing and planned dams, along with data on roads and transmission line systems, we developed a new conceptual framework to estimate the relative impacts of all planned dams. There are plans for 151 new dams greater than 2 MW over the next 20 years, more than a 300% increase. These dams would include five of the six major Andean tributaries of the Amazon. Our ecological impact analysis classified 47% of the potential new dams as high impact and just 19% as low impact. Sixty percent of the dams would cause the first major break in connectivity between protected Andean headwaters and the lowland Amazon. More than 80% would drive deforestation due to new roads, transmission lines, or inundation. We conclude with a discussion of three major policy implications of these findings. 1 There is a critical need for further strategic regional and basin scale evaluation of dams. 2 There is an urgent need for a strategic plan to maintain Andes-Amazon connectivity. 3 Reconsideration of hydropower as a low-impact energy source in the Neotropics.

Modelling sustainable international tourism demand to the Brazilian Amazon

NARCIS (Netherlands)

J.A. Divino (Jose Angelo); M.J. McAleer (Michael)

2008-01-01

textabstractThe Amazon rainforest is one of the world’s greatest natural wonders and holds great importance and significance for the world’s environmental balance. Around 60% of the Amazon rainforest is located in the Brazilian territory. The two biggest states of the Amazon region are Amazonas (the

Business as Usual: Amazon.com and the Academic Library

Science.gov (United States)

Van Ullen, Mary K.; Germain, Carol Anne

2002-01-01

In 1999, Steve Coffman proposed that libraries form a single interlibrary loan based entity patterned after Amazon.com. This study examined the suitability of Amazon.com's Web interface and record enhancements for academic libraries. Amazon.com could not deliver circulating monographs in the University at Albany Libraries' collection quickly…

A Double-Blind, Randomised, Placebo-Controlled Trial of EMLA® Cream (Eutectic Lidocaine/Prilocaine Cream) for Analgesia Prior to Cryotherapy of Plantar Warts in Adults.

Science.gov (United States)

Lee, Siew Hui; Pakdeethai, Janthorn; Toh, Matthias P H S; Aw, Derrick C W

2014-10-01

Cryotherapy with liquid nitrogen is an effective, safe and convenient form of treatment for plantar warts. EMLA® cream (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) is a topical local anaesthetic agent that has proven to be effective and well tolerated in the relief of pain associated with various minor interventions in numerous clinical settings. In a single-centre, double-blind, randomised placebo-controlled study, 64 subjects were randomised into 2 groups. The subjects had a thick layer of EMLA® cream or placebo cream applied to pared plantar wart(s) and onto the surrounding margin of 1 mm to 2 mm under occlusion for 60 minutes prior to receiving cryotherapy. The pain of cryotherapy was evaluated by the subjects using a self-administered Visual Analogue Scale (VAS) immediately after the cryotherapy. There was no statistical difference between the mean VAS score for EMLA® cream (47.0 ± 21.4 mm) and placebo (48.9 ± 22.0 mm). Those with more than 1 wart had a significantly higher VAS score than those with only 1 wart (59.1 ± 21.8 vs. 44.3 ± 20.4, P cryotherapy. We conclude that the application of EMLA® cream prior to cryotherapy does not reduce the pain associated with cryotherapy.

Evapotranspiration seasonality across the Amazon Basin

Science.gov (United States)

Eiji Maeda, Eduardo; Ma, Xuanlong; Wagner, Fabien Hubert; Kim, Hyungjun; Oki, Taikan; Eamus, Derek; Huete, Alfredo

2017-06-01

Evapotranspiration (ET) of Amazon forests is a main driver of regional climate patterns and an important indicator of ecosystem functioning. Despite its importance, the seasonal variability of ET over Amazon forests, and its relationship with environmental drivers, is still poorly understood. In this study, we carry out a water balance approach to analyse seasonal patterns in ET and their relationships with water and energy drivers over five sub-basins across the Amazon Basin. We used in situ measurements of river discharge, and remotely sensed estimates of terrestrial water storage, rainfall, and solar radiation. We show that the characteristics of ET seasonality in all sub-basins differ in timing and magnitude. The highest mean annual ET was found in the northern Rio Negro basin (˜ 1497 mm year-1) and the lowest values in the Solimões River basin (˜ 986 mm year-1). For the first time in a basin-scale study, using observational data, we show that factors limiting ET vary across climatic gradients in the Amazon, confirming local-scale eddy covariance studies. Both annual mean and seasonality in ET are driven by a combination of energy and water availability, as neither rainfall nor radiation alone could explain patterns in ET. In southern basins, despite seasonal rainfall deficits, deep root water uptake allows increasing rates of ET during the dry season, when radiation is usually higher than in the wet season. We demonstrate contrasting ET seasonality with satellite greenness across Amazon forests, with strong asynchronous relationships in ever-wet watersheds, and positive correlations observed in seasonally dry watersheds. Finally, we compared our results with estimates obtained by two ET models, and we conclude that neither of the two tested models could provide a consistent representation of ET seasonal patterns across the Amazon.

Is Amazon the next Google?

OpenAIRE

Budzinski, Oliver; Köhler, Karoline Henrike

2015-01-01

Dominant or apparently dominant internet platform increasingly become subject to both antitrust investigations and further-reaching political calls for regulation. While Google is currently in the focus of the discussion, the next candidate is already on the horizon - the ubiquitous online trading platform Amazon. Competitors and suppliers but also famous economists like Paul Krugman unite in criticizing Amazon's market power and alleged abuse of it. In this paper, we collect the multitude of...

Activated protein C inhibits neutrophil migration in allergic asthma: a randomised trial

NARCIS (Netherlands)

de Boer, J. Daan; Berger, Marieke; Majoor, Christof J.; Kager, Liesbeth M.; Meijers, Joost C. M.; Terpstra, Sanne; Nieuwland, Rienk; Boing, Anita N.; Lutter, René; Wouters, Diana; van Mierlo, Gerard J.; Zeerleder, Sacha S.; Bel, Elisabeth H.; van't Veer, Cornelis; de Vos, Alex F.; van der Zee, Jaring S.; van der Poll, Tom

2015-01-01

Asthma patients show evidence of a procoagulant state in their airways, accompanied by an impaired function of the anticoagulant protein C system. We aimed to study the effect of recombinant human activated protein C (rhAPC) in allergic asthma patients.We conducted a randomised, double-blind,

Amazon Forests’ Response to Droughts: A Perspective from the MAIAC Product

Directory of Open Access Journals (Sweden)

Jian Bi

2016-04-01

Full Text Available Amazon forests experienced two severe droughts at the beginning of the 21st century: one in 2005 and the other in 2010. How Amazon forests responded to these droughts is critical for the future of the Earth’s climate system. It is only possible to assess Amazon forests’ response to the droughts in large areal extent through satellite remote sensing. Here, we used the Multi-Angle Implementation of Atmospheric Correction (MAIAC Moderate Resolution Imaging Spectroradiometer (MODIS vegetation index (VI data to assess Amazon forests’ response to droughts, and compared the results with those from the standard (Collection 5 and Collection 6 MODIS VI data. Overall, the MAIAC data reveal more realistic Amazon forests inter-annual greenness dynamics than the standard MODIS data. Our results from the MAIAC data suggest that: (1 the droughts decreased the greenness (i.e., photosynthetic activity of Amazon forests; (2 the Amazon wet season precipitation reduction induced by El Niño events could also lead to reduced photosynthetic activity of Amazon forests; and (3 in the subsequent year after the water stresses, the greenness of Amazon forests recovered from the preceding decreases. However, as previous research shows droughts cause Amazon forests to reduce investment in tissue maintenance and defense, it is not clear whether the photosynthesis of Amazon forests will continue to recover after future water stresses, because of the accumulated damages caused by the droughts.

Simulating fire regimes in the Amazon in response to climate change and deforestation.

Science.gov (United States)

Silvestrini, Rafaella Almeida; Soares-Filho, Britaldo Silveira; Nepstad, Daniel; Coe, Michael; Rodrigues, Hermann; Assunção, Renato

2011-07-01

Fires in tropical forests release globally significant amounts of carbon to the atmosphere and may increase in importance as a result of climate change. Despite the striking impacts of fire on tropical ecosystems, the paucity of robust spatial models of forest fire still hampers our ability to simulate tropical forest fire regimes today and in the future. Here we present a probabilistic model of human-induced fire occurrence for the Amazon that integrates the effects of a series of anthropogenic factors with climatic conditions described by vapor pressure deficit. The model was calibrated using NOAA-12 night satellite hot pixels for 2003 and validated for the years 2002, 2004, and 2005. Assessment of the fire risk map yielded fitness values > 85% for all months from 2002 to 2005. Simulated fires exhibited high overlap with NOAA-12 hot pixels regarding both spatial and temporal distributions, showing a spatial fit of 50% within a radius of 11 km and a maximum yearly frequency deviation of 15%. We applied this model to simulate fire regimes in the Amazon until 2050 using IPCC's A2 scenario climate data from the Hadley Centre model and a business-as-usual (BAU) scenario of deforestation and road expansion from SimAmazonia. Results show that the combination of these scenarios may double forest fire occurrence outside protected areas (PAs) in years of extreme drought, expanding the risk of fire even to the northwestern Amazon by midcentury. In particular, forest fires may increase substantially across southern and southwestern Amazon, especially along the highways slated for paving and in agricultural zones. Committed emissions from Amazon forest fires and deforestation under a scenario of global warming and uncurbed deforestation may amount to 21 +/- 4 Pg of carbon by 2050. BAU deforestation may increase fires occurrence outside PAs by 19% over the next four decades, while climate change alone may account for a 12% increase. In turn, the combination of climate change

Randomised, double-blinded, placebo-controlled, clinical trial of ozone therapy as treatment of sudden sensorineural hearing loss.

Science.gov (United States)

Ragab, A; Shreef, E; Behiry, E; Zalat, S; Noaman, M

2009-01-01

To investigate the safety and efficacy of ozone therapy in adult patients with sudden sensorineural hearing loss. Prospective, randomised, double-blinded, placebo-controlled, parallel group, clinical trial. Forty-five adult patients presented with sudden sensorineural hearing loss, and were randomly allocated to receive either placebo (15 patients) or ozone therapy (auto-haemotherapy; 30 patients). For the latter treatment, 100 ml of the patient's blood was treated immediately with a 1:1 volume, gaseous mixture of oxygen and ozone (from an ozone generator) and re-injected into the patient by intravenous infusion. Treatments were administered twice weekly for 10 sessions. The following data were recorded: pre- and post-treatment mean hearing gains; air and bone pure tone averages; speech reception thresholds; speech discrimination scores; and subjective recovery rates. Significant recovery was observed in 23 patients (77 per cent) receiving ozone treatment, compared with six (40 per cent) patients receiving placebo (p < 0.05). Mean hearing gains, pure tone averages, speech reception thresholds and subjective recovery rates were significantly better in ozone-treated patients compared with placebo-treated patients (p < 0.05). Ozone therapy is a significant modality for treatment of sudden sensorineural hearing loss; no complications were observed.

Selective logging in the Brazilian Amazon.

Science.gov (United States)

G. P. Asner; D. E. Knapp; E. N. Broadbent; P. J. C. Oliveira; M Keller; J. N. Silva

2005-01-01

Amazon deforestation has been measured by remote sensing for three decades. In comparison, selective logging has been mostly invisible to satellites. We developed a large-scale, high-resolution, automated remote-sensing analysis of selective logging in the top five timber-producing states of the Brazilian Amazon. Logged areas ranged from 12,075 to 19,823 square...

A double-blind randomised controlled trial of a natural oil-based emulsion (Moogoo Udder Cream®) containing allantoin versus aqueous cream for managing radiation-induced skin reactions in patients with cancer

International Nuclear Information System (INIS)

Chan, Raymond Javan; Keller, Jacqui; Cheuk, Robyn; Blades, Rae; Tripcony, Lee; Keogh, Samantha

2012-01-01

Radiation-induced skin reaction (RISR) is one of the most common and distressing side effects of radiotherapy in patients with cancer. It is featured with swelling, redness, itching, pain, breaks in skin, discomfort, and a burning sensation. There is a lack of convincing evidence supporting any single practice in the prevention or management of RISR. This double-blinded randomised controlled trial aims to investigate the effects of a natural oil-based emulsion containing allantoin (as known as Moogoo Udder Cream®) versus aqueous cream in reducing RISR, improving pain, itching and quality of life in this patient group. One group will receive Moogoo Udder Cream®. Another group will receive aqueous cream. Outcome measures will be collected using patient self-administered questionnaire, interviewer administered questionnaire and clinician assessment at commencement of radiotherapy, weekly during radiotherapy, and four weeks after the completion of radiotherapy. Despite advances of radiologic advances and supportive care, RISR are still not well managed. There is a lack of efficacious interventions in managing RISR. While anecdotal evidence suggests that Moogoo Udder Cream® may be effective in managing RISR, research is needed to substantiate this claim. This paper presents the design of a double blind randomised controlled trial that will evaluate the effects of Moogoo Udder Cream® versus aqueous cream for managing in RISR in patients with cancer. ACTRN 12612000568819

A double-blind randomised controlled trial of a natural oil-based emulsion (Moogoo Udder Cream®) containing allantoin versus aqueous cream for managing radiation-induced skin reactions in patients with cancer.

Science.gov (United States)

Chan, Raymond Javan; Keller, Jacqui; Cheuk, Robyn; Blades, Rae; Tripcony, Lee; Keogh, Samantha

2012-07-31

Radiation-induced skin reaction (RISR) is one of the most common and distressing side effects of radiotherapy in patients with cancer. It is featured with swelling, redness, itching, pain, breaks in skin, discomfort, and a burning sensation. There is a lack of convincing evidence supporting any single practice in the prevention or management of RISR. This double-blinded randomised controlled trial aims to investigate the effects of a natural oil-based emulsion containing allantoin (as known as Moogoo Udder Cream®) versus aqueous cream in reducing RISR, improving pain, itching and quality of life in this patient group. One group will receive Moogoo Udder Cream®. Another group will receive aqueous cream. Outcome measures will be collected using patient self-administered questionnaire, interviewer administered questionnaire and clinician assessment at commencement of radiotherapy, weekly during radiotherapy, and four weeks after the completion of radiotherapy. Despite advances of radiologic advances and supportive care, RISR are still not well managed. There is a lack of efficacious interventions in managing RISR. While anecdotal evidence suggests that Moogoo Udder Cream® may be effective in managing RISR, research is needed to substantiate this claim. This paper presents the design of a double blind randomised controlled trial that will evaluate the effects of Moogoo Udder Cream® versus aqueous cream for managing in RISR in patients with cancer. ACTRN 12612000568819.

Melatonin for chronic whiplash syndrome with delayed melatonin onset randomised, placebo-controlled trial

NARCIS (Netherlands)

Wieringen, S. van; Jansen, T.; Smits, M.G.; Nagtegaal, J.E.; Coenen, A.M.L.

2001-01-01

Objective: To assess the influence of melatonin in patients with chronic whiplash syndrome and delayed melatonin onset. Design: Randomised, double-blind, placebo-controlled, parallel-group trial. One-week baseline was followed by a 4-week treatment period with either melatonin or placebo. In the

Efficacy of single and double doses of albendazole and mebendazole alone and in combination in the treatment of Trichuris trichiura in school-age children in Uganda

DEFF Research Database (Denmark)

Namwanje, Harriet; Kabatereine, Narcis B.; Olsen, Annette

2011-01-01

A randomised clinical trial was conducted in Kabale District, southwestern Uganda, to compare the efficacies of single and double doses of a combination of 400mg albendazole (ALB) and 500mg mebendazole (MBZ) with those of single and double doses of each drug given alone in the treatment of Trichu......A randomised clinical trial was conducted in Kabale District, southwestern Uganda, to compare the efficacies of single and double doses of a combination of 400mg albendazole (ALB) and 500mg mebendazole (MBZ) with those of single and double doses of each drug given alone in the treatment...

The effect of oxcarbazepine in peripheral neuropathic pain depends on pain phenotype: a randomised, double-blind, placebo-controlled phenotype-stratified study

DEFF Research Database (Denmark)

Demant, Dyveke T; Lund, Karen; Vollert, Jan

2014-01-01

In neuropathic pain it has been suggested that pain phenotype based on putative pain mechanisms may predict response to treatment. This was a randomised, double-blind, placebo-controlled, and phenotype-stratified study with 2 6-week treatment periods of oxcarbazepine (1800-2400mg) and placebo...... patients: 31 with the irritable and 52 with the nonirritable nociceptor phenotype. In the total sample, oxcarbazepine relieved pain of 0.7 points (on a numeric rating scale 0-10; 95% confidence interval [CI] 0.4-1.4) more than placebo (P=0.015) and there was a significant interaction between treatment....... The primary efficacy measure was change in median pain intensity between baseline and the last week of treatment measured on an 11-point numeric rating scale, and the primary objective was to compare the effect of oxcarbazepine in patients with and without the irritable nociceptor phenotype as defined...

A randomised, double blind, placebo-controlled, multi-centric parallel arm trial to assess the effects of homoeopathic medicines on chronic rhinosinusitis

Directory of Open Access Journals (Sweden)

Raj K Manchanda

2014-01-01

Full Text Available Background: Chronic rhinosinusitis (CRS is one of the most common illnesses interfering with patient′s quality of life and work. Observational studies conducted by the Council indicate positive outcome. This protocol has been developed to ascertain the usefulness of homoeopathic intervention in comparison with control group in a randomised control setting. Objectives: Primary objective is to evaluate the changes in TSS (Total Symptoms Score and SNOT-22 (Sino-nasal Outcome Test-22 within the two groups of the study (Homoeopathy + Placebo. Secondary objective is to evaluate changes in SNOT-22 at end of the trial, changes in Lund and Mackay staging of CT scan, rhinoscopy grading, absolute eosinophil count, global assessment by investigator and patient, and number of acute exacerbations of CRS (for frequency, duration and intensity as per TSS scale compared to placebo. Methods/Design: This is a randomised double blind, placebo-controlled, multi-centric parallel arm trial of 6 months (three months treatment and three months observation period with 14 days run-in period. The primary outcome is a composite of the changes in the TSS and SNOT-22 over 3 months from baseline with area under the curve and changes over 3 months in the Sinus Nasal Outcome Test 22 (SNOT-22 from baseline. Prescription shall be made as per the homoeopathic principles. Efficacy data will be analysed in the intention-to-treat population. Discussion: This trial will help to evaluate the efficacy of homoeopathic individualised treatment using LM-potencies versus placebo in patients suffering from CRS as per the homoeopathic dictum.

Erythropoietin in patients with aneurysmal subarachnoid haemorrhage: a double blind randomised clinical trial

DEFF Research Database (Denmark)

Springborg, J B; Møller, C; Gideon, P

2007-01-01

but preliminarily terminated because of a lower than expected inclusion rate. However, 73 patients were randomised to treatment with EPO (500 IU/kg/day for three days) or placebo. The primary endpoint was Glasgow Outcome Score at six months. We further studied surrogate measures of secondary ischaemia, i...

Ecological carbon sequestration via wood harvest and storage (WHS): Can it be a viable climate mitigation and adaptation strategy for the Amazon?

Science.gov (United States)

Zeng, N.

2015-12-01

A carbon sequestration strategy is proposed in which forests are sustainably managed to optimal carbon productivity, and a fraction of the wood is selectively harvested and stored to prevent decomposition under anaerobic, dry or cold conditions. Because a large flux of CO2 is constantly assimilated into the world's forests via photosynthesis, cutting off its return pathway to the atmosphere forms an effective carbon sink. The live trees serve as a 'carbon scrubber' or 'carbon remover' that provides continuous sequestration (negative emissions). The stored wood is a semi-permanent carbon sink, but also serves as a 'biomass/bioenergy reserve' that could be utilized in the future. We discuss the particular relevance of this strategy to the Amazon which is under the double threat of climate change and deforestation. As an alternative to REDD, we propose mixed-use of peripheral Amazon basin while keeping the core of the Amazon intact. We argue that this may be a more practical solution in light of the likely climate change impact and human activities.

Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double-blind study.

Science.gov (United States)

Scheidtmann, K; Fries, W; Müller, F; Koenig, E

2001-09-08

Functional disability is generally caused by hemiplegia after stroke. Physiotherapy used to be the only way of improving motor function in such patients. However, administration of amphetamines in addition to exercise improves motor recovery in animals, probably by increasing the concentration of norepinephrine in the central nervous system. Our aim was to ascertain whether levodopa could enhance the efficacy of physiotherapy after hemiplegia. We did a prospective, randomised, placebo-controlled, double-blind study in which we enrolled 53 primary stroke patients. For the first 3 weeks patients received single doses of levodopa 100 mg or placebo daily in combination with physiotherapy. For the second 3 weeks patients had only physiotherapy. We quantitatively assessed motor function every week with Rivermead motor assessment (RMA). Six patients were excluded from analyses because of non-neurological complications. Motor recovery was significantly improved after 3 weeks of drug intervention in those on levodopa (RMA improved by 6.4 points) compared with placebo (4.1), and the result was independent of initial degree of impairment (pstroke rehabilitation.

Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial.

Science.gov (United States)

Barnes, Thomas R E; Leeson, Verity C; Paton, Carol; Costelloe, Céire; Simon, Judit; Kiss, Noemi; Osborn, David; Killaspy, Helen; Craig, Tom K J; Lewis, Shôn; Keown, Patrick; Ismail, Shajahan; Crawford, Mike; Baldwin, David; Lewis, Glyn; Geddes, John; Kumar, Manoj; Pathak, Rudresh; Taylor, Simon

2016-04-01

Negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialisation, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence suggests that a combination of antipsychotic and antidepressant medication may be effective in treating negative symptoms, it is too limited to allow any firm conclusions. To establish the clinical effectiveness and cost-effectiveness of augmentation of antipsychotic medication with the antidepressant citalopram for the management of negative symptoms in schizophrenia. A multicentre, double-blind, individually randomised, placebo-controlled trial with 12-month follow-up. Adult psychiatric services, treating people with schizophrenia. Inpatients or outpatients with schizophrenia, on continuing, stable antipsychotic medication, with persistent negative symptoms at a criterion level of severity. Eligible participants were randomised 1 : 1 to treatment with either placebo (one capsule) or 20 mg of citalopram per day for 48 weeks, with the clinical option at 4 weeks to increase the daily dosage to 40 mg of citalopram or two placebo capsules for the remainder of the study. The primary outcomes were quality of life measured at 12 and 48 weeks assessed using the Heinrich's Quality of Life Scale, and negative symptoms at 12 weeks measured on the negative symptom subscale of the Positive and Negative Syndrome Scale. No therapeutic benefit in terms of improvement in quality of life or negative symptoms was detected for citalopram over 12 weeks or at 48 weeks, but secondary analysis suggested modest improvement in the negative symptom domain, avolition/amotivation, at 12 weeks (mean difference -1.3, 95% confidence interval -2.5 to -0.09). There were no statistically significant differences between the two treatment arms over 48-week

The impact of Amazonian deforestation on Amazon basin rainfall

Science.gov (United States)

Spracklen, D. V.; Garcia-Carreras, L.

2015-11-01

We completed a meta-analysis of regional and global climate model simulations (n = 96) of the impact of Amazonian deforestation on Amazon basin rainfall. Across all simulations, mean (±1σ) change in annual mean Amazon basin rainfall was -12 ± 11%. Variability in simulated rainfall was not explained by differences in model resolution or surface parameters. Across all simulations we find a negative linear relationship between rainfall and deforestation extent, although individual studies often simulate a nonlinear response. Using the linear relationship, we estimate that deforestation in 2010 has reduced annual mean rainfall across the Amazon basin by 1.8 ± 0.3%, less than the interannual variability in observed rainfall. This may explain why a reduction in Amazon rainfall has not consistently been observed. We estimate that business-as-usual deforestation (based on deforestation rates prior to 2004) would lead to an 8.1 ± 1.4% reduction in annual mean Amazon basin rainfall by 2050, greater than natural variability.

Insecta, Coleoptera, Elmidae, Amazon region

Directory of Open Access Journals (Sweden)

Passos, M. I. S.

2010-01-01

Full Text Available A list of Elmidae species from Amazon is presented. The list was prepared based on a literature surveyand examination of the entomological collection of Instituto Nacional de Pesquisas da Amazônia (INPA. The listincludes 102 species, with ten new occurrences recorded, being one for the Amazon (which includes areas ofBrazil, Bolivia, Colombia, Guyana, French Guyana, Peru, Suriname and Venezuela three for the Amazonas state,and six for other localities in Brazil. Reports about species bibliography contents were also included, as well asavailable species municipalities distributional data.

Amazon River investigations, reconnaissance measurements of July 1963

Science.gov (United States)

Oltman, Roy Edwin; Sternberg, H. O'R.; Ames, F.C.; Davis, L.C.

1964-01-01

The first measurements of the flow of the Amazon River were made in July 1963 as a joint project of the University of Brazil, the Brazilian Navy, and the U.S. Geological Survey. The discharge of the Amazon River at Obidos was 7,640,000 cfs at an annual flood stage somewhat lower than the average. For comparison the maximum known discharge of the Mississippi River at Vicksburg is about 2,300,000 cfs. Dissolved-solids concentrations and sediment loads of the Amazon River and of several major tributaries were found to be low.

Radium and barium in the Amazon River system

International Nuclear Information System (INIS)

Moore, W.S.; Edmond, J.M.

1984-01-01

Data for 226 Ra and 228 Ra in the Amazon River system show that the activity of each radium isotope is strongly correlated with barium concentrations. Two trends are apparent, one for rivers which drain shield areas and another for all other rivers. These data suggest that there has been extensive fractionation of U, Th, and Ba during weathering in the Amazon basin. The 226 Ra data fit a flux model for the major ions indicating that 226 Ra behaves conservatively along the main channel of the Amazon River

A double-blind randomised controlled trial of a natural oil-based emulsion (Moogoo Udder Cream® containing allantoin versus aqueous cream for managing radiation-induced skin reactions in patients with cancer

Directory of Open Access Journals (Sweden)

Chan Raymond

2012-07-01

Full Text Available Abstract Background Radiation-induced skin reaction (RISR is one of the most common and distressing side effects of radiotherapy in patients with cancer. It is featured with swelling, redness, itching, pain, breaks in skin, discomfort, and a burning sensation. There is a lack of convincing evidence supporting any single practice in the prevention or management of RISR. Methods/Designs This double-blinded randomised controlled trial aims to investigate the effects of a natural oil-based emulsion containing allantoin (as known as Moogoo Udder Cream® versus aqueous cream in reducing RISR, improving pain, itching and quality of life in this patient group. One group will receive Moogoo Udder Cream®. Another group will receive aqueous cream. Outcome measures will be collected using patient self-administered questionnaire, interviewer administered questionnaire and clinician assessment at commencement of radiotherapy, weekly during radiotherapy, and four weeks after the completion of radiotherapy. Discussion Despite advances of radiologic advances and supportive care, RISR are still not well managed. There is a lack of efficacious interventions in managing RISR. While anecdotal evidence suggests that Moogoo Udder Cream® may be effective in managing RISR, research is needed to substantiate this claim. This paper presents the design of a double blind randomised controlled trial that will evaluate the effects of Moogoo Udder Cream® versus aqueous cream for managing in RISR in patients with cancer. Trial registration ACTRN 12612000568819

Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks

Science.gov (United States)

Zemp, Delphine Clara; Schleussner, Carl-Friedrich; Barbosa, Henrique M. J.; Hirota, Marina; Montade, Vincent; Sampaio, Gilvan; Staal, Arie; Wang-Erlandsson, Lan; Rammig, Anja

2017-03-01

Reduced rainfall increases the risk of forest dieback, while in return forest loss might intensify regional droughts. The consequences of this vegetation-atmosphere feedback for the stability of the Amazon forest are still unclear. Here we show that the risk of self-amplified Amazon forest loss increases nonlinearly with dry-season intensification. We apply a novel complex-network approach, in which Amazon forest patches are linked by observation-based atmospheric water fluxes. Our results suggest that the risk of self-amplified forest loss is reduced with increasing heterogeneity in the response of forest patches to reduced rainfall. Under dry-season Amazonian rainfall reductions, comparable to Last Glacial Maximum conditions, additional forest loss due to self-amplified effects occurs in 10-13% of the Amazon basin. Although our findings do not indicate that the projected rainfall changes for the end of the twenty-first century will lead to complete Amazon dieback, they suggest that frequent extreme drought events have the potential to destabilize large parts of the Amazon forest.

Effects of kinesiotaping on foot posture in participants with pronated foot: a quasi-randomised, double-blind study.

Science.gov (United States)

Luque-Suarez, Alejandro; Gijon-Nogueron, Gabriel; Baron-Lopez, Francisco Javier; Labajos-Manzanares, Maria Teresa; Hush, Julia; Hancock, Mark Jonathan

2014-03-01

To investigate whether kinesiotaping improves excessive foot pronation compared with sham kinesiotaping. Quasi-randomised, double-blind study. One primary care centre. One hundred and thirty participants were screened for inclusion. Sixty-eight participants with pronated feet [Foot Posture Index (FPI)≥ 6] were enrolled, and the follow-up rate was 100%. Participants were allocated into one of two groups: an experimental kinesiotaping group (KT1) and a sham taping group (KT2). Measures were collected by a blinded assessor at baseline, and 1 minute, 10 minutes, 60 minutes and 24 hours after taping. The primary outcome was total FPI score, and the secondary outcome was rear-foot FPI score. There were no significant differences in total FPI score between kinesiotaping and sham taping at any time point. Similarly, there were no significant differences in rear-foot FPI score, apart from at 60-minute follow-up when the difference between groups was significant (P=0.04) but the effect size was very small (0.85 points on the rear-foot FPI score between -6 and +6). Kinesiotaping does not correct foot pronation compared with sham kinesiotaping in people with pronated feet. Copyright © 2013 Chartered Society of Physiotherapy. All rights reserved.

Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis

Science.gov (United States)

Evans, E Glyn V; Sigurgeirsson, Bárdur

1999-01-01

Objective To compare the efficacy and safety of continuous terbinafine with intermittent itraconazole in the treatment of toenail onychomycosis. Design Prospective, randomised, double blind, double dummy, multicentre, parallel group study lasting 72 weeks. Setting 35 centres in six European countries. Subjects 496 patients aged 18 to 75 years with a clinical and mycological diagnosis of dermatophyte onychomycosis of the toenail. Interventions Study patients were randomly divided into four parallel groups to receive either terbinafine 250 mg a day for 12 or 16 weeks (groups T12 and T16) or itraconazole 400 mg a day for 1 week in every 4 weeks for 12 or 16 weeks (groups I3 and I4). Main outcome measures Assessment of primary efficacy at week 72 was mycological cure, defined as negative results on microscopy and culture of samples from the target toenail. Results At week 72 the mycological cure rates were 75.7% (81/107) in the T12 group and 80.8% (80/99) in the T16 group compared with 38.3% (41/107) in the I3 group and 49.1 % (53/108) in the I4 group. All comparisons (T12 v I3, T12 v I4, T16 v I3, T16 v I4) showed significantly higher cure rates in the terbinafine groups (all Pterbinafine at week 72. There were no differences in the number or type of adverse events recorded in the terbinafine or itraconazole groups. Conclusion Continuous terbinafine is significantly more effective than intermittent itraconazole in the treatment of patients with toenail onychomycosis. Key messagesGiven a correct diagnosis, fungal nail disease (onychomycosis) is curableTerbinafine is an allylamine antifungal with a primarily fungicidal mode of actionContinuous terbinafine treatment over 12 or 16 weeks achieves higher rates of clinical and mycological cure than intermittent itraconazole given over the same periodsTerbinafine is safe and well tolerated over 12 or 16 weeks of continuous treatmentContinuous terbinafine should be the current treatment of choice for onychomycosis PMID

Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients.

Science.gov (United States)

W, Eisenbeiß; F, Siemers; G, Amtsberg; P, Hinz; B, Hartmann; T, Kohlmann; A, Ekkernkamp; U, Albrecht; O, Assadian; A, Kramer

2012-01-01

Moist wound treatment improves healing of skin graft donor site wounds. Microbial colonised wounds represent an increased risk of wound infection; while antimicrobially active, topical antiseptics may impair epithelialization. The aim of this prospective randomised controlled clinical trial was to examine the influence of an Octenidine-dihydrochloride (OCT) hydrogel on bacterial colonisation and epithelialization of skin graft donor sites. The study was designed as a randomised, double-blinded, controlled clinical trial. Skin graft donor sites from a total of 61 patients were covered either with 0.05% OCT (n=31) or an OCT-free placebo wound hydrogel (n=30). Potential interaction with wound healing was assessed by measuring the time until 100% re-epithelialization. In addition, microbial wound colonisation was quantitatively determined in all skin graft donor sites. There was no statistically significant difference in the time for complete epithelialization of skin graft donor sites in the OCT and the placebo group (7.3±0.2 vs. 6.9±0.2 days; p=0.236). Microbial wound colonisation was significantly lower in the OCT group than in the placebo group (p=0.014). The OCT-based hydrogel showed no delay in wound epithelialization and demonstrated a significantly lower bacterial colonisation of skin graft donor site wounds.

Cloud characteristics, thermodynamic controls and radiative impacts during the Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5) experiment

International Nuclear Information System (INIS)

Giangrande, Scott E.; Feng, Zhe; Jensen, Michael P.; Comstock, Jennifer M.; Johnson, Karen L.

2017-01-01

Routine cloud, precipitation and thermodynamic observations collected by the Atmospheric Radiation Measurement (ARM) Mobile Facility (AMF) and Aerial Facility (AAF) during the 2-year US Department of Energy (DOE) ARM Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5) campaign are summarized. These observations quantify the diurnal to large-scale thermodynamic regime controls on the clouds and precipitation over the undersampled, climatically important Amazon basin region. The extended ground deployment of cloud-profiling instrumentation enabled a unique look at multiple cloud regimes at high temporal and vertical resolution. This longer-term ground deployment, coupled with two short-term aircraft intensive observing periods, allowed new opportunities to better characterize cloud and thermodynamic observational constraints as well as cloud radiative impacts for modeling efforts within typical Amazon wet and dry seasons.

Late Miocene onset of the Amazon River and the Amazon deep-sea fan: Evidence from the Foz do Amazonas Basin

NARCIS (Netherlands)

Figueiredo, J.; Hoorn, C.; van der Ven, P.; Soares, E.

2009-01-01

New biostratigraphic, isotopic, and well log data from exploration wells on the outer continental shelf and uppermost Amazon deep-sea fan, Brazil, reveal that the Amazon River was initiated as a transcontinental river between 11.8 and 11.3 Ma ago (middle to late Miocene), and reached its present

A randomised controlled trial for the effectiveness of intra-articular Ropivacaine and Bupivacaine on pain after knee arthroscopy: the DUPRA (DUtch Pain Relief after Arthroscopy)-trial

NARCIS (Netherlands)

Campo, M. M.; Kerkhoffs, G. M. M. J.; Sierevelt, I. N.; Weeseman, R. R.; van der Vis, H. M.; Albers, G. H. R.

2012-01-01

In this double-blinded, randomised clinical trial, the aim was to compare the analgesic effects of low doses of intra-articular Bupivacaine and Ropivacaine against placebo after knee arthroscopy performed under general anaesthesia. A total of 282 patients were randomised to 10 cc NaCl 0.9%, 10 cc

Diversity of palm uses in the western Amazon

DEFF Research Database (Denmark)

Paniagua Zambrana, N.Y.; Byg, A.; Svenning, J.-C.

2007-01-01

Abstract  We used palm knowledge to understand the interaction between people and the rainforests and the factors that influence this dynamic process. We interviewed 278 informants in 12 villages in the Pastaza and Madidi areas of the western Amazon basin. Together they used 38 different palm......, the great variation in the knowledge they possess, and the fact that the differences between villages is so great, are important elements to consider when developing management plans for the sustainable use of the rainforest resources in the western Amazon. Keywords  Local knowledge - Palms - Western Amazon...

[Pilot study of echocardiographic studies using color- and pulsed-wave spectral Doppler methods in blue-crowned amazons (Amazona ventralis) and blue-fronted amazons (Amazona a. aestiva)].

Science.gov (United States)

Pees, M; Straub, J; Schumacher, J; Gompf, R; Krautwald-Junghanns, M E

2005-02-01

Colour-flow and pulsed-wave spectral Doppler echocardiography was performed on 6 healthy, adult Hispaniolan amazon parrots (Amazona ventralis) and 6 blue-fronted amazon parrots (Amazona a. aestiva) to establish normal reference values. Birds were anesthetized with isoflurane in oxygen and placed in dorsal recumbency. An electrocardiogram was recorded continuously and birds were imaged with a micro-phased-array scanner with a frequency of 7.0 MHz. After assessment of cardiac function in 2-D-echocardiography, blood flow across the left and the right atrioventricular valve and across the aortic valve was determined using color-flow and pulsed-wave spectral Doppler echocardiography. Diastolic inflow (mean value +/- standard deviation) into the left ventricle was 0.17 +/- 0.02 m/s (Hispaniolan amazons) and 0.18 +/- 0.03 m/s (Blue fronted amazons). Diastolic inflow into the right ventricle was 0.22 +/- 0.05 m/s (Hispaniolan amazons) and 0.22 +/- 0.04 m/s (Blue fronted amazons). Velocity across the aortic valve was 0.84 +/- 0.07 m/s (Hispaniolan amazons) and 0.83 +/- 0.08 m/s (Blue fronted amazons). Systolic pulmonary flow could not be detected in any of the birds in this study. No significant differences were evident between the two species examined. Results of this study indicate that Doppler echocardiography is a promising technique to determine blood flow in the avian heart. Further studies in other avian species are needed to establish reference values for assessment of cardiac function in diseased birds.

Ozone measurements in the Amazon

Science.gov (United States)

Kirchhoff, V. W. J. H.

Several scientists of the Brazilian Institute for Space Research (Instituto de Pesquisas Espacias, or INPE; headquarters at Sāo Jose dos Campos, Sao Paulo) went to Manaus (3°S, 60°W), in the central region of the Amazon forest during July-August 1985 to study the atmosphere of the equatorial rainforest. The expedition to the Amazon was part of a large binational atmospheric chemistry field campaign that was organized to measure several atmospheric gases of the forest environment. This was definitely the largest scientific field expedition in this field ever performed on Brazilian territory.

Integrating the avoidance of forest degradation into systematic conservation planning in the Eastern Amazon

Science.gov (United States)

Ferreira, J.; Barlow, J.; Thompson, J.; Berenguer, E.; Aragão, L. E.; Lees, A.; Lennox, G.; Brancalion, P.; Ferraz, S.; Moura, N.; Oliveira, V. H.; Louzada, J.; Solar, R.; Nunes, S.; Parry, L.; Fonseca, T.; Garrett, R.; Vieira, I.; MacNally, R.; Gardner, T.

2017-12-01

Undisturbed forests are becoming increasingly rare in the tropics. The area of forest degraded by some form of disturbance, such as logging or fire, in the Brazilian Amazon now greatly exceeds that which had been deforested. Yet forest policy in the Amazon, as elsewhere in the tropics, remains overwhelmingly focused curbing the rate of forest loss without considering impacts on forest quality. We use a unique data set from the Sustainable Amazon Network (RAS), in the eastern Brazilian Amazon to assess the impacts of forest disturbance on biodiversity and assess the benefits of including avoided degradation measures in conservation planning. Biodiversity data on trees and fauna from two large regions, Santarém and Paragominas, were combined with remote sensing data to model biodiversity patterns as well as estimates of above-ground carbon stocks across a range of land-use types and forest conditions. We found that impact of forest disturbance on biodiversity loss in the state of Pará equates to double that lost from deforestation alone, -the equivalent of losing 92,000-139,000 km2 of primary forest. We found a strong positive relationship between increasing carbon stocks and higher biodiversity in varyingly disturbed forests. Simulations demonstrated that a carbon-focused conservation strategy is least effective at conserving biodiversity in the least disturbed forests, highlighting the importance of on-the-ground biodiversity surveys to prioritise conservation investments in the most species rich forests. We explored trade-offs among management actions to guide priorities for habitat protection, avoided degradation and restoration and found that where restoration imposes significant opportunity and implementation costs, efforts to avoid and reverse the degradation of existing forests can deliver greater returns on investment for biodiversity conservation. Systemic planning of forest management options at regional scales can substantially improve biodiversity

Trace elements distribution in the Amazon floodplain soils

International Nuclear Information System (INIS)

Fernandes, E.A.N.; Ferraz, E.S.B.; Oliveira, H.

1994-01-01

Neutron activation analysis was performed on aluvial soil samples from several sites on the foodplains of the Amazon River and its major tributaries for trace elements determination. The spatial and temporal variations of chemical composition of floodland sediments in the Amazon basin are discussed. No significant difference was found in trace elemental distribution in the floodland soils along the Amazon main channel, even after the source material has been progressively diluted with that from lowland draining tributaries. It was also seen that the average chemical composition of floodplain soils compares well with that of the suspended sedimets. (author) 12 refs.; 5 figs.; 2 tabs

Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial.

Science.gov (United States)

Iijima, Kazumoto; Sako, Mayumi; Nozu, Kandai; Mori, Rintaro; Tuchida, Nao; Kamei, Koichi; Miura, Kenichiro; Aya, Kunihiko; Nakanishi, Koichi; Ohtomo, Yoshiyuki; Takahashi, Shori; Tanaka, Ryojiro; Kaito, Hiroshi; Nakamura, Hidefumi; Ishikura, Kenji; Ito, Shuichi; Ohashi, Yasuo

2014-10-04

Rituximab could be an effective treatment for childhood-onset, complicated, frequently relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS). We investigated the efficacy and safety of rituximab in patients with high disease activity. We did a multicentre, double-blind, randomised, placebo-controlled trial at nine centres in Japan. We screened patients aged 2 years or older experiencing a relapse of FRNS or SDNS, which had originally been diagnosed as nephrotic syndrome when aged 1-18 years. Patients with complicated FRNS or SDNS who met all other criteria were eligible for inclusion after remission of the relapse at screening. We used a computer-generated sequence to randomly assign patients (1:1) to receive rituximab (375 mg/m(2)) or placebo once weekly for 4 weeks, with age, institution, treatment history, and the intervals between the previous three relapses as adjustment factors. Patients, guardians, caregivers, physicians, and individuals assessing outcomes were masked to assignments. All patients received standard steroid treatment for the relapse at screening and stopped taking immunosuppressive agents by 169 days after randomisation. Patients were followed up for 1 year. The primary endpoint was the relapse-free period. Safety endpoints were frequency and severity of adverse events. Patients who received their assigned intervention were included in analyses. This trial is registered with the University Hospital Medical Information Network clinical trials registry, number UMIN000001405. Patients were centrally registered between Nov 13, 2008, and May 19, 2010. Of 52 patients who underwent randomisation, 48 received the assigned intervention (24 were given rituximab and 24 placebo). The median relapse-free period was significantly longer in the rituximab group (267 days, 95% CI 223-374) than in the placebo group (101 days, 70-155; hazard ratio: 0·27, 0·14-0·53; p<0·0001). Ten patients (42%) in the rituximab group and six (25

Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks

OpenAIRE

Zemp, Delphine Clara; Schleussner, Carl Friedrich; Barbosa, Henrique M J; Hirota, Marina; Montade, Vincent; Sampaio, Gilvan; Staal, Arie; Wang-Erlandsson, L.; Rammig, Anja

2017-01-01

Reduced rainfall increases the risk of forest dieback, while in return forest loss might intensify regional droughts. The consequences of this vegetation–atmosphere feedback for the stability of the Amazon forest are still unclear. Here we show that the risk of self-amplified Amazon forest loss increases nonlinearly with dry-season intensification. We apply a novel complexnetwork approach, in which Amazon forest patches are linked by observation-based atmospheric water fluxes. ...

Double-blind, randomised study of the effect of combined treatment with vitamin C and E on albuminuria in Type 2 diabetic patients

DEFF Research Database (Denmark)

Gaede, P; Poulsen, H E; Parving, H H

2001-01-01

AIMS: Elevated levels of urinary albumin excretion rate (AER) predict high risk for progressing to end-stage renal disease. In streptozotocin-induced diabetes, supplementation with vitamin C or E reduces albuminuria and glomerular hypertrophy. We tested the hypothesis that supplementation of both...... vitamin C and E in pharmacological doses lowers AER in Type 2 diabetic patients with persistent micro/macroalbuminuria. METHODS: Thirty Type 2 diabetic patients with AER 30-300 mg/24 h were included in a double-blind randomised, cross-over trial. Patients received vitamin C (1250 mg) and vitamin E (680 IU......) per day or matching placebo for 4 weeks with a 3-week wash-out period between treatment periods in random order. RESULTS: Combined treatment with vitamin C and E reduced AER by 19% (95% CI 6-34%) (p = 0.04), geometric mean 197 mg/24 h (95% CI 114-341 mg/24 h) vs. 243 mg/24 h (146-404 mg/24 h...

Effectiveness of Lactobacillus helveticus and Lactobacillus rhamnosus for the management of antibiotic-associated diarrhoea in healthy adults: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Evans, Malkanthi; Salewski, Ryan P; Christman, Mary C; Girard, Stephanie-Anne; Tompkins, Thomas A

2016-07-01

Broad-spectrum antibiotic use can disrupt the gastrointestinal microbiota resulting in diarrhoea. Probiotics may be beneficial in managing this type of diarrhoea. The aim of this 10-week randomised, double-blind, placebo-controlled, parallel study was to investigate the effect of Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011 supplementation on antibiotic-associated diarrhoea in healthy adults. Subjects were randomised to receive 1 week of amoxicillin-clavulanic acid (875 mg/125 mg) once per day, plus a daily dose of 8×109 colony-forming units of a multi-strain probiotic (n 80) or placebo (n 80). The probiotic or placebo intervention was maintained for 1 week after completion of the antibiotic. Primary study outcomes of consistency and frequency of bowel movements were not significantly different between the probiotic and placebo groups. The secondary outcomes of diarrhoea-like defecations, Gastrointestinal Symptoms Rating Scale scores, safety parameters and adverse events were not significantly different between the probiotic intervention and the placebo. A post hoc analysis on the duration of diarrhoea-like defecations showed that probiotic intervention reduced the length of these events by 1 full day (probiotic, 2·70 (sem 0·36) d; placebo, 3·71 (sem 0·36) d; P=0·037; effect size=0·52). In conclusion, this study provides novel evidence that L. helveticus R0052 and L. rhamnosus R0011 supplementation significantly reduced the duration of diarrhoea-like defecations in healthy adults receiving antibiotics.

Carbon Emissions from Deforestation in the Brazilian Amazon Region

Science.gov (United States)

Potter, C.; Klooster, S.; Genovese, V.

2009-01-01

A simulation model based on satellite observations of monthly vegetation greenness from the Moderate Resolution Imaging Spectroradiometer (MODIS) was used to estimate monthly carbon fluxes in terrestrial ecosystems of Brazilian Amazon and Cerrado regions over the period 2000-2002. The NASA-CASA (Carnegie Ames Stanford Approach) model estimates of annual forest production were used for the first time as the basis to generate a prediction for the standing pool of carbon in above-ground biomass (AGB; gC/sq m) for forested areas of the Brazilian Amazon region. Plot-level measurements of the residence time of carbon in wood in Amazon forest from Malhi et al. (2006) were interpolated by inverse distance weighting algorithms and used with CASA to generate a new regional map of AGB. Data from the Brazilian PRODES (Estimativa do Desflorestamento da Amazonia) project were used to map deforested areas. Results show that net primary production (NPP) sinks for carbon varied between 4.25 Pg C/yr (1 Pg=10(exp 15)g) and 4.34 Pg C for the region and were highest across the eastern and northern Amazon areas, whereas deforestation sources of CO2 flux from decomposition of residual woody debris were higher and less seasonal in the central Amazon than in the eastern and southern areas. Increased woody debris from past deforestation events was predicted to alter the net ecosystem carbon balance of the Amazon region to generate annual CO2 source fluxes at least two times higher than previously predicted by CASA modeling studies. Variations in climate, land cover, and forest burning were predicted to release carbon at rates of 0.5 to 1 Pg C/yr from the Brazilian Amazon. When direct deforestation emissions of CO2 from forest burning of between 0.2 and 0.6 Pg C/yr in the Legal Amazon are overlooked in regional budgets, the year-to-year variations in this net biome flux may appear to be large, whereas our model results implies net biome fluxes had actually been relatively consistent from

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

DEFF Research Database (Denmark)

Jørgensen, Anette; Stengaard-Pedersen, Kristian; Simonsen, Lars Ole

2010-01-01

Objective To examine the long-term efficacy and safety of five intra-articular injections with hyaluronan in knee osteoarthritis. Methods A multicentre, randomised, placebo-controlled double-blind study of 337 patients fulfilling the American College of Rheumatology (ACR) criteria for knee...... osteoarthritis (clinical and laboratory) and with a Lequesne algofunctional index score (LFI) of 10 or greater. Patients received a hyaluronan product (sodium hyaluronate; Hyalgan) (n= 167) or saline (n= 170) intra-articularly weekly for 5 weeks and were followed up to 1 year. Time to recurrence was the primary...... efficacy parameter. LFI, pain on walking 50 m based on visual analogue scale (VAS pain 50 m), paracetamol consumption, patients' global assessment, Nottingham health profile, joint effusion and number of responders were secondary efficacy parameters. The efficacy parameters were analysed by intention...

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

DEFF Research Database (Denmark)

Jørgensen, Anette; Stengaard-Pedersen, Kristian; Simonsen, Ole

2010-01-01

OBJECTIVE: To examine the long-term efficacy and safety of five intra-articular injections with hyaluronan in knee osteoarthritis. METHODS: A multicentre, randomised, placebo-controlled double-blind study of 337 patients fulfilling the American College of Rheumatology (ACR) criteria for knee...... osteoarthritis (clinical and laboratory) and with a Lequesne algofunctional index score (LFI) of 10 or greater. Patients received a hyaluronan product (sodium hyaluronate; Hyalgan) (n=167) or saline (n=170) intra-articularly weekly for 5 weeks and were followed up to 1 year. Time to recurrence was the primary...... the ACR criteria for osteoarthritis of the knee with moderate to severe disease activity (LFI > or = 10), five intra-articular injections of hyaluronan did not improve pain, function, paracetamol consumption or other efficacy parameters 3, 6, 9 and 12 months after the treatment....

Double blind randomised controlled trial of two different breathing techniques in the management of asthma.

Science.gov (United States)

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic-Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-08-01

Previous studies have shown that breathing techniques reduce short acting beta(2) agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non-specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non-specific upper body exercises.

The Amazon, measuring a mighty river

Science.gov (United States)

,

1967-01-01

The Amazon, the world's largest river, discharges enough water into the sea each day to provide fresh water to the City of New York for over 9 years. Its flow accounts for about 15 percent of all the fresh water discharged into the oceans by all the rivers of the world. By comparison, the Amazon's flow is over 4 times that of the Congo River, the world's second largest river. And it is 10 times that of the Mississippi, the largest river on the North American Continent.

Rethinking the strategy of Amazon.com

OpenAIRE

Heng, Michael S.H.

2001-01-01

The strategic challenge facing Amazon.com is that it is not able to convince the investment community that it is able to generate profits in the long run. The doubt of investors is well grounded. This paper argues that Amazon should make a strategic shift to operate as a provider of technical services and business consulting in the area of business-to-consumer e-commerce. At the same time it should reduce the range of the items sold on-line to, say, books and CDs, and treat this part of its b...

Aspartame Sensitivity? A Double Blind Randomised Crossover Study

OpenAIRE

Sathyapalan, Thozhukat; Thatcher, Natalie J.; Hammersley, Richard; Rigby, Alan S.; Pechlivanis, Alexandros; Gooderham, Nigel J.; Holmes, Elaine; le Roux, Carel W.; Atkin, Stephen L.; Courts, Fraser

2015-01-01

Background Aspartame is a commonly used intense artificial sweetener, being approximately 200 times sweeter than sucrose. There have been concerns over aspartame since approval in the 1980s including a large anecdotal database reporting severe symptoms. The objective of this study was to compare the acute symptom effects of aspartame to a control preparation. Methods This was a double-blind randomized cross over study conducted in a clinical research unit in United Kingdom. Forty-eight indivi...

Postoperative symbiotic in patients with head and neck cancer: a double-blind randomised trial.

Science.gov (United States)

Lages, Priscilla C; Generoso, Simone V; Correia, Maria Isabel T D

2018-01-01

Studies on the 'gut origin of sepsis' have suggested that stressful insults, such as surgery, can affect intestinal permeability, leading to bacterial translocation. Symbiotics have been reported to be able to improve gut permeability and modulate the immunologic system, thereby decreasing postoperative complications. Therefore we aimed to evaluate the postoperative use of symbiotics in head and neck cancer surgical patients for intestinal function and permeability, as well as the postoperative outcomes. Patients were double-blind randomised into the symbiotic (n 18) or the control group (n 18). Samples were administered twice a day by nasoenteric tube, starting on the 1st postoperative day until the 5th to 7th day, and comprised 109 colony-forming units/ml each of Lactobacillus paracasei, L. rhamnosus, L. acidophilus, and Bifidobacterium lactis plus 6 g of fructo-oligosaccharides, or a placebo (6 g of maltodextrin). Intestinal function (day of first evacuation, total stool episodes, stool consistency, gastrointestinal tract symptoms and gut permeability by diamine oxidase (DAO) enzyme) and postoperative complications (infectious and non-infectious) were assessed. Results of comparison of the pre- and postoperative periods showed that the groups were similar for all outcome variables. In all, twelve patients had complications in the symbiotic group v. nine in the control group (P>0·05), and the preoperative-postoperative DAO activity ranged from 28·5 (sd 15·4) to 32·7 (sd 11·0) ng/ml in the symbiotic group and 35·2 (sd 17·7) to 34·1 (sd 12·0) ng/ml in the control group (P>0·05). In conclusion, postoperative symbiotics did not impact on intestinal function and postoperative outcomes of head and neck surgical patients.

Unusual presentation of an Amazon parrot (Amazon a species) with hepatocellular carcinoma

International Nuclear Information System (INIS)

Freeman, K.P.; Hahn, K.A.; Jones, M.P.; Petersen, M.G.; Toal, R.L.

1999-01-01

Non-haematopoietic hepatic malignancies are uncommon in birds. The clinical presentation (i.e, chronic buphthalmos) and non-specific radiographic findings observed in this adult Amazon parrot (Amazona spp,) were not consistent with previous reports describing the natural behaviour of metastatic hepatocellular carcinoma in birds

Lipid Panel Reference Intervals for Amazon Parrots (Amazona species).

Science.gov (United States)

Ravich, Michelle; Cray, Carolyn; Hess, Laurie; Arheart, Kristopher L

2014-09-01

The lipoprotein panel is a useful diagnostic tool that allows clinicians to evaluate blood lipoprotein fractions. It is a standard diagnostic test in human medicine but is poorly understood in avian medicine. Amazon parrots (Amazona species) are popular pets that frequently lead a sedentary lifestyle and are customarily fed high-fat diets. Similar to people with comparable diets and lifestyles, Amazon parrots are prone to obesity and atherosclerosis. In human medicine, these conditions are typically correlated with abnormalities in the lipoprotein panel. To establish reference intervals for the lipoprotein panel in Amazon parrots, plasma samples from 31 captive Amazon parrots were analyzed for concentrations of cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). The data were also grouped according to sex, diet, body condition score, and age. Aside from HDL levels, which were significantly different between male and female parrots, no intergroup differences were found for any of the lipoprotein fractions.

Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation.

Science.gov (United States)

Riezzo, G; Orlando, A; D'Attoma, B; Linsalata, M; Martulli, M; Russo, F

2018-01-29

Dysbiosis may contribute to constipation and its symptoms, therefore probiotic administration could improve significantly gut health and functions. The aim of the study was to investigate the effects of a long-lasting administration of Lactobacillus reuteri DSM 17938 (LR DSM 17938) on symptoms and quality of life (QoL) score in patients with functional constipation (FC). 56 FC patients with normal colonic transit time and without anorectal disorders and pelvic floor dysfunctions completed the study. LR DSM 17938 was administered for 105 days in a randomised double-blind clinical trial (28 patients per arm). Individual and cumulative scores including the Constipaq, a modified Constipation Scoring System (CSS) that considers the patient assessment of constipation-QoL (PAC-QoL), were calculated during the preliminary visit (V0), at day 15 (end of the induction period with a LR DSM 17938 double dosage, 4×10 8 cfu), day 60 (intermediate evaluation) and day 105 (V4) after a standard dosage (2×10 8 cfu). At the end of treatment, the beneficial effect of LR DSM 17938 compared to placebo was significantly evident for symptoms related to gas content and dysbiosis (abdominal discomfort, pain and bloating), incomplete defecation and helps for defecation (PDSM 17938 treatment, a marked and positive effect on both the CSS single and the cumulative items was evident with the exception of unfruitful attempt and Bristol score. Present findings indicate that LR DSM 17938 has an effect on symptoms different from stool consistency, and they suggest that this probiotic can effectively be used in association therapy rather than as single-drug therapy in the management of FC.

Randomised clinical trial: relief of upper gastrointestinal symptoms by an acid pocket-targeting alginate-antacid (Gaviscon Double Action) - a double-blind, placebo-controlled, pilot study in gastro-oesophageal reflux disease.

Science.gov (United States)

Thomas, E; Wade, A; Crawford, G; Jenner, B; Levinson, N; Wilkinson, J

2014-03-01

The alginate-antacid, Gaviscon Double Action (Gaviscon DA; Reckitt Benckiser, Slough, UK) suppresses reflux after meals by creating a gel-like barrier that caps and displaces the acid pocket distal to the oesophago-gastric junction. The effect of Gaviscon DA on reflux and dyspepsia symptoms has not yet been demonstrated with a modern trial design. A pilot study to assess the efficacy and safety of Gaviscon DA compared with matched placebo for decreasing upper gastrointestinal symptoms in symptomatic gastro-oesophageal reflux disease (GERD) patients. A randomised, double-blind, parallel group study was performed in 110 patients with symptoms of GERD. Patients received Gaviscon DA or placebo tablets for 7 consecutive days. The primary endpoint compared the change in overall Reflux Disease Questionnaire (RDQ) symptom score (combined heartburn/regurgitation/dyspepsia). Secondary endpoints assessed individual dimensions, GERD dimension (heartburn and regurgitation) and overall treatment evaluation (OTE). There was a greater decrease in overall RDQ symptom score in the Gaviscon DA group compared with the placebo group (Least Squares Mean difference -0.55; P = 0.0033), and for each of the dimensions independently. Patients in the Gaviscon DA group evaluated their overall treatment response higher than patients in the placebo group [mean (standard deviation) OTE 4.1 (2.44) vs. 1.9 (3.34); P = 0.0005]. No differences in the incidence of adverse events were observed between treatment groups. Gaviscon DA decreases reflux and dyspeptic symptoms in GERD patients compared with matched placebo and has a favourable benefit-risk balance. Larger scale clinical investigations of medications targeting the acid pocket are warranted. (EudraCT, 2012-002188-84). © 2014 John Wiley & Sons Ltd.

Amazon: Navigating the Jungle of a Business

OpenAIRE

McIntosh Theroux, Brett; Rais El Fenni, Tarik

2014-01-01

This project investigated Amazon.com, Inc’s business model and environment, particularly, the effect of Amazon’s implementation of a drone delivery system and the Amazon Fire TV, and its related services. This was achieved through an examination of four areas, the four working questions; revolving around an analysis and discussion of Amazon’s business model and environment, with particular focus on the two new features. Also, an analysis and discussion of how Amazon’s business model could be ...

Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial.

Science.gov (United States)

Bruix, Jordi; Qin, Shukui; Merle, Philippe; Granito, Alessandro; Huang, Yi-Hsiang; Bodoky, György; Pracht, Marc; Yokosuka, Osamu; Rosmorduc, Olivier; Breder, Valeriy; Gerolami, René; Masi, Gianluca; Ross, Paul J; Song, Tianqiang; Bronowicki, Jean-Pierre; Ollivier-Hourmand, Isabelle; Kudo, Masatoshi; Cheng, Ann-Lii; Llovet, Josep M; Finn, Richard S; LeBerre, Marie-Aude; Baumhauer, Annette; Meinhardt, Gerold; Han, Guohong

2017-01-07

There are no systemic treatments for patients with hepatocellular carcinoma (HCC) whose disease progresses during sorafenib treatment. We aimed to assess the efficacy and safety of regorafenib in patients with HCC who have progressed during sorafenib treatment. In this randomised, double-blind, parallel-group, phase 3 trial done at 152 sites in 21 countries, adults with HCC who tolerated sorafenib (≥400 mg/day for ≥20 of last 28 days of treatment), progressed on sorafenib, and had Child-Pugh A liver function were enrolled. Participants were randomly assigned (2:1) by a computer-generated randomisation list and interactive voice response system and stratified by geographical region, Eastern Cooperative Oncology Group performance status, macrovascular invasion, extrahepatic disease, and α-fetoprotein level to best supportive care plus oral regorafenib 160 mg or placebo once daily during weeks 1-3 of each 4-week cycle. Investigators, patients, and the funder were masked to treatment assignment. The primary endpoint was overall survival (defined as time from randomisation to death due to any cause) and analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01774344. Between May 14, 2013, and Dec 31, 2015, 843 patients were screened, of whom 573 were enrolled and randomised (379 to regorafenib and 194 to placebo; population for efficacy analyses), and 567 initiated treatment (374 received regorafenib and 193 received placebo; population for safety analyses). Regorafenib improved overall survival with a hazard ratio of 0·63 (95% CI 0·50-0·79; one-sided p<0·0001); median survival was 10·6 months (95% CI 9·1-12·1) for regorafenib versus 7·8 months (6·3-8·8) for placebo. Adverse events were reported in all regorafenib recipients (374 [100%] of 374) and 179 (93%) of 193 placebo recipients. The most common clinically relevant grade 3 or 4 treatment-emergent events were hypertension (57 patients [15%] in the regorafenib group

Programming Amazon Web Services S3, EC2, SQS, FPS, and SimpleDB

CERN Document Server

Murty, James

2009-01-01

With this book, you'll learn how companies can take advantage of Amazon Web Services (AWS) to rent" computing power, data storage and bandwidth on Amazon's vast network infrastructure. Programming Amazon Web Services gives developers the background and technical detail they need for using Amazon's subscription-based Simple Storage Service (S3), Elastic Compute Cloud (EC2), Simple Queue Service (SQS), Flexible Payments Service (FPS), and SimpleDB to build web-scale business applications. "

Amazon soils : a reconnaissance of the soils of the Brazilian Amazon region

NARCIS (Netherlands)

Sombroek, W.G.

1966-01-01

The study deals with soils of the Brazilian part of the Amazon basin. Most soils are Latosols, some with soft or hardened plinthite. The Latosols are characterized by a latosolic B horizon as defined in Brazil.

Plinthite, its formation and morphology were extensively described. Five main

Reduced anaesthetic requirements and postoperative analgesics in patients undergoing laparoscopic cholecystectomy: premedication with intravenous paracetamol versus ketorolac, a double blind and randomised clinical trial.

Science.gov (United States)

Medina-Vera, A J; Novoa, L M

2017-02-01

To compare the effects of premedication with intravenous paracetamol versus ketorolac, in decreasing intraoperative anaesthetic and postoperative opioid analgesics requirements in patients undergoing laparoscopic cholecystectomy. An experimental, prospective, comparative, double blind, and randomised clinical trial was conducted to determine intraoperative opioid requirements, and pain and analgesic requirements in the postoperative period in 100 healthy patients undergoing laparoscopic cholecystectomy. They were randomised into 2 groups: Group 1: pre-medicated with paracetamol 1g, and Group 2: with ketorolac 30mg (both administered intravenously 30minutes prior to surgery). There were no statistically significant differences between groups as regards intraoperative remifentanil use (Group 1: 0.0739±0.016μg/kg/min, Group 2: 0.0741±0.018μg/kg/min). The number of patients in Group 2 that had values of VAS>4 points (22.4%) was lower than in Group 1 (28.6%), but with no statistically significant difference. Of the patients who needed postoperative opioid rescue, most required a single rescue and application of analgesics during hospitalisation, that prevailed between 3 and 12hours, without any significant differences between groups. No adverse effects were observed in the study sample. Paracetamol 1g IV given preoperatively decreased anaesthetic requirements and the need for postoperative analgesics similar to the preoperative administration of ketorolac 30mg IV. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Double blind randomised controlled trial of two different breathing techniques in the management of asthma

Science.gov (United States)

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic‐Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-01-01

Background Previous studies have shown that breathing techniques reduce short acting β2 agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non‐specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. Methods After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Results Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Conclusion Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non‐specific upper body exercises. PMID:16517572

Butorphanol pre-treatment prevents myoclonus induced by etomidate: a randomised, double-blind, controlled clinical trial.

Science.gov (United States)

He, Liang; Ding, Ying; Chen, Huiyu; Qian, Yanning; Li, Zhong

2014-01-01

Myoclonic movements are common problems during induction of anaesthesia with etomidate. The myoclonus occurring after etomidate administration may represent a form of seizure. Agonistic modulation of the κ opiate receptor may reduce seizures, and butorphanol acts in such a manner. The aim of this randomised, double-blind, placebo-controlled clinical trial was to test our hypothesis that pre-treatment with butorphanol might reduce the incidence and severity of myoclonus induced by etomidate. Patients (108) with American Society of Anaesthesiologists physical status I or II were randomly assigned to one of two groups to receive either 0.015 mg/kg of butorphanol (n = 54) or saline (n = 54) intravenously. At two minutes after infusion of butorphanol or saline, 0.3 mg/kg etomidate was given. The occurrence and severity (observational score of 0-3) of myoclonus was assessed during 2 minutes after administration of etomidate. For each patient, blood pressure (BP), saturation of peripheral oxygen (SpO₂), and heart rate (HR) were measured. The incidence of myoclonus was significantly lower in Group Butorphanol than in Group Saline (13.0% vs 79.6%; RR = 0.163, 95%CI: 0.081-0.329; χ² = 48.265, p <0.0001). The severity levels of myoclonic movement were also significantly lower in Group Butorphanol than in Group Saline (p <0.0001). Throughout the procedure, changes of BP, SpO₂, and HR did not differ between the groups. There were no problems with bradycardia or hypotension. Infusion of 0.015 mg/kg butorphanol 2 minutes before etomidate administration is effective for suppressing myoclonus induced by etomidate during induction of general anaesthesia.

Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial

Science.gov (United States)

Bennell, K; Hinman, R; Metcalf, B; Buchbinder, R; McConnell, J; McColl, G; Green, S; Crossley, K

2005-01-01

Objective: To determine whether a multimodal physiotherapy programme including taping, exercises, and massage is effective for knee osteoarthritis, and if benefits can be maintained with self management. Methods: Randomised, double blind, placebo controlled trial; 140 community volunteers with knee osteoarthritis participated and 119 completed the trial. Physiotherapy and placebo interventions were applied by 10 physiotherapists in private practices for 12 weeks. Physiotherapy included exercise, massage, taping, and mobilisation, followed by 12 weeks of self management. Placebo was sham ultrasound and light application of a non-therapeutic gel, followed by no treatment. Primary outcomes were pain measured by visual analogue scale and patient global change. Secondary measures included WOMAC, knee pain scale, SF-36, assessment of quality of life index, quadriceps strength, and balance test. Results: Using an intention to treat analysis, physiotherapy and placebo groups showed similar pain reductions at 12 weeks: –2.2 cm (95% CI, –2.6 to –1.7) and –2.0 cm (–2.5 to –1.5), respectively. At 24 weeks, pain remained reduced from baseline in both groups: –2.1 (–2.6 to –1.6) and –1.6 (–2.2 to –1.0), respectively. Global improvement was reported by 70% of physiotherapy participants (51/73) at 12 weeks and by 59% (43/73) at 24 weeks. Similarly, global improvement was reported by 72% of placebo participants (48/67) at 12 weeks and by 49% (33/67) at 24 weeks (all p>0.05). Conclusions: The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability. PMID:15897310

Tofacitinib for induction and maintenance therapy of Crohn's disease: results of two phase IIb randomised placebo-controlled trials

NARCIS (Netherlands)

Panés, Julian; Sandborn, William J.; Schreiber, Stefan; Sands, Bruce E.; Vermeire, Séverine; D'Haens, Geert; Panaccione, Remo; Higgins, Peter D. R.; Colombel, Jean-Frederic; Feagan, Brian G.; Chan, Gary; Moscariello, Michele; Wang, Wenjin; Niezychowski, Wojciech; Marren, Amy; Healey, Paul; Maller, Eric

2017-01-01

Tofacitinib is an oral, small-molecule Janus kinase inhibitor that is being investigated for IBD. We evaluated the efficacy and safety of tofacitinib for induction and maintenance treatment in patients with moderate-to-severe Crohn's disease (CD). We conducted two randomised, double-blind,

Misoprostol for cervical priming prior to hysteroscopy in postmenopausal and premenopausal nulliparous women; a multicentre randomised placebo controlled trial

NARCIS (Netherlands)

Tasma, M L; Louwerse, M D; Hehenkamp, W J; Geomini, P M; Bongers, M Y; Veersema, S; van Kesteren, P J; Tromp, E; Huirne, J A; Graziosi, G C

OBJECTIVE: To evaluate the reduction of pain by misoprostol compared with placebo prior to hysteroscopy in postmenopausal and premenopausal nulliparous women. DESIGN: Randomised multicentre double-blind placebo controlled trial. SETTING: Two Dutch teaching hospitals and one Dutch university medical

Trophic opportunism of central Amazon floodplain fish

OpenAIRE

Mortillaro, J. M.; Pouilly, Marc; Wach, M.; Freitas, C. E. C.; Abril, G.; Meziane, T.

2015-01-01

The food web of the central Amazon basin displays one of the largest discrepancies in food source utilisation versus availability for consumers. While C-4 macrophytes dominate the primary producing biomass in floodplains, the food web is dominated by the use of C-3 carbon sources. Amazon fish species have wide-ranging diets and show feeding flexibility in response to spatial and temporal patterns in food source availability. Fish are therefore expected to use a range of available resources. F...

East of the Andes: The genetic profile of the Peruvian Amazon populations.

Science.gov (United States)

Di Corcia, T; Sanchez Mellado, C; Davila Francia, T J; Ferri, G; Sarno, S; Luiselli, D; Rickards, O

2017-06-01

Assuming that the differences between the Andes and the Amazon rainforest at environmental and historical levels have influenced the distribution patterns of genes, languages, and cultures, the maternal and paternal genetic reconstruction of the Peruvian Amazon populations was used to test the relationships within and between these two extreme environments. We analyzed four Peruvian Amazon communities (Ashaninka, Huambisa, Cashibo, and Shipibo) for both Y chromosome (17 STRs and 8 SNPs) and mtDNA data (control region sequences, two diagnostic sites of the coding region, and one INDEL), and we studied their variability against the rest of South America. We detected a high degree of genetic diversity in the Peruvian Amazon people, both for mtDNA than for Y chromosome, excepting for Cashibo people, who seem to have had no exchanges with their neighbors, in contrast with the others communities. The genetic structure follows the divide between the Andes and the Amazon, but we found a certain degree of gene flow between these two environments, as particularly emerged with the Y chromosome descent cluster's (DCs) analysis. The Peruvian Amazon is home to an array of populations with differential rates of genetic exchanges with their neighbors and with the Andean people, depending on their peculiar demographic histories. We highlighted some successful Y chromosome lineages expansions originated in Peru during the pre-Columbian history which involved both Andeans and Amazon Arawak people, showing that at least a part of the Amazon rainforest did not remain isolated from those exchanges. © 2017 Wiley Periodicals, Inc.

Dampak Peningkatan Kepuasan Pelanggan dalam Proses Bisnis E-Commerce pada Perusahaan Amazon.Com

Directory of Open Access Journals (Sweden)

I Gusti Made Karmawan

2014-12-01

Full Text Available The Purpose of writing is to describe the impact of increased customer satisfaction in the business process of e-commerce at Amazon.com and analyzed e-commerce strategies used in the company.The Benefits are to get an overview of the strategies in the Amazon.com for improving customer satisfaction and the impact of increased satisfaction. The method of writing is conducting reviews of existing sources to gain an overview strategy and business processes e-commerce at Amazon.com. The paper results are gaining knowledge of thenumber of visitors and Sales that accurred at Amazon.com. The Conclusions is about the impact of increasing customer Satisfaction in the business process e-commerce in the Amazone.com.

The changing hydrology of a dammed Amazon

Science.gov (United States)

Timpe, Kelsie; Kaplan, David

2017-01-01

Developing countries around the world are expanding hydropower to meet growing energy demand. In the Brazilian Amazon, >200 dams are planned over the next 30 years, and questions about the impacts of current and future hydropower in this globally important watershed remain unanswered. In this context, we applied a hydrologic indicator method to quantify how existing Amazon dams have altered the natural flow regime and to identify predictors of alteration. The type and magnitude of hydrologic alteration varied widely by dam, but the largest changes were to critical characteristics of the flood pulse. Impacts were largest for low-elevation, large-reservoir dams; however, small dams had enormous impacts relative to electricity production. Finally, the “cumulative” effect of multiple dams was significant but only for some aspects of the flow regime. This analysis is a first step toward the development of environmental flows plans and policies relevant to the Amazon and other megadiverse river basins. PMID:29109972

Investigation of the potentiation of the analgesic effects of fentanyl by ketamine in humans: a double-blinded, randomised, placebo controlled, crossover study of experimental pain[ISRCTN83088383

Directory of Open Access Journals (Sweden)

Nadeson Raymond

2005-04-01

Full Text Available Abstract Background Despite preclinical evidence suggesting a synergistic interaction between ketamine and opioids promoting analgesia, several clinical trials have not identified dosing regimens capable of eliciting a benefit in the co-administration of ketamine with opioids. Methods Ten healthy volunteers participated in a double blinded, randomised, placebo controlled, crossover laboratory study in order to determine whether a low dose of ketamine potentiated the antinociceptive effect of fentanyl without causing an increase in sedative effects. A battery of tests was used to assess both nociception and sedation including electrical current, pressure, thermal stimuli, psychometric tests, and both subjective and objective scores of sedation. Target controlled infusions of the study drugs were used. Ketamine and fentanyl were administered alone and in combination in a double-blinded randomised crossover design. Saline was used as the control, and propofol was used to validate the tests of sedation. Cardiovascular and respiratory parameters were also assessed. Results The electrical current pain threshold dose response curve of fentanyl combined with ketamine was markedly steeper than the dose response curve of fentanyl alone. While a ketamine serum concentration of 30 ng/ml did not result in a change in electrical pain threshold when administered alone, when it was added to fentanyl, the combination resulted in greater increase in pain threshold than that of fentanyl administered alone. When nociception was assessed using heat and pressure stimuli, ketamine did not potentiate the anti-nociceptive effect of fentanyl. There was no difference between the sedative effect of fentanyl and fentanyl in combination with ketamine as assessed by both subjective and objective measures of sedation. Cardiovascular and respiratory parameters were unaffected by the study drugs at the doses given. Conclusion A serum concentration of ketamine that did not alter

Effectiveness of transcranial direct current stimulation preceding cognitive behavioural management for chronic low back pain: sham controlled double blinded randomised controlled trial.

Science.gov (United States)

Luedtke, Kerstin; Rushton, Alison; Wright, Christine; Jürgens, Tim; Polzer, Astrid; Mueller, Gerd; May, Arne

2015-04-16

To evaluate the effectiveness of transcranial direct current stimulation alone and in combination with cognitive behavioural management in patients with non-specific chronic low back pain. Double blind parallel group randomised controlled trial with six months' follow-up conducted May 2011-March 2013. Participants, physiotherapists, assessors, and analyses were blinded to group allocation. Interdisciplinary chronic pain centre. 135 participants with non-specific chronic low back pain >12 weeks were recruited from 225 patients assessed for eligibility. Participants were randomised to receive anodal (20 minutes to motor cortex at 2 mA) or sham transcranial direct current stimulation (identical electrode position, stimulator switched off after 30 seconds) for five consecutive days immediately before cognitive behavioural management (four week multidisciplinary programme of 80 hours). Two primary outcome measures of pain intensity (0-100 visual analogue scale) and disability (Oswestry disability index) were evaluated at two primary endpoints after stimulation and after cognitive behavioural management. Analyses of covariance with baseline values (pain or disability) as covariates showed that transcranial direct current stimulation was ineffective for the reduction of pain (difference between groups on visual analogue scale 1 mm (99% confidence interval -8.69 mm to 6.3 mm; P=0.68)) and disability (difference between groups 1 point (-1.73 to 1.98; P=0.86)) and did not influence the outcome of cognitive behavioural management (difference between group 3 mm (-10.32 mm to 6.73 mm); P=0.58; difference between groups on Oswestry disability index 0 point (-2.45 to 2.62); P=0.92). The stimulation was well tolerated with minimal transitory side effects. This results of this trial on the effectiveness of transcranial direct current stimulation for the reduction of pain and disability do not support its clinical use for managing non-specific chronic low back pain

Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial.

Science.gov (United States)

Abate, E; Elias, D; Getachew, A; Alemu, S; Diro, E; Britton, S; Aseffa, A; Stendahl, O; Schön, T

2015-02-01

Despite several review papers and experimental studies concerning the impact of chronic helminth infection on tuberculosis in recent years, there is a scarcity of data from clinical field studies in highly endemic areas for these diseases. We believe this is the first randomised clinical trial investigating the impact of albendazole treatment on the clinical and immunological outcomes of helminth co-infected tuberculosis patients. A randomised, double-blind, placebo-controlled trial of albendazole (400mg per day for 3 days) in helminth-positive tuberculosis patients was conducted in Gondar, Ethiopia. The primary outcome was clinical improvement (ΔTB score) after 2 months. Among secondary outcomes were changes in the levels of eosinophils, CD4+ T cells, regulatory T cells, IFN-γ, IL-5 and IL-10 after 3 months. A total of 140 helminth co-infected tuberculosis patients were included with an HIV co-infection rate of 22.8%. There was no significant effect on the primary outcome (ΔTB score: 5.6±2.9 for albendazole versus 5.9±2.5 for placebo, P=0.59). The albendazole-treated group showed a decline in eosinophil cells (P=0.001) and IL-10 (P=0.017) after 3 months. In an exploratory analysis after 12 weeks, the albendazole treated group showed a trend towards weight gain compared with the placebo group (11.2±8.5 kg versus 8.2±8.7 kg, P=0.08)). The reductions in eosinophil counts and IL-10 show that asymptomatic helminth infection significantly affects host immunity during tuberculosis and can be effectively reversed by albendazole treatment. The clinical effects of helminth infection on chronic infectious diseases such as tuberculosis merit further characterisation. Copyright © 2014 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

The Legal Protection of Ecoturism on Amazon State

OpenAIRE

Bárbara Dias Cabral

2016-01-01

This article presents the legislation on ecotourism in the Amazon, which stands as polo Brazilian and global ecotourism. An answer search the following questioning: analyzing the social, environmental and cultural aspects, we can say that the Brazilian legal system and legislation promote Amazon Ecotourism? The methodology is deductive, with doctrinal, legislative and interdisciplinary research, as it quotes the thought of some tourismologists, agronomists and environmentalists. There in the ...

The efficacy of cyclosporine A in cats with presumed atopic dermatitis: a double blind, randomised prednisolone-controlled study.

Science.gov (United States)

Wisselink, Marinus A; Willemse, Ton

2009-04-01

The objective of this study was to compare the efficacy of cyclosporine A (CsA) and prednisolone in feline atopic dermatitis (AD) in a randomised, controlled double blind study. Twenty-nine cats with feline AD were randomly allocated to two groups. Eleven cats were treated orally with prednisolone (1mg/kg SID) and 18 were treated with CsA (5mg/kg/day) for 4 weeks. At day 0 (D0) and D28, skin lesions were graded by means of the canine atopic dermatitis extent and severity index (CADESI). Skin biopsies and intradermal allergy tests were performed at D0 and blood samples for haematology and serum biochemistry were collected at D0 and D28. During the trial the cat owners were asked to evaluate the intensity of the pruritus once weekly on a linear analog scale and to record side effects. Based on the CADESI there was no significant difference between the two groups in the amount of remission (P=0.0562) or in the number of cats that improved by >25% (P=0.0571). The effect of CsA and prednisolone on pruritus as evaluated by the owners was not significantly different (P=0.41) between the two groups. No serious side effects were observed. The conclusion was that CsA is an effective alternative to prednisolone therapy in cats with presumed atopic dermatitis.

Election-driven weakening of deforestation control in the Brazilian Amazon

NARCIS (Netherlands)

Rodrigues-Filho, S.; Verburg, R.W.; Lindoso, D.; Debortoli, N.; Bursztyn, M.; Vilhena, A.M.G.

2015-01-01

Commodity prices, exchange rate, infrastructural projects and migration patterns are known and important drivers of Amazon deforestation, but cannot solely explain the high rates observed in 1995 and 2003–2004 in six Brazilian Amazon states. Deforestation predictions using those widely applied

Election-driven weakening of deforestation control in the Brazilian Amazon.

NARCIS (Netherlands)

Rodrigues-Filho, S; Verburg, R.W.; Bursztyn, M; Lindoso, D; Debortoli, N

2015-01-01

Commodity prices, exchange rate, infrastructural projects and migration patterns are known and important drivers of Amazon deforestation, but cannot solely explain the high rates observed in 1995 and 2003–2004 in six Brazilian Amazon states. Deforestation predictions using those widely applied

Bimatoprost 0.03% preservative-free ophthalmic solution versus bimatoprost 0.03% ophthalmic solution (Lumigan) for glaucoma or ocular hypertension: a 12-week, randomised, double-masked trial

Science.gov (United States)

Day, Douglas G; Walters, Thomas R; Schwartz, Gail F; Mundorf, Thomas K; Liu, Charlie; Schiffman, Rhett M; Bejanian, Marina

2013-01-01

Background/Aim To evaluate efficacy and safety of bimatoprost 0.03% preservative-free (PF) ophthalmic solution versus bimatoprost 0.03% (Lumigan) ophthalmic solution for glaucoma or ocular hypertension. Methods In this double-masked, parallel-group study, patients were randomised to bimatoprost PF or bimatoprost for 12 weeks. The primary analysis for non-inferiority was change from baseline in worse eye intraocular pressure (IOP) in the per-protocol population at week 12. For equivalence, it was average eye IOP in the intent-to-treat population at each time point at weeks 2, 6 and 12. Results 597 patients were randomised (bimatoprost PF, n=302 and bimatoprost, n=295). The 95% CI upper limit for worse eye IOP change from baseline was <1.5 mm Hg at each week 12 time point, meeting prespecified non-inferiority criteria. The 95% CI upper limit for the treatment difference for average IOP was 0.69 mm Hg and the lower limit was −0.50 mm Hg at all follow-up time points (hours 0, 2 and 8 at weeks 2, 6 and 12), meeting equivalence criteria. Both treatments showed decreases in mean average eye IOP at all follow-up time points (p<0.001), were safe and well tolerated. Conclusions Bimatoprost PF is non-inferior and equivalent to bimatoprost in its ability to reduce IOP-lowering with a safety profile similar to bimatoprost. PMID:23743437

The Amazon's energetic paradox

International Nuclear Information System (INIS)

Silva, Marcos Vinicius Miranda da; Bermann, Celio

1999-01-01

The main energy sources in Amazon region are hydroelectric, biomass, and natural gas. Although abundance of these resources, the energy consumption in this region is one of the most low of Brazil. The article overviews this paradox. In this context, economical, geopolitical, and technical aspects are presented

Following Saharan Dust Outbreak Toward The Amazon Basin

Science.gov (United States)

Ben Ami, Y.; Koren, I.; Rudich, Y.; Flores, M.

2008-12-01

The role of the Amazon rainforest on earth climatic system is well recognized. To keep forest wellbeing and the fragile balance between the rainforest and the atmosphere, the Amazon must contain a satisfactory amount of nutrients to support the plants. The extensive rain and floods wash most of the soluble nutrients from the rainforest soil, leaving behind acidic kaolinite clay or sandy soil, with limited minerals for plant growth. It was suggested that lack of mineral in the soil may be replenished by deposition of Saharan mineral dust. Using remote sensing data (from the A-train satellites constellation) following with in-situ measurements (as part of the AMazonian Aerosol CharacteriZation Experiment (AMZE) campaign), ground-based data (from AErosol RObotic NETwork (AERONET)) and back trajectory calculations, we analyzed Saharan dust transport toward the Amazon basin during the AMZE period (Feb 7 to Mar 14, 2008). Dust mass, sink, vertical distribution and surface wind speeds were analyzed over the Bodele depression (located in Chad), where most of the dust is emitted, along the Atlantic Ocean and near the Brazilian coastline. Using an integrated data analysis approach we followed dust packages from their emission in the Sahara to their sink in the Amazon forest.

Long-term decline of the Amazon carbon sink.

Science.gov (United States)

Brienen, R J W; Phillips, O L; Feldpausch, T R; Gloor, E; Baker, T R; Lloyd, J; Lopez-Gonzalez, G; Monteagudo-Mendoza, A; Malhi, Y; Lewis, S L; Vásquez Martinez, R; Alexiades, M; Álvarez Dávila, E; Alvarez-Loayza, P; Andrade, A; Aragão, L E O C; Araujo-Murakami, A; Arets, E J M M; Arroyo, L; Aymard C, G A; Bánki, O S; Baraloto, C; Barroso, J; Bonal, D; Boot, R G A; Camargo, J L C; Castilho, C V; Chama, V; Chao, K J; Chave, J; Comiskey, J A; Cornejo Valverde, F; da Costa, L; de Oliveira, E A; Di Fiore, A; Erwin, T L; Fauset, S; Forsthofer, M; Galbraith, D R; Grahame, E S; Groot, N; Hérault, B; Higuchi, N; Honorio Coronado, E N; Keeling, H; Killeen, T J; Laurance, W F; Laurance, S; Licona, J; Magnussen, W E; Marimon, B S; Marimon-Junior, B H; Mendoza, C; Neill, D A; Nogueira, E M; Núñez, P; Pallqui Camacho, N C; Parada, A; Pardo-Molina, G; Peacock, J; Peña-Claros, M; Pickavance, G C; Pitman, N C A; Poorter, L; Prieto, A; Quesada, C A; Ramírez, F; Ramírez-Angulo, H; Restrepo, Z; Roopsind, A; Rudas, A; Salomão, R P; Schwarz, M; Silva, N; Silva-Espejo, J E; Silveira, M; Stropp, J; Talbot, J; ter Steege, H; Teran-Aguilar, J; Terborgh, J; Thomas-Caesar, R; Toledo, M; Torello-Raventos, M; Umetsu, R K; van der Heijden, G M F; van der Hout, P; Guimarães Vieira, I C; Vieira, S A; Vilanova, E; Vos, V A; Zagt, R J

2015-03-19

Atmospheric carbon dioxide records indicate that the land surface has acted as a strong global carbon sink over recent decades, with a substantial fraction of this sink probably located in the tropics, particularly in the Amazon. Nevertheless, it is unclear how the terrestrial carbon sink will evolve as climate and atmospheric composition continue to change. Here we analyse the historical evolution of the biomass dynamics of the Amazon rainforest over three decades using a distributed network of 321 plots. While this analysis confirms that Amazon forests have acted as a long-term net biomass sink, we find a long-term decreasing trend of carbon accumulation. Rates of net increase in above-ground biomass declined by one-third during the past decade compared to the 1990s. This is a consequence of growth rate increases levelling off recently, while biomass mortality persistently increased throughout, leading to a shortening of carbon residence times. Potential drivers for the mortality increase include greater climate variability, and feedbacks of faster growth on mortality, resulting in shortened tree longevity. The observed decline of the Amazon sink diverges markedly from the recent increase in terrestrial carbon uptake at the global scale, and is contrary to expectations based on models.

Tree rings and rainfall in the equatorial Amazon

Science.gov (United States)

Granato-Souza, Daniela; Stahle, David W.; Barbosa, Ana Carolina; Feng, Song; Torbenson, Max C. A.; de Assis Pereira, Gabriel; Schöngart, Jochen; Barbosa, Joao Paulo; Griffin, Daniel

2018-05-01

The Amazon basin is a global center of hydroclimatic variability and biodiversity, but there are only eight instrumental rainfall stations with continuous records longer than 80 years in the entire basin, an area nearly the size of the coterminous US. The first long moisture-sensitive tree-ring chronology has been developed in the eastern equatorial Amazon of Brazil based on dendrochronological analysis of Cedrela cross sections cut during sustainable logging operations near the Rio Paru. The Rio Paru chronology dates from 1786 to 2016 and is significantly correlated with instrumental precipitation observations from 1939 to 2016. The strength and spatial scale of the precipitation signal vary during the instrumental period, but the Rio Paru chronology has been used to develop a preliminary reconstruction of February to November rainfall totals from 1786 to 2016. The reconstruction is related to SSTs in the Atlantic and especially the tropical Pacific, similar to the stronger pattern of association computed for the instrumental rainfall data from the eastern Amazon. The tree-ring data estimate extended drought and wet episodes in the mid- to late-nineteenth century, providing a valuable, long-term perspective on the moisture changes expected to emerge over the Amazon in the coming century due to deforestation and anthropogenic climate change.

A randomised controlled trial of complete denture impression materials.

Science.gov (United States)

Hyde, T P; Craddock, H L; Gray, J C; Pavitt, S H; Hulme, C; Godfrey, M; Fernandez, C; Navarro-Coy, N; Dillon, S; Wright, J; Brown, S; Dukanovic, G; Brunton, P A

2014-08-01

There is continuing demand for non-implant prosthodontic treatment and yet there is a paucity of high quality Randomised Controlled Trial (RCT) evidence for best practice. The aim of this research was to provide evidence for best practice in prosthodontic impressions by comparing two impression materials in a double-blind, randomised, crossover, controlled, clinical trial. Eighty-five patients were recruited, using published eligibility criteria, to the trial at Leeds Dental Institute, UK. Each patient received two sets of dentures; made using either alginate or silicone impressions. Randomisations determined the order of assessment and order of impressions. The primary outcome was patient blinded preference for unadjusted dentures. Secondary outcomes were patient preference for the adjusted dentures, rating of comfort, stability and chewing efficiency, experience of each impression, and an OHIP-EDENT questionnaire. Seventy-eight (91.8%) patients completed the primary assessment. 53(67.9%) patients preferred dentures made from silicone impressions while 14(17.9%) preferred alginate impressions. 4(5.1%) patients found both dentures equally satisfactory and 7 (9.0%) found both equally unsatisfactory. There was a 50% difference in preference rates (in favour of silicone) (95%CI 32.7-67.3%, pUnilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mining drives extensive deforestation in the Brazilian Amazon

OpenAIRE

Sonter, Laura J.; Herrera, Diego; Barrett, Damian J.; Galford, Gillian L.; Moran, Chris J.; Soares-Filho, Britaldo S.

2017-01-01

Mining poses significant and potentially underestimated risks to tropical forests worldwide. In Brazil’s Amazon, mining drives deforestation far beyond operational lease boundaries, yet the full extent of these impacts is unknown and thus neglected in environmental licensing. Here we quantify mining-induced deforestation and investigate the aspects of mining operations, which most likely contribute. We find mining significantly increased Amazon forest loss up to 70 km beyond mining lease boun...

Thermodynamics and Cloud Radiative Effect from the First Year of GoAmazon

Science.gov (United States)

Collow, Allie Marquardt; Miller, Mark; Trabachino, Lynne

2015-01-01

Deforestation is an ongoing concern for the Amazon Rainforest of Brazil and associated changes to the land surface have been hypothesized to alter the climate in the region. A comprehensive set of meteorological observations at the surface and within the lower troposphere above Manacapuru, Brazil and data from the Modern Era Retrospective Analysis for Research and Applications Version 2 (MERRA-2) are used to evaluate the seasonal cycle of cloudiness, thermodynamics, and the radiation budget. While ample moisture is present in the Amazon Rainforest year round, the northward progression of the Hadley circulation during the dry season contributes to a drying of the middle troposphere and inhibits the formation of deep convection. This results in a reduction in cloudiness and precipitation as well as an increase in the height of the lifting condensation level, which is shown to have a negative correlation to the fraction of low clouds. Frequent cloudiness prevents solar radiation from reaching the surface and clouds are often reflective with high values of shortwave cloud radiative effect at the surface and top of the atmosphere. Cloud radiative effect is reduced during the dry season however the dry season surface shortwave cloud radiative effect is still double what is observed during the wet season in other tropical locations. Within the column, the impact of clouds on the radiation budget is more prevalent in the longwave part of the spectrum, with a net warming in the wet season.

The Impacts of Amazon Deforestation on Pacific Climate

Science.gov (United States)

Lindsey, Leah

Variability in eastern Pacific sea surface temperatures (SSTs) associated with the El Nino Southern Oscillation are known to affect Amazonian precipitation, but to what extent do changing Amazonian vegetation and rainfall impact eastern Pacific SST? The Amazon rainforest is threatened by many factors including climate change and clearing for agricultural reasons. Forest fires and dieback are more likely due to increased frequency and intensity of droughts in the region. It is possible that extensive Amazon deforestation can enhance El Nino conditions by weakening the Walker circulation. Correlations between annual rainfall rates over the Amazon and other atmospheric parameters (global precipitation, surface air temperature, low cloud amount, 500 hPa vertical velocity, surface winds, and 200 hPa winds) over the eastern Pacific indicate strong relationships among these fields. Maps of these correlations (teleconnection maps) reveal that when the Amazon is rainy SSTs in the central and eastern Pacific are cold, rainfall is suppressed over the central and eastern Pacific, low clouds are prominent over the eastern and southeastern Pacific, and subsidence over the central and eastern Pacific is enhanced. Precipitation in the Amazon is also consistent with a strong Walker circulation (La Nina conditions), manifest as strong correlations with the easterly surface and westerly 200 hPa zonal winds. Coupling between Amazon rainfall and these fields are seen in observations and model data. Correlations were calculated using data from observations, reanalysis data, two models under the Coupled Model Intercomparison Project/Atmospheric Model Intercomparison Project (CMIP5/AMIP), and an AMIP run with the model used in this study, the Community Earth System Model (CESM1.1.1). Although the correlations between Amazon precipitation and the aforementioned fields are strong, they do not show causality. In order to investigate the impact of tropical South American deforestation on the

Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion

DEFF Research Database (Denmark)

Secher, Niels Jørgen; MaCormack, CD; Weber, Tom

2007-01-01

OBJECTIVE: To evaluate the effect of double cerclage compared with a single cerclage. DESIGN: Randomised, controlled multicentre trial. SETTING: Ten different countries are participating with both secondary and tertiary centres. The countries participating are Denmark, Sweden, Germany, United...... Kingdom, Spain, South Africa, Australia and India. This gives both a broad spectrum of diversity global and local. We expect a total of 242 women enrolled per year. POPULATION: Prophylactic study: 1. History of cervical incompetence/insufficiency. (Delivery 15 to ..., without the membranes being exposed to the vagina. 6. Tertiary cerclage: Short cervix, membranes exposed to the vagina. Observational study: Eligible women who refuse to be randomised will participate in an observational study. 7. Repeat/requested cervical occlusion. METHODS: The women will be randomised...

Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks

NARCIS (Netherlands)

Zemp, Delphine Clara; Schleussner, Carl Friedrich; Barbosa, Henrique M J; Hirota, Marina; Montade, Vincent; Sampaio, Gilvan; Staal, Arie; Wang-Erlandsson, L.; Rammig, Anja

2017-01-01

Reduced rainfall increases the risk of forest dieback, while in return forest loss might intensify regional droughts. The consequences of this vegetation-atmosphere feedback for the stability of the Amazon forest are still unclear. Here we show that the risk of self-amplified Amazon forest loss

A single dose desensitization for summer hay fever. Results of a double blind study-1988.

Science.gov (United States)

Fell, P; Brostoff, J

1990-01-01

A new type of desensitising vaccine, enzyme potentiated was subjected to a double-blind randomised study during the hay fever season. The vaccine is a convenient single injection given in March and the results show good protection throughout the grass pollen season.

Metagenome sequencing of the microbial community of two Brazilian anthropogenic Amazon dark earth sites, Brazil.

Science.gov (United States)

Lemos, Leandro Nascimento; de Souza, Rosineide Cardoso; de Souza Cannavan, Fabiana; Patricio, André; Pylro, Victor Satler; Hanada, Rogério Eiji; Mui, Tsai Siu

2016-12-01

The Anthropogenic Amazon Dark Earth soil is considered one of the world's most fertile soils. These soils differs from conventional Amazon soils because its higher organic content concentration. Here we describe the metagenome sequencing of microbial communities of two sites of Anthropogenic Amazon Dark Earth soils from Amazon Rainforest, Brazil. The raw sequence data are stored under Short Read Accession number: PRJNA344917.

Petrobras eyes LNG project in Amazon region

International Nuclear Information System (INIS)

Anon.

1995-01-01

The Brazilian state oil company has proved gas reserves in the Rio Urucu area of the Amazon jungle totaling 1.84 tcf. That compares with 3.08 tcf contained in the offshore Campos basin, source of most of Brazil's oil and gas production. The environmentally sensitive Urucu region is one of the most dense, remote jungles in the world. Because of environmental concerns about pipelines in the rain forest and a government emphasis on boosting the natural gas share of Brazil's energy mix, a small liquefied natural gas project is shaping up as the best option for developing and marketing Urucu gas. The amazon campaign underscores a government initiative to boost Brazilian consumption of natural gas. In Brazil natural gas accounts for only 4% of primary energy consumption. Some years ago, the government set an official goal of boosting the gas share of the primary energy mix to 10% by 2000. The paper discusses current drilling activities, gas production and processing, the logistics of the upper Amazon, and gas markets

Towards the integration of StoRM on Amazon Simple Storage Service (S3)

Energy Technology Data Exchange (ETDEWEB)

Andreozzi, S; Magnoni, L; Zappi, R [INFN-CNAF, Viale Carlo Berti Pichat, 6/2, 40127, Bologna (Italy)], E-mail: sergio.andreozzi@cnaf.infn.it, E-mail: luca.magnoni@cnaf.infn.it, E-mail: riccardo.zappi@cnaf.infn.it

2008-07-15

In Grid systems, a core resource being shared among geographically-dispersed communities of users is the storage. For this resource, a standard interface specification (Storage Resource Management or SRM) was defined and is being evolved in the context of the Open Grid Forum. By implementing this interface, all storage resources part of a Grid could be managed in an homogenous fashion. In this work, we consider the extension of StoRM (STOrage Resource Manager, an implementation of SRM v2.2) in order to integrate a new type of storage resource: the Amazon Simple Storage Service (Amazon S3). Amazon S3 is a simple Web services interface offering access to the same highly scalable, reliable, fast, inexpensive data storage infrastructure that Amazon uses to run its own global network of Web sites. By performing this integration, we offer to the Grid community the capability to manage and access an incredible amount of storage resources freeing them from considering the costs associated with server maintenance, or whether they have enough storage available. The characteristics of StoRM are suitable for a smooth integration with Amazon S3. In particular, StoRM is designed to be easily adapted to the underlying storage resource via a plug-in mechanism, therefore a new plugin for integration with the Amazon S3 Web Service will be written. As regards the access policies, StoRM translates the Grid authorization rules into the Amazon S3 ones and applies them to the Amazon Web Services identity.

Towards the integration of StoRM on Amazon Simple Storage Service (S3)

International Nuclear Information System (INIS)

Andreozzi, S; Magnoni, L; Zappi, R

2008-01-01

In Grid systems, a core resource being shared among geographically-dispersed communities of users is the storage. For this resource, a standard interface specification (Storage Resource Management or SRM) was defined and is being evolved in the context of the Open Grid Forum. By implementing this interface, all storage resources part of a Grid could be managed in an homogenous fashion. In this work, we consider the extension of StoRM (STOrage Resource Manager, an implementation of SRM v2.2) in order to integrate a new type of storage resource: the Amazon Simple Storage Service (Amazon S3). Amazon S3 is a simple Web services interface offering access to the same highly scalable, reliable, fast, inexpensive data storage infrastructure that Amazon uses to run its own global network of Web sites. By performing this integration, we offer to the Grid community the capability to manage and access an incredible amount of storage resources freeing them from considering the costs associated with server maintenance, or whether they have enough storage available. The characteristics of StoRM are suitable for a smooth integration with Amazon S3. In particular, StoRM is designed to be easily adapted to the underlying storage resource via a plug-in mechanism, therefore a new plugin for integration with the Amazon S3 Web Service will be written. As regards the access policies, StoRM translates the Grid authorization rules into the Amazon S3 ones and applies them to the Amazon Web Services identity

Randomised, double-blind, comparative study to evaluate the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia.

Science.gov (United States)

Amarapurkar, Deepak N; Rane, Priya

2004-12-01

Prokinetic agents like itopride hydrochloride and mosapride citrate are commonly used in the management of functional dyspepsia. However, in a recently conducted international, multicentric study, efficacy of 3 different regimens of mosapride was shown to be comparable to placebo. The objective of this phase 4 randomised, double blind, prospective study was to compare the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia among patients attending the gastroenterology outpatient department of a tertiary care hospital. Ganaton 50 mg or mosapride citrate 5 mg three times daily before meals for a period of 2 weeks was administered orally. Thirty functional dyspepsia patients in each group (total = 60) were randomised to receive itopride hydrochloride or mosapride citrate treatment for 2 weeks. In itopride versus mosapride groups, global efficacy as judged by patients was excellent in 17 versus 9 (p itopride versus mosapride group global efficacy as judged by physician was excellent in 24 (80%) versus 15 (50%) and poor in 0 (0%) versus 3 (10%) patients respectively. The global efficacy was rated as excellent to good in significantly (p itopride (93.3%) group as compared to mosapride (63.33 %) group. None of the patients reported any adverse events with itopride treatment. In the mosapride group 5 patients (16.7%) reported adverse events. Two patients (6.7%) were withdrawn from mosapride treatment due to adverse events. The physician rated global tolerability ofitopride versus mosapride treatment as excellent in 23 (76.7%) versus 8 (26.7%) (p itopride hydrochloride) is superior in efficacy and safety over mosapride citrate in the management of functional dyspepsia.

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

Directory of Open Access Journals (Sweden)

Osborne Richard

2007-09-01

Full Text Available Abstract Background Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA, there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA. Methods/Design Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA. Trial registration ACTR12605000503628; NCT00415259.

Potential groundwater contribution to Amazon evapotranspiration

Science.gov (United States)

Fan, Y.; Miguez-Macho, G.

2010-07-01

Climate and land ecosystem models simulate a dry-season vegetation stress in the Amazon forest, but observations show enhanced growth in response to higher radiation under less cloudy skies, indicating an adequate water supply. Proposed mechanisms include larger soil water store and deeper roots in nature and the ability of roots to move water up and down (hydraulic redistribution). Here we assess the importance of the upward soil water flux from the groundwater driven by capillarity. We present a map of water table depth from observations and groundwater modeling, and a map of potential capillary flux these water table depths can sustain. The maps show that the water table beneath the Amazon can be quite shallow in lowlands and river valleys (2.1 mm day-1 to the land surface averaged over Amazonia, but varies from 0.6 to 3.7 mm day-1 across nine study sites. Current models simulate a large-scale reduction in dry-season photosynthesis under today's climate and a possible dieback under projected future climate with a longer dry season, converting the Amazon from a net carbon sink to a source and accelerating warming. The inclusion of groundwater and capillary flux may modify the model results.

5 year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: a cluster-randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Bhattacharya, Sujit K; Sur, Dipika; Ali, Mohammad; Kanungo, Suman; You, Young Ae; Manna, Byomkesh; Sah, Binod; Niyogi, Swapan K; Park, Jin Kyung; Sarkar, Banwarilal; Puri, Mahesh K; Kim, Deok Ryun; Deen, Jacqueline L; Holmgren, Jan; Carbis, Rodney; Dhingra, Mandeep Singh; Donner, Allan; Nair, G Balakrish; Lopez, Anna Lena; Wierzba, Thomas F; Clemens, John D

2013-12-01

Efficacy and safety of a two-dose regimen of bivalent killed whole-cell oral cholera vaccine (Shantha Biotechnics, Hyderabad, India) to 3 years is established, but long-term efficacy is not. We aimed to assess protective efficacy up to 5 years in a slum area of Kolkata, India. In our double-blind, cluster-randomised, placebo-controlled trial, we assessed incidence of cholera in non-pregnant individuals older than 1 year residing in 3933 dwellings (clusters) in Kolkata, India. We randomly allocated participants, by dwelling, to receive two oral doses of modified killed bivalent whole-cell cholera vaccine or heat-killed Escherichia coli K12 placebo, 14 days apart. Randomisation was done by use of a computer-generated sequence in blocks of four. The primary endpoint was prevention of episodes of culture-confirmed Vibrio cholerae O1 diarrhoea severe enough for patients to seek treatment in a health-care facility. We identified culture-confirmed cholera cases among participants seeking treatment for diarrhoea at a study clinic or government hospital between 14 days and 1825 days after receipt of the second dose. We assessed vaccine protection in a per-protocol population of participants who had completely ingested two doses of assigned study treatment. 69 of 31 932 recipients of vaccine and 219 of 34 968 recipients of placebo developed cholera during 5 year follow-up (incidence 2·2 per 1000 in the vaccine group and 6·3 per 1000 in the placebo group). Cumulative protective efficacy of the vaccine at 5 years was 65% (95% CI 52-74; pcholera vaccines. Established long-term efficacy of this vaccine could assist policy makers formulate rational vaccination strategies to reduce overall cholera burden in endemic settings. Bill & Melinda Gates Foundation and the governments of South Korea and Sweden. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Heczko, Piotr B; Tomusiak, Anna; Adamski, Paweł; Jakimiuk, Artur J; Stefański, Grzegorz; Mikołajczyk-Cichońska, Aleksandra; Suda-Szczurek, Magdalena; Strus, Magdalena

2015-12-03

This multicentre, randomised, double-blind, placebo-controlled trial was performed to determine whether the use of oral probiotic preparation (prOVag®) containing three Lactobacillus strains together with standard metronidazole treatment and also targeted antibiotic treatment (following the failure of metronidazole therapy) could reduce the recurrence rates of bacterial vaginosis (BV) and aerobic vaginitis (AV). Patients at private gynaecological clinics in Poland with histories of recurrent BV/AV and current symptoms were randomly allocated to receive metronidazole and probiotic or placebo, and assessed monthly on visits II and III-V. The total number of study visits was 5-6 (I, II, II bis - if applicable, III, IV, V). One probiotic or placebo capsule was administered with metronidazole/targeted antibiotic twice daily for 10 days; during follow up, patients took one capsule daily for 10 days perimenstrually. Clinical examination and vaginal swabbing were performed at each visit. Primary outcomes were clinical or microbiological BV/AV recurrence and probiotic safety. Secondary outcomes were vaginal pH, Nugent score, and Lactobacillus counts in the vaginal microbiota. Safety analysis was performed in 578 (probiotic, n = 285; placebo, n = 293) 18-50-year-old women who were randomised. BV/AV was confirmed microbiologically in 241 (probiotic, n = 118; placebo, n = 123) participants, who continued the trial. Data from 154 (probiotic, n = 73; placebo, n = 81) participants who completed the study were analysed to determine the efficacy of prOVag. Additional analyses included 37 (probiotic, n = 22; placebo, n = 15) participants who received targeted antibiotics and probiotics or placebo. prOVag lengthened the time to clinical relapse of BV/AV symptoms up to 51 % (p vaginal pH and Nugent score, and increased vaginal Lactobacillus counts following standard treatment. This study demonstrated that oral probiotics lengthened remission in

Integrating Ecosystem Management, Protected Areas, and Mammal Conservation in the Brazilian Amazon

Directory of Open Access Journals (Sweden)

Claudia Azevedo-Ramos

2006-12-01

Full Text Available The Amazon forest has been converted to a matrix of pristine and modified habitats. Landscape-scale biodiversity conservation requires an understanding of species' distributions over this matrix to guarantee both effective protection and use for present and future generations. In this study, we evaluated how much of the existing and future planned protected areas (PAs would be contributing to the conservation of Brazilian Amazon mammals (N = 399, including threatened species (N = 51. Currently, almost 37% of Brazilian Amazon is protected and that may increase to 46% if planned PAs are implemented. In the current PA system, 22% are indigenous land and 11% are sustainable use units, e.g., production forests. Only one-fifth of the whole range of mammal species occurring in Brazilian Amazon is actually protected by Brazilian PAs. However, considering only the part of the ranges within the Brazilian Amazon, and therefore under the scope of Brazilian actions, Brazilian PAs assume an important role in the protection of 39% of mammal distribution ranges, particularly the threatened species (39%. These results suggest that an integrated network of protected areas among Amazon countries would be necessary to increase their efficiency in mammal conservation. The need for strengthening of the forest sector and good management practices in Brazil appears critical for the maintenance of large extents of forest and species conservation. Under such a scenario, the contribution of developed nations and international agencies must assume an important role for the maintenance and enlargement of the protected area network in Amazon region.

A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old.

Science.gov (United States)

2015-09-01

This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF) vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were titered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose.

A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old

Directory of Open Access Journals (Sweden)

2015-09-01

Full Text Available This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were tittered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose.

Beginning Amazon Web Services with Node.js

CERN Document Server

Shackelford, Adam

2015-01-01

Beginning Amazon Web Services with Node.js teaches any novice Node.js developer to configure, deploy, and maintain scalable small to large scale Node.js applications in Amazon Web Services. Hosting a Node.js application in a production environment usually means turning to PaaS hosting, but this approach brings problems. Deploying Node.js directly to AWS solves the problems you encounter in these situations, enabling you to cut out the middle man. You will begin with a basic RESTful web service in Node.js, using the popular Express.js framework, pre-built and ready to run in your local env

Effectiveness of single dose rifampicin in preventing leprosy in close contacts of patients with newly diagnosed leprosy: cluster randomised controlled trial

NARCIS (Netherlands)

Moet, F. Johannes; Pahan, David; Oskam, Linda; Richardus, Jan H.; van Brakel, Wim H.; Klatser, Paul R.; Saunderson, Paul R.; Smith, W. Cairns S.; Withington, Steve G.; Richardus, Jan Hendrik; Schuring, Ron P.; Faber, Roel; Borsboom, Gerard J. J. M.

2008-01-01

OBJECTIVE: To determine the effectiveness of chemoprophylaxis using a single dose of rifampicin to prevent leprosy in close contacts. DESIGN: Single centre, double blind, cluster randomised, placebo controlled trial. SETTING: Leprosy control programme in two districts of northwest Bangladesh with a

Efficacy and safety of the biosimilar ABP 501 compared with adalimumab in patients with moderate to severe rheumatoid arthritis: a randomised, double-blind, phase III equivalence study.

Science.gov (United States)

Cohen, Stanley; Genovese, Mark C; Choy, Ernest; Perez-Ruiz, Fernando; Matsumoto, Alan; Pavelka, Karel; Pablos, Jose L; Rizzo, Warren; Hrycaj, Pawel; Zhang, Nan; Shergy, William; Kaur, Primal

2017-10-01

ABP 501 is a Food and Drug Administration-approved biosimilar to adalimumab; structural, functional and pharmacokinetic evaluations have shown that the two are highly similar. We report results from a phase III study comparing efficacy, safety and immunogenicity between ABP 501 and adalimumab. In this randomised, double-blind, active comparator-controlled, 26-week equivalence study, patients with moderate to severe active rheumatoid arthritis (RA) despite methotrexate were randomised (1:1) to ABP 501 or adalimumab (40 mg) every 2 weeks. Primary endpoint was risk ratio (RR) of ACR20 between groups at week 24. Primary hypothesis that the treatments were equivalent would be confirmed if the 90% CI for RR of ACR20 at week 24 fell between 0.738 and 1.355, demonstrating that ABP 501 is similar to adalimumab. Secondary endpoints included Disease Activity Score 28-joint count-C reactive protein (DAS28-CRP). Safety was assessed via adverse events (AEs) and laboratory evaluations. Antidrug antibodies were assessed to determine immunogenicity. A total of 526 patients were randomised (n=264, ABP 501; n=262 adalimumab) and 494 completed the study. ACR20 response at week 24 was 74.6% (ABP 501) and 72.4% (adalimumab). At week 24, the RR of ACR20 (90% CI) between groups was 1.039 (0.954, 1.133), confirming the primary hypothesis. Changes from baseline in DAS28-CRP, ACR50 and ACR70 were similar. There were no clinically meaningful differences in AEs and laboratory abnormalities. A total of 38.3% (ABP 501) and 38.2% (adalimumab) of patients tested positive for binding antidrug antibodies. Results from this study demonstrate that ABP 501 is similar to adalimumab in clinical efficacy, safety and immunogenicity in patients with moderate to severe RA. NCT01970475; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

From where does the Amazon forest gets its water?

Science.gov (United States)

Miguez-Macho, G.; Fan, Y.

2016-12-01

The Amazon receives abundant annual rainfall but parts of it experience a multi-month dry season. Here we ask: what is the water source that sustains the dry-season ET? Where over the Amazon it is largely local and recent rain (hence ET shutting down in dry season), or past rain that is stored in the deep soils and the groundwater (deep roots tapping deep reservoirs sustaining ET), or is it rain that fell on higher grounds (through topography-driven lateral convergence)? Using synthesis of isotope and other tracer observations and basin-wide inverse modeling (shallow soil, deep soil, with and without groundwater, with and without dynamic rooting depth), we attempt to tease out these components. The results shed light on likely ET sources and how future global change may preferentially impact Amazon ecosystem functioning.

Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial

NARCIS (Netherlands)

S. Koning (Sander); L.W.A. van Suijlekom-Smit (Lisette); J.L. Nouwen (Jan); C.M. Verduin (Cees); R.M.D. Bernsen (Roos); A.P. Oranje (Arnold); S. Thomas (Siep); J.C. van der Wouden (Hans)

2002-01-01

textabstractOBJECTIVE: To test the hypothesis that fusidic acid would not increase the treatment effect of disinfecting with povidone-iodine alone in children with impetigo. DESIGN: Randomised placebo controlled trial. SETTING: General practices in Greater Rotterdam.

Participant experiences from chronic administration of a multivitamin versus placebo on subjective health and wellbeing: a double-blind qualitative analysis of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Sarris Jerome

2012-12-01

Full Text Available Abstract Background While many randomised controlled trials have been conducted on multivitamins, to our knowledge no qualitative research exploring the subjective experience of taking a multivitamin during a clinical trial has been reported. Methods Semi-structured and open-ended written questions were incorporated into a 16-week double-blind, randomised, placebo-controlled, parallel groups trial of once-daily multivitamin administration. At the final study visit (week 16, three open-ended questions were posed to elucidate any positive, negative or unusual experiences from taking either the multivitamin or matched placebo. Qualitative thematic analysis was undertaken by researchers who were blind as to treatment condition of participants, and triangulation (independent analysis from three researchers was employed to ensure methodological rigour. Participant’s experiences were categorised as “positive” or “negative” and a Chi Square analysis was then applied to each of the experiential themes, to compare experiences between the multivitamin and placebo groups, (subdividing the groups by gender. Usual experiences were categorised and discussed separately. Results Of the 182 participants enrolled, 116 completed the study and qualitative data were available from 114 participants. Thematic analysis revealed significant effects in favour of the multivitamin over placebo for participants experiencing increased energy levels (p=.022 and enhanced mood (p=.027. The beneficial effect on energy levels was particularly evident among female participants. A trend was found for participants reporting better sleep in the multivitamin over placebo. The multivitamin and placebo groups did not significantly differ in perceived positive or negative effects in areas relating to other aspects of mental function or physical health. No significant negative effects were revealed, although there was a non-significant trend for more people in the multivitamin

Protocol for a double-blind randomised placebo-controlled trial of lithium carbonate in patients with amyotrophic lateral sclerosis (LiCALS) [Eudract number: 2008-006891-31].

Science.gov (United States)

Al-Chalabi, Ammar; Shaw, Pamela J; Young, Carolyn A; Morrison, Karen E; Murphy, Caroline; Thornhill, Marie; Kelly, Joanna; Steen, I Nicholas; Leigh, P Nigel

2011-09-21

Amyotrophic lateral sclerosis is a rapidly progressive neurodegenerative disorder characterised by loss of motor neurons leading to severe weakness and death from respiratory failure within 3-5 years. Riluzole prolongs survival in ALS. A published report has suggested a dramatic effect of lithium carbonate on survival. 44 patients were studied, with 16 randomly selected to take LiCO3 and riluzole and 28 allocated to take riluzole alone. In the group treated with lithium, no patients had died (i.e., 100% survival) at the end of the study (15 months from entry), compared to 71% surviving in the riluzole-only group. Although the trial can be criticised on several grounds, there is a substantial rationale from other laboratory studies that lithium is worth investigating therapeutically in amyotrophic lateral sclerosis. LiCALS is a multi-centre double-blind randomised parallel group controlled trial of the efficacy, safety, and tolerability of lithium carbonate (LiCO3) at doses to achieve stable 'therapeutic' plasma levels (0.4-0.8 mmol/L), plus standard treatment, versus matched placebo plus standard treatment, in patients with amyotrophic lateral sclerosis. The study will be based in the UK, in partnership with the MND Association and DeNDRoN (the Dementias and Neurodegnerative Diseases Clinical Research Network). 220 patients will be recruited. All patients will be on the standard treatment for ALS of riluzole 100 mg daily. The primary outcome measure will be death from any cause at 18 months defined from the date of randomisation. Secondary outcome measures will be changes in three functional rating scales, the ALS Functional Rating Scale-Revised, The EuroQOL (EQ-5D), and the Hospital Anxiety and Depression Scale.Eligible patients will have El Escorial Possible, Laboratory-supported Probable, Probable or Definite amyotrophic lateral sclerosis with disease duration between 6 months and 36 months (inclusive), vital capacity ≥ 60% of predicted within 1 month prior to

Protocol for a double-blind randomised placebo-controlled trial of lithium carbonate in patients with amyotrophic Lateral Sclerosis (LiCALS [Eudract number: 2008-006891-31

Directory of Open Access Journals (Sweden)

Kelly Joanna

2011-09-01

Full Text Available Abstract Background Amyotrophic lateral sclerosis is a rapidly progressive neurodegenerative disorder characterised by loss of motor neurons leading to severe weakness and death from respiratory failure within 3-5 years. Riluzole prolongs survival in ALS. A published report has suggested a dramatic effect of lithium carbonate on survival. 44 patients were studied, with 16 randomly selected to take LiCO3 and riluzole and 28 allocated to take riluzole alone. In the group treated with lithium, no patients had died (i.e., 100% survival at the end of the study (15 months from entry, compared to 71% surviving in the riluzole-only group. Although the trial can be criticised on several grounds, there is a substantial rationale from other laboratory studies that lithium is worth investigating therapeutically in amyotrophic lateral sclerosis. Methods/Design LiCALS is a multi-centre double-blind randomised parallel group controlled trial of the efficacy, safety, and tolerability of lithium carbonate (LiCO3 at doses to achieve stable 'therapeutic' plasma levels (0.4-0.8 mmol/L, plus standard treatment, versus matched placebo plus standard treatment, in patients with amyotrophic lateral sclerosis. The study will be based in the UK, in partnership with the MND Association and DeNDRoN (the Dementias and Neurodegnerative Diseases Clinical Research Network. 220 patients will be recruited. All patients will be on the standard treatment for ALS of riluzole 100 mg daily. The primary outcome measure will be death from any cause at 18 months defined from the date of randomisation. Secondary outcome measures will be changes in three functional rating scales, the ALS Functional Rating Scale-Revised, The EuroQOL (EQ-5D, and the Hospital Anxiety and Depression Scale. Eligible patients will have El Escorial Possible, Laboratory-supported Probable, Probable or Definite amyotrophic lateral sclerosis with disease duration between 6 months and 36 months (inclusive, vital

A randomised, double-masked phase III/IV study of the efficacy and safety of Avastin® (Bevacizumab intravitreal injections compared to standard therapy in subjects with choroidal neovascularisation secondary to age-related macular degeneration: clinical trial design

Directory of Open Access Journals (Sweden)

Bunce Catey

2008-10-01

Full Text Available Abstract Background The management of neovascular age-related macular degeneration (nAMD has been transformed by the introduction of agents delivered by intravitreal injection which block the action of vascular endothelial growth factor-A (anti-VEGF agents. One such agent in widespread use is bevacizumab which was initially developed for use in oncology. Most of the evidence supporting the use of bevacizumab for nAMD has come from interventional case series and this clinical trial was initiated because of the increasing and widespread use of this agent in the treatment of nAMD (an off-label indication despite a lack of definitive unbiased safety and efficacy data. Methods and design The Avastin® (bevacizumab for choroidal neovascularisation (ABC trial is a double-masked randomised controlled trial comparing intravitreal bevacizumab injections to standard therapy in the treatment of nAMD. Patients are randomised to intravitreal bevacizumab or standard therapy available at the time of trial initiation (verteporfin photodynamic therapy, intravitreal pegaptanib or sham treatment. Ranibizumab treatment was not included in the control arm as it had not been licensed for use at the start of recruitment for this trial. The primary outcome is the proportion of patients gaining ≥ 15 letters of visual acuity at 1 year and secondary outcomes include the proportion of patients with stable vision and mean visual acuity change. Discussion The ABC Trial is the first double-masked randomised control trial to investigate the efficacy and safety of intravitreal bevacizumab in the treatment of nAMD. This trial fully recruited in November 2007 and results should be available in early 2009. Important design issues for this clinical trial include (a defining the control group (b use of gain in vision as primary efficacy end-point and (c use of pro re nata treatment using intravitreal bevacizumab rather than continuous therapy. Trial registration Current controlled

Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment

Directory of Open Access Journals (Sweden)

Crotty Maria

2010-09-01

Full Text Available Abstract Background Shoulder pain is a common complication of a stroke which can impede participation in rehabilitation programs and has been associated with poorer outcomes. The evidence base for current medical and therapeutic management options of hemiplegic shoulder pain is limited. This study will evaluate the use of suprascapular nerve block injection as part of an interdisciplinary approach to the treatment of shoulder pain following stroke. The technique has previously been proven safe and effective in the treatment of shoulder pain associated with rheumatoid arthritis and degenerative shoulder conditions but its usefulness in a stroke population is unclear. Methods/Design A double blind randomised placebo controlled trial will assess the effect of a suprascapular nerve block compared with placebo in a population of 66 stroke patients. The trial will measure effect of injection on the primary outcome of pain, and secondary outcomes of function and quality of life. Measurements will take place at baseline, and 1, 4 and 12 weeks post intervention. Both groups will continue to receive routine physiotherapy and standard ward care. Discussion The results of this study could reduce pain symptoms in persons with mechanical shoulder pain post stroke and provide improvement in upper limb function. Trial Registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR - ACTRN12609000621213.

Calcium from salmon and cod bone is well absorbed in young healthy men: a double-blinded randomised crossover design.

Science.gov (United States)

Malde, Marian K; Bügel, Susanne; Kristensen, Mette; Malde, Ketil; Graff, Ingvild E; Pedersen, Jan I

2010-07-20

Calcium (Ca) - fortified foods are likely to play an important role in helping the consumer achieve an adequate Ca intake, especially for persons with a low intake of dairy products. Fish bones have a high Ca content, and huge quantities of this raw material are available as a by-product from the fish industry. Previously, emphasis has been on producing high quality products from fish by-products by use of bacterial proteases. However, documentation of the nutritional value of the enzymatically rinsed Ca-rich bone fraction remains unexplored. The objective of the present study was to assess the bioavailability of calcium in bones of Atlantic salmon (oily fish) and Atlantic cod (lean fish) in a double-blinded randomised crossover design. Ca absorption was measured in 10 healthy young men using 47Ca whole body counting after ingestion of a test meal extrinsically labelled with the 47Ca isotope. The three test meals contained 800 mg of Ca from three different calcium sources: cod bones, salmon bones and control (CaCO3). Mean Ca absorption (+/- SEE) from the three different Ca sources were 21.9 +/- 1.7%, 22.5 +/- 1.7% and 27.4 +/- 1.8% for cod bones, salmon bones, and control (CaCO3), respectively. We conclude that bones from Atlantic salmon and Atlantic cod are suitable as natural Ca sources in e.g. functional foods or as supplements.

Dexketoprofen/tramadol 25 mg/75 mg: randomised double-blind trial in moderate-to-severe acute pain after abdominal hysterectomy.

Science.gov (United States)

Moore, R A; McQuay, H J; Tomaszewski, J; Raba, G; Tutunaru, D; Lietuviete, N; Galad, J; Hagymasy, L; Melka, D; Kotarski, J; Rechberger, T; Fülesdi, B; Nizzardo, A; Guerrero-Bayón, C; Cuadripani, S; Pizà-Vallespir, B; Bertolotti, M

2016-01-22

Dexketoprofen trometamol plus tramadol hydrochloride is a new oral combination of two analgesics, which have different mechanisms of action for the treatment of moderate to severe acute pain. Randomised, double-blind, parallel, placebo and active-controlled, single and multiple-dose study to evaluate the analgesic efficacy and safety of dexketoprofen/tramadol 25 mg/75 mg in comparison with the single agents (dexketoprofen 25 mg and tramadol 100 mg) in moderate to severe acute pain after abdominal hysterectomy. Patients received seven consecutive doses of study drug within a 3-day period, each dose separated by an 8-hour interval. A placebo arm was included during the single-dose phase to validate the pain model. Efficacy assessments included pain intensity, pain relief, patient global evaluation and use of rescue medication. The primary endpoint was the mean sum of pain intensity differences over the first 8 h (SPID8). The efficacy analysis included 606 patients, with a mean age of 48 years (range 25-73). The study results confirmed the superiority of the combination over the single agents in terms of the primary endpoint (p pain, as confirmed by the single-dose efficacy, repeated-dose sustained effect and good safety profile observed. EU Clinical Trials Register (EudraCT number 2012-004545-32, registered 04 October 2012); Clinicaltrials.gov ( NCT01904149, registered 17 July 2013).

A Randomised, Double-Blind, Placebo-Controlled Trial of Actovegin in Patients with Post-Stroke Cognitive Impairment: ARTEMIDA Study Design

Directory of Open Access Journals (Sweden)

Alla Guekht

2013-12-01

Full Text Available Background: No drug treatment to date has shown convincing clinical evidence of restoring cognitive function or preventing further decline after stroke. The ongoing ARTEMIDA study will evaluate the efficacy and safety of Actovegin for the symptomatic treatment of post-stroke cognitive impairment (PSCI and will explore whether Actovegin has any disease-modifying effect by assessing whether any changes are sustained after treatment. Design: ARTEMIDA is a 12-month, multicentre trial in patients (planned a total of 500, now recruited with cognitive impairment following ischaemic stroke. The study consists of a baseline screening (≤7 days after stroke, after which eligible patients are randomised to Actovegin (2,000 mg/day for up to 20 intravenous infusions followed by 1,200 mg/day orally or placebo for a 6-month double-blind treatment period. Patients will be followed up for a further 6 months, during which time they will be treated in accordance with standard clinical practice. The primary study endpoint is change from baseline in the Alzheimer's Disease Assessment Scale, cognitive subscale, extended version. Secondary outcomes include: Montreal Cognitive Assessment; dementia diagnosis (ICD-10; National Institutes of Health Stroke Scale; Barthel Index; EQ-5D; Beck Depression Inventory, version II, and safety. Conclusion: There is a clear need for effective treatments for PSCI. ARTEMIDA should provide important insights into the use of a novel drug therapy for PSCI.

Mining drives extensive deforestation in the Brazilian Amazon.

Science.gov (United States)

Sonter, Laura J; Herrera, Diego; Barrett, Damian J; Galford, Gillian L; Moran, Chris J; Soares-Filho, Britaldo S

2017-10-18

Mining poses significant and potentially underestimated risks to tropical forests worldwide. In Brazil's Amazon, mining drives deforestation far beyond operational lease boundaries, yet the full extent of these impacts is unknown and thus neglected in environmental licensing. Here we quantify mining-induced deforestation and investigate the aspects of mining operations, which most likely contribute. We find mining significantly increased Amazon forest loss up to 70 km beyond mining lease boundaries, causing 11,670 km 2 of deforestation between 2005 and 2015. This extent represents 9% of all Amazon forest loss during this time and 12 times more deforestation than occurred within mining leases alone. Pathways leading to such impacts include mining infrastructure establishment, urban expansion to support a growing workforce, and development of mineral commodity supply chains. Mining-induced deforestation is not unique to Brazil; to mitigate adverse impacts of mining and conserve tropical forests globally, environmental assessments and licensing must considered both on- and off-lease sources of deforestation.

Radium-226 in waters of the Amazon river

International Nuclear Information System (INIS)

Shirshova, M.P.; Vinogradova, A.S.; Popov, N.I.

1987-01-01

Analysis of the Amazon river waters for 226 Ra content is carried out. Exploration works are carried out in the framework of the soviet investigations of the Amazon river in 1983 by the Academy of Science of USSR on board a research ship ''Professor Schtokman'' with the agreement and participation of brazilian scientists. Radium determination has been carried out in reference with equilibrium radon preliminary accumulated in samples (30 y) tightly closed. The general 226 Ra concentrations observed in the Amazon waters exceed 4-6 times the values known before relating to a ''diluted'' element fraction. It happens due to the presence of the river suspended matter in the water analysed; it is a carrier of additional quantities of 226 Ra, and considerable. The mixture zone of river and ocean waters is shown to be no ''geochemical barrier'' on the way to the ocean for river radium inlike the other microelements of the river run-off

Homeopathy for Perennial Asthma in Adolescents: Pilot Feasibility Study Testing a Randomised Withdrawal Design.

Science.gov (United States)

Mitchiguian Hotta, Livia; Cardinalli Adler, Ubiratan; de Toledo Cesar, Amarilys; Martinez, Edson Zangiacomi; Demarzo, Marcelo Marcos Piva

2018-05-01

 Previous findings from a pragmatic trial suggest that usual care compared with usual care plus individualised homeopathy is not a feasible design to address homeopathic interventions for asthma.  The main purpose of this article was to investigate the feasibility of the randomised withdrawal design as a strategy to assess the effectiveness of a standardised clinical-pharmaceutical homeopathic protocol ( Organon.modus ) on perennial asthma in adolescents.  Randomised withdrawal, double-blind, parallel, placebo-controlled, 12-week study. 12 to 17 years old adolescents, with the diagnosis of perennial asthma, using inhalatory beclomethasone (plus fenoterol for wheezing episodes), who achieved 3 months of well-controlled asthma, after a variable period of individualised homeopathic treatment according to Organon.modus protocol. a secondary care medical specialist centre. continuation with the individualised homeopathic medicine or with indistinguishable placebo during 12 weeks of beclomethasone step-down. number of days of well-controlled asthma. Secondary measures: number of days of fenoterol use, number of visits to an emergency service (without hospitalisation) and percentage of patients excluded due to an exacerbation characterising a partly controlled asthma. Tolerability was assessed by Adverse Events, registered at every visit.  Nineteen patients were randomised to continue treatment with homeopathy and 21 with placebo. Effectiveness measures for the homeopathy and placebo groups respectively were median number of days of good clinical control: 84 versus 30 ( p  = 0.18); median number of days of fenoterol use per patient: 3 versus 5 ( p  = 0.41); visits to an emergency room: 1 versus 6 ( p  = 0.35); percentage of exclusion due to partly controlled asthma: 36.8% versus 71.4% ( p  = 0.05). Few Adverse Events were reported.  This pilot study supports the feasibility of the double-blind randomised withdrawal design in studies investigating

Transforming Data: An Ethnography of Scientific Data from the Brazilian Amazon

DEFF Research Database (Denmark)

Walford, Antonia Caitlin

This thesis is an ethnography of scientific data produced by a Brazil-led scientific project in the Brazilian Amazon. It describes how the researchers and technicians make data about the Amazon forest, and how this data in turn generates different scientific communities, scientific subjectivities...

LBA-ECO LC-07 JERS-1 SAR Wetlands Masks and Land Cover, Amazon Basin: 1995-1996

Data.gov (United States)

National Aeronautics and Space Administration — ABSTRACT: This data set provides three Amazon Basin wetland image products: (1) a Central Amazon Wetlands Mask, (2) a Central Amazon Wetlands Vegetative-hydrologic...

Impact of Atmospheric Albedo on Amazon Evapotranspiration

Science.gov (United States)

Lopes, A. V.; Thompson, S. E.; Dracup, J. A.

2013-12-01

The vulnerability of the Amazon region to climate and anthropogenic driven disturbances has been the subject of extensive research efforts, given its importance in the global and regional climate and ecologic systems. The evaluation of such vulnerabilities requires the proper understanding of physical mechanisms controlling water and energy balances and how the disturbances change them. Among those mechanisms, the effects of atmospheric albedo on evapotranspiration have not been fully explored yet and are explored in this study. Evapotranspiration in the Amazon is sustained at high levels across all seasons and represents a large fraction of water and energy surface budgets. In this study, statistical analysis of data from four flux towers installed at Amazon primary forest sites was employed to quantify the impact of atmospheric albedo, mostly resulted from cloudiness, on evapotranspiration and to compare it to the effect of water limitation. Firstly, the difference in eddy-flux derived evapotranspiration at the flux towers under rainy and non-rainy antecedent conditions was tested for significance. Secondly, the same statistical comparison was performed under cloudy and clear sky conditions at hourly and daily time scales, using the reduction in incoming solar radiation as an indicator of cloudiness. Finally, the sensitivity of seasonal evapotranspiration totals to atmospheric albedo resulted from rainfall patterns is evaluated. That was done by sampling daily evapotranspiration estimates from empirical probability distribution functions conditioned to rainfall occurrence and then varying the number of dry days in each season. It was found that light limitation is much more important than water limitation in the Amazon, resulting in up to 43% reduction in daily evapotranspiration. Also, this effect varies by location and by season, the largest impact being in wet season, from December do January. Moreover, seasonal evapotranspiration totals were found to be

LBA-ECO LC-07 JERS-1 SAR Wetlands Masks and Land Cover, Amazon Basin: 1995-1996

Data.gov (United States)

National Aeronautics and Space Administration — This data set provides three Amazon Basin wetland image products: (1) a Central Amazon Wetlands Mask, (2) a Central Amazon Wetlands Vegetative-hydrologic Land Cover...

Hypoxia adaptation in fish of the Amazon: a never-ending task

African Journals Online (AJOL)

ance, fish of the Amazon have developed multiple adaptive solutions which occur at all biological levels. These solutions are thought to represent adaptive convergence rather than phylogenetic relatedness. Fish of the ..... these adjustments, morpho-functional adaptations of gills ..... Ecology of the flshes in the Amazon and.

The effect of phosphatidylserine administration on memory and symptoms of attention-deficit hyperactivity disorder: a randomised, double-blind, placebo-controlled clinical trial.

Science.gov (United States)

Hirayama, S; Terasawa, K; Rabeler, R; Hirayama, T; Inoue, T; Tatsumi, Y; Purpura, M; Jäger, R

2014-04-01

Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed behavioural disorder of childhood, affecting 3-5% of school-age children. The present study investigated whether the supplementation of soy-derived phosphatidylserine (PS), a naturally occurring phospholipid, improves ADHD symptoms in children. Thirty six children, aged 4-14 years, who had not previously received any drug treatment related to ADHD, received placebo (n = 17) or 200 mg day(-1) PS (n = 19) for 2 months in a randomised, double-blind manner. Main outcome measures included: (i) ADHD symptoms based on DSM-IV-TR; (ii) short-term auditory memory and working memory using the Digit Span Test of the Wechsler Intelligence Scale for Children; and (iii) mental performance to visual stimuli (GO/NO GO task). PS supplementation resulted in significant improvements in: (i) ADHD (P short-term auditory memory (P short-term auditory memory in children. PS supplementation might be a safe and natural nutritional strategy for improving mental performance in young children suffering from ADHD. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Efficacy of Bacillus coagulans Unique IS2 in treatment of irritable bowel syndrome in children: a double blind, randomised placebo controlled study.

Science.gov (United States)

Sudha, M Ratna; Jayanthi, N; Aasin, M; Dhanashri, R D; Anirudh, T

2018-04-26

The efficacy of the probiotic strain, Bacillus coagulans Unique IS2 in the treatment of Irritable Bowel Syndrome (IBS) was evaluated in children. A total of 141 children of either sex in the age group 4-12 years, diagnosed with IBS according to the Rome III criteria, participated in the double-blind randomised controlled trial. Children received either B. coagulans Unique IS2 chewable tablets or placebo once daily for eight weeks followed by a two week follow-up period. Reduction in pain intensity as well as other symptoms associated with Irritable Bowel Syndrome like abdominal discomfort, bloating, distension, sense of incomplete evacuation, straining at stool, urgency of bowel movement, passage of gas and mucus, and bowel habit satisfaction were assessed. B. coagulans Unique IS2 treated group showed a greater reduction in pain scores as evaluated by a weekly pain intensity scale. There was a significant reduction (Pcoagulans Unique IS2 treated group as compared to the placebo group. This study demonstrates the efficacy of B. coagulans Unique IS2 in reducing the symptoms of Irritable Bowel Syndrome in children in the age group of 4-12 years.

The Infant Fish Oil Supplementation Study (IFOS): design and research protocol of a double-blind, randomised controlled n--3 LCPUFA intervention trial in term infants.

Science.gov (United States)

Meldrum, S J; D'Vaz, N; Dunstan, J; Mori, T A; Prescott, S L

2011-09-01

The Infant Fish Oil Supplementation Study is a double-blind randomised controlled trial investigating whether the incidence of allergic disease can be reduced and developmental outcomes enhanced through supplementation with omega-3 fatty acids. Infants at high risk of developing allergic disease will be randomised to receive either fish oil or olive oil supplements until 6 months of age and followed up at six postnatal clinic visits to assess allergy outcomes and infant neurodevelopment. Study groups to consist of a treatment group allocated to receive 650 mg of fish oil daily (250-280 mg docosahexaenoic acid and at least 60 mg eicosapentaenoic acid and a placebo group (olive oil) from birth to 6 months of age. Allergy outcomes will be assessed by clinical history, clinical assessments and allergen skin prick tests at the 12, 30 and 60 month visits. Neurodevelopmental assessments to be conducted at 18 months, and language questionnaires at 12, 18 and 30 months. Samples will be collected from mothers antenatally, from infants at birth, and at clinic visits from 6 months onwards for immunological assessments. Fatty acid composition to be measured in erythrocytes and plasma (at birth and after the supplementation period) to assess the effect of the intervention on fatty acid status. Information on medical history, diet and other lifestyle factors at an antenatal clinic visit and postnatal clinic visits will also be collected. This study is designed to examine clinically relevant effects of a novel, non-invasive and potentially low cost approach to reduce the incidence of allergic disease and facilitate neurodevelopment during early childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU).

Science.gov (United States)

Jull, Andrew; Wadham, Angela; Bullen, Chris; Parag, Varsha; Kerse, Ngaire; Waters, Jill

2017-11-24

Objective  To determine the effect of low dose aspirin on ulcer healing in patients with venous leg ulcers. Design  Pragmatic, community based, parallel group, double blind, randomised controlled trial. Setting  Five community nursing centres in New Zealand. Participants  251 adults with venous leg ulcers who could safely be treated with aspirin or placebo: 125 were randomised to aspirin and 126 to placebo. Interventions  150 mg oral aspirin daily or matching placebo for up to 24 weeks treatment, with compression therapy as standard background treatment. Main outcome measures  The primary outcome was time to complete healing of the reference ulcer (largest ulcer if more than one ulcer was present). Secondary outcomes included proportion of participants healed, change in ulcer area, change in health related quality of life, and adverse events. Analysis was by intention to treat. Results  The median number of days to healing of the reference ulcer was 77 in the aspirin group and 69 in the placebo group (hazard ratio 0.85, 95% confidence interval 0.64 to 1.13, P=0.25). The number of participants healed at the endpoint was 88 (70%) in the aspirin group and 101 (80%) in the placebo group (risk difference -9.8%, 95% confidence interval -20.4% to 0.9%, P=0.07). Estimated change in ulcer area was 4.1 cm 2 in the aspirin group and 4.8 cm 2 in the placebo group (mean difference -0.7 cm 2 , 95% confidence interval -1.9 to 0.5 cm 2 , P=0.25). 40 adverse events occurred among 29 participants in the aspirin group and 37 adverse events among 27 participants in the placebo group (incidence rate ratio 1.1, 95% confidence interval 0.7 to 1.7, P=0.71). Conclusion  Our findings do not support the use of low dose aspirin as adjuvant treatment for venous leg ulcers. Trial registration  ClinicalTrials.gov NCT02158806. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Greenhouse problem in the Amazon jungle clearing

International Nuclear Information System (INIS)

Reis, E.J.; Margulis, S.

1991-01-01

This paper discusses the contribution of Amazon jungle clearing to the greenhouse problem and makes an assessment of long-run prospects. The introductory sections pose the problem from both international and Brazilian perspectives. The next section describes major features of the Amazonia ecosystems and presents methods and evidence on deforestation and on its impact on carbon dioxide emissions. Based upon cross-section information for a sample of municipalities in the Brazilian Amazon, the following section estimates elasticities of deforestation in relation to major economic factors- government policies included- and uses them to make projections for the future pace of deforestation. The last section discusses policy alternatives to slow down forest conversion

Drug therapy for improving walking distance in intermittent claudication: a systematic review and meta-analysis of robust randomised controlled studies

DEFF Research Database (Denmark)

Momsen, A H; Jensen, Martin Bach; Norager, C B

2009-01-01

of the databases to February 2009. In addition, reference lists were manually searched. REVIEW METHODS: Based upon a power calculation, only robust (n>56), peer-reviewed, double-blinded, randomised and placebo-controlled trials were included. The main outcomes evaluated were maximal walking distance (MWD) and pain...

Isoprene photochemistry over the Amazon rainforest.

Science.gov (United States)

Liu, Yingjun; Brito, Joel; Dorris, Matthew R; Rivera-Rios, Jean C; Seco, Roger; Bates, Kelvin H; Artaxo, Paulo; Duvoisin, Sergio; Keutsch, Frank N; Kim, Saewung; Goldstein, Allen H; Guenther, Alex B; Manzi, Antonio O; Souza, Rodrigo A F; Springston, Stephen R; Watson, Thomas B; McKinney, Karena A; Martin, Scot T

2016-05-31

Isoprene photooxidation is a major driver of atmospheric chemistry over forested regions. Isoprene reacts with hydroxyl radicals (OH) and molecular oxygen to produce isoprene peroxy radicals (ISOPOO). These radicals can react with hydroperoxyl radicals (HO2) to dominantly produce hydroxyhydroperoxides (ISOPOOH). They can also react with nitric oxide (NO) to largely produce methyl vinyl ketone (MVK) and methacrolein (MACR). Unimolecular isomerization and bimolecular reactions with organic peroxy radicals are also possible. There is uncertainty about the relative importance of each of these pathways in the atmosphere and possible changes because of anthropogenic pollution. Herein, measurements of ISOPOOH and MVK + MACR concentrations are reported over the central region of the Amazon basin during the wet season. The research site, downwind of an urban region, intercepted both background and polluted air masses during the GoAmazon2014/5 Experiment. Under background conditions, the confidence interval for the ratio of the ISOPOOH concentration to that of MVK + MACR spanned 0.4-0.6. This result implies a ratio of the reaction rate of ISOPOO with HO2 to that with NO of approximately unity. A value of unity is significantly smaller than simulated at present by global chemical transport models for this important, nominally low-NO, forested region of Earth. Under polluted conditions, when the concentrations of reactive nitrogen compounds were high (>1 ppb), ISOPOOH concentrations dropped below the instrumental detection limit (Amazon rainforest.

Soluble iron nutrients in Saharan dust over the central Amazon rainforest

Science.gov (United States)

Rizzolo, Joana A.; Barbosa, Cybelli G. G.; Borillo, Guilherme C.; Godoi, Ana F. L.; Souza, Rodrigo A. F.; Andreoli, Rita V.; Manzi, Antônio O.; Sá, Marta O.; Alves, Eliane G.; Pöhlker, Christopher; Angelis, Isabella H.; Ditas, Florian; Saturno, Jorge; Moran-Zuloaga, Daniel; Rizzo, Luciana V.; Rosário, Nilton E.; Pauliquevis, Theotonio; Santos, Rosa M. N.; Yamamoto, Carlos I.; Andreae, Meinrat O.; Artaxo, Paulo; Taylor, Philip E.; Godoi, Ricardo H. M.

2017-02-01

The intercontinental transport of aerosols from the Sahara desert plays a significant role in nutrient cycles in the Amazon rainforest, since it carries many types of minerals to these otherwise low-fertility lands. Iron is one of the micronutrients essential for plant growth, and its long-range transport might be an important source for the iron-limited Amazon rainforest. This study assesses the bioavailability of iron Fe(II) and Fe(III) in the particulate matter over the Amazon forest, which was transported from the Sahara desert (for the sake of our discussion, this term also includes the Sahel region). The sampling campaign was carried out above and below the forest canopy at the ATTO site (Amazon Tall Tower Observatory), a near-pristine area in the central Amazon Basin, from March to April 2015. Measurements reached peak concentrations for soluble Fe(III) (48 ng m-3), Fe(II) (16 ng m-3), Na (470 ng m-3), Ca (194 ng m-3), K (65 ng m-3), and Mg (89 ng m-3) during a time period of dust transport from the Sahara, as confirmed by ground-based and satellite remote sensing data and air mass backward trajectories. Dust sampled above the Amazon canopy included primary biological aerosols and other coarse particles up to 12 µm in diameter. Atmospheric transport of weathered Saharan dust, followed by surface deposition, resulted in substantial iron bioavailability across the rainforest canopy. The seasonal deposition of dust, rich in soluble iron, and other minerals is likely to assist both bacteria and fungi within the topsoil and on canopy surfaces, and especially benefit highly bioabsorbent species. In this scenario, Saharan dust can provide essential macronutrients and micronutrients to plant roots, and also directly to plant leaves. The influence of this input on the ecology of the forest canopy and topsoil is discussed, and we argue that this influence would likely be different from that of nutrients from the weathered Amazon bedrock, which otherwise provides the

Uranium geochemistry on the Amazon shelf: Evidence for uranium release from bottom sediments

International Nuclear Information System (INIS)

McKee, B.A.; DeMaster, D.J.; Nittrouer, C.A.

1987-01-01

In Amazon-shelf waters, as salinity increases to 36.5 x 10 -3 , dissolved uranium activities increase to a maximum of 4.60 dpm 1 -1 . This value is much higher than the open-ocean value (2.50 dpm 1 -1 ), indicating a source of dissolved uranium to shelf waters in addition to that supplied from open-ocean and riverine waters. Uranium activities are much lower for surface sediments in the Amazon-shelf sea bed (mean: 0.69 ± .09 dpm g -1 ) than for suspended sediments in the Amazon river (1.82 dpm g -1 ). Data suggest that the loss of particulate uranium from riverine sediments is probably the result of uranium desorption from the ferric-oxyhydroxide coatings on sediment particles, and/or uranium release by mobilization of the ferric oxyhydroxides. The total flux of dissolved 238 U from the Amazon shelf (about 1.2 x 10 15 dpm yr -1 ) constitutes about 15% of uranium input to the world ocean, commensurate to the Amazon River's contribution to world river-water discharge. Measurement of only the riverine flux of dissolved 238 U underestimates, by a factor of about 5, the flux of dissolved 238 U from the Amazon shelf to the open ocean

Prevention of head louse infestation: a randomised, double-blind, cross-over study of a novel concept product, 1% 1,2-octanediol spray versus placebo.

Science.gov (United States)

Burgess, Ian F; Brunton, Elizabeth R; French, Rebecca; Burgess, Nazma A; Lee, Peter N

2014-05-30

To determine whether regular use of a spray containing 1,2-octanediol 1%, which has been shown to inhibit survival of head lice, is able to work as a preventive against establishment of new infestations. Randomised, double-blind, cross-over, community study in Cambridgeshire, UK. 63 male and female schoolchildren aged 4-16 years judged to have a high risk of recurrent infestation. Only the youngest member of a household attending school participated. Participants were treated to eliminate lice, randomised between 1% octanediol or placebo sprays for 6 weeks then crossed-over to the other spray for 6 weeks. Parents applied the sprays at least twice weekly or more frequently if the hair was washed. Investigators monitored weekly for infestation and replenished supplies of spray. The primary endpoint was the time taken until the first infestation event occurred. The secondary measure was safety of the product in regular use. Intention-to-treat analysis found a total of 32 confirmed infestations in 20 participants, with 9 of them infested while using both products. In these nine participants the time to first infestation showed a significant advantage to 1% octanediol (p=0.0129). Per-protocol analysis showed only trends because the population included was not large enough to demonstrate significance. There were no serious adverse events and only two adverse events possibly related to treatment, one was a case of transient erythema and another of a rash that resolved after 5 days. Routine use of 1% octanediol spray provided a significant level of protection from infestation. It was concluded that this product is effective if applied regularly and thoroughly. ISRCTN09524995. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Chiswick, Carolyn; Reynolds, Rebecca M; Denison, Fiona; Drake, Amanda J; Forbes, Shareen; Newby, David E; Walker, Brian R; Quenby, Siobhan; Wray, Susan; Weeks, Andrew; Lashen, Hany; Rodriguez, Aryelly; Murray, Gordon; Whyte, Sonia; Norman, Jane E

2015-10-01

Maternal obesity is associated with increased birthweight, and obesity and premature mortality in adult offspring. The mechanism by which maternal obesity leads to these outcomes is not well understood, but maternal hyperglycaemia and insulin resistance are both implicated. We aimed to establish whether the insulin sensitising drug metformin improves maternal and fetal outcomes in obese pregnant women without diabetes. We did this randomised, double-blind, placebo-controlled trial in antenatal clinics at 15 National Health Service hospitals in the UK. Pregnant women (aged ≥16 years) between 12 and 16 weeks' gestation who had a BMI of 30 kg/m(2) or more and normal glucose tolerance were randomly assigned (1:1), via a web-based computer-generated block randomisation procedure (block size of two to four), to receive oral metformin 500 mg (increasing to a maximum of 2500 mg) or matched placebo daily from between 12 and 16 weeks' gestation until delivery of the baby. Randomisation was stratified by study site and BMI band (30-39 vs ≥40 kg/m(2)). Participants, caregivers, and study personnel were masked to treatment assignment. The primary outcome was Z score corresponding to the gestational age, parity, and sex-standardised birthweight percentile of liveborn babies delivered at 24 weeks or more of gestation. We did analysis by modified intention to treat. This trial is registered, ISRCTN number 51279843. Between Feb 3, 2011, and Jan 16, 2014, inclusive, we randomly assigned 449 women to either placebo (n=223) or metformin (n=226), of whom 434 (97%) were included in the final modified intention-to-treat analysis. Mean birthweight at delivery was 3463 g (SD 660) in the placebo group and 3462 g (548) in the metformin group. The estimated effect size of metformin on the primary outcome was non-significant (adjusted mean difference -0·029, 95% CI -0·217 to 0·158; p=0·7597). The difference in the number of women reporting the combined adverse outcome of miscarriage

Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study.

Science.gov (United States)

Kim, Jong S; Lee, Eun-Jae; Chang, Dae-Il; Park, Jong-Ho; Ahn, Seong Hwan; Cha, Jae-Kwan; Heo, Ji Hoe; Sohn, Sung-Il; Lee, Byung-Chul; Kim, Dong-Eog; Kim, Hahn Young; Kim, Seongheon; Kwon, Do-Young; Kim, Jei; Seo, Woo-Keun; Lee, Jun; Park, Sang-Won; Koh, Seong-Ho; Kim, Jin Young; Choi-Kwon, Smi

2017-01-01

Mood and emotional disturbances are common in patients with stroke, and adversely affect the clinical outcome. We aimed to evaluate the efficacy of early administration of escitalopram to reduce moderate or severe depressive symptoms and improve emotional and neurological dysfunction in patients with stroke. This was a placebo controlled, double-blind trial done at 17 centres in South Korea. Patients who had had an acute stroke within the past 21 days were randomly assigned in a 1:1 ratio to receive oral escitalopram (10 mg/day) or placebo for 3 months. Randomisation was done with permuted blocks stratified by centre, via a web-based system. The primary endpoint was the frequency of moderate or severe depressive symptoms (Montgomery-Åsberg Depression Rating Scale [MADRS] ≥16). Endpoints were assessed at 3 months after randomisation in the full analysis set (patients who took study medication and underwent assessment of primary endpoint after randomisation), in all patients who were enrolled and randomly assigned (intention to treat), and in all patients who completed the trial (per-protocol analysis). This trial is registered with ClinicalTrials.gov, number NCT01278498. Between Jan 27, 2011, and June 30, 2014, 478 patients were assigned to placebo (n=237) or escitalopram (n=241); 405 were included in the full analysis set (195 in the placebo group, 210 in the escitalopram group). The primary outcome did not differ by study group in the full analysis set (25 [13%] patients in the placebo group vs 27 [13%] in the escitalopram group; odds ratio [OR] 1·00, 95% CI 0·56-1·80; p>0·99) or in the intention-to-treat analysis (34 [14%] vs 35 [15%]; OR 1·01, 95% CI 0·61-1·69, p=0·96). The study medication was generally well tolerated; the most common adverse events were constipation (14 [6%] patients who received placebo vs 14 [6%] who received escitalopram), muscle pain (16 [7%] vs ten [4%]), and insomnia (12 [5%] vs 12 [5%]). Diarrhoea was more common in the

Effect of eltrombopag on platelet counts and bleeding during treatment of chronic idiopathic thrombocytopenic purpura: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Bussel, James B; Provan, Drew; Shamsi, Tahir; Cheng, Gregory; Psaila, Bethan; Kovaleva, Lidia; Salama, Abdulgabar; Jenkins, Julian M; Roychowdhury, Debasish; Mayer, Bhabita; Stone, Nicole; Arning, Michael

2009-02-21

Eltrombopag is an oral, non-peptide, thrombopoietin-receptor agonist that stimulates thrombopoiesis, leading to increased platelet production. This study assessed the efficacy, safety, and tolerability of once daily eltrombopag 50 mg, and explored the efficacy of a dose increase to 75 mg. In this phase III, randomised, double-blind, placebo-controlled study, adults from 63 sites in 23 countries with chronic idiopathic thrombocytopenic purpura (ITP), platelet counts less than 30 000 per muL of blood, and one or more previous ITP treatment received standard care plus once-daily eltrombopag 50 mg (n=76) or placebo (n=38) for up to 6 weeks. Patients were randomly assigned in a 2:1 ratio of eltrombopag:placebo by a validated randomisation system. After 3 weeks, patients with platelet counts less than 50 000 per microL could increase study drug to 75 mg. The primary endpoint was the proportion of patients achieving platelet counts 50 000 per microL or more at day 43. All participants who received at least one dose of their allocated treatment were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT00102739. 73 patients in the eltrombopag group and 37 in the placebo group were included in the efficacy population and were evaluable for day-43 analyses. 43 (59%) eltrombopag patients and six (16%) placebo patients responded (ie, achieved platelet counts >/=50 000 per microL; odds ratio [OR] 9.61 [95% CI 3.31-27.86]; ptime during the study than did those receiving placebo (OR 0.49 [95% CI 0.26-0.89]; p=0.021). The frequency of grade 3-4 adverse events during treatment (eltrombopag, two [3%]; placebo, one [3%]) and adverse events leading to study discontinuation (eltrombopag, three [4%]; placebo, two [5%]), were similar in both groups. Eltrombopag is an effective treatment for managment of thrombocytopenia in chronic ITP.

A double-blind randomised, placebo-controlled trial evaluating the influence of oral long-acting muscle relaxant (Mebeverine MR), and insufflation with CO{sub 2} on pain associated with barium enema

Energy Technology Data Exchange (ETDEWEB)

Lowe, A.S.; Chapman, A.H.; Wilson, D.; Culpan, A.G. [Department of Radiology, St. James' s University Hospital, Beckett Street, LS9 7TF, Leeds (United Kingdom)

2003-07-01

Previous investigators have shown significant benefit using CO{sub 2} for bowel insufflation. Others have suggested that the long-acting smooth muscle relaxant, Mebeverine, may be of benefit. We subjected this to a randomised double-blind trial. A total of 181 outpatients were randomised to receive either Mebeverine or placebo as pre-medication, and either air or CO{sub 2} for bowel insufflation, thus creating four treatment groups. Visual-analogue lines were used to record pain scores before, during, and up to 8 h following the enema. All groups showed increased pain scores during the enema, with peak pain scores at the end of the examination, falling to baseline scores by 8 h. Patients receiving the combination of C0{sub 2} and placebo had significantly lower pain scores at 1 and 4 h (P=0.00 and P=0.014, respectively; Kruskal-Wallis test) compared with all other groups. Having Mebeverine as a pre-medication did not significantly lower pain scores compared with placebo, and decreased the amount of benefit received from the CO{sub 2}. We confirm that CO{sub 2} is of benefit in decreasing pain during barium enema, and we recommend its routine use to improve the comfort of patients. Mebeverine is not of benefit, and its use as a pre-medication for enemas is not recommended. (orig.)

The effects of resveratrol supplementation on cardiovascular risk factors in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled study.

Science.gov (United States)

Faghihzadeh, Forouzan; Adibi, Payman; Hekmatdoost, Azita

2015-09-14

Non-alcoholic fatty liver disease (NAFLD) is usually associated with insulin resistance, central obesity, reduced glucose tolerance, type 2 diabetes mellitus and hypertriacylglycerolaemia. The beneficial effects of resveratrol on metabolic disorders have been shown previously. The aim of this study was to evaluate the effects of resveratrol supplementation on cardiovascular risk factors in patients with NAFLD. In this randomised double-blinded placebo-controlled clinical trial, fifty NAFLD patients were supplemented with either a 500-mg resveratrol capsule or a placebo capsule for 12 weeks. Both groups were advised to follow an energy-balanced diet and physical activity recommendations. resveratrol supplementation reduced alanine aminotransferase (ALT) and hepatic steatosis significantly more than placebo (P0·05). There were no significant changes in blood pressure, insulin resistance markers and TAG in either group (P>0·05). Our data have shown that 12-week supplementation of 500 mg resveratrol does not have any beneficial effect on anthropometric measurements, insulin resistance markers, lipid profile and blood pressure; however, it reduced ALT and hepatic steatosis in patients with NAFLD.

Theobromine for the treatment of persistent cough: a randomised, multicentre, double-blind, placebo-controlled clinical trial.

Science.gov (United States)

Morice, Alyn H; McGarvey, Lorcan; Pavord, Ian D; Higgins, Bernard; Chung, Kian Fan; Birring, Surinder S

2017-07-01

To investigate the effect of BC1036 on health-related quality of life (QOL) in subjects with persistent cough. The secondary objective was to investigate the effect of BC1036 on subjective cough severity. This was a randomised, multicentre, double-blind, placebo-controlled, parallel-group study in 289 subjects with persistent cough. Subjects received BC1036 or placebo twice daily for 14 days. The primary endpoint comprised cough-related QOL assessed using the validated Leicester Cough Questionnaire (LCQ) at Day 14. Secondary endpoints comprised the LCQ scores at Day 7 and Day 28, cough severity VAS scores at each visit and pulmonary function tests. At baseline, mean total LCQ score in the BC1036 group was lower (i.e., worse QOL) than placebo (P<0.001), indicating significant between-group heterogeneity. Mean baseline-adjusted change in LCQ score at Day 14 was greater for BC1036 [mean (SD) 2.4±3.5] compared to placebo [mean (SD) score 2.2±3.0], but did not reach statistical significance (P=0.60). Mean cough severity VAS score decreased to a greater extent in the BC1036 group compared to placebo, but again the results were not statistically significant (-12.2±23.28 in BC1036 group and -11.0±21.34 in placebo group at Day 14, P=0.688). There was no significant change in pulmonary function measurements. The adverse event (AE) profile was similar in both groups. This study showed that BC1036 was well tolerated and, although the primary endpoint did not achieve statistical significance, the magnitude of improvement was greater with BC1036 compared to placebo with respect to improving QOL and reducing cough severity. ClinicalTrials.gov: NCT01656668.

Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study.

Science.gov (United States)

Schein, M H; Gavish, B; Herz, M; Rosner-Kahana, D; Naveh, P; Knishkowy, B; Zlotnikov, E; Ben-Zvi, N; Melmed, R N

2001-04-01

To examine the efficacy of a new device, which slows and regularises breathing, as a non-pharmacological treatment of hypertension and thus to evaluate the contribution of breathing modulation in the blood pressure (BP) reduction. Randomised, double-blind controlled study, carried out in three urban family practice clinics in Israel. Sixty-five male and female hypertensives, either receiving antihypertensive drug therapy or unmedicated. Four patients dropped out at the beginning of the study. Self treatment at home, 10 minutes daily for 8 consecutive weeks, using either the device (n = 32), which guides the user towards slow and regular breathing using musical sound patterns, or a Walkman, with which patients listened to quiet music (n = 29). Medication was unchanged 2 months prior to and during the study period. Systolic BP, diastolic BP and mean arterial pressure (MAP) changes from baseline. BP reduction in the device group was significantly greater than a predetermined 'clinically meaningful threshold' of 10.0, 5.0 and 6.7 mm Hg for the systolic BP, diastolic BP and MAP respectively (P = 0.035, P = 0.0002 and P = 0.001). Treatment with the device reduced systolic BP, diastolic BP and MAP by 15.2, 10.0 and 11.7 mm Hg respectively, as compared to 11.3, 5.6 and 7.5 mm Hg (P = 0.14, P = 0.008, P = 0.03) with the Walkman. Six months after treatment had stopped, diastolic BP reduction in the device group remained greater than the 'threshold' (P < 0.02) and also greater than in the walkman group (P = 0.001). The device was found to be efficacious in reducing high BP during 2 months of self-treatment by patients at home. Breathing pattern modification appears to be an important component in this reduction.

Postpartum perineal reapir performed by midwives: A randomised trial comparing two suture techniques for perineal repair leaving the skin unsutured

DEFF Research Database (Denmark)

Kindberg, Sara; Misan, Stehouwer; Hvidman, Lone

2008-01-01

Postpartum perineal repair performed by midwives: A randomised trial comparing two suture techniques leaving the skin unsutured. Objective      To compare a continuous suture technique to interrupted stitches using inverted knots for postpartum perineal repair of second-degree lacerations...... and episiotomies.   Design          A double blind randomised controlled trial.   Setting          A Danish university hospital with more than 4800 deliveries annually.   Population   400 healthy primiparous women with a vaginal delivery at term.   Method         Randomisation was computer-controlled. Structured...... healing, patient satisfaction, dyspareunia or need for resuturing. The continuous suture technique was significantly faster (15 min. vs. 17 min, p=0.03) and less suture material was used (1 vs. 2 packets, pskin unsutured...

Amazon estuary - assessment of trace elements in seabed sediments

International Nuclear Information System (INIS)

Lara, L.B.L.S.; Fernandes, E.A.N.; Oliveira, H.; Bacchi, M.A.; Ferraz, E.S.B.

1997-01-01

The interactive processes operating on the continental shelf to the river mouth control the amount and the characteristics of the Amazon discharge reaching the Atlantic Ocean. In this study, the distribution of trace elemental concentrations, with emphasis to the rare-earth elements, in sediment cores collected at several stations from the Amazon continental shelf during the falling water period was investigated by instrumental neutron activation analysis. Cores from the terrigenous and blue water zones have relatively uniform REE concentrations throughout the profile. Cerium anomalies for samples of the upper section of the eight stations are consistently positive and of high values (normally > 2). Similar variation in the elemental concentration ratios between the seabed sediments and Amazon River suspended sediments was seen for stations located in the biogenic and blue water zones, with an enrichment for Ce, Sm, Fe, Th, and Sc and a depletion for the La, Eu, Tb, Yb, Co, Cr, Cs, Hf, Ta, and Zn. The shale-normalized REE patterns from shelf sediments are enriched in LREE relative to HREE, with enrichment factors varying from 1.5 for stations near the river mouth (terrigenous zone) to 1.9 for station located far in the blue water zone. Published data for the Amazon River suspended sediment agree remarkably well with this observation of LREE-enrichment. (author)

Renal effects of atorvastatin and rosuvastatin in patients with diabetes who have progressive renal disease (PLANET I) : a randomised clinical trial

NARCIS (Netherlands)

de Zeeuw, Dick; Anzalone, Deborah A.; Cain, Valerie A.; Cressman, Michael D.; Lambers Heerspink, Hiddo J.; Molitoris, Bruce A.; Monyak, John T.; Parving, Hans-Henrik; Remuzzi, Giuseppe; Sowers, James R.; Vidt, Donald G.

Background The role of lipid-lowering treatments in renoprotection for patients with diabetes is debated. We studied the renal effects of two statins in patients with diabetes who had proteinuria. Methods PLANET I was a randomised, double-blind, parallel-group trial done in 147 research centres in

Lactobacillus reuteri influences regrowth of mutans streptococci after full-mouth disinfection: a double-blind, randomised controlled trial.

Science.gov (United States)

Romani Vestman, N; Hasslöf, P; Keller, M K; Granström, E; Roos, S; Twetman, S; Stecksén-Blicks, C

2013-01-01

This study assessed whether the persistence of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 in saliva could delay the regrowth of mutans streptococci (MS) after a full-mouth disinfection with chlorhexidine (CHX). A randomised, double-blind, placebo-controlled study with a 6-week intervention period and 3- and 6-month follow-up was performed. 62 healthy subjects with moderate to high counts of MS were randomly assigned to a test group (n = 32) or a placebo group (n = 30). Before onset of the intervention, subjects received two sessions of professional cleaning, flossing, and application of CHX varnish and rinsed their mouth with a CHX solution between the sessions (2 days). Thereafter, the test group used probiotic lozenges (2/day) containing L. reuteri (DSM 17938 and ATCC PTA 5289; 1 × 10(8) CFU of each strain), and the placebo group used identical lozenges lacking the lactobacilli. Saliva samples were collected and cultured onto selective media, and isolates of L. reuteri as well as DNA directly extracted from saliva were tested by polymerase chain reaction (PCR) with specific primers. Presence of salivary MS was analysed with a chair-side test. L. reuteri was frequently detected by culture during the intervention period but in only 3 test group subjects at follow-ups. Regrowth of MS statistically significantly differed depending on the presence or absence of L. reuteri DSM 17938 detected by PCR. We conclude that cultivable L. reuteri strains may only sporadically be confirmed after termination of the intervention, but subjects with PCR-detected L. reuteri demonstrated slower regrowth of MS. Copyright © 2013 S. Karger AG, Basel.

The Climate Effects of Deforestation the Amazon Rainforest under Global Warming Conditions

Science.gov (United States)

Werth, D.; Avissar, R.

2006-12-01

Replacement of tropical rainforests has been observed to have a strong drying effect in Amazon simulations, with effects reaching high into the atmospheric column and into the midlatitudes. The drying effects of deforestation, however, can be moderated by the effects of global warming, which should accelerate the hydrologic cycle of the Amazon. The effects of a prescribed, time-varying Amazon deforestation done in conjunction with a steady, moderate increase in CO2 concentrations are determined using a climate model. The model agrees with previous studies when each forcing is applied individually - compared to a control run, Amazon deforestation decreases the local precipitation and global warming increases it. When both are applied, however, the precipitation and other hydrologic variables decrease, but to a lesser extent than when deforestation alone was applied. In effect, the two effects act opposite to one another and bring the simulated climate closer to that of the control.

Basin-Wide Amazon Forest Tree Mortality From a Large 2005 Storm

Science.gov (United States)

Negron Juarez, R. I.; Chambers, J. Q.; Guimaraes, G.; Zeng, H.; Raupp, C.; Marra, D. M.; Ribeiro, G.; Saatchi, S. S.; Higuchi, N.

2010-12-01

Blowdowns are a recurrent characteristic of Amazon forests and are produced, among others, by squall lines. Squall lines are aligned clusters (typical length of 1000 km, width of 200 km) of deep convective cells that produce heavy rainfall during the dry season and significant rainfall during the wet season. These squall lines (accompanied by intense downbursts from convective cells) have been associated with large blowdowns characterized by uprooted, snapped trees, and trees being dragged down by other falling trees. Most squall lines in Amazonia form along the northeastern coast of South America as sea breeze-induced instability lines and propagate inside the continent. They occur frequently (~4 times per month), and can reach the central and even extreme western parts of Amazonia. Squall lines can also be generated inside the Amazon and propagate toward the equator. In January 2005 a squall line propagated from south to north across the entire Amazon basin producing widespread forest tree mortality and contributed to the elevated mortality observed that year. Over the Manaus region (3.4 x104 km2), disturbed forest patches generated by the squall produced a mortality of 0.3-0.5 million trees, equivalent to 30% of the observed annual deforestation reported in 2005 over the same area. The elevated mortality observed in the Central Amazon in 2005 is unlikely to be related to the 2005 Amazon drought since drought did not affect Central or Eastern Amazonia. Assuming a similar rate of forest mortality across the basin, the squall line could have potentially produced tree mortality estimated at 542 ± 121 million trees, equivalent to 23% of the mean annual biomass accumulation estimated for these forests. Our results highlight the vulnerability of Amazon trees to wind-driven mortality associated with convective storms. This vulnerability is likely to increase in a warming climate with models projecting an increase in storm intensity.

Net Heterotrophy in the Amazon Continental Shelf Changes Rapidly to a Sink of CO2 in the Outer Amazon Plume

Directory of Open Access Journals (Sweden)

Nathalie Lefèvre

2017-09-01

Full Text Available The Amazon continental shelf and adjacent oceanic area were sampled for inorganic and organic carbon parameters in order to improve data coverage and understanding of carbon cycling dynamics within this important region. Seasonal coverage of the Amazon plume on the French Guiana continental shelf further north, was provided by CO2 monitoring using a merchant ship sailing from France to French Guiana (2006–2016. Salinity ranged from 1 to 36 (transects in April 2013, and May 2014. At salinity below 10, strong outgassing was observed with fugacity of CO2 (fCO2 over 2,000 μatm. This region displayed net heterotrophy, fueled by organic matter with terrestrial origin, as shown by δ13C and δ15N values of suspended particles. A δ13C cross shelf average of −31% was measured during May 2014, contrasting with oceanic values in excess of −20%. The reactivity of this terrestrial material resulted in the local production of dissolved inorganic and organic carbon as well as fluorescent humic compounds. Further offshore, the dilution of freshwater by ocean waters created a sink for CO2, enhanced by biological activity. The strongest CO2 drawdowns, associated with high chlorophyll a concentrations, were observed on the French Guiana continental shelf in the outer Amazon plume, with fCO2 values below 150 μatm. Here, a CO2 sink was present almost throughout the year, with a seasonal maximum of −9.2 mmol CO2 m−2d−1 observed in June 2015. However, both the CO2 and salinity distributions could vary significantly within a few days, confirming the presence of many eddies in this region. The Amazon continental shelf hence behaved as a transition zone between an inshore source of CO2 to the atmosphere and an offshore sink. Some marine phytoplankton production was detected but occurred mainly close to the French Guiana shelf. A mean net CO2 outgassing of 44 ± 43.6 mmol m−2d−1 was estimated for the area. Quantifying the CO2 flux for the entire Amazon

A 6-week, multicentre, randomised, double-blind, double-dummy, active-controlled, clinical safety study of lumiracoxib and rofecoxib in osteoarthritis patients

Directory of Open Access Journals (Sweden)

Yu Sue

2008-09-01

Full Text Available Abstract Background Lumiracoxib is a selective cyclooxygenase-2 inhibitor effective in the treatment of osteoarthritis (OA with a superior gastrointestinal (GI safety profile as compared to traditional non-steroidal anti-inflammatory drugs (NSAIDs, ibuprofen and naproxen. This safety study compared the GI tolerability, the blood pressure (BP profile and the incidence of oedema with lumiracoxib and rofecoxib in the treatment of OA. Rofecoxib was withdrawn worldwide due to an associated increased risk of CV events and lumiracoxib has been withdrawn from Australia, Canada, Europe and a few other countries following reports of suspected adverse liver reactions. Methods This randomised, double-blind study enrolled 309 patients (aged greater than or equal to 50 years with primary OA across 51 centres in Europe. Patients were randomly allocated to receive either lumiracoxib 400 mg od (four times the recommended dose in OA (n = 154 or rofecoxib 25 mg od (n = 155. The study was conducted for 6 weeks and assessments were performed at Weeks 3 and 6. The primary safety measures were the incidence of predefined GI adverse events (AEs and peripheral oedema. The secondary safety measures included effect of treatment on the mean sitting systolic and diastolic blood pressure (msSBP and msDBP. Tolerability of lumiracoxib 400 mg was assessed by the incidence of AEs. Results Lumiracoxib and rofecoxib displayed similar GI safety profiles with no statistically significant difference in predefined GI AEs between the two groups (43.5% vs. 37.4%, respectively. The incidence and severity of individual predefined GI AEs was comparable between the two groups. The incidence of peripheral oedema was low and identical in both the groups (n = 9, 5.8%. Only one patient in the lumiracoxib group and three patients in the rofecoxib group had a moderate or severe event. At Week 6 there was a significantly lower msSBP and msDBP in the lumiracoxib group compared to the rofecoxib

Seroprevalence of Toxoplasma gondii in free-living Amazon river dolphins (Inia geoffrensis) from central Amazon, Brazil

Science.gov (United States)

Toxoplasma gondii is an important pathogen in aquatic mammals and its presence in these animals may indicate water contamination of aquatic environment by oocysts. Serum samples from 95 dolphins from free-living Amazon River dolphins (Inia geoffrensis) from Sustainable Development Reserve Mamirauá (...

Dampak Peningkatan Kepuasan Pelanggan dalam Proses Bisnis E-Commerce pada Perusahaan Amazon.com

OpenAIRE

I Gusti Made Karmawan

2014-01-01

The Purpose of writing is to describe the impact of increased customer satisfaction in the business process of e-commerce at Amazon.com and analyzed e-commerce strategies used in the company.The Benefits are to get an overview of the strategies in the Amazon.com for improving customer satisfaction and the impact of increased satisfaction. The method of writing is conducting reviews of existing sources to gain an overview strategy and business processes e-commerce at Amazon.com. The paper resu...

Sedative Effects of Intranasal Midazolam Administration in Wild Caught Blue-fronted Amazon (Amazona aestiva) and Orange-winged Amazon (Amazona amazonica) Parrots.

Science.gov (United States)

Schaffer, Débora P H; de Araújo, Nayone L L C; Raposo, Ana Cláudia S; Filho, Emanoel F Martins; Vieira, João Victor R; Oriá, Arianne P

2017-09-01

Safe and effective sedation protocols are important for chemical restraint of birds in clinical and diagnostic procedures, such as clinical evaluations, radiographic positioning, and blood collection. These protocols may reduce stress and ease the management of wild-caught birds, which are susceptible to injury or death when exposed to stressful situations. We compare the sedative effect of intranasal midazolam in wild-caught blue-fronted (Amazona aestiva) and orange-winged (Amazona amazonica) Amazon parrots. Ten adult parrots of each species (n = 20), of unknown sex, weighing 0.337 ± 0.04 (blue-fronted) and 0.390 ± 0.03 kg (orange-winged), kg were used. Midazolam (2 mg/kg) was administered intranasally and the total volume of the drug was divided equally between the 2 nostrils. Onset time and total sedation time were assessed. Satisfactory sedation for clinical evaluation was induced in all birds. Onset time and total sedation times were similar in both species: 5.36 ± 1.16 and 25.40 ± 5.72 minutes, respectively, for blue-fronted Amazons and 5.09 ± 0.89 and 27.10 ± 3.73 minutes, respectively, for orange-winged Amazons. A total of 15 animals showed absence of vocalization, with moderate muscle relaxation and wing movement upon handling, and 2 animals presented with lateral recumbence, with intense muscle relaxation and no wing movement, requiring no restraint. Three blue-fronted Amazons had no effective sedation. Intranasally administered midazolam at a dose of 2 mg/kg effectively promoted sedative effects with a short latency time and fast recovery in wild-caught parrots.

Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial.

Science.gov (United States)

Norman, Jane Elizabeth; Marlow, Neil; Messow, Claudia-Martina; Shennan, Andrew; Bennett, Phillip R; Thornton, Steven; Robson, Stephen C; McConnachie, Alex; Petrou, Stavros; Sebire, Neil J; Lavender, Tina; Whyte, Sonia; Norrie, John

2016-05-21

Progesterone administration has been shown to reduce the risk of preterm birth and neonatal morbidity in women at high risk, but there is uncertainty about longer term effects on the child. We did a double-blind, randomised, placebo-controlled trial of vaginal progesterone, 200 mg daily taken from 22-24 to 34 weeks of gestation, on pregnancy and infant outcomes in women at risk of preterm birth (because of previous spontaneous birth at ≤34 weeks and 0 days of gestation, or a cervical length ≤25 mm, or because of a positive fetal fibronectin test combined with other clinical risk factors for preterm birth [any one of a history in a previous pregnancy of preterm birth, second trimester loss, preterm premature fetal membrane rupture, or a history of a cervical procedure to treat abnormal smears]). The objective of the study was to determine whether vaginal progesterone prophylaxis given to reduce the risk of preterm birth affects neonatal and childhood outcomes. We defined three primary outcomes: fetal death or birth before 34 weeks and 0 days gestation (obstetric), a composite of death, brain injury, or bronchopulmonary dysplasia (neonatal), and a standardised cognitive score at 2 years of age (childhood), imputing values for deaths. Randomisation was done through a web portal, with participants, investigators, and others involved in giving the intervention, assessing outcomes, or analysing data masked to treatment allocation until the end of the study. Analysis was by intention to treat. This trial is registered at ISRCTN.com, number ISRCTN14568373. Between Feb 2, 2009, and April 12, 2013, we randomly assigned 1228 women to the placebo group (n=610) and the progesterone group (n=618). In the placebo group, data from 597, 587, and 439 women or babies were available for analysis of obstetric, neonatal, and childhood outcomes, respectively; in the progesterone group the corresponding numbers were 600, 589, and 430. After correction for multiple outcomes

Does hydroxyapatite coating enhance ingrowth and improve longevity of a Zweymuller type stem? A double-blinded randomised RSA trial.

Science.gov (United States)

Hoornenborg, Daniel; Sierevelt, Inger N; Spuijbroek, Joost A; Cheung, John; van der Vis, Harm M; Beimers, Lijkele; Haverkamp, Daniel

2017-09-11

An ongoing discussion is whether using a hydroxyapatite coating enhances the ingrowth and longevity of a femoral stem in total hip arthroplasty. The best way to predict speed of ingrowth and long-term outcome is by evaluating micromotion by radiostereometric analysis. To study the effect of hydroxyapatite (HA) coating on the migration of the SL-PLUS hip stem, we performed a prospective double blind randomised controlled trial comparing the early migration of the hydroxyapatite (HA)-coated SL-PLUS stem compared to the Standard (non-coated) SL-PLUS stem. 51 patients were randomly assigned to receive either an uncoated or a HA-coated femoral component during total hip replacement. RSA images were obtained direct postoperatively and at 6 weeks, 12 weeks, 6 months, 12 months and 24 months. HOOS scores were obtained preoperative and at final follow-up. RSA evaluation demonstrated significant migration up to 3 months postoperatively in both groups. After initial setting no significant migration was observed. There was no significant difference in migration between the HA-coated group and the uncoated group.Both Harris Hip Score (HHS) and HOOS domain scores (pain and ADL) significantly improved compared to baseline at 24 months after surgery in both treatment groups (p<0.001 for all comparisons). Improvement did not differ significantly between the 2 groups. At 2 years follow-up, the HA-coated and uncoated Zweymuller type, distal fitting stem do not show different migration patterns.

Synthetic Influenza vaccine (FLU-v) stimulates cell mediated immunity in a double-blind, randomised, placebo-controlled Phase I trial.

Science.gov (United States)

Pleguezuelos, Olga; Robinson, Stuart; Stoloff, Gregory A; Caparrós-Wanderley, Wilson

2012-06-29

Current Influenza vaccines elicit antibody mediated prophylactic immunity targeted to viral capsid antigens. Despite their global use these vaccines must be administered yearly to the population, cannot be manufactured until the circulating viral strain(s) have been identified and have limited efficacy. A need remains for Influenza vaccines addressing these issues and here we report the results of a Phase Ib trial of a novel synthetic Influenza vaccine (FLU-v) targeting T cell responses to NP, M1 and M2. Forty-eight healthy males aged 18-40 were recruited for this single-centre, randomised, double blind study. Volunteers received one single low (250 μg) or high (500 μg) dose of FLU-v, either alone or adjuvanted. Safety, tolerability and basic immunogenicity (IgG and IFN-γ responses) parameters were assessed pre-vaccination and for 21 days post-vaccination. FLU-v was found to be safe and well tolerated with no vaccine associated severe adverse events. Dose-dependent IFN-γ responses >2-fold the pre-vaccination level were detected in 80% and 100% of volunteers receiving, respectively, the low and high dose adjuvanted FLU-v formulations. No formulation tested induced any significant FLU-v antibody response. FLU-v is safe and induces a vaccine-specific cellular immunity. Cellular immune responses are historically known to control and mitigate infection and illness during natural infection. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

Directory of Open Access Journals (Sweden)

Gerritsen Pieter G

2009-09-01

Full Text Available Abstract Background Anterior open treatment of the inguinal hernia with a tension free mesh has reduced the incidence of recurrence and direct postoperative pain. The Lichtenstein procedure rules nowadays as reference technique for hernia treatment. Not recurrences but chronic pain is the main postoperative complication in inguinal hernia repair after Lichtenstein's technique. Preliminary experiences with a soft mesh placed in the preperitoneal space showed good results and less chronic pain. Methods The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work and recurrence. Both groups will be evaluated. Success rate of hernia repair and complications will be measured as safeguard for quality. To demonstrate that inguinal hernia repair according to the transinguinal preperitoneal (TIPP technique reduces postoperative pain to Discussion The TULIP trial is aimed to show a reduction in postoperative chronic pain after anterior hernia repair according to the transinguinal preperitoneal (TIPP technique, compared to Lichtenstein. In our hypothesis the TIPP technique reduces chronic pain compared to Lichtenstein. Trial registration ISRCTN 93798494

Calcium from salmon and cod bone is well absorbed in young healthy men: a double-blinded randomised crossover design

Directory of Open Access Journals (Sweden)

Graff Ingvild E

2010-07-01

Full Text Available Abstract Background Calcium (Ca - fortified foods are likely to play an important role in helping the consumer achieve an adequate Ca intake, especially for persons with a low intake of dairy products. Fish bones have a high Ca content, and huge quantities of this raw material are available as a by-product from the fish industry. Previously, emphasis has been on producing high quality products from fish by-products by use of bacterial proteases. However, documentation of the nutritional value of the enzymatically rinsed Ca-rich bone fraction remains unexplored. The objective of the present study was to assess the bioavailability of calcium in bones of Atlantic salmon (oily fish and Atlantic cod (lean fish in a double-blinded randomised crossover design. Methods Ca absorption was measured in 10 healthy young men using 47Ca whole body counting after ingestion of a test meal extrinsically labelled with the 47Ca isotope. The three test meals contained 800 mg of Ca from three different calcium sources: cod bones, salmon bones and control (CaCO3. Results Mean Ca absorption (± SEE from the three different Ca sources were 21.9 ± 1.7%, 22.5 ± 1.7% and 27.4 ± 1.8% for cod bones, salmon bones, and control (CaCO3, respectively. Conclusion We conclude that bones from Atlantic salmon and Atlantic cod are suitable as natural Ca sources in e.g. functional foods or as supplements.

The Amazon Basin in transition

Science.gov (United States)

Eric A. Davidson; Alessandro C. de Araujo; Paulo Artaxo; Jennifer K. Balch; I. Foster Brown; Mercedes M.C. Bustamente; Michael T. Coe; Ruth S. DeFriess; Michael Keller; Marcos Longo; J. William Munger; Wilfrid Schroeder; Britaldo Soares-Filho; Carlos M. Souza, Jr.; Steven C. Wofsy

2012-01-01

Agricultural expansion and climate variability have become important agents of disturbance in the Amazon basin. Recent studies have demonstrated considerable resilience of Amazonian forests to moderate annual drought, but they also show that interactions between deforestation, fire and drought potentially lead to losses of carbon storage and changes in regional...

Desmidias (zygnemaphyceae) of a small tributary of the Amazons River in Colombia

International Nuclear Information System (INIS)

Nunez Avellaneda, Marcela; Duque, Santiago

2000-01-01

This is a contribution to the knowledge of the freshwater algae of the Colombian Amazon region. Two of the 13 taxa are reported for the first time from Colombia and 10 are new records for the Colombian Amazon. Ecological characteristics are given for these desmids

Repeated nebulisation of non-viral CFTR gene therapy in patients with cystic fibrosis: a randomised, double-blind, placebo-controlled, phase 2b trial.

Science.gov (United States)

Alton, Eric W F W; Armstrong, David K; Ashby, Deborah; Bayfield, Katie J; Bilton, Diana; Bloomfield, Emily V; Boyd, A Christopher; Brand, June; Buchan, Ruaridh; Calcedo, Roberto; Carvelli, Paula; Chan, Mario; Cheng, Seng H; Collie, D David S; Cunningham, Steve; Davidson, Heather E; Davies, Gwyneth; Davies, Jane C; Davies, Lee A; Dewar, Maria H; Doherty, Ann; Donovan, Jackie; Dwyer, Natalie S; Elgmati, Hala I; Featherstone, Rosanna F; Gavino, Jemyr; Gea-Sorli, Sabrina; Geddes, Duncan M; Gibson, James S R; Gill, Deborah R; Greening, Andrew P; Griesenbach, Uta; Hansell, David M; Harman, Katharine; Higgins, Tracy E; Hodges, Samantha L; Hyde, Stephen C; Hyndman, Laura; Innes, J Alastair; Jacob, Joseph; Jones, Nancy; Keogh, Brian F; Limberis, Maria P; Lloyd-Evans, Paul; Maclean, Alan W; Manvell, Michelle C; McCormick, Dominique; McGovern, Michael; McLachlan, Gerry; Meng, Cuixiang; Montero, M Angeles; Milligan, Hazel; Moyce, Laura J; Murray, Gordon D; Nicholson, Andrew G; Osadolor, Tina; Parra-Leiton, Javier; Porteous, David J; Pringle, Ian A; Punch, Emma K; Pytel, Kamila M; Quittner, Alexandra L; Rivellini, Gina; Saunders, Clare J; Scheule, Ronald K; Sheard, Sarah; Simmonds, Nicholas J; Smith, Keith; Smith, Stephen N; Soussi, Najwa; Soussi, Samia; Spearing, Emma J; Stevenson, Barbara J; Sumner-Jones, Stephanie G; Turkkila, Minna; Ureta, Rosa P; Waller, Michael D; Wasowicz, Marguerite Y; Wilson, James M; Wolstenholme-Hogg, Paul

2015-09-01

Lung delivery of plasmid DNA encoding the CFTR gene complexed with a cationic liposome is a potential treatment option for patients with cystic fibrosis. We aimed to assess the efficacy of non-viral CFTR gene therapy in patients with cystic fibrosis. We did this randomised, double-blind, placebo-controlled, phase 2b trial in two cystic fibrosis centres with patients recruited from 18 sites in the UK. Patients (aged ≥12 years) with a forced expiratory volume in 1 s (FEV1) of 50-90% predicted and any combination of CFTR mutations, were randomly assigned, via a computer-based randomisation system, to receive 5 mL of either nebulised pGM169/GL67A gene-liposome complex or 0.9% saline (placebo) every 28 days (plus or minus 5 days) for 1 year. Randomisation was stratified by % predicted FEV1 (<70 vs ≥70%), age (<18 vs ≥18 years), inclusion in the mechanistic substudy, and dosing site (London or Edinburgh). Participants and investigators were masked to treatment allocation. The primary endpoint was the relative change in % predicted FEV1. The primary analysis was per protocol. This trial is registered with ClinicalTrials.gov, number NCT01621867. Between June 12, 2012, and June 24, 2013, we randomly assigned 140 patients to receive placebo (n=62) or pGM169/GL67A (n=78), of whom 116 (83%) patients comprised the per-protocol population. We noted a significant, albeit modest, treatment effect in the pGM169/GL67A group versus placebo at 12 months' follow-up (3.7%, 95% CI 0.1-7.3; p=0.046). This outcome was associated with a stabilisation of lung function in the pGM169/GL67A group compared with a decline in the placebo group. We recorded no significant difference in treatment-attributable adverse events between groups. Monthly application of the pGM169/GL67A gene therapy formulation was associated with a significant, albeit modest, benefit in FEV1 compared with placebo at 1 year, indicating a stabilisation of lung function in the treatment group. Further improvements in

Estuarine beaches of the Amazon coast: environmental and recreational characterization

OpenAIRE

de Sousa, Rosigleyse C.; Pereira, Luci Cajueiro Carneiro; Jiménez Quintana, José Antonio

2016-01-01

The Amazon coast is rich in natural resources, with highly valued natural landscapes and ecological systems. These environments include estuarine beaches, which are important areas for recreational activities. The present study provides an environmental and recreational diagnosis of three of these estuarine beaches on the Amazon coast (Colares, Maruda, and Murubira). The study was conducted in July, 2012, 2013 and 2015. An set of variables was assessed: (i) physical variables (hydrodynamics),...

Chronic Effects of a Wild Green Oat Extract Supplementation on Cognitive Performance in Older Adults: A Randomised, Double-Blind, Placebo-Controlled, Crossover Trial

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Narelle M. Berry

2012-05-01

Full Text Available Background and aim: Preliminary evaluation of a wild green oat extract (WGOE (Neuravena^® ELFA^®955, Frutarom, Switzerland revealed an acute cognitive benefit of supplementation. This study investigated whether regular daily WGOE supplementation would result in sustained cognitive improvements. Method: A 12-week randomised, double-blind, placebo-controlled cross-over trial of WGOE supplementation (1500 mg/day versus placebo was undertaken in 37 healthy adults aged 67 ± 0.8 years (mean ± SEM. Cognitive assessments included the Stroop colour-word test, letter cancellation, the rule-shift task, a computerised multi-tasking test battery and the trail-making task. All assessments were conducted in Week 12 and repeated in Week 24 whilst subjects were fasted and at least 18 h after taking the last dose of supplement. Result: Chronic WGOE supplementation did not affect any measures of cognition. Conclusion: It appears that the cognitive benefit of acute WGOE supplementation does not persist with chronic treatment in older adults with normal cognition. It remains to be seen whether sustained effects of WGOE supplementation may be more evident in those with mild cognitive impairment.

A Randomised Controlled Trial of complete denture impression materials

Science.gov (United States)

Hyde, T.P.; Craddock, H.L.; Gray, J.C.; Pavitt, S.H.; Hulme, C.; Godfrey, M.; Fernandez, C.; Navarro-Coy, N.; Dillon, S.; Wright, J.; Brown, S.; Dukanovic, G.; Brunton, P.A.

2014-01-01

Objectives There is continuing demand for non-implant prosthodontic treatment and yet there is a paucity of high quality Randomised Controlled Trial (RCT) evidence for best practice. The aim of this research was to provide evidence for best practice in prosthodontic impressions by comparing two impression materials in a double-blind, randomised, crossover, controlled, clinical trial. Methods Eighty-five patients were recruited, using published eligibility criteria, to the trial at Leeds Dental Institute, UK. Each patient received two sets of dentures; made using either alginate or silicone impressions. Randomisations determined the order of assessment and order of impressions. The primary outcome was patient blinded preference for unadjusted dentures. Secondary outcomes were patient preference for the adjusted dentures, rating of comfort, stability and chewing efficiency, experience of each impression, and an OHIP-EDENT questionnaire. Results Seventy-eight (91.8%) patients completed the primary assessment. 53(67.9%) patients preferred dentures made from silicone impressions while 14(17.9%) preferred alginate impressions. 4(5.1%) patients found both dentures equally satisfactory and 7 (9.0%) found both equally unsatisfactory. There was a 50% difference in preference rates (in favour of silicone) (95%CI 32.7–67.3%, p alginate as their material of choice for secondary impressions for complete dentures. Trial Registration: ISRCTN 01528038.

 This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014. PMID:24995473

Do prebiotics reduce the number of fever episodes in healthy children in their first year of life : a randomised controlled trial

NARCIS (Netherlands)

van Stuijvenberg, Margriet; Eisses, Annemieke M.; Gruber, Christoph; Mosca, Fabio; Arslanoglu, Sertac; Chirico, Gaetano; Braegger, Christian P.; Riedler, Josef; Boehm, Gunther; Sauer, Pieter J. J.

2011-01-01

The objective of the present study was to assess the effect of adding specific prebiotics to standard formula feeding on the number of fever episodes in the first year of life. In the present randomised, double-blind, placebo-controlled trial in seven centres in five West European countries, 830

Naming and Shaming for Conservation: Evidence from the Brazilian Amazon

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Cisneros, Elías; Zhou, Sophie Lian; Börner, Jan

2015-01-01

Deforestation in the Brazilian Amazon has dropped substantially after a peak of over 27 thousand square kilometers in 2004. Starting in 2008, the Brazilian Ministry of the Environment has regularly published blacklists of critical districts with high annual forest loss. Farms in blacklisted districts face additional administrative hurdles to obtain authorization for clearing forests. In this paper we add to the existing literature on evaluating the Brazilian anti-deforestation policies by specifically quantifying the impact of blacklisting on deforestation. We first use spatial matching techniques using a set of covariates that includes official blacklisting criteria to identify control districts. We then explore the effect of blacklisting on change in deforestation in double difference regressions with panel data covering the period from 2002 to 2012. Multiple robustness checks are conducted including an analysis of potential causal mechanisms behind the success of the blacklist. We find that the blacklist has considerably reduced deforestation in the affected districts even after controlling for the potential mechanism effects of field-based enforcement, environmental registration campaigns, and rural credit. PMID:26398096

Naming and Shaming for Conservation: Evidence from the Brazilian Amazon.

Science.gov (United States)

Cisneros, Elías; Zhou, Sophie Lian; Börner, Jan

2015-01-01

Deforestation in the Brazilian Amazon has dropped substantially after a peak of over 27 thousand square kilometers in 2004. Starting in 2008, the Brazilian Ministry of the Environment has regularly published blacklists of critical districts with high annual forest loss. Farms in blacklisted districts face additional administrative hurdles to obtain authorization for clearing forests. In this paper we add to the existing literature on evaluating the Brazilian anti-deforestation policies by specifically quantifying the impact of blacklisting on deforestation. We first use spatial matching techniques using a set of covariates that includes official blacklisting criteria to identify control districts. We then explore the effect of blacklisting on change in deforestation in double difference regressions with panel data covering the period from 2002 to 2012. Multiple robustness checks are conducted including an analysis of potential causal mechanisms behind the success of the blacklist. We find that the blacklist has considerably reduced deforestation in the affected districts even after controlling for the potential mechanism effects of field-based enforcement, environmental registration campaigns, and rural credit.

Effects of environmental change on malaria in the Amazon region of Brazil

NARCIS (Netherlands)

Takken, W.; Tarso Vilarinhos, de P.; Schneider, P.; Santos, dos F.

2003-01-01

Malaria is endemic in Brazil, affecting mostly the Amazon states. Whereas 50 years ago good progress was made towards its control, since the opening up of the Amazon region for forestry, agriculture and livestock activities, the disease has rapidly increased in incidence, peaking to >500,000

Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.

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Tucker, David L; Rockett, Mark; Hasan, Mehedi; Poplar, Sarah; Rule, Simon A

2015-06-01

Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS). 70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure. No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated. TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study. NCT02005354. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Forcing and mixing processes in the Amazon estuary: a study case

International Nuclear Information System (INIS)

Bizerra, M.O.M.; Pontes, R.K. da S.; Carmo, A.M.C.; Rosario, R.P.; Gallo, M.N.; Vinzon, S.B.

2008-01-01

The research area of this paper is located at the estuary of the Amazon River (Brazil), more precisely at the river mouth (parallels 00 0 30 ' N and 1 0 30 ' N meridians 049 0 00 ' W and 050 0 00 ' W). This paper presents the results of air movement analysis on the surface atmospheric circulation over the Mouth of the Amazon River, salinity and temperature measures as well as measurements of currents, carried out along a longitudinal section in the navigation canal region of the Northern Bar of the Amazon River (Barra Norte do Rio Amazonas) in June 2006, during the river flood season in the quadrature tide. This paper purports to contribute towards better interpreting the dynamic effect in hydrodynamic, meteorological and hydro geographical parameters at the river mouth. The conclusion drawn from an examination of the issues and related research is that: a) the saline wedge-type stratification can be seen approximately 100 km away from the mouth of the Amazon River during the end of the rainy season in the quadrature tide; b) probably, at Amazon estuary quadrature entrainment processes are predominant and are the responsible for increased salinity in surface layer, whereas turbulence scattering mixing is secondary to it. c) The large flow of fresh water from the Amazon River at the end of the rainy season implies the displacement of the front saline position over the internal Amazon continental platform. d) The tidal wave shows a positive asymmetry in the canal, with floods lasting less than the ebb tide. This asymmetry in the canal, with floods lasting less than the ebb tide. This asymmetry decreases towards the ocean, eventually becoming reversed in the presence of a saline wedge. The speeds, however, have a negative asymmetry, with more intense ebb tides, due to the river flow and is more evident by the existence of quadrature tides. e) The progressive behavior of the tidal wave in its propagation in the Northern Channel as well as the effect of morphology on

Social and health dimensions of climate change in the Amazon.

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Brondízio, Eduardo S; de Lima, Ana C B; Schramski, Sam; Adams, Cristina

2016-07-01

The Amazon region has been part of climate change debates for decades, yet attention to its social and health dimensions has been limited. This paper assesses literature on the social and health dimensions of climate change in the Amazon. A conceptual framework underscores multiple stresses and exposures created by interactions between climate change and local social-environmental conditions. Using the Thomson-Reuter Web of Science, this study bibliometrically assessed the overall literature on climate change in the Amazon, including Physical Sciences, Social Sciences, Anthropology, Environmental Science/Ecology and Public, Environmental/Occupational Health. From this assessment, a relevant sub-sample was selected and complemented with literature from the Brazilian database SciELO. This sample discusses three dimensions of climate change impacts in the region: livelihood changes, vector-borne diseases and microbial proliferation, and respiratory diseases. This analysis elucidates imbalance and disconnect between ecological, physical and social and health dimensions of climate change and between continental and regional climate analysis, and sub-regional and local levels. Work on the social and health implications of climate change in the Amazon falls significantly behind other research areas, limiting reliable information for analytical models and for Amazonian policy-makers and society at large. Collaborative research is called for.

Safety and efficacy of AMG 334 for prevention of episodic migraine: a randomised, double-blind, placebo-controlled, phase 2 trial.

Science.gov (United States)

Sun, Hong; Dodick, David W; Silberstein, Stephen; Goadsby, Peter J; Reuter, Uwe; Ashina, Messoud; Saper, Joel; Cady, Roger; Chon, Yun; Dietrich, Julie; Lenz, Robert

2016-04-01

The calcitonin gene-related peptide (CGRP) pathway is a promising target for preventive therapies in patients with migraine. We assessed the safety and efficacy of AMG 334, a fully human monoclonal antibody against the CGRP receptor, for migraine prevention. In this multicentre, randomised, double-blind, placebo-controlled, phase 2 trial, patients aged 18-60 years with 4 to 14 migraine days per month were enrolled at 59 headache and clinical research centres in North America and Europe, and randomly assigned in a 3:2:2:2 ratio to monthly subcutaneous placebo, AMG 334 7 mg, AMG 334 21 mg, or AMG 334 70 mg using a sponsor-generated randomisation sequence centrally executed by an interactive voice response or interactive web response system. Study site personnel, patients, and the sponsor study personnel were masked to the treatment assignment. The primary endpoint was the change in monthly migraine days from baseline to the last 4 weeks of the 12-week double-blind treatment phase. The primary endpoint was calculated using the least squares mean at each timepoint from a generalised linear mixed-effect model for repeated measures. Safety endpoints were adverse events, clinical laboratory values, vital signs, and anti-AMG 334 antibodies. The study is registered with ClinicalTrials.gov, number NCT01952574. An open-label extension phase of up to 256 weeks is ongoing and will assess the long-term safety of AMG 334. From Aug 6, 2013, to June 30, 2014, 483 patients were randomly assigned to placebo (n=160), AMG 334 7 mg (n=108), AMG 334 21 mg (n=108), or AMG 334 70 mg (n=107). The mean change in monthly migraine days at week 12 was -3·4 (SE 0·4) days with AMG 334 70 mg versus -2·3 (0·3) days with placebo (difference -1·1 days [95% CI -2·1 to -0·2], p=0·021). The mean reductions in monthly migraine days with the 7 mg (-2·2 [SE 0·4]) and the 21 mg (-2·4 [0·4]) doses were not significantly different from that with placebo. Adverse events were recorded in 82 (54

Study protocol: a phase III randomised, double-blind, parallel arm, stratified, block randomised, placebo-controlled trial investigating the clinical effect and cost-effectiveness of sertraline for the palliative relief of breathlessness in people with chronic breathlessness.

Science.gov (United States)

Watts, Gareth J; Clark, Katherine; Agar, Meera; Davidson, Patricia M; McDonald, Christine; Lam, Lawrence T; Sajkov, Dimitar; McCaffrey, Nicola; Doogue, Matthew; Abernethy, Amy P; Currow, David C

2016-11-29

Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness. This paper presents the protocol for a large, adequately powered randomised study evaluating the use of sertraline for chronic breathlessness in people with progressive life-limiting illnesses. A total of 240 participants with modified Medical Research Council Dyspnoea Scale breathlessness of level 2 or higher will be randomised to receive either sertraline or placebo for 28 days in this multisite, double-blind study. The dose will be titrated up every 3 days to a maximum of 100 mg daily. The primary outcome will be to compare the efficacy of sertraline with placebo in relieving the intensity of worst breathlessness as assessed by a 0-100 mm Visual Analogue Scale. A number of other outcome measures and descriptors of breathlessness as well as caregiver assessments will also be recorded to ensure adequate analysis of participant breathlessness and to allow an economic analysis to be performed. Participants will also be given the option of continuing blinded treatment until either study data collection is complete or net benefit ceases. Appropriate statistical analysis of primary and secondary outcomes will be used to describe the wealth of data obtained. Ethics approval was obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences. ACTRN12610000464066. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Extreme Drought Events Revealed in Amazon Tree Ring Records

Science.gov (United States)

Jenkins, H. S.; Baker, P. A.; Guilderson, T. P.

2010-12-01

The Amazon basin is a center of deep atmospheric convection and thus acts as a major engine for global hydrologic circulation. Yet despite its significance, a full understanding of Amazon rainfall variability remains elusive due to a poor historical record of climate. Temperate tree rings have been used extensively to reconstruct climate over the last thousand years, however less attention has been given to the application of dendrochronology in tropical regions, in large part due to a lower frequency of tree species known to produce annual rings. Here we present a tree ring record of drought extremes from the Madre de Dios region of southeastern Peru over the last 190 years. We confirm that tree ring growth in species Cedrela odorata is annual and show it to be well correlated with wet season precipitation. This correlation is used to identify extreme dry (and wet) events that have occurred in the past. We focus on drought events identified in the record as drought frequency is expected to increase over the Amazon in a warming climate. The Cedrela chronology records historic Amazon droughts of the 20th century previously identified in the literature and extends the record of drought for this region to the year 1816. Our analysis shows that there has been an increase in the frequency of extreme drought (mean recurrence interval = 5-6 years) since the turn of the 20th century and both Atlantic and Pacific sea surface temperature (SST) forcing mechanisms are implicated.

Mulberry-extract improves glucose tolerance and decreases insulin concentrations in normoglycaemic adults: Results of a randomised double-blind placebo-controlled study.

Directory of Open Access Journals (Sweden)

Mark Lown

Full Text Available High sugar and refined carbohydrate intake is associated with weight gain, increased incidence of diabetes and is linked with increased cardiovascular mortality. Reducing the health impact of poor quality carbohydrate intake is a public health priority. Reducose, a proprietary mulberry leaf extract (ME, may reduce blood glucose responses following dietary carbohydrate intake by reducing absorption of glucose from the gut.A double-blind, randomised, repeat measure, phase 2 crossover design was used to study the glycaemic and insulinaemic response to one reference product and three test products at the Functional Food Centre, Oxford Brooks University, UK. Participants; 37 adults aged 19-59 years with a BMI ≥ 20kg/m2 and ≤ 30kg/m2. The objective was to determine the effect of three doses of mulberry-extract (Reducose versus placebo on blood glucose and insulin responses when co-administered with 50g maltodextrin in normoglycaemic healthy adults. We also report the gastrointestinal tolerability of the mulberry extract.Thirty-seven participants completed the study: The difference in the positive Incremental Area Under the Curve (pIAUC (glucose (mmol / L x h for half, normal and double dose ME compared with placebo was -6.1% (-18.2%, 5.9%; p = 0.316, -14.0% (-26.0%, -2.0%; p = 0.022 and -22.0% (-33.9%, -10.0%; p<0.001 respectively. The difference in the pIAUC (insulin (mIU / L x h for half, normal and double dose ME compared with placebo was -9.7% (-25.8%, 6.3%; p = 0.234, -23.8% (-39.9%, -7.8%; p = 0.004 and -24.7% (-40.8%, -8.6%; p = 0.003 respectively. There were no statistically significant differences between any of the 4 groups in the odds of experiencing one or more gastrointestinal symptoms (nausea, abdominal cramping, distension or flatulence.Mulberry leaf extract significantly reduces total blood glucose rise after ingestion of maltodextrin over 120 minutes. The pattern of effect demonstrates a classical dose response curve with

Efficacy and safety of intermittent preventive treatment with sulfadoxine-pyrimethamine for malaria in African infants: a pooled analysis of six randomised, placebo-controlled trials

NARCIS (Netherlands)

Aponte, John J.; Schellenberg, David; Egan, Andrea; Breckenridge, Alasdair; Carneiro, Ilona; Critchley, Julia; Danquah, Ina; Dodoo, Alexander; Kobbe, Robin; Lell, Bertrand; May, Jürgen; Premji, Zul; Sanz, Sergi; Sevene, Esperanza; Soulaymani-Becheikh, Rachida; Winstanley, Peter; Adjei, Samuel; Anemana, Sylvester; Chandramohan, Daniel; Issifou, Saadou; Mockenhaupt, Frank; Owusu-Agyei, Seth; Greenwood, Brian; Grobusch, Martin P.; Kremsner, Peter G.; Macete, Eusebio; Mshinda, Hassan; Newman, Robert D.; Slutsker, Laurence; Tanner, Marcel; Alonso, Pedro; Menendez, Clara

2009-01-01

BACKGROUND: Intermittent preventive treatment (IPT) is a promising strategy for malaria control in infants. We undertook a pooled analysis of the safety and efficacy of IPT in infants (IPTi) with sulfadoxine-pyrimethamine in Africa. METHODS: We pooled data from six double-blind, randomised,

How Do Tropical Sea Surface Temperatures Influence the Seasonal Distribution of Precipitation in the Equatorial Amazon?.

Science.gov (United States)

Fu, Rong; Dickinson, Robert E.; Chen, Mingxuan; Wang, Hui

2001-10-01

Although the correlation between precipitation over tropical South America and sea surface temperatures (SSTs) over the Pacific and Atlantic has been documented since the early twentieth century, the impact of each ocean on the timing and intensity of the wet season over tropical South America and the underlying mechanisms have remained unclear. Numerical experiments have been conducted using the National Center for Atmospheric Research Community Climate Model Version 3 to explore these impacts. The results suggest the following.1)Seasonality of SSTs in the tropical Pacific and Atlantic has an important influence on precipitation in the eastern Amazon during the equinox seasons. The eastern side of the Amazon is influenced both by the direct thermal circulation of the Atlantic intertropical convergence zone (ITCZ) and by Rossby waves. These processes are enhanced by the seasonal cycles of SSTs in the tropical Atlantic and Pacific. SSTs affect Amazon precipitation much less during the solstice seasons and in the western Amazon.2)The seasonality of SSTs in the Atlantic more strongly affects Amazon rainfall than does that of the Pacific. Without the former, austral spring in the eastern equatorial Amazon would be a wet season, rather than the observed dry season. As a consequence of the lag at that time of the southward seasonal migration of the Atlantic SSTs behind that of the insolation, the Atlantic ITCZ centers itself near 10°N, instead of at the equator, imposing subsidence and low-level anticyclonic flow over the eastern equatorial Amazon, thus drying the air above the planetary boundary layer and reducing the low-level moisture convergence. Consequently, convection in the eastern Amazon is suppressed despite strong surface heating.3)Seasonality of the SSTs in the tropical Pacific also tends to reduce precipitation in the eastern Amazon during both spring and fall. In spring, subsidence is enhanced not only through a zonal direct circulation, but also through

Osteoma in a blue-fronted Amazon parrot (Amazona aestiva).

Science.gov (United States)

Cardoso, João Felipe Rito; Levy, Marcelo Guilherme Bezerra; Liparisi, Flavia; Romão, Mario Antonio Pinto

2013-09-01

Osteoma is an uncommon bone formation documented in avian species and other animals. A blue-fronted Amazon parrot (Amazona aestiva) with clinical respiratory symptoms was examined because of a hard mass present on the left nostril. Radiographs suggested a bone tumor, and the mass was surgically excised. Histopathologic examination revealed features of an osteoma. To our knowledge, this is the first description of an osteoma in a blue-fronted Amazon parrot. Osteoma should be considered as a differential diagnosis in birds with respiratory distress and swelling of the nostril.

Hypoxia adaptation in fish of the Amazon: a never-ending task | Val ...

African Journals Online (AJOL)

In addition to seasonal long-term changes in dissolved oxygen and carbon dioxide, water bodies of the Amazon present periodic short-term episodes of hypoxia and even anoxia. To preserve gas exchange and acid base balance, fish of the Amazon have developed multiple adaptive solutions which occur at all biological ...

Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial

DEFF Research Database (Denmark)

Majholm, Birgitte; Møller, Ann M

2011-01-01

Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded stu......, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band....

Amazon boundary layer aerosol concentration sustained by vertical transport during rainfall.

Science.gov (United States)

Wang, Jian; Krejci, Radovan; Giangrande, Scott; Kuang, Chongai; Barbosa, Henrique M J; Brito, Joel; Carbone, Samara; Chi, Xuguang; Comstock, Jennifer; Ditas, Florian; Lavric, Jost; Manninen, Hanna E; Mei, Fan; Moran-Zuloaga, Daniel; Pöhlker, Christopher; Pöhlker, Mira L; Saturno, Jorge; Schmid, Beat; Souza, Rodrigo A F; Springston, Stephen R; Tomlinson, Jason M; Toto, Tami; Walter, David; Wimmer, Daniela; Smith, James N; Kulmala, Markku; Machado, Luiz A T; Artaxo, Paulo; Andreae, Meinrat O; Petäjä, Tuukka; Martin, Scot T

2016-11-17

The nucleation of atmospheric vapours is an important source of new aerosol particles that can subsequently grow to form cloud condensation nuclei in the atmosphere. Most field studies of atmospheric aerosols over continents are influenced by atmospheric vapours of anthropogenic origin (for example, ref. 2) and, in consequence, aerosol processes in pristine, terrestrial environments remain poorly understood. The Amazon rainforest is one of the few continental regions where aerosol particles and their precursors can be studied under near-natural conditions, but the origin of small aerosol particles that grow into cloud condensation nuclei in the Amazon boundary layer remains unclear. Here we present aircraft- and ground-based measurements under clean conditions during the wet season in the central Amazon basin. We find that high concentrations of small aerosol particles (with diameters of less than 50 nanometres) in the lower free troposphere are transported from the free troposphere into the boundary layer during precipitation events by strong convective downdrafts and weaker downward motions in the trailing stratiform region. This rapid vertical transport can help to maintain the population of particles in the pristine Amazon boundary layer, and may therefore influence cloud properties and climate under natural conditions.

Modelling basin-wide variations in Amazon forest photosynthesis

Science.gov (United States)

Mercado, Lina; Lloyd, Jon; Domingues, Tomas; Fyllas, Nikolaos; Patino, Sandra; Dolman, Han; Sitch, Stephen

2010-05-01

Given the importance of Amazon rainforest in the global carbon and hydrological cycles, there is a need to use parameterized and validated ecosystem gas exchange and vegetation models for this region in order to adequately simulate present and future carbon and water balances. Recent research has found major differences in above-ground net primary productivity (ANPP), above ground biomass and tree dynamics across Amazonia. West Amazonia is more dynamic, with younger trees, higher stem growth rates and lower biomass than central and eastern Amazon (Baker et al. 2004; Malhi et al. 2004; Phillips et al. 2004). A factor of three variation in above-ground net primary productivity has been estimated across Amazonia by Malhi et al. (2004). Different hypotheses have been proposed to explain the observed spatial variability in ANPP (Malhi et al. 2004). First, due to the proximity to the Andes, sites from western Amazonia tend to have richer soils than central and eastern Amazon and therefore soil fertility could possibly be highly related to the high wood productivity found in western sites. Second, if GPP does not vary across the Amazon basin then different patterns of carbon allocation to respiration could also explain the observed ANPP gradient. However since plant growth depends on the interaction between photosynthesis, transport of assimilates, plant respiration, water relations and mineral nutrition, variations in plant gross photosynthesis (GPP) could also explain the observed variations in ANPP. In this study we investigate whether Amazon GPP can explain variations of observed ANPP. We use a sun and shade canopy gas exchange model that has been calibrated and evaluated at five rainforest sites (Mercado et al. 2009) to simulate gross primary productivity of 50 sites across the Amazon basin during the period 1980-2001. Such simulation differs from the ones performed with global vegetation models (Cox et al. 1998; Sitch et al. 2003) where i) single plant functional

Large emissions from floodplain trees close the Amazon methane budget

Science.gov (United States)

Pangala, Sunitha R.; Enrich-Prast, Alex; Basso, Luana S.; Peixoto, Roberta Bittencourt; Bastviken, David; Hornibrook, Edward R. C.; Gatti, Luciana V.; Marotta, Humberto; Calazans, Luana Silva Braucks; Sakuragui, Cassia Mônica; Bastos, Wanderley Rodrigues; Malm, Olaf; Gloor, Emanuel; Miller, John Bharat; Gauci, Vincent

2017-12-01

Wetlands are the largest global source of atmospheric methane (CH4), a potent greenhouse gas. However, methane emission inventories from the Amazon floodplain, the largest natural geographic source of CH4 in the tropics, consistently underestimate the atmospheric burden of CH4 determined via remote sensing and inversion modelling, pointing to a major gap in our understanding of the contribution of these ecosystems to CH4 emissions. Here we report CH4 fluxes from the stems of 2,357 individual Amazonian floodplain trees from 13 locations across the central Amazon basin. We find that escape of soil gas through wetland trees is the dominant source of regional CH4 emissions. Methane fluxes from Amazon tree stems were up to 200 times larger than emissions reported for temperate wet forests and tropical peat swamp forests, representing the largest non-ebullitive wetland fluxes observed. Emissions from trees had an average stable carbon isotope value (δ13C) of -66.2 ± 6.4 per mil, consistent with a soil biogenic origin. We estimate that floodplain trees emit 15.1 ± 1.8 to 21.2 ± 2.5 teragrams of CH4 a year, in addition to the 20.5 ± 5.3 teragrams a year emitted regionally from other sources. Furthermore, we provide a ‘top-down’ regional estimate of CH4 emissions of 42.7 ± 5.6 teragrams of CH4 a year for the Amazon basin, based on regular vertical lower-troposphere CH4 profiles covering the period 2010-2013. We find close agreement between our ‘top-down’ and combined ‘bottom-up’ estimates, indicating that large CH4 emissions from trees adapted to permanent or seasonal inundation can account for the emission source that is required to close the Amazon CH4 budget. Our findings demonstrate the importance of tree stem surfaces in mediating approximately half of all wetland CH4 emissions in the Amazon floodplain, a region that represents up to one-third of the global wetland CH4 source when trees are combined with other emission sources.

Large emissions from floodplain trees close the Amazon methane budget.

Science.gov (United States)

Pangala, Sunitha R; Enrich-Prast, Alex; Basso, Luana S; Peixoto, Roberta Bittencourt; Bastviken, David; Hornibrook, Edward R C; Gatti, Luciana V; Marotta, Humberto; Calazans, Luana Silva Braucks; Sakuragui, Cassia Mônica; Bastos, Wanderley Rodrigues; Malm, Olaf; Gloor, Emanuel; Miller, John Bharat; Gauci, Vincent

2017-12-14

Wetlands are the largest global source of atmospheric methane (CH 4 ), a potent greenhouse gas. However, methane emission inventories from the Amazon floodplain, the largest natural geographic source of CH 4 in the tropics, consistently underestimate the atmospheric burden of CH 4 determined via remote sensing and inversion modelling, pointing to a major gap in our understanding of the contribution of these ecosystems to CH 4 emissions. Here we report CH 4 fluxes from the stems of 2,357 individual Amazonian floodplain trees from 13 locations across the central Amazon basin. We find that escape of soil gas through wetland trees is the dominant source of regional CH 4 emissions. Methane fluxes from Amazon tree stems were up to 200 times larger than emissions reported for temperate wet forests and tropical peat swamp forests, representing the largest non-ebullitive wetland fluxes observed. Emissions from trees had an average stable carbon isotope value (δ 13 C) of -66.2 ± 6.4 per mil, consistent with a soil biogenic origin. We estimate that floodplain trees emit 15.1 ± 1.8 to 21.2 ± 2.5 teragrams of CH 4 a year, in addition to the 20.5 ± 5.3 teragrams a year emitted regionally from other sources. Furthermore, we provide a 'top-down' regional estimate of CH 4 emissions of 42.7 ± 5.6 teragrams of CH 4 a year for the Amazon basin, based on regular vertical lower-troposphere CH 4 profiles covering the period 2010-2013. We find close agreement between our 'top-down' and combined 'bottom-up' estimates, indicating that large CH 4 emissions from trees adapted to permanent or seasonal inundation can account for the emission source that is required to close the Amazon CH 4 budget. Our findings demonstrate the importance of tree stem surfaces in mediating approximately half of all wetland CH 4 emissions in the Amazon floodplain, a region that represents up to one-third of the global wetland CH 4 source when trees are combined with other emission sources.

Isoprene photochemistry over the Amazon rainforest

Science.gov (United States)

Liu, Yingjun; Brito, Joel; Dorris, Matthew R.; Rivera-Rios, Jean C.; Seco, Roger; Bates, Kelvin H.; Artaxo, Paulo; Duvoisin, Sergio; Keutsch, Frank N.; Kim, Saewung; Goldstein, Allen H.; Guenther, Alex B.; Manzi, Antonio O.; Souza, Rodrigo A. F.; Springston, Stephen R.; Watson, Thomas B.; McKinney, Karena A.

2016-01-01

Isoprene photooxidation is a major driver of atmospheric chemistry over forested regions. Isoprene reacts with hydroxyl radicals (OH) and molecular oxygen to produce isoprene peroxy radicals (ISOPOO). These radicals can react with hydroperoxyl radicals (HO2) to dominantly produce hydroxyhydroperoxides (ISOPOOH). They can also react with nitric oxide (NO) to largely produce methyl vinyl ketone (MVK) and methacrolein (MACR). Unimolecular isomerization and bimolecular reactions with organic peroxy radicals are also possible. There is uncertainty about the relative importance of each of these pathways in the atmosphere and possible changes because of anthropogenic pollution. Herein, measurements of ISOPOOH and MVK + MACR concentrations are reported over the central region of the Amazon basin during the wet season. The research site, downwind of an urban region, intercepted both background and polluted air masses during the GoAmazon2014/5 Experiment. Under background conditions, the confidence interval for the ratio of the ISOPOOH concentration to that of MVK + MACR spanned 0.4–0.6. This result implies a ratio of the reaction rate of ISOPOO with HO2 to that with NO of approximately unity. A value of unity is significantly smaller than simulated at present by global chemical transport models for this important, nominally low-NO, forested region of Earth. Under polluted conditions, when the concentrations of reactive nitrogen compounds were high (>1 ppb), ISOPOOH concentrations dropped below the instrumental detection limit (<60 ppt). This abrupt shift in isoprene photooxidation, sparked by human activities, speaks to ongoing and possible future changes in the photochemistry active over the Amazon rainforest. PMID:27185928

NILVAD protocol: a European multicentre double-blind placebo-controlled trial of nilvadipine in mild-to-moderate Alzheimer's disease

NARCIS (Netherlands)

Lawlor, B.; Kennelly, S.; O'Dwyer, S.; Cregg, F.; Walsh, C.; Coen, R.; Kenny, R.A.; Howard, R.; Murphy, C.; Adams, J.; Daly, L.; Segurado, R.; Gaynor, S.; Crawford, F.; Mullan, M.; Lucca, U.; Banzi, R.; Pasquier, F.; Breuilh, L.; Riepe, M.; Kalman, J.; Wallin, A.; Borjesson, A.; Molloy, W.; Tsolaki, M.; Olde Rikkert, M.G.M.

2014-01-01

INTRODUCTION: This study is a European multicentre, randomised, double-blind, placebo-controlled trial investigating the efficacy and safety of nilvadipine as a disease course modifying treatment for mild-to-moderate Alzheimer's disease (AD) in a phase III study that will run for a period of 82

Trace elements distribution in bottom sediments from Amazon River estuary

International Nuclear Information System (INIS)

Lara, L.B.L.S.; Nadai Fernandes, E. de; Oliveira, H. de; Bacchi, M.A.

1994-01-01

The Amazon River discharges into a dynamic marine environment where there have been many interactive processes affecting dissolved and particulate solids, either those settling on the shelf or reaching the ocean. Trace elemental concentration, especially of the rare earth elements, have been determined by neutron activation analysis in sixty bottom sediment samples of the Amazon River estuary, providing information for the spatial and temporal variation study of those elements. (author). 16 refs, 6 figs, 3 tabs

The economic value of the climate regulation ecosystem service provided by the Amazon rainforest

Science.gov (United States)

Heil Costa, Marcos; Pires, Gabrielle; Fontes, Vitor; Brumatti, Livia

2017-04-01

The rainy Amazon climate allowed important activities to develop in the region as large rainfed agricultural lands and hydropower plants. The Amazon rainforest is an important source of moisture to the regional atmosphere and helps regulate the local climate. The replacement of forest by agricultural lands decreases the flux of water vapor into the atmosphere and changes the precipitation patterns, which may severely affect such economic activities. Assign an economic value to this ecosystem service may emphasize the significance to preserve the Amazon rainforest. In this work, we provide a first approximation of the quantification of the climate regulation ecosystem service provided by the Amazon rainforest using the marginal production method. We use climate scenarios derived from Amazon deforestation scenarios as input to crop and runoff models to assess how land use change would affect agriculture and hydropower generation. The effects of forest removal on soybean production and on cattle beef production can both be as high as US 16 per year per ha deforested, and the effects on hydropower generation can be as high as US 8 per year per ha deforested. We consider this as a conservative estimate of a permanent service provided by the rainforest. Policy makers and other Amazon agriculture and energy businesses must be aware of these numbers, and consider them while planning their activities.

Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): a multicentre, randomised, double-blind, phase 3 trial

DEFF Research Database (Denmark)

Kwon, Eugene D; Drake, Charles G; Scher, Howard I

2014-01-01

BACKGROUND: Ipilimumab is a fully human monoclonal antibody that binds cytotoxic T-lymphocyte antigen 4 to enhance antitumour immunity. Our aim was to assess the use of ipilimumab after radiotherapy in patients with metastatic castration-resistant prostate cancer that progressed after docetaxel...... chemotherapy. METHODS: We did a multicentre, randomised, double-blind, phase 3 trial in which men with at least one bone metastasis from castration-resistant prostate cancer that had progressed after docetaxel treatment were randomly assigned in a 1:1 ratio to receive bone-directed radiotherapy (8 Gy in one...... fraction) followed by either ipilimumab 10 mg/kg or placebo every 3 weeks for up to four doses. Non-progressing patients could continue to receive ipilimumab at 10 mg/kg or placebo as maintenance therapy every 3 months until disease progression, unacceptable toxic effect, or death. Patients were randomly...

Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study

Directory of Open Access Journals (Sweden)

S S Nethra

2015-01-01

Full Text Available Background and Aim: The newer trend in regional anaesthesia for ambulatory anorectal surgeries advocate use of lower dose of local anaesthetic, providing segmental block with adjuvants such as opioids and α2 agonists to prolong analgesia. The current study investigated effects of addition of 5 μg of dexmedetomidine to 6 mg of hyperbaric bupivacaine on duration of analgesia, sensory and motor block characteristics for perianal ambulatory surgeries. Methods: This study is a prospective randomised controlled double blind study. Forty adult patients between 18 and 55 years of age were divided into 2 groups. Group D received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml with injection dexmedetomidine 5 μg in 0.5 ml of normal saline and Group N received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml with 0.5 ml of normal saline. The parameters assessed were time to regression of sensory blockade, motor blockade, ambulation, time to void, first administration of analgesic. Statistical analysis was done using appropriate tests. Results: Time for regression of sensory level and time for first administration of analgesic were prolonged in Group D (430.05 ± 89.13 min, 459.8 ± 100.9 min, respectively in comparison to Group N (301.10 ± 94.86 min, 321.85 ± 95.08 min, respectively. However, the duration of motor blockade, time to ambulation, and time to void were also significantly prolonged in Group D (323.05 ± 54.58 min, 329.55 ± 54.06 min, 422.30 ± 87.59 min than in Group N (220.10 ± 63.61 min, 221.60 ± 63.84 min, 328.45 ± 113.38 min. Conclusion: Intrathecal dexmedetomidine 5 μg added to intrathecal bupivacaine 6 mg as adjuvant may not be suitable for ambulatory perianal surgeries due to prolongation of motor blockade.

Effect of dexamethasone added to lidocaine in supraclavicular brachial plexus block: A prospective, randomised, double-blind study

Directory of Open Access Journals (Sweden)

Prashant A Biradar

2013-01-01

Full Text Available Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomised, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of supraclavicular brachial plexus block as this is the most common type of brachial block performed in our institute. Methods: Sixty American Society of Anaesthesiologist′s physical status I and II patients undergoing elective hand, forearm and elbow surgery under brachial plexus block were randomly allocated to receive either 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of normal saline (group C, n=30 or 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of dexamethasone (8 mg (group D, n=30. The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade were assessed. The sensory and motor blockade of radial, median, ulnar and musculocutaneous nerves were evaluated and recorded at 5, 10, 20, 120 min, and at every 30 min thereafter. Results: Two patients were excluded from the study because of block failure. The onset of sensory and motor blockade (13.4±2.8 vs. 16.0±2.3 min and 16.0±2.7 vs. 18.7±2.8 min, respectively were significantly more rapid in the dexamethasone group than in the control group ( P=0.001. The duration of sensory and motor blockade (326±58.6 vs. 159±20.1 and 290.6±52.7 vs. 135.5±20.3 min, respectively were significantly longer in the dexamethasone group than in the control group ( P=0.001. Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade.

Dry needling and exercise for chronic whiplash - a randomised controlled trial

Directory of Open Access Journals (Sweden)

Souvlis Tina

2009-12-01

Full Text Available Abstract Background Chronic whiplash is a common and costly problem. Sensory hypersensitivity is a feature of chronic whiplash that is associated with poor responsiveness to physical treatments such as exercise. Modalities such as dry-needling have shown some capacity to modulate sensory hypersensitivity, suggesting that when combined with advice and exercise, such an approach may be more effective in the management of chronic whiplash. The primary aim of this project is to investigate the effectiveness of dry-needling, advice and exercise for chronic whiplash. Method/Design A double-blind randomised controlled trial will be conducted. 120 participants with chronic whiplash, grade II will be randomised to receive either 1 dry-needling, advice and exercise or 2 sham dry-needling, advice and exercise. All participants will receive an educational booklet on whiplash. Participants who are randomised to Group 1 will receive 6 treatments of combined dry-needling and exercise delivered in the first 3 weeks of the 6 week program, and 4 treatments of exercise only in the last 3 weeks of the program. Participants randomised to Group 2 will receive an identical protocol, except that a sham dry-needling technique will be used instead of dry-needling. The primary outcome measures are the Neck Disability Index (NDI and participants' perceived recovery. Outcomes will be measured at 6, 12, 24 and 52 weeks after randomization by an assessor who is blind to the group allocation of the participants. In parallel, an economic analysis will be conducted. Discussion This trial will utilise high quality trial methodologies in accordance with CONSORT guidelines. The successful completion of this trial will provide evidence of the effectiveness and cost-effectiveness of a combined treatment approach for the management of chronic whiplash. Trial registration ACTRN12609000470291

[Ground-clearing fires in the amazon and respiratory disease].

Science.gov (United States)

Gonçalves, Karen dos Santos; de Castro, Hermano Albuquerque; Hacon, Sandra de Souza

2012-06-01

The intentional burning of forest biomass commonly known as "ground-clearing fires" is an age-old and widespread practice in the country and is seen as a major contributor to global emissions of greenhouse gases. However, global awareness of their potential impact is relatively recent. The occurrence of large ground-clearing fires in the Brazilian and international scenarios drew attention to the problem, but the measures taken to prevent and/or control the fires are still insufficient. In the Amazon region, with distinct geographical and environmental features from the rest of the country, with its historic process of land occupation, every year the ground-clearing fires expose larger portions of the population making them vulnerable to its effects. In this context, this non-systematic review presents the papers written over the past five years about the fires in the Brazilian Amazon and respiratory illness. The main objective is to provide information for managers and leaders on environmental issues about the problems related to biomass burning in the Amazon region.

Progress Towards Improved MOPITT-based Biomass Burning Emission Inventories for the Amazon Basin

Science.gov (United States)

Deeter, M. N.; Emmons, L. K.; Martinez-Alonso, S.; Wiedinmyer, C.; Arellano, A. F.; Fischer, E. V.; González-Alonso, L.; Val Martin, M.; Gatti, L. V.; Miller, J. B.; Gloor, M.; Domingues, L. G.; Correia, C. S. D. C.

2016-12-01

The 17-year long record of carbon monoxide (CO) concentrations from the MOPITT satellite instrument is uniquely suited for studying the interannual variability of biomass burning emissions. Data assimilation methods based on Ensemble Kalman Filtering are currently being developed to infer CO emissions within the Amazon Basin from MOPITT measurements along with additional datasets. The validity of these inversions will depend on the characteristics of the MOPITT CO retrievals (e.g., retrieval biases and vertical resolution) as well as the representation of chemistry and dynamics in the chemical transport model (CAM-Chem) used in the data assimilation runs. For example, the assumed vertical distribution ("injection height") of the biomass burning emissions plays a particularly important role. We will review recent progress made on a project to improve biomass burning emission inventories for the Amazon Basin. MOPITT CO retrievals over the Amazon Basin are first characterized, focusing on the MOPITT Version 6 "multispectral" retrieval product (exploiting both thermal-infrared and near-infrared channels). Validation results based on in-situ vertical profiles measured between 2010 and 2013 are presented for four sites in the Amazon Basin. Results indicate a significant negative bias in MOPITT retrieved lower-tropospheric CO concentrations. The seasonal and geographical variability of smoke injection height over the Amazon Basin is then analyzed using a MISR plume height climatology. This work has led to the development of a new fire emission injection height parameterization that was implemented in CAM-Chem and GEOS-Chem.. Finally, we present initial data assimilation results for the Amazon Basin and evaluate the results using available field campaign measurements.

77 FR 14852 - Advanced Growing Systems, Inc., Advantage Capital Development Corp., Amazon Biotech, Inc...

Science.gov (United States)

2012-03-13

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Advanced Growing Systems, Inc., Advantage Capital Development Corp., Amazon Biotech, Inc., Andover Holdings, Inc. a/k/a Andover Energy Holdings, Inc... securities of Amazon [[Page 14853

Future of oil and gas development in the western Amazon

International Nuclear Information System (INIS)

Finer, Matt; Babbitt, Bruce; Novoa, Sidney; Ferrarese, Francesco; Pappalardo, Salvatore Eugenio; Marchi, Massimo De; Saucedo, Maria; Kumar, Anjali

2015-01-01

The western Amazon is one of the world’s last high-biodiversity wilderness areas, characterized by extraordinary species richness and large tracts of roadless humid tropical forest. It is also home to an active hydrocarbon (oil and gas) sector, characterized by operations in extremely remote areas that require new access routes. Here, we present the first integrated analysis of the hydrocarbon sector and its associated road-building in the western Amazon. Specifically, we document the (a) current panorama, including location and development status of all oil and gas discoveries, of the sector, and (b) current and future scenario of access (i.e. access road versus roadless access) to discoveries. We present an updated 2014 western Amazon hydrocarbon map illustrating that oil and gas blocks now cover 733 414 km 2 , an area much larger than the US state of Texas, and have been expanding since the last assessment in 2008. In terms of access, we documented 11 examples of the access road model and six examples of roadless access across the region. Finally, we documented 35 confirmed and/or suspected untapped hydrocarbon discoveries across the western Amazon. In the Discussion, we argue that if these reserves must be developed, use of the offshore inland model—a method that strategically avoids the construction of access roads—is crucial to minimizing ecological impacts in one of the most globally important conservation regions. (letter)

[Folklore and popular medicine in the Amazon].

Science.gov (United States)

Henrique, Márcio Couto

2009-01-01

This discussion of the relations between folklore and popular medicine in the Amazon takes Canuto Azevedo's story "Filhos do boto" (Children of the porpoise) as an analytical reference point. Replete with elements of cultural reality, folk tales can serve as historical testimonies expressing clashes between different traditions. Folk records are fruit of what is often a quarrelsome dialogue between folklorists, social scientists, physicians, and pajés and their followers, and their analysis should take into account the conditions under which they were produced. Based on the imaginary attached to the figure of the porpoise--a seductive creature with healing powers--the article explores how we might expand knowledge of popular medicine as practiced in the Amazon, where the shamanistic rite known as pajelança cabocla has a strong presence.

Analisis E-Bisnis Terhadap Amazon dan Aquarelle

Directory of Open Access Journals (Sweden)

Evawaty Tanuar

2010-12-01

Full Text Available The internet and digital world is one thing that needs to be taken into account by the Company. Business through Internet, known as e-business, is another way to increase the relation between company and customers or prospective customers. Analysis from the view point of customers and the integration of technologies was conducted on 2 examples sites that well known in doing online business but have different history on how it started the e-commerce. They are Amazon and Aquarelle. By comparing the two sites, the characteristics of e-commerce sites could be studied. As a result, there are striking differences between these two sites, where Amazon is more oriented to sales, while Aquarelle more on customer-oriented impact to the design and implementation of their e-business. 

Molecular characterization of an earliest cacao (Theobroma cacao L.) collection from Peruvian Amazon using microsatllite DNA markers

Science.gov (United States)

Cacao (Theobroma cacao L.) is indigenous to the Amazon region of South America. The Peruvian Amazon harbors a large number of diverse cacao populations. Since the 1930s, several numbers of populations have been collected from the Peruvian Amazon and maintained as ex situ germplasm repositories in ...

The Battle for Critical Internet Resources: South America vs. Amazon.com, Inc.

Directory of Open Access Journals (Sweden)

Patricia Vargas-Leon

2015-04-01

Full Text Available Purpose – To analyze the controversy about the allocation of critical Internet resources generated by ICANN's new gTLD program with a particular focus on the .AMAZON TLD. Methodology/approach/design – This article presents an exploratory case study about the .AMAZON controversy. The initial analysis of this ongoing research is based on data collected from various reports and media coverage on ICANN's new gTLD policy. The article draws from political economy theory to analyze disputes about critical Internet resources. Findings – This article discusses preliminary findings of the .AMAZON case, a contested prime example in ICANN's efforts to extend the Internet's domain name space. Practical implications – The findings may inform related controversies in the gTLD program and contribute to a differentiated understanding of CIR allocation in Internet governance, and respective policy-making. Originality/value – The value of this article is the specific discussion of the .AMAZON case in the larger context of ICANN's new gTLD program, and its analysis that describes the controversy from a property rights perspective.

The Battle for Critical Internet Resources: South America vs. Amazon.com, Inc.

Directory of Open Access Journals (Sweden)

Patricia Vargas-Leon

2015-05-01

Full Text Available Purpose – To analyze the controversy about the allocation of critical Internet resources generated by ICANN's new gTLD program with a particular focus on the .AMAZON TLD. Methodology/approach/design – This article presents an exploratory case study about the .AMAZON controversy. The initial analysis of this ongoing research is based on data collected from various reports and media coverage on ICANN's new gTLD policy. The article draws from political economy theory to analyze disputes about critical Internet resources. Findings – This article discusses preliminary findings of the .AMAZON case, a contested prime example in ICANN's efforts to extend the Internet's domain name space. Practical implications – The findings may inform related controversies in the gTLD program and contribute to a differentiated understanding of CIR allocation in Internet governance, and respective policy-making. Originality/value – The value of this article is the specific discussion of the .AMAZON case in the larger context of ICANN's new gTLD program, and its analysis that describes the controversy from a property rights perspective.

Reserves protect against deforestation fires in the Amazon.

Directory of Open Access Journals (Sweden)

J Marion Adeney

Full Text Available BACKGROUND: Reserves are the principal means to conserve forests and biodiversity, but the question of whether reserves work is still debated. In the Amazon, fires are closely linked to deforestation, and thus can be used as a proxy for reserve effectiveness in protecting forest cover. We ask whether reserves in the Brazilian Amazon provide effective protection against deforestation and consequently fires, whether that protection is because of their location or their legal status, and whether some reserve types are more effective than others. METHODOLOGY/PRINCIPAL FINDINGS: Previous work has shown that most Amazonian fires occur close to roads and are more frequent in El Niño years. We quantified these relationships for reserves and unprotected areas by examining satellite-detected hot pixels regressed against road distance across the entire Brazilian Amazon and for a decade with 2 El Niño-related droughts. Deforestation fires, as measured by hot pixels, declined exponentially with increasing distance from roads in all areas. Fewer deforestation fires occurred within protected areas than outside and the difference between protected and unprotected areas was greatest near roads. Thus, reserves were especially effective at preventing these fires where they are known to be most likely to burn; but they did not provide absolute protection. Even within reserves, at a given distance from roads, there were more deforestation fires in regions with high human impact than in those with low impact. The effect of El Niño on deforestation fires was greatest outside of reserves and near roads. Indigenous reserves, limited-use reserves, and fully protected reserves all had fewer fires than outside areas and did not appear to differ in their effectiveness. CONCLUSIONS/SIGNIFICANCE: Taking time, regional factors, and climate into account, our results show that reserves are an effective tool for curbing destructive burning in the Amazon.

Reserves Protect against Deforestation Fires in the Amazon

Science.gov (United States)

Adeney, J. Marion; Christensen, Norman L.; Pimm, Stuart L.

2009-01-01

Background Reserves are the principal means to conserve forests and biodiversity, but the question of whether reserves work is still debated. In the Amazon, fires are closely linked to deforestation, and thus can be used as a proxy for reserve effectiveness in protecting forest cover. We ask whether reserves in the Brazilian Amazon provide effective protection against deforestation and consequently fires, whether that protection is because of their location or their legal status, and whether some reserve types are more effective than others. Methodology/Principal Findings Previous work has shown that most Amazonian fires occur close to roads and are more frequent in El Niño years. We quantified these relationships for reserves and unprotected areas by examining satellite-detected hot pixels regressed against road distance across the entire Brazilian Amazon and for a decade with 2 El Niño-related droughts. Deforestation fires, as measured by hot pixels, declined exponentially with increasing distance from roads in all areas. Fewer deforestation fires occurred within protected areas than outside and the difference between protected and unprotected areas was greatest near roads. Thus, reserves were especially effective at preventing these fires where they are known to be most likely to burn; but they did not provide absolute protection. Even within reserves, at a given distance from roads, there were more deforestation fires in regions with high human impact than in those with low impact. The effect of El Niño on deforestation fires was greatest outside of reserves and near roads. Indigenous reserves, limited-use reserves, and fully protected reserves all had fewer fires than outside areas and did not appear to differ in their effectiveness. Conclusions/Significance Taking time, regional factors, and climate into account, our results show that reserves are an effective tool for curbing destructive burning in the Amazon. PMID:19352423

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

OpenAIRE

Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

2004-01-01

Background: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative.

Charcoal chronology of the Amazon forest

NARCIS (Netherlands)

Goulart, Ana Carolina; Macario, Kita D.; Scheel-Ybert, Rita; Alves, Eduardo Q.; Bachelet, Caroline; Pereira, Bruna B.; Levis, Carolina; Marimon Junior, Ben Hur; Marimon, Beatriz S.; Quesada, Carlos Alberto; Feldpausch, Ted R.

2017-01-01

The Amazon region holds a wide variety of ethnic groups and microclimates, enabling different interactions between humans and environment. To better understand the evolution of this region, ancient remains need to be analysed by all possible means. In this context, the study of natural and/or

Tocolysis for repeat external cephalic version in breech presentation at term: a randomised, double-blinded, placebo-controlled trial.

Science.gov (United States)

Impey, Lawrence; Pandit, Meghana

2005-05-01

External cephalic version (ECV) reduces the incidence of breech presentation at term and caesarean section for non-cephalic births. Tocolytics may improve success rates, but are time consuming, may cause side effects and have not been proven to alter caesarean section rates. The aim of this trial was to determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. To determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. Randomised, double-blinded, placebo-controlled trial. UK teaching hospital. One hundred and twenty-four women with a breech presentation at term who had undergone an unsuccessful attempt at ECV. Relative risks with 95% confidence intervals for categorical variables and a t test for continuous variables. Analysis was by intention to treat. Incidence of cephalic presentation at delivery. Secondary outcomes were caesarean section and measures of neonatal and maternal morbidity. The use of tocolysis for a repeat attempt at ECV significantly increases the incidence of cephalic presentation at delivery (RR 3.21; 95% CI 1.23-8.39) and reduces the incidence of caesarean section (RR 0.33; 95% CI 0.14-0.80). The effects were most marked in multiparous women (RR for cephalic presentation at delivery 9.38; 95% CI 1.64-53.62). Maternal and neonatal morbidity remain unchanged. The use of tocolysis increases the success rate of repeat ECV and reduces the incidence of caesarean section. A policy of only using tocolysis where an initial attempt has failed leads to a relatively high success rate with minimum usage of tocolysis.

Drought sensitivity of the Amazon rainforest.

Science.gov (United States)

Phillips, Oliver L; Aragão, Luiz E O C; Lewis, Simon L; Fisher, Joshua B; Lloyd, Jon; López-González, Gabriela; Malhi, Yadvinder; Monteagudo, Abel; Peacock, Julie; Quesada, Carlos A; van der Heijden, Geertje; Almeida, Samuel; Amaral, Iêda; Arroyo, Luzmila; Aymard, Gerardo; Baker, Tim R; Bánki, Olaf; Blanc, Lilian; Bonal, Damien; Brando, Paulo; Chave, Jerome; de Oliveira, Atila Cristina Alves; Cardozo, Nallaret Dávila; Czimczik, Claudia I; Feldpausch, Ted R; Freitas, Maria Aparecida; Gloor, Emanuel; Higuchi, Niro; Jiménez, Eliana; Lloyd, Gareth; Meir, Patrick; Mendoza, Casimiro; Morel, Alexandra; Neill, David A; Nepstad, Daniel; Patiño, Sandra; Peñuela, Maria Cristina; Prieto, Adriana; Ramírez, Fredy; Schwarz, Michael; Silva, Javier; Silveira, Marcos; Thomas, Anne Sota; Steege, Hans Ter; Stropp, Juliana; Vásquez, Rodolfo; Zelazowski, Przemyslaw; Alvarez Dávila, Esteban; Andelman, Sandy; Andrade, Ana; Chao, Kuo-Jung; Erwin, Terry; Di Fiore, Anthony; Honorio C, Eurídice; Keeling, Helen; Killeen, Tim J; Laurance, William F; Peña Cruz, Antonio; Pitman, Nigel C A; Núñez Vargas, Percy; Ramírez-Angulo, Hirma; Rudas, Agustín; Salamão, Rafael; Silva, Natalino; Terborgh, John; Torres-Lezama, Armando

2009-03-06

Amazon forests are a key but poorly understood component of the global carbon cycle. If, as anticipated, they dry this century, they might accelerate climate change through carbon losses and changed surface energy balances. We used records from multiple long-term monitoring plots across Amazonia to assess forest responses to the intense 2005 drought, a possible analog of future events. Affected forest lost biomass, reversing a large long-term carbon sink, with the greatest impacts observed where the dry season was unusually intense. Relative to pre-2005 conditions, forest subjected to a 100-millimeter increase in water deficit lost 5.3 megagrams of aboveground biomass of carbon per hectare. The drought had a total biomass carbon impact of 1.2 to 1.6 petagrams (1.2 x 10(15) to 1.6 x 10(15) grams). Amazon forests therefore appear vulnerable to increasing moisture stress, with the potential for large carbon losses to exert feedback on climate change.

Protecting the Amazon with protected areas

Science.gov (United States)

Walker, Robert; Moore, Nathan J.; Arima, Eugenio; Perz, Stephen; Simmons, Cynthia; Caldas, Marcellus; Vergara, Dante; Bohrer, Claudio

2009-01-01

This article addresses climate-tipping points in the Amazon Basin resulting from deforestation. It applies a regional climate model to assess whether the system of protected areas in Brazil is able to avoid such tipping points, with massive conversion to semiarid vegetation, particularly along the south and southeastern margins of the basin. The regional climate model produces spatially distributed annual rainfall under a variety of external forcing conditions, assuming that all land outside protected areas is deforested. It translates these results into dry season impacts on resident ecosystems and shows that Amazonian dry ecosystems in the southern and southeastern basin do not desiccate appreciably and that extensive areas experience an increase in precipitation. Nor do the moist forests dry out to an excessive amount. Evidently, Brazilian environmental policy has created a sustainable core of protected areas in the Amazon that buffers against potential climate-tipping points and protects the drier ecosystems of the basin. Thus, all efforts should be made to manage them effectively. PMID:19549819

Climatic and ecological future of the Amazon: likelihood and causes of change

Science.gov (United States)

Cook, B.; Zeng, N.; Yoon, J.-H.

2010-05-01

Some recent climate modeling results suggested a possible dieback of the Amazon rainforest under future climate change, a prediction that raised considerable interest as well as controversy. To determine the likelihood and causes of such changes, we analyzed the output of 15 models from the Intergovernmental Panel on Climate Change Fourth Assessment Report (IPCC/AR4) and a dynamic vegetation model VEGAS driven by these climate output. Our results suggest that the core of the Amazon rainforest should remain largely stable as rainfall is projected to increase in nearly all models. However, the periphery, notably the southern edge of the Amazon and further south in central Brazil, are in danger of drying out, driven by two main processes. Firstly, a decline in precipitation of 22% in the southern Amazon's dry season (May-September) reduces soil moisture, despite an increase in precipitation during the wet season, due to nonlinear responses in hydrology and ecosystem dynamics. Two dynamical mechanisms may explain the lower dry season rainfall: (1) a general subtropical drying under global warming when the dry season southern Amazon is under the control of the subtropical high pressure; (2) a stronger north-south tropical Atlantic sea surface temperature gradient, and to lesser degree a warmer eastern equatorial Pacific. Secondly, evaporation demand will increase due to the general warming, further reducing soil moisture. In terms of ecosystem response, higher maintenance cost and reduced productivity under warming may also have additional adverse impact. The drying corresponds to a lengthening of the dry season by 11 days. As a consequence, the median of the models projects a reduction of 20% in vegetation carbon stock in the southern Amazon, central Brazil, and parts of the Andean Mountains. Further, VEGAS predicts enhancement of fire risk by 10-15%. The increase in fire is primarily due to the reduction in soil moisture, and the decrease in dry season rainfall, which

Historical satellite data used to map Pan-Amazon forest cover

Science.gov (United States)

Kalluri, Satya; Desch, Arthur; Curry, Troy; Altstatt, Alice; Devers, Didier; Townshend, John; Tucker, Compton

Deforestation in the Brazilian Amazon is well documented and the contributions of Brazilian deforestation to global change have been extensively discussed in both scientific and popular literature [e.g., Skole and Tucker, 1993]. However, deforestation within the non-Brazilian tropics of South America has received much less attention. The Pan-Amazon region covering Venezuela, Colombia, Ecuador, Peru, and Bolivia comprises ˜2 million km2 of tropical forest that is under increasing pressure from logging and development. Wall-to-wall high-resolution forest cover maps are needed to properly document the complex distribution patterns of deforestation in the Pan-Amazon [Tucker and Townshend, 2000]. The Deforestation Mapping Group at the University of Marylands Global Land Cover Facility is using Landsat data to generate tropical forest cover maps in this region (Figure l). The study shows that while rates of forest loss are generally lower than those in Brazil, there are hot spots where deforestation rates run as high as 2,200 km2 yr1.

In Search of the Amazon - Brazil, the United States and the Nature of a Region

OpenAIRE

Garfield, Seth

2013-01-01

Chronicling the dramatic history of the Brazilian Amazon during the Second World War, Seth Garfield provides fresh perspectives on contemporary environmental debates. His multifaceted analysis explains how the Amazon became the object of geopolitical rivalries, state planning, media coverage, popular fascination, and social conflict. In need of rubber, a vital war material, the United States spent millions of dollars to revive the Amazon's rubber trade. In the name of development and national...

Single-Dose Pharmacokinetics of Piperacillin/Tazobactam in Hispaniolan Amazon Parrots ( Amazona ventralis ).

Science.gov (United States)

Carpenter, James W; Tully, Thomas N; Gehring, Ronette; Guzman, David Sanchez-Migallon

2017-06-01

To determine the pharmacokinetics of piperacillin/tazobactam in Hispaniolan Amazon parrots ( Amazona ventralis ), 8 healthy adult parrots of both sexes were used in a 2-part study. In a pilot study, piperacillin (87 mg/kg) in combination with tazobactam (11 mg/kg) was administered intramuscularly (IM) to 2 birds, and blood samples were obtained at 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, and 10 hours after administration. Based on the results obtained, a main study was done in which piperacillin/tazobactam was administered at 2 different doses. In 3 birds, the initial dose of piperacillin (87 mg/kg)/tazobactam (11 mg/kg) IM was administered, and in 3 birds, the dose was doubled to piperacillin (174 mg/kg)/tazobactam (22 mg/kg) IM. In all 6 birds, blood samples were obtained at 0, 5, 15, and 30 minutes and at 1, 1.5, 2, 2.5, 3, and 4 hours after administration. Quantification of plasma piperacillin and tazobactam concentrations was determined by validated liquid chromatography-mass spectrometry assay. Pharmacokinetic parameters were determined by noncompartmental analysis. After intramuscular administration, the mean ± standard error values of T 1/2 (h) was 0.52 ± 0.05 and 0.32 ± 0.07, T max (h) was 0.28 ± 0.09 and 0.25 ± 0.10, C max (μg/mL) was 86.34 ± 20.62 and 9.03 ± 2.88, and C max /dose was 0.99 ± 0.24 and 0.83 ± 0.26 for piperacillin (87 mg/kg) and tazobactam (11 mg/kg), respectively. When the doses were doubled, the T 1/2 (h) was 0.65 ± 0.08 and 0.34 ± 0.02, T max (h) was 0.28 ± 0.12 and 0.14 ± 0.06, C max (μg/mL) was 233.0 ± 6.08 and 22.13 ± 2.35, and C max /dose was 1.34 ± 0.03 and 1.02 ± 0.11 for piperacillin and tazobactam, respectively. Results indicate that piperacillin is rapidly absorbed and reaches high initial concentrations; however, it is also rapidly eliminated in the Hispaniolan Amazon parrot, and tazobactam has similar pharmacokinetics as piperacillin. Administration of piperacillin at 87 mg/kg IM q3-4h is recommended for this species

Separating the Effects of Tropical Atlantic and Pacific SST-driven Climate Variability on Amazon Carbon Exchange

Science.gov (United States)

Liptak, J.; Keppel-Aleks, G.

2016-12-01

Amazon forests store an estimated 25% percent of global terrestrial carbon per year1, 2, but the responses of Amazon carbon uptake to climate change is highly uncertain. One source of this uncertainty is tropical sea surface temperature variability driven by teleconnections. El Nino-Southern Oscillation (ENSO) is a key driver of year-to-year Amazon carbon exchange, with associated temperature and precipitation changes favoring net carbon storage in La Nina years, and net carbon release during El Nino years3. To determine how Amazon climate and terrestrial carbon fluxes react to ENSO alone and in concert with other SST-driven teleconnections such as the Atlantic Multidecadal Oscillation (AMO), we force the atmosphere (CAM5) and land (CLM4) components of the CESM(BGC) with prescribed monthly SSTs over the period 1950—2014 in a Historical control simulation. We then run an experiment (PAC) with time-varying SSTs applied only to the tropical equatorial Pacific Ocean, and repeating SST seasonal cycle climatologies elsewhere. Limiting SST variability to the equatorial Pacific indicates that other processes enhance ENSO-driven Amazon climate anomalies. Compared to the Historical control simulation, warming, drying and terrestrial carbon loss over the Amazon during El Nino periods are lower in the PAC simulation, especially prior to 1990 during the cool phase of the AMO. Cooling, moistening, and net carbon uptake during La Nina periods are also reduced in the PAC simulation, but differences are greater after 1990 during the warm phase of the AMO. By quantifying the relationships among climate drivers and carbon fluxes in the Historical and PAC simulations, we both assess the sensitivity of these relationships to the magnitude of ENSO forcing and quantify how other teleconnections affect ENSO-driven Amazon climate feedbacks. We expect that these results will help us improve hypotheses for how Atlantic and Pacific climate trends will affect future Amazon carbon carbon

Oral doxycycline for the prevention of postoperative trachomatous trichiasis in Ethiopia: a randomised, double-blind, placebo-controlled trial

Directory of Open Access Journals (Sweden)

Esmael Habtamu, PhD

2018-05-01

Full Text Available Summary: Background: Trachomatous trichiasis is treated surgically to prevent sight loss. Unfavourable surgical outcomes remain a major challenge. We investigated the hypothesis that doxycycline might reduce the risk of postoperative trichiasis following surgery in patients with trachomatous trichiasis through anti-matrix metalloproteinase and anti-inflammatory activity. Methods: In this randomised, double-blind, placebo-controlled trial, adults (aged >18 years with upper lid trachomatous trichiasis in association with tarsal conjunctive scarring were recruited through community-based screening and surgical outreach campaigns in Ethiopia. Individuals who had previously had eyelid surgery were excluded. Participants were randomly assigned (1:1, with random block sizes of four or six, to receive oral doxycycline (100 mg once a day or placebo for 28 days immediately after trichiasis surgery. Randomisation was stratified by surgeon. Patients, investigators, surgeons, and all other study team members were masked to study group allocation and treatment. Participants were examined at 10 days, and 1, 6, and 12 months after surgery. The primary outcome was the cumulative proportion of individuals who developed postoperative trichiasis by 12 months. Primary analyses were done in all participants who attended at least one of the four follow-up assessments. Safety analyses were done in all participants who attended either the 10 day or 1 month follow-up assessments. This trial is registered with the Pan African Clinical Trials Registry, number PACTR201512001370307. Findings: Between Dec 21, 2015, and April 6, 2016, 1000 patients with trichiasis were enrolled and randomly assigned to treatment (499 patients to doxycycline, 501 patients to placebo. All but one participant attended at least one follow-up assessment. Thus, 999 participants were assessed for the primary outcome: 498 in the doxycycline group and 501 in the placebo group. By month 12, 58 (12% of

The Visibility of Work among Ticuna Women in the Amazon

Directory of Open Access Journals (Sweden)

Iraildes Caldas Torres

2007-05-01

Full Text Available This paper analyzes the Amazon Indian craftsmanship, done by Ticuna Women. Crafts are shown to be an important product in the strong positive development in the rural Amazon community. It works with data observed and collected in research done as a consultant for Sebrae/Amazonas in 2004. It shows how women work is an organizing element of the domestic economy for the Ticuna ethnicity. A principal feature of the sexual division of labor places women as having more responsibility for family maintenance.

Efficacy of lycopene-enriched virgin olive oil for treating burning mouth syndrome: a double-blind randomised.

Science.gov (United States)

Cano-Carrillo, P; Pons-Fuster, A; López-Jornet, P

2014-04-01

Burning mouth syndrome (BMS) is an intensive chronic oral mucosal pain condition of unknown aetiology. The aim of this study was to evaluate the clinical performance of lycopene-enriched virgin olive oil used to treat the condition, comparing this with a placebo. This study took the form of a double-bind, randomised clinical trial. A total of 60 patients with BMS were randomly divided into two groups: Group I (n = 30) treated with lycopene-enriched virgin olive oil (300 ppm) (1.5 mL three times a day) and Group II (n=treated with a placebo (1.5 mL three times a day). Evaluations were made before and after 12 weeks of product/placebo application. Symptoms were evaluated by VAS, whilst patient psychological profiles were assessed using the HAD scale and patient quality of life using the Oral Health Impact Profile-14 (OHIP-14) and the Medical Outcome Short Form Health Survey questionnaire (SF36). Fifty patients completed the 12-week treatment (26 in Group I and 24 in Group II). Visual analogue scale pain values improved in both groups but without statistically significant differences between the groups (P = 0.57). Oral quality of life also improved. Four patients in Group I (treatment) left the study and six left Group II (placebo). No patients experienced any adverse effects resulting from treatment at any of the evaluation times. Patients were lost from the sample due to lack of compliance. It was found that the lipid profile did not change during the 3-month study period as a result of the application of lycopene-enriched olive oil (Group I); nor did any change occur in the placebo group (Group II). In this way, the placebo effect was seen to be strong. The topical lycopene-enriched virgin olive oil is a very safe and an effective similar way that the placebo for treating patients with BMS. However, future studies are required to establish the treatment for patients with chronic and painful syndrome.

The Amazon hydrometeorology: Climatology, variability and links to changes in weather patterns

Science.gov (United States)

Fernandes, Katia De Avila

My thesis focuses on improving the quantification of the hydrological cycle and understanding the atmospheric processes that link weather to climate in the Amazon River basin. By using ERA40 and independent observations, I assess how well we can estimate the surface water budget in the Amazon River basin. I find that ERA40 basin wide annual precipitation (P) overall agrees with observations showing a slight underestimation of 10% in average, whereas runoff (R) is underestimated by a larger margin (˜25%). Observed residual of precipitation and runoff (denoted as P-R) is better estimated by ERA40 P-R than actual ET which includes soil moisture nudging. The causes for said discrepancies were found to partly relate to soil moisture nudging that needs to be applied during the dry season to produce realistic ET and compensate for the low soil moisture recharge during the previous wet season. Insufficient recharge may in part be caused by underestimation of rainfall amount and intensity; moreover the shallow root layer in the model does not represent the deep soil water reservoir characteristic of the Amazonian forest. Whether the hydrological cycle and weather patterns in the Amazon have changed during the past few decades is a highly debatable but central question for detecting climate change in the region. The second part of my thesis focus on the physical links between rainfall changes detected in observations, and changes of synoptic scale systems as represented by ERA40. My results suggest that an observed delayed wet season onset is consistent with a decreasing number of cold air incursion (CAI) days in southern Amazon for the period 1979--2001. The variability of CAI into southern Amazon is related to the variability of SST upstream of South America in the tropical Pacific and Indian Oceans. A Singular Value Decomposition Analysis (SVD) between CAI days and global SST reveal three main modes of co-variability. The first mode describes the effect of the El Nino

Projected increases in the annual flood pulse of the Western Amazon

OpenAIRE

Zulkafli, Z.; Buytaert, W.; Manz, B.; Rosas, C. V.; Willems, P.; Lavado-Casimiro, W.; Guyot, Jean-Loup; Santini, William

2016-01-01

The impact of a changing climate on the Amazon basin is a subject of intensive research because of its rich biodiversity and the significant role of rainforests in carbon cycling. Climate change has also a direct hydrological impact, and increasing efforts have focused on understanding the hydrological dynamics at continental and subregional scales, such as the Western Amazon. New projections from the Coupled Model Inter-comparison Project Phase 5 ensemble indicate consistent climatic warming...

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

NARCIS (Netherlands)

Voskuijl, W.; de Lorijn, F.; Verwijs, W.; Hogeman, P.; Heijmans, J.; Mäkel, W.; Taminiau, J.; Benninga, M.

2004-01-01

Background: Recently, polyethylene glycol ( PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. Aims: To compare PEG 3350 (

Foraminifera and Thecamoebians as hydrodynamic indicators for Amazon estuarine system

Science.gov (United States)

Laut, L. L.; Figueiredo, A. G.; Santos, V. F.; Souza-Vieira, S.

2007-05-01

The Amazon mangrove forest in Brazilian territory is one of the most extended in the world. It goes from Ponta do Tubarao (4S e 43W) to Cape Orange (5N e 51W) along 2,250 km of coast line. Because the Amazon River System influence, it can be divided into two regions; one with river influence toward north and the other without river influence. In order to characterize the mangrove environment hydrodynamic on both sides of the Amazon River System, foraminifera and thecamoebians assemblages were investigated in the sediment of two estuaries; Araguari to the North (1 15S - 50 30W) and Caete to the South (0 50S - 46 30W). For both estuaries forams and thecamoebians species distribution are atypical relative to other world regions. In both, there are only few calcareous forams and almost all are small and possible of being transported in suspension. Typical estuarine species were not identified. The typical mangrove forams which are agglutinated species were dominant in both estuaries. However, the Caete estuary has a large number of forams species (29), indicating better efficiency in mixing fresh and salt water in comparison to the Araguari. On the other hand, the Araguari has big richness of thecamoebians species (15) indicating fresh water prevalence. The fresh water predominance is due to the Amazon water plume being diverted to the Amapa coast where the Araguari estuary is located. The foraminifera species was also used to determine the salt water penetration in the estuary. In the Caete estuary, salt water penetrates to about 40 km while in the Araguari it does coincide with the limit of the bore tide wave "pororoca" penetration, 45 km. Based on the species succession (forams to thecamoebians species) the Araguary estuary can be divided into three regions controlled by turbidity: the outer, middle and inner estuary. The Caete species succession is not that clear and only could be divided based on salinity into outer and inner estuary. In both estuaries forams and

Health Concerns in the Amazon Region

Centers for Disease Control (CDC) Podcasts

Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.

Angiotensin receptor blockade in acute stroke. The Scandinavian Candesartan Acute Stroke Trial: rationale, methods and design of a multicentre, randomised- and placebo-controlled clinical trial (NCT00120003)

DEFF Research Database (Denmark)

Sandset, Else Charlotte; Murray, Gordon; Boysen, Gudrun Margrethe

2010-01-01

AND DESIGN: The Scandinavian Candesartan Acute Stroke Trial is an international randomised, placebo-controlled, double-blind trial of candesartan in acute stroke. We plan to recruit 2500 patients presenting within 30 h of stroke (ischaemic or haemorrhagic) and with systolic blood pressure =140 mm......Hg. The recruited patients are randomly assigned to candesartan or placebo for 7-days (doses increasing from 4 to 16 mg once daily). Randomisation is performed centrally via a secure web interface. The follow-up period is 6-months. Patients are included from the following nine North-European countries: Norway...

A randomised, controlled study of peri-operative low dose s(+)-ketamine in combination with postoperative patient-controlled s(+)-ketamine and morphine after radical prostatectomy.

NARCIS (Netherlands)

Snijdelaar, D.G.; Cornelisse, H.B.; Schmid, R.L.; Katz, J.

2004-01-01

In a randomised, double-blind prospective study we compared the effects on postoperative pain and analgesic consumption of intra-operative s(+)-ketamine (100 microg.kg-1 bolus and a continuous infusion of 2 microg.kg-1.min-1) followed by postoperative patient-controlled analgesia with morphine (1 mg

Quantifying How Climate Affects Vegetation in the Amazon Rainforest

Science.gov (United States)

Das, K.; Kodali, A.; Szubert, M.; Ganguly, S.; Bongard, J.

2016-12-01

Amazon droughts in 2005 and 2010 have raised serious concern about the future of the rainforest. Amazon forests are crucial because of their role as the largest carbon sink in the world which would effect the global warming phenomena with decreased photosynthesis activity. Especially, after a decline in plant growth in 1.68 million km2 forest area during the once-in-a-century severe drought in 2010, it is of primary importance to understand the relationship between different climatic variables and vegetation. In an earlier study, we have shown that non-linear models are better at capturing the relation dynamics of vegetation and climate variables such as temperature and precipitation, compared to linear models. In this research, we learn precise models between vegetation and climatic variables (temperature, precipitation) for normal conditions in the Amazon region using genetic programming based symbolic regression. This is done by removing high elevation and drought affected areas and also considering the slope of the region as one of the important factors while building the model. The model learned reveals new and interesting ways historical and current climate variables affect the vegetation at any location. MAIAC data has been used as a vegetation surrogate in our study. For temperature and precipitation, we have used TRMM and MODIS Land Surface Temperature data sets while learning the non-linear regression model. However, to generalize the model to make it independent of the data source, we perform transfer learning where we regress a regularized least squares to learn the parameters of the non-linear model using other data sources such as the precipitation and temperature from the Climatic Research Center (CRU). This new model is very similar in structure and performance compared to the original learned model and verifies the same claims about the nature of dependency between these climate variables and the vegetation in the Amazon region. As a result of this

Inositol for the prevention of neural tube defects: a pilot randomised controlled trial.

Science.gov (United States)

Greene, Nicholas D E; Leung, Kit-Yi; Gay, Victoria; Burren, Katie; Mills, Kevin; Chitty, Lyn S; Copp, Andrew J

2016-03-28

Although peri-conceptional folic acid (FA) supplementation can prevent a proportion of neural tube defects (NTD), there is increasing evidence that many NTD are FA non-responsive. The vitamin-like molecule inositol may offer a novel approach to preventing FA-non-responsive NTD. Inositol prevented NTD in a genetic mouse model, and was well tolerated by women in a small study of NTD recurrence. In the present study, we report the Prevention of Neural Tube Defects by Inositol (PONTI) pilot study designed to gain further experience of inositol usage in human pregnancy as a preliminary trial to a future large-scale controlled trial to evaluate efficacy of inositol in NTD prevention. Study subjects were UK women with a previous NTD pregnancy who planned to become pregnant again. Of 117 women who made contact, ninety-nine proved eligible and forty-seven agreed to be randomised (double-blind) to peri-conceptional supplementation with inositol plus FA or placebo plus FA. In total, thirty-three randomised pregnancies produced one NTD recurrence in the placebo plus FA group (n 19) and no recurrences in the inositol plus FA group (n 14). Of fifty-two women who declined randomisation, the peri-conceptional supplementation regimen and outcomes of twenty-two further pregnancies were documented. Two NTD recurred, both in women who took only FA in their next pregnancy. No adverse pregnancy events were associated with inositol supplementation. The findings of the PONTI pilot study encourage a large-scale controlled trial of inositol for NTD prevention, but indicate the need for a careful study design in view of the unwillingness of many high-risk women to be randomised.

Rainfall trends in the Brazilian Amazon Basin in the past eight decades

Science.gov (United States)

Satyamurty, Prakki; de Castro, Aline Anderson; Tota, Julio; da Silva Gularte, Lucia Eliane; Manzi, Antonio Ocimar

2010-01-01

Rainfall series at 18 stations along the major rivers of the Brazilian Amazon Basin, having data since 1920s or 1930s, are analyzed to verify if there are appreciable long-term trends. Annual, rainy-season, and dry-season rainfalls are individually analyzed for each station and for the region as a whole. Some stations showed positive trends and some negative trends. The trends in the annual rainfall are significant at only six stations, five of which reporting increasing trends (Barcelos, Belem, Manaus, Rio Branco, and Soure stations) and just one (Itaituba station) reporting decreasing trend. The climatological values of rainfall before and after 1970 show significant differences at six stations (Barcelos, Belem, Benjamin Constant, Iaurete, Itaituba, and Soure). The region as a whole shows an insignificant and weak downward trend; therefore, we cannot affirm that the rainfall in the Brazilian Amazon basin is experiencing a significant change, except at a few individual stations. Subregions with upward and downward trends are interspersed in space from the far eastern Amazon to western Amazon. Most of the seasonal trends follow the annual trends, thus, indicating a certain consistency in the datasets and analysis.

Amazon Forests Maintain Consistent Canopy Structure and Greenness During the Dry Season

Science.gov (United States)

Morton, Douglas C.; Nagol, Jyoteshwar; Carabajal, Claudia C.; Rosette, Jacqueline; Palace, Michael; Cook, Bruce D.; Vermote, Eric F.; Harding, David J.; North, Peter R. J.

2014-01-01

The seasonality of sunlight and rainfall regulates net primary production in tropical forests. Previous studies have suggested that light is more limiting than water for tropical forest productivity, consistent with greening of Amazon forests during the dry season in satellite data.We evaluated four potential mechanisms for the seasonal green-up phenomenon, including increases in leaf area or leaf reflectance, using a sophisticated radiative transfer model and independent satellite observations from lidar and optical sensors. Here we show that the apparent green up of Amazon forests in optical remote sensing data resulted from seasonal changes in near-infrared reflectance, an artefact of variations in sun-sensor geometry. Correcting this bidirectional reflectance effect eliminated seasonal changes in surface reflectance, consistent with independent lidar observations and model simulations with unchanging canopy properties. The stability of Amazon forest structure and reflectance over seasonal timescales challenges the paradigm of light-limited net primary production in Amazon forests and enhanced forest growth during drought conditions. Correcting optical remote sensing data for artefacts of sun-sensor geometry is essential to isolate the response of global vegetation to seasonal and interannual climate variability.

Oil and gas projects in the Western Amazon: threats to wilderness, biodiversity, and indigenous peoples.

Science.gov (United States)

Finer, Matt; Jenkins, Clinton N; Pimm, Stuart L; Keane, Brian; Ross, Carl

2008-08-13

The western Amazon is the most biologically rich part of the Amazon basin and is home to a great diversity of indigenous ethnic groups, including some of the world's last uncontacted peoples living in voluntary isolation. Unlike the eastern Brazilian Amazon, it is still a largely intact ecosystem. Underlying this landscape are large reserves of oil and gas, many yet untapped. The growing global demand is leading to unprecedented exploration and development in the region. We synthesized information from government sources to quantify the status of oil development in the western Amazon. National governments delimit specific geographic areas or "blocks" that are zoned for hydrocarbon activities, which they may lease to state and multinational energy companies for exploration and production. About 180 oil and gas blocks now cover approximately 688,000 km(2) of the western Amazon. These blocks overlap the most species-rich part of the Amazon. We also found that many of the blocks overlap indigenous territories, both titled lands and areas utilized by peoples in voluntary isolation. In Ecuador and Peru, oil and gas blocks now cover more than two-thirds of the Amazon. In Bolivia and western Brazil, major exploration activities are set to increase rapidly. Without improved policies, the increasing scope and magnitude of planned extraction means that environmental and social impacts are likely to intensify. We review the most pressing oil- and gas-related conservation policy issues confronting the region. These include the need for regional Strategic Environmental Impact Assessments and the adoption of roadless extraction techniques. We also consider the conflicts where the blocks overlap indigenous peoples' territories.

Oil and Gas Projects in the Western Amazon: Threats to Wilderness, Biodiversity, and Indigenous Peoples

Science.gov (United States)

Finer, Matt; Jenkins, Clinton N.; Pimm, Stuart L.; Keane, Brian; Ross, Carl

2008-01-01

Background The western Amazon is the most biologically rich part of the Amazon basin and is home to a great diversity of indigenous ethnic groups, including some of the world's last uncontacted peoples living in voluntary isolation. Unlike the eastern Brazilian Amazon, it is still a largely intact ecosystem. Underlying this landscape are large reserves of oil and gas, many yet untapped. The growing global demand is leading to unprecedented exploration and development in the region. Methodology/Principal Findings We synthesized information from government sources to quantify the status of oil development in the western Amazon. National governments delimit specific geographic areas or “blocks” that are zoned for hydrocarbon activities, which they may lease to state and multinational energy companies for exploration and production. About 180 oil and gas blocks now cover ∼688,000 km2 of the western Amazon. These blocks overlap the most species-rich part of the Amazon. We also found that many of the blocks overlap indigenous territories, both titled lands and areas utilized by peoples in voluntary isolation. In Ecuador and Peru, oil and gas blocks now cover more than two-thirds of the Amazon. In Bolivia and western Brazil, major exploration activities are set to increase rapidly. Conclusions/Significance Without improved policies, the increasing scope and magnitude of planned extraction means that environmental and social impacts are likely to intensify. We review the most pressing oil- and gas-related conservation policy issues confronting the region. These include the need for regional Strategic Environmental Impact Assessments and the adoption of roadless extraction techniques. We also consider the conflicts where the blocks overlap indigenous peoples' territories. PMID:18716679

Oil and gas projects in the Western Amazon: threats to wilderness, biodiversity, and indigenous peoples.

Directory of Open Access Journals (Sweden)

Matt Finer

Full Text Available BACKGROUND: The western Amazon is the most biologically rich part of the Amazon basin and is home to a great diversity of indigenous ethnic groups, including some of the world's last uncontacted peoples living in voluntary isolation. Unlike the eastern Brazilian Amazon, it is still a largely intact ecosystem. Underlying this landscape are large reserves of oil and gas, many yet untapped. The growing global demand is leading to unprecedented exploration and development in the region. METHODOLOGY/PRINCIPAL FINDINGS: We synthesized information from government sources to quantify the status of oil development in the western Amazon. National governments delimit specific geographic areas or "blocks" that are zoned for hydrocarbon activities, which they may lease to state and multinational energy companies for exploration and production. About 180 oil and gas blocks now cover approximately 688,000 km(2 of the western Amazon. These blocks overlap the most species-rich part of the Amazon. We also found that many of the blocks overlap indigenous territories, both titled lands and areas utilized by peoples in voluntary isolation. In Ecuador and Peru, oil and gas blocks now cover more than two-thirds of the Amazon. In Bolivia and western Brazil, major exploration activities are set to increase rapidly. CONCLUSIONS/SIGNIFICANCE: Without improved policies, the increasing scope and magnitude of planned extraction means that environmental and social impacts are likely to intensify. We review the most pressing oil- and gas-related conservation policy issues confronting the region. These include the need for regional Strategic Environmental Impact Assessments and the adoption of roadless extraction techniques. We also consider the conflicts where the blocks overlap indigenous peoples' territories.

Oil frontiers and indigenous resistance in the Peruvian Amazon

Energy Technology Data Exchange (ETDEWEB)

Orta-Martinez, Marti [ICTA, Universitat Autonoma de Barcelona, 08193 Barcelona (Spain); Finer, Matt [Save America' s Forests, 4 Library Court. NW, Washington DC 20003 (United States)

2010-12-15

The Peruvian Amazon is culturally and biologically one of the most diverse regions on Earth. Since the 1920s oil exploration and extraction in the region have threatened both biodiversity and indigenous peoples, particularly those living in voluntary isolation. We argue that the phenomenon of peak oil, combined with rising demand and consumption, is now pushing oil extraction into the most remote corners of the world. Modern patterns of production and consumption and high oil prices are forcing a new oil exploratory boom in the Peruvian Amazon. While conflicts spread on indigenous territories, new forms of resistance appear and indigenous political organizations are born and become more powerful. The impacts of oil exploration and exploitation and indigenous resistance throughout the oil history of the Peruvian Amazon are reviewed here, focusing on the Achuar people in Rio Corrientes. The driving forces, impacts, and responses to the current oil exploration boom are analyzed from an environmental justice perspective. We conclude that, in a context of peak oil and growing global demand for oil, such devastating effects for minor quantities of oil are likely to increase and impact other remote parts of the world. (author)

Rural electrification of the Brazilian Amazon - Achievements and lessons

International Nuclear Information System (INIS)

Gomez, Maria F.; Silveira, Semida

2010-01-01

The Brazilian government has the ambition to provide complete electricity coverage for all citizens as a means to promote development and reduce inequalities. Full coverage implies the provision of electricity to 15 million people in the country by the end of 2010 through the program Luz para Todos (LPT - light for all) launched in 2003. So far, 11 million people have benefited, 2 million of which live in the Amazon. In this paper, we analyze the linkages between development and rural electrification through the Human Development Index (HDI) and within the context of the Amazon. We examine the suitability of the HDI as a planning and monitoring tool for improving energy access and development. We show that the recognition of electricity access as a driver for development has led to concrete goals for electrification, actual action and welfare improvement. Our study serves to highlight the role of LPT in the development of the Amazon region, and the specific features and achievements of the Brazilian policy for universal electrification. We conclude that some challenges related to the electrification of isolated areas still lie ahead. We finalize with a discussion on the relevance of the Brazilian experience to other developing countries.

Hydrological Retrospective of floods and droughts: Case study in the Amazon

Science.gov (United States)

Wongchuig Correa, Sly; Cauduro Dias de Paiva, Rodrigo; Carlo Espinoza Villar, Jhan; Collischonn, Walter

2017-04-01

Recent studies have reported an increase in intensity and frequency of hydrological extreme events in many regions of the Amazon basin over last decades, these events such as seasonal floods and droughts have originated a significant impact in human and natural systems. Recently, methodologies such as climatic reanalysis are being developed in order to create a coherent register of climatic systems, thus taking this notion, this research efforts to produce a methodology called Hydrological Retrospective (HR), that essentially simulate large rainfall datasets over hydrological models in order to develop a record over past hydrology, enabling the analysis of past floods and droughts. We developed our methodology on the Amazon basin, thus we used eight large precipitation datasets (more than 30 years) through a large scale hydrological and hydrodynamic model (MGB-IPH), after that HR products were validated against several in situ discharge gauges dispersed throughout Amazon basin, given focus in maximum and minimum events. For better HR results according performance metrics, we performed a forecast skill of HR to detect floods and droughts considering in-situ observations. Furthermore, statistical temporal series trend was performed for intensity of seasonal floods and drought in the whole Amazon basin. Results indicate that better HR represented well most past extreme events registered by in-situ observed data and also showed coherent with many events cited by literature, thus we consider viable to use some large precipitation datasets as climatic reanalysis mainly based on land surface component and datasets based in merged products for represent past regional hydrology and seasonal hydrological extreme events. On the other hand, an increase trend of intensity was realized for maximum annual discharges (related to floods) in north-western regions and for minimum annual discharges (related to drought) in central-south regions of the Amazon basin, these features were

Assessing the Amazon Cloud Suitability for CLARREO's Computational Needs

Science.gov (United States)

Goldin, Daniel; Vakhnin, Andrei A.; Currey, Jon C.

2015-01-01

In this document we compare the performance of the Amazon Web Services (AWS), also known as Amazon Cloud, with the CLARREO (Climate Absolute Radiance and Refractivity Observatory) cluster and assess its suitability for computational needs of the CLARREO mission. A benchmark executable to process one month and one year of PARASOL (Polarization and Anistropy of Reflectances for Atmospheric Sciences coupled with Observations from a Lidar) data was used. With the optimal AWS configuration, adequate data-processing times, comparable to the CLARREO cluster, were found. The assessment of alternatives to the CLARREO cluster continues and several options, such as a NASA-based cluster, are being considered.

Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial.

Directory of Open Access Journals (Sweden)

H Asita de Silva

2011-05-01

Full Text Available Envenoming from snakebites is most effectively treated by antivenom. However, the antivenom available in South Asian countries commonly causes acute allergic reactions, anaphylactic reactions being particularly serious. We investigated whether adrenaline, promethazine, and hydrocortisone prevent such reactions in secondary referral hospitals in Sri Lanka by conducting a randomised, double-blind placebo-controlled trial.In total, 1,007 patients were randomized, using a 2 × 2 × 2 factorial design, in a double-blind, placebo-controlled trial of adrenaline (0.25 ml of a 1∶1,000 solution subcutaneously, promethazine (25 mg intravenously, and hydrocortisone (200 mg intravenously, each alone and in all possible combinations. The interventions, or matching placebo, were given immediately before infusion of antivenom. Patients were monitored for mild, moderate, or severe adverse reactions for at least 96 h. The prespecified primary end point was the effect of the interventions on the incidence of severe reactions up to and including 48 h after antivenom administration. In total, 752 (75% patients had acute reactions to antivenom: 9% mild, 48% moderate, and 43% severe; 89% of the reactions occurred within 1 h; and 40% of all patients were given rescue medication (adrenaline, promethazine, and hydrocortisone during the first hour. Compared with placebo, adrenaline significantly reduced severe reactions to antivenom by 43% (95% CI 25-67 at 1 h and by 38% (95% CI 26-49 up to and including 48 h after antivenom administration; hydrocortisone and promethazine did not. Adding hydrocortisone negated the benefit of adrenaline.Pretreatment with low-dose adrenaline was safe and reduced the risk of acute severe reactions to snake antivenom. This may be of particular importance in countries where adverse reactions to antivenom are common, although the need to improve the quality of available antivenom cannot be overemphasized.

Amazon Molly, Poecilia formosa, as a model for studies of the effects of ionizing radiation

International Nuclear Information System (INIS)

Woodhead, A.D.; Setlow, R.B.; Hart, R.W.

1977-01-01

It is suggested that the viviparous teleost, Poecilia formosa, (Amazon molly) may have wide potential use for aquatic radiation studies. The Amazon molly is a naturally occurring gynogenetic species, in which the eggs are activated after mating with the males of closely related species, without the subsequent genetic contribution from the male. The offspring of a single original female constitute a clone, having identical genotypes. Clones of the genetically homogeneous Amazon molly may prove to be equally as valuable to aquatic radiobiologists as the inbred rodent lines have been to mammalian studies. In many other respects the Amazon molly is a satisfactory laboratory animal. It is robust, easy to rear, and has large broods of young when fully grown. Maintenance costs are low. Details are given of the conditions under which colonies reproduce

Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial.

Science.gov (United States)

Cuzick, Jack; Sestak, Ivana; Forbes, John F; Dowsett, Mitch; Knox, Jill; Cawthorn, Simon; Saunders, Christobel; Roche, Nicola; Mansel, Robert E; von Minckwitz, Gunter; Bonanni, Bernardo; Palva, Tiina; Howell, Anthony

2014-03-22

Aromatase inhibitors effectively prevent breast cancer recurrence and development of new contralateral tumours in postmenopausal women. We assessed the efficacy and safety of the aromatase inhibitor anastrozole for prevention of breast cancer in postmenopausal women who are at high risk of the disease. Between Feb 2, 2003, and Jan 31, 2012, we recruited postmenopausal women aged 40-70 years from 18 countries into an international, double-blind, randomised placebo-controlled trial. To be eligible, women had to be at increased risk of breast cancer (judged on the basis of specific criteria). Eligible women were randomly assigned (1:1) by central computer allocation to receive 1 mg oral anastrozole or matching placebo every day for 5 years. Randomisation was stratified by country and was done with blocks (size six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation; only the trial statistician was unmasked. The primary endpoint was histologically confirmed breast cancer (invasive cancers or non-invasive ductal carcinoma in situ). Analyses were done by intention to treat. This trial is registered, number ISRCTN31488319. 1920 women were randomly assigned to receive anastrozole and 1944 to placebo. After a median follow-up of 5·0 years (IQR 3·0-7·1), 40 women in the anastrozole group (2%) and 85 in the placebo group (4%) had developed breast cancer (hazard ratio 0·47, 95% CI 0·32-0·68, pbreast cancers after 7 years was 5·6% in the placebo group and 2·8% in the anastrozole group. 18 deaths were reported in the anastrozole group and 17 in the placebo group, and no specific causes were more common in one group than the other (p=0·836). Anastrozole effectively reduces incidence of breast cancer in high-risk postmenopausal women. This finding, along with the fact that most of the side-effects associated with oestrogen deprivation were not attributable to treatment, provides support for the use of anastrozole in

Utvärdering av Amazon Machine Learning för taggsystem

OpenAIRE

Madosh, Farzana; Lundsten, Erik

2017-01-01

How companies deal with machine learning is currently a highly-discussed topic, as it can facilitate corporate manual work by training computers to recognize patterns and thus automate the working procedure. However, this requires resources and knowledge in the field. As a result, various companies like Amazon and Google provide machine learning services without requiring the user to have deep knowledge in the area. This study evaluates Amazon Machine Learning program for a tag system with da...

The trace-elements of the atmospheric aerosol of the Amazon basin

International Nuclear Information System (INIS)

Orsini, C.M.Q.; Artaxo Netto, P.E.; Tabacniks, M.H.

1981-05-01

The distribution of the trace-elements AL, Si, P, S, CL, K, Ca, Ti, Fe and V in the atmospheric aerosol of the Amazon Basin was determined by means of samples collected between August 23 and September 2 of 1980, at a remote place located in the Amazon Forest, about 30 Km NE of the city of Manaus, Brazil. 33 samples were succesfully analyzed by the PIXE method (Particle Induced X-Ray Emission) by using α-particle beam of the Pelletron Accelerator of the University of Sao Paulo, and the results revealed that the trace-elements S and K have a large predominance, mainly as fine particle size relative to the others; this fact is consistent with the statement that the natural cycles of these two elements are critically involved in the biophysical processes responsible for the life of the tropical rain forest of the Amazon. (Author) [pt

Adjunctive sarcosine plus benzoate improved cognitive function in chronic schizophrenia patients with constant clinical symptoms: A randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Lin, Chun-Yuan; Liang, Sun-Yuan; Chang, Yue-Cune; Ting, Shuo-Yen; Kao, Ching-Ling; Wu, Yu-Hsin; Tsai, Guochuan E; Lane, Hsien-Yuan

2017-08-01

Objectives Hypofunction of NMDA receptor is implicated in the pathophysiology, particularly cognitive impairment, of schizophrenia. Sarcosine, a glycine transporter I (GlyT-1) inhibitor, and sodium benzoate, a d-amino acid oxidase (DAAO) inhibitor, can both enhance NMDA receptor-mediated neurotransmission. We proposed simultaneously inhibiting DAAO and GlyT-1 may be more effective than inhibition of either in improving the cognitive and global functioning of schizophrenia patients. Methods This study compared add-on sarcosine (2 g/day) plus benzoate (1 g/day) vs. sarcosine (2 g/day) for the clinical symptoms, as well as the cognitive and global functioning, of chronic schizophrenia patients in a 12-week, double-blind, randomised, placebo-controlled trial. Participants were measured with the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale every 3 weeks. Seven cognitive domains, recommended by the Measurement and Treatment Research to Improve Cognition in Schizophrenia Committee, were measured at weeks 0 and 12. Results Adjunctive sarcosine plus benzoate, but not sarcosine alone, improved the cognitive and global functioning of patients with schizophrenia, even when their clinical symptoms had not improved. Conclusions This finding suggests N-methyl-d-aspartate receptor-enhancement therapy can improve the cognitive function of patients with schizophrenia, further indicating this pro-cognitive effect can be primary without improvement in clinical symptoms.

Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial.

Science.gov (United States)

Zenico, T; Cicero, A F G; Valmorri, L; Mercuriali, M; Bercovich, E

2009-04-01

Lepidium meyenii (Maca) is a cultivated root belonging to the brassica family used in the Andean region for its supposed aphrodisiac properties. We carried out a double-blind clinical trial on 50 Caucasian men affected by mild erectile dysfunction (ED), randomised to treatment with Maca dry extract, 2400 mg, or placebo. The treatment effect on ED and subjective well-being was tested administrating before and after 12 weeks the International Index of Erectile Function (IIEF-5) and the Satisfaction Profile (SAT-P). After 12 weeks of treatment, both Maca- and placebo-treated patients experienced a significant increase in IIEF-5 score (P Maca experienced a more significant increase than those taking placebo (1.6 +/- 1.1 versus 0.5 +/- 0.6, P Maca- and placebo-treated subjects experienced a significant improvement in psychological performance-related SAT-P score, but the Maca group higher than that of placebo group (+9 +/- 6 versus +6 +/- 5, P Maca-treated patients experienced a significant improvement in physical and social performance-related SAT-P score compared with the baseline (+7 +/- 6 and +7 +/- 6, both P Maca supplementation on subjective perception of general and sexual well-being in adult patients with mild ED.

Granular cell tumor in an endangered Puerto Rican Amazon parrot (Amazon vittata)

Science.gov (United States)

Quist, C.F.; Latimer, K.S.; Goldade, S.L.; Rivera, A.; Dein, F.J.

1999-01-01

A 3 cm diameter mass from the metacarpus of a Puerto Rican Amazon parrot was diagnosed as a granular cell tumour based on light microscopy. The cytoplasmic granules were periodic-acid Schiff positive and diastase resistant. Ultrastructural characteristics of the cells included convoluted nuclei and the presence of numerous cytoplasmic tertiary lysosomes. This is only the second granular cell tumour reported in a bird. We speculate that most granular cell tumours are derived from cells that are engaged in some type of cellular degradative process, creating a similar morphologic appearance, but lacking a uniform histogenesis.

Cancer mortality and oil production in the Amazon Region of Ecuador, 1990-2005.

Science.gov (United States)

Kelsh, Michael A; Morimoto, Libby; Lau, Edmund

2009-02-01

To compare cancer mortality rates in Amazon cantons (counties) with and without long-term oil exploration and extraction activities. Mortality (1990 through 2005) and population census (1990 and 2001) data for cantons in the provinces of the northern Amazon Region (Napo, Orellana, Sucumbios, and Pastaza), as well as the province with the capital city of Quito (Pichincha province) were obtained from the National Statistical Office of Ecuador, Instituto Nacional del Estadistica y Censos (INEC). Age- and sex-adjusted mortality rate ratios (RR) and 95% confidence intervals (CI) were estimated to evaluate total and cause-specific mortality in the study regions. Among Amazon cantons with long-term oil extraction, activities there was no evidence of increased rates of death from all causes (RR = 0.98; 95% CI = 0.95-1.01) or from overall cancer (RR = 0.82; 95% CI = 0.73-0.92), and relative risk estimates were also lower for most individual site-specific cancer deaths. Mortality rates in the Amazon provinces overall were significantly lower than those observed in Pichincha for all causes (RR = 0.82; 95% CI = 0.81-0.83), overall cancer (RR = 0.46; 95% CI = 0.43-0.49), and for all site-specific cancers. In regions with incomplete cancer registration, mortality data are one of the few sources of information for epidemiologic assessments. However, epidemiologic assessments in this region of Ecuador are limited by underreporting, exposure and disease misclassification, and study design limitations. Recognizing these limitations, our analyses of national mortality data of the Amazon Region in Ecuador does not provide evidence for an excess cancer risk in regions of the Amazon with long-term oil production. These findings were not consistent or supportive of earlier studies in this region that suggested increased cancer risks.

A second hydrocarbon boom threatens the Peruvian Amazon: trends, projections, and policy implications

Energy Technology Data Exchange (ETDEWEB)

Finer, Matt [Save America' s Forests, 4 Library Court NW, Washington, DC 20003 (United States); Orta-Martinez, Marti, E-mail: matt@saveamericasforests.or, E-mail: martiorta@gmail.co [Institut de Ciencia i Tecnologia Ambiental, Universitat Autonoma de Barcelona, 08193 Bellaterra (Barcelona) (Spain)

2010-01-15

The Peruvian Amazon is home to extraordinary biological and cultural diversity, and vast swaths of this mega-diverse region remain largely intact. Recent analysis indicates, however, that the rapid proliferation of oil and gas exploration zones now threatens the region's biodiversity, indigenous peoples, and wilderness areas. To better elucidate this dynamic situation, we analyzed official Peruvian government hydrocarbon information and generated a quantitative analysis of the past, present, and future of oil and gas activities in the Peruvian Amazon. We document an extensive hydrocarbon history for the region-over 104 000 km of seismic lines and 679 exploratory and production wells-highlighted by a major exploration boom in the early 1970s. We show that an unprecedented 48.6% of the Peruvian Amazon has been recently covered by oil and gas concessions, up from just 7.1% in 2003. These oil and gas concessions overlap 17.1% of the Peruvian Amazon protected area system and over half of all titled indigenous lands. Moreover, we found that up to 72% of the Peruvian Amazon has been zoned for hydrocarbon activities (concessions plus technical evaluation agreements and proposed concessions) in the past two years, and over 84% at some point during the past 40 years. We project that the recent rapid proliferation of hydrocarbon zones will lead to a second exploration boom, characterized by over 20 000 km of new seismic testing and construction of over 180 new exploratory wells in remote, intact, and sensitive forest areas. As the Peruvian Amazon oil frontier rapidly expands, we conclude that a rigorous policy debate is urgently needed in order to avoid the major environmental impacts associated with the first exploration boom of the 1970s and to minimize the social conflict that recently led to deadly encounters between indigenous protesters and government forces.

A second hydrocarbon boom threatens the Peruvian Amazon: trends, projections, and policy implications

International Nuclear Information System (INIS)

Finer, Matt; Orta-Martinez, Marti

2010-01-01

The Peruvian Amazon is home to extraordinary biological and cultural diversity, and vast swaths of this mega-diverse region remain largely intact. Recent analysis indicates, however, that the rapid proliferation of oil and gas exploration zones now threatens the region's biodiversity, indigenous peoples, and wilderness areas. To better elucidate this dynamic situation, we analyzed official Peruvian government hydrocarbon information and generated a quantitative analysis of the past, present, and future of oil and gas activities in the Peruvian Amazon. We document an extensive hydrocarbon history for the region-over 104 000 km of seismic lines and 679 exploratory and production wells-highlighted by a major exploration boom in the early 1970s. We show that an unprecedented 48.6% of the Peruvian Amazon has been recently covered by oil and gas concessions, up from just 7.1% in 2003. These oil and gas concessions overlap 17.1% of the Peruvian Amazon protected area system and over half of all titled indigenous lands. Moreover, we found that up to 72% of the Peruvian Amazon has been zoned for hydrocarbon activities (concessions plus technical evaluation agreements and proposed concessions) in the past two years, and over 84% at some point during the past 40 years. We project that the recent rapid proliferation of hydrocarbon zones will lead to a second exploration boom, characterized by over 20 000 km of new seismic testing and construction of over 180 new exploratory wells in remote, intact, and sensitive forest areas. As the Peruvian Amazon oil frontier rapidly expands, we conclude that a rigorous policy debate is urgently needed in order to avoid the major environmental impacts associated with the first exploration boom of the 1970s and to minimize the social conflict that recently led to deadly encounters between indigenous protesters and government forces.

Annual Carbon Emissions from Deforestation in the Amazon Basin between 2000 and 2010.

Science.gov (United States)

Song, Xiao-Peng; Huang, Chengquan; Saatchi, Sassan S; Hansen, Matthew C; Townshend, John R

2015-01-01

Reducing emissions from deforestation and forest degradation (REDD+) is considered one of the most cost-effective strategies for mitigating climate change. However, historical deforestation and emission rates-critical inputs for setting reference emission levels for REDD+-are poorly understood. Here we use multi-source, time-series satellite data to quantify carbon emissions from deforestation in the Amazon basin on a year-to-year basis between 2000 and 2010. We first derive annual deforestation indicators by using the Moderate Resolution Imaging Spectroradiometer Vegetation Continuous Fields (MODIS VCF) product. MODIS indicators are calibrated by using a large sample of Landsat data to generate accurate deforestation rates, which are subsequently combined with a spatially explicit biomass dataset to calculate committed annual carbon emissions. Across the study area, the average deforestation and associated carbon emissions were estimated to be 1.59 ± 0.25 M ha•yr(-1) and 0.18 ± 0.07 Pg C•yr(-1) respectively, with substantially different trends and inter-annual variability in different regions. Deforestation in the Brazilian Amazon increased between 2001 and 2004 and declined substantially afterwards, whereas deforestation in the Bolivian Amazon, the Colombian Amazon, and the Peruvian Amazon increased over the study period. The average carbon density of lost forests after 2005 was 130 Mg C•ha(-1), ~11% lower than the average carbon density of remaining forests in year 2010 (144 Mg C•ha(-1)). Moreover, the average carbon density of cleared forests increased at a rate of 7 Mg C•ha(-1)•yr(-1) from 2005 to 2010, suggesting that deforestation has been progressively encroaching into high-biomass lands in the Amazon basin. Spatially explicit, annual deforestation and emission estimates like the ones derived in this study are useful for setting baselines for REDD+ and other emission mitigation programs, and for evaluating the performance of such efforts.

Comparing membranes and bone substitutes in a one-stage procedure for horizontal bone augmentation. A double-blind randomised controlled trial.

Science.gov (United States)

Merli, Mauro; Moscatelli, Marco; Mariotti, Giorgia; Pagliaro, Umberto; Raffaelli, Eugenia; Nieri, Michele

2015-01-01

The objective of this parallel randomised controlled trial is to compare two bone substitutes and collagen membranes in a one-stage procedure for horizontal bone augmentation: anorganic bovine bone (Bio-Oss) and collagen porcine membranes (Bio-Gide) (BB group) versus a synthetic resorbable bone graft substitute made of pure β-tricalcium phosphate (Ceros TCP) and porcine pericardium collagen membranes (Jason) (CJ group). Patients in need of implant treatment having at least one site with horizontal osseous defects at a private clinic in Rimini (Italy) were included in this study. Patients were randomised to receive either the BB or CJ treatment. Randomisation was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes. Patients and the outcome assessor were blinded to group assignment. The main outcome measures were implant failure, complications, clinical bone gain at augmented sites, and complete filling of the bone defect. Secondary outcome measures were chair-time, postoperative pain and peri-implant marginal bone level changes. Twenty-five patients with 32 implants were allocated to the BB group and 25 patients with 29 implants to the CJ group. All 50 randomised patients received the treatment as allocated and there were no dropouts up to 6-months post-loading (12 months post-surgery). There were no failures and there were three complications in the BB group and three complications in the CJ group (relative risk: 1.00, 95% CI from 0.22 to 4.49, P = 1.00). The estimated difference between treatments in the vertical defect bone gain was -0.15 mm (95% CI from -0.65 to 0.35, P = 0.5504) favouring the BB group, and the estimated difference between treatments in the horizontal defect bone gain was -0.27 mm (95%CI from -0.73 to 0.19, P = 0.3851) favouring the BB group. There was no difference in the complete filling of the defect (relative risk: 0.88, 95%CI from 0.58 to 1.34, P = 0.7688). No significant differences were

Helping the Amazon's Caboclos riverine communities cope with ...

International Development Research Centre (IDRC) Digital Library (Canada)

2013-11-15

Nov 15, 2013 ... Tides expand the Amazon's delta's lacework of rivers and streams twice a day, ... last longer, causing more environmental damage and threatening their communities. ... Managing flood risk through collaborative governance.

Amazonía y el medio ambiente

OpenAIRE

Mosquera Mesa, Ricardo

2010-01-01

Editorial: Amazonía: responsabilidad de todos -- Ecología y economía -- El patrimonio cultural amazónico -- La universidad y el liderazgo investigativo -- cooperación internacional -- Realizaciones y perspectivas -- Por una política de investigación ambiental

Spectral tuning of Amazon parrot feather coloration by psittacofulvin pigments and spongy structures.

Science.gov (United States)

Tinbergen, Jan; Wilts, Bodo D; Stavenga, Doekele G

2013-12-01

The feathers of Amazon parrots are brightly coloured. They contain a unique class of pigments, the psittacofulvins, deposited in both barbs and barbules, causing yellow or red coloured feathers. In specific feather areas, spongy nanostructured barb cells exist, reflecting either in the blue or blue-green wavelength range. The blue-green spongy structures are partly enveloped by a blue-absorbing, yellow-colouring pigment acting as a spectral filter, thus yielding a green coloured barb. Applying reflection and transmission spectroscopy, we characterized the Amazons' pigments and spongy structures, and investigated how they contribute to the feather coloration. The reflectance spectra of Amazon feathers are presumably tuned to the sensitivity spectra of the visual photoreceptors.

Estimation of the evapotranspiration in the Amazon Basin

International Nuclear Information System (INIS)

Villa Nova, N.A.; Salati, E.; Matsui, E.

1976-01-01

The establishment of a water balance for the Amazon Basin constitutes a problem of difficult solution, not only on the account of its extension and characteristics, but also for lack of sufficient meteorological and hydrological data. In an attempt to estimate the magnitude of the main components of the water balance, a study was made with data from the Brazilian Amazon Region and from some observation stations in other countries. An energy balance was made and based on this balance the water balance of the region was established, having the Penman method been adapted to forest conditions. The data obtained indicate that 90% of the evaportranspiration is due to the energy balance. The evaportranspiration in this area should be very close to the potential evaportranspiration, and the average found was of the order of 4mm/day, i.e., 1460mm/year. As a first approximation it was found that the Amazon Basin system receives 14,4X10 12 m 3 water/year through precipitation, this total being balanced by a surface discharge of 5,5 x10 12 m 3 /year and an evaportranspiration of 8,9x10 12 m 3 /year. Since transpiration by plants represents 61,8% of the water balance, all seems to indicate that intensive deforestation shall bring about alterations of the hydrological cycle [pt

Forecasting Malaria in the Western Amazon

Science.gov (United States)

Pan, W. K.; Zaitchik, B. F.; Pizzitutti, F.; Berky, A.; Feingold, B.; Mena, C.; Janko, M.

2017-12-01

Reported cases of malaria in the western Amazon regions of Peru, Colombia and Ecuador have more than tripled since 2011. Responding to this epidemic has been challenging given large-scale environmental impacts and demographic changes combined with changing financial and political priorities. In Peru alone, malaria cases increased 5-fold since 2011. Reasons include changes in the Global Malaria Fund, massive flooding in 2012, the "mega" El Nino in 2016, and continued natural resource extraction via logging and mining. These challenges prompted the recent creation of the Malaria Cero program in 2017 with the goal to eradicate malaria by 2021. To assist in malaria eradiation, a team of investigators supported by NASA have been developing an Early Warning System for Malaria. The system leverages demographic, epidemiological, meteorological and land use/cover data to develop a four-component system that will improve detection of malaria across the western Amazon Basin. System components include a land data assimilation system (LDAS) to estimate past and future hydrological states and flux, a seasonal human population model to estimate population at risk and spatial connectivity to high risk transmission areas, a sub-regional statistical model to identify when and where observed malaria cases have exceeded those expected, and an Agent Based Model (ABM) to integrate human, environmental, and entomological transmission dynamics with potential strategies for control. Data include: daily case detection reports between 2000 and 2017 from all health posts in the region of Loreto in the northern Peruvian Amazon; LDAS outputs (precipitation, temperature, humidity, solar radiation) at a 1km and weekly scale; satellite-derived estimates of land cover; and human population size from census and health data. This presentation will provide an overview of components, focusing on how the system identifies an outbreak and plans for technology transfer.

New products made with lignocellulosic nanofibers from Brazilian amazon forest

International Nuclear Information System (INIS)

Bufalino, L; Mendes, L M; Tonoli, G H D; Fonseca, A; Rodrigues, A; Cunha, P I; Marconcini, J M

2014-01-01

The biodiversity of the Amazon forest is undoubtedly rich; hence there is considerable variety of plant fibers regarding their morphological, chemical and structural properties. The legal exploration of the Brazilian Amazon is based on sustainable management techniques, but the generation of a relevant amount of plant wastes still cant be avoided. The correct destination of such materials is a challenge that Brazilian companies have to face. In this context, the National Council of Science and Technology (CNPq) promoted the creation of investigation nets on sustainability of Brazilian agribusiness. The Brazilian Net on Lignocellulosic Composites and Nanocomposites was then created, with partnership between several national and international research institutions. Until the moment, the results showed that Amazon plant fibers that are discarded as residues have great potential to nanofiber production. Nanopapers with considerable high mechanical and physical strength, proper opacity and great crystalline index were produced by using a clean and simple mechanical method. Those materials are candidates to several uses such as packaging, substrates transparent conductive films, gas barrier films, solar cells and e-papers

Potential for producing bio-fuel in the Amazon deforested areas

Energy Technology Data Exchange (ETDEWEB)

Costa, Ricardo Cunha da [Banco Nacional de Desenvolvimento Economico e Social (BNDES), Rio de Janeiro, RJ (Brazil)

2004-05-01

This paper analyzes the possibility of producing bio-fuel in the Amazon degraded lands. The aim here is to combine environmental concerns with an improvement of local people well-being. Firstly, a historical analysis is conducted in order to figure out the major deforestation driving forces in Amazon and to help to arrive at a feasible energy choice. Secondly, the geographical area is chosen. It is the spatial boundaries of Carajas Iron Ore Program in the southeastern Amazon where most of the deforestation has taken place in the last few decades. For this specific context, palm oil is chosen as a technological energy alternative due to its social production structure, its environmental benefits and its productivity . A quantified analysis is realized in terms of income generation (2000-3000 US dollars/family/yr), job creation (200,000-300,000 families settled), land required and restored (2-3.2 million ha), and carbon emission from fossil fuel avoided (13.1 Mt C). Some recommendations related to institutional and economic barriers are proposed in order to encourage the technology penetration in the market. (Author)

New products made with lignocellulosic nanofibers from Brazilian amazon forest

Science.gov (United States)

Bufalino, L.; Mendes, L. M.; Tonoli, G. H. D.; Rodrigues, A.; Fonseca, A.; Cunha, P. I.; Marconcini, J. M.

2014-08-01

The biodiversity of the Amazon forest is undoubtedly rich; hence there is considerable variety of plant fibers regarding their morphological, chemical and structural properties. The legal exploration of the Brazilian Amazon is based on sustainable management techniques, but the generation of a relevant amount of plant wastes still cant be avoided. The correct destination of such materials is a challenge that Brazilian companies have to face. In this context, the National Council of Science and Technology (CNPq) promoted the creation of investigation nets on sustainability of Brazilian agribusiness. The Brazilian Net on Lignocellulosic Composites and Nanocomposites was then created, with partnership between several national and international research institutions. Until the moment, the results showed that Amazon plant fibers that are discarded as residues have great potential to nanofiber production. Nanopapers with considerable high mechanical and physical strength, proper opacity and great crystalline index were produced by using a clean and simple mechanical method. Those materials are candidates to several uses such as packaging, substrates transparent conductive films, gas barrier films, solar cells and e-papers.

Origin and processing of terrestrial organic carbon in the Amazon system: lignin phenols in river, shelf, and fan sediments

Science.gov (United States)

Sun, Shuwen; Schefuß, Enno; Mulitza, Stefan; Chiessi, Cristiano M.; Sawakuchi, André O.; Zabel, Matthias; Baker, Paul A.; Hefter, Jens; Mollenhauer, Gesine

2017-05-01

The Amazon River transports large amounts of terrestrial organic carbon (OCterr) from the Andean and Amazon neotropical forests to the Atlantic Ocean. In order to compare the biogeochemical characteristics of OCterr in the fluvial sediments from the Amazon drainage basin and in the adjacent marine sediments, we analysed riverbed sediments from the Amazon mainstream and its main tributaries as well as marine surface sediments from the Amazon shelf and fan for total organic carbon (TOC) content, organic carbon isotopic composition (δ13CTOC), and lignin phenol compositions. TOC and lignin content exhibit positive correlations with Al / Si ratios (indicative of the sediment grain size) implying that the grain size of sediment discharged by the Amazon River plays an important role in the preservation of TOC and leads to preferential preservation of lignin phenols in fine particles. Depleted δ13CTOC values (-26.1 to -29.9 ‰) in the main tributaries consistently correspond with the dominance of C3 vegetation. Ratios of syringyl to vanillyl (S / V) and cinnamyl to vanillyl (C / V) lignin phenols suggest that non-woody angiosperm tissues are the dominant source of lignin in the Amazon basin. Although the Amazon basin hosts a rich diversity of vascular plant types, distinct regional lignin compositions are not observed. In the marine sediments, the distribution of δ13CTOC and Λ8 (sum of eight lignin phenols in organic carbon (OC), expressed as mg/100 mg OC) values implies that OCterr discharged by the Amazon River is transported north-westward by the North Brazil Current and mostly deposited on the inner shelf. The lignin compositions in offshore sediments under the influence of the Amazon plume are consistent with the riverbed samples suggesting that processing of OCterr during offshore transport does not change the encoded source information. Therefore, the lignin compositions preserved in these offshore sediments can reliably reflect the vegetation in the Amazon

A double blind randomised controlled clinical trial comparing a novel anti-stain and calculus reducing dentifrice with a standard fluoride dentifrice.

Science.gov (United States)

Jowett, Adrian K; Marlow, Ian; Rawlinson, Andrew

2013-04-01

This clinical trial tested the anti-stain efficacy at 3 and 6 months of a novel, sodium polyaspartate-containing, anti-stain dentifrice. In addition, the efficacy of the new dentifrice in controlling gingival inflammation and inhibition of calculus deposition was tested. Participants were recruited to this double blind randomised control clinical trial, and allocated to either test or control groups. The presence of stain and calculus were entry criteria. Measurements of stain, calculus and gingival inflammation were recorded using the Shaw and Murray Stain score, Volpe-Manhold Calculus score and the Modified Gingival Index respectively. Measurements were made at baseline, prior to the removal of stain and calculus, and after 3 and 6 months. Missing data were imputed by and the outcomes were analysed using univariate analysis. At three months, toothpaste containing sodium polyaspartate was better (difference of mean 1.13 with SEM 0.57) than control for the control of dental stain (p0.05). There was no difference between toothpastes with respect to calculus deposition or gingival inflammation. Toothpaste containing sodium polyaspartate was more effective than a control toothpaste at preventing deposition of dental stain for 3 months after professional tooth cleaning but showed no significant effect at 6 months. Sodium polyaspartate toothpaste was more effective than a control toothpaste at preventing dental stain formation and maybe helpful in controlling staining between episodes of scaling and polishing. Copyright © 2012 Elsevier Ltd. All rights reserved.

B vitamins to enhance treatment response to antidepressants in middle-aged and older adults: results from the B-VITAGE randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Almeida, Osvaldo P; Ford, Andrew H; Hirani, Varsha; Singh, Vash; vanBockxmeer, Frank M; McCaul, Kieran; Flicker, Leon

2014-12-01

Depression is common and the efficacy of antidepressants is suboptimal. High plasma homocysteine has been consistently associated with depression, and treatment with certain B vitamins demonstrably reduces its concentration. To determine whether vitamins B6, B12 and folic acid enhance response to antidepressant treatment over 52 weeks. Randomised, double-blind, placebo-controlled trial of citalopram (20-40 g) together with 0.5 mg of vitamin B12, 2 mg of folic acid and 25 mg of vitamin B6 for 52 weeks (Australian and New Zealand Clinical Trials Registry: 12609000256279). Participants were community-dwelling adults aged 50 years or over with DSM-IV-TR major depression. We measured severity of symptoms with the Montgomery-Åsberg Depression Rating Scale (MADRS). The primary outcome was remission of the depressive episode after 12, 26 and 52 weeks. Secondary outcomes included reduction of MADRS scores over time and relapse of major depression after recovery by week 12. Results In total, 153 people were randomised (76 placebo, 77 vitamins). Remission of symptoms was achieved by 78.1 and 79.4% of participants treated with placebo and vitamins by week 12 (P = 0.840), by 76.5 and 85.3% at week 26 and 75.8 and 85.5% at week 52 (effect of intervention over 52 weeks: odds ratio (OR) = 2.49, 95% CI 1.12-5.51). Group differences in MADRS scores over time were not significant (P = 0.739). The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamins than placebo group (OR = 0.33, 95% CI 0.12-0.94). B vitamins did not increase the 12-week efficacy of antidepressant treatment, but enhanced and sustained antidepressant response over 1 year. Replication of these findings would mandate that treatment guidelines adopt the adjunctive use of B vitamins as a safe and inexpensive strategy to manage major depression in middle-aged and older adults. Royal College of Psychiatrists.

Implications of Scientific Collaboration Networks on Studies of Aquatic Vertebrates in the Brazilian Amazon.

Science.gov (United States)

Salinero, María Celeste; Michalski, Fernanda

2016-01-01

The quantity of wildlife extracted from the Amazon has increased in the past decades as a consequence of an increase in human population density and income growth. To evaluate the spatial distribution of studies on subsistence and/or commercial hunting conducted in the Brazilian Amazon, we selected eight mid-sized and large-bodied aquatic vertebrate species with a history of human exploitation in the region. We used a combination of searches in the gray and scientific literature from the past 24 years to provide an updated distributional map of studies on the target species. We calculated the distances between the study sites and the locations of the research institutes/universities that the first and last authors of the same study were affiliated to. For the period of 1990 to 2014, we found 105 studies on the subsistence and/or commercial hunting of aquatic vertebrates in the Brazilian Amazon in 271 locations that involved 43 institutions (37 Brazilian and 6 international). The spatial distribution of the studies across the Brazilian Amazon varied, but over 80% took place in the northeast and central Amazon, encompassing three States of the Legal Brazilian Amazon (Amazonas, 51.42%; Pará, 19.05%; and Amapá, 16.19%). Over half of the research study sites (52.91%) were within 500 km of the research institute/university of the first or last authors. Some research institutes/universities did not have any inter-institutional collaborations, while others collaborated with eight or more institutes. Some research institutes/universities conducted many studies, had an extensive collaboration network, and contributed greatly to the network of studies on Amazonian aquatic vertebrates. Our research contributes to the knowledge of studies on the subsistence and/or commercial hunting of the most exploited aquatic vertebrates of the Brazilian Amazon, illustrates the impact that collaboration networks have on research, and highlights potential areas for improvement and the

A novel reflux inhibitor lesogaberan (AZD3355) as add-on treatment in patients with GORD with persistent reflux symptoms despite proton pump inhibitor therapy: a randomised placebo-controlled trial

NARCIS (Netherlands)

Boeckxstaens, Guy E.; Beaumont, Hanneke; Hatlebakk, Jan G.; Silberg, Debra G.; Björck, Karin; Karlsson, Maria; Denison, Hans

2011-01-01

o evaluate the efficacy and tolerability of add-on treatment with lesogaberan (AZD3355), a novel reflux inhibitor, in patients with persistent gastro-oesophageal reflux disease (GORD) symptoms despite proton pump inhibitor (PPI) therapy. double-blind, placebo-controlled, randomised, parallel-group,

The Amazons and an analysis of breast mutilation from a plastic surgeon's perspective.

Science.gov (United States)

Karacalar, Ahmet

2007-03-01

The Amazon philosophy has been increasing in popularity because of the evolving status of women in society. Many references point to Themiscrya on the southern coast of the Black Sea in Anatolia as the Amazon homeland. The primary objective of this article is to discuss the different femininity of the Amazons and their breast mutilation from the perspective of a plastic surgeon who has been living in this region that the Amazons inhabited. Findings from archaeology, linguistics, anthropology, medicine, history, psychology, and the fine arts were integrated. The hypotheses that have been proposed to explain the method of breast mutilation include amputation, cauterization, breast searing, and breast pinching. It is generally believed that the primary purpose was to facilitate the efficient use of a bow. Another explanation would be that breast mutilation was performed for medical reasons, including the prevention of breast pain, the development of a tender lump, or cancer. There is another school of thought on this involving religious and sociological reasons that breast mutilation was a badge of honor for warrior women and a sign that a woman had become a real warrior and a sacrifice to Artemis as a sign of service. Much indirect proof and archaeological evidence point to their historical existence. The Amazons, who lived in an autonomous and original social model, changed their image and function to suit the needs of the society and the times.

The effect of benzocaine and ketoprofen gels on pain during fixed orthodontic appliance treatment: a randomised, double-blind, crossover trial.

Science.gov (United States)

Eslamian, Ladan; Borzabadi-Farahani, Ali; Gholami, Hadi

2016-05-01

To compare the analgesic effect of topical benzocaine (5%) and ketoprofen (1.60 mg/mL) after 2 mm activation of 7 mm long delta loops used for maxillary en-masse orthodontic space closure. Twenty patients (seven males, 13 females, 15-25 years of age, mean age of 19.5 years) participated in a randomised crossover, double-blind trial. After appliance activation, participants were instructed to use analgesic gels and record pain perception at 2, 6, 24 hours and 2, 3 and 7 days (at 18.00 hrs), using a visual analogue scale ruler (VAS, 0-4). Each patient received all three gels (benzocaine, ketoprofen, and a control (placebo)) randomly, but at three different appliance activation visits following a wash-over gap of one month. After the first day, the patients were instructed to repeat gel application twice a day at 10:00 and 18:00 hrs for three days. The recorded pain scores were subjected to non-parametric analysis. The highest pain was recorded at 2 and 6 hours. Pain scores were significantly different between the three groups (Kruskal-Wallis test, p 0.05). A significant pain reduction was observed following the use of ketoprofen when tested against a control gel (placebo). The highest pain scores were experienced in patients administered the placebo and the lowest scores in patients who applied ketoprofen gel. Benzocaine had an effect mid-way between ketoprofen and the placebo. The highest pain scores were recorded 2 hours following force application, which decreased to the lowest scores after 7 days.

Deforestation crimes and conflicts in the Amazon

NARCIS (Netherlands)

Boekhout van Solinge, T.

2010-01-01

This article explores and explains deforestation of the Brazilian Amazon rainforest. It primarily takes a green criminological perspective and looks at the harm that is inflicted on many of the Amazon’s inhabitants, including indigenous populations such as ‘uncontacted’ tribes of hunters-gatherers,

Tropical North Atlantic ocean-atmosphere interactions synchronize forest carbon losses from hurricanes and Amazon fires

Science.gov (United States)

Chen, Yang; Randerson, James T.; Morton, Douglas C.

2015-08-01

We describe a climate mode synchronizing forest carbon losses from North and South America by analyzing time series of tropical North Atlantic sea surface temperatures (SSTs), landfall hurricanes and tropical storms, and Amazon fires during 1995-2013. Years with anomalously high tropical North Atlantic SSTs during March-June were often followed by a more active hurricane season and a larger number of satellite-detected fires in the southern Amazon during June-November. The relationship between North Atlantic tropical cyclones and southern Amazon fires (r = 0.61, p forests.

Interactions among Amazon land use, forests and climate: prospects for a near-term forest tipping point

OpenAIRE

Nepstad, Daniel C; Stickler, Claudia M; Filho, Britaldo Soares-; Merry, Frank

2008-01-01

Some model experiments predict a large-scale substitution of Amazon forest by savannah-like vegetation by the end of the twenty-first century. Expanding global demands for biofuels and grains, positive feedbacks in the Amazon forest fire regime and drought may drive a faster process of forest degradation that could lead to a near-term forest dieback. Rising worldwide demands for biofuel and meat are creating powerful new incentives for agro-industrial expansion into Amazon forest regions. For...

Holocene provenance shift of suspended particulate matter in the Amazon River basin

Science.gov (United States)

Höppner, Natalie; Lucassen, Friedrich; Chiessi, Cristiano M.; Sawakuchi, André O.; Kasemann, Simone A.

2018-06-01

The strontium (Sr), neodymium (Nd) and lead (Pb) isotope signatures of suspended particulate matter (SPM) in rivers reflect the radiogenic isotope signatures of the rivers' drainage basin. These signatures are not significantly affected by weathering, transport or depositional cycles, but document the sedimentary contributions of the respective sources. We report new Sr, Nd and Pb isotope ratios and element concentrations of modern SPM from the Brazilian Amazon River basin and document the past evolution of the basin by analyzing radiogenic isotopes of a marine sediment core from the slope off French Guiana archiving the last 40 kyr of Amazon River SPM, and the Holocene section of sediment cores raised between the Amazon River mouth and the slope off French Guiana. The composition of modern SPM confirms two main source areas, the Andes and the cratonic Shield. In the marine sediment core notable changes occurred during the second phase of Heinrich Stadial 1 (i.e. increased proportion of Shield rivers SPM) and during the last deglaciation (i.e. increased proportion of Madeira River SPM) together with elsewhere constant source contributions. Furthermore, we report a prominent offset in Sr and Nd isotopic composition between the average core value (εNd: -11.7 ± 0.9 (2SD), 87Sr/86Sr: 0.7229 ± 0.0016 (2SD)) and the average modern Amazon River SPM signal (εNd: -10.5 ± 0.5 (2SD), 87Sr/86Sr: 0.7213 ± 0.0036 (2SD)). We suggest that a permanent change in the Amazon River basin sediment supply during the late Holocene to a more Andean dominated SPM was responsible for the offset.

Melatonin versus Placebo in Children with Autism Spectrum Conditions and Severe Sleep Problems Not Amenable to Behaviour Management Strategies: A Randomised Controlled Crossover Trial

Science.gov (United States)

Wright, Barry; Sims, David; Smart, Siobhan; Alwazeer, Ahmed; Alderson-Day, Ben; Allgar, Victoria; Whitton, Clare; Tomlinson, Heather; Bennett, Sophie; Jardine, Jenni; McCaffrey, Nicola; Leyland, Charlotte; Jakeman, Christine; Miles, Jeremy

2011-01-01

Twenty-two children with autism spectrum disorders who had not responded to supported behaviour management strategies for severe dysomnias entered a double blind, randomised, controlled crossover trial involving 3 months of placebo versus 3 months of melatonin to a maximum dose of 10 mg. 17 children completed the study. There were no significant…

Gender-specific out-migration, deforestation and urbanization in the Ecuadorian Amazon

Science.gov (United States)

Barbieri, Alisson F.; Carr, David L.

2005-07-01

The Ecuadorian Amazon, one of the richest reserves of biodiversity in the world, has faced one of the highest rates of deforestation of any Amazonian nation. Most of this forest elimination has been caused by agricultural colonization that followed the discovery of oil fields in 1967. Since the 1990s, an increasing process of urbanization has also engendered new patterns of population mobility within the Amazon, along with traditional ways by which rural settlers make their living. However, while very significant in its effects on deforestation, urbanization and regional development, population mobility within the Amazon has hardly been studied at all, as well as the distinct migration patterns between men and women. This paper uses a longitudinal dataset of 250 farm households in the Northern Ecuadorian Amazon to understand differentials between men and women migrants to urban and rural destinations and between men and women non-migrants. First, we use hazard analysis based on the Kaplan-Meier (KM) estimator to obtain the cumulative probability that an individual living in the study area in 1990 or at time t, will out-migrated at some time, t+ n, before 1999. Results indicate that out-migration to other rural areas in the Amazon, especially pristine areas is considerably greater than out-migration to the growing, but still incipient, Amazonian urban areas. Furthermore, men are more likely to out-migrate to rural areas than women, while the reverse occurs for urban areas. Difference-of-means tests were employed to examine potential factors accounting for differentials between male and female out-migration to urban and rural areas. Among the key results, relative to men younger women are more likely to out-migrate to urban areas; more difficult access from farms to towns and roads constrains women's migration; and access to new lands in the Amazon-an important cause of further deforestation-is more associated with male out-migration. Economic factors such as

Investigating smoke's influence on primary production throughout the Amazon

Science.gov (United States)

Flanner, M. G.; Mahowald, N. M.; Zender, C. S.; Randerson, J. T.; Tosca, M. G.

2007-12-01

Smoke from annual burning in the Amazon causes large reduction in surface insolation and increases the diffuse fraction of photosynthetically-active radiation (PAR). These effects have competing influence on gross primary production (GPP). Recent studies indicate that the sign of net influence depends on aerosol optical depth, but the magnitude of smoke's effect on continental-scale carbon cycling is very poorly constrained and may constitute an important term of fire's net impact on carbon storage. To investigate widespread effects of Amazon smoke on surface radiation properties, we apply a version of the NCAR Community Atmosphere Model with prognostic aerosol transport, driven with re-analysis winds. Carbon aerosol emissions are derived from the Global Fire Emissions Database (GFED). We use AERONET observations to identify model biases in aerosol optical depth, single-scatter albedo, and surface radiative forcing, and prescribe new aerosol optical properties based on field observations to improve model agreement with AERONET data. Finally, we quantify a potential range of smoke-induced change in large-scale GPP based on: 1) ground measurements of GPP in the Amazon as a function of aerosol optical depth and diffuse fraction of PAR, and 2) empirical functions of ecosystem-scale photosynthesis rates currently employed in models such as the Community Land Model (CLM).

Co-crystal of Tramadol-Celecoxib in Patients with Moderate to Severe Acute Post-surgical Oral Pain: A Dose-Finding, Randomised, Double-Blind, Placebo- and Active-Controlled, Multicentre, Phase II Trial.

Science.gov (United States)

López-Cedrún, José; Videla, Sebastián; Burgueño, Miguel; Juárez, Inma; Aboul-Hosn, Samir; Martín-Granizo, Rafael; Grau, Joan; Puche, Miguel; Gil-Diez, José-Luis; Hueto, José-Antonio; Vaqué, Anna; Sust, Mariano; Plata-Salamán, Carlos; Monner, Antoni

2018-06-01

Co-crystal of tramadol-celecoxib (CTC), containing equimolar quantities of the active pharmaceutical ingredients (APIs) tramadol and celecoxib (100 mg CTC = 44 mg rac-tramadol hydrochloride and 56 mg celecoxib), is a novel API-API co-crystal for the treatment of pain. We aimed to establish the effective dose of CTC for treating acute pain following oral surgery. A dose-finding, double-blind, randomised, placebo- and active-controlled, multicentre (nine Spanish hospitals), phase II study (EudraCT number: 2011-002778-21) was performed in male and female patients aged ≥ 18 years experiencing moderate to severe pain following extraction of two or more impacted third molars requiring bone removal. Eligible patients were randomised via a computer-generated list to receive one of six single-dose treatments (CTC 50, 100, 150, 200 mg; tramadol 100 mg; and placebo). The primary efficacy endpoint was the sum of pain intensity difference (SPID) over 8 h assessed in the per-protocol population. Between 10 February 2012 and 13 February 2013, 334 patients were randomised and received study treatment: 50 mg (n = 55), 100 mg (n = 53), 150 mg (n = 57), or 200 mg (n = 57) of CTC, 100 mg tramadol (n = 58), or placebo (n = 54). CTC 100, 150, and 200 mg showed significantly higher efficacy compared with placebo and/or tramadol in all measures: SPID (0-8 h) (mean [standard deviation]): - 90 (234), - 139 (227), - 173 (224), 71 (213), and 22 (228), respectively. The proportion of patients experiencing treatment-emergent adverse events was lower in the 50 (12.7% [n = 7]), 100 (11.3% [n = 6]), and 150 (15.8% [n = 9]) mg CTC groups, and similar in the 200 mg (29.8% [n = 17]) CTC group, compared with the tramadol group (29.3% [n = 17]), with nausea, dizziness, and vomiting the most frequent events. Significant improvement in the benefit-risk ratio was observed for CTC (doses ≥ 100 mg) over tramadol and placebo in

Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of third stage of labour.

OpenAIRE

McDonald, S J; Prendiville, W J; Blair, E

1993-01-01

OBJECTIVE--To compare intramuscular oxytocin alone and intramuscular oxytocin with ergometrine (Syntometrine) for their effect in reducing the risk of postpartum haemorrhage when both are used as part of the active management of the third stage of labour. DESIGN--Double blind, randomised controlled trial. SETTING--Two metropolitan teaching hospitals in Perth, Western Australia. SUBJECTS--All women who expected a vaginal birth during the period of the trial. Informed consent was obtained. MAIN...

African Dust Fertilizing the Amazon Rainforest: An Assessment with Seven-year Record of CALIOP Measurements

Science.gov (United States)

Yu, H.; Chin, M.; Yuan, T.; Bian, H.; Prospero, J. M.; Omar, A. H.; Remer, L. A.; Winker, D. M.; Yang, Y.; Zhang, Y.; Zhang, Z.

2014-12-01

The productivity of Amazon rainforest is constrained by the availability of nutrients, in particular phosphorus (P). Deposition of transported African dust in boreal winter and spring is considered an important nutrient input for the Amazon Basin, though its magnitude is not well qunatified. This study provides a remote sensing observation-based estimate of dust deposition in the Amazon Basin using a 7-year (2007-2013) record of three dimensional (3D) distributions of aerosol in both cloud-free and above-cloud conditions from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP). It is estimated that the 7-year average of dust deposition into the Amazon Basin amounts to 15.1 ~ 32.1 Tg a-1 (Tg = 1012 g). This imported dust could provide 0.012 ~ 0.025 Tg P a-1 or equivalent to 12 ~ 26 g P ha-1 a-1 to fertilize the Amazon rainforest, which largely compensates the hydrological loss of P. The CLAIOP-based estimate agrees better with estimates from in-situ measurements and model simulations than what has been reported in literature. The closer agreement benefits from a more realistic geographic definition of the Amazon Basin and inclusion of meridional dust transport calculation in addition to the 3D nature of CALIOP aerosol measurements. The trans-Atlantic transport and deposition of dust shows strong interannual variations that are found to correlate with the North Atlantic Oscillation index in the winter season and anticorrelate with the prior-year Sahel Precipitation Index on an annual basis. Uncertainties associated with the estimate will also be discussed.

The Salford Lung Study protocol: a pragmatic, randomised phase III real-world effectiveness trial in asthma.

Science.gov (United States)

Woodcock, Ashley; Bakerly, Nawar Diar; New, John P; Gibson, J Martin; Wu, Wei; Vestbo, Jørgen; Leather, David

2015-12-10

Novel therapies need to be evaluated in normal clinical practice to allow a true representation of the treatment effectiveness in real-world settings. The Salford Lung Study is a pragmatic randomised controlled trial in adult asthma, evaluating the clinical effectiveness and safety of once-daily fluticasone furoate (100 μg or 200 μg)/vilanterol 25 μg in a novel dry-powder inhaler, versus existing asthma maintenance therapy. The study was initiated before this investigational treatment was licensed and conducted in real-world clinical practice to consider adherence, co-morbidities, polypharmacy, and real-world factors. Asthma Control Test at week 24; safety endpoints include the incidence of serious pneumonias. The study utilises the Salford electronic medical record, which allows near to real-time collection and monitoring of safety data. The Salford Lung Study is the world's first pragmatic randomised controlled trial of a pre-licensed medication in asthma. Use of patients' linked electronic health records to collect clinical endpoints offers minimal disruption to patients and investigators, and also ensures patient safety. This highly innovative study will complement standard double-blind randomised controlled trials in order to improve our understanding of the risk/benefit profile of fluticasone furoate/vilanterol in patients with asthma in real-world settings. Clinicaltrials.gov, NCT01706198; 04 October 2012.

Oil pollution in soils and sediments from the Northern Peruvian Amazon.

Science.gov (United States)

Rosell-Melé, Antoni; Moraleda-Cibrián, Núria; Cartró-Sabaté, Mar; Colomer-Ventura, Ferran; Mayor, Pedro; Orta-Martínez, Martí

2018-01-01

Oil has been extracted from the Northern Peruvian Amazon for over four decades. However, few scientific studies have assessed the impacts of such activities in the environment and health of indigenous communities in the region. We have investigated the occurrence of petrogenic hydrocarbon pollution in soils and sediments from areas favoured as hunting or fishing grounds by local indigenous inhabitants. The study was conducted in one of the most productive oil blocks in Peru, located in the headwaters of the Amazon river. Soils and river sediments, in the vicinity of oil extraction and processing infrastructure, contained an oil pollution signature as attested by the occurrence of hopanes and steranes. Given the lack of any other significant source of oil pollution in the region, the sources of hydrocarbons are likely to be the activities of the oil industry in the oil block, from voluntary discharges or accidental spills. Spillage of produced water was commonplace until 2009. Moreover, petrogenic compounds were absent in control samples in sites far removed from any oil infrastructure in the oil block. Our findings suggest that wildlife and indigenous populations in this region of the Amazon are exposed to the ingestion of oil polluted soils and sediments. The data obtained supports previous claims that the local spillage of oil and produced waters in the water courses in the Corrientes and Pastaza basins could have eventually reached the main water course of the Amazon. Copyright © 2017 Elsevier B.V. All rights reserved.

Potential contribution of groundwater to dry-season ET in the Amazon

Science.gov (United States)

Miguez-Macho, Gonzalo; Fan, Ying

2010-05-01

Climate and land ecosystem models simulate vegetation stress in the Amazon forest in the dry season, but observations show enhanced growth in response to higher radiation under less cloudy skies indicating an adequate water supply. The question is: how does the vegetation obtain sufficient water, and what is missing in the models? Shallow model soil and rooting depth is a factor; the ability of roots to move water up and down (hydraulic redistribution) may be another, but another cause may lie in the buffering effect of the groundwater found in nature but absent in models. We present observational and modeling evidence that the vast groundwater store, consequence of high annual rainfall combined with poor drainage in the Amazon, may provide a stable source for dry-season photosynthesis. The water table beneath the Amazon is sufficiently shallow (38% area 2mm/day to dry-season evapotranspiration, a non-negligible portion of tower-observed flux of 3-4mm/day, the latter including canopy-interception loss and open-water evaporation. This may have important implications to our understanding of Amazonia ecosystem response and feedback to climate change. Current models, lacking groundwater, predict a significant reduction in dry-season photosynthesis under current climate and large-scale dieback under projected future climate converting the Amazon from a net carbon sink to a net source and accelerating warming. If groundwater is considered in the models, the magnitude of the responses and feedbacks may be reduced.

Progress in Remote Sensing of Photosynthetic Activity over the Amazon Basin

Science.gov (United States)

Resende de Sousa, Celio Helder; Hilker, Thomas; Waring, Richard; Mendes De Moura, Yhasmin; Lyapustin, Alexei

2017-01-01

Although quantifying the massive exchange of carbon that takes place over the Amazon Basin remains a challenge, progress is being made as the remote sensing community moves from using traditional, reflectance-based vegetation indices, such as the Normalized Difference Vegetation Index (NDVI), to the more functional Photochemical Reflectance Index (PRI). This new index, together with satellite-derived estimates of canopy light interception and Sun-Induced Fluorescence (SIF), provide improved estimates of Gross Primary Production (GPP). This paper traces the development of these new approaches, compares the results of their analyses from multiple years of data acquired across the Amazon Basin and suggests further improvements in instrument design, data acquisition and processing. We demonstrated that our estimates of PRI are in generally good agreement with eddy-flux tower measurements of photosynthetic light use efficiency (epsilon) at four sites in the Amazon Basin: r(exp 2) values ranged from 0.37 to 0.51 for northern flux sites and to 0.78for southern flux sites. This is a significant advance over previous approaches seeking to establish a link between global-scale photosynthetic activity and remotely-sensed data. When combined with measurements of Sun-Induced Fluorescence (SIF), PRI provides realistic estimates of seasonal variation in photosynthesis over the Amazon that relate well to the wet and dry seasons. We anticipate that our findings will steer the development of improved approaches to estimate photosynthetic activity over the tropics.

RETRACTED: Treatment of postoperative emetic symptoms with granisetron in women undergoing abdominal hysterectomy: a randomized, double-blind, placebo-controlled, dose-ranging study

Directory of Open Access Journals (Sweden)

MD Yoshitaka Fujii

2004-07-01

Fujii Y, Tanaka H, Somekawa Y. Treatment of postoperative emetic symptoms with granisetron in women undergoing abdominal hysterectomy: a randomised, double-blind, placebo-controlled, dose-ranging study. Current Therapeutic Research 2004;65:321–9. https://www.sciencedirect.com/science/article/pii/S0011393X04800018

Amazon rainforest responses to elevated CO2: Deriving model-based hypotheses for the AmazonFACE experiment

Science.gov (United States)

Rammig, A.; Fleischer, K.; Lapola, D.; Holm, J.; Hoosbeek, M.

2017-12-01

Increasing atmospheric CO2 concentration is assumed to have a stimulating effect ("CO2 fertilization effect") on forest growth and resilience. Empirical evidence, however, for the existence and strength of such a tropical CO2 fertilization effect is scarce and thus a major impediment for constraining the uncertainties in Earth System Model projections. The implications of the tropical CO2 effect are far-reaching, as it strongly influences the global carbon and water cycle, and hence future global climate. In the scope of the Amazon Free Air CO2 Enrichment (FACE) experiment, we addressed these uncertainties by assessing the CO2 fertilization effect at ecosystem scale. AmazonFACE is the first FACE experiment in an old-growth, highly diverse tropical rainforest. Here, we present a priori model-based hypotheses for the experiment derived from a set of 12 ecosystem models. Model simulations identified key uncertainties in our understanding of limiting processes and derived model-based hypotheses of expected ecosystem responses to elevated CO2 that can directly be tested during the experiment. Ambient model simulations compared satisfactorily with in-situ measurements of ecosystem carbon fluxes, as well as carbon, nitrogen, and phosphorus stocks. Models consistently predicted an increase in photosynthesis with elevated CO2, which declined over time due to developing limitations. The conversion of enhanced photosynthesis into biomass, and hence ecosystem carbon sequestration, varied strongly among the models due to different assumptions on nutrient limitation. Models with flexible allocation schemes consistently predicted an increased investment in belowground structures to alleviate nutrient limitation, in turn accelerating turnover rates of soil organic matter. The models diverged on the prediction for carbon accumulation after 10 years of elevated CO2, mainly due to contrasting assumptions in their phosphorus cycle representation. These differences define the expected

A randomised placebo-controlled trial of early treatment of the patent ductus arteriosus.

Science.gov (United States)

Kluckow, Martin; Jeffery, Michele; Gill, Andy; Evans, Nick

2014-03-01

Failure of closure of the patent ductus arteriosus (PDA) may be associated with harm. Early cardiac ultrasound-targeted treatment of a large PDA may result in a reduction in adverse outcomes and need for later PDA closure with no increase in adverse effects. Multicentre, double-blind, placebo-controlled randomised trial. Three neonatal intensive care units in Australia. Eligible infants born <29 weeks were screened for a large PDA and received indomethacin or placebo before age 12 h. Death or abnormal cranial ultrasound. The trial ceased enrolment early due to lack of availability of indomethacin. 164 eligible infants were screened before 12 h; of the 92 infants with a large PDA, 44 were randomised to indomethacin and 48 to placebo. There was no difference in the main outcome between groups. Infants receiving early indomethacin had significantly less early pulmonary haemorrhage (PH) (2% vs 21%), a trend towards less periventricular/intraventricular haemorrhage (PIVH) (4.5% vs 12.5%) and were less likely to receive later open-label treatment for a PDA (20% vs 40%). The 72 non-randomised infants with a small PDA were at low risk of pulmonary haemorrhage and had an 80% spontaneous PDA closure rate. Early cardiac ultrasound-targeted treatment of a large PDA is feasible and safe, resulted in a reduction in early pulmonary haemorrhage and later medical treatment but had no effect on the primary outcome of death or abnormal cranial ultrasound. Australian New Zealand Clinical Trials Registry (ACTRN12608000295347).

Phylogeography of the dark fruit-eating bat Artibeus obscurus in the Brazilian Amazon.

Science.gov (United States)

Ferreira, Wallax Augusto Silva; Borges, Bárbara do Nascimento; Rodrigues-Antunes, Symara; de Andrade, Fernanda Atanaena Gonçalves; Aguiar, Gilberto Ferreira de Souza; de Sousa e Silva-Junior, José; Marques-Aguiar, Suely Aparecida; Harada, Maria Lúcia

2014-01-01

Artibeus obscurus (Mammalia: Chiroptera) is endemic to South America, being found in at least 18 Brazilian states. Recent studies revealed that different populations of this genus present distinct phylogeographic patterns; however, very little is known on the population genetics structure of A. obscurus in the Amazon rainforest. Here, using a fragment (1010bp) of the mitochondrial gene cytochrome b from 87 samples, we investigated patterns of genetic divergence among populations of A. obscurus from different locations in the Brazilian Amazon rainforest and compared them with other Brazilian and South American regions. Analysis of molecular variance (AMOVA), fixation index (Fst) analysis, and phylogeographic patterns showed divergence between two major monophyletic groups, each one corresponding to a geographic region associated with the Atlantic and Amazon forest biomes. The Atlantic forest clusters formed a monophyletic group with a high bootstrap support and a fragmented distribution that follows the pattern predicted by the Refuge Theory. On the other hand, a different scenario was observed for the Amazon forest, where no fragmentation was identified. The AMOVA results revealed a significant geographic heterogeneity in the distribution of genetic variation, with 70% found within populations across the studied populations (Fst values ranging from 0.05864 to 0.09673; φST = 0.55). The intrapopulational analysis revealed that one population (Bragança) showed significant evidence of population expansion, with the formation of 2 distinct phylogroups, suggesting the occurrence of a subspecies or at least a different population in this region. These results also suggest considerable heterogeneity for A. obscurus in the Amazon region.

Transport of hazardous materials in the Amazon area; Transporte de produtos perigosos na regiao Amazonica

Energy Technology Data Exchange (ETDEWEB)

Cunha, Wallace de Castro [FURNAS Centrais Eletricas S.A., Rio de Janeiro, RJ (Brazil); Fernandes, Elton; Nassi, Carlos David [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE)

2008-07-01

Amongst several exploratory sources of the subject 'hazardous materials transport', it is distinguished: 'the threat to the environment'. This paper presents an exploratory investigation of this subject line in the Amazon region. In view of the diversity of 'existing hazardous materials' and the raised dimension of the oil transport and its derivatives in this context, this paper focused in these products. Regarding to the geographic region, the approach was given to the State of Amazon, considering the amplitude of this State in the Amazon region and the availability of data. Therefore, this work explores and analyzes macro aspects inherent to the State of Amazon pertinent to the oil transport and its derivatives. In the macro context, it is observed the necessity of a higher control in the transport of hazardous materials in the region. The absence of registered data and the unfamiliarity on the risks related to the transport of hazardous materials by authorities and transporters indicate a relative absence of qualification in the region to deal with the monitoring of the transport of hazardous materials. So far, it is not possible up till now to make any evaluation of the environment threats of accidents with transport of hazardous materials in the Amazon region.(author)

Transport of hazardous materials in the Amazon area; Transporte de produtos perigosos na regiao Amazonica

Energy Technology Data Exchange (ETDEWEB)

Cunha, Wallace de Castro [FURNAS Centrais Eletricas S.A., Rio de Janeiro, RJ (Brazil); Fernandes, Elton; Nassi, Carlos David [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE)

2008-07-01

Amongst several exploratory sources of the subject 'hazardous materials transport', it is distinguished: 'the threat to the environment'. This paper presents an exploratory investigation of this subject line in the Amazon region. In view of the diversity of 'existing hazardous materials' and the raised dimension of the oil transport and its derivatives in this context, this paper focused in these products. Regarding to the geographic region, the approach was given to the State of Amazon, considering the amplitude of this State in the Amazon region and the availability of data. Therefore, this work explores and analyzes macro aspects inherent to the State of Amazon pertinent to the oil transport and its derivatives. In the macro context, it is observed the necessity of a higher control in the transport of hazardous materials in the region. The absence of registered data and the unfamiliarity on the risks related to the transport of hazardous materials by authorities and transporters indicate a relative absence of qualification in the region to deal with the monitoring of the transport of hazardous materials. So far, it is not possible up till now to make any evaluation of the environment threats of accidents with transport of hazardous materials in the Amazon region.(author)

A geomorphological assessments of the distribution of sediment sinks along the lower Amazon River

Science.gov (United States)

Park, E.; Latrubesse, E. M.

2017-12-01

Floodplain sediment storage budget is examined along the 1,000 km reach of the lower Amazon River based on extensive sets of remote sensing data and field measurements. Incorporating the washload discharges at gauge stations at the main channel and major tributaries, we analyzed the roles of vast floodplain on the Amazon River seasonal variability in sediment discharges. Annual washload accumulation rate on floodplain along the reach in between Manacapuru and Obidos of is estimated to be 79 Mt over inter-annual average. Period that the net loss over to the floodplain of washload coincide with discharge rising phase of the Amazon River at Obidos, when the river water level rises to make hydrologic connections to floodplain. Only during the early falling phase (July-August), 3.6 Mt of washload net gain occurred in a year, which was less than 5% of the annual net loss to the floodplain. To assess the spatial distribution of sediment sinks along the lower Amazon, we incorporated various hydro-geomorphic factors regarding floodplain geomorphic styles and morphometric parameters, such floodplain width, levee heights, water-saturated area, suspended sediment distribution over floodplain and distribution of impeded floodplain. Impeded floodplain that contains numerous large rounded lakes is the definition of active sediment sinks along the lower Amazon, which seasonally stores most of the water and traps sediment from the river. The results of these hydro-geomorphic factors collectively indicate that the extent and magnitudes of sediment sinks becomes larger downstream (from Manacapuru to Monte Alegre), which is proportionally related to the development of the water-saturated floodplain. This indicates the nonlinear geomorphic evolution of the Amazon floodplain through its longitudinal profile since the late Holocene that downstream reaches are still to be infilled with sediments (incomplete floodplain) thus acting as sediment sinks.

Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Attal, Nadine; de Andrade, Daniel C; Adam, Frédéric; Ranoux, Danièle; Teixeira, Manoel J; Galhardoni, Ricardo; Raicher, Irina; Üçeyler, Nurcan; Sommer, Claudia; Bouhassira, Didier

2016-05-01

Data from previous studies suggest that botulinum toxin A has analgesic effects against peripheral neuropathic pain, but the quality of the evidence is low. We aimed to assess the safety and efficacy of repeated administrations of botulinum toxin A in patients with neuropathic pain. We did a randomised, double-blind, placebo-controlled trial at two outpatient clinics in France (Clinical Pain Centre, Ambroise Paré Hospital, APHP, Boulogne-Billancourt, and Neurological Centre, Hôpital Dupuytren, Limoges) and one in Brazil (Neurological Department, Hospital das Clínicas da FMUSP, São Paulo). Patients aged 18-85 years with peripheral neuropathic pain were randomly assigned (1:1) by block randomisation, according to a centralised schedule, to receive two subcutaneous administrations of botulinum toxin A (up to 300 units) or placebo, 12 weeks apart. All patients and investigators were masked to treatment assignment. The primary outcome was the efficacy of botulinum toxin A versus placebo, measured as the change from baseline in self-reported mean weekly pain intensity over the course of 24 weeks from the first administration. The primary efficacy analysis was a mixed-model repeated-measures analysis in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT01251211. Between Oct 2, 2010, and Aug 2, 2013, 152 patients were enrolled, of whom 68 were randomly assigned (34 per group), and 66 (37 [56%] men) were included in the primary analysis (34 in the botulinum toxin A group and 32 in the placebo group). Botulinum toxin A reduced pain intensity over 24 weeks compared with placebo (adjusted effect estimate -0·77, 95% CI -0·95 to -0·59; pbotulinum toxin A group and 17 (53%) of those in the placebo group (p=1·0). Severe pain was experienced by ten (29%) participants in the botulinum toxin A group and 11 (34%) in the placebo group (p=0·8). Two administrations of botulinum toxin A, each of which comprised several injections, have a

The effect of intravenous dextrose administration for prevention of post-operative nausea and vomiting after laparoscopic cholecystectomy: A double-blind, randomised controlled trial.

Science.gov (United States)

Firouzian, Abolfazl; Kiasari, Alieh Zamani; Godazandeh, Gholamali; Baradari, Afshin Gholipour; Alipour, Abbas; Taheri, Arman; Emami Zeydi, Amir; Montazemi, Maryam

2017-10-01

Post-operative nausea and vomiting (PONV) is a common and distressing complication after laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the effect of intravenous (IV) dextrose administration for the prophylaxis of PONV after LC. In a double-blind, randomised controlled trial, a total of 150 female patients who were scheduled for elective LC were randomly assigned into two groups (A and B). Thirty minutes before induction of anaesthesia, patients received an infusion of 500 cc lactated Ringer's solution (Group A) and 5% dextrose in lactated Ringer's solution (Group B) and over a period of 30 min. All patients rated their nausea and vomiting intensity using the verbal rating scale immediately at post-anaesthesia care unit (PACU) arrival; 30, 60, 90 and 120 min after arriving at the PACU and 6, 12 and 24 h after surgery. There was a statistically significant time trend and group effect along with significant differences in time/group interaction effect in both groups for nausea and vomiting scores ( P Dextrose administration reduced the odds of vomiting events compared to placebo (estimate: -0.87, odds ratio = 0.42, 95% confidence interval: 0.28-0.64). Administration of IV dextrose before anaesthesia induction may be recommended as an effective, and safe method for the prophylaxis of PONV after LC.

Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial.

NARCIS (Netherlands)

Oosterhof, J.; Boo, T.M. de; Oostendorp, R.A.B.; Wilder-Smith, O.H.G.; Crul, B.J.P.

2006-01-01

The aim of this study was to test the efficacy of shortterm transcutaneous electrical nerve stimulation (TENS) treatment in chronic pain with respect to pain intensity and patients' satisfaction with treatment results. We therefore performed a randomised controlled trial comparing TENS and sham

Comparison of single and combination diuretics on glucose tolerance (PATHWAY-3): protocol for a randomised double-blind trial in patients with essential hypertension.

Science.gov (United States)

Brown, Morris J; Williams, Bryan; MacDonald, Thomas M; Caulfield, Mark; Cruickshank, J Kennedy; McInnes, Gordon; Sever, Peter; Webb, David J; Salsbury, Jackie; Morant, Steve; Ford, Ian

2015-08-07

Thiazide diuretics are associated with increased risk of diabetes mellitus. This risk may arise from K(+)-depletion. We hypothesised that a K(+)-sparing diuretic will improve glucose tolerance, and that combination of low-dose thiazide with K(+)-sparing diuretic will improve both blood pressure reduction and glucose tolerance, compared to a high-dose thiazide. This is a parallel-group, randomised, double-blind, multicentre trial, comparing hydrochlorothiazide 25-50 mg, amiloride 10-20 mg and combination of both diuretics at half these doses. A single-blind placebo run-in of 1 month is followed by 24 weeks of blinded active treatment. There is forced dose-doubling after 3 months. The Primary end point is the blood glucose 2 h after oral ingestion of a 75 g glucose drink (OGTT), following overnight fasting. The primary outcome is the difference between 2 h glucose at weeks 0, 12 and 24. Secondary outcomes include the changes in home systolic blood pressure (BP) and glycated haemoglobin and prediction of response by baseline plasma renin. Eligibility criteria are: age 18-79, systolic BP on permitted background treatment ≥ 140 mm Hg and home BP ≥ 130 mm Hg and one component of the metabolic syndrome additional to hypertension. Principal exclusions are diabetes, estimated-glomerular filtration rate 200 mm Hg or DBP >120 mm Hg (box 2). The sample size calculation indicates that 486 patients will give 80% power at α=0.01 to detect a difference in means of 1 mmol/L (SD=2.2) between 2 h glucose on hydrochlorothiazide and comparators. PATHWAY-3 was approved by Cambridge South Ethics Committee, number 09/H035/19. The trial results will be published in a peer-reviewed scientific journal. Eudract number 2009-010068-41 and clinical trials registration number: NCT02351973. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Response of the Amazon rainforest to late Pleistocene climate variability

Science.gov (United States)

Häggi, Christoph; Chiessi, Cristiano M.; Merkel, Ute; Mulitza, Stefan; Prange, Matthias; Schulz, Michael; Schefuß, Enno

2017-12-01

Variations in Amazonian hydrology and forest cover have major consequences for the global carbon and hydrological cycles as well as for biodiversity. Yet, the climate and vegetation history of the lowland Amazon basin and its effect on biogeography remain debated due to the scarcity of suitable high-resolution paleoclimate records. Here, we use the isotopic composition (δD and δ13C) of plant-waxes from a high-resolution marine sediment core collected offshore the Amazon River to reconstruct the climate and vegetation history of the integrated lowland Amazon basin for the period from 50,000 to 12,800 yr before present. Our results show that δD values from the Last Glacial Maximum were more enriched than those from Marine Isotope Stage (MIS) 3 and the present-day. We interpret this trend to reflect long-term changes in precipitation and atmospheric circulation, with overall drier conditions during the Last Glacial Maximum. Our results thus suggest a dominant glacial forcing of the climate in lowland Amazonia. In addition to previously suggested thermodynamic mechanisms of precipitation change, which are directly related to temperature, we conclude that changes in atmospheric circulation are crucial to explain the temporal evolution of Amazonian rainfall variations, as demonstrated in climate model experiments. Our vegetation reconstruction based on δ13C values shows that the Amazon rainforest was affected by intrusions of savannah or more open vegetation types in its northern sector during Heinrich Stadials, while it was resilient to glacial drying. This suggests that biogeographic patterns in tropical South America were affected by Heinrich Stadials in addition to glacial-interglacial climate variability.

Characteristics and Diurnal Cycle of GPM Rainfall Estimates over the Central Amazon Region

Directory of Open Access Journals (Sweden)

Rômulo Oliveira

2016-06-01

Full Text Available Studies that investigate and evaluate the quality, limitations and uncertainties of satellite rainfall estimates are fundamental to assure the correct and successful use of these products in applications, such as climate studies, hydrological modeling and natural hazard monitoring. Over regions of the globe that lack in situ observations, such studies are only possible through intensive field measurement campaigns, which provide a range of high quality ground measurements, e.g., CHUVA (Cloud processes of tHe main precipitation systems in Brazil: A contribUtion to cloud resolVing modeling and to the GlobAl Precipitation Measurement and GoAmazon (Observations and Modeling of the Green Ocean Amazon over the Brazilian Amazon during 2014/2015. This study aims to assess the characteristics of Global Precipitation Measurement (GPM satellite-based precipitation estimates in representing the diurnal cycle over the Brazilian Amazon. The Integrated Multi-satellitE Retrievals for Global Precipitation Measurement (IMERG and the Goddard Profiling Algorithm—Version 2014 (GPROF2014 algorithms are evaluated against ground-based radar observations. Specifically, the S-band weather radar from the Amazon Protection National System (SIPAM, is first validated against the X-band CHUVA radar and then used as a reference to evaluate GPM precipitation. Results showed satisfactory agreement between S-band SIPAM radar and both IMERG and GPROF2014 algorithms. However, during the wet season, IMERG, which uses the GPROF2014 rainfall retrieval from the GPM Microwave Imager (GMI sensor, significantly overestimates the frequency of heavy rainfall volumes around 00:00–04:00 UTC and 15:00–18:00 UTC. This overestimation is particularly evident over the Negro, Solimões and Amazon rivers due to the poorly-calibrated algorithm over water surfaces. On the other hand, during the dry season, the IMERG product underestimates mean precipitation in comparison to the S-band SIPAM

Effects of environmental change on malaria in the Amazon region of Brazil

OpenAIRE

Takken, W.; Tarso Vilarinhos, de, P.; Schneider, P.; Santos, dos, F.

2003-01-01

Malaria is endemic in Brazil, affecting mostly the Amazon states. Whereas 50 years ago good progress was made towards its control, since the opening up of the Amazon region for forestry, agriculture and livestock activities, the disease has rapidly increased in incidence, peaking to >500,000 cases annually in the 1990s. Rondônia state was particularly hard hit, with thousands of new immigrants suffering malaria attacks. It is argued that the environmental change caused by deforestation has...

Climatic and ecological future of the Amazon: likelihood and causes of change

OpenAIRE

B. Cook; N. Zeng; J.-H. Yoon

2010-01-01

Some recent climate modeling results suggested a possible dieback of the Amazon rainforest under future climate change, a prediction that raised considerable interest as well as controversy. To determine the likelihood and causes of such changes, we analyzed the output of 15 models from the Intergovernmental Panel on Climate Change Fourth Assessment Report (IPCC/AR4) and a dynamic vegetation model VEGAS driven by these climate output. Our results suggest that the core of the Amazon rainforest...

The Battle for Critical Internet Resources: South America vs. Amazon.com, Inc.

OpenAIRE

Patricia Vargas-Leon; Andreas Kuehn

2015-01-01

Purpose – To analyze the controversy about the allocation of critical Internet resources generated by ICANN's new gTLD program with a particular focus on the .AMAZON TLD. Methodology/approach/design – This article presents an exploratory case study about the .AMAZON controversy. The initial analysis of this ongoing research is based on data collected from various reports and media coverage on ICANN's new gTLD policy. The article draws from political economy theory to analyze disputes about...

Changes in the Carbon Cycle of Amazon Ecosystems During the 2010 Drought

Science.gov (United States)

Potter, Christophera; Klooster, Steven; Hiatt, Cyrus; Genovese, Vanessa; Castilla-Rubino, Juan Carlos

2011-01-01

Satellite remote sensing was combined with the NASA-CASA carbon cycle simulation model to evaluate the impact of the 2010 drought (July through September) throughout tropical South America. Results indicated that net primary production (NPP) in Amazon forest areas declined by an average of 7% in 2010 compared to 2008. This represented a loss of vegetation CO2 uptake and potential Amazon rainforest growth of nearly 0.5 Pg C in 2010. The largest overall decline in ecosystem carbon gains by land cover type was predicted for closed broadleaf forest areas of the Amazon River basin, including a large fraction of regularly flooded forest areas. Model results support the hypothesis that soil and dead wood carbon decomposition fluxes of CO2 to the atmosphere were elevated during the drought period of 2010 in periodically flooded forest areas, compared to forests outside the main river floodplains.

Changes in the carbon cycle of Amazon ecosystems during the 2010 drought

International Nuclear Information System (INIS)

Potter, Christopher; Klooster, Steven; Hiatt, Cyrus; Genovese, Vanessa; Castilla-Rubio, Juan Carlos

2011-01-01

Satellite remote sensing was combined with the NASA-CASA (Carnegie Ames Stanford Approach) carbon cycle simulation model to evaluate the impact of the 2010 drought (July through September) throughout tropical South America. Results indicated that net primary production in Amazon forest areas declined by an average of 7% in 2010 compared to 2008. This represented a loss of vegetation CO 2 uptake and potential Amazon rainforest growth of nearly 0.5 Pg C in 2010. The largest overall decline in ecosystem carbon gains by land cover type was predicted for closed broadleaf forest areas of the Amazon river basin, including a large fraction of regularly flooded forest areas. Model results support the hypothesis that soil and dead wood carbon decomposition fluxes of CO 2 to the atmosphere were elevated during the drought period of 2010 in periodically flooded forest areas, compared to those for forests outside the main river floodplains.

Green Ocean Amazon 2014/15 Terrestrial Ecosystem Project (Geco) Field Campaign Report

Energy Technology Data Exchange (ETDEWEB)

Jardine, Kolby [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-06-01

In conjunction with the U.S. Department of Energy (DOE)’s Atmospheric Radiation Measurement (ARM) Climate Research Facility GoAmazon campaign, the Terrestrial Ecosystem Science (TES)-funded Green Ocean Amazon (GoAmazon 2014/15) terrestrial ecosystem project (Geco) was designed to: • evaluate the strengths and weaknesses of leaf-level algorithms for biogenic volatile organic compounds (BVOCs) emissions in Amazon forests near Manaus, Brazil, and • conduct mechanistic field studies to characterize biochemical and physiological processes governing leaf- and landscape-scale tropical forest BVOC emissions, and the influence of environmental drivers that are expected to change with a warming climate. Through a close interaction between modeling and observational activities, including the training of MS and PhD graduate students, post-doctoral students, and technicians at the National Institute for Amazon Research (INPA), the study aimed at improving the representation of BVOC-mediated biosphere-atmosphere interactions and feedbacks under a warming climate. BVOCs can form cloud condensation nuclei (CCN) that influence precipitation dynamics and modify the quality of down welling radiation for photosynthesis. However, our ability to represent these coupled biosphere-atmosphere processes in Earth system models suffers from poor understanding of the functions, identities, quantities, and seasonal patterns of BVOC emissions from tropical forests as well as their biological and environmental controls. The Model of Emissions of Gases and Aerosols from Nature (MEGAN), the current BVOC sub-model of the Community Earth System Model (CESM), was evaluated to explore mechanistic controls over BVOC emissions. Based on that analysis, a combination of observations and experiments were studied in forests near Manaus, Brazil, to test existing parameterizations and algorithm structures in MEGAN. The model was actively modified as needed to improve tropical BVOC emission simulations on

The Green Ocean Amazon Experiment (GoAmazon2014/5) Observes Pollution Affecting Gases, Aerosols, Clouds, and Rainfall over the Rain Forest

Energy Technology Data Exchange (ETDEWEB)

Martin, S. T. [Harvard University, Cambridge, Massachusetts; Artaxo, P. [University of São Paulo, São Paulo, Brazil; Machado, L. [National Institute for Space Research, São José dos Campos, Brazil; Manzi, A. O. [National Institute of Amazonian Research, Manaus, Amazonas, Brazil; Souza, R. A. F. [Amazonas State University, Amazonas, Brazil; Schumacher, C. [Texas A& amp,M University, College Station, Texas; Wang, J. [Brookhaven National Laboratory, Upton, New York; Biscaro, T. [National Institute for Space Research, São José dos Campos, Brazil; Brito, J. [University of São Paulo, São Paulo, Brazil; Calheiros, A. [National Institute for Space Research, São José dos Campos, Brazil; Jardine, K. [Lawrence Berkeley National Lab, Berkeley, California; Medeiros, A. [Amazonas State University, Amazonas, Brazil; Portela, B. [National Institute of Amazonian Research, Manaus, Amazonas, Brazil; de Sá, S. S. [Harvard University, Cambridge, Massachusetts; Adachi, K. [Meteorological Research Institute, Tsukuba, Ibaraki, Japan; Aiken, A. C. [Los Alamos National Laboratory, Los Alamos, New Mexico; Albrecht, R. [University of São Paulo, São Paulo, Brazil; Alexander, L. [Pacific Northwest National Laboratory, Richland, Washington; Andreae, M. O. [Max Planck Institute for Chemistry, Mainz, Germany; Barbosa, H. M. J. [University of São Paulo, São Paulo, Brazil; Buseck, P. [Arizona State University, Tempe, Arizona; Chand, D. [Pacific Northwest National Laboratory, Richland, Washington; Comstock, J. M. [Pacific Northwest National Laboratory, Richland, Washington; Day, D. A. [University of Colorado Boulder, Boulder, Colorado; Dubey, M. [Los Alamos National Laboratory, Los Alamos, New Mexico; Fan, J. [Pacific Northwest National Laboratory, Richland, Washington; Fast, J. [Pacific Northwest National Laboratory, Richland, Washington; Fisch, G. [Aeronautic and Space Institute, São José dos Campos, Brazil; Fortner, E. [Aerodyne, Inc., Billerica, Massachusetts; Giangrande, S. [Brookhaven National Laboratory, Upton, New York; Gilles, M. [Lawrence Berkeley National Lab, Berkeley, California; Goldstein, A. H. [University of California, Berkeley, Berkeley, California; Guenther, A. [University of California, Irvine, Irvine, California; Hubbe, J. [Pacific Northwest National Laboratory, Richland, Washington; Jensen, M. [Brookhaven National Laboratory, Upton, New York; Jimenez, J. L. [University of Colorado Boulder, Boulder, Colorado; Keutsch, F. N. [Harvard University, Cambridge, Massachusetts; Kim, S. [University of California, Irvine, Irvine, California; Kuang, C. [Brookhaven National Laboratory, Upton, New York; Laskin, A. [Pacific Northwest National Laboratory, Richland, Washington; McKinney, K. [Harvard University, Cambridge, Massachusetts; Mei, F. [Pacific Northwest National Laboratory, Richland, Washington; Miller, M. [Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Nascimento, R. [Amazonas State University, Amazonas, Brazil; Pauliquevis, T. [Federal University of São Paulo, São Paulo, Brazil; Pekour, M. [Pacific Northwest National Laboratory, Richland, Washington; Peres, J. [University of São Paulo, São Paulo, Brazil; Petäjä, T. [University of Helsinki, Helsinki, Finland; Pöhlker, C. [Max Planck Institute for Chemistry, Mainz, Germany; Pöschl, U. [Max Planck Institute for Chemistry, Mainz, Germany; Rizzo, L. [Federal University of São Paulo, São Paulo, Brazil; Schmid, B. [Pacific Northwest National Laboratory, Richland, Washington; Shilling, J. E. [Pacific Northwest National Laboratory, Richland, Washington; Dias, M. A. Silva [University of São Paulo, São Paulo, Brazil; Smith, J. N. [University of California, Irvine, Irvine, California; Tomlinson, J. M. [Pacific Northwest National Laboratory, Richland, Washington; Tóta, J. [Federal University of West Para, Santarém, Pará, Brazil; Wendisch, M. [University of Leipzig, Leipzig, Germany

2017-05-01

The Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5) experiment took place around the urban region of Manaus in central Amazonia across two years. The urban pollution plume was used to study the susceptibility of gases, aerosols, clouds, and rainfall to human activities in a tropical environment. Many aspects of air quality, weather, terrestrial ecosystems, and climate work differently in the tropics than in the more thoroughly studied USA, employed an unparalleled suite of measurements at nine ground sites and onboard two aircraft to investigate the flow of background air into Manaus, the emissions into the air over the city, and the advection of the pollution downwind of the city. Herein, to visualize this train of processes and its effects, observations aboard a low-flying aircraft are presented. Comparative measurements within and adjacent to the plume followed the emissions of biogenic volatile organic carbon compounds (BVOCs) from the tropical forest, their transformations by the atmospheric oxidant cycle, alterations of this cycle by the influence of the pollutants, transformations of the chemical products into aerosol particles, the relationship of these particles to cloud condensation nuclei (CCN) activity, and the differences in cloud properties and rainfall for background compared to polluted conditions. The observations of the GoAmazon2014/5 experiment illustrate how the hydrologic cycle, radiation balance, and carbon recycling may be affected by present-day as well as future economic development and pollution over the Amazonian tropical forest.

Placebo versus low-dose ketamine infusion in addition to remifentanil target-controlled infusion for conscious sedation during oocyte retrieval: A prospective, double-blinded, randomised controlled trial.

Science.gov (United States)

Morue, Hélène I; Raj-Lawrence, Shalini; Saxena, Sarah; Delbaere, Anne; Engelman, Edgard; Barvais, Luc A

2018-04-30

Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes. Controlled, randomised, prospective, double-blinded study. The current study was conducted in a tertiary-level hospital in Brussels (Belgium) from December 2013 to June 2014. Of the 132 women undergoing oocyte retrieval included, 121 completed the study. After randomisation, patients received either a ketamine infusion (40 μg kg min over 5 min followed by 2.5 μg kg min) or a 0.9% saline infusion in addition to the variable remifentanil TCI. The primary outcome was the number of respiratory depression episodes. Effect site target remifentanil concentrations, side effects, pain score, patient satisfaction and incidence of pregnancy were also recorded. No significant difference in the incidence of respiratory events was noted (pulse oximetry oxygen saturation the ketamine group and 63% in the control group; P = 0.121). No patient required ventilatory support. In the ketamine group, visual analogue pain score and remifentanil concentrations were significantly reduced, but the latter remained above 2 ng ml. Postoperative nausea was less frequent in the ketamine group, 4 versus 15% (P = 0.038). The addition of ketamine did not influence length of stay nor patient satisfaction. The addition of low plasma levels of ketamine to a TCI remifentanil conscious sedation technique did not decrease the incidence nor the severity of respiratory depression. Continuous monitoring of capnography and oxygen saturation is

Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial.

Science.gov (United States)

Pathan, Sameer A; Mitra, Biswadev; Straney, Lahn D; Afzal, Muhammad Shuaib; Anjum, Shahzad; Shukla, Dharmesh; Morley, Kostantinos; Al Hilli, Shatha A; Al Rumaihi, Khalid; Thomas, Stephen H; Cameron, Peter A

2016-05-14

The excruciating pain of patients with renal colic on presentation to the emergency department requires effective analgesia to be administered in the shortest possible time. Trials comparing intramuscular non-steroidal anti-inflammatory drugs with intravenous opioids or paracetamol have been inconclusive because of the challenges associated with concealment of randomisation, small sample size, differences in outcome measures, and inadequate masking of participants and assessors. We did this trial to develop definitive evidence regarding the choice of initial analgesia and route of administration in participants presenting with renal colic to the emergency department. In this three-treatment group, double-blind, randomised controlled trial, adult participants (aged 18-65 years) presenting to the emergency department of an academic, tertiary care hospital in Qatar, with moderate to severe renal colic (Numerical pain Rating Scale ≥ 4) were recruited. With the use of computer-generated block randomisation (block sizes of six and nine), participants were assigned (1:1:1) to receive diclofenac (75 mg/3 mL intramuscular), morphine (0.1 mg/kg intravenous), or paracetamol (1 g/100 mL intravenous). Participants, clinicians, and trial personnel were masked to treatment assignment. The primary outcome was the proportion of participants achieving at least a 50% reduction in initial pain score at 30 min after analgesia, assessed by intention-to-treat analysis and per-protocol analysis, which included patients where a calculus in the urinary tract was detected with imaging. This trial is registered with ClinicalTrials.gov, number NCT02187614. Between Aug 5, 2014, and March 15, 2015, we randomly assigned 1645 participants, of whom 1644 were included in the intention-to-treat analysis (547 in the diclofenac group, 548 in the paracetemol group, and 549 in the morphine group). Ureteric calculi were detected in 1316 patients, who were analysed as the per-protocol population (438 in

Passive microwave observations of inundation area and the area/stage relation in the Amazon River floodplain

International Nuclear Information System (INIS)

Sippel, S.J.; Hamilton, S.K.; Melack, J.M.; Novo, E.M.M.

1998-01-01

Inundation patterns in Amazon River floodplains are revealed by analysis of the 37GHz polarization difference observed by the Scanning Multichannel Microwave Radiometer on the Nimbus-7 satellite. Flooded area is estimated at monthly intervals for January 1979 through August 1987 using mixing models that account for the major landscape units with distinctive microwave emission characteristics. Results are presented separately for 12 longitudinal reaches along the Amazon River main stem in Brazil as well as for three major tributaries (the Jurua, Purus and Madeira rivers). The total area along the Amazon River main stem that was flooded (including both floodplain and open water) varied between 19 000 and 91 000 km 2 . The correlation between flooded area and river stage is used to develop a predictive relationship and reconstruct regional inundation patterns in the floodplain of the Amazon River main stem over the past 94 years of stage records (1903± 1996). The mean flooded area along the Amazon River during this 94-year period was 46 800 km 2 , of which the openwater surfaces of river channels and floodplain lakes comprised about 20 700 km 2 . (author)

Persistent occiput posterior: OUTcomes following digital rotation: a pilot randomised controlled trial.

Science.gov (United States)

Graham, Kathryn; Phipps, Hala; Hyett, Jon A; Ludlow, Joanne P; Mackie, Adam; Marren, Anthony; De Vries, Bradley

2014-06-01

To determine the feasibility of a multicentre randomised controlled trial (RCT) to investigate whether digital rotation of the fetal head from occiput posterior (OP) position in the second stage of labour reduces the risk of operative delivery (defined as caesarean section (CS) or instrumental delivery). We conducted the study between December 2010 and December 2011 in a tertiary referral hospital in Australia. A transabdominal ultrasound was performed early in the second stage of labour on women with cephalic, singleton pregnancies to determine the fetal position. Those women with a fetus in the OP position were randomised to either a digital rotation or a sham procedure. In all other ways, participants received their usual intrapartum care. Data regarding demographics, mode of delivery, labour, post natal period and neonatal outcomes were collected. One thousand and four women were consented, 834 achieved full dilatation, and 30 were randomised. An additional portable ultrasound scan and a blinded 'sham' digital rotation were acceptable to women and staff. Operative delivery rates were 13/15 in the digital rotation (four CS and nine instrumental) and 12/15 in the sham (three CS and nine instrumental) groups, respectively. A large double-blinded multicentre RCT would be feasible and acceptable to women and staff. Strategies to improve recruitment such as consenting women with an effective epidural in active labour should be considered. This would be the first RCT to answer a clinically important question which could significantly affect the operative delivery rate in Australia and internationally. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Pressure RElieving Support SUrfaces: a Randomised Evaluation 2 (PRESSURE 2): study protocol for a randomised controlled trial.

Science.gov (United States)

Brown, Sarah; Smith, Isabelle L; Brown, Julia M; Hulme, Claire; McGinnis, Elizabeth; Stubbs, Nikki; Nelson, E Andrea; Muir, Delia; Rutherford, Claudia; Walker, Kay; Henderson, Valerie; Wilson, Lyn; Gilberts, Rachael; Collier, Howard; Fernandez, Catherine; Hartley, Suzanne; Bhogal, Moninder; Coleman, Susanne; Nixon, Jane E

2016-12-20

Pressure ulcers represent a major burden to patients, carers and the healthcare system, affecting approximately 1 in 17 hospital and 1 in 20 community patients. They impact greatly on an individual's functional status and health-related quality of life. The mainstay of pressure ulcer prevention practice is the provision of pressure redistribution support surfaces and patient repositioning. The aim of the PRESSURE 2 study is to compare the two main mattress types utilised within the NHS: high-specification foam and alternating pressure mattresses, in the prevention of pressure ulcers. PRESSURE 2 is a multicentre, open-label, randomised, double triangular, group sequential, parallel group trial. A maximum of 2954 'high-risk' patients with evidence of acute illness will be randomised on a 1:1 basis to receive either a high-specification foam mattress or alternating-pressure mattress in conjunction with an electric profiling bed frame. The primary objective of the trial is to compare mattresses in terms of the time to developing a new Category 2 or above pressure ulcer by 30 days post end of treatment phase. Secondary endpoints include time to developing new Category 1 and 3 or above pressure ulcers, time to healing of pre-existing Category 2 pressure ulcers, health-related quality of life, cost-effectiveness, incidence of mattress change and safety. Validation objectives are to determine the responsiveness of the Pressure Ulcer Quality of Life-Prevention instrument and the feasibility of having a blinded endpoint assessment using photography. The trial will have a maximum of three planned analyses with unequally spaced reviews at event-driven coherent cut-points. The futility boundaries are constructed as non-binding to allow a decision for stopping early to be overruled by the Data Monitoring and Ethics Committee. The double triangular, group sequential design of the PRESSURE 2 trial will provide an efficient design through the possibility of early stopping for

Crop damage of Eriotheca gracilipes (Bombacaceae by the Blue-Fronted Amazon (Amazona aestiva, Psittacidae, in the Brazilian Cerrado

Directory of Open Access Journals (Sweden)

J Ragusa-Netto

Full Text Available Seed predation has major effects on the reproductive success of individuals, spatial patterns of populations, genetic variability, interspecific interactions and ultimately in the diversity of tree communities. At a Brazilian savanna, I evaluated the proportional crop loss of Eriotheca gracilipes due the Blue-Fronted Amazon (Amazona aestiva during a fruiting period. Also, I analyzed the relationship between proportional crop loss to Amazons and both fruit crop size and the distance from the nearest damaged conspecific. Trees produced from 1 to 109 fruits, so that Amazons foraged more often on trees bearing larger fruit crop size, while seldom visited less productive trees. Moreover, the relationship between fruit crop sizes and the number of depredated fruits was significant. However, when only damaged trees were assessed, I found a negative and significant relation between fruit crop size and proportional crop loss to Blue-Fronted Amazons. Taking into account this as a measure more directly related to the probability of seed survival, a negative density dependent effect emerged. Also, Amazons similarly damaged the fruit crops of either close or distant neighboring damaged trees. Hence, in spite of Blue-Fronted Amazons searched for E. gracilipes bearing large fruit crops, they were swamped due to the presence of more fruits than they could eat. Moderate seed predation by Blue-Fronted Amazons either at trees with large fruit crops or in areas where fruiting trees were aggregated implies in an enhanced probability of E. gracilipes seed survival and consequent regeneration success.

Crop damage of Eriotheca gracilipes (Bombacaceae) by the Blue-Fronted Amazon (Amazona aestiva, Psittacidae), in the Brazilian Cerrado.

Science.gov (United States)

Ragusa-Netto, J

2014-11-01

Seed predation has major effects on the reproductive success of individuals, spatial patterns of populations, genetic variability, interspecific interactions and ultimately in the diversity of tree communities. At a Brazilian savanna, I evaluated the proportional crop loss of Eriotheca gracilipes due the Blue-Fronted Amazon (Amazona aestiva) during a fruiting period. Also, I analyzed the relationship between proportional crop loss to Amazons and both fruit crop size and the distance from the nearest damaged conspecific. Trees produced from 1 to 109 fruits, so that Amazons foraged more often on trees bearing larger fruit crop size, while seldom visited less productive trees. Moreover, the relationship between fruit crop sizes and the number of depredated fruits was significant. However, when only damaged trees were assessed, I found a negative and significant relation between fruit crop size and proportional crop loss to Blue-Fronted Amazons. Taking into account this as a measure more directly related to the probability of seed survival, a negative density dependent effect emerged. Also, Amazons similarly damaged the fruit crops of either close or distant neighboring damaged trees. Hence, in spite of Blue-Fronted Amazons searched for E. gracilipes bearing large fruit crops, they were swamped due to the presence of more fruits than they could eat. Moderate seed predation by Blue-Fronted Amazons either at trees with large fruit crops or in areas where fruiting trees were aggregated implies in an enhanced probability of E. gracilipes seed survival and consequent regeneration success.

A poly-herbal blend (Herbagut®) on adults presenting with gastrointestinal complaints: a randomised, double-blind, placebo-controlled study.

Science.gov (United States)

Lopresti, Adrian L; Gupta, Hemant; Smith, Stephen J

2018-03-20

To evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits. This was a randomised, double-blind, placebo-controlled trial. Fifty adults with self-reported unsatisfactory bowel habits, primarily characterised by chronic constipation were randomly allocated to take Herbagut or a matching placebo for 28 days. Efficacy of gastrointestinal changes was measured by the completion of a patient daily diary evaluating changes in stool type (Bristol Stool Form Scale), ease of bowel movements, and feeling of complete evacuation; and the Gastrointestinal Symptom Rating Scale (GSRS). Changes in quality of life were also examined using the World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL). All participants completed the 28-day trial with no adverse events reported. Compared to the placebo, weekly bowel movements increased over time (p pain, constipation, diarrhoea, indigestion, and reflux also decreased significantly in people taking Herbagut compared to placebo (p < .001, for all domains). Moreover, quality of life significantly improved in the Herbagut group compared to placebo as indicated by significantly greater improvement in WHOQOL-BREF domain ratings for overall quality of life, social relations, environmental health, psychological health, and physical health (p < .001, for all domains); and PAC-QOL domain ratings for physical discomfort, psychosocial discomfort, worries and concerns, and life satisfaction (p < .001, for all domains). The changes were considered clinically meaningful as evidenced by their large effect sizes. Herbagut ingestion over a 28-day period resulted in improvements in several gastrointestinal symptoms and overall quality of life. Further investigation

Datový sklad v prostředí Amazon Web Services

OpenAIRE

Kuželka, Kryštof

2015-01-01

The primary objective of this work is to investigate the potential of utilizing Hadoop and Amazon Redshift in the Amazon Web Services ("AWS") cloud, in order to design and implement a data warehouse, the efficacy of which will be tested afterwards. Contributions of this work include: documenting the technologies in the AWS cloud in Czech, demonstration of the design and performance tests of the data warehouse and the ETL part. Another considerable benefit is the added value to the company for...

Health Concerns in the Amazon Region

Centers for Disease Control (CDC) Podcasts

2009-04-09

Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.  Created: 4/9/2009 by Emerging Infectious Diseases.   Date Released: 4/9/2009.

Potential hydrologic changes in the Amazon by the end of the 21st century and the groundwater buffer

International Nuclear Information System (INIS)

Pokhrel, Yadu N; Fan, Ying; Miguez-Macho, Gonzalo

2014-01-01

This study contributes to the discussions on the future of the Amazon rainforest under a projected warmer-drier climate from the perspectives of land hydrology. Using IPCC HadGEM2-ES simulations of the present and future Amazon climate to drive a land hydrology model that accounts for groundwater constraint on land drainage, we assess potential hydrologic changes in soil water, evapotranspiration (ET), water table depth, and river discharge, assuming unchanged vegetation. We ask: how will ET regimes shift at the end of the 21st century, and will the groundwater help buffer the anticipated water stress in some places-times? We conducted four 10 yr model simulations, at the end of 20th and 21st century, with and without the groundwater. Our model results suggest that, first, over the western and central Amazon, ET will increase due to increased potential evapotranspiration (PET) with warmer temperatures, despite a decrease in soil water; that is, ET will remain PET or atmospheric demand-limited. Second, in the eastern Amazon dry season, ET will decrease in response to decreasing soil water, despite increasing PET demand; that is, ET in these regions-seasons will remain or become more soil water or supply-limited. Third, the area of water-limited regions will likely expand in the eastern Amazonia, with the dry season, as indicated by soil water store, even drier and longer. Fourth, river discharge will be significantly reduced over the entire Amazon but particularly so in the southeastern Amazon. By contrasting model results with and without the groundwater, we found that the slow soil drainage constrained by shallow groundwater can buffer soil water stress, particularly in southeastern Amazon dry season. Our model suggests that, if groundwater buffering effect is accounted for, the future Amazon water stress may be less than that projected by most climate models. (letter)

Does the Amazon suffer from BSE prevention?

NARCIS (Netherlands)

Elferink, E.V.; Nonhebel, S.; Schoot Uiterkamp, A.J.M.

In the last decade, large-scale production of soybeans has been a major driver of the enhanced deforestation in the Brazilian Amazon. We show that these soybeans are mainly exported to the EU to substitute for the BSE related banned meat and bone meal in livestock feed. This strongly suggests a link

Randomised controlled trial of the effects of L-ornithine on stress markers and sleep quality in healthy workers

OpenAIRE

Miyake, Mika; Kirisako, Takayoshi; Kokubo, Takeshi; Miura, Yutaka; Morishita, Koji; Okamura, Hisayoshi; Tsuda, Akira

2014-01-01

Background L-ornithine is a non-essential, non-protein amino acid. Although L-ornithine is contained in various foods, the amount is usually small. Recently, studies have shown that orally administered L-ornithine reduced the stress response in animals. From these findings, we speculated that L-ornithine may play a role in the relieve of stress and improve sleep and fatigue symptoms in humans. Through a randomised, double-blind, placebo-controlled clinical study, we asked if L-ornithine could...

Effect of a single prophylactic preoperative oral antibiotic dose on surgical site infection following complex dermatological procedures on the nose and ear: a prospective, randomised, controlled, double-blinded trial.

Science.gov (United States)

Rosengren, Helena; Heal, Clare F; Buttner, Petra G

2018-04-19

There is limited published research studying the effect of antibiotic prophylaxis on surgical site infection (SSI) in dermatological surgery, and there is no consensus for its use in higher-risk cases. The objective of this study was to determine the effectiveness of a single oral preoperative 2 g dose of cephalexin in preventing SSI following flap and graft dermatological closures on the nose and ear. Prospective double-blinded, randomised, placebo-controlled trial testing for difference in infection rates. Primary care skin cancer clinics in North Queensland, Australia, were randomised to 2 g oral cephalexin or placebo 40-60 min prior to skin incision. 154 consecutive eligible patients booked for flap or graft closure following skin cancer excision on the ear and nose. 2 g dose of cephalexin administered 40-60 min prior to surgery. Overall 8/69 (11.6%) controls and 1/73 (1.4%) in the intervention group developed SSI (p=0.015; absolute SSI reduction 10.2%; number needed to treat (NNT) for benefit 9.8, 95% CI 5.5 to 45.5). In males, 7/44 controls and 0/33 in the intervention group developed SSI (p=0.018; absolute SSI reduction 15.9%; NNT for benefit 6.3, 95% CI 3.8 to 19.2). SSI was much lower in female controls (1/25) and antibiotic prophylaxis did not further reduce this (p=1.0). There was no difference between the study groups in adverse symptoms attributable to high-dose antibiotic administration (p=0.871). A single oral 2 g dose of cephalexin given before complex skin closure on the nose and ear reduced SSI. ANZCTR 365115; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

EFFECTIVENESS OF DOUBLE WASH SWIM-UP VERSUS DOUBLE DENSITY GRADIENT SWIM-UP TECHNIQUE OF SPERM PREPARATION IN IN VITRO FERTILISATION

Directory of Open Access Journals (Sweden)

Srinivas Sangisapu

2017-10-01

Swim-up (DDGSU, which is statistically significant (p=0.007 from the Double Wash Swim-up (DWSU method. CONCLUSION Double density gradient swim-up method of sperm preparation seems to be strongly associated with successful fertilisation of oocytes and is statistically, significantly different from that of double wash swim-up method. Further, more prospective randomised controlled study is desirable to arrive at good quality of evidence to assess the effectiveness of both the methods of semen preparation.

Changes in the carbon cycle of Amazon ecosystems during the 2010 drought

Energy Technology Data Exchange (ETDEWEB)

Potter, Christopher [NASA Ames Research Center, Moffett Field, CA (United States); Klooster, Steven; Hiatt, Cyrus; Genovese, Vanessa [California State University Monterey Bay, Seaside, CA (United States); Castilla-Rubio, Juan Carlos, E-mail: chris.potter@nasa.gov [Planetary Skin Institute, Silicon Valley, CA (United States)

2011-07-15

Satellite remote sensing was combined with the NASA-CASA (Carnegie Ames Stanford Approach) carbon cycle simulation model to evaluate the impact of the 2010 drought (July through September) throughout tropical South America. Results indicated that net primary production in Amazon forest areas declined by an average of 7% in 2010 compared to 2008. This represented a loss of vegetation CO{sub 2} uptake and potential Amazon rainforest growth of nearly 0.5 Pg C in 2010. The largest overall decline in ecosystem carbon gains by land cover type was predicted for closed broadleaf forest areas of the Amazon river basin, including a large fraction of regularly flooded forest areas. Model results support the hypothesis that soil and dead wood carbon decomposition fluxes of CO{sub 2} to the atmosphere were elevated during the drought period of 2010 in periodically flooded forest areas, compared to those for forests outside the main river floodplains.

Insight on the Peruvian Amazon River: A Planform Metric Characterization of its Morphodynamics

Science.gov (United States)

Garcia, A. M. P.; Ortals, C.; Frias, C. E.; Abad, J. D.; Vizcarra, J.

2014-12-01

Starting in Peru, the Amazon River flows through Colombia and Brazil; additionally, tributaries from Bolivia, Venezuela, and Ecuador contribute to the massive river and its unique geomorphic features. Accordingly, the Amazon Basin has become an important aspect of South America; it is an area of extraordinary biodiversity, rich resources, and unique cultures. However, due to the sheer magnitude and exceptionality of the Amazon River, research regarding the morphodynamic processes that shape and define the river has been difficult. Consequently, current research has not completely understood the planform dynamics of some portions of this river that present a main channel and secondary channels known as "anabranching structures". The purpose of this research was to gain an understanding of the geomorphology of the upper Amazon, the Peruvian section, by obtaining migration rates and planform metrics, including channel count, length, width, and sinuosity, as well as island count, area, and shape. With this data, the morphodynamics of the Peruvian Amazon, especially the relationship between the main channel and its secondary channels in each "anabranching structure" along the river, could be analyzed according to correlations found between various metrics. This analysis was carried out for 5-year time spans over a period of 25 years. Preliminary results showed that the average migration rate versus channel bend radius envelope peak is lower for the secondary channels than for the main channel. However, the maximum migration rate was not always found in the main channel; for several structures, the most dynamic channels were the secondary ones. This implies a certain periodicity to the river's migratory patterns that could be related to the valley boundaries, the local channel sinuosity or geological formations in the study area.

Lidar observed seasonal variation of vertical canopy structure in the Amazon evergreen forests

Science.gov (United States)

Tang, H.; Dubayah, R.

2017-12-01

Both light and water are important environmental factors governing tree growth. Responses of tropical forests to their changes are complicated and can vary substantially across different spatial and temporal scales. Of particular interest is the dry-season greening-up of Amazon forests, a phenomenon undergoing considerable debates whether it is real or a "light illusion" caused by artifacts of passive optical remote sensing techniques. Here we analyze seasonal dynamic patterns of vertical canopy structure in the Amazon forests using lidar observations from NASA's Ice, Cloud, and and land Elevation Satellite (ICESat). We found that the net greening of canopy layer coincides with the wet-to-dry transition period, and its net browning occurs mostly at the late dry season. The understory also shows a seasonal cycle, but with an opposite variation to canopy and minimal correlation to seasonal variations in rainfall or radiation. Our results further suggest a potential interaction between canopy layers in the light regime that can optimize the growth of Amazon forests during the dry season. This light regime variability that exists in both spatial and temporal domains can better reveal the dry-season greening-up phenomenon, which appears less obvious when treating the Amazon forests as a whole.

Environment, energy and economic development in Amazon; Desenvolvimento economico-energetico e o meio ambiente na Amazonia

Energy Technology Data Exchange (ETDEWEB)

Pinguelli Rosa, Luiz; Alveal, Carmem [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia; Reis, Hugo Regis do [Companhia Nacional de Defesa e pelo Desenvolvimento da Amazonia (CNDDA), Manaus, AM (Brazil); Mesquita, Alvaro Augusto [ELETRONORTE, Belem, PA (Brazil)

1991-12-31

This paper shows the aspects related to the sustainable development of the brazilian Amazon region. The aspects of human-forest relations, electric power generation, land ownership, brazilian indians populations, all of these related to the social and economical development for the Amazon region

Getting started With Amazon Redshift

CERN Document Server

Bauer, Stefan

2013-01-01

Getting Started With Amazon Redshift is a step-by-step, practical guide to the world of Redshift. Learn to load, manage, and query data on Redshift.This book is for CIOs, enterprise architects, developers, and anyone else who needs to get familiar with RedShift. The CIO will gain an understanding of what their technical staff is working on; the technical implementation personnel will get an in-depth view of the technology, and what it will take to implement their own solutions.

Radon concentrations profiles over the brazilian Amazon basin during wet season

International Nuclear Information System (INIS)

Pereira, E.B.; Dias, P.L.S.; Nordemann, D.J.R.

1991-01-01

Atmospheric radon measurements were performed airborne in the Brazilian Amazon Basin during the wet season ABLE-2B experiment. The vertical profiles of radon showed a small decrease of concentration with increasing altitude at a rate varying from 6.5 to 11 x 10 - 2 Bq m - 3 km - 1. The calculation of the flux balance of radon in the troposphere above the Amazon Basin indicated a residual flux at the upper boundary of the measurement domain (6 km) of 0.14 atom cm - 2 s - 1. This residue may be associated with the turbulent transport of radon due to cloud activity. (author)

Antibiotics for bronchiectasis exacerbations in children: rationale and study protocol for a randomised placebo-controlled trial

Directory of Open Access Journals (Sweden)

Chang Anne B

2012-08-01

Full Text Available Abstract Background Despite bronchiectasis being increasingly recognised as an important cause of chronic respiratory morbidity in both indigenous and non-indigenous settings globally, high quality evidence to inform management is scarce. It is assumed that antibiotics are efficacious for all bronchiectasis exacerbations, but not all practitioners agree. Inadequately treated exacerbations may risk lung function deterioration. Our study tests the hypothesis that both oral azithromycin and amoxicillin-clavulanic acid are superior to placebo at improving resolution rates of respiratory exacerbations by day 14 in children with bronchiectasis unrelated to cystic fibrosis. Methods We are conducting a bronchiectasis exacerbation study (BEST, which is a multicentre, randomised, double-blind, double-dummy, placebo-controlled, parallel group trial, in five centres (Brisbane, Perth, Darwin, Melbourne, Auckland. In the component of BEST presented here, 189 children fulfilling inclusion criteria are randomised (allocation-concealed to receive amoxicillin-clavulanic acid (22.5 mg/kg twice daily with placebo-azithromycin; azithromycin (5 mg/kg daily with placebo-amoxicillin-clavulanic acid; or placebo-azithromycin with placebo-amoxicillin-clavulanic acid for 14 days. Clinical data and a paediatric cough-specific quality of life score are obtained at baseline, at the start and resolution of exacerbations, and at day 14. In most children, blood and deep nasal swabs are also collected at the same time points. The primary outcome is the proportion of children whose exacerbations have resolved at day 14. The main secondary outcome is the paediatric cough-specific quality of life score. Other outcomes are time to next exacerbation; requirement for hospitalisation; duration of exacerbation; and spirometry data. Descriptive viral and bacteriological data from nasal samples and blood markers will also be reported. Discussion Effective, evidence-based management

A randomised, double-blind, placebo-controlled, crossover study to assess the efficacy and safety of three dosing schedules of agalsidase alfa enzyme replacement therapy for Fabry disease.

Science.gov (United States)

Hughes, D A; Deegan, P B; Milligan, A; Wright, N; Butler, L H; Jacobs, A; Mehta, A B

2013-07-01

Anecdotal reports suggest that the currently approved dosing interval of agalsidase alfa (0.2 mg/kg/2 weeks) for Fabry disease treatment is too long. This randomised, double-blind, placebo-controlled, crossover study investigated three altered dosing intervals. 18 Fabry patients received three agalsidase alfa dosing schedules, each for four weeks (A: 0.2 mg/kg∗2 weeks, B: 0.1 mg/kg/week, C: 0.2 mg/kg/week). Health state, pain levels, sweat volume and latency and plasma and urinary globotriaosylceramide levels were recorded throughout the study. No significant differences were found among the schedules for the primary efficacy outcome of self-assessed health state, or for pain scores. A trend toward increased sweat volume on QSART testing, and reduced urine globotriaosylceramide concentration were seen with treatment schedule C. Agalsidase alfa was safe and well tolerated with all schedules. In conclusion, the primary analyses did not find weekly infusions of agalsidase alfa to be statistically better than the approved dosing schedule however the data indicates that further studies with more patients over a longer period are required to more accurately determine the optimum dose and schedule. Copyright © 2013 Elsevier Inc. All rights reserved.

Synergy between land use and climate change increases future risk in Amazon forests

OpenAIRE

Le Page, Yannick; Morton, Douglas; Hartin, Corinne; Bond-Lamberty, Ben; Pereira, José Miguel Cardoso; Hurtt, George; Asrar, Ghassem

2017-01-01

Tropical forests have been a permanent feature of the Amazon basin for at least 55 million years, yet climate change and land use threaten the forest’s future over the next century. Understory forest fires, which are common under the current climate in frontier forests, may accelerate Amazon forest losses from climatedriven dieback and deforestation. Far from land use frontiers, scarce fire ignitions and high moisture levels preclude significant burning, yet projected climate and ...

Principal Connection / Amazon and the Whole Teacher

Science.gov (United States)

Hoerr, Thomas R.

2015-01-01

A recent controversy over Amazon's culture has strong implications for the whole child approach, and it offers powerful lessons for principals. A significant difference between the culture of so many businesses today and the culture at good schools is that in good schools, the welfare of the employees is very important. Student success is the…

A Slippery Slope: Children's Perceptions of Their Role in Environmental Preservation in the Peruvian Amazon

Science.gov (United States)

Galeano, Rebecca

2013-01-01

Despite international attention and attempts to preserve the environmental diversity of the Amazon, it is an accepted fact that those who inhabit the forest must be the ones who preserve it. This article presents an analysis of how children in small rural riverine communities along the Amazon understand the importance of environmental preservation…

New species of Microcentrum Scudder, 1862 (Orthoptera: Tettigonioidea: Phaneropteridae) from Amazon rainforest.

Science.gov (United States)

Da Silva Sovano, Rafael S; Cadena-Castañeda, Oscar J

2015-03-26

A regional study is performed for the Amazonian species of the genus Microcentrum Scudder, 1862, its proposed Microcentrum punctifrons Brunner von Wattenwyl, 1891 as nomen dubium n. stat. and two new species are described: Microcentrum amacayacu Cadena-Casteñada, Sovano n. sp. and Microcentrum xavieri Sovano, Cadena-Casteñada n. sp. the Colombian and Brazilian Amazon, respectively. A list and a key to the Amazonian species are also provided, along with a discussion on their distribution, according to endemism areas established to Amazon rainforest.

Land-use and climate change risks in the Amazon and the need of a novel sustainable development paradigm

Science.gov (United States)

Nobre, Carlos A.; Sampaio, Gilvan; Borma, Laura S.; Castilla-Rubio, Juan Carlos; Silva, José S.; Cardoso, Manoel

2016-09-01

For half a century, the process of economic integration of the Amazon has been based on intensive use of renewable and nonrenewable natural resources, which has brought significant basin-wide environmental alterations. The rural development in the Amazonia pushed the agricultural frontier swiftly, resulting in widespread land-cover change, but agriculture in the Amazon has been of low productivity and unsustainable. The loss of biodiversity and continued deforestation will lead to high risks of irreversible change of its tropical forests. It has been established by modeling studies that the Amazon may have two “tipping points,” namely, temperature increase of 4 °C or deforestation exceeding 40% of the forest area. If transgressed, large-scale “savannization” of mostly southern and eastern Amazon may take place. The region has warmed about 1 °C over the last 60 y, and total deforestation is reaching 20% of the forested area. The recent significant reductions in deforestation—80% reduction in the Brazilian Amazon in the last decade—opens up opportunities for a novel sustainable development paradigm for the future of the Amazon. We argue for a new development paradigm—away from only attempting to reconcile maximizing conservation versus intensification of traditional agriculture and expansion of hydropower capacity—in which we research, develop, and scale a high-tech innovation approach that sees the Amazon as a global public good of biological assets that can enable the creation of innovative high-value products, services, and platforms through combining advanced digital, biological, and material technologies of the Fourth Industrial Revolution in progress.

Land-use and climate change risks in the Amazon and the need of a novel sustainable development paradigm

Science.gov (United States)

Nobre, Carlos A.; Sampaio, Gilvan; Borma, Laura S.; Castilla-Rubio, Juan Carlos; Silva, José S.; Cardoso, Manoel

2016-01-01

For half a century, the process of economic integration of the Amazon has been based on intensive use of renewable and nonrenewable natural resources, which has brought significant basin-wide environmental alterations. The rural development in the Amazonia pushed the agricultural frontier swiftly, resulting in widespread land-cover change, but agriculture in the Amazon has been of low productivity and unsustainable. The loss of biodiversity and continued deforestation will lead to high risks of irreversible change of its tropical forests. It has been established by modeling studies that the Amazon may have two “tipping points,” namely, temperature increase of 4 °C or deforestation exceeding 40% of the forest area. If transgressed, large-scale “savannization” of mostly southern and eastern Amazon may take place. The region has warmed about 1 °C over the last 60 y, and total deforestation is reaching 20% of the forested area. The recent significant reductions in deforestation—80% reduction in the Brazilian Amazon in the last decade—opens up opportunities for a novel sustainable development paradigm for the future of the Amazon. We argue for a new development paradigm—away from only attempting to reconcile maximizing conservation versus intensification of traditional agriculture and expansion of hydropower capacity—in which we research, develop, and scale a high-tech innovation approach that sees the Amazon as a global public good of biological assets that can enable the creation of innovative high-value products, services, and platforms through combining advanced digital, biological, and material technologies of the Fourth Industrial Revolution in progress. PMID:27638214

First record of Annonaceae wood for the Neogene of South America, Amazon Basin, Brazil

Directory of Open Access Journals (Sweden)

Emilio Alberto Amaral Soares

Full Text Available ABSTRACT: The relief of the regions of Manaus and Itacoatiara, Central Amazon, is supported by Neogene siliciclastic rocks, bounded at the base and top by lateritic paleosols and covered by quaternary sedimentary deposits from the Solimões-Amazon river system. This unit is informally assigned to the Novo Remanso Formation, consists of usually reddish and ferruginized sandstones, conglomerates and pelites, with few identified fossil records, a fact that has hindered its stratigraphic position, and the paleoenvironmental reconstruction of the last phase of the Amazon Basin settling. This study describes, for the first time, the occurrence of fossil wood in outcroppings of the left bank of the Amazon River, where anatomical and morphological data has enabled its characterization to the species level. Thus, the data marks the record of the Annonaceae in South America, as well as the depositional processes related to incorporation of organic material in the sandy layer and the fossilization processes that allowed its preservation. In an unprecedented way, this study has described Duguetiaxylon amazonicum nov. gen and sp. and provided information on the anatomical and systematic character, as well as data on plant-insect interaction, and a better understanding of the family.

Placentation in dolphins from the Amazon River Basin

DEFF Research Database (Denmark)

da Silva, Vera M F; Carter, Anthony M; Ambrosio, Carlos E

2007-01-01

A recent reassessment of the phylogenetic affinities of cetaceans makes it timely to compare their placentation with that of the artiodactyls. We studied the placentae of two sympatric species of dolphin from the Amazon River Basin, representing two distinct families. The umbilical cord branched ...

Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial.

Science.gov (United States)

Chan, Francis K L; Ching, Jessica Y L; Tse, Yee Kit; Lam, Kelvin; Wong, Grace L H; Ng, Siew C; Lee, Vivian; Au, Kim W L; Cheong, Pui Kuan; Suen, Bing Y; Chan, Heyson; Kee, Ka Man; Lo, Angeline; Wong, Vincent W S; Wu, Justin C Y; Kyaw, Moe H

2017-06-17

Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin. After ulcer healing, an independent staff member randomly assigned (1:1) patients who were negative for Helicobacter pylori with a computer-generated list of random numbers to receive oral administrations of either celecoxib 100 mg twice per day plus esomeprazole 20 mg once per day or naproxen 500 mg twice per day plus esomeprazole 20 mg once per day for 18 months. All patients resumed aspirin 80 mg once per day. Both patients and investigators were masked to their treatments. The primary endpoint was recurrent upper gastrointestinal bleeding within 18 months. The primary endpoint and secondary safety endpoints were analysed in the modified intention-to-treat population. This study was registered with ClinicalTrials.gov, number NCT00153660. Between May 24, 2005, and Nov 28, 2012, we enrolled 514 patients, assigning 257 patients to each study group, all of whom were included in the intention-to-treat population. Recurrent upper gastrointestinal bleeding occurred in 14 patients in the celecoxib group (nine gastric ulcers and five duodenal ulcers) and 31 patients in the naproxen group (25 gastric ulcers, three duodenal ulcers, one gastric ulcer and duodenal ulcer, and two bleeding erosions). The cumulative incidence of recurrent bleeding in 18 months

Atmospheric mercury concentrations in the basin of the amazon, Brazil.

Science.gov (United States)

Hachiya, N; Takizawa, Y; Hisamatsu, S; Abe, T; Abe, Y; Motohashi, Y

1998-01-01

A wide regional mercury pollution in Amazon, Brazil is closely associated with goldmining that has been carried out in the basin of tributaries of the Amazon since the eighteenth century. Possible involvement has been discussed on atmospheric circulation in distributing the volatile pollutant. We developed a portable air sampler for the collection of mercury compounds and determined atmospheric mercury concentrations at several sites in Brazil including the basin of the Amazon tributaries. The mean concentration of total mercury was between 9.1 and 14.0 ng/m(3) in the basin of the Uatumã River located in the tropical rain forest far from goldmining sites and from urbanized area. These mercury levels exceeded the background level previously reported in rural area and, furthermore, were higher than concentrations observed in Rio de Janeiro and in Manaus that were compatible with the reference values for urban area. Mercury concentrations were also determined in gold refineries in the basin of the Tapajos River, and detected at a significant but not a health deteriorating level. Although only preliminary data were available, the present observations were in favor of the hypothesis that mercury is distributed widely by long distant transport by the atmospheric circulation after released at gold mining sites.

The complexity of amazon culture and its repercussions on the organization and representation of information

Directory of Open Access Journals (Sweden)

Anderson Luiz Cardoso Rodrigues

2012-11-01

Full Text Available Introduction: It explores and analyzes the ‘Amazon culture’ domain in the context of organization and information representation. It presents concepts of culture in order to support reflections about the studied domain. Method: The supporting theoretical reference is focused on the Ranganathan’s Faceted Classification Theory and on the Theory of Integrated Levels from the Classification Research Group, as theoretical-methodological basis to build a classificatory structure model. The selection of concepts took place based on the terms resulted from an oral research in three geographical cities of Amazon: Bragança, Castanhal and Marajó archipelago. Results: The analysis of etymological origins of the words indicated the influence of foreign culture from the European, African, Asiatic and American continents in the Amazon language. Conclusions: The analysis of those results showed the feasibility of developing a working methodology in order to outline a classification structure and a set of concepts to represent the ‘Amazon culture’ domain in its fundamental roots as a basis for the building of organizing systems of knowledge.

Land Use Dynamics in the Brazilian Amazon

Science.gov (United States)

Robert Walker

1996-01-01

The articles presented in this special issue of Ecological Economics address the important theme of land use dynamics as it pertains to the Brazilian Amazon. Much environmental change is an ecological artifact of human agency, and such agency is often manifested in land use impacts, particularly in tropical areas. The critical problem of tropical deforestation is but...

Efficacy and cost-effectiveness of a physiotherapy program for chronic rotator cuff pathology: A protocol for a randomised, double-blind, placebo-controlled trial

Science.gov (United States)

Bennell, Kim; Coburn, Sally; Wee, Elin; Green, Sally; Harris, Anthony; Forbes, Andrew; Buchbinder, Rachelle

2007-01-01

Background Chronic rotator cuff pathology (CRCP) is a common shoulder condition causing pain and disability. Physiotherapy is often the first line of management for CRCP yet there is little conclusive evidence to support or refute its effectiveness and no formal evaluation of its cost-effectiveness. Methods/Design This randomised, double-blind, placebo-controlled trial will involve 200 participants with CRCP recruited from medical practices, outpatient departments and the community via print and radio media. Participants will be randomly allocated to a physiotherapy or placebo group using concealed allocation stratified by treating physiotherapist. Both groups will receive 10 sessions of individual standardised treatment over 10 weeks from one of 10 project physiotherapists. For the following 12 weeks, the physiotherapy group will continue a home exercise program and the placebo group will receive no treatment. The physiotherapy program will comprise shoulder joint and spinal mobilisation, soft tissue massage, postural taping, and home exercises for scapular control, posture and rotator cuff strengthening. The placebo group will receive inactive ultrasound and gentle application of an inert gel over the shoulder region. Blinded assessment will be conducted at baseline and at 10 weeks and 22 weeks after randomisation. The primary outcome measures are self reported questionnaires including the shoulder pain and disability index (SPADI), average pain on an 11-point numeric rating scale and participant perceived global rating of change. Secondary measures include Medical Outcomes Study 36-item short form (SF-36), Assessment of Quality of Life index, numeric rating scales for shoulder pain and stiffness, participant perceived rating of change for pain, strength and stiffness, and manual muscle testing for shoulder strength using a handheld dynamometer. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log

Efficacy and cost-effectiveness of a physiotherapy program for chronic rotator cuff pathology: A protocol for a randomised, double-blind, placebo-controlled trial

Directory of Open Access Journals (Sweden)

Harris Anthony

2007-08-01

Full Text Available Abstract Background Chronic rotator cuff pathology (CRCP is a common shoulder condition causing pain and disability. Physiotherapy is often the first line of management for CRCP yet there is little conclusive evidence to support or refute its effectiveness and no formal evaluation of its cost-effectiveness. Methods/Design This randomised, double-blind, placebo-controlled trial will involve 200 participants with CRCP recruited from medical practices, outpatient departments and the community via print and radio media. Participants will be randomly allocated to a physiotherapy or placebo group using concealed allocation stratified by treating physiotherapist. Both groups will receive 10 sessions of individual standardised treatment over 10 weeks from one of 10 project physiotherapists. For the following 12 weeks, the physiotherapy group will continue a home exercise program and the placebo group will receive no treatment. The physiotherapy program will comprise shoulder joint and spinal mobilisation, soft tissue massage, postural taping, and home exercises for scapular control, posture and rotator cuff strengthening. The placebo group will receive inactive ultrasound and gentle application of an inert gel over the shoulder region. Blinded assessment will be conducted at baseline and at 10 weeks and 22 weeks after randomisation. The primary outcome measures are self reported questionnaires including the shoulder pain and disability index (SPADI, average pain on an 11-point numeric rating scale and participant perceived global rating of change. Secondary measures include Medical Outcomes Study 36-item short form (SF-36, Assessment of Quality of Life index, numeric rating scales for shoulder pain and stiffness, participant perceived rating of change for pain, strength and stiffness, and manual muscle testing for shoulder strength using a handheld dynamometer. To evaluate cost-effectiveness, participants will record the use of all health

Impact on caesarean section rates following injections of sterile water (ICARIS): a multicentre randomised controlled trial.

Science.gov (United States)

Lee, Nigel; Mårtensson, Lena B; Homer, Caroline; Webster, Joan; Gibbons, Kristen; Stapleton, Helen; Dos Santos, Natalie; Beckmann, Michael; Gao, Yu; Kildea, Sue

2013-05-03

Sterile water injections have been used as an effective intervention for the management of back pain during labour. The objective of the current research is to determine if sterile water injections, as an intervention for back pain in labour, will reduce the intrapartum caesarean section rate. A double blind randomised placebo controlled trialSetting: Maternity hospitals in AustraliaParticipants: 1866 women in labour, ≥18 years of age who have a singleton pregnancy with a fetus in a cephalic presentation at term (between 37 + 0 and 41 + 6 weeks gestation), who assess their back pain as equal to or greater than seven on a visual analogue scale when requesting analgesia and able to provide informed consent. Participants will be randomised to receive either 0.1 to 0.3 millilitres of sterile water or a normal saline placebo via four intradermal injections into four anatomical points surrounding the Michaelis' rhomboid over the sacral area. Two injections will be administered over the posterior superior iliac spine (PSIS) and the remaining two at two centimetres posterior, and one centimetre medial to the PSIS respectively. Proportion of women who have a caesarean section in labour.Randomisation: Permuted blocks stratified by research site.Blinding (masking):Double-blind trial in which participants, clinicians and research staff blinded to group assignment. Funded by the National Health and Medical Research CouncilTrial registration:Australian New Zealand Clinical Trials Registry (No ACTRN12611000221954). Sterile water injections, which may have a positive effect on reducing the CS rate, have been shown to be a safe and simple analgesic suitable for most maternity settings. A procedure that could reduce intervention rates without adversely affecting safety for mother and baby would benefit Australian families and taxpayers and would reduce requirements for maternal operating theatre time. Results will have external validity, as the technique may be easily applied to

Deforestation in the Brazilian Amazon: A Classroom Project.

Science.gov (United States)

Nijman, Jan; Hill, A. David

1991-01-01

Presents a classroom project dealing with tropical deforestation in the Brazilian Amazon. Addresses environmental consequences and economic, social, and political causes. Involves both lectures and individual research and reports by student groups on deforestation causes. Includes a note-playing activity in which students make recommendations for…

Binocular treatment of amblyopia using videogames (BRAVO): study protocol for a randomised controlled trial.

Science.gov (United States)

Guo, Cindy X; Babu, Raiju J; Black, Joanna M; Bobier, William R; Lam, Carly S Y; Dai, Shuan; Gao, Tina Y; Hess, Robert F; Jenkins, Michelle; Jiang, Yannan; Kowal, Lionel; Parag, Varsha; South, Jayshree; Staffieri, Sandra Elfride; Walker, Natalie; Wadham, Angela; Thompson, Benjamin

2016-10-18

Amblyopia is a common neurodevelopmental disorder of vision that is characterised by visual impairment in one eye and compromised binocular visual function. Existing evidence-based treatments for children include patching the nonamblyopic eye to encourage use of the amblyopic eye. Currently there are no widely accepted treatments available for adults with amblyopia. The aim of this trial is to assess the efficacy of a new binocular, videogame-based treatment for amblyopia in older children and adults. We hypothesise that binocular treatment will significantly improve amblyopic eye visual acuity relative to placebo treatment. The BRAVO study is a double-blind, randomised, placebo-controlled multicentre trial to assess the effectiveness of a novel videogame-based binocular treatment for amblyopia. One hundred and eight participants aged 7 years or older with anisometropic and/or strabismic amblyopia (defined as ≥0.2 LogMAR interocular visual acuity difference, ≥0.3 LogMAR amblyopic eye visual acuity and no ocular disease) will be recruited via ophthalmologists, optometrists, clinical record searches and public advertisements at five sites in New Zealand, Canada, Hong Kong and Australia. Eligible participants will be randomised by computer in a 1:1 ratio, with stratification by age group: 7-12, 13-17 and 18 years and older. Participants will be randomised to receive 6 weeks of active or placebo home-based binocular treatment. Treatment will be in the form of a modified interactive falling-blocks game, implemented on a 5th generation iPod touch device viewed through red/green anaglyphic glasses. Participants and those assessing outcomes will be blinded to group assignment. The primary outcome is the change in best-corrected distance visual acuity in the amblyopic eye from baseline to 6 weeks post randomisation. Secondary outcomes include distance and near visual acuity, stereopsis, interocular suppression, angle of strabismus (where applicable) measured at

Nuclear analytical techniques applied to characterization of atmospheric aerosols in Amazon Region

International Nuclear Information System (INIS)

Gerab, Fabio; Artaxo, Paulo

1996-01-01

This work presents the atmospheric aerosols characterization that exist in different regions of Amazon basin. The biogenic aerosol emission by forest, as well as the atmospheric emissions of particulate materials due to biomass burning, were analyzed. Samples of aerosol particles were collected during three years in two different locations of Amazon region using Stacked Unit Filters. In order to study these samples some analytical nuclear techniques were used. The high concentrations of aerosols as a result of biomass burning process were observed in the period of june-september

The fate of particle-reactive radionuclides on the Amazon and Yangtze continental shelves

International Nuclear Information System (INIS)

McKee, B.A.

1986-01-01

Water column and seabed samples collected from the continental shelves adjacent to the Yangtze and Amazon Rivers were analyzed for particle-reactive radionuclides ( 234 Th, 228 Th, 210 Pb), and their respective parent nuclides ( 238 U, 228 Ra, 226 Ra). On the Amazon shelf, dissolved 238 U activities increase with increasing salinity to a shelf maximum (4.6 dpm 1 -1 ) that is much higher than the open-ocean value (2.5 dpm 1 -1 ) because uranium is desorbed from the ferric-oxyhydroxide coatings of bottom sediments and advected into the overlying water column during periodic resuspension events. As a result, measurement of only the riverine flux of dissolved 238 U underestimates (by a factor of 5) the flux of dissolved uranium from the Amazon shelf to the open ocean. K e values decrease with increased SSC and range from 10 5 ·10 6 ml g -1 for Th and from 10 4 ·10 6 ml g -1 for Po and Pb. The approach to equilibrium can best be described as a two-step process that is initially rapid (rate constants: 10-100 d -1 , during the first 30 minutes), but becomes less rapid (rate constants: 1-4 d -1 ) as equilibrium is attained. Distribution coefficients for 234 Th, 228 Th and 210 Pb exhibit large spatial variability on the Amazon shelf (range: 10 3 - 10 6 ml g -1 ) and on the Yangtze shelf (range: 10 4 - 10 6 ml g -1 ). On the Amazon shelf, particle residence time is short (2-3 hours) relative to scavenging residence time (15-20 hours) therefore, only 1-31% of equilibrium between dissolved and particulate thorium is attained. On the Yangtze shelf, particle residence time is long (12-89 hours) relative to scavenging time (2-23 hours) resulting in K d values near (97-100%) equilibrium

Applying NASA Imaging Radar Datasets to Investigate the Geomorphology of the Amazon's Planalto

Science.gov (United States)

McDonald, K. C.; Campbell, K.; Islam, R.; Alexander, P. M.; Cracraft, J.

2016-12-01

The Amazon basin is a biodiversity rich biome and plays a significant role into shaping Earth's climate, ocean and atmospheric gases. Understanding the history of the formation of this basin is essential to our understanding of the region's biodiversity and its response to climate change. During March 2013, the NASA/JPL L-band polarimetric airborne imaging radar, UAVSAR, conducted airborne studies over regions of South America including portions of the western Amazon basin. We utilize UAVSAR imagery acquired during that time over the Planalto, in the Madre de Dios region of southeastern Peru in an assessment of the underlying geomorphology, its relationship to the current distribution of vegetation, and its relationship to geologic processes through deep time. We employ UAVSAR data collections to assess the utility of these high quality imaging radar data for use in identifying geomorphologic features and vegetation communities within the context of improving the understanding of evolutionary processes, and their utility in aiding interpretation of datasets from Earth-orbiting satellites to support a basin-wide characterization across the Amazon. We derive maps of landcover and river branching structure from UAVSAR imagery. We compare these maps to those derived using imaging radar datasets from the Japanese Space Agency's ALOS PALSAR and Digital Elevation Models (DEMs) from NASA's Shuttle Radar Topography Mission (SRTM). Results provide an understanding of the underlying geomorphology of the Amazon planalto as well as its relationship to geologic processes and will support interpretation of the evolutionary history of the Amazon Basin. Portions of this work have been carried out within the framework of the ALOS Kyoto & Carbon Initiative. PALSAR data were provided by JAXA/EORC and the Alaska Satellite Facility.This work is carried out with support from the NASA Biodiversity Program and the NSF DIMENSIONS of Biodiversity Program.

A phase III double-blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis

International Nuclear Information System (INIS)

O'Brien, Peter C.; Franklin, C. Ian; Dear, Keith B.G.; Hamilton, Christopher C.; Poulsen, Michael; Joseph, David J.; Spry, Nigel; Denham, James W.

1997-01-01

Background and purpose: A limited number of studies have suggested that oral sucralfate reduces the acute and late gastro-intestinal side-effects of pelvic radiotherapy and sucralfate enemas ameliorate symptoms of chronic proctitis. Sucralfate may act via local bFGF at the mucosal level in promoting angiogenesis and reducing epithelial associated microvascular injury. This multi-institutional study was designed to test the hypothesis that sucralfate given as an enema would have a significant protective effect against acute radiation induced rectal injury by direct application to the mucosa. Materials and methods: Eighty-six patients having radiotherapy for localised carcinoma of the prostate were randomised in a double-blind placebo-controlled study to receive either 15 ml of placebo suspension or 3 g of sucralfate in 15 ml suspension, given as a once daily enema during and for 2 weeks following radiotherapy. Assessment was based on the EORTC/RTOG acute toxicity criteria and a patient self-assessment diary. Results: There was no significant difference between placebo and sucralfate for peak incidences of EORTC/RTOG proctitis. For the placebo and sucralfate arms 95 and 88% (difference 7 ± 11%) suffered some degree of proctitis, with 71 and 61% (difference 10 ± 19%) reaching grade 2, respectively. The median period to onset of grade 2 proctitis was 33.5 and 36 days, with the median duration being 9.5 and 15 days, respectively, again these difference being non-significant. Thirty-five and 37% of patients rated the effect of radiotherapy on bowel habit as 'a lot' with a moderate or severe effect on normal daily living in 52 and 49%, respectively. Conclusion: This study suggests that sucralfate given as a once daily enema does not substantially reduce the incidence of symptoms associated with acute radiation proctitis and its routine clinical use cannot be recommended. This cohort of patients will be followed to determine if any difference develops in relation to late

Water stress detection in the Amazon using radar

Science.gov (United States)

van Emmerik, Tim; Steele-Dunne, Susan; Paget, Aaron; Oliveira, Rafael S.; Bittencourt, Paulo R. L.; Barros, Fernanda de V.; van de Giesen, Nick

2017-07-01

The Amazon rainforest plays an important role in the global water and carbon cycle, and though it is predicted to continue drying in the future, the effect of drought remains uncertain. Developments in remote sensing missions now facilitate large-scale observations. The RapidScat scatterometer (Ku band) mounted on the International Space Station observes the Earth in a non-Sun-synchronous orbit, which allows for studying changes in the diurnal cycle of radar backscatter over the Amazon. Diurnal cycles in backscatter are significantly affected by the state of the canopy, especially during periods of increased water stress. We use RapidScat backscatter time series and water deficit measurements from dendrometers in 20 trees during a 9 month period to relate variations in backscatter to increased tree water deficit. Morning radar bacskcatter dropped significantly with increased tree water deficit measured with dendrometers. This provides unique observational evidence that demonstrates the sensitivity of radar backscatter to vegetation water stress, highlighting the potential of drought detection and monitoring using radar.

Highly reactive light-dependent monoterpenes in the Amazon

Science.gov (United States)

Jardine, A. B.; Jardine, K. J.; Fuentes, J. D.; Martin, S. T.; Martins, G.; Durgante, F.; Carneiro, V.; Higuchi, N.; Manzi, A. O.; Chambers, J. Q.

2015-03-01

Despite orders of magnitude difference in atmospheric reactivity and great diversity in biological functioning, little is known about monoterpene speciation in tropical forests. Here we report vertically resolved ambient air mixing ratios for 12 monoterpenes in a central Amazon rainforest including observations of the highly reactive cis-β-ocimene (160 ppt), trans-β-ocimene (79 ppt), and terpinolene (32 ppt) which accounted for an estimated 21% of total monoterpene composition yet 55% of the upper canopy monoterpene ozonolysis rate. All 12 monoterpenes showed a mixing ratio peak in the upper canopy, with three demonstrating subcanopy peaks in 7 of 11 profiles. Leaf level emissions of highly reactive monoterpenes accounted for up to 1.9% of photosynthesis confirming light-dependent emissions across several Amazon tree genera. These results suggest that highly reactive monoterpenes play important antioxidant roles during photosynthesis in plants and serve as near-canopy sources of secondary organic aerosol precursors through atmospheric photooxidation via ozonolysis.

Weather forecasting for Eastern Amazon with OLAM model

Directory of Open Access Journals (Sweden)

Renato Ramos da Silva

2014-12-01

Full Text Available The OLAM model has as its characteristics the advantage to represent simultaneously the global and regional meteorological phenomena using the application of a grid refinement scheme. During the REMAM project the model was applied for a few case studies to evaluate its performance on numerical weather prediction for the eastern Amazon region. Case studies were performed for the twelve months of the year of 2009. The model results for those numerical experiments were compared with the observed data for the region of study. Precipitation data analysis showed that OLAM is able to represent the average mean accumulated precipitation and the seasonal features of the events occurrence, but can't predict the local total amount of precipitation. However, individual evaluation for a few cases had shown that OLAM was able to represent the dynamics and forecast a few days in advance the development of coastal meteorological systems such as the squall lines that are one of the most important precipitating systems of the Amazon.

Tasimelteon for non-24-hour sleep-wake disorder in totally blind people (SET and RESET): two multicentre, randomised, double-masked, placebo-controlled phase 3 trials.

Science.gov (United States)

Lockley, Steven W; Dressman, Marlene A; Licamele, Louis; Xiao, Changfu; Fisher, Dennis M; Flynn-Evans, Erin E; Hull, Joseph T; Torres, Rosarelis; Lavedan, Christian; Polymeropoulos, Mihael H

2015-10-31

Most totally blind people have non-24-hour sleep-wake disorder (non-24), a rare circadian rhythm disorder caused by an inability of light to reset their circadian pacemaker. In two consecutive placebo-controlled trials (SET and RESET), we assessed safety and efficacy (in terms of circadian entrainment and maintenance) of once-daily tasimelteon, a novel dual-melatonin receptor agonist. We undertook the placebo-controlled, randomised, double-masked trials in 27 US and six German clinical research centres and sleep centres. We screened totally blind adults (18-75 years of age), who were eligible for the randomisation phase of SET if they had a non-24-hour circadian period (τ) of 24·25 h or longer (95% CI greater than 24·0 and up to 24·9 h), as calculated from measurements of urinary 6-sulphatoxymelatonin rhythms. For SET, we used block randomisation to assign patients (1:1) to receive tasimelteon (20 mg) or placebo every 24 h at a fixed clock time 1 h before target bedtime for 26 weeks. Patients who entered the open-label group receiving tasimelteon in SET or who did not meet the SET inclusion criteria but did meet the RESET inclusion criteria were screened for RESET. A subset of the patients who entered the open-label group before the RESET study and who had eligible τ values were screened for RESET after completing the open-label treatment. In RESET, we withdrew tasimelteon in a randomised manner (1:1) in patients who responded (ie, entrained) after a tasimelteon run-in period. Entrainment was defined as having τ of 24·1 h or less and a 95% CI that included 24·0 h. In SET, the primary endpoint was the proportion of entrained patients, assessed in the intention-to-treat population. The planned step-down primary endpoint assessed the proportion of patients who had a clinical response (entrainment at month 1 or month 7 plus clinical improvement, measured by the Non-24 Clinical Response Scale). In RESET, the primary endpoint was the proportion of non

Vorinostat in patients with advanced malignant pleural mesothelioma who have progressed on previous chemotherapy (VANTAGE-014): a phase 3, double-blind, randomised, placebo-controlled trial.

Science.gov (United States)

Krug, Lee M; Kindler, Hedy L; Calvert, Hilary; Manegold, Christian; Tsao, Anne S; Fennell, Dean; Öhman, Ronny; Plummer, Ruth; Eberhardt, Wilfried E E; Fukuoka, Kazuya; Gaafar, Rabab M; Lafitte, Jean-Jacques; Hillerdal, Gunnar; Chu, Quincy; Buikhuisen, Wieneke A; Lubiniecki, Gregory M; Sun, Xing; Smith, Margaret; Baas, Paul

2015-04-01

Vorinostat is a histone deacetylase inhibitor that changes gene expression and protein activity. On the basis of the clinical benefit reported in patients with malignant pleural mesothelioma treated in a phase 1 study of vorinostat, we designed this phase 3 trial to investigate whether vorinostat given as a second-line or third-line therapy improved patients' overall survival. This double-blind, randomised, placebo-controlled trial was done in 90 international centres. Patients with measurable advanced malignant pleural mesothelioma and disease progression after one or two previous systemic regimens were eligible. After stratification for Karnofsky performance status, histology, and number of previous chemotherapy regimens, patients were randomly assigned (1:1) by use of an interactive voice response system with a block size of four to either treatment with vorinostat or placebo. Patients received oral vorinostat 300 mg (or matching placebo) twice daily on days 1, 2, 3, 8, 9, 10, 15, 16, and 17 of a 21-day cycle. The primary endpoints were overall survival and safety and tolerability of vorinostat. The primary efficacy comparison was done in the intention-to-treat population, and safety and tolerability was assessed in the treated population. This trial is registered with ClinicalTrials.gov, number NCT00128102. From July 12, 2005, to Feb 14, 2011, 661 patients were enrolled and randomly assigned to receive either vorinostat (n=329) or placebo (n=332) and included in the intention-to-treat analysis. Median overall survival for vorinostat was 30·7 weeks (95% CI 26·7-36·1) versus 27·1 weeks (23·1-31·9) for placebo (hazard ratio 0·98, 95% CI 0·83-1·17, p=0·86). The most common grade 3 or worse adverse events for patients treated with vorinostat were fatigue or malaise (51 [16%] patients in the vorinostat group vs 25 [8%] in the placebo group]) and dyspnoea (35 [11%] vs 45 [14%]). In this randomised trial, vorinostat given as a second-line or third

Patterns of geographic expansion of Aedes aegypti in the Peruvian Amazon.

Directory of Open Access Journals (Sweden)

Sarah Anne Guagliardo

2014-08-01

Full Text Available In the Peruvian Amazon, the dengue vector Aedes aegypti is abundant in large urban centers such as Iquitos. In recent years, it has also been found in a number of neighboring rural communities with similar climatic and socioeconomic conditions. To better understand Ae. aegypti spread, we compared characteristics of communities, houses, and containers in infested and uninfested communities.We conducted pupal-demographic surveys and deployed ovitraps in 34 communities surrounding the city of Iquitos. Communities surveyed were located along two transects: the Amazon River and a 95 km highway. We calculated entomological indices, mapped Ae. aegypti presence, and developed univariable and multivariable logistic regression models to predict Ae. aegypti presence at the community, household, or container level.Large communities closer to Iquitos were more likely to be infested with Ae. aegypti. Within infested communities, houses with Ae. aegypti had more passively-filled containers and were more often infested with other mosquito genera than houses without Ae. aegypti. For containers, large water tanks/drums and containers with solar exposure were more likely to be infested with Ae. aegypti. Maps of Ae. aegypti presence revealed a linear pattern of infestation along the highway, and a scattered pattern along the Amazon River. We also identified the geographical limit of Ae. aegypti expansion along the highway at 19.3 km south of Iquitos.In the Peruvian Amazon, Ae. aegypti geographic spread is driven by human transportation networks along rivers and highways. Our results suggest that urban development and oviposition site availability drive Ae. aegypti colonization along roads. Along rivers, boat traffic is likely to drive long-distance dispersal via unintentional transport of mosquitoes on boats.

The effects of an oral multivatimin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind placebo-controlled trial.

NARCIS (Netherlands)

Carroll, D.; Ring, C.; Suter, M.; Willemsen, A.H.M.

2000-01-01

Rationale: Vitamin and mineral supplements may be associated with improved psychological status. Objective: The present study tested the effects of a multivitamin and mineral supplement (Berocca®) on psychological well-being. Methods: In a double-blind randomised-control trial, 80 healthy male

A vicious circle of fire, deforestation and climate change: an integrative study for the Amazon region

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Thonicke, K.; Rammig, A.; Gumpenberger, M.; Vohland, K.; Poulter, B.; Cramer, W.

2009-04-01

The Amazon rainforest is threatened by deforestation due to wood extraction and agricultural production leading to increasing forest fragmentation and forest degradation. These changes in land surface characteristics and water fluxes are expected to further reduce convective precipitation. Under future climate change the stability of the Amazon rainforest is likely to decrease thus leading to forest dieback (savannization) or forest degradation (secondarization). This puts the Amazon rainforest at risk to reduce the generation of precipitation, to act as a carbon sink and biodiversity hotspot. Fires increased in the past during drought years and in open vegetation thereby further accelerating forest degradation. Deforestation as a result of socioeconomic development in the Amazon basin is projected to further increase in the 21st century and brings climate-induced changes forward. Combined effects of deforestation vs. climate change on the stability of the Amazon rainforest and the role of fire in this system need to be quantified in an integrated study. We present simulation results from future climate (AR4) and deforestation (SimAmazon) experiments using the LPJmL-SPITFIRE vegetation model. Land use change is the main driving factor of forest degradation before 2050, whereas extreme climate change scenarios lead to forest degradation by the end of 2100. Forest fires increase with increasing drought conditions during the 21st century. The resulting effects on vegetation secondarization and savannization and their feedbacks on fire spread and emissions will be presented. The effect of wildfires and intentional burning on forest degradation under future climate and socioeconomic change will be discussed, and recommendations for an integrated land use and fire management are given.

A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study.

Science.gov (United States)

Park, Won; Hrycaj, Pawel; Jeka, Slawomir; Kovalenko, Volodymyr; Lysenko, Grygorii; Miranda, Pedro; Mikazane, Helena; Gutierrez-Ureña, Sergio; Lim, MieJin; Lee, Yeon-Ah; Lee, Sang Joon; Kim, HoUng; Yoo, Dae Hyun; Braun, Jürgen

2013-10-01

To compare the pharmacokinetics (PK), safety and efficacy of innovator infliximab (INX) and CT-P13, a biosimilar to INX, in patients with active ankylosing spondylitis (AS). Phase 1 randomised, double-blind, multicentre, multinational, parallel-group study. Patients were randomised to receive 5 mg/kg of CT-P13 (n=125) or INX (n=125). Primary endpoints were area under the concentration-time curve (AUC) at steady state and observed maximum steady state serum concentration (Cmax,ss) between weeks 22 and 30. Additional PK, efficacy endpoints, including 20% and 40% improvement response according to Assessment in Ankylosing Spondylitis International Working Group criteria (ASAS20 and ASAS40), and safety outcomes were also assessed. Geometric mean AUC was 32 765.8 μgh/ml for CT-P13 and 31 359.3 μgh/ml for INX. Geometric mean Cmax,ss was 147.0 μg/ml for CT-P13 and 144.8 μg/ml for INX. The ratio of geometric means was 104.5% (90% CI 94% to 116%) for AUC and 101.5% (90% CI 95% to 109%) for Cmax,ss. ASAS20 and ASAS40 responses at week 30 were 70.5% and 51.8% for CT-P13 and 72.4% and 47.4% for INX, respectively. In the CT-P13 and INX groups more than one adverse event occurred in 64.8% and 63.9% of patients, infusion reactions occurred in 3.9% and 4.9%, active tuberculosis occurred in 1.6% and 0.8%, and 27.4% and 22.5% of patients tested positive for anti-drug antibodies, respectively. The PK profiles of CT-P13 and INX were equivalent in patients with active AS. CT-P13 was well tolerated, with an efficacy and safety profile comparable to that of INX up to week 30.

Closed-loop double-vasopressor automated system vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean section: a randomised controlled trial.

Science.gov (United States)

Sng, B L; Tan, H S; Sia, A T H

2014-01-01

Hypotension necessitating vasopressor administration occurs commonly during caesarean section under spinal anaesthesia. We developed a novel vasopressor delivery system that automatically administers phenylephrine or ephedrine based on continuous non-invasive arterial pressure monitoring. A phenylephrine bolus of 50 μg was given at 30-s intervals when systolic blood pressure fell manual boluses of either phenylephrine 100 μg or ephedrine 8 mg, administered at 1-min intervals based on the same thresholds for systolic pressure and heart rate. This randomised, controlled, double-blinded trial involved 213 healthy women who underwent elective caesarean delivery under spinal anaesthesia using 11 mg hyperbaric bupivacaine with 15 μg fentanyl and 100 μg morphine. The automated vasopressor group had better systolic pressure control, with 37/106 (34.9%) having any beat-to-beat systolic pressure reading 120% of baseline, with 8/106 (7.5%) in the automated vasopressor group vs 14/107 (13.1%) in the control group, or total dose of vasopressors. The automated vasopressor group had lower median absolute performance error of 8.5% vs control of 9.8% (p = 0.013), and reduced incidence of nausea (1/106 (0.9%) vs 11/107 (10.3%), p = 0.005). Neonatal umbilical cord pH, umbilical lactate and Apgar scores were similar. Hence, our system afforded better control of maternal blood pressure and reduced nausea with no increase in reactive hypertension when compared with manual boluses. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Environmental considerations in energy planning for the Amazon region: Downstream effects of dams

International Nuclear Information System (INIS)

Manyari, Waleska Valenca; de Carvalho, Osmar Abilio

2007-01-01

The most salient current feature of the electric energy sector in Brazil is the pressing need for expansion. In this context, the hydroelectric resources of the Amazon region are considered a competitive alternative despite the structural problems they entail. These include reliance of new investments and environmental restrictions. Concerning the latter, plans to build large-scale dams in the region have drawn criticism mainly on account of the loss of forest cover in areas flooded by dam reservoirs and the conflicts concerning the relocation of indigenous and riverside communities in the region. This article seeks to contribute to better understanding of the environmental issue in the Amazon by focusing attention on the downstream effects of dams, which have large-scale, hitherto neglected ecological repercussions. The impact of dams extends well beyond the area surrounding the artificial lakes they create, harming rich Amazon wetland ecosystems. The morphology of dammed rivers changes in response to new inputs of energy and matter, which may in turn destroy certain biotopes. This is a remote-sensing-based case study of the Tucurui hydroelectric scheme in the Amazon state of Para. Attention is drawn to the need to take into account effects on alluvial rivers downstream from hydroelectric power plants when it comes to making planning decisions, as part of a sustainable energy policy

The Pulse of the Amazon

Science.gov (United States)

Spencer, R. G.; Moura, J. M. S.; Mitsuya, M.; Peucker-Ehrenbrink, B.; Holmes, R. M.; Galy, V.; Drake, T.

2017-12-01

Rivers integrate over a fixed and definable area (the watershed), with their discharge and chemistry at any given point a function of upstream processes. As a consequence, examination of riverine discharge and chemistry can provide powerful indictors of change within a watershed. To assess the validity of this approach long-term datasets are required from fluvial environments around the globe. The Amazon River delivers one-fifth of the total freshwater discharged to the ocean and so represents a fundamentally important site for examination of long-term major ion, trace element, nutrient, and organic matter (OM) export. Here we describe data from a multi-year, monthly sampling campaign of the Amazon River at Obidos (Para, Brazil). Clear seasonality in all analyte fluxes is apparent and is linked to hydrology, however dissolved OM composition appears dominated by allochthonous sources throughout the year as evidenced by optical parameters indicative of high molecular weight and high relative aromatic content. Annual loads of some analytes for 2011-2013 inclusive varied by up to 50%, highlighting significant variability in flux from year to year that was linked to inter-annual hydrologic shifts (i.e. higher fluxes in wetter years). Finally, encompassing both intra- and inter-annual variability, a robust correlation was observed between chromophoric dissolved OM (CDOM) absorbance and dissolved organic carbon (DOC) concentration highlighting the potential to improve DOC flux estimates at this globally significant site via CDOM measurements from in situ technologies or remote sensing techniques.

A user experience evaluation of Amazon Kindle mobile application

Science.gov (United States)

Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Musa, Ja'afaru; Mortada, Salah

2017-10-01

There is a dramatic increase in the development of mobile applications in recent years. This makes the usability evaluation of these mobile applications an important aspect in the advancement and application of technology. In this paper, a laboratory-based usability evaluation was carried out on the Amazon Kindle app using 15 users who performed 5 tasks on the Kindle e-book mobile app. A post-test questionnaire was administered to elicit users' perception on the usability of the application. The results demonstrate that almost all the participants were satisfied with services provided by the Amazon Kindle e-book mobile app. On all the four user experience factors examined, namely, perceived ease-of-use, perceived visibility, perceived enjoyabilty, and perceived efficiency, the evaluation outcome shows that the participants had a good and rich mobile experience with the application.

Origin, transport and deposition of leaf-wax biomarkers in the Amazon Basin and the adjacent Atlantic

Science.gov (United States)

Häggi, Christoph; Sawakuchi, André O.; Chiessi, Cristiano M.; Mulitza, Stefan; Mollenhauer, Gesine; Sawakuchi, Henrique O.; Baker, Paul A.; Zabel, Matthias; Schefuß, Enno

2016-11-01

Paleoenvironmental studies based on terrigenous biomarker proxies from sediment cores collected close to the mouth of large river systems rely on a proper understanding of the processes controlling origin, transport and deposition of biomarkers. Here, we contribute to the understanding of these processes by analyzing long-chain n-alkanes from the Amazon River system. We use the δD composition of long-chain n-alkanes from river bed sediments from the Amazon River and its major tributaries, as well as marine core-top samples collected off northeastern South America as tracers for different source areas. The δ13C composition of the same compounds is used to differentiate between long-chain n-alkanes from modern forest vegetation and petrogenic organic matter. Our δ13C results show depleted δ13C values (-33 to -36‰) in most samples, indicating a modern forest source for most of the samples. Enriched values (-31 to -33‰) are only found in a few samples poor in organic carbon indicating minor contributions from a fossil petrogenic source. Long-chain n-alkane δD analyses show more depleted values for the western tributaries, the Madeira and Solimões Rivers (-152 to -168‰), while n-alkanes from the lowland tributaries, the Negro, Xingu and Tocantins Rivers (-142 to -154‰), yield more enriched values. The n-alkane δD values thus reflect the mean annual isotopic composition of precipitation, which is most deuterium-depleted in the western Amazon Basin and more enriched in the eastern sector of the basin. Samples from the Amazon estuary show a mixed long-chain n-alkane δD signal from both eastern lowland and western tributaries. Marine core-top samples underlying the Amazon freshwater plume yield δD values similar to those from the Amazon estuary, while core-top samples from outside the plume showed more enriched values. Although the variability in the river bed data precludes quantitative assessment of relative contributions, our results indicate that long

Rare models: Roger Casement, the Amazon, and the ethnographic picturesque.

Science.gov (United States)

Wylie, Lesley

2010-01-01

In 1910 Roger Casement was sent by the British government to investigate the alleged humanitarian abuses of the Peruvian Amazon Company in the Putumayo, a disputed border zone in North West Amazonia. Casement brought more than verbal and written testimony back to London. On 26 June, some six months after he returned from the Amazon, Casement collected two Amerindian boys - Omarino and Ricudo - from Southampton docks. This paper will reconstruct the brief period that these young men spent in Britain in the summer of 1911 and assess, in particular, to what extent they were treated as 'exhibits' by Casement, who not only introduced them to leading members of the British establishment but also arranged for them to be painted and photographed following contemporary ethnographic conventions.

Diel variation of larval fish abundance in the Amazon and Rio Negro

Directory of Open Access Journals (Sweden)

ARAUJO-LIMA C. A. R. M.

2001-01-01

Full Text Available Many streams and large rivers present higher ichthyoplankton densities at night. However, in some rivers this does not occur and larvae are equally abundant during the day. Larval drift diel variation is an important information for planning sampling programs for evaluating larval distribution and production. The aim of this study was to test whether the abundance of larval fish was different at either period. We tested it by comparing day and night densities of characiform, clupeiform and siluriform larvae during five years in the Amazon and one year in Rio Negro. We found that larvae of three species of characiform and larvae of siluriform were equally abundant during day and night in the Amazon. Conversely, the catch of Pellona spp. larvae was significantly higher during the day. In Rio Negro, however, larval abundance was higher during the night. These results imply that day samplings estimate adequately the abundance of these characiform and siluriform larvae in the Amazon, but not Pellona larvae. Evaluations of larved densities of Rio Negro will have to consider night sampling.

Diel variation of larval fish abundance in the Amazon and Rio Negro

Directory of Open Access Journals (Sweden)

C. A. R. M. ARAUJO-LIMA

Full Text Available Many streams and large rivers present higher ichthyoplankton densities at night. However, in some rivers this does not occur and larvae are equally abundant during the day. Larval drift diel variation is an important information for planning sampling programs for evaluating larval distribution and production. The aim of this study was to test whether the abundance of larval fish was different at either period. We tested it by comparing day and night densities of characiform, clupeiform and siluriform larvae during five years in the Amazon and one year in Rio Negro. We found that larvae of three species of characiform and larvae of siluriform were equally abundant during day and night in the Amazon. Conversely, the catch of Pellona spp. larvae was significantly higher during the day. In Rio Negro, however, larval abundance was higher during the night. These results imply that day samplings estimate adequately the abundance of these characiform and siluriform larvae in the Amazon, but not Pellona larvae. Evaluations of larved densities of Rio Negro will have to consider night sampling.

Interactions among Amazon land use, forests and climate: prospects for a near-term forest tipping point.

Science.gov (United States)

Nepstad, Daniel C; Stickler, Claudia M; Filho, Britaldo Soares-; Merry, Frank

2008-05-27

Some model experiments predict a large-scale substitution of Amazon forest by savannah-like vegetation by the end of the twenty-first century. Expanding global demands for biofuels and grains, positive feedbacks in the Amazon forest fire regime and drought may drive a faster process of forest degradation that could lead to a near-term forest dieback. Rising worldwide demands for biofuel and meat are creating powerful new incentives for agro-industrial expansion into Amazon forest regions. Forest fires, drought and logging increase susceptibility to further burning while deforestation and smoke can inhibit rainfall, exacerbating fire risk. If sea surface temperature anomalies (such as El Niño episodes) and associated Amazon droughts of the last decade continue into the future, approximately 55% of the forests of the Amazon will be cleared, logged, damaged by drought or burned over the next 20 years, emitting 15-26Pg of carbon to the atmosphere. Several important trends could prevent a near-term dieback. As fire-sensitive investments accumulate in the landscape, property holders use less fire and invest more in fire control. Commodity markets are demanding higher environmental performance from farmers and cattle ranchers. Protected areas have been established in the pathway of expanding agricultural frontiers. Finally, emerging carbon market incentives for reductions in deforestation could support these trends.

Amazon Forest Structure from IKONOS Satellite Data and the Automated Characterization of Forest Canopy Properties

Science.gov (United States)

Michael Palace; Michael Keller; Gregory P. Asner; Stephen Hagen; Bobby . Braswell

2008-01-01

We developed an automated tree crown analysis algorithm using 1-m panchromatic IKONOS satellite images to examine forest canopy structure in the Brazilian Amazon. The algorithm was calibrated on the landscape level with tree geometry and forest stand data at the Fazenda Cauaxi (3.75◦ S, 48.37◦ W) in the eastern Amazon, and then compared with forest...

A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin.

Science.gov (United States)

Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

2017-09-01

Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve™ gel (DELP) and a cheaper alternative, Zerobase Emollient™ cream (ZBC). This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) comparison in 18 females with atopic eczema and dry skin on their lower legs. DELP gel and ZBC cream were each applied to one lower leg twice daily for 4 days and on the morning only on day 5. The efficacy of both products was assessed by hydration measurements using a Corneometer CM825 probe (Courage-Khazaka Electronic). The measurements were made three times daily on days 1 to 5. The primary efficacy variable was the area under the curve (AUC) of the change from baseline corneometer readings over the 5 days. Skin hydration using DELP gel was significantly higher than using ZBC cream (p skin hydration observed for DELP gel was substantial and long lasting. In contrast, for ZBC cream, there was no significant improvement of the cumulative skin hydration as measured by the AUC (p = 0.22). DELP gel achieved substantial, long-lasting and cumulative skin hydration, whilst ZBC cream achieved no measurable improvement in skin hydration compared to before treatment. Healthcare professionals should be aware that different emollients can perform differently. Dermal Laboratories Ltd. EudraCT number:2014-001026-16.

Impact of Amazon deforestation on climate simulations using the NCAR CCM2/BATS model

Energy Technology Data Exchange (ETDEWEB)

Hahmann, A.N.; Dickinson, R.E. [Univ. of Arizona, Tucson, AZ (United States)

1996-12-31

Model validation and results are briefly presented for a simulation of deforestation of the Amazon rainforest. This initial study is made using assumptions regarding deforestation similar to those in earlier studies with several versions of the NCAR Community Climate Model (CCM) couples to the Biosphere-Atmosphere Transfer Scheme (BATS). The model used is a revised version of the NCAR CCM Version 2 coupled to BATS Version 1e. This paper discusses the portion of validation dealing with the distribution of precipitation; the simulation displays very good agreement with observed rainfall rates for the austral summer. Preliminary results from an 8-year simulation of deforestation are similar to that of previous studies. Annual precipitation and evaporation are reduced, while surface air temperatures show a slight increase. A substantial bimodal pattern appears in the results, with the Amazon decrease of precipitation and temperature increase accompanied by changes in the opposite sign to the southeast of the Amazon. Similar patterns have occurred in other studies, but not always in exactly the same locations. Evidently, how much of the region of rainfall increase occurs in the deforested area over the Amazon strongly affects the inferred statistics. It is likely that this pattern depends on the model control climatology and possibly other features. 16 refs., 2 figs., 2 tabs.

Cloud Condensation Nuclei Activity of Aerosols during GoAmazon 2014/15 Field Campaign Report

Energy Technology Data Exchange (ETDEWEB)

Wang, J. [Brookhaven National Lab. (BNL), Upton, NY (United States); Martin, S. T. [Harvard Univ., Cambridge, MA (United States); Kleinman, L. [Brookhaven National Lab. (BNL), Upton, NY (United States); Thalman, R. M. [Brookhaven National Lab. (BNL), Upton, NY (United States)

2016-03-01

Aerosol indirect effects, which represent the impact of aerosols on climate through influencing the properties of clouds, remain one of the main uncertainties in climate predictions (Stocker et al. 2013). Reducing this large uncertainty requires both improved understanding and representation of aerosol properties and processes in climate models, including the cloud activation properties of aerosols. The Atmospheric System Research (ASR) science program plan of January 2010 states that: “A key requirement for simulating aerosol-cloud interactions is the ability to calculate cloud condensation nuclei and ice nuclei (CCN and IN, respectively) concentrations as a function of supersaturation from the chemical and microphysical properties of the aerosol.” The Observations and Modeling of the Green Ocean Amazon (GoAmazon 2014/15) study seeks to understand how aerosol and cloud life cycles are influenced by pollutant outflow from a tropical megacity (Manaus)—in particular, the differences in cloud-aerosol-precipitation interactions between polluted and pristine conditions. One key question of GoAmazon2014/5 is: “What is the influence of the Manaus pollution plume on the cloud condensation nuclei (CCN) activities of the aerosol particles and the secondary organic material in the particles?” To address this question, we measured size-resolved CCN spectra, a critical measurement for GoAmazon2014/5.

The Expansion of the Economic Frontier and the Diffusion of Violence in the Amazon

Directory of Open Access Journals (Sweden)

Patrícia Feitosa Souza

2015-05-01

Full Text Available Over the last few decades, the occupation of the Amazon and the expansion of large-scale economic activities have exerted a significant negative impact on the Amazonian environment and on the health of the Amazon’s inhabitants. These processes have altered the context of the manifestation of health problems in time and space and changed the characteristics of the spatial diffusion of health problems in the region. This study analyzed the relationships between the various economic processes of territorial occupation in the Amazon and the spatial diffusion of homicidal violence through the configuration of networks of production, as well as the movements of population and merchandise. Statistical data on violence, deforestation, the production of agricultural items, and socio-economic variables, georeferenced and available for the 771 municipalities of the Legal Amazon were used in this study. The results suggest that the diffusion of violence closely follows the economic expansion front, which is related to deforestation and livestock production but has little relation to grain production, demonstrating steps and typologies of recent occupation in the Amazon that promote violence. These spatial patterns reveal environmental and socio-economic macro-determinants that materialize in geographic space through the construction of highways and the formation of city networks.

Multicentre randomised double bind crossover trial on contamination of conventional ties and bow ties in routine obstetric and gynaecological practice.

Science.gov (United States)

Biljan, M M; Hart, C A; Sunderland, D; Manasse, P R; Kingsland, C R

1993-01-01

OBJECTIVE--To assess level of contamination of neckwear worn by gynaecologists and obstetricians during routine working week. DESIGN--Multicentre randomised double blind crossover trial. Participants wore the same conventional ties for three days in one week and bow ties for the same period in second week. SETTING--Two teaching and three district general hospitals in the midlands, Wales, and north England. SUBJECTS--15 registrars and senior registrars. INTERVENTIONS--A swab soaked in sterile saline was taken from specific area on ties at end of first and third working days and sent in transport medium for culture on chocolatised blood and MacConkey agar for 48 hours. MAIN OUTCOME MEASURES--Level of bacteriological growth assessed semiquantitatively (0 for no contamination; for heavy contamination) after swabs had been cultured. At end of study the participants completed a questionnaire to assess their attitude toward wearing different types of necktie. RESULTS--12 doctors (80%) completed the study. Although bow ties were significantly less contaminated at end of first working day (z = -2.354, p = 0.019), this difference was not maintained; there was no difference in level of contamination on third day. Level of contamination did not increase between first and third day of wearing the same garment. One of the 10 doctors who returned the questionnaire found the bow tie very uncomfortable. All participants would consider wearing a bow tie if it proved to be less contaminated than a conventional tie. CONCLUSIONS--Although a significant difference in contamination was established between conventional and bow ties on first day of study, this difference was not confirmed on third day and there is unlikely to be any real association between tie type and bacterial contamination. Because of its negative image and difficulty to tie, the bow tie will probably remain a minority fashion. Images p1583-a PMID:8292945

Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial.

Science.gov (United States)

Martinez de Tejada, B; Karolinski, A; Ocampo, M C; Laterra, C; Hösli, I; Fernández, D; Surbek, D; Huespe, M; Drack, G; Bunader, A; Rouillier, S; López de Degani, G; Seidenstein, E; Prentl, E; Antón, J; Krähenmann, F; Nowacki, D; Poncelas, M; Nassif, J C; Papera, R; Tuma, C; Espoile, R; Tiberio, O; Breccia, G; Messina, A; Peker, B; Schinner, E; Mol, B W; Kanterewicz, L; Wainer, V; Boulvain, M; Othenin-Girard, V; Bertolino, M V; Irion, O

2015-01-01

To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Multicentre, randomised, double-blind, placebo-controlled trial. Twenty-nine centres in Switzerland and Argentina. A total of 385 women with preterm labour (24(0/7) to 33(6/7) weeks of gestation) treated with acute tocolysis. Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at <32 and <34 weeks did not differ between the two groups (12.9 versus 9.7%; [RR 1.3; 95% CI 0.7-2.5] and 19.7 versus 12.9% [RR 1.5; 95% CI 0.9-2.4], respectively). The duration of tocolysis, hospitalisation, and recurrence of preterm labour were comparable between groups. Neonatal morbidity occurred in 44 (22.8%) cases on progesterone versus 35 (18.8%) cases on placebo (RR: 1.2; 95% CI 0.82-1.8), whereas there were 4 (2%) neonatal deaths in each study group. There is no evidence that the daily administration of 200 mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour. © 2014 Royal College of Obstetricians and Gynaecologists.

Erythropoietin in amyotrophic lateral sclerosis: a multicentre, randomised, double blind, placebo controlled, phase III study.

Science.gov (United States)

Lauria, Giuseppe; Dalla Bella, Eleonora; Antonini, Giovanni; Borghero, Giuseppe; Capasso, Margherita; Caponnetto, Claudia; Chiò, Adriano; Corbo, Massimo; Eleopra, Roberto; Fazio, Raffaella; Filosto, Massimiliano; Giannini, Fabio; Granieri, Enrico; La Bella, Vincenzo; Logroscino, Giancarlo; Mandrioli, Jessica; Mazzini, Letizia; Monsurrò, Maria Rosaria; Mora, Gabriele; Pietrini, Vladimiro; Quatrale, Rocco; Rizzi, Romana; Salvi, Fabrizio; Siciliano, Gabriele; Sorarù, Gianni; Volanti, Paolo; Tramacere, Irene; Filippini, Graziella

2015-08-01

To assess the efficacy of recombinant human erythropoietin (rhEPO) in amyotrophic lateral sclerosis (ALS). Patients with probable laboratory-supported, probable or definite ALS were enrolled by 25 Italian centres and randomly assigned (1:1) to receive intravenous rhEPO 40,000 IU or placebo fortnightly as add-on treatment to riluzole 100 mg daily for 12 months. The primary composite outcome was survival, tracheotomy or >23 h non-invasive ventilation (NIV). Secondary outcomes were ALSFRS-R, slow vital capacity (sVC) and quality of life (ALSAQ-40) decline. Tolerability was evaluated analysing adverse events (AEs) causing withdrawal. The randomisation sequence was computer-generated by blocks, stratified by centre, disease severity (ALSFRS-R cut-off score of 33) and onset (spinal or bulbar). The main outcome analysis was performed in all randomised patients and by intention-to-treat for the entire population and patients stratified by severity and onset. The study is registered, EudraCT 2009-016066-91. We randomly assigned 208 patients, of whom 5 (1 rhEPO and 4 placebo) withdrew consent and 3 (placebo) became ineligible (retinal thrombosis, respiratory insufficiency, SOD1 mutation) before receiving treatment; 103 receiving rhEPO and 97 placebo were eligible for analysis. At 12 months, the annualised rate of death (rhEPO 0.11, 95% CI 0.06 to 0.20; placebo: 0.08, CI 0.04 to 0.17), tracheotomy or >23 h NIV (rhEPO 0.16, CI 0.10 to 0.27; placebo 0.18, CI 0.11 to 0.30) did not differ between groups, also after stratification by onset and ALSFRS-R at baseline. Withdrawal due to AE was 16.5% in rhEPO and 8.3% in placebo. No differences were found for secondary outcomes. RhEPO 40,000 IU fortnightly did not change the course of ALS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Commons management and ecotourism: Ethnographic evidence from the Amazon

NARCIS (Netherlands)

Stronza, Amanda Lee

2010-01-01

TThe paper evaluates the relationship between ecotourism and commons management. Social and economic impacts of ecotourism in an indigenous village in the Peruvian Amazon are considered in relation to opportunities for collective action to manage common pool resources, including wildlife, forests,

Remote Ischaemic PrEconditioning of Human Myocardium (RIPE): study protocol for a double-blinded randomised controlled trial.

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Deja, Marek A; Wiaderkiewicz, Ryszard; Czekaj, Piotr; Czech, Ewa; Malinowski, Marcin; Machej, Leszek; Węglarzy, Andrzej; Kowalówka, Adam; Piekarska, Magda; Szurlej, Bartosz; Latusek, Tomasz

2018-01-01

Remote preconditioning has been shown to be a potent protective phenomenon in many animals. Several studies aimed to demonstrate it was feasible in humans by trying to show its protective effect during cardiac surgery. Of these, some small studies and one larger trial were positive while two other bigger studies showed no effectiveness of remote preconditioning as assessed by levels of postoperatively released cardiac markers. Recently, two large clinical trials also failed to prove the benefit of remote preconditioning in cardiac surgery. No study showed that remote preconditioning actually increases resistance of human myocardium to standardised ischaemic and reperfusion stimulus in experimental settings. In animal studies, remote preconditioning was shown to improve mitochondrial function and structure, but such data on human myocardium are scarce. The aim of the study is to determine whether remote preconditioning protects human myocardium against ischaemia-reperfusion injury in both in vivo and in vitro conditions. The trial is designed as a single-centre, double-blinded, sham-controlled trial of 120 patients. We randomise (1:1) patients referred for coronary artery bypass grafting for stable coronary artery disease to remote preconditioning or "sham" intervention. The remote preconditioning is obtained by three cycles of 5 min inflation and 5 min deflation of a blood pressure cuff on the right arm. Postoperative course including myocardial enzymes profile will be analysed. Moreover, in the in-vitro arm the clinically preconditioned myocardium will be assessed for function, mitochondria structure, and mitochondria-dependent apoptosis. The informed consent of all patients is obtained before enrolment into the study by the investigator. The study conforms to the spirit and the letter of the declaration of Helsinki. In case the effect of remote preconditioning is not measurable in ex-vivo assessment, any future attempt at implementing this phenomenon in clinical

Microsatellites for the gynogenetic Amazon molly, Poecilia formosa

Indian Academy of Sciences (India)

Home; Journals; Journal of Genetics; Volume 85; Issue 1. Microsatellites for the gynogenetic Amazon molly, Poecilia formosa: useful tools for detection of mutation rate, ploidy determination and overall genetic diversity. Kathrin P. Lampert Dunja K. Lamatsch Susanne Schories Armin Hopf Francisco J. García De León ...

The recent extreme hydrological events in the Western Amazon Basin: The role of the Pacific and Atlantic Oceans

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Espinoza, J.; Ronchail, J.; Guyot, J.; Santini, W.; Lavado, W.; Ore-Hybam Observatory

2013-05-01

The Peruvian Amazonas River, the main western tributary of the Amazon basin, has a huge drainage (750 000 km2, 50% of which lies in the Andes) and a mean discharge estimated in 32 000 m3/s, which correspond to 15% of the Amazon discharge at the estuary. Recently, in a context of significant discharge diminution during the low-water season (1970-2012), severe hydrological events, as intense droughts and floods, have been reported in the Peruvian Amazonas River. As they have not been always observed in other regions of the Amazon basin and because they have strong impacts on vulnerable riverside residents, we shall focus on the origin and the predictability of the western Amazon extremes, providing a review of the main findings about the climate features during recent extreme hydrological events in western Amazon. While the lowest discharge value was observed in September 2010 (8 300 m3/s) at the hydrological Tamshiyacu station (near to Iquitos city), a rapid transition toward a high discharge was noticed in April 2011 (45 000 m3/s). Finally, in April 2012, during the on going high waters period, the Amazonas River is experimenting its historical highest discharge (55 000 m3/s). Our work is based on several datasets including in-situ discharge and rainfall information from ORE-HYBAM observatory. Extreme droughts (1995, 2005 and 2010) are generally associated with positive SST anomalies in the tropical North Atlantic and weak trade winds and water vapor transport toward the western Amazon, which, in association with increased subsidence over central and southern Amazon, explain the lack of rainfall and very low discharge values. But, in 1998, toward the end of the 1997-98 El Niño event, the drought has been more likely related to an anomalous divergence of water vapor in the western Amazon that is characteristic of a warm event in the Pacific. The years with a rapid transition form low waters to very high floods (e.g. September 2010 to April 2011) are characterized

No greens in the forest? Note on the limited consumption of greens in the Amazon

Directory of Open Access Journals (Sweden)

Esther Katz

2012-12-01

Full Text Available The consumption of greens is reported as being very minor among Amazonian Indians. The authors of this article present a new review of this subject, based on fieldwork with Amerindians and other populations in different parts of the Brazilian Amazon and French Guiana. Written sources on Brazilian, Peruvian, Columbian and Venezuelan Amazon were also reviewed. The consumption of cultivated, semi-cultivated and wild species of greens was taken into account here, as the data specific to wild greens is very scarce. It is confirmed that greens are not commonly eaten among native Amazonians and that some ethnic groups do not consume them at all. The consumed species are usually young shoots of weeds or cassava leaves. Common in the Belém region are some specific aromatic plants, which have been diffused to other parts of the Amazon, together with introduced plants such as kale and coriander. Migrants from Northeastern Brazil settled in the Amazon consume some cultivated greens, especially aromatic plants. Maroons are the ones who use more greens in their diet. Native Amazonian people, who supplement agriculture with game and fish, follow a hunter-gatherer pattern, preferring wild fruit and tubers to greens.

Satellite-based Analysis of CO Variability over the Amazon Basin

Science.gov (United States)

Deeter, M. N.; Emmons, L. K.; Martinez-Alonso, S.; Tilmes, S.; Wiedinmyer, C.

2017-12-01

Pyrogenic emissions from the Amazon Basin exert significant influence on both climate and air quality but are highly variable from year to year. The ability of models to simulate the impact of biomass burning emissions on downstream atmospheric concentrations depends on (1) the quality of surface flux estimates (i.e., emissions inventories), (2) model dynamics (e.g., horizontal winds, large-scale convection and mixing) and (3) the representation of atmospheric chemical processes. With an atmospheric lifetime of a few months, carbon monoxide (CO) is a commonly used diagnostic for biomass burning. CO products are available from several satellite instruments and allow analyses of CO variability over extended regions such as the Amazon Basin with useful spatial and temporal sampling characteristics. The MOPITT ('Measurements of Pollution in the Troposphere') instrument was launched on the NASA Terra platform near the end of 1999 and is still operational. MOPITT is uniquely capable of measuring tropospheric CO concentrations using both thermal-infrared and near-infrared observations, resulting in the ability to independently retrieve lower- and upper-troposphere CO concentrations. We exploit the 18-year MOPITT record and related datasets to analyze the variability of CO over the Amazon Basin and evaluate simulations performed with the CAM-chem chemical transport model. We demonstrate that observed differences between MOPITT observations and model simulations provide important clues regarding emissions inventories, convective mixing and long-range transport.

Biomass burning losses of carbon estimated from ecosystem modeling and satellite data analysis for the Brazilian Amazon region

Science.gov (United States)

Potter, Christopher; Brooks Genovese, Vanessa; Klooster, Steven; Bobo, Matthew; Torregrosa, Alicia

To produce a new daily record of gross carbon emissions from biomass burning events and post-burning decomposition fluxes in the states of the Brazilian Legal Amazon (Instituto Brasileiro de Geografia e Estatistica (IBGE), 1991. Anuario Estatistico do Brasil, Vol. 51. Rio de Janeiro, Brazil pp. 1-1024). We have used vegetation greenness estimates from satellite images as inputs to a terrestrial ecosystem production model. This carbon allocation model generates new estimates of regional aboveground vegetation biomass at 8-km resolution. The modeled biomass product is then combined for the first time with fire pixel counts from the advanced very high-resolution radiometer (AVHRR) to overlay regional burning activities in the Amazon. Results from our analysis indicate that carbon emission estimates from annual region-wide sources of deforestation and biomass burning in the early 1990s are apparently three to five times higher than reported in previous studies for the Brazilian Legal Amazon (Houghton et al., 2000. Nature 403, 301-304; Fearnside, 1997. Climatic Change 35, 321-360), i.e., studies which implied that the Legal Amazon region tends toward a net-zero annual source of terrestrial carbon. In contrast, our analysis implies that the total source fluxes over the entire Legal Amazon region range from 0.2 to 1.2 Pg C yr -1, depending strongly on annual rainfall patterns. The reasons for our higher burning emission estimates are (1) use of combustion fractions typically measured during Amazon forest burning events for computing carbon losses, (2) more detailed geographic distribution of vegetation biomass and daily fire activity for the region, and (3) inclusion of fire effects in extensive areas of the Legal Amazon covered by open woodland, secondary forests, savanna, and pasture vegetation. The total area of rainforest estimated annually to be deforested did not differ substantially among the previous analyses cited and our own.

Potential groundwater contribution to Amazon evapotranspiration

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Y. Fan

2010-10-01

Full Text Available Climate and land ecosystem models simulate a dry-season vegetation stress in the Amazon forest, but observations do not support these results, indicating adequate water supply. Proposed mechanisms include larger soil water store and deeper roots in nature and the ability of roots to move water up and down (hydraulic redistribution, both absent in the models. Here we provide a first-order assessment of the potential importance of the upward soil water flux from the groundwater driven by capillarity. We present a map of equilibrium water table depth from available observations and a groundwater model simulation constrained by these observations. We then present a map of maximum capillary flux these water table depths, combined with the fine-textured soils in the Amazon, can potentially support. The maps show that the water table beneath the Amazon can be shallow in lowlands and river valleys (<5 m in 36% and <10 m in 60% of Amazonia. These water table depths can potentially accommodate a maximum capillary flux of 2.1 mm day⁻¹ to the land surface averaged over Amazonia, but varies from 0.6 to 3.7 mm day⁻¹ across nine study sites.

We note that the results presented here are based on limited observations and simple equilibrium model calculations, and as such, have important limitations and must be interpreted accordingly. The potential capillary fluxes are not indicative of their contribution to the actual evapotranspiration, and they are only an assessment of the possible rate at which this flux can occur, to illustrate the power of soil capillary force acting on a shallow water table in fine textured soils. They may over-estimate the actual flux where the surface soils remain moist. Their contribution to the actual evapotranspiration can only be assessed through fully coupled model simulation of the dynamic feedbacks between soil water and groundwater with sub-daily climate forcing. The equilibrium water table

A Comparison of Traditional Book Reviews and Amazon.com Book Reviews of Fiction Using a Content Analysis Approach

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Christy Sich

2017-03-01

Full Text Available Objective - This study compared the quality and helpfulness of traditional book review sources with the online user rating system in Amazon.com in order to determine if one mode is superior to the other and should be used by library selectors to assist in making purchasing decisions. Methods - For this study, 228 reviews of 7 different novels were analyzed using a content analysis approach. Of these, 127 reviews came from traditional review sources and 101 reviews were published on Amazon.com. Results - Using a checklist developed for this study, a significant difference in the quality of reviews was discovered. Reviews from traditional sources scored significantly higher than reviews from Amazon.com. The researcher also looked at review length. On average, Amazon.com reviews are shorter than reviews from traditional sources. Review rating—favourable, unfavourable, or mixed/neutral—also showed a lack of consistency between the two modes of reviews. Conclusion - Although Amazon.com provides multiple reviews of a book on one convenient site, traditional sources of professionally written reviews would most likely save librarians more time in making purchasing decisions, given the higher quality of the review assessment.

Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD A double-blind, randomised, non-inferiority, parallel-group, multicentre study

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Andersson Eva

2009-02-01

Full Text Available Abstract Background Oral corticosteroids and inhaled bronchodilators with or without antibiotics represent standard treatment of COPD exacerbations of moderate severity. Frequent courses of oral steroids may be a safety issue. We wanted to evaluate in an out-patient setting whether a 2-week course of inhaled budesonide/formoterol would be equally effective for treatment of acute COPD exacerbations as standard therapy in patients judged by the investigator not to require hospitalisation. Methods This was a double-blind, randomised, non-inferiority, parallel-group, multicentre study comparing two treatment strategies; two weeks' treatment with inhaled budesonide/formoterol (320/9 μg, qid was compared with prednisolone (30 mg once daily plus inhaled formoterol (9 μg bid in patients with acute exacerbations of COPD attending a primary health care centre. Inclusion criteria were progressive dyspnoea for less than one week, FEV1 30–60% of predicted normal after acute treatment with a single dose of oral corticosteroid plus nebulised salbutamol/ipratropium bromide and no requirement for subsequent immediate hospitalisation, i.e the clinical status after the acute treatment allowed for sending the patient home. A total of 109 patients (mean age 67 years, 33 pack-years, mean FEV1 45% of predicted were randomized to two weeks' double-blind treatment with budesonide/formoterol or prednisolone plus formoterol and subsequent open-label budesonide/formoterol (320/9 μg bid for another 12 weeks. Change in FEV1 was the primary efficacy variable. Non-inferiority was predefined. Results Non-inferiority of budesonide/formoterol was proven because the lower limit of FEV1-change (97.5% CI was above 90% of the efficacy of the alternative treatment. Symptoms, quality of life, treatment failures, need for reliever medication (and exacerbations during follow-up did not differ between the groups. No safety concerns were identified. Conclusion High dose budesonide

Amazon water lenses and the influence of the North Brazil Current on the continental shelf

Science.gov (United States)

Prestes, Yuri O.; Silva, Alex Costa da; Jeandel, Catherine

2018-05-01

The exchange processes on the Amazon continental shelf in northern Brazil are subject to complex interactions that involve forcings derived from distinct sources. The Amazon shelf is a unique and highly dynamic environment in which considerable discharge of freshwater enters the Atlantic Ocean, producing extensive Amazon Water Lenses (AWL). In addition to the presence of the AWL, the shelf is influenced by the semidiurnal oscillations of the tides and the strong North Brazil Current (NBC), a boundary current of the western Atlantic. The present study was based primarily on the influence of the freshwater input and the NBC on the shelf and the Amazon Shelf Break (ASB) off the mouth of the Pará River. For this purpose, hydrographic and hydrodynamic data were obtained by moorings of the AMANDES Project (April-July 2008), located on the Amazon shelf and the ASB. Spectral analysis and the continuous wavelet transform were applied to define tidal (high frequency/short period) and subtidal (low frequency/long period) signals. The results indicated that on both the shelf and the break, the semidiurnal tides are responsible for the residual landward transport and are predominantly across-shelf. Low-frequency motions in the synoptic bands and the AWL are related to spatial changes in the velocity field, mainly on the ASB in the along-shelf direction. The flow of the NBC can be interpreted as an along-shelf low-frequency oscillation capable of altering the spatial configuration of the velocity field, although its influence is perceived only in the absence of the AWL.

Habitual dietary fibre intake influences gut microbiota response to an inulin-type fructan prebiotic: a randomised, double-blind, placebo-controlled, cross-over, human intervention study.

Science.gov (United States)

Healey, Genelle; Murphy, Rinki; Butts, Christine; Brough, Louise; Whelan, Kevin; Coad, Jane

2018-01-01

Dysbiotic gut microbiota have been implicated in human disease. Diet-based therapeutic strategies have been used to manipulate the gut microbiota towards a more favourable profile. However, it has been demonstrated that large inter-individual variability exists in gut microbiota response to a dietary intervention. The primary objective of this study was to investigate whether habitually low dietary fibre (LDF) v. high dietary fibre (HDF) intakes influence gut microbiota response to an inulin-type fructan prebiotic. In this randomised, double-blind, placebo-controlled, cross-over study, thirty-four healthy participants were classified as LDF or HDF consumers. Gut microbiota composition (16S rRNA bacterial gene sequencing) and SCFA concentrations were assessed following 3 weeks of daily prebiotic supplementation (Orafti® Synergy 1; 16 g/d) or placebo (Glucidex® 29 Premium; 16 g/d), as well as after 3 weeks of the alternative intervention, following a 3-week washout period. In the LDF group, the prebiotic intervention led to an increase in Bifidobacterium (P=0·001). In the HDF group, the prebiotic intervention led to an increase in Bifidobacterium (Pgut microbiota response and are therefore more likely to benefit from an inulin-type fructan prebiotic than those with LDF intakes. Future studies aiming to modulate the gut microbiota and improve host health, using an inulin-type fructan prebiotic, should take habitual dietary fibre intake into account.

Protocol for extended antibiotic therapy after laparoscopic cholecystectomy for acute calculous cholecystitis (Cholecystectomy Antibiotic Randomised Trial, CHART).

Science.gov (United States)

Pellegrini, Pablo; Campana, Juan Pablo; Dietrich, Agustín; Goransky, Jeremías; Glinka, Juan; Giunta, Diego; Barcan, Laura; Alvarez, Fernando; Mazza, Oscar; Sánchez Claria, Rodrigo; Palavecino, Martin; Arbues, Guillermo; Ardiles, Victoria; de Santibañes, Eduardo; Pekolj, Juan; de Santibañes, Martin

2015-11-18

Acute calculous cholecystitis represents one of the most common complications of cholelithiasis. While laparoscopic cholecystectomy is the standard treatment in mild and moderate forms, the need for antibiotic therapy after surgery remains undefined. The aim of the randomised controlled Cholecystectomy Antibiotic Randomised Trial (CHART) is therefore to assess if there are benefits in the use of postoperative antibiotics in patients with mild or moderate acute cholecystitis in whom a laparoscopic cholecystectomy is performed. A single-centre, double-blind, randomised trial. After screening for eligibility and informed consent, 300 patients admitted for acute calculus cholecystitis will be randomised into two groups of treatment, either receiving amoxicillin/clavulanic acid or placebo for 5 consecutive days. Postoperative evaluation will take place during the first 30 days. Postoperative infectious complications are the primary end point. Secondary end points are length of hospital stay, readmissions, need of reintervention (percutaneous or surgical reinterventions) and overall mortality. The results of this trial will provide strong evidence to either support or abandon the use of antibiotics after surgery, impacting directly in the incidence of adverse events associated with the use of antibiotics, the emergence of bacterial resistance and treatment costs. This study and informed consent sheets have been approved by the Research Projects Evaluating Committee (CEPI) of Hospital Italiano de Buenos Aires (protocol N° 2111). The results of the trial will be reported in a peer-reviewed publication. NCT02057679. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluation of last extreme drought events in Amazon basin using remotely sensing data

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Panisset, Jéssica S.; Gouveia, Célia M.; Libonati, Renata; Peres, Leonardo; Machado-Silva, Fausto; França, Daniela A.; França, José R. A.

2017-04-01

Amazon basin has experienced several intense droughts among which were highlighted last recent ones in 2005 and 2010. Climate models suggest these events will be even more frequent due to higher concentration of greenhouse gases that are also driven forward by alteration in forest dynamics. Environmental and social impacts demand to identify these intense droughts and the behavior of climate parameters that affect vegetation. This present study also identifies a recent intense drought in Amazon basin during 2015. Meteorological parameters and vegetation indices suggest this event was the most severe already registered in the region. We have used land surface temperature (LST), vegetation indices, rainfall and shortwave radiation from 2000 to 2015 to analyze and compare droughts of 2005, 2010 and 2015. Our results show singularities among the three climate extreme events. The austral winter was the most affected season in 2005 and 2010, but not in 2015 when austral summer presented extreme conditions. Precipitation indicates epicenter of 2005 in west Amazon corroborating with previous studies. In 2010, the west region was strongly affected again together with the northwest and the southeast areas. However, 2015 epicenters were concentrated in the east of the basin. In 2015, shortwave radiation has exceeded the maximum values of 2005 and temperature the maximum value of 2010. Vegetation indices have shown positive and negative anomalies. Despite of heterogenous response of Amazon forest to drought, hybrid vegetation indices using NDVI (Normalized Difference Vegetation Index) and LST highlights the exceptionality of 2015 drought episode that exhibits higher vegetation water stress than the cases of 2010 and 2005. Finally, this work has shown how meteorological parameters influence droughts and the effects on vegetation in Amazon basin. Complexity of climate, ecosystem heterogeneity and high diversity of Amazon forest are response by idiosyncrasies of each drought. All

Pre-Columbian urbanism, anthropogenic landscapes, and the future of the Amazon.

Science.gov (United States)

Heckenberger, Michael J; Russell, J Christian; Fausto, Carlos; Toney, Joshua R; Schmidt, Morgan J; Pereira, Edithe; Franchetto, Bruna; Kuikuro, Afukaka

2008-08-29

The archaeology of pre-Columbian polities in the Amazon River basin forces a reconsideration of early urbanism and long-term change in tropical forest landscapes. We describe settlement and land-use patterns of complex societies on the eve of European contact (after 1492) in the Upper Xingu region of the Brazilian Amazon. These societies were organized in articulated clusters, representing small independent polities, within a regional peer polity. These patterns constitute a "galactic" form of prehistoric urbanism, sharing features with small-scale urban polities in other areas. Understanding long-term change in coupled human-environment systems relating to these societies has implications for conservation and sustainable development, notably to control ecological degradation and maintain regional biodiversity.

A comparison of the effect of two doses of oral melatonin with oral midazolam and placebo on pre-operative anxiety, cognition and psychomotor function in children: A randomised double-blind study

Directory of Open Access Journals (Sweden)

Madhuri S Kurdi

2016-01-01

Full Text Available Background and Aims: Melatonin (MT, a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2-0.5 mg/kg in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. Methods: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5-15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014. Mentally disordered children were excluded from the study. They were randomised into four groups of 25 each (A, B, C, D to receive either oral MT 0.5 mg/kg or 0.75 mg/kg or oral midazolam 0.5 mg/kg or placebo 45-60 min, respectively, before induction. The child′s anxiety, cognition and psychomotor function before and after pre-medication, behaviour during the parental separation and venepuncture were appropriately scored. Kruskal-Wallis analysis of variance for intergroup and Wilcoxon matched pairs tests for intragroup comparisons of data were applied. Results: The four groups were comparable regarding mean age, weight and sex. The anxiety score reductions in the three groups when compared to placebo were statistically significant. Children receiving MT 0.75 mg/kg had maximum anxiolysis and venepuncture compliance (P < 0.05. Cognition was decreased with maximum sedation, successful parental separation and psychomotor impairment in the midazolam group (P < 0.05. Conclusion: Oral MT (0.5 mg/kg and 0.75 mg/kg in children decreases pre-operative anxiety without impairing cognitive and psychomotor functions, the 0.75 mg/kg dose being most effective.

Pilvipalvelut: Microsoft Azure vs. Amazon Web Services

OpenAIRE

Aro, Marko

2016-01-01

Opinnäytetyön tarkoituksena oli tutustua kahteen suosittuun pilvipalveluntarjoajaan, Microsoft Azureen ja Amazon Web Serviceen, sekä vertailla miten ne eroavat toisistaan ominaisuuksiltaan, palveluiltaan ja hinnoittelultaan. Opinnäytetyön tavoitteena oli antaa hyvä yleiskuva vertailtavista pilvipalveluntarjoajista, niiden tarjoamista palveluista, ja niiden sopivuudesta yrityksen pilviratkaisuksi. Vertailu tehtiin yrityksen näkökulmasta. Työn alussa tarkasteltiin pilvipalveluita yleisesti ...

A social-ecological database to advance research on infrastructure development impacts in the Brazilian Amazon.

Science.gov (United States)

Tucker Lima, Joanna M; Valle, Denis; Moretto, Evandro Mateus; Pulice, Sergio Mantovani Paiva; Zuca, Nadia Lucia; Roquetti, Daniel Rondinelli; Beduschi, Liviam Elizabeth Cordeiro; Praia, Amanda Salles; Okamoto, Claudia Parucce Franco; da Silva Carvalhaes, Vinicius Leite; Branco, Evandro Albiach; Barbezani, Bruna; Labandera, Emily; Timpe, Kelsie; Kaplan, David

2016-08-30

Recognized as one of the world's most vital natural and cultural resources, the Amazon faces a wide variety of threats from natural resource and infrastructure development. Within this context, rigorous scientific study of the region's complex social-ecological system is critical to inform and direct decision-making toward more sustainable environmental and social outcomes. Given the Amazon's tightly linked social and ecological components and the scope of potential development impacts, effective study of this system requires an easily accessible resource that provides a broad and reliable data baseline. This paper brings together multiple datasets from diverse disciplines (including human health, socio-economics, environment, hydrology, and energy) to provide investigators with a variety of baseline data to explore the multiple long-term effects of infrastructure development in the Brazilian Amazon.

[Treating pain after dental surgery: a randomised, controlled, double-blind trial to assess a new formulation of paracetamol, opium powder and caffeine versus tramadol or placebo].

Science.gov (United States)

Borel, Jean-François; Deschaumes, Christophe; Devoize, Laurent; Huard, Cédric; Orliaguet, Thierry; Dubray, Claude; Baudet-Pommel, Martine; Dallel, Radhouane

2010-05-01

The aim of this study was to evaluate the analgesic efficacy and the safety of the association, paracetamol, opium prepared and caffeine, in two different dosages as compared to the conventional analgesic tramadol hydrochloride, on acute postoperative dental pain. We conducted a randomised, double-blind, multicentre, parallel-group clinical trial to test the efficacy and safety of single doses of two associations; paracetamol 500 mg, caffeine 50mg, opium prepared 25, and paracetamol 500 mg, caffeine 50mg, opium prepared 50mg, as compared to tramadol hydrochloride 100mg (called hereafter tramadol 100), and placebo, in the control of postoperative pain following the removal of 2 ipsilateral impacted third molars. The primary efficacy criterion was the sum of pain intensity differences as assessed every 30 minutes within 3 hours after the baseline assessment and administration of study treatment (SPID(0-3h)). Of the 232 randomised patients, 228 (98%) completed the study. Analysis of the primary efficacy criterion (SPID(0-3h)) established: (i) the superiority of the 3 active study treatments vs. placebo (popium 25mg, and paracetamol, caffeine, and opium 50mg vs. tramadol. Besides, both formulations of paracetamol, caffeine, and opium showed: (i) a faster onset of analgesic effect as compared to tramadol 100; (ii) a significantly stronger analgesic efficacy than tramadol 100, as measured 1 hour after the treatment intake; this superiority lasted all over the study duration for paracetamol, caffeine, and opium 50mg but not for paracetamol, caffeine, and opium 25mg. No unexpected safety concerns occurred, the two formulations of paracetamol, caffeine, and opium showed a good safety profile especially with paracetamol, caffeine, and opium 25mg as compared to tramadol. This study evidenced the non-inferiority of the paracetamol, caffeine, and opium 25mg or 50mg vs. tramadol 100, and even though the strengths of the tested formulations were higher than that of the 2009

Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial

NARCIS (Netherlands)

Kolk, A. van der; Yang, K.G.; Tamminga, R.; Hoeven, H. van der

2013-01-01

The aim of this study was to determine the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff. This was a randomised controlled trial in which 82 patients (mean age 47 years (24 to 67)) with chronic tendinitis diagnosed clinically were

Double gloving to reduce surgical cross-infection.

Science.gov (United States)

Tanner, J; Parkinson, H

2006-07-19

The invasive nature of surgery, with its increased exposure to blood, means that during surgery there is a high risk of transfer of pathogens. Pathogens can be transferred through contact between surgical patients and the surgical team, resulting in post-operative or blood borne infections in patients or blood borne infections in the surgical team. Both patients and the surgical team need to be protected from this risk. This risk can be reduced by implementing protective barriers such as wearing surgical gloves. Wearing two pairs of surgical gloves, triple gloves, glove liners or cloth outer gloves, as opposed to one pair, is considered to provide an additional barrier and further reduce the risk of contamination. The primary objective of this review was to determine if additional glove protection reduces the number of surgical site or blood borne infections in patients or the surgical team. The secondary objective was to determine if additional glove protection reduces the number of perforations to the innermost pair of surgical gloves. The innermost gloves (next to skin) compared with the outermost gloves are considered to be the last barrier between the patient and the surgical team. We searched the Cochrane Wounds Group Specialised Register (January 2006), and the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library Issue 4, 2005). We also contacted glove manufacturing companies and professional organisations. Randomised controlled trials involving: single gloving, double gloving, triple gloving, glove liners, knitted outer gloves, steel weave outer gloves and perforation indicator systems. Both authors independently assessed the relevance and quality of each trial. Data was extracted by one author and cross checked for accuracy by the second author. Two trials were found which addressed the primary outcome, namely, surgical site infections in patients. Both trials reported no infections. Thirty one randomised controlled trials

Lost between the Qatar Sands and the Equatorial Amazon. The Daly-Correa Proposal for preserving oil in the subsoil (The Yasuni-ITT Initiative)

International Nuclear Information System (INIS)

Damian, Michel

2013-01-01

This article presents the Daly-Correa proposal concerning taxation and international compensations to stop oil exploitation in the Equatorial Amazon -The Yasuni-ITT Initiative- until President Rafael Correa of Equator abandoned it, last August 15. Highly sensitive issues are involved: autochthon people's development, oil exporting countries policies, international governance, climate negotiations around keeping carbon in the subsoil and the internal fights around the Buen Vivir. Also at stake there is the political economy of all these issues, especially the positions and commitments of ecological economists. Author suggests that French diplomacy could place the Yasuni-ITT initiative in the Climate Conference agenda that will take place in Paris at end of 2015, adding to it the Daly-Correa proposition to tax exported oil and some policy measures concerning carbon. There is some scepticism around the feasibility and realism of this kind of international compensations, but it is necessary to discuss them in Paris. It is important not to abandon a double challenge: 1) keeping some quantity of carbon in the subsoil, 2) the issue of 'development' - however defined and without adopting developmentalist naivetes - fully respectful of communities and populations. It is true also for climate that contemporary conflicts and negotiations move closer to societies and social actors who become crucial protagonists. It is necessary to incorporate those extra-state actors, even if they are buried in the core of Equatorial Amazon. (author)

Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial

International Nuclear Information System (INIS)

Palmers, Yvan; Kuhn, Fritz-Peter; Petersen, Dirk; De Greef, Danielle

2002-01-01

The objective of the trial was to compare the safety and efficacy of the non-ionic, dimeric, isotonic contrast medium iodixanol (Visipaque 270 and 320 mgI/ml) with those of iotrolan (Isovist 300 mgI/ml) in myelography. After lumbar or cervical puncture, 315 patients were examined in a multicentre, double-blind, randomised, comparative myelography study. Image quality, changes in vital signs, immediate and delayed adverse events were registered. There was a tendency for better images with iodixanol 320 than with iodixanol 270 and iotrolan 300, but the overall quality was good or excellent with all products. The frequency of patients reporting adverse events and headache varied much across centres, but there was no statistically significant difference between the contrast media. The incidence of events was higher after lumbar puncture than after cervical puncture, in women rather than in men, and after puncture with a 22-gauge (G) bevel-tipped needle compared with a 24 G Sprotte needle. The frequency of headache did not correlate with the absence of pathology. The higher iodine concentration in iodixanol 320 could be an advantage for film quality. When compared with iotrolan 300, iodixanol 320 and 270 give similar incidences of adverse events, including headache. (orig.)

The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double-blind randomised controlled trial.

Science.gov (United States)

Mirghafourvand, Mojgan; Mohammad-Alizadeh, Sakineh; Abbasalizadeh, Fatemeh; Shirdel, Mina

2015-02-01

To determine the effect of prophylactic tranexamic acid (TA) on calculated and measured blood loss after vaginal delivery in women at low risk of postpartum haemorrhage. In this double-blind randomised controlled trial, 120 women with a singleton pregnancy were randomly allocated to receive either one gram intravenous TA or placebo in addition to 10 IU oxytocin after delivery of the fetus. Calculated blood loss was determined based on haematocrit before delivery and 12-24 h postdelivery. The quantity of blood loss was measured during two time periods: from delivery of the fetus to placental expulsion and from placental expulsion to the end of the second hour after childbirth. The mean (SD) calculated total blood loss (519 (320) vs 659 (402) mL, P = 0.036) and measured blood loss from placental delivery to 2 h postpartum (69 (39) vs 108 (53) mL, P  1000 mL was lower in the TA group (7% vs 18%, P = 0.048). Prophylactic TA reduces blood loss after vaginal delivery in women with a low risk of postpartum haemorrhage. The prophylactic use of TA may reduce blood loss complications and enhance maternal health. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Palms and Palm Communities in the Upper Ucayali River Valley - a Little-Known Region in the Amazon Basin

DEFF Research Database (Denmark)

Balslev, Henrik; Eiserhardt, Wolf L.; Kristiansen, Thea

2010-01-01

The Amazon region and its palms are inseparable. Palms make up such an important part of the rain forest ecosystem that it is impossible to imagine the Amazon basin without them. Palms are visible in the canopy and often fill up the forest understory. Palms – because of their edible fruits...... – are cornerstone species for the survival of many animals, and palms contribute substantially to forest inventories in which they are often among the ten most important families. Still, the palms and palm communities of some parts of the Amazon basin remain poorly studied and little known. We travelled to a little......-explored corner of the western Amazon basin, the upper Ucayali river valley. There, we encountered 56 different palms, 18 of which had not been registered for the region previously, and 21 of them were found 150–400 km beyond their previously known limits....

Poverty in the Brazilian Amazon: An Assessment of Poverty Focused on the State of Para

OpenAIRE

Verner, Dorte

2004-01-01

The states in the Brazilian Amazon have made progress in reducing poverty and improving social indicators in the last decade. Despite this progress, the poverty rate in the Amazon is among the highest in Brazil. As of 2000, rural poverty is the greatest challenge. In Par?, not only is the headcount poverty rate of 58.4 percent in rural areas more than 55 percent higher than headcount pover...

Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

Science.gov (United States)

Ulven, Stine M; Leder, Lena; Elind, Elisabeth; Ottestad, Inger; Christensen, Jacob J; Telle-Hansen, Vibeke H; Skjetne, Anne J; Raael, Ellen; Sheikh, Navida A; Holck, Marianne; Torvik, Kristin; Lamglait, Amandine; Thyholt, Kari; Byfuglien, Marte G; Granlund, Linda; Andersen, Lene F; Holven, Kirsten B

2016-10-01

The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (PLDL-cholesterol (Pcholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

Climatic factors driving vegetation declines in the 2005 and 2010 Amazon droughts.

Directory of Open Access Journals (Sweden)

Wenqian Zhao

Full Text Available Along with global climate change, the occurrence of extreme droughts in recent years has had a serious impact on the Amazon region. Current studies on the driving factors of the 2005 and 2010 Amazon droughts has focused on the influence of precipitation, whereas the impacts of temperature and radiation have received less attention. This study aims to explore the climate-driven factors of Amazonian vegetation decline during the extreme droughts using vegetation index, precipitation, temperature and radiation datasets. First, time-lag effects of Amazonian vegetation responses to precipitation, radiation and temperature were analyzed. Then, a multiple linear regression model was established to estimate the contributions of climatic factors to vegetation greenness, from which the dominant climate-driving factors were determined. Finally, the climate-driven factors of Amazonian vegetation greenness decline during the 2005 and 2010 extreme droughts were explored. The results showed that (i in the Amazon vegetation greenness responded to precipitation, radiation and temperature, with apparent time lags for most averaging interval periods associated with vegetation index responses of 0-4, 0-9 and 0-6 months, respectively; (ii on average, the three climatic factors without time lags explained 27.28±21.73% (mean±1 SD of vegetation index variation in the Amazon basin, and this value increased by 12.22% and reached 39.50±27.85% when time lags were considered; (iii vegetation greenness in this region in non-drought years was primarily affected by precipitation and shortwave radiation, and these two factors altogether accounted for 93.47% of the total explanation; and (iv in the common epicenter of the two droughts, pixels with a significant variation in precipitation, radiation and temperature accounted for 36.68%, 40.07% and 10.40%, respectively, of all pixels showing a significant decrease in vegetation index in 2005, and 15.69%, 2.01% and 45.25% in

LBA-ECO LC-01 Hydrography, Morphology, Edaphology Maps, Northern Ecuadorian Amazon

Data.gov (United States)

National Aeronautics and Space Administration — ABSTRACT: This data set provides map images of hydrographic, morphologic, and edaphic features for the northern Amazon Basin in eastern Ecuador. The hydrographic...

The Amazon River’s Ecosystem: Where Land Meets the Sea

Energy Technology Data Exchange (ETDEWEB)

Ward, Nicholas; Sawakuchi, Henrique; Richey, Jeffrey

2018-01-18

What happens to plant matter on its journey down the Amazon River to the Atlantic Ocean? One research group investigated the region where river and ocean meet to fill in this part of the story.

Sustainable Amazon : Limitations and Opportunities for Rural Development

OpenAIRE

Schneider, Robert R.; Arima, Eugenio; Verissimo, Adalberto; Souza, Carlos, Jr.; Barreto, Paulo

2002-01-01

The report contributes to the debate surrounding land use in the Brazilian Amazon. It sets the context by reviewing the evidence concerning the deleterious effect of increasing levels of rainfall on agricultural settlement, and productivity. Next, it compares the economic future of an Amazonian community, under the traditional "predatory logging followed by ranching" model, and under susta...

Learning big data with Amazon Elastic MapReduce

CERN Document Server

Singh, Amarkant

2014-01-01

This book is aimed at developers and system administrators who want to learn about Big Data analysis using Amazon Elastic MapReduce. Basic Java programming knowledge is required. You should be comfortable with using command-line tools. Prior knowledge of AWS, API, and CLI tools is not assumed. Also, no exposure to Hadoop and MapReduce is expected.

Randomised trial of biofeedback training for encopresis

NARCIS (Netherlands)

van der Plas, R. N.; Benninga, M. A.; Redekop, W. K.; Taminiau, J. A.; Büller, H. A.

1996-01-01

To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. Prospective controlled randomised study. PATIENT INTERVENTIONS: A multimodal treatment of six weeks. Children were randomised into two groups. Each group received dietary and toilet advice, enemas,

Lovastatin for adult patients with dengue: protocol for a randomised controlled trial

Science.gov (United States)

2012-01-01

Background Dengue is the most important vector-borne viral infection of man, with approximately 2 billion people living in areas at risk. Infection results in a range of manifestations from asymptomatic infection through to life-threatening shock and haemorrhage. One of the hallmarks of severe dengue is vascular endothelial disruption. There is currently no specific therapy and clinical management is limited to supportive care. Statins are a class of drug initially developed for lipid lowering. There has been considerable recent interest in their effects beyond lipid lowering. These include anti-inflammatory effects at the endothelium. In addition, it is possible that lovastatin may have an anti-viral effect against dengue. Observational data suggest that the use of statins may improve outcomes for such conditions as sepsis and pneumonia. This paper describes the protocol for a randomised controlled trial investigating a short course of lovastatin therapy in adult patients with dengue. Methods/design A randomised, double-blind, placebo-controlled trial will investigate the effects of lovastatin therapy in the treatment of dengue. The trial will be conducted in two phases with an escalation of dose between phases if an interim safety review is satisfactory. This is an exploratory study focusing on safety and there are no data on which to base a sample size calculation. A target sample size of 300 patients in the second phase, enrolled over two dengue seasons, was chosen based on clinical judgement and feasibility considerations. In a previous randomised trial in dengue, about 10% and 30% of patients experienced at least one serious adverse event or adverse event, respectively. With 300 patients, we will have 80% power to detect an increase of 12% (from 10% to 22%) or 16% (from 30% to 46%) in the frequency of adverse events. Furthermore, this sample size ensures some power to explore the efficacy of statins. Discussion The development of a dengue therapeutic that can

OSL dating of sediments from Negro and Solimões rivers – Amazon, Brazil

International Nuclear Information System (INIS)

Fiore, M.; Soares, E.A.A.; Mittani, J.C.R.; Yee, M.; Tatumi, S.H.

2014-01-01

In this work, the OSL dating results of Quaternary fluvial deposits from the confluence of Negro and Solimões rivers were studied. The equivalent doses (D e ) of sediments were obtained using a Single Aliquot Regeneration (SAR) protocol. Statistic studies were made using frequency histogram, weighted histogram and Radial plot in order to analyze the D e fluctuations. Ages from 74.5 to 205 thousand of years (Pleistocene) were recorded. The gamma-ray spectroscopy was used to evaluate the natural radioisotopes concentrations of the samples and low concentrations were found with values between 0.64 and 3.71 ppm for 235 U and 238 U; 2.01–9.77 ppm for 232 Th; already, for 40 K, the concentration was negligible. The OSL dating of sediments has contributed to a better understanding of the evolution of Negro and Solimões rivers, in Amazon, Brazil. - Highlights: ► OSL dating of fluvial terraces from Amazon. ► SAR protocols applied to Amazon sediments dating. ► OSL dating of Solimão and Negro rivers sediments

Near real time detection of deforestation in the Brazilian Amazon using MODIS imagery

Directory of Open Access Journals (Sweden)

Egídio Arai

2007-06-01

Full Text Available The objective of this paper is to provide near real time information about deforestation detection (DETER in the entire Brazilian Amazon using MODIS high temporal resolution images. It is part of the operational deforestation monitoring project to estimate the annual deforestation rate in the Brazilian Amazon (PRODES. A rapid deforestation detection method was designed to support land use policies in this region. In order to evaluate the proposed method a test site was selected covering a Landsat ETM+ scene (227/68 located in Mato Grosso State. For this purpose a multitemporal series of MODIS surface reflectance images (MOD09 and the corresponding ETM+ images from June to October 2002 were analyzed. It was found that small deforested areas (lower than 15 ha were detected by MODIS images with lower accuracy when compared with ETM+ images. As the deforested areas increase MODIS and ETM+ results tend to converge. This procedure showed to be adequate to operationally detect and monitor deforested areas and has been used since 2004 as part of a government plan to control the Amazon deforestation.

LBA-ECO LC-01 Hydrography, Morphology, Edaphology Maps, Northern Ecuadorian Amazon

Data.gov (United States)

National Aeronautics and Space Administration — This data set provides map images of hydrographic, morphologic, and edaphic features for the northern Amazon Basin in eastern Ecuador. The hydrographic data are...

Public policies and communication affecting forest cover in the Amazon

Science.gov (United States)

Kawakami Savaget, E.; Batistella, M.; Aguiar, A. P. D.

2014-12-01

The research program Amazalert was based on information delivered by the IPCC through its 2007 report, which indicates forest degradation processes in the Amazonian region as a consequence of anthropogenic actions. Such processes affecting the structural and functional characteristics of ecosystems would harm environmental services that guarantee, for example, the regulation of climate and the provision of fresh water. A survey was organized, through a multidisciplinary perspective, on the main policies and programs that can affect forest cover in the Amazon. These rules and norms seek to regulate societal actions by defining a developmental model for the region. Although deforestation rates in the Brazilian Amazon have decreased significantly since 2004, some locations maintain high levels of deforestation. In 2013, for example, the municipalities of Monte Alegre, Óbidos, Alenquer, Oriximiná, Curuá and Almeirin, in the northern region of the state of Para, showed the highest rates of deforestation in the Amazon. Managers and stakeholders within these areas are being interviewed to provide insights on how policies are interpreted and applied locally. There is an understanding delay between discourses normalized by federal governmental institutions and claims of local societies. The possible lack of clarity in official discourses added to the absence of a local communicative dynamics cause the phenomenon of incomplete information. Conflicts often occur in local institutional arenas resulting in violence and complex social and historical dissonances, enhanced by other public policies idealized in different temporal and spatial conditions.

Randomised clinical trial: vonoprazan, a novel potassium-competitive acid blocker, vs. lansoprazole for the healing of erosive oesophagitis.

Science.gov (United States)

Ashida, K; Sakurai, Y; Hori, T; Kudou, K; Nishimura, A; Hiramatsu, N; Umegaki, E; Iwakiri, K

2016-01-01

Vonoprazan is a novel potassium-competitive acid blocker which may provide clinical benefit in acid-related disorders. To verify the non-inferiority of vonoprazan vs. lansoprazole in patients with erosive oesophagitis (EE), and to establish its long-term safety and efficacy as maintenance therapy. In this multicentre, randomised, double-blind, parallel-group comparison study, patients with endoscopically confirmed EE (LA Classification Grades A-D) were randomly allocated to receive vonoprazan 20 mg or lansoprazole 30 mg once daily after breakfast. The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy up to week 8. In addition, subjects who achieved healed EE in the comparison study were re-randomised into a long-term study to investigate the safety and efficacy of vonoprazan 10 or 20 mg as maintenance therapy for 52 weeks. Of the 409 eligible subjects randomised, 401 completed the comparison study, and 305 entered the long-term maintenance study. The proportion of patients with healed EE up to week 8 was 99.0% for vonoprazan (203/205) and 95.5% for lansoprazole (190/199), thus verifying the non-inferiority of vonoprazan (P lansoprazole in EE was verified in the comparison study, and vonoprazan was well-tolerated and effective during the long-term maintenance study. © 2015 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

Reduced precipitation over large water bodies in the Brazilian Amazon shown from TRMM data

Science.gov (United States)

Paiva, Rodrigo Cauduro Dias; Buarque, Diogo Costa; Clarke, Robin T.; Collischonn, Walter; Allasia, Daniel Gustavo

2011-02-01

Tropical Rainfall Measurement Mission (TRMM) data show lower rainfall over large water bodies in the Brazilian Amazon. Mean annual rainfall (P), number of wet days (rainfall > 2 mm) (W) and annual rainfall accumulated over 3-hour time intervals (P3hr) were computed from TRMM 3B42 data for 1998-2009. Reduced rainfall was marked over the Rio Solimões/Amazon, along most Amazon tributaries and over the Balbina reservoir. In a smaller test area, a heuristic argument showed that P and W were reduced by 5% and 6.5% respectively. Allowing for TRMM 3B42 spatial resolution, the reduction may be locally greater. Analyses of diurnal rainfall patterns showed that rainfall is lowest over large rivers during the afternoon, when most rainfall is convective, but at night and early morning the opposite occurs, with increased rainfall over rivers, although this pattern is less marked. Rainfall patterns reported from studies of smaller Amazonian regions therefore exist more widely.

[Globalization, inequality, and transmission of tropical diseases in the Venezuelan Amazon].

Science.gov (United States)

Botto-Abella, Carlos; Graterol-Mendoza, Beatriz

2007-01-01

Economic globalization appears to be causing greater inequalities and increased vulnerability to tropical diseases around the world. The Venezuelan Amazon population, especially the rural indigenous population, displays among the worst health indicators in the Americas. High infant mortality rates in remote indigenous populations indicate that such communities have been affected by the globalization of disease, rather than favored by globalization of health. Globalization has also influenced public policies in the country, affecting the efficiency of control programs targeting tropical diseases. A new global pact for the sustainable development of the planet is needed, supported by the globalization of human values and rights. In Venezuela, new policies for the indigenous health sector, more resources, and greater autonomy could help reduce the inequities described here in the Venezuelan Amazon.

Incorporating phylogenetic information for the definition of floristic districts in hyperdiverse Amazon forests: Implications for conservation.

Science.gov (United States)

Guevara Andino, Juan Ernesto; Pitman, Nigel C A; Ter Steege, Hans; Mogollón, Hugo; Ceron, Carlos; Palacios, Walter; Oleas, Nora; Fine, Paul V A

2017-11-01

Using complementary metrics to evaluate phylogenetic diversity can facilitate the delimitation of floristic units and conservation priority areas. In this study, we describe the spatial patterns of phylogenetic alpha and beta diversity, phylogenetic endemism, and evolutionary distinctiveness of the hyperdiverse Ecuador Amazon forests and define priority areas for conservation. We established a network of 62 one-hectare plots in terra firme forests of Ecuadorian Amazon. In these plots, we tagged, collected, and identified every single adult tree with dbh ≥10 cm. These data were combined with a regional community phylogenetic tree to calculate different phylogenetic diversity (PD) metrics in order to create spatial models. We used Loess regression to estimate the spatial variation of taxonomic and phylogenetic beta diversity as well as phylogenetic endemism and evolutionary distinctiveness. We found evidence for the definition of three floristic districts in the Ecuadorian Amazon, supported by both taxonomic and phylogenetic diversity data. Areas with high levels of phylogenetic endemism and evolutionary distinctiveness in Ecuadorian Amazon forests are unprotected. Furthermore, these areas are severely threatened by proposed plans of oil and mining extraction at large scales and should be prioritized in conservation planning for this region.

Um estudo da simulação de serviços da Amazon ec2 utilizando o simulador Cloudsim

OpenAIRE

Crespo Guzmán, Alberto

2011-01-01

English: In the first part of the project, is made a theoric study of Cloud Computing's technology and Amazon's company. After this, it has a introduction about the simulador CloudSim. The second part is devoted to the adaptation of CloudSim with the Amazon's Company, the extration of estadistics and theirs conclusions Castellano: En la primera parte del proyecto se hace un estudio teórico de la tecnología de la Computación en Nube y de la empresa Amazon. Es seguido por una introducción al...