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Sample records for average treatment effect

  1. Estimating the average treatment effect on survival based on observational data and using partly conditional modeling.

    Science.gov (United States)

    Gong, Qi; Schaubel, Douglas E

    2017-03-01

    Treatments are frequently evaluated in terms of their effect on patient survival. In settings where randomization of treatment is not feasible, observational data are employed, necessitating correction for covariate imbalances. Treatments are usually compared using a hazard ratio. Most existing methods which quantify the treatment effect through the survival function are applicable to treatments assigned at time 0. In the data structure of our interest, subjects typically begin follow-up untreated; time-until-treatment, and the pretreatment death hazard are both heavily influenced by longitudinal covariates; and subjects may experience periods of treatment ineligibility. We propose semiparametric methods for estimating the average difference in restricted mean survival time attributable to a time-dependent treatment, the average effect of treatment among the treated, under current treatment assignment patterns. The pre- and posttreatment models are partly conditional, in that they use the covariate history up to the time of treatment. The pre-treatment model is estimated through recently developed landmark analysis methods. For each treated patient, fitted pre- and posttreatment survival curves are projected out, then averaged in a manner which accounts for the censoring of treatment times. Asymptotic properties are derived and evaluated through simulation. The proposed methods are applied to liver transplant data in order to estimate the effect of liver transplantation on survival among transplant recipients under current practice patterns. © 2016, The International Biometric Society.

  2. Model averaging in the presence of structural uncertainty about treatment effects: influence on treatment decision and expected value of information.

    Science.gov (United States)

    Price, Malcolm J; Welton, Nicky J; Briggs, Andrew H; Ades, A E

    2011-01-01

    Standard approaches to estimation of Markov models with data from randomized controlled trials tend either to make a judgment about which transition(s) treatments act on, or they assume that treatment has a separate effect on every transition. An alternative is to fit a series of models that assume that treatment acts on specific transitions. Investigators can then choose among alternative models using goodness-of-fit statistics. However, structural uncertainty about any chosen parameterization will remain and this may have implications for the resulting decision and the need for further research. We describe a Bayesian approach to model estimation, and model selection. Structural uncertainty about which parameterization to use is accounted for using model averaging and we developed a formula for calculating the expected value of perfect information (EVPI) in averaged models. Marginal posterior distributions are generated for each of the cost-effectiveness parameters using Markov Chain Monte Carlo simulation in WinBUGS, or Monte-Carlo simulation in Excel (Microsoft Corp., Redmond, WA). We illustrate the approach with an example of treatments for asthma using aggregate-level data from a connected network of four treatments compared in three pair-wise randomized controlled trials. The standard errors of incremental net benefit using structured models is reduced by up to eight- or ninefold compared to the unstructured models, and the expected loss attaching to decision uncertainty by factors of several hundreds. Model averaging had considerable influence on the EVPI. Alternative structural assumptions can alter the treatment decision and have an overwhelming effect on model uncertainty and expected value of information. Structural uncertainty can be accounted for by model averaging, and the EVPI can be calculated for averaged models. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights

  3. The balanced survivor average causal effect.

    Science.gov (United States)

    Greene, Tom; Joffe, Marshall; Hu, Bo; Li, Liang; Boucher, Ken

    2013-05-07

    Statistical analysis of longitudinal outcomes is often complicated by the absence of observable values in patients who die prior to their scheduled measurement. In such cases, the longitudinal data are said to be "truncated by death" to emphasize that the longitudinal measurements are not simply missing, but are undefined after death. Recently, the truncation by death problem has been investigated using the framework of principal stratification to define the target estimand as the survivor average causal effect (SACE), which in the context of a two-group randomized clinical trial is the mean difference in the longitudinal outcome between the treatment and control groups for the principal stratum of always-survivors. The SACE is not identified without untestable assumptions. These assumptions have often been formulated in terms of a monotonicity constraint requiring that the treatment does not reduce survival in any patient, in conjunction with assumed values for mean differences in the longitudinal outcome between certain principal strata. In this paper, we introduce an alternative estimand, the balanced-SACE, which is defined as the average causal effect on the longitudinal outcome in a particular subset of the always-survivors that is balanced with respect to the potential survival times under the treatment and control. We propose a simple estimator of the balanced-SACE that compares the longitudinal outcomes between equivalent fractions of the longest surviving patients between the treatment and control groups and does not require a monotonicity assumption. We provide expressions for the large sample bias of the estimator, along with sensitivity analyses and strategies to minimize this bias. We consider statistical inference under a bootstrap resampling procedure.

  4. Identification and Sensitivity Analysis for Average Causal Mediation Effects with Time-Varying Treatments and Mediators: Investigating the Underlying Mechanisms of Kindergarten Retention Policy.

    Science.gov (United States)

    Park, Soojin; Steiner, Peter M; Kaplan, David

    2018-06-01

    Considering that causal mechanisms unfold over time, it is important to investigate the mechanisms over time, taking into account the time-varying features of treatments and mediators. However, identification of the average causal mediation effect in the presence of time-varying treatments and mediators is often complicated by time-varying confounding. This article aims to provide a novel approach to uncovering causal mechanisms in time-varying treatments and mediators in the presence of time-varying confounding. We provide different strategies for identification and sensitivity analysis under homogeneous and heterogeneous effects. Homogeneous effects are those in which each individual experiences the same effect, and heterogeneous effects are those in which the effects vary over individuals. Most importantly, we provide an alternative definition of average causal mediation effects that evaluates a partial mediation effect; the effect that is mediated by paths other than through an intermediate confounding variable. We argue that this alternative definition allows us to better assess at least a part of the mediated effect and provides meaningful and unique interpretations. A case study using ECLS-K data that evaluates kindergarten retention policy is offered to illustrate our proposed approach.

  5. Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?

    Science.gov (United States)

    Reardon, Sean F.; Raudenbush, Stephen W.

    2013-01-01

    The increasing availability of data from multi-site randomized trials provides a potential opportunity to use instrumental variables methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions…

  6. LARF: Instrumental Variable Estimation of Causal Effects through Local Average Response Functions

    Directory of Open Access Journals (Sweden)

    Weihua An

    2016-07-01

    Full Text Available LARF is an R package that provides instrumental variable estimation of treatment effects when both the endogenous treatment and its instrument (i.e., the treatment inducement are binary. The method (Abadie 2003 involves two steps. First, pseudo-weights are constructed from the probability of receiving the treatment inducement. By default LARF estimates the probability by a probit regression. It also provides semiparametric power series estimation of the probability and allows users to employ other external methods to estimate the probability. Second, the pseudo-weights are used to estimate the local average response function conditional on treatment and covariates. LARF provides both least squares and maximum likelihood estimates of the conditional treatment effects.

  7. Identification and estimation of survivor average causal effects.

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    Tchetgen Tchetgen, Eric J

    2014-09-20

    In longitudinal studies, outcomes ascertained at follow-up are typically undefined for individuals who die prior to the follow-up visit. In such settings, outcomes are said to be truncated by death and inference about the effects of a point treatment or exposure, restricted to individuals alive at the follow-up visit, could be biased even if as in experimental studies, treatment assignment were randomized. To account for truncation by death, the survivor average causal effect (SACE) defines the effect of treatment on the outcome for the subset of individuals who would have survived regardless of exposure status. In this paper, the author nonparametrically identifies SACE by leveraging post-exposure longitudinal correlates of survival and outcome that may also mediate the exposure effects on survival and outcome. Nonparametric identification is achieved by supposing that the longitudinal data arise from a certain nonparametric structural equations model and by making the monotonicity assumption that the effect of exposure on survival agrees in its direction across individuals. A novel weighted analysis involving a consistent estimate of the survival process is shown to produce consistent estimates of SACE. A data illustration is given, and the methods are extended to the context of time-varying exposures. We discuss a sensitivity analysis framework that relaxes assumptions about independent errors in the nonparametric structural equations model and may be used to assess the extent to which inference may be altered by a violation of key identifying assumptions. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  8. Identifying the Average Causal Mediation Effects with Multiple Mediators in the Presence of Treatment Non-Compliance

    Science.gov (United States)

    Park, Soojin

    2015-01-01

    Identifying the causal mechanisms is becoming more essential in social and medical sciences. In the presence of treatment non-compliance, the Intent-To-Treated effect (hereafter, ITT effect) is identified as long as the treatment is randomized (Angrist et al., 1996). However, the mediated portion of effect is not identified without additional…

  9. Quasi-analytical treatment of spatially averaged radiation transfer in complex terrain

    Science.gov (United States)

    LöWe, H.; Helbig, N.

    2012-10-01

    We provide a new quasi-analytical method to compute the subgrid topographic influences on the shortwave radiation fluxes and the effective albedo in complex terrain as required for large-scale meteorological, land surface, or climate models. We investigate radiative transfer in complex terrain via the radiosity equation on isotropic Gaussian random fields. Under controlled approximations we derive expressions for domain-averaged fluxes of direct, diffuse, and terrain radiation and the sky view factor. Domain-averaged quantities can be related to a type of level-crossing probability of the random field, which is approximated by long-standing results developed for acoustic scattering at ocean boundaries. This allows us to express all nonlocal horizon effects in terms of a local terrain parameter, namely, the mean-square slope. Emerging integrals are computed numerically, and fit formulas are given for practical purposes. As an implication of our approach, we provide an expression for the effective albedo of complex terrain in terms of the Sun elevation angle, mean-square slope, the area-averaged surface albedo, and the ratio of atmospheric direct beam to diffuse radiation. For demonstration we compute the decrease of the effective albedo relative to the area-averaged albedo in Switzerland for idealized snow-covered and clear-sky conditions at noon in winter. We find an average decrease of 5.8% and spatial patterns which originate from characteristics of the underlying relief. Limitations and possible generalizations of the method are discussed.

  10. Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media.

    Science.gov (United States)

    Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George

    2008-01-01

    Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

  11. A Complier Average Causal Effect Analysis of the Stimulant Reduction Intervention using Dosed Exercise Study.

    Science.gov (United States)

    Carmody, Thomas; Greer, Tracy L; Walker, Robrina; Rethorst, Chad D; Trivedi, Madhukar H

    2018-06-01

    Exercise is a promising treatment for substance use disorders, yet an intention-to-treat analysis of a large, multi-site study found no reduction in stimulant use for exercise versus health education. Exercise adherence was sub-optimal; therefore, secondary post-hoc complier average causal effects (CACE) analysis was conducted to determine the potential effectiveness of adequately dosed exercise. The STimulant use Reduction Intervention using Dosed Exercise study was a randomized controlled trial comparing a 12 kcal/kg/week (KKW) exercise dose versus a health education control conducted at nine residential substance use treatment settings across the U.S. that are affiliated with the National Drug Abuse Treatment Clinical Trials Network. Participants were sedentary but medically approved for exercise, used stimulants within 30 days prior to study entry, and received a DSM-IV stimulant abuse or dependence diagnosis within the past year. A CACE analysis adjusted to include only participants with a minimum threshold of adherence (at least 8.3 KKW) and using a negative-binomial hurdle model focused on 218 participants who were 36.2% female, mean age 39.4 years ( SD =11.1), and averaged 13.0 ( SD =9.2) stimulant use days in the 30 days before residential treatment. The outcome was days of stimulant use as assessed by the self-reported TimeLine Follow Back and urine drug screen results. The CACE-adjusted analysis found a significantly lower probability of relapse to stimulant use in the exercise group versus the health education group (41.0% vs. 55.7%, p <.01) and significantly lower days of stimulant use among those who relapsed (5.0 days vs. 9.9 days, p <.01). The CACE adjustment revealed significant, positive effects for exercise. Further research is warranted to develop strategies for exercise adherence that can ensure achievement of an exercise dose sufficient to produce a significant treatment effect.

  12. The Health Effects of Income Inequality: Averages and Disparities.

    Science.gov (United States)

    Truesdale, Beth C; Jencks, Christopher

    2016-01-01

    Much research has investigated the association of income inequality with average life expectancy, usually finding negative correlations that are not very robust. A smaller body of work has investigated socioeconomic disparities in life expectancy, which have widened in many countries since 1980. These two lines of work should be seen as complementary because changes in average life expectancy are unlikely to affect all socioeconomic groups equally. Although most theories imply long and variable lags between changes in income inequality and changes in health, empirical evidence is confined largely to short-term effects. Rising income inequality can affect individuals in two ways. Direct effects change individuals' own income. Indirect effects change other people's income, which can then change a society's politics, customs, and ideals, altering the behavior even of those whose own income remains unchanged. Indirect effects can thus change both average health and the slope of the relationship between individual income and health.

  13. Definition of dose intensity (DI), average relative DI and effective DI

    International Nuclear Information System (INIS)

    Alberto, P.

    1995-01-01

    The cytotoxic activity of cancer chemotherapy is related to the dose and to the amount of drug delivered per time unit. the significance of time in the effectiveness of a treatment program is frequently overlooked. The term of dose intensity (DI) is used to define the drug dose delivered per time unit and is expressed as mg/m 2 per week. A delay in the sequence of treatment cycles decreases the DI in the DI in the same proportion as a reduction of dose. Average relative DI corresponds to the mean DI of combined agents and is expressed as a fraction of a similar combination selected as a standard. Di is useful to compare the dose actually received with the prescribed dose. The relation of DI with tumor response or survival has not been fully demonstrated. A threshold DI level for therapeutic activity is evident. Above this threshold, a linear relationship of DI and effectiveness is not obvious, particularly regarding high-dose chemotherapy. The term of DI is more useful in its principle than in the significance of its calculated value. (authors). 19 refs., 3 tabs., 3 figs

  14. Dosimetric consequences of planning lung treatments on 4DCT average reconstruction to represent a moving tumour

    International Nuclear Information System (INIS)

    Dunn, L.F.; Taylor, M.L.; Kron, T.; Franich, R.

    2010-01-01

    Full text: Anatomic motion during a radiotherapy treatment is one of the more significant challenges in contemporary radiation therapy. For tumours of the lung, motion due to patient respiration makes both accurate planning and dose delivery difficult. One approach is to use the maximum intensity projection (MIP) obtained from a 40 computed tomography (CT) scan and then use this to determine the treatment volume. The treatment is then planned on a 4DCT average reco struction, rather than assuming the entire ITY has a uniform tumour density. This raises the question: how well does planning on a 'blurred' distribution of density with CT values greater than lung density but less than tumour density match the true case of a tumour moving within lung tissue? The aim of this study was to answer this question, determining the dosimetric impact of using a 4D-CT average reconstruction as the basis for a radiotherapy treatment plan. To achieve this, Monte-Carlo sim ulations were undertaken using GEANT4. The geometry consisted of a tumour (diameter 30 mm) moving with a sinusoidal pattern of amplitude = 20 mm. The tumour's excursion occurs within a lung equivalent volume beyond a chest wall interface. Motion was defined parallel to a 6 MY beam. This was then compared to a single oblate tumour of a magnitude determined by the extremes of the tumour motion. The variable density of the 4DCT average tumour is simulated by a time-weighted average, to achieve the observed density gradient. The generic moving tumour geometry is illustrated in the Figure.

  15. The Lake Wobegon effect: are all cancer patients above average?

    Science.gov (United States)

    Wolf, Jacqueline H; Wolf, Kevin S

    2013-12-01

    When elderly patients face a terminal illness such as lung cancer, most are unaware that what we term in this article "the Lake Wobegon effect" taints the treatment advice imparted to them by their oncologists. In framing treatment plans, cancer specialists tend to intimate that elderly patients are like the children living in Garrison Keillor's mythical Lake Wobegon: above average and thus likely to exceed expectations. In this article, we use the story of our mother's death from lung cancer to investigate the consequences of elderly people's inability to reconcile the grave reality of their illness with the overly optimistic predictions of their physicians. In this narrative analysis, we examine the routine treatment of elderly, terminally ill cancer patients through alternating lenses: the lens of a historian of medicine who also teaches ethics to medical students and the lens of an actuary who is able to assess physicians' claims for the outcome of medical treatments. We recognize that a desire to instill hope in patients shapes physicians' messages. We argue, however, that the automatic optimism conveyed to elderly, dying patients by cancer specialists prompts those patients to choose treatment that is ineffective and debilitating. Rather than primarily prolong life, treatments most notably diminish patients' quality of life, weaken the ability of patients and their families to prepare for their deaths, and contribute significantly to the unsustainable costs of the U.S. health care system. The case described in this article suggests how physicians can better help elderly, terminally ill patients make medical decisions that are less damaging to them and less costly to the health care system. © 2013 Milbank Memorial Fund.

  16. An investigation of scale effects in family substance abuse treatment programs

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    Lee A James

    2010-07-01

    Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

  17. Environmental stresses can alleviate the average deleterious effect of mutations

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    Leibler Stanislas

    2003-05-01

    Full Text Available Abstract Background Fundamental questions in evolutionary genetics, including the possible advantage of sexual reproduction, depend critically on the effects of deleterious mutations on fitness. Limited existing experimental evidence suggests that, on average, such effects tend to be aggravated under environmental stresses, consistent with the perception that stress diminishes the organism's ability to tolerate deleterious mutations. Here, we ask whether there are also stresses with the opposite influence, under which the organism becomes more tolerant to mutations. Results We developed a technique, based on bioluminescence, which allows accurate automated measurements of bacterial growth rates at very low cell densities. Using this system, we measured growth rates of Escherichia coli mutants under a diverse set of environmental stresses. In contrast to the perception that stress always reduces the organism's ability to tolerate mutations, our measurements identified stresses that do the opposite – that is, despite decreasing wild-type growth, they alleviate, on average, the effect of deleterious mutations. Conclusions Our results show a qualitative difference between various environmental stresses ranging from alleviation to aggravation of the average effect of mutations. We further show how the existence of stresses that are biased towards alleviation of the effects of mutations may imply the existence of average epistatic interactions between mutations. The results thus offer a connection between the two main factors controlling the effects of deleterious mutations: environmental conditions and epistatic interactions.

  18. Thermal motion in proteins: Large effects on the time-averaged interaction energies

    International Nuclear Information System (INIS)

    Goethe, Martin; Rubi, J. Miguel; Fita, Ignacio

    2016-01-01

    As a consequence of thermal motion, inter-atomic distances in proteins fluctuate strongly around their average values, and hence, also interaction energies (i.e. the pair-potentials evaluated at the fluctuating distances) are not constant in time but exhibit pronounced fluctuations. These fluctuations cause that time-averaged interaction energies do generally not coincide with the energy values obtained by evaluating the pair-potentials at the average distances. More precisely, time-averaged interaction energies behave typically smoother in terms of the average distance than the corresponding pair-potentials. This averaging effect is referred to as the thermal smoothing effect. Here, we estimate the strength of the thermal smoothing effect on the Lennard-Jones pair-potential for globular proteins at ambient conditions using x-ray diffraction and simulation data of a representative set of proteins. For specific atom species, we find a significant smoothing effect where the time-averaged interaction energy of a single atom pair can differ by various tens of cal/mol from the Lennard-Jones potential at the average distance. Importantly, we observe a dependency of the effect on the local environment of the involved atoms. The effect is typically weaker for bulky backbone atoms in beta sheets than for side-chain atoms belonging to other secondary structure on the surface of the protein. The results of this work have important practical implications for protein software relying on free energy expressions. We show that the accuracy of free energy expressions can largely be increased by introducing environment specific Lennard-Jones parameters accounting for the fact that the typical thermal motion of protein atoms depends strongly on their local environment.

  19. Thermal motion in proteins: Large effects on the time-averaged interaction energies

    Energy Technology Data Exchange (ETDEWEB)

    Goethe, Martin, E-mail: martingoethe@ub.edu; Rubi, J. Miguel [Departament de Física Fonamental, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona (Spain); Fita, Ignacio [Institut de Biologia Molecular de Barcelona, Baldiri Reixac 10, 08028 Barcelona (Spain)

    2016-03-15

    As a consequence of thermal motion, inter-atomic distances in proteins fluctuate strongly around their average values, and hence, also interaction energies (i.e. the pair-potentials evaluated at the fluctuating distances) are not constant in time but exhibit pronounced fluctuations. These fluctuations cause that time-averaged interaction energies do generally not coincide with the energy values obtained by evaluating the pair-potentials at the average distances. More precisely, time-averaged interaction energies behave typically smoother in terms of the average distance than the corresponding pair-potentials. This averaging effect is referred to as the thermal smoothing effect. Here, we estimate the strength of the thermal smoothing effect on the Lennard-Jones pair-potential for globular proteins at ambient conditions using x-ray diffraction and simulation data of a representative set of proteins. For specific atom species, we find a significant smoothing effect where the time-averaged interaction energy of a single atom pair can differ by various tens of cal/mol from the Lennard-Jones potential at the average distance. Importantly, we observe a dependency of the effect on the local environment of the involved atoms. The effect is typically weaker for bulky backbone atoms in beta sheets than for side-chain atoms belonging to other secondary structure on the surface of the protein. The results of this work have important practical implications for protein software relying on free energy expressions. We show that the accuracy of free energy expressions can largely be increased by introducing environment specific Lennard-Jones parameters accounting for the fact that the typical thermal motion of protein atoms depends strongly on their local environment.

  20. Patients knowledge about side effects of orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Mia Amalia

    2011-07-01

    Full Text Available Disharmonious of dental arrangement can possibly create problems for the patient, such as the masticatory function, esthetical, psychosocial, and also the increased risk of trauma and periodontal disease. These are reasons for a patient to seek orthodontic treatment. The aim of this study was to know the patient’s knowledge about the side effects possibility that they receive during orthodontic treatment. The side effects include pain experience during orthodontic treatment, the possibility of soft tissue damage, email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders, and relapse. A cross-sectional study was conducted in patients who registered at Orthodontic Department, Faculty of Dentistry, Universitas Indonesia on March-June 2009. The participants of this study were 100 patients, consist of 86 women and 14 men respectively. Twenty-seven questions about the side-effects of orthodontic treatment were used to obtain the patient’s knowledge and the result was categorized into 3 groups, good, average and poor. The result of the study showed that patient’s knowledge about the side effect of pain experience during orthodontic treatment was average and the patient’s knowledge about the possibility of soft tissue damage due to orthodontic treatment was good. However, the patient’s knowledge about the possibility of email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders and relapse due to orthodontic treatment was low.

  1. Analysis of subchannel effects and their treatment in average channel PWR core models

    International Nuclear Information System (INIS)

    Cuervo, D.; Ahnert, C.; Aragones, J.M.

    2004-01-01

    Neutronic thermal-hydraulic coupling is meanly made at this moment using whole plant thermal-hydraulic codes with one channel per assembly or quarter of assembly in more detailed cases. To extract safety limits variables a new calculation has to be performed using thermal-hydraulic subchannel codes in an embedded or off-line manner what implies an increase of calculation time. Another problem of this separated analysis of whole core and not channel is that the whole core calculation is not resolving the real problem due to the modification of the variables values by the homogenization process that is carried out to perform the whole core analysis. This process is making that some magnitudes are over or under-predicted causing that the problem that is being solved is not the original one. The purpose of the work that is being developed is to investigate the effects of the averaging process in the results obtained by the whole core analysis and to develop some corrections that may be included in this analysis to obtain results closer to the ones obtained by a detailed subchannel analysis. This paper shows the results obtained for a sample case and the conclusions for future work. (author)

  2. Alternate day treatment and late effects: The concept of an effective dose per fraction

    International Nuclear Information System (INIS)

    Courdi, A.; Hery, M.; Gabillat, J.M.

    1990-01-01

    Although most institutions treat all fields each day, some radiotherapists continue to adopt an alternate day schedule. The resulting daily variations of the dose per fraction in laterally located targets have been analyzed using the linear-quadratic model. Patients with breast carcinoma treated with definitive radiotherapy in 1974-1975 with one field a day were studied. An effective dose per fraction was derived, with a value higher than the average dose per fraction received by the reference point. The greater the fluctuations between the doses per fraction on successive days, the higher the effective dose per fraction. The corresponding cell survival due to alternate treatment as compared to survival with daily treatment depends on the alpha/beta ratio. For a late effect with low alpha/beta ratio, an alternate treatment may lead to almost 10-fold increase in cell kill in these lateral targets such as those responsible for subcutaneous sclerosis as compared to daily treatment of all fields with the same total dose. Taking the average effective dose per fraction in our series, the increase in cell kill was 4-fold. Acute effects would suffer less damage due to alternate treatment because of a high alpha/beta ratio. Treatment on an alternate schedule should be restricted to palliative radiotherapy

  3. GI Joe or Average Joe? The impact of average-size and muscular male fashion models on men's and women's body image and advertisement effectiveness.

    Science.gov (United States)

    Diedrichs, Phillippa C; Lee, Christina

    2010-06-01

    Increasing body size and shape diversity in media imagery may promote positive body image. While research has largely focused on female models and women's body image, men may also be affected by unrealistic images. We examined the impact of average-size and muscular male fashion models on men's and women's body image and perceived advertisement effectiveness. A sample of 330 men and 289 women viewed one of four advertisement conditions: no models, muscular, average-slim or average-large models. Men and women rated average-size models as equally effective in advertisements as muscular models. For men, exposure to average-size models was associated with more positive body image in comparison to viewing no models, but no difference was found in comparison to muscular models. Similar results were found for women. Internalisation of beauty ideals did not moderate these effects. These findings suggest that average-size male models can promote positive body image and appeal to consumers. 2010 Elsevier Ltd. All rights reserved.

  4. A Capital Mistake? The Neglected Effect of Immigration on Average Wages

    OpenAIRE

    Declan Trott

    2011-01-01

    Much recent literature on the wage effects of immigration assumes that the return to capital, and therefore the average wage, is unaffected in the long run. If immigration is modelled as a continuous flow rather than a one off shock, this result does not necessarily hold. A simple calibration with pre-crisis US immigration rates gives a reduction in average wages of 5%, larger than most estimates of its effect on relative wages.

  5. A multifactorial intervention for frail older people is more than twice as effective among those who are compliant: complier average causal effect analysis of a randomised trial.

    Science.gov (United States)

    Fairhall, Nicola; Sherrington, Catherine; Cameron, Ian D; Kurrle, Susan E; Lord, Stephen R; Lockwood, Keri; Herbert, Robert D

    2017-01-01

    What is the effect of a multifactorial intervention on frailty and mobility in frail older people who comply with their allocated treatment? Secondary analysis of a randomised, controlled trial to derive an estimate of complier average causal effect (CACE) of treatment. A total of 241 frail community-dwelling people aged ≥ 70 years. Intervention participants received a 12-month multidisciplinary intervention targeting frailty, with home exercise as an important component. Control participants received usual care. Primary outcomes were frailty, assessed using the Cardiovascular Health Study criteria (range 0 to 5 criteria), and mobility measured using the 12-point Short Physical Performance Battery. Outcomes were assessed 12 months after randomisation. The treating physiotherapist evaluated the amount of treatment received on a 5-point scale. 216 participants (90%) completed the study. The median amount of treatment received was 25 to 50% (range 0 to 100). The CACE (ie, the effect of treatment in participants compliant with allocation) was to reduce frailty by 1.0 frailty criterion (95% CI 0.4 to 1.5) and increase mobility by 3.2 points (95% CI 1.8 to 4.6) at 12 months. The mean CACE was substantially larger than the intention-to-treat effect, which was to reduce frailty by 0.4 frailty criteria (95% CI 0.1 to 0.7) and increase mobility by 1.4 points (95% CI 0.8 to 2.1) at 12 months. Overall, compliance was low in this group of frail people. The effect of the treatment on participants who comply with allocated treatment was substantially greater than the effect of allocation on all trial participants. Australian and New Zealand Trial Registry ANZCTRN12608000250336. [Fairhall N, Sherrington C, Cameron ID, Kurrle SE, Lord SR, Lockwood K, Herbert RD (2016) A multifactorial intervention for frail older people is more than twice as effective among those who are compliant: complier average causal effect analysis of a randomised trial.Journal of Physiotherapy63: 40

  6. Optimal transformation for correcting partial volume averaging effects in magnetic resonance imaging

    International Nuclear Information System (INIS)

    Soltanian-Zadeh, H.; Windham, J.P.; Yagle, A.E.

    1993-01-01

    Segmentation of a feature of interest while correcting for partial volume averaging effects is a major tool for identification of hidden abnormalities, fast and accurate volume calculation, and three-dimensional visualization in the field of magnetic resonance imaging (MRI). The authors present the optimal transformation for simultaneous segmentation of a desired feature and correction of partial volume averaging effects, while maximizing the signal-to-noise ratio (SNR) of the desired feature. It is proved that correction of partial volume averaging effects requires the removal of the interfering features from the scene. It is also proved that correction of partial volume averaging effects can be achieved merely by a linear transformation. It is finally shown that the optimal transformation matrix is easily obtained using the Gram-Schmidt orthogonalization procedure, which is numerically stable. Applications of the technique to MRI simulation, phantom, and brain images are shown. They show that in all cases the desired feature is segmented from the interfering features and partial volume information is visualized in the resulting transformed images

  7. Perceived Average Orientation Reflects Effective Gist of the Surface.

    Science.gov (United States)

    Cha, Oakyoon; Chong, Sang Chul

    2018-03-01

    The human ability to represent ensemble visual information, such as average orientation and size, has been suggested as the foundation of gist perception. To effectively summarize different groups of objects into the gist of a scene, observers should form ensembles separately for different groups, even when objects have similar visual features across groups. We hypothesized that the visual system utilizes perceptual groups characterized by spatial configuration and represents separate ensembles for different groups. Therefore, participants could not integrate ensembles of different perceptual groups on a task basis. We asked participants to determine the average orientation of visual elements comprising a surface with a contour situated inside. Although participants were asked to estimate the average orientation of all the elements, they ignored orientation signals embedded in the contour. This constraint may help the visual system to keep the visual features of occluding objects separate from those of the occluded objects.

  8. The background effective average action approach to quantum gravity

    DEFF Research Database (Denmark)

    D’Odorico, G.; Codello, A.; Pagani, C.

    2016-01-01

    of an UV attractive non-Gaussian fixed-point, which we find characterized by real critical exponents. Our closure method is general and can be applied systematically to more general truncations of the gravitational effective average action. © Springer International Publishing Switzerland 2016....

  9. The effects of average revenue regulation on electricity transmission investment and pricing

    International Nuclear Information System (INIS)

    Matsukawa, Isamu

    2008-01-01

    This paper investigates the long-run effects of average revenue regulation on an electricity transmission monopolist who applies a two-part tariff comprising a variable congestion price and a non-negative fixed access fee. A binding constraint on the monopolist's expected average revenue lowers the access fee, promotes transmission investment, and improves consumer surplus. In a case of any linear or log-linear electricity demand function with a positive probability that no congestion occurs, average revenue regulation is allocatively more efficient than a Coasian two-part tariff if the level of capacity under average revenue regulation is higher than that under a Coasian two-part tariff. (author)

  10. Estimation of average causal effect using the restricted mean residual lifetime as effect measure

    DEFF Research Database (Denmark)

    Mansourvar, Zahra; Martinussen, Torben

    2017-01-01

    with respect to their survival times. In observational studies where the factor of interest is not randomized, covariate adjustment is needed to take into account imbalances in confounding factors. In this article, we develop an estimator for the average causal treatment difference using the restricted mean...... residual lifetime as target parameter. We account for confounding factors using the Aalen additive hazards model. Large sample property of the proposed estimator is established and simulation studies are conducted in order to assess small sample performance of the resulting estimator. The method is also......Although mean residual lifetime is often of interest in biomedical studies, restricted mean residual lifetime must be considered in order to accommodate censoring. Differences in the restricted mean residual lifetime can be used as an appropriate quantity for comparing different treatment groups...

  11. The Influence of Direct Instruction on Student Self-appraisals: A Hierarchical Analysis of Treatment and Aptitude-Treatment Interaction Effects.

    Science.gov (United States)

    Corno, Lyn; And Others

    1981-01-01

    Treatment and aptitude-treatment interaction (ATI) effects were assessed on grade 3 student self-appraisal data relating to self-esteem, attitude, anxiety, and locus of control. In particular, parent instruction in learning skills resulted in significantly higher average scores on student self-esteem and attitude and lower scores on anxiety.…

  12. On Estimation of the Survivor Average Causal Effect in Observational Studies when Important Confounders are Missing Due to Death

    Science.gov (United States)

    Egleston, Brian L.; Scharfstein, Daniel O.; MacKenzie, Ellen

    2008-01-01

    We focus on estimation of the causal effect of treatment on the functional status of individuals at a fixed point in time t* after they have experienced a catastrophic event, from observational data with the following features: (1) treatment is imposed shortly after the event and is non-randomized, (2) individuals who survive to t* are scheduled to be interviewed, (3) there is interview non-response, (4) individuals who die prior to t* are missing information on pre-event confounders, (5) medical records are abstracted on all individuals to obtain information on post-event, pre-treatment confounding factors. To address the issue of survivor bias, we seek to estimate the survivor average causal effect (SACE), the effect of treatment on functional status among the cohort of individuals who would survive to t* regardless of whether or not assigned to treatment. To estimate this effect from observational data, we need to impose untestable assumptions, which depend on the collection of all confounding factors. Since pre-event information is missing on those who die prior to t*, it is unlikely that these data are missing at random (MAR). We introduce a sensitivity analysis methodology to evaluate the robustness of SACE inferences to deviations from the MAR assumption. We apply our methodology to the evaluation of the effect of trauma center care on vitality outcomes using data from the National Study on Costs and Outcomes of Trauma Care. PMID:18759833

  13. Observation on the therapeutic effect of aspirin in combined with acupuncture in the treatment of TIA

    Directory of Open Access Journals (Sweden)

    Jing Gao

    2017-02-01

    Full Text Available Objective: To observe the effect of aspirin in combined with acupuncture in the treatment of transient ischemic attack (TIA. Methods: A total of 90 patients with TIA who were admitted in our hospital were included in the study and randomized into the observation group and the control group with 45 cases in each group. The patients in the two groups were given aspirin and routine symptomatic treatments. On this basis, the patients in the observation group were given acupuncture. Two-week treatment was regarded as one course. The fasting venous blood before treatment and one course after treatment was collected to detect the serum lipid level. TCD was used to detect the average peak flow velocity of MCA, VA, and BA. A follow-up visit was paid to TIA attack times within 3 months. Results: TC, TG, and LDL levels after treatment in the two groups were significantly reduced when compared with before treatment, while HDL was significantly elevated when compared with before treatment. The comparison of TC, TG, LDL, and HDL after treatment between the two groups was not statistically significant. The comparison of the average peak flow velocity of MCA, VA, and BA before treatment between the two groups was not statistically significant. The average peak flow velocity of MCA and BA after treatment were significantly slowing down when compared with before treatment, while the average peak flow velocity of VA was not significantly different from that before treatment. The average peak flow velocity of MCA and BA after treatment in the treatment group was significantly lower than that in the control group. The average attack time of TIA every week after treatment in the observation group was significantly lower than that in the control group. Conclusions: Aspirin in combined with acupuncture in the treatment of TIA can effectively improve the cerebral hemodynamic indicators, and reduce TIA attack time; therefore, it deserves to be widely recommended in the

  14. Fractional averaging of repetitive waveforms induced by self-imaging effects

    Science.gov (United States)

    Romero Cortés, Luis; Maram, Reza; Azaña, José

    2015-10-01

    We report the theoretical prediction and experimental observation of averaging of stochastic events with an equivalent result of calculating the arithmetic mean (or sum) of a rational number of realizations of the process under test, not necessarily limited to an integer record of realizations, as discrete statistical theory dictates. This concept is enabled by a passive amplification process, induced by self-imaging (Talbot) effects. In the specific implementation reported here, a combined spectral-temporal Talbot operation is shown to achieve undistorted, lossless repetition-rate division of a periodic train of noisy waveforms by a rational factor, leading to local amplification, and the associated averaging process, by the fractional rate-division factor.

  15. The ugliness-in-averageness effect: Tempering the warm glow of familiarity.

    Science.gov (United States)

    Carr, Evan W; Huber, David E; Pecher, Diane; Zeelenberg, Rene; Halberstadt, Jamin; Winkielman, Piotr

    2017-06-01

    Mere exposure (i.e., stimulus repetition) and blending (i.e., stimulus averaging) are classic ways to increase social preferences, including facial attractiveness. In both effects, increases in preference involve enhanced familiarity. Prominent memory theories assume that familiarity depends on a match between the target and similar items in memory. These theories predict that when individual items are weakly learned, their blends (morphs) should be relatively familiar, and thus liked-a beauty-in-averageness effect ( BiA ). However, when individual items are strongly learned, they are also more distinguishable. This "differentiation" hypothesis predicts that with strongly encoded items, familiarity (and thus, preference) for the blend will be relatively lower than individual items-an ugliness-in-averageness effect ( UiA ). We tested this novel theoretical prediction in 5 experiments. Experiment 1 showed that with weak learning, facial morphs were more attractive than contributing individuals (BiA effect). Experiments 2A and 2B demonstrated that when participants first strongly learned a subset of individual faces (either in a face-name memory task or perceptual-tracking task), morphs of trained individuals were less attractive than the trained individuals (UiA effect). Experiment 3 showed that changes in familiarity for the trained morph (rather than interstimulus conflict) drove the UiA effect. Using a within-subjects design, Experiment 4 mapped out the transition from BiA to UiA solely as a function of memory training. Finally, computational modeling using a well-known memory framework (REM) illustrated the familiarity transition observed in Experiment 4. Overall, these results highlight how memory processes illuminate classic and modern social preference phenomena. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Coherence effects and average multiplicity in deep inelastic scattering at small χ

    International Nuclear Information System (INIS)

    Kisselev, A.V.; Petrov, V.A.

    1988-01-01

    The average hadron multiplicity in deep inelastic scattering at small χ is calculated in this paper. Its relationship with the average multiplicity in e + e - annihilation is established. As shown the results do not depend on a choice of the gauge vector. The important role of coherence effects in both space-like and time-like jet evolution is clarified. (orig.)

  17. Averaging models: parameters estimation with the R-Average procedure

    Directory of Open Access Journals (Sweden)

    S. Noventa

    2010-01-01

    Full Text Available The Functional Measurement approach, proposed within the theoretical framework of Information Integration Theory (Anderson, 1981, 1982, can be a useful multi-attribute analysis tool. Compared to the majority of statistical models, the averaging model can account for interaction effects without adding complexity. The R-Average method (Vidotto & Vicentini, 2007 can be used to estimate the parameters of these models. By the use of multiple information criteria in the model selection procedure, R-Average allows for the identification of the best subset of parameters that account for the data. After a review of the general method, we present an implementation of the procedure in the framework of R-project, followed by some experiments using a Monte Carlo method.

  18. A Method for Measuring Treatment Effects on the Treated without Randomization

    Directory of Open Access Journals (Sweden)

    P.A.V.B. Swamy

    2016-03-01

    Full Text Available This paper contributes to the literature on the estimation of causal effects by providing an analytical formula for individual specific treatment effects and an empirical methodology that allows us to estimate these effects. We derive the formula from a general model with minimal restrictions, unknown functional form and true unobserved variables such that it is a credible model of the underlying real world relationship. Subsequently, we manipulate the model in order to put it in an estimable form. In contrast to other empirical methodologies, which derive average treatment effects, we derive an analytical formula that provides estimates of the treatment effects on each treated individual. We also provide an empirical example that illustrates our methodology.

  19. Estimating scaled treatment effects with multiple outcomes.

    Science.gov (United States)

    Kennedy, Edward H; Kangovi, Shreya; Mitra, Nandita

    2017-01-01

    In classical study designs, the aim is often to learn about the effects of a treatment or intervention on a single outcome; in many modern studies, however, data on multiple outcomes are collected and it is of interest to explore effects on multiple outcomes simultaneously. Such designs can be particularly useful in patient-centered research, where different outcomes might be more or less important to different patients. In this paper, we propose scaled effect measures (via potential outcomes) that translate effects on multiple outcomes to a common scale, using mean-variance and median-interquartile range based standardizations. We present efficient, nonparametric, doubly robust methods for estimating these scaled effects (and weighted average summary measures), and for testing the null hypothesis that treatment affects all outcomes equally. We also discuss methods for exploring how treatment effects depend on covariates (i.e., effect modification). In addition to describing efficiency theory for our estimands and the asymptotic behavior of our estimators, we illustrate the methods in a simulation study and a data analysis. Importantly, and in contrast to much of the literature concerning effects on multiple outcomes, our methods are nonparametric and can be used not only in randomized trials to yield increased efficiency, but also in observational studies with high-dimensional covariates to reduce confounding bias.

  20. Thermal effects in high average power optical parametric amplifiers.

    Science.gov (United States)

    Rothhardt, Jan; Demmler, Stefan; Hädrich, Steffen; Peschel, Thomas; Limpert, Jens; Tünnermann, Andreas

    2013-03-01

    Optical parametric amplifiers (OPAs) have the reputation of being average power scalable due to the instantaneous nature of the parametric process (zero quantum defect). This Letter reveals serious challenges originating from thermal load in the nonlinear crystal caused by absorption. We investigate these thermal effects in high average power OPAs based on beta barium borate. Absorption of both pump and idler waves is identified to contribute significantly to heating of the nonlinear crystal. A temperature increase of up to 148 K with respect to the environment is observed and mechanical tensile stress up to 40 MPa is found, indicating a high risk of crystal fracture under such conditions. By restricting the idler to a wavelength range far from absorption bands and removing the crystal coating we reduce the peak temperature and the resulting temperature gradient significantly. Guidelines for further power scaling of OPAs and other nonlinear devices are given.

  1. Batch medication of intestinal infections in nursery pigs—A randomised clinical trial on the efficacy of treatment strategy, type of antibiotic and bacterial load on average daily weight gain

    DEFF Research Database (Denmark)

    Weber, Nicolai Rosager; Pedersen, Ken Steen; Hansen, Christian Fink

    2017-01-01

    after weaning) on average daily weight gain (ADG); (2) to compare the effect of treatment with doxycycline or tylosine on diarrhoea prevalence, pathogenic bacterial load, and ADG; (3) to evaluate PCR testing of faecal pen floor samples as a diagnostic tool for determining the optimal time of treatment...... difference (p = 0.04) of mean diarrhoea prevalence on day 21 of the study between pens treated with tylosine (0.254, 95% CI: 0.184–0.324), and doxycycline (0.167, 95% CI: 0.124–0.210). The type of antibiotic compound was not found to have a significant effect on ADG (p = 0.209). (3) Pigs starting treatment...... was achieved when treatment was initiated 14 days after weaning in pens where intestinal pathogens were detected. Doxycycline was more effective in reducing diarrhoea and LI excretion levels than treatment with tylosine....

  2. Sensitivity analysis for matched pair analysis of binary data: From worst case to average case analysis.

    Science.gov (United States)

    Hasegawa, Raiden; Small, Dylan

    2017-12-01

    In matched observational studies where treatment assignment is not randomized, sensitivity analysis helps investigators determine how sensitive their estimated treatment effect is to some unmeasured confounder. The standard approach calibrates the sensitivity analysis according to the worst case bias in a pair. This approach will result in a conservative sensitivity analysis if the worst case bias does not hold in every pair. In this paper, we show that for binary data, the standard approach can be calibrated in terms of the average bias in a pair rather than worst case bias. When the worst case bias and average bias differ, the average bias interpretation results in a less conservative sensitivity analysis and more power. In many studies, the average case calibration may also carry a more natural interpretation than the worst case calibration and may also allow researchers to incorporate additional data to establish an empirical basis with which to calibrate a sensitivity analysis. We illustrate this with a study of the effects of cellphone use on the incidence of automobile accidents. Finally, we extend the average case calibration to the sensitivity analysis of confidence intervals for attributable effects. © 2017, The International Biometric Society.

  3. Extension of the time-average model to Candu refueling schemes involving reshuffling

    International Nuclear Information System (INIS)

    Rouben, Benjamin; Nichita, Eleodor

    2008-01-01

    Candu reactors consist of a horizontal non-pressurized heavy-water-filled vessel penetrated axially by fuel channels, each containing twelve 50-cm-long fuel bundles cooled by pressurized heavy water. Candu reactors are refueled on-line and, as a consequence, the core flux and power distributions change continuously. For design purposes, a 'time-average' model was developed in the 1970's to calculate the average over time of the flux and power distribution and to study the effects of different refueling schemes. The original time-average model only allows treatment of simple push-through refueling schemes whereby fresh fuel is inserted at one end of the channel and irradiated fuel is removed from the other end. With the advent of advanced fuel cycles and new Candu designs, novel refueling schemes may be considered, such as reshuffling discharged fuel from some channels into other channels, to achieve better overall discharge burnup. Such reshuffling schemes cannot be handled by the original time-average model. This paper presents an extension of the time-average model to allow for the treatment of refueling schemes with reshuffling. Equations for the extended model are presented, together with sample results for a simple demonstration case. (authors)

  4. [Cost effectiveness in treatment of acute myeloid leukemia].

    Science.gov (United States)

    Nordmann, P; Schaffner, A; Dazzi, H

    2000-12-23

    Although the rise in health costs is a widely debated issue, in Switzerland it was until recently taken for granted that patients are given the best available treatment regardless of cost. An example of a disease requiring costly treatment is acute myelogenous leukaemia (AML). To relate cost to benefit we calculated expenditure per life years gained. To assess costs we determined the real cost of treatment up to total remission, followed by consolidation or withdrawal of treatment or death. For survival time exceeding the 2-year observation period we used data from recent literature. The average cost of treatment ranges up to 107,592 Swiss francs (CHF). In 1997 we treated 23 leukaemia patients at Zurich University Hospital and gained a total of 210 life years. This represents an average cost of CHF 11,741 per life year gained. Chief cost items were therapy and personnel costs for nursing staff, followed by hotel business and personnel costs for doctors and diagnosis. Our results for AML treatment are far removed from the $61,500 ranging up to $166,000 discussed in the literature as the "critical" QALY (quality adjusted life years) value. This is the first time the actual costs of AML therapy have been shown for a Swiss cohort. Despite high initial treatment costs and success only in a limited number of patients, the expenditure per QALY is surprisingly low and shows clearly the effectiveness of apparently costly acute medicine.

  5. The Effects of Average Revenue Regulation on Electricity Transmission Investment and Pricing

    OpenAIRE

    Isamu Matsukawa

    2005-01-01

    This paper investigates the long-run effects of average revenue regulation on an electricity transmission monopolist who applies a two- part tariff comprising a variable congestion price and a non-negative fixed access fee. A binding constraint on the monopolist fs expected average revenue lowers the access fee, promotes transmission investment, and improves consumer surplus. In a case of any linear or log-linear electricity demand function with a positive probability that no congestion occur...

  6. Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis.

    Science.gov (United States)

    Cardona-Arias, Jaiberth Antonio; López-Carvajal, Liliana; Tamayo Plata, Mery Patricia; Vélez, Iván Darío

    2017-05-01

    The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost-effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis. Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta-analysis. A standard costing was conducted. Average and incremental cost-effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses. The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost-effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta-analysis, thermotherapy may be a dominant strategy. The excellent cost-effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  7. Providing cost-effective treatment of hard-to-heal wounds in the community through use of NPWT.

    Science.gov (United States)

    Hampton, Jane

    2015-06-01

    The treatment of non-healing wounds accounts for a high proportion of wound care costs. Advanced technology treatments, such as negative pressure wound therapy (NPWT), could be cost-effective if they result in faster healing. The objective of this study is to assess the effect on healing and the cost-effectiveness of a single-use NPWT (i.e PICO by Smith & Nephew) when used on hard-to-heal wounds in a community setting. This was a cohort case study in which wounds were treated with NWPT for 2 weeks. Wounds were assessed every 2-4 weeks to a healed state. The weekly cost of treatment prior to intervention, that is, the products used and nurse time, were compared with treatment costs associated with NWPT and after a return to standard treatment. The study included 9 patients with leg ulcers or pressure ulcers that had been slow healing or non-healing for at least 6 weeks. While treated with NPWT, the average weekly reduction in wound size was 21%. The wound size achieved with NPWT was reached on average 10 weeks earlier than predicted. The increased healing rate continued after PICO stopped and 5 wounds healed on average 8 weeks later. Frequency of dressing changes fell from 4 times weekly at baseline to 2 times a week with NPWT and to 1.8 after NPWT stopped. Weekly cost of treatment with NPWT was, on average, 1.6 times higher than the baseline, but fell to 3 times less when NPWT stopped owing to the reduction in dressing changes. The amount of change in healing rate was considerably higher than the increase in costs associated with NPWT. NWPT is a cost-effective treatment for hard-to-heal wounds. Wounds decreased in size and healed more quickly under NWPT treatment than under standard treatment. Additional NPWT costs can be quickly offset by faster healing and a shortened treatment period.

  8. Effects of averaging over motion and the resulting systematic errors in radiation therapy

    International Nuclear Information System (INIS)

    Evans, Philip M; Coolens, Catherine; Nioutsikou, Elena

    2006-01-01

    The potential for systematic errors in radiotherapy of a breathing patient is considered using the statistical model of Bortfeld et al (2002 Phys. Med. Biol. 47 2203-20). It is shown that although averaging over 30 fractions does result in a narrow Gaussian distribution of errors, as predicted by the central limit theorem, the fact that one or a few samples of the breathing patient's motion distribution are used for treatment planning (in contrast to the many treatment fractions that are likely to be delivered) may result in a much larger error with a systematic component. The error distribution may be particularly large if a scan at breath-hold is used for planning. (note)

  9. TH-E-BRE-03: A Novel Method to Account for Ion Chamber Volume Averaging Effect in a Commercial Treatment Planning System Through Convolution

    International Nuclear Information System (INIS)

    Barraclough, B; Li, J; Liu, C; Yan, G

    2014-01-01

    Purpose: Fourier-based deconvolution approaches used to eliminate ion chamber volume averaging effect (VAE) suffer from measurement noise. This work aims to investigate a novel method to account for ion chamber VAE through convolution in a commercial treatment planning system (TPS). Methods: Beam profiles of various field sizes and depths of an Elekta Synergy were collected with a finite size ion chamber (CC13) to derive a clinically acceptable beam model for a commercial TPS (Pinnacle 3 ), following the vendor-recommended modeling process. The TPS-calculated profiles were then externally convolved with a Gaussian function representing the chamber (σ = chamber radius). The agreement between the convolved profiles and measured profiles was evaluated with a one dimensional Gamma analysis (1%/1mm) as an objective function for optimization. TPS beam model parameters for focal and extra-focal sources were optimized and loaded back into the TPS for new calculation. This process was repeated until the objective function converged using a Simplex optimization method. Planar dose of 30 IMRT beams were calculated with both the clinical and the re-optimized beam models and compared with MapCHEC™ measurements to evaluate the new beam model. Results: After re-optimization, the two orthogonal source sizes for the focal source reduced from 0.20/0.16 cm to 0.01/0.01 cm, which were the minimal allowed values in Pinnacle. No significant change in the parameters for the extra-focal source was observed. With the re-optimized beam model, average Gamma passing rate for the 30 IMRT beams increased from 92.1% to 99.5% with a 3%/3mm criterion and from 82.6% to 97.2% with a 2%/2mm criterion. Conclusion: We proposed a novel method to account for ion chamber VAE in a commercial TPS through convolution. The reoptimized beam model, with VAE accounted for through a reliable and easy-to-implement convolution and optimization approach, outperforms the original beam model in standard IMRT QA

  10. Averaging in spherically symmetric cosmology

    International Nuclear Information System (INIS)

    Coley, A. A.; Pelavas, N.

    2007-01-01

    The averaging problem in cosmology is of fundamental importance. When applied to study cosmological evolution, the theory of macroscopic gravity (MG) can be regarded as a long-distance modification of general relativity. In the MG approach to the averaging problem in cosmology, the Einstein field equations on cosmological scales are modified by appropriate gravitational correlation terms. We study the averaging problem within the class of spherically symmetric cosmological models. That is, we shall take the microscopic equations and effect the averaging procedure to determine the precise form of the correlation tensor in this case. In particular, by working in volume-preserving coordinates, we calculate the form of the correlation tensor under some reasonable assumptions on the form for the inhomogeneous gravitational field and matter distribution. We find that the correlation tensor in a Friedmann-Lemaitre-Robertson-Walker (FLRW) background must be of the form of a spatial curvature. Inhomogeneities and spatial averaging, through this spatial curvature correction term, can have a very significant dynamical effect on the dynamics of the Universe and cosmological observations; in particular, we discuss whether spatial averaging might lead to a more conservative explanation of the observed acceleration of the Universe (without the introduction of exotic dark matter fields). We also find that the correlation tensor for a non-FLRW background can be interpreted as the sum of a spatial curvature and an anisotropic fluid. This may lead to interesting effects of averaging on astrophysical scales. We also discuss the results of averaging an inhomogeneous Lemaitre-Tolman-Bondi solution as well as calculations of linear perturbations (that is, the backreaction) in an FLRW background, which support the main conclusions of the analysis

  11. Average effect estimates remain similar as evidence evolves from single trials to high-quality bodies of evidence: a meta-epidemiologic study.

    Science.gov (United States)

    Gartlehner, Gerald; Dobrescu, Andreea; Evans, Tammeka Swinson; Thaler, Kylie; Nussbaumer, Barbara; Sommer, Isolde; Lohr, Kathleen N

    2016-01-01

    The objective of our study was to use a diverse sample of medical interventions to assess empirically whether first trials rendered substantially different treatment effect estimates than reliable, high-quality bodies of evidence. We used a meta-epidemiologic study design using 100 randomly selected bodies of evidence from Cochrane reports that had been graded as high quality of evidence. To determine the concordance of effect estimates between first and subsequent trials, we applied both quantitative and qualitative approaches. For quantitative assessment, we used Lin's concordance correlation and calculated z-scores; to determine the magnitude of differences of treatment effects, we calculated standardized mean differences (SMDs) and ratios of relative risks. We determined qualitative concordance based on a two-tiered approach incorporating changes in statistical significance and magnitude of effect. First trials both overestimated and underestimated the true treatment effects in no discernible pattern. Nevertheless, depending on the definition of concordance, effect estimates of first trials were concordant with pooled subsequent studies in at least 33% but up to 50% of comparisons. The pooled magnitude of change as bodies of evidence advanced from single trials to high-quality bodies of evidence was 0.16 SMD [95% confidence interval (CI): 0.12, 0.21]. In 80% of comparisons, the difference in effect estimates was smaller than 0.5 SMDs. In first trials with large treatment effects (>0.5 SMD), however, estimates of effect substantially changed as new evidence accrued (mean change 0.68 SMD; 95% CI: 0.50, 0.86). Results of first trials often change, but the magnitude of change, on average, is small. Exceptions are first trials that present large treatment effects, which often dissipate as new evidence accrues. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Effect of tank geometry on its average performance

    Science.gov (United States)

    Orlov, Aleksey A.; Tsimbalyuk, Alexandr F.; Malyugin, Roman V.; Leontieva, Daria A.; Kotelnikova, Alexandra A.

    2018-03-01

    The mathematical model of non-stationary filling of vertical submerged tanks with gaseous uranium hexafluoride is presented in the paper. There are calculations of the average productivity, heat exchange area, and filling time of various volumes tanks with smooth inner walls depending on their "height : radius" ratio as well as the average productivity, degree, and filling time of horizontal ribbing tank with volume 6.10-2 m3 with change central hole diameter of the ribs. It has been shown that the growth of "height / radius" ratio in tanks with smooth inner walls up to the limiting values allows significantly increasing tank average productivity and reducing its filling time. Growth of H/R ratio of tank with volume 1.0 m3 to the limiting values (in comparison with the standard tank having H/R equal 3.49) augments tank productivity by 23.5 % and the heat exchange area by 20%. Besides, we have demonstrated that maximum average productivity and a minimum filling time are reached for the tank with volume 6.10-2 m3 having central hole diameter of horizontal ribs 6.4.10-2 m.

  13. Lowest-order average effect of turbulence on atmospheric profiles derived from radio occultation

    International Nuclear Information System (INIS)

    Eshleman, V.R.; Haugstad, B.S.

    1977-01-01

    Turbulence in planetary atmospheres and ionospheres causes changes in angles of refraction of radio waves used in occultation experiments. Atmospheric temperature and pressure profiles, and ionospheric electron concentration profiles, derived from radio occultation measurements of Doppler frequency contain errors due to such angular offsets. The lowest-order average errors are derived from a geometrical-optics treatment of the radio-wave phase advance caused by the addition of uniform turbulence to an initially homogeneous medium. It is concluded that the average profile errors are small and that precise Doppler frequency measurements at two or more wavelengths could be used to help determine characteristics of the turbulence, as well as accuracy limits and possible correction terms for the profiles. However, a more detailed study of both frequency and intensity characteristics in radio and optical occultation measurements of turbulent planetary atmospheres and ionospheres is required to realize the full potential of such measurements

  14. A METHOD FOR DETERMINING THE RADIALLY-AVERAGED EFFECTIVE IMPACT AREA FOR AN AIRCRAFT CRASH INTO A STRUCTURE

    Energy Technology Data Exchange (ETDEWEB)

    Walker, William C. [ORNL

    2018-02-01

    This report presents a methodology for deriving the equations which can be used for calculating the radially-averaged effective impact area for a theoretical aircraft crash into a structure. Conventionally, a maximum effective impact area has been used in calculating the probability of an aircraft crash into a structure. Whereas the maximum effective impact area is specific to a single direction of flight, the radially-averaged effective impact area takes into consideration the real life random nature of the direction of flight with respect to a structure. Since the radially-averaged effective impact area is less than the maximum effective impact area, the resulting calculated probability of an aircraft crash into a structure is reduced.

  15. Evaluation on the cost-effective threshold of osteoporosis treatment on elderly women in China using discrete event simulation model.

    Science.gov (United States)

    Ni, W; Jiang, Y

    2017-02-01

    This study used a simulation model to determine the cost-effective threshold of fracture risk to treat osteoporosis among elderly Chinese women. Osteoporosis treatment is cost-effective among average-risk women who are at least 75 years old and above-average-risk women who are younger than 75 years old. Aging of the Chinese population is imposing increasing economic burden of osteoporosis. This study evaluated the cost-effectiveness of osteoporosis treatment among the senior Chinese women population. A discrete event simulation model using age-specific probabilities of hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture; costs (2015 US dollars); and quality-adjusted life years (QALYs) was used to assess the cost-effectiveness of osteoporosis treatment. Incremental cost-effectiveness ratio (ICER) was calculated. The willingness to pay (WTP) for a QALY in China was compared with the calculated ICER to decide the cost-effectiveness. To determine the absolute 10-year hip fracture probability at which the osteoporosis treatment became cost-effective, average age-specific probabilities for all fractures were multiplied by a relative risk (RR) that was systematically varied from 0 to 10 until the WTP threshold was observed for treatment relative to no intervention. Sensitivity analyses were also performed to evaluate the impacts from WTP and annual treatment costs. In baseline analysis, simulated ICERs were higher than the WTP threshold among Chinese women younger than 75, but much lower than the WTP among the older population. Sensitivity analyses indicated that cost-effectiveness could vary due to a higher WTP threshold or a lower annual treatment cost. A 30 % increase in WTP or a 30 % reduction in annual treatment costs will make osteoporosis treatment cost-effective for Chinese women population from 55 to 85. The current study provides evidence that osteoporosis treatment is cost-effective among a subpopulation of

  16. Treatment Effects

    DEFF Research Database (Denmark)

    Heckman, James J.; Lopes, Hedibert F.; Piatek, Rémi

    2014-01-01

    This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low-dimensional v......This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low...... to observe the same person in both the treated and untreated states, but it also turns out to be straightforward to implement. Formulae are provided to compute mean treatment effects as well as their distributional versions. A Monte Carlo simulation study is carried out to illustrate how the methodology can...

  17. Effect of temporal averaging of meteorological data on predictions of groundwater recharge

    Directory of Open Access Journals (Sweden)

    Batalha Marcia S.

    2018-06-01

    Full Text Available Accurate estimates of infiltration and groundwater recharge are critical for many hydrologic, agricultural and environmental applications. Anticipated climate change in many regions of the world, especially in tropical areas, is expected to increase the frequency of high-intensity, short-duration precipitation events, which in turn will affect the groundwater recharge rate. Estimates of recharge are often obtained using monthly or even annually averaged meteorological time series data. In this study we employed the HYDRUS-1D software package to assess the sensitivity of groundwater recharge calculations to using meteorological time series of different temporal resolutions (i.e., hourly, daily, weekly, monthly and yearly averaged precipitation and potential evaporation rates. Calculations were applied to three sites in Brazil having different climatological conditions: a tropical savanna (the Cerrado, a humid subtropical area (the temperate southern part of Brazil, and a very wet tropical area (Amazonia. To simplify our current analysis, we did not consider any land use effects by ignoring root water uptake. Temporal averaging of meteorological data was found to lead to significant bias in predictions of groundwater recharge, with much greater estimated recharge rates in case of very uneven temporal rainfall distributions during the year involving distinct wet and dry seasons. For example, at the Cerrado site, using daily averaged data produced recharge rates of up to 9 times greater than using yearly averaged data. In all cases, an increase in the time of averaging of meteorological data led to lower estimates of groundwater recharge, especially at sites having coarse-textured soils. Our results show that temporal averaging limits the ability of simulations to predict deep penetration of moisture in response to precipitation, so that water remains in the upper part of the vadose zone subject to upward flow and evaporation.

  18. Cognitive Capitalism: Economic Freedom Moderates the Effects of Intellectual and Average Classes on Economic Productivity.

    Science.gov (United States)

    Coyle, Thomas R; Rindermann, Heiner; Hancock, Dale

    2016-10-01

    Cognitive ability stimulates economic productivity. However, the effects of cognitive ability may be stronger in free and open economies, where competition rewards merit and achievement. To test this hypothesis, ability levels of intellectual classes (top 5%) and average classes (country averages) were estimated using international student assessments (Programme for International Student Assessment; Trends in International Mathematics and Science Study; and Progress in International Reading Literacy Study) (N = 99 countries). The ability levels were correlated with indicators of economic freedom (Fraser Institute), scientific achievement (patent rates), innovation (Global Innovation Index), competitiveness (Global Competitiveness Index), and wealth (gross domestic product). Ability levels of intellectual and average classes strongly predicted all economic criteria. In addition, economic freedom moderated the effects of cognitive ability (for both classes), with stronger effects at higher levels of freedom. Effects were particularly robust for scientific achievements when the full range of freedom was analyzed. The results support cognitive capitalism theory: cognitive ability stimulates economic productivity, and its effects are enhanced by economic freedom. © The Author(s) 2016.

  19. Overfulfilling the norm : The Better-Than-Average effect in judgments of attitudes

    NARCIS (Netherlands)

    Stavrova, O.; Koeneke, Vanessa; Schloesser, Thomas

    This research extends the better-than-average (BTA) effect commonly observed in judgments of abilities and personality traits to the domain of attitudes. Participants reported their attitudes toward 18 sociopolitical issues and estimated the attitudes of most other people toward these issues.

  20. The cost-effectiveness of depression treatment for co-occurring disorders: a clinical trial

    OpenAIRE

    Watkins, Katherine E.; Cuellar, Alison E.; Hepner, Kimberly A.; Hunter, Sarah B.; Paddock, Susan M.; Ewing, Brett A.; de la Cruz, Erin

    2013-01-01

    The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment. Using a quasi-experimental design and an intention-to-treat analysis, the incremental cost-effectiveness and cost-utility ratio of the intervention were estimated relative to usual care residential treatment. The average cost of a treatment episode was $908, compared to $180 for usual care. The i...

  1. The partially averaged field approach to cosmic ray diffusion

    International Nuclear Information System (INIS)

    Jones, F.C.; Birmingham, T.J.; Kaiser, T.B.

    1976-08-01

    The kinetic equation for particles interacting with turbulent fluctuations is derived by a new nonlinear technique which successfully corrects the difficulties associated with quasilinear theory. In this new method the effects of the fluctuations are evaluated along particle orbits which themselves include the effects of a statistically averaged subset of the possible configurations of the turbulence. The new method is illustrated by calculating the pitch angle diffusion coefficient D/sub Mu Mu/ for particles interacting with slab-model magnetic turbulence, i.e., magnetic fluctuations linearly polarized transverse to a mean magnetic field. Results are compared with those of quasilinear theory and also with those of Monte Carlo calculations. The major effect of the nonlinear treatment in this illustration is the determination of D/sub Mu Mu/ in the vicinity of 90 deg pitch angles where quasilinear theory breaks down. The spatial diffusion coefficient parallel to a mean magnetic field is evaluated using D/sub Mu Mu/ as calculated by this technique. It is argued that the partially averaged field method is not limited to small amplitude fluctuating fields, and is, hence, not a perturbation theory

  2. Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT).

    Science.gov (United States)

    2005-09-10

    To compare the cost effectiveness of social behaviour and network therapy, a new treatment for alcohol problems, with that of the proved motivational enhancement therapy. Cost effectiveness analysis alongside a pragmatic randomised trial. Seven treatment sites around Birmingham, Cardiff, and Leeds. 742 clients with alcohol problems; 617 (83.2%) were interviewed at 12 months and full economic data were obtained on 608 (98.5% of 617). Main economic measures Quality adjusted life years (QALYs), costs of trial treatments, and consequences for public sector resources (health care, other alcohol treatment, social services, and criminal justice services). Both therapies saved about five times as much in expenditure on health, social, and criminal justice services as they cost. Neither net savings nor cost effectiveness differed significantly between the therapies, despite the average cost of social behaviour and network therapy (221 pounds sterling; 385 dollars; 320 euros) being significantly more than that of motivational enhancement therapy (129 pounds sterling). If a QALY were worth 30,000 pounds sterling, then the motivational therapy would have 58% chance of being more cost effective than the social therapy, and the social therapy would have 42% chance of being more cost effective than the motivational therapy. Participants reported highly significant reductions in drinking and associated problems and costs. The novel social behaviour and network therapy did not differ significantly in cost effectiveness from the proved motivational enhancement therapy.

  3. Improved averaging for non-null interferometry

    Science.gov (United States)

    Fleig, Jon F.; Murphy, Paul E.

    2013-09-01

    Arithmetic averaging of interferometric phase measurements is a well-established method for reducing the effects of time varying disturbances, such as air turbulence and vibration. Calculating a map of the standard deviation for each pixel in the average map can provide a useful estimate of its variability. However, phase maps of complex and/or high density fringe fields frequently contain defects that severely impair the effectiveness of simple phase averaging and bias the variability estimate. These defects include large or small-area phase unwrapping artifacts, large alignment components, and voids that change in number, location, or size. Inclusion of a single phase map with a large area defect into the average is usually sufficient to spoil the entire result. Small-area phase unwrapping and void defects may not render the average map metrologically useless, but they pessimistically bias the variance estimate for the overwhelming majority of the data. We present an algorithm that obtains phase average and variance estimates that are robust against both large and small-area phase defects. It identifies and rejects phase maps containing large area voids or unwrapping artifacts. It also identifies and prunes the unreliable areas of otherwise useful phase maps, and removes the effect of alignment drift from the variance estimate. The algorithm has several run-time adjustable parameters to adjust the rejection criteria for bad data. However, a single nominal setting has been effective over a wide range of conditions. This enhanced averaging algorithm can be efficiently integrated with the phase map acquisition process to minimize the number of phase samples required to approach the practical noise floor of the metrology environment.

  4. Effective dose evaluation for BNCT treatment in the epithermal neutron beam at THOR

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J.N. [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)] [Division of Health Physics, Institute of Nuclear Energy Research, No. 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan (China); Huang, C.K. [Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Tsai, W.C. [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Liu, Y.H. [Nuclear Science and Technol. Develop. Center, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Jiang, S.H., E-mail: shjiang@mx.nthu.edu.tw [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)] [Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)

    2011-12-15

    This paper aims to evaluate the effective dose as well as equivalent doses of several organs of an adult hermaphrodite mathematical phantom according to the definition of ICRP Publication 60 for BNCT treatments of brain tumors in the epithermal neutron beam at THOR. The MCNP5 Monte Carlo code was used for the calculation of the average absorbed dose of each organ. The effective doses for a typical brain tumor treatment with a tumor treatment dose of 20 Gy-eq were evaluated to be 0.59 and 0.35 Sv for the LLAT and TOP irradiation geometries, respectively. In addition to the stochastic effect, it was found that it is also likely to produce deterministic effects, such as cataracts and depression of haematopoiesis.

  5. Influence of timer end-effects on Gamma knife (Type B) treatment

    International Nuclear Information System (INIS)

    Baba, Sadaaki; Ito, Teruo; Toyoda, Tatsuya; Wakamatsu, Osamu; Machida, Toru

    2004-01-01

    We investigated the influence of timer end-effects retrospectively in cases treated with Gamma knife (Type B) in the first year and in the fifth year after installation. Objects were 113 cases from April 1997 to December 1997 and 230 cases between January 2001 and December 2001. The influence of timer end-effects was calculated in the following formula: influence of timer end-effects=Σ (timer end-effects/shot time)/(number of lesions x number of shots). Ten factors such as the output at the center of polystyrene sphere phantom, the number of lesions, the number of shots, the delivered maximum absorbed dose, total irradiation time and the frequency in the use of each collimator helmet were examined as factors of the influence. The average values of timer end-effects were 4.7±0.27, 4.3±0.27, 3.6±0.24 and 3.5±0.29%/min. for 18, 14, 8 and 4 mm collimator helmets, respectively and depended on field size. We believe that the unit '%/min.' must be accepted instead of '%'. Gamma knife treatment is stereotactic radiosurgery and 40-50 Gy is irradiated within several hours with about ten shots. So the influence of timer end-effects was calculated 0.82±0.80% in 1997 and 0.51±0.41% in 2001 on average. These data suggest that there was little influence on the treatment. These figures were average values per lesion, so the influence may be more complicated in each part of lesions. The difference between the influence of timer end-effects in 1997 and 2001 was considered to be caused by the elongation of shot time according to Cobalt-60 decay, the reduction of the number of shots by frequent use of 14 mm collimator helmet, and the restriction of the number of treated lesions. (author)

  6. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

    Directory of Open Access Journals (Sweden)

    Chola Lumbwe

    2009-10-01

    Full Text Available Abstract Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions.

  7. Mental health care and average happiness: strong effect in developed nations.

    Science.gov (United States)

    Touburg, Giorgio; Veenhoven, Ruut

    2015-07-01

    Mental disorder is a main cause of unhappiness in modern society and investment in mental health care is therefore likely to add to average happiness. This prediction was checked in a comparison of 143 nations around 2005. Absolute investment in mental health care was measured using the per capita number of psychiatrists and psychologists working in mental health care. Relative investment was measured using the share of mental health care in the total health budget. Average happiness in nations was measured with responses to survey questions about life-satisfaction. Average happiness appeared to be higher in countries that invest more in mental health care, both absolutely and relative to investment in somatic medicine. A data split by level of development shows that this difference exists only among developed nations. Among these nations the link between mental health care and happiness is quite strong, both in an absolute sense and compared to other known societal determinants of happiness. The correlation between happiness and share of mental health care in the total health budget is twice as strong as the correlation between happiness and size of the health budget. A causal effect is likely, but cannot be proved in this cross-sectional analysis.

  8. Weighing the potential effectiveness of various treatments for sleep bruxism.

    Science.gov (United States)

    Huynh, Nelly; Manzini, Christiane; Rompré, Pierre H; Lavigne, Gilles J

    2007-10-01

    Sleep bruxism may lead to a variety of problems, but its pathophysiology has not been completely elucidated. As such, there is no definitive treatment, but certain preventive measures and/or drugs may be used in acute cases, particularly those involving pain. This article is intended to guide clinician scientists to the treatment most appropriate for future clinical studies. To determine the best current treatment, 2 measures were used to compare the results of 10 clinical studies on sleep bruxism, 3 involving oral devices and 7 involving pharmacologic therapy. The first measure, the number needed to treat (NNT), allows several randomized clinical studies to be compared and a general conclusion to be drawn. The second measure, effect size, allows evaluation of the impact of treatment relative to a placebo using different studies of similar design. Taking into account the NNT, the effect size and the power of each study, it can be concluded that the following treatments reduce sleep bruxism: mandibular advancement device, clonidine and occlusal splint. However, the first 2 of these have been linked to adverse effects. The occlusal splint is therefore the treatment of choice, as it reduces grinding noise and protects the teeth from premature wear with no reported adverse effects. The NNT could not be calculated for an alternative pharmacologic treatment, short-term clonazepam therapy, which had a large effect size and reduced the average bruxism index. However, the risk of dependency limits its use over long periods. Assessment of efficacy and safety of the most promising treatments will require studies with larger sample sizes over longer periods.

  9. Cost-effectiveness analysis of treatments for premenstrual dysphoric disorder.

    Science.gov (United States)

    Rendas-Baum, Regina; Yang, Min; Gricar, Joseph; Wallenstein, Gene V

    2010-01-01

    Premenstrual syndrome (PMS) is reported to affect between 13% and 31% of women. Between 3% and 8% of women are reported to meet criteria for the more severe form of PMS, premenstrual dysphoric disorder (PMDD). Although PMDD has received increased attention in recent years, the cost effectiveness of treatments for PMDD remains unknown. To evaluate the cost effectiveness of the four medications with a US FDA-approved indication for PMDD: fluoxetine, sertraline, paroxetine and drospirenone plus ethinyl estradiol (DRSP/EE). A decision-analytic model was used to evaluate both direct costs (medication and physician visits) and clinical outcomes (treatment success, failure and discontinuation). Medication costs were based on average wholesale prices of branded products; physician visit costs were obtained from a claims database study of PMDD patients and the Agency for Healthcare Research and Quality. Clinical outcome probabilities were derived from published clinical trials in PMDD. The incremental cost-effectiveness ratio (ICER) was calculated using the difference in costs and percentage of successfully treated patients at 6 months. Deterministic and probabilistic sensitivity analyses were used to assess the impact of uncertainty in parameter estimates. Threshold values where a change in the cost-effective strategy occurred were identified using a net benefit framework. Starting therapy with DRSP/EE dominated both sertraline and paroxetine, but not fluoxetine. The estimated ICER of initiating treatment with fluoxetine relative to DRSP/EE was $US4385 per treatment success (year 2007 values). Cost-effectiveness acceptability curves revealed that for ceiling ratios>or=$US3450 per treatment success, fluoxetine had the highest probability (>or=0.37) of being the most cost-effective treatment, relative to the other options. The cost-effectiveness acceptability frontier further indicated that DRSP/EE remained the option with the highest expected net monetary benefit for

  10. Treatment and posttreatment effects of mandibular cervical headgear followed by fixed appliances in Class III malocclusion.

    Science.gov (United States)

    Rey, Diego; Angel, David; Oberti, Giovanni; Baccetti, Tiziano

    2008-03-01

    In this cephalometric investigation, we compared the treatment and posttreatment effects on patients undergoing an initial phase of mandibular cervical headgear (MCH) therapy followed later by comprehensive edgewise therapy with untreated Class III controls. The treated sample consisted of 21 patients treated consecutively with MCH before the pubertal growth spurt (average age, 10 years 2 months at the beginning of treatment). At the final observation period (average age, 15 years 3 months), all patients were in decelerative growth phases as determined by the cervical vertebral maturation method. Active treatment and posttreatment effects were evaluated in the treated group with nonparametric statistical analysis for paired samples. The treated sample was compared with a nonparametric statistical test for independent samples with 20 untreated Class III subjects who were matched for malocclusion, sex, and stage of cervical vertebral maturation to the treatment group. MCH therapy followed by fixed appliances was shown to be an effective treatment for the correction of skeletal Class III malocclusion at postpubertal observation. The favorable skeletal effects consisted mainly of smaller increases in mandibular length and advancement with respect to the controls, with the final outcome of significant improvements in the sagittal skeletal (+4 mm for the Wits appraisal) and dental (+2.7 mm for overjet, -4.4 mm for molar relationship) parameters. This treatment protocol also induced significant downward rotation of the mandible (2.8 degrees ).

  11. Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation

    Directory of Open Access Journals (Sweden)

    Hartz Susanne

    2012-02-01

    Full Text Available Abstract Background Previous cost-effectiveness studies of cholinesterase inhibitors have modeled Alzheimer's disease (AD progression and treatment effects through single or global severity measures, or progression to "Full Time Care". This analysis evaluates the cost-effectiveness of donepezil versus memantine or no treatment in Germany by considering correlated changes in cognition, behavior and function. Methods Rates of change were modeled using trial and registry-based patient level data. A discrete event simulation projected outcomes for three identical patient groups: donepezil 10 mg, memantine 20 mg and no therapy. Patient mix, mortality and costs were developed using Germany-specific sources. Results Treatment of patients with mild to moderately severe AD with donepezil compared to no treatment was associated with 0.13 QALYs gained per patient, and 0.01 QALYs gained per caregiver and resulted in average savings of €7,007 and €9,893 per patient from the healthcare system and societal perspectives, respectively. In patients with moderate to moderately-severe AD, donepezil compared to memantine resulted in QALY gains averaging 0.01 per patient, and savings averaging €1,960 and €2,825 from the healthcare system and societal perspective, respectively. In probabilistic sensitivity analyses, donepezil dominated no treatment in most replications and memantine in over 70% of the replications. Donepezil leads to savings in 95% of replications versus memantine. Conclusions Donepezil is highly cost-effective in patients with AD in Germany, leading to improvements in health outcomes and substantial savings compared to no treatment. This holds across a variety of sensitivity analyses.

  12. Stochastic modelling to assess economic effects of treatment of chronic subclinical mastitis caused by Streptococcus uberis.

    Science.gov (United States)

    Steeneveld, Wilma; Swinkels, Jantijn; Hogeveen, Henk

    2007-11-01

    Chronic subclinical mastitis is usually not treated during the lactation. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of chronic subclinical mastitis caused by Streptococcus uberis. Factors in the model included the probability of cure after treatment, probability of the cow becoming clinically diseased, transmission of infection to other cows, and physiological effects of the infection. Using basic input parameters for Dutch circumstances, the average economic costs per cow of an untreated chronic subclinical mastitis case caused by Str. uberis in a single quarter from day of diagnosis onwards was euro109. With treatment, the average costs were higher (euro120). Thus, for the average cow, treatment was not efficient economically. However, the risk of high costs was much higher when cows with chronic subclinical mastitis were not treated. A sensitivity analysis showed that profitability of treatment of chronic subclinical Str. uberis mastitis depended on farm-specific factors (such as economic value of discarded milk) and cow-specific factors (such as day of diagnosis, duration of infection, amount of transmission to other cows and cure rate). Therefore, herd level protocols are not sufficient and decision support should be cow specific. Given the importance of cow-specific factors, information from the current model could be applied to automatic decision support systems.

  13. The side-effects to CPAP treatment inventory: the development and initial validation of a new tool for the measurement of side-effects to CPAP treatment.

    Science.gov (United States)

    Broström, Anders; Arestedt, Kristofer Franzén; Nilsen, Per; Strömberg, Anna; Ulander, Martin; Svanborg, Eva

    2010-12-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side-effects are common. No validated self-rating scale measuring side-effects to CPAP treatment exists today. The aim was to develop the side-effects to CPAP treatment inventory (SECI), and investigate the validity and reliability of the instrument among patients with OSAS. SECI was developed on the basis of: (1) in-depth interviews with 23 patients; (2) examination of the scientific literature and (3) consensus agreement of a multi-professional expert panel. This yielded 15 different types of side-effects related to CPAP treatment. Each side-effect has three sub-questions (scales): perceived frequency (a) and magnitude (b) of the side-effect, as well as its perceived impact on CPAP use (c). A cross-sectional descriptive design was used. A total of 329 patients with OSAS with an average use of CPAP treatment for 39 months (2 weeks to 182 months) were recruited. Data were collected with SECI, and obtained from medical records (clinical variables and data related to CPAP treatment). Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation). A logical two-factor solution, the device subscale and symptom subscale, emerged across all three scales. The symptom subscale describing physical and psychological side-effects and the device subscale described mask and device-related side-effects. Internal consistency reliability of the three scales was good (Cronbach's α = 0.74-0.86) and acceptable for the subscales (Cronbach's α = 0.62-0.86). The satisfactory measurement properties of this new instrument are promising and indicate that SECI can be used to measure side-effects to CPAP treatment. © 2010 European Sleep Research Society.

  14. Effects of topical anaesthetic and buccal meloxicam on average daily gain, behaviour and inflammation of unweaned beef calves following surgical castration.

    Science.gov (United States)

    Van der Saag, D; Lomax, S; Windsor, P A; Taylor, C; Thomson, P; Hall, E; White, P J

    2018-02-26

    Although the pain caused by castration of calves is a significant animal welfare issue for the beef industry, analgesia is not always used for this procedure, largely because of practical limitations associated with injectable forms of pain relief. Novel analgesic formulations have now been developed for livestock to allow topical and buccal administration, offering practical options to improve cattle welfare if shown to be effective. To assess the effects of topical anaesthetic (TA) and buccal meloxicam (BM) on average daily gain (ADG), behaviour and inflammation following surgical castration of beef calves, a total of 50 unweaned bull calves were randomly allocated to: (1) sham castration (SHAM, n=10); (2) surgical castration (C, n=10); (3) surgical castration with pre-operative buccal meloxicam (CBM, n=10); (4) surgical castration with post-operative topical anaesthetic (CTA, n=10); and (5) surgical castration with pre-operative buccal meloxicam and post-operative topical anaesthetic (CBMTA, n=10). Calves were recorded on video for 5 h following treatment and the frequency and duration of specific behaviours displayed by each animal was later observed for 5 min every hour (total of 25 min). Average daily gain was calculated 1, 2 and 6 days following treatment. Scrotal diameter measurements and photographs of wounds were collected from all castrated calves 1, 2 and 6 days following treatment to evaluate inflammation and wound healing. Infrared photographs were used to identify maximum scrotal temperature. Digital photographs were used to visually score wounds on a numerical rating scale of 1 to 5, with signs of inflammation increasing and signs of healing decreasing with progressive scores. Sham castration calves displayed significantly less, and C calves displayed significantly more foot stamps than all other calves (P=0.005). Observations on the duration of time that calves displayed a hypometric 'stiff gait' locomotion, indicated that SHAM calves tended to

  15. Effect of Helicobacter Pylori Treatment on the Number and Intensity of Migraine Attacks

    Directory of Open Access Journals (Sweden)

    Alireza Bakhshipour

    2012-06-01

    Full Text Available Background: Migraine is a common headache with an unknown cause. Migraine is about three times more common in women (18.2% than in men (6.2%. The recent studies have posed the possible relationship between the Helicobacter pylori infection and migraine headache. This study tries to analyze the effect of treating H. pylori infection on number and severity of migraine attacks.Materials and Methods: In this clinical pilot study, a number of 60 patients with migraine were examined in terms of infecting with H. pylori. Patients with the infections were treated by H. pylori eradication treatment standard triple regimen and the frequency and severity of their migraine attacks were measured for three months and finally the average of frequency and severity of attacks before and after treatment were compared. Results: The average frequency of the migraine attacks in patients with the H.pylori infection who have been treated was 7.1 before treatment and 2.7 after treatment (p=0.001. Likewise, the severity rate of such attacks in such patients was 9 which decreased to 4.5 after treatment (p=0.002. Conclusion: According to our study, patients with migraine attacks are preferred to be examined tested in terms of infecting with H. pylori. Thus, and eradication of this infection can be effective in decreasing of the migraine attacks.

  16. Effect of random edge failure on the average path length

    Energy Technology Data Exchange (ETDEWEB)

    Guo Dongchao; Liang Mangui; Li Dandan; Jiang Zhongyuan, E-mail: mgliang58@gmail.com, E-mail: 08112070@bjtu.edu.cn [Institute of Information Science, Beijing Jiaotong University, 100044, Beijing (China)

    2011-10-14

    We study the effect of random removal of edges on the average path length (APL) in a large class of uncorrelated random networks in which vertices are characterized by hidden variables controlling the attachment of edges between pairs of vertices. A formula for approximating the APL of networks suffering random edge removal is derived first. Then, the formula is confirmed by simulations for classical ER (Erdoes and Renyi) random graphs, BA (Barabasi and Albert) networks, networks with exponential degree distributions as well as random networks with asymptotic power-law degree distributions with exponent {alpha} > 2. (paper)

  17. Angle-averaged effective proton-carbon analyzing powers at intermediate energies

    International Nuclear Information System (INIS)

    Amir-Ahmadi, H.R.; Berg, A.M. van den; Hunyadi, M.; Kalantar-Nayestanaki, N.; Kis, M.; Mahjour-Shafiei, M.; Messchendorp, J.G.; Woertche, H.J.

    2006-01-01

    The angle-averaged effective analyzing powers, A-bar c , for proton-carbon inclusive scattering were measured as a function of the kinetic energy of protons in a double scattering experiment. The measurements were performed in the kinetic energy range of 44.8-136.5MeV at the center of 1-5cm thick graphite analyzers using a polarized proton beam on a CH 2 film or liquid hydrogen serving as target for the primary scattering. These data can be used for measuring the polarization of protons emerging from other reactions such as H(d-bar ,p-bar )d

  18. Averaging for solitons with nonlinearity management

    International Nuclear Information System (INIS)

    Pelinovsky, D.E.; Kevrekidis, P.G.; Frantzeskakis, D.J.

    2003-01-01

    We develop an averaging method for solitons of the nonlinear Schroedinger equation with a periodically varying nonlinearity coefficient, which is used to effectively describe solitons in Bose-Einstein condensates, in the context of the recently proposed technique of Feshbach resonance management. Using the derived local averaged equation, we study matter-wave bright and dark solitons and demonstrate a very good agreement between solutions of the averaged and full equations

  19. Multiphase averaging of periodic soliton equations

    International Nuclear Information System (INIS)

    Forest, M.G.

    1979-01-01

    The multiphase averaging of periodic soliton equations is considered. Particular attention is given to the periodic sine-Gordon and Korteweg-deVries (KdV) equations. The periodic sine-Gordon equation and its associated inverse spectral theory are analyzed, including a discussion of the spectral representations of exact, N-phase sine-Gordon solutions. The emphasis is on physical characteristics of the periodic waves, with a motivation from the well-known whole-line solitons. A canonical Hamiltonian approach for the modulational theory of N-phase waves is prescribed. A concrete illustration of this averaging method is provided with the periodic sine-Gordon equation; explicit averaging results are given only for the N = 1 case, laying a foundation for a more thorough treatment of the general N-phase problem. For the KdV equation, very general results are given for multiphase averaging of the N-phase waves. The single-phase results of Whitham are extended to general N phases, and more importantly, an invariant representation in terms of Abelian differentials on a Riemann surface is provided. Several consequences of this invariant representation are deduced, including strong evidence for the Hamiltonian structure of N-phase modulational equations

  20. Is aggressive treatment of traumatic brain injury cost-effective?

    Science.gov (United States)

    Whitmore, Robert G; Thawani, Jayesh P; Grady, M Sean; Levine, Joshua M; Sanborn, Matthew R; Stein, Sherman C

    2012-05-01

    The object of this study was to determine whether aggressive treatment of severe traumatic brain injury (TBI), including invasive intracranial monitoring and decompressive craniectomy, is cost-effective. A decision-analytical model was created to compare costs, outcomes, and cost-effectiveness of 3 strategies for treating a patient with severe TBI. The aggressive-care approach is compared with "routine care," in which Brain Trauma Foundation guidelines are not followed. A "comfort care" category, in which a single day in the ICU is followed by routine floor care, is included for comparison only. Probabilities of each treatment resulting in various Glasgow Outcome Scale (GOS) scores were obtained from the literature. The GOS scores were converted to quality-adjusted life years (QALYs), based on expected longevity and calculated quality of life associated with each GOS category. Estimated direct (acute and long-term medical care) and indirect (loss of productivity) costs were calculated from the perspective of society. Sensitivity analyses employed a 2D Monte Carlo simulation of 1000 trials, each with 1000 patients. The model was also used to estimate these values for patients 40, 60, and 80 years of age. For the average 20-year-old, aggressive care yields 11.7 (± 1.6 [SD]) QALYs, compared with routine care (10.0 ± 1.5 QALYs). This difference is highly significant (p care remains significantly better at all ages. When all costs are considered, aggressive care is also significantly less costly than routine care ($1,264,000 ± $118,000 vs $1,361,000 ± $107,000) for the average 20-year-old. Aggressive care remains significantly less costly until age 80, at which age it costs more than routine care. However, even in the 80-year-old, aggressive care is likely the more cost-effective approach. Comfort care is associated with poorer outcomes at all ages and with higher costs for all groups except 80-year-olds. When all the costs of severe TBI are considered, aggressive

  1. The Effect of Temperature Treatment on the Structure of Polyelectrolyte Multilayers

    Directory of Open Access Journals (Sweden)

    Maximilian Zerball

    2016-04-01

    Full Text Available The study addresses the effect of thermal treatment on the internal structure of polyelectrolyte multilayers (PEMs. In order to get insight into the internal structure of PEMs, Neutron Reflectometry (NR was used. PEMs with a deuterated inner block towards the substrate and a non-deuterated outer block were prepared and measured in 1% RH and in D2O before and after a thermal treatment. Complementarily, PEMs with the same number of layers but completely non-deuterated were investigated by ellipsometry. The analysis for the overall thickness (d, the average scattering length density (SLD and the refractive index (n indicate a degradation of the PEM. The loss in material is independent of the number of layers, i.e., only a constant part of the PEM is affected by degradation. The analysis of the internal structure revealed a more complex influence of thermal treatment on PEM structure. Only the outermost part of the PEM degenerates, while the inner part becomes denser during the thermal treatment. In addition, the swelling behavior of PEMs is influenced by the thermal treatment. The untreated PEM shows a well pronounced odd—even effect, i.e., PDADMAC-terminated PEMs take up more water than PSS-terminated PEMs. After the thermal treatment, the odd-even effect becomes much weaker.

  2. Averaging Robertson-Walker cosmologies

    International Nuclear Information System (INIS)

    Brown, Iain A.; Robbers, Georg; Behrend, Juliane

    2009-01-01

    The cosmological backreaction arises when one directly averages the Einstein equations to recover an effective Robertson-Walker cosmology, rather than assuming a background a priori. While usually discussed in the context of dark energy, strictly speaking any cosmological model should be recovered from such a procedure. We apply the scalar spatial averaging formalism for the first time to linear Robertson-Walker universes containing matter, radiation and dark energy. The formalism employed is general and incorporates systems of multiple fluids with ease, allowing us to consider quantitatively the universe from deep radiation domination up to the present day in a natural, unified manner. Employing modified Boltzmann codes we evaluate numerically the discrepancies between the assumed and the averaged behaviour arising from the quadratic terms, finding the largest deviations for an Einstein-de Sitter universe, increasing rapidly with Hubble rate to a 0.01% effect for h = 0.701. For the ΛCDM concordance model, the backreaction is of the order of Ω eff 0 ≈ 4 × 10 −6 , with those for dark energy models being within a factor of two or three. The impacts at recombination are of the order of 10 −8 and those in deep radiation domination asymptote to a constant value. While the effective equations of state of the backreactions in Einstein-de Sitter, concordance and quintessence models are generally dust-like, a backreaction with an equation of state w eff < −1/3 can be found for strongly phantom models

  3. The effect of stimulant and sedative use on treatment outcome of patients admitted to methadone maintenance treatment.

    Science.gov (United States)

    DeMaria, P A; Sterling, R; Weinstein, S P

    2000-01-01

    While methadone maintenance treatment (MMT) has been demonstrated to be an effective treatment for opiate dependence, its impact on the treatment outcome of other illicit drug abuse is not as clear. Using the initial urine drug screen (UDS) and follow-up UDS at 1, 6, 12, and 24 months, 167 patients consecutively admitted to MMT were evaluated for opiate, sedative (predominantly benzodiazepine), and stimulant (predominantly cocaine) use. Retention for the opiate only group was 97.32 days longer on average than for patients using opiates along with stimulants, sedatives, or both stimulants and sedatives. Patients abusing opiates only had the greatest decrease in drug use; however, MMT was also associated with decreases in cocaine and sedative use over the 24 month follow-up period. There was no evidence that patients "switched" their drugs of abuse with time in treatment. The negative impact of non-opiate drug use on outcome in MMT and its implications for treatment planning are discussed.

  4. Average spectral efficiency analysis of FSO links over turbulence channel with adaptive transmissions and aperture averaging

    Science.gov (United States)

    Aarthi, G.; Ramachandra Reddy, G.

    2018-03-01

    In our paper, the impact of adaptive transmission schemes: (i) optimal rate adaptation (ORA) and (ii) channel inversion with fixed rate (CIFR) on the average spectral efficiency (ASE) are explored for free-space optical (FSO) communications with On-Off Keying (OOK), Polarization shift keying (POLSK), and Coherent optical wireless communication (Coherent OWC) systems under different turbulence regimes. Further to enhance the ASE we have incorporated aperture averaging effects along with the above adaptive schemes. The results indicate that ORA adaptation scheme has the advantage of improving the ASE performance compared with CIFR under moderate and strong turbulence regime. The coherent OWC system with ORA excels the other modulation schemes and could achieve ASE performance of 49.8 bits/s/Hz at the average transmitted optical power of 6 dBm under strong turbulence. By adding aperture averaging effect we could achieve an ASE of 50.5 bits/s/Hz under the same conditions. This makes ORA with Coherent OWC modulation as a favorable candidate for improving the ASE of the FSO communication system.

  5. Plan averaging for multicriteria navigation of sliding window IMRT and VMAT

    International Nuclear Information System (INIS)

    Craft, David; Papp, Dávid; Unkelbach, Jan

    2014-01-01

    Purpose: To describe a method for combining sliding window plans [intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT)] for use in treatment plan averaging, which is needed for Pareto surface navigation based multicriteria treatment planning. Methods: The authors show that by taking an appropriately defined average of leaf trajectories of sliding window plans, the authors obtain a sliding window plan whose fluence map is the exact average of the fluence maps corresponding to the initial plans. In the case of static-beam IMRT, this also implies that the dose distribution of the averaged plan is the exact dosimetric average of the initial plans. In VMAT delivery, the dose distribution of the averaged plan is a close approximation of the dosimetric average of the initial plans. Results: The authors demonstrate the method on three Pareto optimal VMAT plans created for a demanding paraspinal case, where the tumor surrounds the spinal cord. The results show that the leaf averaged plans yield dose distributions that approximate the dosimetric averages of the precomputed Pareto optimal plans well. Conclusions: The proposed method enables the navigation of deliverable Pareto optimal plans directly, i.e., interactive multicriteria exploration of deliverable sliding window IMRT and VMAT plans, eliminating the need for a sequencing step after navigation and hence the dose degradation that is caused by such a sequencing step

  6. Plan averaging for multicriteria navigation of sliding window IMRT and VMAT.

    Science.gov (United States)

    Craft, David; Papp, Dávid; Unkelbach, Jan

    2014-02-01

    To describe a method for combining sliding window plans [intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT)] for use in treatment plan averaging, which is needed for Pareto surface navigation based multicriteria treatment planning. The authors show that by taking an appropriately defined average of leaf trajectories of sliding window plans, the authors obtain a sliding window plan whose fluence map is the exact average of the fluence maps corresponding to the initial plans. In the case of static-beam IMRT, this also implies that the dose distribution of the averaged plan is the exact dosimetric average of the initial plans. In VMAT delivery, the dose distribution of the averaged plan is a close approximation of the dosimetric average of the initial plans. The authors demonstrate the method on three Pareto optimal VMAT plans created for a demanding paraspinal case, where the tumor surrounds the spinal cord. The results show that the leaf averaged plans yield dose distributions that approximate the dosimetric averages of the precomputed Pareto optimal plans well. The proposed method enables the navigation of deliverable Pareto optimal plans directly, i.e., interactive multicriteria exploration of deliverable sliding window IMRT and VMAT plans, eliminating the need for a sequencing step after navigation and hence the dose degradation that is caused by such a sequencing step.

  7. Plan averaging for multicriteria navigation of sliding window IMRT and VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Craft, David, E-mail: dcraft@partners.org; Papp, Dávid; Unkelbach, Jan [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

    2014-02-15

    Purpose: To describe a method for combining sliding window plans [intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT)] for use in treatment plan averaging, which is needed for Pareto surface navigation based multicriteria treatment planning. Methods: The authors show that by taking an appropriately defined average of leaf trajectories of sliding window plans, the authors obtain a sliding window plan whose fluence map is the exact average of the fluence maps corresponding to the initial plans. In the case of static-beam IMRT, this also implies that the dose distribution of the averaged plan is the exact dosimetric average of the initial plans. In VMAT delivery, the dose distribution of the averaged plan is a close approximation of the dosimetric average of the initial plans. Results: The authors demonstrate the method on three Pareto optimal VMAT plans created for a demanding paraspinal case, where the tumor surrounds the spinal cord. The results show that the leaf averaged plans yield dose distributions that approximate the dosimetric averages of the precomputed Pareto optimal plans well. Conclusions: The proposed method enables the navigation of deliverable Pareto optimal plans directly, i.e., interactive multicriteria exploration of deliverable sliding window IMRT and VMAT plans, eliminating the need for a sequencing step after navigation and hence the dose degradation that is caused by such a sequencing step.

  8. Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load.

    Science.gov (United States)

    Odenwald, Michael; Semrau, Peter

    2013-03-21

    Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, but this has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change and behavioral change. Over the course of two months in 2009, 55 patients admitted to an alcohol detoxification unit of a psychiatric hospital were enrolled in this study. At treatment entry, we assessed lifetime Trauma Load and motivation to change. Mode of discharge was taken from patient files following therapy. We tested whether Trauma Load moderates the effect of motivation to change on dropout from alcohol detoxification using multivariate methods. 55.4% dropped out of detoxification treatment, while 44.6% completed the treatment. Age, gender and days in treatment did not differ between completers and dropouts. Patients who dropped out reported more traumatic event types on average than completers. Treatment completers had higher scores in the URICA subscale Maintenance. Multivariate methods confirmed the moderator effect of Trauma Load: among participants with high Trauma Load, treatment completion was related to higher Maintenance scores at treatment entry; this was not true among patients with low Trauma Load. We found evidence that the effect of motivation to change on detoxification treatment completion is moderated by Trauma Load: among patients with low Trauma Load, motivation to change is not relevant for treatment completion; among highly burdened patients, however, who a priori have a greater risk of dropping out, a high motivation to change might make the difference. This finding justifies targeted and specific interventions for highly burdened alcohol patients to increase their motivation to change.

  9. Fluctuation effects on average cross sections in compound, direct and doorway state resonance reactions

    International Nuclear Information System (INIS)

    Moldauer, P.A.

    1979-01-01

    The main features of the effects of S-matrix flucturations on average cross sections are reviewed with emphasis on recent developments on the enhancement of small cross sections and cross sections between directly coupled channels. Examples are given in which the effect can distort the shape of a doorway state resonance so as to reduce its observed width. 4 figures

  10. Effect of Two Different Levels of Fiber on Feed Intake, Average Daily Gain, Feed Efficiency and Ruminal Metabolites of Holstein Calves

    Directory of Open Access Journals (Sweden)

    A. Salary Neya

    2013-03-01

    Full Text Available This experiment was conducted to determine the effect of feeding alfalfa hay and starter fiber level on feed intake and performance of Holstein dairy calves, using thirty two male calves in a completely randomized design assigned to four diets in a 2×2 factorial arrangement. The experimental treatments were as follow: T1: starter with low fiber and without alfalfa hay, T2: starter with low fiber along with alfalfa hay, T3: starter with high fiber and without alfalfa hay and T4: starter with high fiber along with alfalfa hay. Results showed feed intake was not significantly different in pre-weaning and throughout the study but after weaning there was significant difference among treatments. Average daily gain of calves was not significantly different during pre-weaning period but during post-weaning and throughout the study there was significant difference among treatments for this trait. Feed efficiency was not significantly different among treatments in pre-weaning and post-weaning periods but it was significantly different during throughout the study. The results of this experiment showed adding fiber to dairy calves ration through both starter concentrate and alfalfa hay may reduce their performance.

  11. The cost-effectiveness of depression treatment for co-occurring disorders: a clinical trial.

    Science.gov (United States)

    Watkins, Katherine E; Cuellar, Alison E; Hepner, Kimberly A; Hunter, Sarah B; Paddock, Susan M; Ewing, Brett A; de la Cruz, Erin

    2014-02-01

    The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment. Using a quasi-experimental design and an intention-to-treat analysis, the incremental cost-effectiveness and cost-utility ratio of the intervention were estimated relative to usual care residential treatment. The average cost of a treatment episode was $908, compared to $180 for usual care. The incremental cost effectiveness ratio was $131 for each point improvement of the BDI-II and $49 for each additional depression-free day. The incremental cost-utility ratio ranged from $9,249 to $17,834 for each additional quality adjusted life year. Although the intervention costs substantially more than usual care, the cost effectiveness and cost-utility ratios compare favorably to other depression interventions. Health care reform should promote dissemination of group CBT to individuals with depression in residential SUD treatment. © 2013 Elsevier Inc. All rights reserved.

  12. Detecting treatment-subgroup interactions in clustered data with generalized linear mixed-effects model trees.

    Science.gov (United States)

    Fokkema, M; Smits, N; Zeileis, A; Hothorn, T; Kelderman, H

    2017-10-25

    Identification of subgroups of patients for whom treatment A is more effective than treatment B, and vice versa, is of key importance to the development of personalized medicine. Tree-based algorithms are helpful tools for the detection of such interactions, but none of the available algorithms allow for taking into account clustered or nested dataset structures, which are particularly common in psychological research. Therefore, we propose the generalized linear mixed-effects model tree (GLMM tree) algorithm, which allows for the detection of treatment-subgroup interactions, while accounting for the clustered structure of a dataset. The algorithm uses model-based recursive partitioning to detect treatment-subgroup interactions, and a GLMM to estimate the random-effects parameters. In a simulation study, GLMM trees show higher accuracy in recovering treatment-subgroup interactions, higher predictive accuracy, and lower type II error rates than linear-model-based recursive partitioning and mixed-effects regression trees. Also, GLMM trees show somewhat higher predictive accuracy than linear mixed-effects models with pre-specified interaction effects, on average. We illustrate the application of GLMM trees on an individual patient-level data meta-analysis on treatments for depression. We conclude that GLMM trees are a promising exploratory tool for the detection of treatment-subgroup interactions in clustered datasets.

  13. Effects of average degree of network on an order–disorder transition in opinion dynamics

    International Nuclear Information System (INIS)

    Cun-Fang, Feng; Jian-Yue, Guan; Ying-Hai, Wang; Zhi-Xi, Wu

    2010-01-01

    We have investigated the influence of the average degree (k) of network on the location of an order-disorder transition in opinion dynamics. For this purpose, a variant of majority rule (VMR) model is applied to Watts–Strogatz (WS) small-world networks and Barabási–Albert (BA) scale-free networks which may describe some non-trivial properties of social systems. Using Monte Carlo simulations, we find that the order–disorder transition point of the VMR model is greatly affected by the average degree (k) of the networks; a larger value of (k) results in a more ordered state of the system. Comparing WS networks with BA networks, we find WS networks have better orderliness than BA networks when the average degree (k) is small. With the increase of (k), BA networks have a more ordered state. By implementing finite-size scaling analysis, we also obtain critical exponents β/ν, γ/ν and 1/ν for several values of average degree (k). Our results may be helpful to understand structural effects on order–disorder phase transition in the context of the majority rule model. (general)

  14. The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Aronsson, Mattias; Walfridsson, Håkan; Janzon, Magnus

    2014-01-01

    AIM: The aim of this prospective substudy was to estimate the cost-effectiveness of treating paroxysmal atrial fibrillation (AF) with radiofrequency catheter ablation (RFA) compared with antiarrhythmic drugs (AADs) as first-line treatment. METHODS AND RESULTS: A decision-analytic Markov model......, based on MANTRA-PAF (Medical Antiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation) study data, was developed to study long-term effects and costs of RFA compared with AADs as first-line treatment. Positive clinical effects were found in the overall population, a gain...... of an average 0.06 quality-adjusted life years (QALYs) to an incremental cost of €3033, resulting in an incremental cost-effectiveness ratio of €50 570/QALY. However, the result of the subgroup analyses showed that RFA was less costly and more effective in younger patients. This implied an incremental cost-effectiveness...

  15. Aperture averaging in strong oceanic turbulence

    Science.gov (United States)

    Gökçe, Muhsin Caner; Baykal, Yahya

    2018-04-01

    Receiver aperture averaging technique is employed in underwater wireless optical communication (UWOC) systems to mitigate the effects of oceanic turbulence, thus to improve the system performance. The irradiance flux variance is a measure of the intensity fluctuations on a lens of the receiver aperture. Using the modified Rytov theory which uses the small-scale and large-scale spatial filters, and our previously presented expression that shows the atmospheric structure constant in terms of oceanic turbulence parameters, we evaluate the irradiance flux variance and the aperture averaging factor of a spherical wave in strong oceanic turbulence. Irradiance flux variance variations are examined versus the oceanic turbulence parameters and the receiver aperture diameter are examined in strong oceanic turbulence. Also, the effect of the receiver aperture diameter on the aperture averaging factor is presented in strong oceanic turbulence.

  16. When good = better than average

    Directory of Open Access Journals (Sweden)

    Don A. Moore

    2007-10-01

    Full Text Available People report themselves to be above average on simple tasks and below average on difficult tasks. This paper proposes an explanation for this effect that is simpler than prior explanations. The new explanation is that people conflate relative with absolute evaluation, especially on subjective measures. The paper then presents a series of four studies that test this conflation explanation. These tests distinguish conflation from other explanations, such as differential weighting and selecting the wrong referent. The results suggest that conflation occurs at the response stage during which people attempt to disambiguate subjective response scales in order to choose an answer. This is because conflation has little effect on objective measures, which would be equally affected if the conflation occurred at encoding.

  17. The effects of undergraduate nursing student-faculty interaction outside the classroom on college grade point average.

    Science.gov (United States)

    Al-Hussami, Mahmoud; Saleh, Mohammad Y N; Hayajneh, Ferial; Abdalkader, Raghed Hussein; Mahadeen, Alia I

    2011-09-01

    The effects of student-faculty interactions in higher education have received considerable empirical attention. However, there has been no empirical study that has examined the relation between student-faculty interaction and college grade point average. This is aimed at identifying the effect of nursing student-faculty interaction outside the classroom on students' semester college grade point average at a public university in Jordan. The research was cross-sectional study of the effect of student-faculty interaction outside the classroom on the students' semester college grade point average of participating juniors and seniors. Total interaction of the students was crucial as it is extremely significant (t = 16.2, df = 271, P ≤ 0.001) in relation to students' academic scores between those students who had ≥70 and those who had <70 academic scores. However, gender differences between students, and other variables were not significant either to affect students' academic scores or students' interaction. This study provides some evidence that student-faculty interactions outside classrooms are significantly associated with student's academically achievements. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Value-based medicine, comparative effectiveness, and cost-effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Brown, Heidi C; Peet, Jonathan; Roth, Zachary

    2009-02-01

    To assess the comparative effectiveness and cost-effectiveness (cost-utility) of a 0.05% emulsion of topical cyclosporine (Restasis; Allergan Inc, Irvine, California) for the treatment of moderate to severe dry eye syndrome that is unresponsive to conventional therapy. Data from 2 multicenter, randomized, clinical trials and Food and Drug Administration files for topical cyclosporine, 0.05%, emulsion were used in Center for Value-Based Medicine analyses. Analyses included value-based medicine as a comparative effectiveness analysis and average cost-utility analysis using societal and third-party insurer cost perspectives. Outcome measures of comparative effectiveness were quality-adjusted life-year (QALY) gain and percentage of improvement in quality of life, and for cost-effectiveness were cost-utility ratio (CUR) using dollars per QALY. Topical cyclosporine, 0.05%, confers a value gain (comparative effectiveness) of 0.0319 QALY per year compared with topical lubricant therapy, a 4.3% improvement in quality of life for the average patient with moderate to severe dry eye syndrome that is unresponsive to conventional lubricant therapy. The societal perspective incremental CUR for cyclosporine over vehicle therapy is $34,953 per QALY and the societal perspective average CUR is $11,199 per QALY. The third-party-insurer incremental CUR is $37,179 per QALY, while the third-party-insurer perspective average CUR is $34,343 per QALY. Topical cyclosporine emulsion, 0.05%, confers considerable patient value and is a cost-effective therapy for moderate to severe dry eye syndrome that is unresponsive to conventional therapy.

  19. Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

    Science.gov (United States)

    Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

    2016-01-01

    Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

  20. Effect of mastication and other mechanical treatments on fuel structure in chaparral

    Science.gov (United States)

    Brennan, Teresa J.; Keeley, Jon E.

    2015-01-01

    Mechanical fuel treatments are a common pre-fire strategy for reducing wildfire hazard that alters fuel structure by converting live canopy fuels to a compacted layer of dead surface fuels. Current knowledge concerning their effectiveness, however, comes primarily from forest-dominated ecosystems. Our objectives were to quantify and compare changes in shrub-dominated chaparral following crushing, mastication, re-mastication and mastication-plus-burning treatments, and to assess treatment longevity. Results from analysis of variance (ANOVA) identified significant differences in all fuel components by treatment type, vegetation type and time since treatment. Live woody fuel components of height, cover and mass were positively correlated with time since treatment, whereas downed woody fuel components were negatively correlated. Herbaceous fuels, conversely, were not correlated, and exhibited a 5-fold increase in cover across treatment types in comparison to controls. Average live woody fuel recovery was 50% across all treatment and vegetation types. Differences in recovery between time-since-treatment years 1–8 ranged from 32–65% and exhibited significant positive correlations with time since treatment. These results suggest that treatment effectiveness is short term due to the rapid regrowth of shrubs in these systems and is compromised by the substantial increase in herbaceous fuels. Consequences of not having a full understanding of these treatments are serious and leave concern for their widespread use on chaparral-dominated landscapes.

  1. Ra and the average effective strain of surface asperities deformed in metal-working processes

    DEFF Research Database (Denmark)

    Bay, Niels; Wanheim, Tarras; Petersen, A. S

    1975-01-01

    Based upon a slip-line analysis of the plastic deformation of surface asperities, a theory is developed determining the Ra-value (c.l.a.) and the average effective strain in the surface layer when deforming asperities in metal-working processes. The ratio between Ra and Ra0, the Ra-value after...... and before deformation, is a function of the nominal normal pressure and the initial slope γ0 of the surface asperities. The last parameter does not influence Ra significantly. The average effective strain View the MathML sourcege in the deformed surface layer is a function of the nominal normal pressure...... and γ0. View the MathML sourcege is highly dependent on γ0, View the MathML sourcege increasing with increasing γ0. It is shown that the Ra-value and the strain are hardly affected by the normal pressure until interacting deformation of the asperities begins, that is until the limit of Amonton's law...

  2. Effect of argon plasma treatment on the output performance of triboelectric nanogenerator

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Guang-Gui, E-mail: ggcheng@ujs.edu.cn [Research Center of Micro/Nano Science and Technology, Jiangsu University, Zhenjiang (China); Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, Changzhou (China); Jiang, Shi-Yu; Li, Kai [Research Center of Micro/Nano Science and Technology, Jiangsu University, Zhenjiang (China); Zhang, Zhong-Qiang [Research Center of Micro/Nano Science and Technology, Jiangsu University, Zhenjiang (China); Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, Changzhou (China); Wang, Ying; Yuan, Ning-Yi [Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, Changzhou (China); Ding, Jian-Ning, E-mail: dingjn@ujs.edu.cn [Research Center of Micro/Nano Science and Technology, Jiangsu University, Zhenjiang (China); Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, Changzhou (China); Zhang, Wei [Research Center of Micro/Nano Science and Technology, Jiangsu University, Zhenjiang (China)

    2017-08-01

    Highlights: • Two different kinds of PDMS films were prepared by spin-coated. • The PDMS surface was plasma treated with different power and time. • The output performance of TENG was significantly enhanced by plasma treatment. • Plasma treatment effect has time-efficient, the output declines with store time. - Abstract: Physical and chemical properties of the polymer surface play great roles in the output performance of triboelectric nanogenerator (TENG). Specific texture on the surface of polymer can enlarge the contact area and enhance the power output performance of TENG. In this paper, polydimethylsiloxane (PDMS) films with smooth and micro pillar arrays on the surface were prepared respectively. The surfaces were treated by argon plasma before testing their output performance. By changing treatment parameters such as treating time and plasma power, surfaces with different roughness and their relationship were achieved. The electrical output performances of the assembled TENG for each specimen showed that argon plasma treatment has a significant etching effect on the PDMS surface and greatly strengthen its output performance. The average surface roughness of PDMS film increases with the etching time from 5 mins to 15 mins when the argon plasma power is 60 W. Nevertheless, the average surface roughness is inversely proportional to the treatment time for the power of 90W. When treated with 90 W and 5 mins, many uniform micro pillars appeared on the both PDMS surface, and the output performance of the TENG for plasma treated smooth surface is 2.6 times larger than that before treatment. The output voltage increases from 42 V to 72 V, and the short circuit current increases from 4.2 μA to 8.3 μA after plasma treatment of the micro pillar array surface. However, this plasma treatment has time-efficient due to the hydrophobic recovery property of Ar plasma treated PDMS surface, both output voltage and short circuit current decrease significantly after 3

  3. State Averages

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of a variety of averages for each state or territory as well as the national average, including each quality measure, staffing, fine amount and number of...

  4. Safety Impact of Average Speed Control in the UK

    DEFF Research Database (Denmark)

    Lahrmann, Harry Spaabæk; Brassøe, Bo; Johansen, Jonas Wibert

    2016-01-01

    of automatic speed control was point-based, but in recent years a potentially more effective alternative automatic speed control method has been introduced. This method is based upon records of drivers’ average travel speed over selected sections of the road and is normally called average speed control...... in the UK. The study demonstrates that the introduction of average speed control results in statistically significant and substantial reductions both in speed and in number of accidents. The evaluation indicates that average speed control has a higher safety effect than point-based automatic speed control....

  5. Benefits of Dominance over Additive Models for the Estimation of Average Effects in the Presence of Dominance

    Directory of Open Access Journals (Sweden)

    Pascal Duenk

    2017-10-01

    Full Text Available In quantitative genetics, the average effect at a single locus can be estimated by an additive (A model, or an additive plus dominance (AD model. In the presence of dominance, the AD-model is expected to be more accurate, because the A-model falsely assumes that residuals are independent and identically distributed. Our objective was to investigate the accuracy of an estimated average effect (α^ in the presence of dominance, using either a single locus A-model or AD-model. Estimation was based on a finite sample from a large population in Hardy-Weinberg equilibrium (HWE, and the root mean squared error of α^ was calculated for several broad-sense heritabilities, sample sizes, and sizes of the dominance effect. Results show that with the A-model, both sampling deviations of genotype frequencies from HWE frequencies and sampling deviations of allele frequencies contributed to the error. With the AD-model, only sampling deviations of allele frequencies contributed to the error, provided that all three genotype classes were sampled. In the presence of dominance, the root mean squared error of α^ with the AD-model was always smaller than with the A-model, even when the heritability was less than one. Remarkably, in the absence of dominance, there was no disadvantage of fitting dominance. In conclusion, the AD-model yields more accurate estimates of average effects from a finite sample, because it is more robust against sampling deviations from HWE frequencies than the A-model. Genetic models that include dominance, therefore, yield higher accuracies of estimated average effects than purely additive models when dominance is present.

  6. Effect of treatment temperature on the microstructure of asphalt binders: insights on the development of dispersed domains.

    Science.gov (United States)

    Menapace, I; Masad, E; Bhasin, A

    2016-04-01

    This paper offers important insights on the development of the microstructure in asphalt binders as a function of the treatment temperature. Different treatment temperatures are useful to understand how dispersed domains form when different driving energies for the mobility of molecular species are provided. Small and flat dispersed domains, with average diameter between 0.02 and 0.70 μm, were detected on the surface of two binders at room temperature, and these domains were observed to grow with an increase in treatment temperature (up to over 2 μm). Bee-like structures started to appear after treatment at or above 100°C. Moreover, the effect of the binder thickness on its microstructure at room temperature and at higher treatment temperatures was investigated and is discussed in this paper. At room temperature, the average size of the dispersed domains increased as the binder thickness decreased. A hypothesis that conciliates current theories on the origin and development of dispersed domains is proposed. Small dispersed domains (average diameter around 0.02 μm) are present in the bulk of the binder, whereas larger domains and bee-like structures develop on the surface, following heat treatment or mechanical disturbance that reduces the film thickness. Molecular mobility and association are the key factors in the development of binder microstructure. © 2015 The Authors Journal of Microscopy © 2015 Royal Microscopical Society.

  7. The effectiveness of empirical anti-parasitic treatment in returning travellers with persistent abdominal symptoms.

    Science.gov (United States)

    Nissan, Batel; Lachish, Tamar; Schwartz, Eli

    2018-01-01

    Persistent abdominal symptoms (PAS) are common among returning-travellers. In the absence of sensitive tests to identify intestinal parasites, gastrointestinal (GI) symptoms often remain a diagnostic challenge. In this study we examined the effectiveness of empirical anti-parasitic treatment in returning-travellers with PAS despite no positive stool-test. A retrospective study among returning travellers who approached the clinic between the years 2014 and 2016 with GI complaints without a positive stool-test. The empirical treatment included broad-spectrum anti-parasitic agents-oral Tinidazole and Albendazole. A follow-up questionnaire was performed at least 6 months post-treatment. A total of 102 patients responded the questionnaire-50% women; average age 31.14 (±12.20) years. The average duration of complaints before treatment was 16.52 (±30.06) months. Common GI symptoms included abdominal pain (83.3%) and diarrhoea (78.4%); 67.6% of the patients complained of extreme fatigue. Overall, 69% of the patients reported an improvement in GI symptoms, 37% of them reported full recovery within a few weeks post-treatment. Furthermore, there was an improvement in the energy level and general well-being in 68% and 70% of the patients, respectively. Only 33% of the patients reported minor side effects related to the treatment. The improvement in GI symptoms, energy level and general well-being shortly after anti-parasitic treatment justifies this empirical approach in returning-travellers with PAS despite negative stool-tests. The association between fatigue and PAS post-travel and the improvement in both as a response to treatment defines fatigue as part of a new syndrome-'Post-travel fatigue and abdominal symptoms'. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  8. Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal

    Directory of Open Access Journals (Sweden)

    Kent David M

    2010-08-01

    Full Text Available Abstract Mounting evidence suggests that there is frequently considerable variation in the risk of the outcome of interest in clinical trial populations. These differences in risk will often cause clinically important heterogeneity in treatment effects (HTE across the trial population, such that the balance between treatment risks and benefits may differ substantially between large identifiable patient subgroups; the "average" benefit observed in the summary result may even be non-representative of the treatment effect for a typical patient in the trial. Conventional subgroup analyses, which examine whether specific patient characteristics modify the effects of treatment, are usually unable to detect even large variations in treatment benefit (and harm across risk groups because they do not account for the fact that patients have multiple characteristics simultaneously that affect the likelihood of treatment benefit. Based upon recent evidence on optimal statistical approaches to assessing HTE, we propose a framework that prioritizes the analysis and reporting of multivariate risk-based HTE and suggests that other subgroup analyses should be explicitly labeled either as primary subgroup analyses (well-motivated by prior evidence and intended to produce clinically actionable results or secondary (exploratory subgroup analyses (performed to inform future research. A standardized and transparent approach to HTE assessment and reporting could substantially improve clinical trial utility and interpretability.

  9. Leading multiple teams: average and relative external leadership influences on team empowerment and effectiveness.

    Science.gov (United States)

    Luciano, Margaret M; Mathieu, John E; Ruddy, Thomas M

    2014-03-01

    External leaders continue to be an important source of influence even when teams are empowered, but it is not always clear how they do so. Extending research on structurally empowered teams, we recognize that teams' external leaders are often responsible for multiple teams. We adopt a multilevel approach to model external leader influences at both the team level and the external leader level of analysis. In doing so, we distinguish the influence of general external leader behaviors (i.e., average external leadership) from those that are directed differently toward the teams that they lead (i.e., relative external leadership). Analysis of data collected from 451 individuals, in 101 teams, reporting to 25 external leaders, revealed that both relative and average external leadership related positively to team empowerment. In turn, team empowerment related positively to team performance and member job satisfaction. However, while the indirect effects were all positive, we found that relative external leadership was not directly related to team performance, and average external leadership evidenced a significant negative direct influence. Additionally, relative external leadership exhibited a significant direct positive influence on member job satisfaction as anticipated, whereas average external leadership did not. These findings attest to the value in distinguishing external leaders' behaviors that are exhibited consistently versus differentially across empowered teams. Implications and future directions for the study and management of external leaders overseeing multiple teams are discussed.

  10. ASSESSMENT OF THE AVERAGE ANNUAL EFFECTIVE DOSES FOR THE INHABITANTS OF THE SETTLEMENTS LOCATED IN THE TERRITORIES CONTAMINATED DUE TO THE CHERNOBYL ACCIDENT

    Directory of Open Access Journals (Sweden)

    N. G. Vlasova

    2012-01-01

    Full Text Available Catalogue of the average annual effective exposure doses of the inhabitants of the territories contaminated due to the Chernobul accident had been developed according to the method of the assessment of the average annual effective exposure doses of the settlements inhabitants. The cost-efficacy of the use of the average annual effective dose assessment method was 250 000 USD for the current 5 years. Average annual effective dose exceeded 1 mSv/year for 191 Belarus settlements from 2613. About 50 000 persons are living in these settlements.

  11. Effects of turbulence on average refraction angles in occultations by planetary atmospheres

    Science.gov (United States)

    Eshleman, V. R.; Haugstad, B. S.

    1978-01-01

    Four separable effects of atmospheric turbulence on average refraction angles in occultation experiments are derived from a simplified analysis, and related to more general formulations by B. S. Haugstad. The major contributors are shown to be due to gradients in height of the strength of the turbulence, and the sense of the resulting changes in refraction angles is explained in terms of Fermat's principle. Because the results of analyses of such gradient effects by W. B. Hubbard and J. R. Jokipii are expressed in other ways, a special effort is made to compare all of the predictions on a common basis. We conclude that there are fundamental differences, and use arguments based on energy conservation and Fermat's principle to help characterize the discrepancies.

  12. HIV Reactivation from Latency after Treatment Interruption Occurs on Average Every 5-8 Days--Implications for HIV Remission.

    Directory of Open Access Journals (Sweden)

    Mykola Pinkevych

    2015-07-01

    Full Text Available HIV infection can be effectively controlled by anti-retroviral therapy (ART in most patients. However therapy must be continued for life, because interruption of ART leads to rapid recrudescence of infection from long-lived latently infected cells. A number of approaches are currently being developed to 'purge' the reservoir of latently infected cells in order to either eliminate infection completely, or significantly delay the time to viral recrudescence after therapy interruption. A fundamental question in HIV research is how frequently the virus reactivates from latency, and thus how much the reservoir might need to be reduced to produce a prolonged antiretroviral-free HIV remission. Here we provide the first direct estimates of the frequency of viral recrudescence after ART interruption, combining data from four independent cohorts of patients undergoing treatment interruption, comprising 100 patients in total. We estimate that viral replication is initiated on average once every ≈6 days (range 5.1- 7.6 days. This rate is around 24 times lower than previous thought, and is very similar across the cohorts. In addition, we analyse data on the ratios of different 'reactivation founder' viruses in a separate cohort of patients undergoing ART-interruption, and estimate the frequency of successful reactivation to be once every 3.6 days. This suggests that a reduction in the reservoir size of around 50-70-fold would be required to increase the average time-to-recrudescence to about one year, and thus achieve at least a short period of anti-retroviral free HIV remission. Our analyses suggests that time-to-recrudescence studies will need to be large in order to detect modest changes in the reservoir, and that macaque models of SIV latency may have much higher frequencies of viral recrudescence after ART interruption than seen in human HIV infection. Understanding the mean frequency of recrudescence from latency is an important first step in

  13. SU-D-213-04: Accounting for Volume Averaging and Material Composition Effects in An Ionization Chamber Array for Patient Specific QA

    International Nuclear Information System (INIS)

    Fugal, M; McDonald, D; Jacqmin, D; Koch, N; Ellis, A; Peng, J; Ashenafi, M; Vanek, K

    2015-01-01

    Purpose: This study explores novel methods to address two significant challenges affecting measurement of patient-specific quality assurance (QA) with IBA’s Matrixx Evolution™ ionization chamber array. First, dose calculation algorithms often struggle to accurately determine dose to the chamber array due to CT artifact and algorithm limitations. Second, finite chamber size and volume averaging effects cause additional deviation from the calculated dose. Methods: QA measurements were taken with the Matrixx positioned on the treatment table in a solid-water Multi-Cube™ phantom. To reduce the effect of CT artifact, the Matrixx CT image set was masked with appropriate materials and densities. Individual ionization chambers were masked as air, while the high-z electronic backplane and remaining solid-water material were masked as aluminum and water, respectively. Dose calculation was done using Varian’s Acuros XB™ (V11) algorithm, which is capable of predicting dose more accurately in non-biologic materials due to its consideration of each material’s atomic properties. Finally, the exported TPS dose was processed using an in-house algorithm (MATLAB) to assign the volume averaged TPS dose to each element of a corresponding 2-D matrix. This matrix was used for comparison with the measured dose. Square fields at regularly-spaced gantry angles, as well as selected patient plans were analyzed. Results: Analyzed plans showed improved agreement, with the average gamma passing rate increasing from 94 to 98%. Correction factors necessary for chamber angular dependence were reduced by 67% compared to factors measured previously, indicating that previously measured factors corrected for dose calculation errors in addition to true chamber angular dependence. Conclusion: By comparing volume averaged dose, calculated with a capable dose engine, on a phantom masked with correct materials and densities, QA results obtained with the Matrixx Evolution™ can be significantly

  14. Visualization of Radial Peripapillary Capillaries Using Optical Coherence Tomography Angiography: The Effect of Image Averaging.

    Directory of Open Access Journals (Sweden)

    Shelley Mo

    Full Text Available To assess the effect of image registration and averaging on the visualization and quantification of the radial peripapillary capillary (RPC network on optical coherence tomography angiography (OCTA.Twenty-two healthy controls were imaged with a commercial OCTA system (AngioVue, Optovue, Inc.. Ten 10x10° scans of the optic disc were obtained, and the most superficial layer (50-μm slab extending from the inner limiting membrane was extracted for analysis. Rigid registration was achieved using ImageJ, and averaging of each 2 to 10 frames was performed in five ~2x2° regions of interest (ROI located 1° from the optic disc margin. The ROI were automatically skeletonized. Signal-to-noise ratio (SNR, number of endpoints and mean capillary length from the skeleton, capillary density, and mean intercapillary distance (ICD were measured for the reference and each averaged ROI. Repeated measures analysis of variance was used to assess statistical significance. Three patients with primary open angle glaucoma were also imaged to compare RPC density to controls.Qualitatively, vessels appeared smoother and closer to histologic descriptions with increasing number of averaged frames. Quantitatively, number of endpoints decreased by 51%, and SNR, mean capillary length, capillary density, and ICD increased by 44%, 91%, 11%, and 4.5% from single frame to 10-frame averaged, respectively. The 10-frame averaged images from the glaucomatous eyes revealed decreased density correlating to visual field defects and retinal nerve fiber layer thinning.OCTA image registration and averaging is a viable and accessible method to enhance the visualization of RPCs, with significant improvements in image quality and RPC quantitative parameters. With this technique, we will be able to non-invasively and reliably study RPC involvement in diseases such as glaucoma.

  15. Determining average path length and average trapping time on generalized dual dendrimer

    Science.gov (United States)

    Li, Ling; Guan, Jihong

    2015-03-01

    Dendrimer has wide number of important applications in various fields. In some cases during transport or diffusion process, it transforms into its dual structure named Husimi cactus. In this paper, we study the structure properties and trapping problem on a family of generalized dual dendrimer with arbitrary coordination numbers. We first calculate exactly the average path length (APL) of the networks. The APL increases logarithmically with the network size, indicating that the networks exhibit a small-world effect. Then we determine the average trapping time (ATT) of the trapping process in two cases, i.e., the trap placed on a central node and the trap is uniformly distributed in all the nodes of the network. In both case, we obtain explicit solutions of ATT and show how they vary with the networks size. Besides, we also discuss the influence of the coordination number on trapping efficiency.

  16. The cost-effectiveness of IVF in the UK: a comparison of three gonadotrophin treatments.

    Science.gov (United States)

    Sykes, D; Out, H J; Palmer, S J; van Loon, J

    2001-12-01

    The objective of this study was to evaluate the cost-effectiveness of women undergoing IVF treatment with recombinant FSH (rFSH) in comparison with highly purified urinary FSH (uFSH-HP) and human menopausal gonadotrophins (HMG). A decision-analytic model was used to estimate cost-effectiveness ratios for 'the average cost per ongoing pregnancy' and 'incremental cost per additional pregnancy' for women entering into IVF treatment for a maximum of three cycles. The model was constructed based on a previously published large prospective randomized clinical trial comparing rFSH and uFSH-HP. Where necessary, these data were augmented with a combination of expert opinion, evidence from the literature and observational data relating to the management and cost of IVF treatment in the UK. The cost of rFSH, uFSH-HP and HMG were obtained from National Health Service list prices in the UK. The model predicted a cumulative pregnancy rate after three cycles of 57.1% for rFSH and 44.4% for both uFSH-HP and HMG. The cost of IVF treatment was 5135 pounds sterling for rFSH, 4806 pounds sterling for uFSH-HP and 4202 pounds sterling for HMG. When assessed in association with outcomes, the average cost per ongoing pregnancy was more favourable with rFSH (8992 pounds sterling) than with either uFSH-HP (10 834 pounds sterling) or HMG (9472 pounds sterling). The incremental cost per additional pregnancy was 2583 pounds sterling using rFSH instead of uFSH-HP and 7321 pounds sterling using rFSH instead of HMG. These results were robust to changes in the baseline assumptions of the model. rFSH is a cost-effective treatment strategy in ovulation induction prior to IVF.

  17. Nightguard vital bleaching: side effects and patient satisfaction 10 to 17 years post-treatment.

    Science.gov (United States)

    Boushell, Lee W; Ritter, André V; Garland, Glenn E; Tiwana, Karen K; Smith, Lynn R; Broome, Angela; Leonard, Ralph H

    2012-06-01

      The long-term patient satisfaction and safety of nightguard vital bleaching (NGVB) requires further evaluation.   The purpose of this study was to evaluate patients' satisfaction and identify side effects of NGVB up to 17 years post-treatment.   Thirty-one participants who had completed previous NGVB studies using 10% carbamide peroxide were contacted at least 10 years post-treatment (range 10-17 years, average 12.3 years). Participants reported shade satisfaction (very satisfied [VS], partially satisfied [PS], or not satisfied [NS]) as well as potential complications. Participants had teeth # 6 to 11 examined for tooth vitality, gingival inflammation (Löe's Gingival Index [GI]), and radiographically for external cervical resorption (ECR).   All of the participants had successful lightening of their teeth. Sixty-one percent (19) had not retreated their teeth. Of those who had not retreated their teeth and who responded to the question of whitening satisfaction, 31% (4/13) were VS, 54% (7/13) were PS, and 15% (2/13) were NS with their current shade. Of those who had retreated their teeth, all were VS or PS. Ninety-one percent of the examined teeth had GI = 0 (normal), 7% had GI = 1 (mild inflammation), and 2% had GI = 2 (moderate inflammation). Sixty-nine percent of teeth tested responded to a cold stimulus. Radiographs did not detect ECR or apical lesions. No participant reported having a gingival biopsy post-treatment, and 87% would whiten again.   Patient satisfaction with NGVB may last as long as 12.3 years in average (range 10-17 years) post-treatment. GI and ECR findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post-NGVB side effects up to 17 years. Nightguard vital bleaching provides patient satisfaction with minimal side effects up to 17 years post-treatment. © 2011 Wiley Periodicals, Inc.

  18. The effects of sex and grade-point average on emotional intelligence.

    Science.gov (United States)

    Tapia, Martha; Marsh, George E

    2006-01-01

    This study was conducted to examine the effects of sex and grade-point average (GPA) on emotional intelligence on secondary students as measured by the Emotional Intelligence Inventory (EII). The EII is a 41-item Likert scale based on the original theoretical model of emotional intelligence developed by Salovey and Mayer. An exploratory factor analysis identified four factors, which were named Empathy, Utilization of Feelings, Handling Relationships, and Self-control. The sample consisted of 319 students, 162 males and 157 females, who attended school at a bilingual (English and Spanish) college preparatory school. General linear analysis revealed significant differences in empathy scores when grouped by gender. There were significant differences in self-control when grouped by GPA levels.

  19. The association between estimated average glucose levels and fasting plasma glucose levels

    Directory of Open Access Journals (Sweden)

    Giray Bozkaya

    2010-01-01

    Full Text Available OBJECTIVE: The level of hemoglobin A1c (HbA1c, also known as glycated hemoglobin, determines how well a patient's blood glucose level has been controlled over the previous 8-12 weeks. HbA1c levels help patients and doctors understand whether a particular diabetes treatment is working and whether adjustments need to be made to the treatment. Because the HbA1c level is a marker of blood glucose for the previous 120 days, average blood glucose levels can be estimated using HbA1c levels. Our aim in the present study was to investigate the relationship between estimated average glucose levels, as calculated by HbA1c levels, and fasting plasma glucose levels. METHODS: The fasting plasma glucose levels of 3891 diabetic patient samples (1497 male, 2394 female were obtained from the laboratory information system used for HbA1c testing by the Department of Internal Medicine at the Izmir Bozyaka Training and Research Hospital in Turkey. These samples were selected from patient samples that had hemoglobin levels between 12 and 16 g/dL. The estimated glucose levels were calculated using the following formula: 28.7 x HbA1c - 46.7. Glucose and HbA1c levels were determined using hexokinase and high performance liquid chromatography (HPLC methods, respectively. RESULTS: A strong positive correlation between fasting plasma glucose levels and estimated average blood glucose levels (r=0.757, p<0.05 was observed. The difference was statistically significant. CONCLUSION: Reporting the estimated average glucose level together with the HbA1c level is believed to assist patients and doctors determine the effectiveness of blood glucose control measures.

  20. Measuring the individual benefit of a medical or behavioral treatment using generalized linear mixed-effects models.

    Science.gov (United States)

    Diaz, Francisco J

    2016-10-15

    We propose statistical definitions of the individual benefit of a medical or behavioral treatment and of the severity of a chronic illness. These definitions are used to develop a graphical method that can be used by statisticians and clinicians in the data analysis of clinical trials from the perspective of personalized medicine. The method focuses on assessing and comparing individual effects of treatments rather than average effects and can be used with continuous and discrete responses, including dichotomous and count responses. The method is based on new developments in generalized linear mixed-effects models, which are introduced in this article. To illustrate, analyses of data from the Sequenced Treatment Alternatives to Relieve Depression clinical trial of sequences of treatments for depression and data from a clinical trial of respiratory treatments are presented. The estimation of individual benefits is also explained. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Effect of alloy deformation on the average spacing parameters of non-deforming particles

    International Nuclear Information System (INIS)

    Fisher, J.; Gurland, J.

    1980-02-01

    It is shown on the basis of stereological definitions and a few simple experiments that the commonly used average dispersion parameters, area fraction (A/sub A/)/sub β/, areal particle density N/sub Aβ/ and mean free path lambda/sub α/, remain invariant during plastic deformation in the case of non-deforming equiaxed particles. Directional effects on the spacing parameters N/sub Aβ/ and lambda/sub α/ arise during uniaxial deformation by rotation and preferred orientation of nonequiaxed particles. Particle arrangement in stringered or layered structures and the effect of deformation on nearest neighbor distances of particles and voids are briefly discussed in relation to strength and fracture theories

  2. Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation

    Directory of Open Access Journals (Sweden)

    Dmitry ePinchuk

    2013-03-01

    Full Text Available The clinical effectiveness of headache treatment by transcranial direct current stimulation with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 – frequent episodic tension-type headaches, 10 – chronic tension-type headaches and in 44 adolescents aged 11 – 16 years with chronic posttraumatic headaches after a mild head injury. Clinical effectiveness of tDCS with 70 – 150 µA current for 30 – 45 minutes via 6.25 cm2 stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of headaches.

  3. The flattening of the average potential in models with fermions

    International Nuclear Information System (INIS)

    Bornholdt, S.

    1993-01-01

    The average potential is a scale dependent scalar effective potential. In a phase with spontaneous symmetry breaking its inner region becomes flat as the averaging extends over infinite volume and the average potential approaches the convex effective potential. Fermion fluctuations affect the shape of the average potential in this region and its flattening with decreasing physical scale. They have to be taken into account to find the true minimum of the scalar potential which determines the scale of spontaneous symmetry breaking. (orig.)

  4. Effect of money supply on the Dow Jones Industrial Average stock index

    Directory of Open Access Journals (Sweden)

    Martin Širůček

    2012-01-01

    Full Text Available This focus of this paper are the effects and implications of a change in the money supply for share price indices in the USA during 1959–2011. The money supply will be measured by the M2 and MZM aggregates (money with zero maturity. The US stock market is represented by the Dow Jones Industrial Average index. The objective of this paper is to find, describe and evaluate the effects of changes to the money supply (M2 and MZM on the US stock market. A partial objective of this paper is to determine whether a change in the monetary aggregate shows in the stock index immediately or with a delay of several weeks. Another aim is to determine whether asset prices influence the money supply.

  5. Treatment Effect in Earlier Trials of Patients With Chronic Medical Conditions: A Meta-Epidemiologic Study.

    Science.gov (United States)

    Alahdab, Fares; Farah, Wigdan; Almasri, Jehad; Barrionuevo, Patricia; Zaiem, Feras; Benkhadra, Raed; Asi, Noor; Alsawas, Mouaz; Pang, Yifan; Ahmed, Ahmed T; Rajjo, Tamim; Kanwar, Amrit; Benkhadra, Khalid; Razouki, Zayd; Murad, M Hassan; Wang, Zhen

    2018-03-01

    To determine whether the early trials in chronic medical conditions demonstrate an effect size that is larger than that in subsequent trials. We identified randomized controlled trials (RCTs) evaluating a drug or device in patients with chronic medical conditions through meta-analyses (MAs) published between January 1, 2007, and June 23, 2015, in the 10 general medical journals with highest impact factor. We estimated the prevalence of having the largest effect size or heterogeneity in the first 2 published trials. We evaluated the association of the exaggerated early effect with several a priori hypothesized explanatory variables. We included 70 MAs that had included a total of 930 trials (average of 13 [range, 5-48] RCTs per MA) with average follow-up of 24 (range, 1-168) months. The prevalence of the exaggerated early effect (ie, proportion of MAs with largest effect or heterogeneity in the first 2 trials) was 37%. These early trials had an effect size that was on average 2.67 times larger than the overall pooled effect size (ratio of relative effects, 2.67; 95% CI, 2.12-3.37). The presence of exaggerated effect was not significantly associated with trial size; number of events; length of follow-up; intervention duration; number of study sites; inpatient versus outpatient setting; funding source; stopping a trial early; adequacy of random sequence generation, allocation concealment, or blinding; loss to follow-up or the test for publication bias. Trials evaluating treatments of chronic medical conditions published early in the chain of evidence commonly demonstrate an exaggerated treatment effect compared with subsequent trials. At the present time, this phenomenon remains unpredictable. Considering the increasing morbidity and mortality of chronic medical conditions, decision makers should act on early evidence with caution. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  6. Pharmacogenomic study of side-effects for antidepressant treatment options in STAR*D.

    Science.gov (United States)

    Clark, S L; Adkins, D E; Aberg, K; Hettema, J M; McClay, J L; Souza, R P; van den Oord, E J C G

    2012-06-01

    Understanding individual differences in susceptibility to antidepressant therapy side-effects is essential to optimize the treatment of depression. We performed genome-wide association studies (GWAS) to search for genetic variation affecting the susceptibility to side-effects. The analysis sample consisted of 1439 depression patients, successfully genotyped for 421K single nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Outcomes included four indicators of side-effects: general side-effect burden, sexual side-effects, dizziness and vision/hearing-related side-effects. Our criterion for genome-wide significance was a prespecified threshold ensuring that, on average, only 10% of the significant findings are false discoveries. Thirty-four SNPs satisfied this criterion. The top finding indicated that 10 SNPs in SACM1L mediated the effects of bupropion on sexual side-effects (p = 4.98 × 10(-7), q = 0.023). Suggestive findings were also found for SNPs in MAGI2, DTWD1, WDFY4 and CHL1. Although our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that could mediate adverse effects of antidepressant medication.

  7. SU-F-J-05: The Effect of Air Pockets in the Urinary Bladder During Bladder Hyperthermia Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Schooneveldt, G.; Kok, H.P.; Bakker, A.; Geijsen, E.D.; Reijke, T.M. de; Crezee, J. [Academisch Medisch Centrum / Universiteit van Amsterdam, Amsterdam (Netherlands)

    2016-06-15

    Purpose: Hyperthermia combined with Mitomycin C is used for the treatment of non-muscle invasive bladder cancer (NMIBC), using a phased array system of microwave antennas for bladder heating. Often some air is present in the bladder, which effectively blocks the microwave radiation, potentially preventing proper treatment of that part of the bladder. Air can be a relevant fraction of the bladder content and large air pockets are expected to have a noticeable influence on achieved temperatures. Methods: We analysed 14 NMIBC patients treated at our institute with our AMC-4 hyperthermia device with four 70MHz antennas around the pelvis. A CT scan was made after treatment and a physician delineated the bladder on the CT scan. On the same scan, the amount of air present in the bladder was delineated. Using our in-house developed hyperthermia treatment planning system, we simulated the treatment using the clinically applied device settings. We did this once with the air pocket delineated on the CT scan, and once with the same volume filled with bladder tissue. Results: The patients had on average 4.2ml (range 0.8–10.1ml) air in the bladder. The bladder volume was delineated by the physician, that is including air pocket and bladder wall, was on average 253ml (range 93–452ml). The average volume in which changes exceeded 0.25°C was 22ml (range 0–108 ml), with the bladder being up to 2°C cooler when an air pocket was present. Except for extreme cases, there was no evident relation between the quantity of air and the difference in temperature. Conclusion: The effect of an air pocket in the bladder during bladder hyperthermia treatment varies strongly between patients. Generally, this leads to lower temperatures in the bladder, potentially affecting treatment quality, and suggesting that care need be taken to minimise the size of air pockets during hyperthermia treatments. The KWF Dutch Cancer Society financially supported this work, grant UVA 2012-5539.

  8. Construction of average adult Japanese voxel phantoms for dose assessment

    International Nuclear Information System (INIS)

    Sato, Kaoru; Takahashi, Fumiaki; Satoh, Daiki; Endo, Akira

    2011-12-01

    The International Commission on Radiological Protection (ICRP) adopted the adult reference voxel phantoms based on the physiological and anatomical reference data of Caucasian on October, 2007. The organs and tissues of these phantoms were segmented on the basis of ICRP Publication 103. In future, the dose coefficients for internal dose and dose conversion coefficients for external dose calculated using the adult reference voxel phantoms will be widely used for the radiation protection fields. On the other hand, the body sizes and organ masses of adult Japanese are generally smaller than those of adult Caucasian. In addition, there are some cases that the anatomical characteristics such as body sizes, organ masses and postures of subjects influence the organ doses in dose assessment for medical treatments and radiation accident. Therefore, it was needed to use human phantoms with average anatomical characteristics of Japanese. The authors constructed the averaged adult Japanese male and female voxel phantoms by modifying the previously developed high-resolution adult male (JM) and female (JF) voxel phantoms. It has been modified in the following three aspects: (1) The heights and weights were agreed with the Japanese averages; (2) The masses of organs and tissues were adjusted to the Japanese averages within 10%; (3) The organs and tissues, which were newly added for evaluation of the effective dose in ICRP Publication 103, were modeled. In this study, the organ masses, distances between organs, specific absorbed fractions (SAFs) and dose conversion coefficients of these phantoms were compared with those evaluated using the ICRP adult reference voxel phantoms. This report provides valuable information on the anatomical and dosimetric characteristics of the averaged adult Japanese male and female voxel phantoms developed as reference phantoms of adult Japanese. (author)

  9. Using forecast modelling to evaluate treatment effects in single-group interrupted time series analysis.

    Science.gov (United States)

    Linden, Ariel

    2018-05-11

    Interrupted time series analysis (ITSA) is an evaluation methodology in which a single treatment unit's outcome is studied serially over time and the intervention is expected to "interrupt" the level and/or trend of that outcome. ITSA is commonly evaluated using methods which may produce biased results if model assumptions are violated. In this paper, treatment effects are alternatively assessed by using forecasting methods to closely fit the preintervention observations and then forecast the post-intervention trend. A treatment effect may be inferred if the actual post-intervention observations diverge from the forecasts by some specified amount. The forecasting approach is demonstrated using the effect of California's Proposition 99 for reducing cigarette sales. Three forecast models are fit to the preintervention series-linear regression (REG), Holt-Winters (HW) non-seasonal smoothing, and autoregressive moving average (ARIMA)-and forecasts are generated into the post-intervention period. The actual observations are then compared with the forecasts to assess intervention effects. The preintervention data were fit best by HW, followed closely by ARIMA. REG fit the data poorly. The actual post-intervention observations were above the forecasts in HW and ARIMA, suggesting no intervention effect, but below the forecasts in the REG (suggesting a treatment effect), thereby raising doubts about any definitive conclusion of a treatment effect. In a single-group ITSA, treatment effects are likely to be biased if the model is misspecified. Therefore, evaluators should consider using forecast models to accurately fit the preintervention data and generate plausible counterfactual forecasts, thereby improving causal inference of treatment effects in single-group ITSA studies. © 2018 John Wiley & Sons, Ltd.

  10. Varying effects of recommended treatments for heart failure with reduced ejection fraction

    DEFF Research Database (Denmark)

    Thomsen, Marius Mark; Lewinter, Christian; Køber, Lars

    2016-01-01

    The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology...... as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included. Meta-analyses, based...... on the outcomes of all-cause mortality and hospitalization because of HF, were performed with relative risk ratio as the effect size. In the identified 47 RCTs, patients were on average 63 years old and 22% were female. Drugs targeting the renin-angiotensin-aldosterone system, beta-blockers, cardiac...

  11. Assessment of treatment efficacy and sebosuppressive effect of fractional radiofrequency microneedle on acne vulgaris.

    Science.gov (United States)

    Lee, Kyung Real; Lee, Eo Gin; Lee, Hee Jung; Yoon, Moon Soo

    2013-12-01

    A minimally invasive fractional radiofrequency microneedle (FRM) device has been used in skin rejuvenation and acne scars, and a recent pilot study demonstrated the positive therapeutic effect on acne. We evaluated the efficacy of FRM device for acne vulgaris in Asians and conducted objective measurement to assess its effect on sebum production. Twenty Korean patients with acne vulgaris received a single full-face FRM treatment. Outcome assessments included standardized photography, physician's global assessment, patient's satisfaction scores, acne lesion count, and objective measurements of casual sebum level (CSL) and sebum excretion rate (SER). They were evaluated at baseline and 2, 4, 8 weeks after the treatment. After a single FRM treatment, the CSL and the SER showed 30-60% and 70-80% reduction, respectively, at week 2 (P acne severity and acne lesion count also revealed clinical improvement with maximum efficacy at week 2, but returned to the baseline in most patients by week 8. Patients' satisfaction scores (0-4) were above 2 on average, and adverse effects were minimal. This prospective study demonstrated the sebosuppressive effect from a single FRM treatment, but its therapeutic efficacy in acne requires further evaluation. © 2013 Wiley Periodicals, Inc.

  12. Post-model selection inference and model averaging

    Directory of Open Access Journals (Sweden)

    Georges Nguefack-Tsague

    2011-07-01

    Full Text Available Although model selection is routinely used in practice nowadays, little is known about its precise effects on any subsequent inference that is carried out. The same goes for the effects induced by the closely related technique of model averaging. This paper is concerned with the use of the same data first to select a model and then to carry out inference, in particular point estimation and point prediction. The properties of the resulting estimator, called a post-model-selection estimator (PMSE, are hard to derive. Using selection criteria such as hypothesis testing, AIC, BIC, HQ and Cp, we illustrate that, in terms of risk function, no single PMSE dominates the others. The same conclusion holds more generally for any penalised likelihood information criterion. We also compare various model averaging schemes and show that no single one dominates the others in terms of risk function. Since PMSEs can be regarded as a special case of model averaging, with 0-1 random-weights, we propose a connection between the two theories, in the frequentist approach, by taking account of the selection procedure when performing model averaging. We illustrate the point by simulating a simple linear regression model.

  13. Effect of tillage fertilizer treatments on maize fodder yield under rainfed conditions of Pakistan

    International Nuclear Information System (INIS)

    Khaliq, P.; Cheema, N.M.; Malik, M.A.

    2012-01-01

    The effect of deep and shallow tillage and fertilizer treatments i.e., recommended dose of fertilizer (RF), farm yard manure (FYM) and recommended dose of fertilizer plus farmyard manure (RF+FYM) on maize fodder yield was studied under rainfed conditions of Pakistan. It was observed that the emergence count m-2, maize fodder biomass, plant height, number of leaves per plant and maize fodder yield enhanced, with the application of RF+FYM. However, the effect of FYM+RF and recommended dose of fertilizer was statistically non-significant and on average basis RF+FYM treatment produced higher green fodder (19971.5 kg ha/sup -1/) than fodder yield of 18349.1 kg ha/sup -1/ produced by applying recommended dose of fertilizer. However, green fodder yield produced with these two fertilizer treatments were significantly higher than that of the FYM and control treatments. The FYM treatment gave lowest fodder yield (16997 kg ha/sup -1/) and was significantly lower than the fodder yield (17278.7 kg ha/sup -1/) obtained in control treatment. The nutrient availability in RF+FYM treatment significantly increased the biomass production, however, application of FYM promoted the weed infestation that reduced the green fodder yield of maize, but it improved the overall forage yield as recorded in RF+FYM treatment. The effect of deep tillage on maize fodder yield was non-significant. (author)

  14. Some consequences of assuming simple patterns for the treatment effect over time in a linear mixed model.

    Science.gov (United States)

    Bamia, Christina; White, Ian R; Kenward, Michael G

    2013-07-10

    Linear mixed models are often used for the analysis of data from clinical trials with repeated quantitative outcomes. This paper considers linear mixed models where a particular form is assumed for the treatment effect, in particular constant over time or proportional to time. For simplicity, we assume no baseline covariates and complete post-baseline measures, and we model arbitrary mean responses for the control group at each time. For the variance-covariance matrix, we consider an unstructured model, a random intercepts model and a random intercepts and slopes model. We show that the treatment effect estimator can be expressed as a weighted average of the observed time-specific treatment effects, with weights depending on the covariance structure and the magnitude of the estimated variance components. For an assumed constant treatment effect, under the random intercepts model, all weights are equal, but in the random intercepts and slopes and the unstructured models, we show that some weights can be negative: thus, the estimated treatment effect can be negative, even if all time-specific treatment effects are positive. Our results suggest that particular models for the treatment effect combined with particular covariance structures may result in estimated treatment effects of unexpected magnitude and/or direction. Methods are illustrated using a Parkinson's disease trial. Copyright © 2012 John Wiley & Sons, Ltd.

  15. A group's physical attractiveness is greater than the average attractiveness of its members : The group attractiveness effect

    NARCIS (Netherlands)

    van Osch, Y.M.J.; Blanken, Irene; Meijs, Maartje H. J.; van Wolferen, Job

    2015-01-01

    We tested whether the perceived physical attractiveness of a group is greater than the average attractiveness of its members. In nine studies, we find evidence for the so-called group attractiveness effect (GA-effect), using female, male, and mixed-gender groups, indicating that group impressions of

  16. A group's physical attractiveness is greater than the average attractiveness of its members: the group attractiveness effect.

    Science.gov (United States)

    van Osch, Yvette; Blanken, Irene; Meijs, Maartje H J; van Wolferen, Job

    2015-04-01

    We tested whether the perceived physical attractiveness of a group is greater than the average attractiveness of its members. In nine studies, we find evidence for the so-called group attractiveness effect (GA-effect), using female, male, and mixed-gender groups, indicating that group impressions of physical attractiveness are more positive than the average ratings of the group members. A meta-analysis on 33 comparisons reveals that the effect is medium to large (Cohen's d = 0.60) and moderated by group size. We explored two explanations for the GA-effect: (a) selective attention to attractive group members, and (b) the Gestalt principle of similarity. The results of our studies are in favor of the selective attention account: People selectively attend to the most attractive members of a group and their attractiveness has a greater influence on the evaluation of the group. © 2015 by the Society for Personality and Social Psychology, Inc.

  17. Batch medication of intestinal infections in nursery pigs-A randomised clinical trial on the efficacy of treatment strategy, type of antibiotic and bacterial load on average daily weight gain.

    Science.gov (United States)

    Weber, Nicolai Rosager; Pedersen, Ken Steen; Hansen, Christian Fink; Denwood, Matthew; Hjulsager, Charlotte Kristiane; Nielsen, Jens Peter

    2017-02-01

    Previous research projects have demonstrated the need for better diagnostic tools to support decisions on medication strategies for infections caused by Escherichia coli F4 (F4) and F18 (F18), Lawsonia intracellularis (LI) and Brachyspira pilosicoli (PILO). This study was carried out as a randomised clinical trial in three Danish pig herds and included 1047 nursery pigs, distributed over 10 batches and 78 pens. The objectives of this study were: (1) to assess the effect of four 5-day treatment strategies (initiated at clinical outbreak of diarrhoea or at fixed time points 14, 21, or 28days after weaning) on average daily weight gain (ADG); (2) to compare the effect of treatment with doxycycline or tylosine on diarrhoea prevalence, pathogenic bacterial load, and ADG; (3) to evaluate PCR testing of faecal pen floor samples as a diagnostic tool for determining the optimal time of treatment. (1) The four treatment strategies had a significant overall effect on ADG (p=0.01). Pigs starting treatment 14days after weaning had a significantly higher ADG (42 g) compared to pigs treated on day 28 (p=0.01). (2) When measured 2days after treatment, doxycycline treatment resulted in fewer LI-positive pens (p=0.004), lower excretion levels of LI (p=0.013), and fewer pens with a high level of LI (p=0.031) compared to pens treated with tylosine. There was no significant difference in F4, F18 and PILO levels after treatment with the two antibiotic compounds. There was a significant difference (p=0.04) of mean diarrhoea prevalence on day 21 of the study between pens treated with tylosine (0.254, 95% CI: 0.184-0.324), and doxycycline (0.167, 95% CI: 0.124-0.210). The type of antibiotic compound was not found to have a significant effect on ADG (p=0.209). (3) Pigs starting treatment on day 14 in pens where F4, F18, LI or PILO were detected by qPCR on the pen floor had a statistically significant increase in ADG (66g) compared to pigs treated on day 14 in pens where no enteric pathogens

  18. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  19. Person perception from changing emotional expressions: primacy, recency, or averaging effect?

    Science.gov (United States)

    Fang, Xia; van Kleef, Gerben A; Sauter, Disa A

    2018-02-01

    Dynamic changes in emotional expressions are a valuable source of information in social interactions. As the expressive behaviour of a person changes, the inferences drawn from the behaviour may also change. Here, we test the possibility that dynamic changes in emotional expressions affect person perception in terms of stable trait attributions. Across three experiments, we examined perceivers' inferences about others' personality traits from changing emotional expressions. Expressions changed from one emotion ("start emotion") to another emotion ("end emotion"), allowing us to disentangle potential primacy, recency, and averaging effects. Drawing on three influential models of person perception, we examined perceptions of dominance and affiliation (Experiment 1a), competence and warmth (Experiment 1b), and dominance and trustworthiness (Experiment 2). A strong recency effect was consistently found across all trait judgments, that is, the end emotion of dynamic expressions had a strong impact on trait ratings. Evidence for a primacy effect was also observed (i.e. the information of start emotions was integrated), but less pronounced, and only for trait ratings relating to affiliation, warmth, and trustworthiness. Taken together, these findings suggest that, when making trait judgements about others, observers weigh the most recently displayed emotion in dynamic expressions more heavily than the preceding emotion.

  20. Significance of Timing on Effect of Metaphylactic Toltrazuril Treatment against Eimeriosis in Calves

    DEFF Research Database (Denmark)

    Enemark, Heidi; Dahl, Jan; Enemark, Jörg Matthias Dehn

    2015-01-01

    of Eimeria bovis and Eimeria zuernii. Three commercial herds and a total of 71 calves, aged 48 – 135 days, were included. Treatment with a single oral dose of toltrazuril (15 mg/kg) was given after relocation to common pens and one week before expected outbreak of eimeriosis. The effect of treatment...... was followed by weekly faecal sampling and weighing initially and at the end of a study period of 8 weeks. In Herd 2 and 3 toltrazuril treated calves gained on average 7.95 kg more than placebo treated calves (p = 0.007), and both oocyst excretion and prevalence of Eimeria spp. were significantly reduced...

  1. AN OVERVIEW ON AVERAGE SPEED ENFORCEMENT SYSTEM AND ROAD SAFETY EFFECTS

    OpenAIRE

    ILGAZ, ARZU; SALTAN, MEHMET

    2017-01-01

    Averagespeed enforcement system is a new intelligent transportation system applicationthat has gained popularity all over the world following Europe and Australiawhich is recently being applied in Turkey as well. The main task of the systemis measuring the average speeds of motorized vehicles for the purpose oftraffic sanctions. A literature survey related with average speed enforcementsystem was carried out in this study at an international scale. In addition toproviding a comprehensive summ...

  2. Effect of Heat Treatment on Microstructure and Impact Toughness of Ti-6Al-4V Manufactured by Selective Laser Melting Process

    Directory of Open Access Journals (Sweden)

    Lee K.-A.

    2017-06-01

    Full Text Available This study manufactured Ti-6Al-4V alloy using one of the powder bed fusion 3D-printing processes, selective laser melting, and investigated the effect of heat treatment (650°C/3hrs on microstructure and impact toughness of the material. Initial microstructural observation identified prior-β grain along the building direction before and after heat treatment. In addition, the material formed a fully martensite structure before heat treatment, and after heat treatment, α and β phase were formed simultaneously. Charpy impact tests were conducted. The average impact energy measured as 6.0 J before heat treatment, and after heat treatment, the average impact energy increased by approximately 20% to 7.3 J. Fracture surface observation after the impact test showed that both alloys had brittle characteristics on macro levels, but showed ductile fracture characteristics and dimples at micro levels.

  3. Wave function collapse implies divergence of average displacement

    OpenAIRE

    Marchewka, A.; Schuss, Z.

    2005-01-01

    We show that propagating a truncated discontinuous wave function by Schr\\"odinger's equation, as asserted by the collapse axiom, gives rise to non-existence of the average displacement of the particle on the line. It also implies that there is no Zeno effect. On the other hand, if the truncation is done so that the reduced wave function is continuous, the average coordinate is finite and there is a Zeno effect. Therefore the collapse axiom of measurement needs to be revised.

  4. Raven's Test Performance of Sub-Saharan Africans: Average Performance, Psychometric Properties, and the Flynn Effect

    Science.gov (United States)

    Wicherts, Jelte M.; Dolan, Conor V.; Carlson, Jerry S.; van der Maas, Han L. J.

    2010-01-01

    This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's test scores as measures of general intelligence.…

  5. Americans' Average Radiation Exposure

    International Nuclear Information System (INIS)

    2000-01-01

    We live with radiation every day. We receive radiation exposures from cosmic rays, from outer space, from radon gas, and from other naturally radioactive elements in the earth. This is called natural background radiation. It includes the radiation we get from plants, animals, and from our own bodies. We also are exposed to man-made sources of radiation, including medical and dental treatments, television sets and emission from coal-fired power plants. Generally, radiation exposures from man-made sources are only a fraction of those received from natural sources. One exception is high exposures used by doctors to treat cancer patients. Each year in the United States, the average dose to people from natural and man-made radiation sources is about 360 millirem. A millirem is an extremely tiny amount of energy absorbed by tissues in the body

  6. The effects of disjunct sampling and averaging time on maximum mean wind speeds

    DEFF Research Database (Denmark)

    Larsén, Xiaoli Guo; Mann, J.

    2006-01-01

    Conventionally, the 50-year wind is calculated on basis of the annual maxima of consecutive 10-min averages. Very often, however, the averages are saved with a temporal spacing of several hours. We call it disjunct sampling. It may also happen that the wind speeds are averaged over a longer time...

  7. A statistical study of gyro-averaging effects in a reduced model of drift-wave transport

    Science.gov (United States)

    da Fonseca, J. D.; del-Castillo-Negrete, D.; Sokolov, I. M.; Caldas, I. L.

    2016-08-01

    A statistical study of finite Larmor radius (FLR) effects on transport driven by electrostatic drift-waves is presented. The study is based on a reduced discrete Hamiltonian dynamical system known as the gyro-averaged standard map (GSM). In this system, FLR effects are incorporated through the gyro-averaging of a simplified weak-turbulence model of electrostatic fluctuations. Formally, the GSM is a modified version of the standard map in which the perturbation amplitude, K0, becomes K0J0(ρ ̂ ) , where J0 is the zeroth-order Bessel function and ρ ̂ is the Larmor radius. Assuming a Maxwellian probability density function (pdf) for ρ ̂ , we compute analytically and numerically the pdf and the cumulative distribution function of the effective drift-wave perturbation amplitude K0J0(ρ ̂ ) . Using these results, we compute the probability of loss of confinement (i.e., global chaos), Pc, and the probability of trapping in the main drift-wave resonance, Pt. It is shown that Pc provides an upper bound for the escape rate, and that Pt provides a good estimate of the particle trapping rate. The analytical results are compared with direct numerical Monte-Carlo simulations of particle transport.

  8. Multi-Repeated Projection Lithography for High-Precision Linear Scale Based on Average Homogenization Effect

    Directory of Open Access Journals (Sweden)

    Dongxu Ren

    2016-04-01

    Full Text Available A multi-repeated photolithography method for manufacturing an incremental linear scale using projection lithography is presented. The method is based on the average homogenization effect that periodically superposes the light intensity of different locations of pitches in the mask to make a consistent energy distribution at a specific wavelength, from which the accuracy of a linear scale can be improved precisely using the average pitch with different step distances. The method’s theoretical error is within 0.01 µm for a periodic mask with a 2-µm sine-wave error. The intensity error models in the focal plane include the rectangular grating error on the mask, static positioning error, and lithography lens focal plane alignment error, which affect pitch uniformity less than in the common linear scale projection lithography splicing process. It was analyzed and confirmed that increasing the repeat exposure number of a single stripe could improve accuracy, as could adjusting the exposure spacing to achieve a set proportion of black and white stripes. According to the experimental results, the effectiveness of the multi-repeated photolithography method is confirmed to easily realize a pitch accuracy of 43 nm in any 10 locations of 1 m, and the whole length accuracy of the linear scale is less than 1 µm/m.

  9. Surfactant Effect on the Average Flow Generation Near Curved Interface

    Science.gov (United States)

    Klimenko, Lyudmila; Lyubimov, Dmitry

    2018-02-01

    The present work is devoted to the average flow generation near curved interface with a surfactant adsorbed on the surface layer. The investigation was carried out for a liquid drop embedded in a viscous liquid with a different density. The liquid flows inside and outside the drop are generated by small amplitude and high frequency vibrations. Surfactant exchange between the drop surface and the surrounding liquid is limited by the process of adsorption-desorption. It was assumed that the surfactant is soluble in the surrounding liquid, but not soluble in the liquid drop. Surrounding liquid and the liquid in the drop are considered incompressible. Normal and shear viscous stresses balance at the interface is performed under the condition that the film thickness of the adsorbed surfactant is negligible. The problem is solved under assumption that the shape of the drop in the presence of adsorbed surfactant remains spherical symmetry. The effective boundary conditions for the tangential velocity jump and shear stress jump, describing the above generation have been obtained by matched asymptotic expansions method. The conditions under which the drop surface can be considered as a quasi-solid are determined. It is shown that in the case of the significant effect of surfactant on the surface tension, the dominant mechanism for the generation is the Schlichting mechanisms under vibrations.

  10. Effects of stratospheric aerosol surface processes on the LLNL two-dimensional zonally averaged model

    International Nuclear Information System (INIS)

    Connell, P.S.; Kinnison, D.E.; Wuebbles, D.J.; Burley, J.D.; Johnston, H.S.

    1992-01-01

    We have investigated the effects of incorporating representations of heterogeneous chemical processes associated with stratospheric sulfuric acid aerosol into the LLNL two-dimensional, zonally averaged, model of the troposphere and stratosphere. Using distributions of aerosol surface area and volume density derived from SAGE 11 satellite observations, we were primarily interested in changes in partitioning within the Cl- and N- families in the lower stratosphere, compared to a model including only gas phase photochemical reactions

  11. Neutron resonance averaging

    International Nuclear Information System (INIS)

    Chrien, R.E.

    1986-10-01

    The principles of resonance averaging as applied to neutron capture reactions are described. Several illustrations of resonance averaging to problems of nuclear structure and the distribution of radiative strength in nuclei are provided. 30 refs., 12 figs

  12. The effect of vilazodone on sexual function during the treatment of major depressive disorder.

    Science.gov (United States)

    Clayton, Anita H; Kennedy, Sidney H; Edwards, John B; Gallipoli, Susan; Reed, Carol R

    2013-10-01

      Sexual dysfunction is common in major depressive disorder (MDD), and many serotonergic antidepressants adversely affect sexual function. Vilazodone, a novel serotonin (5-HT) reuptake inhibitor and 5-HT1A partial agonist approved for MDD, exerts its effects at the 5-HT transporter and at both presynaptic and postsynaptic 5-HT1A receptors. This mechanism may limit sexual dysfunction.   To summarize effects of vilazodone (40 mg/day, with food) on sexual function in adults with MDD.   Data sources were three Phase III studies: two 8-week, placebo-controlled studies (NCT00285376 and NCT00683592) and a 52-week open-label study (NCT00644358). Sexual function was assessed by analyzing changes from baseline to end of treatment (EOT) using validated measures.   Arizona Sexual Experience Scale or Changes in Sexual Functioning Questionnaire.   Population included 869 patients (vilazodone, 436; placebo, 433) from placebo-controlled studies and 599 patients from the open-label study. Sexual dysfunction prevalence was high (50%, men; 68%, women) before treatment and declined during treatment in vilazodone and placebo groups, indicating improvement on average. At EOT, stable/improved sexual function was observed in ≥91% of patients in placebo-controlled studies; treatment group differences in sexual dysfunction at EOT were not statistically significant for either sex. Differences vs. placebo in changes from baseline of sexual function scores were small and were generally not statistically significant; effect sizes (Cohen's D) were generally of low magnitude. In the placebo-controlled studies, 8.0% of vilazodone-treated patients and 0.9% of placebo-treated patients reported ≥1 sexual-function-related treatment-emergent adverse event (P<0.001).   Half of men and two thirds of women with MDD had sexual dysfunction at baseline; sexual function improved on average in both vilazodone and placebo groups. Results suggest that vilazodone may have a small adverse impact on

  13. Effects of organ motion on IMRT treatments with segments of few monitor units

    International Nuclear Information System (INIS)

    Seco, J.; Sharp, G. C.; Turcotte, J.; Gierga, D.; Bortfeld, T.; Paganetti, H.

    2007-01-01

    Interplay between organ (breathing) motion and leaf motion has been shown in the literature to have a small dosimetric impact for clinical conditions (over a 30 fraction treatment). However, previous studies did not consider the case of treatment beams made up of many few-monitor-unit (MU) segments, where the segment delivery time (1-2 s) is of the order of the breathing period (3-5 s). In this study we assess if breathing compromises the radiotherapy treatment with IMRT segments of low number of MUs. We assess (i) how delivered dose varies, from patient to patient, with the number of MU per segment, (ii) if this delivered dose is identical to the average dose calculated without motion over the path of the motion, and (iii) the impact of the daily variation of the delivered dose as a function of MU per segment. The organ motion was studied along two orthogonal directions, representing the left-right and cranial-caudal directions of organ movement for a patient setup in the supine position. Breathing motion was modeled as sin(x), sin 4 (x), and sin 6 (x), based on functions used in the literature to represent organ motion. Measurements were performed with an ionization chamber and films. For a systematic study of motion effects, a MATLAB simulation was written to model organ movement and dose delivery. In the case of a single beam made up of one single segment, the dose delivered to point in a moving target over 30 fractions can vary up to 20% and 10% for segments of 10 MU and 20 MU, respectively. This dose error occurs because the tumor spends most of the time near the edges of the radiation beam. In the case of a single beam made of multiple segments with low MU, we observed 2.4%, 3.3%, and 4.3% differences, respectively, for sin(x), sin 4 (x), and sin 6 (x) motion, between delivered dose and motion-averaged dose for points in the penumbra region of the beam and over 30 fractions. In approximately 5-10% of the cases, differences between the motion-averaged dose

  14. The Effect of Honors Courses on Grade Point Averages

    Science.gov (United States)

    Spisak, Art L.; Squires, Suzanne Carter

    2016-01-01

    High-ability entering college students give three main reasons for not choosing to become part of honors programs and colleges; they and/or their parents believe that honors classes at the university level require more work than non-honors courses, are more stressful, and will adversely affect their self-image and grade point average (GPA) (Hill;…

  15. Raven’s test performance of sub-Saharan Africans: average performance, psychometric properties, and the Flynn Effect

    NARCIS (Netherlands)

    Wicherts, J.M.; Dolan, C.V.; Carlson, J.S.; van der Maas, H.L.J.

    2010-01-01

    This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's

  16. Category structure determines the relative attractiveness of global versus local averages.

    Science.gov (United States)

    Vogel, Tobias; Carr, Evan W; Davis, Tyler; Winkielman, Piotr

    2018-02-01

    Stimuli that capture the central tendency of presented exemplars are often preferred-a phenomenon also known as the classic beauty-in-averageness effect . However, recent studies have shown that this effect can reverse under certain conditions. We propose that a key variable for such ugliness-in-averageness effects is the category structure of the presented exemplars. When exemplars cluster into multiple subcategories, the global average should no longer reflect the underlying stimulus distributions, and will thereby become unattractive. In contrast, the subcategory averages (i.e., local averages) should better reflect the stimulus distributions, and become more attractive. In 3 studies, we presented participants with dot patterns belonging to 2 different subcategories. Importantly, across studies, we also manipulated the distinctiveness of the subcategories. We found that participants preferred the local averages over the global average when they first learned to classify the patterns into 2 different subcategories in a contrastive categorization paradigm (Experiment 1). Moreover, participants still preferred local averages when first classifying patterns into a single category (Experiment 2) or when not classifying patterns at all during incidental learning (Experiment 3), as long as the subcategories were sufficiently distinct. Finally, as a proof-of-concept, we mapped our empirical results onto predictions generated by a well-known computational model of category learning (the Generalized Context Model [GCM]). Overall, our findings emphasize the key role of categorization for understanding the nature of preferences, including any effects that emerge from stimulus averaging. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. The average effective dose of 4-amino-5-(furan-2-yl-4H-1 ,2,4-triazole-3-thiol in experimental hepatitis

    Directory of Open Access Journals (Sweden)

    I. M. Belay

    2014-04-01

    Full Text Available The work presents the research of the average effective dose of 4-amino-5-(furan-2-yl-4H-1,2,4-triazole-3-thiol in experimental hepatitis. Recalculations conducted for the human with the sensitivity coefficient, average effective dose for human is 13,87 mg/kg.

  18. The effectiveness of stuttering treatments in Germany.

    Science.gov (United States)

    Euler, Harald A; Lange, Benjamin P; Schroeder, Sascha; Neumann, Katrin

    2014-03-01

    Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable

  19. Emissions of ammonia, carbon dioxide, and hydrogen sulfide from swine wastewater during and after acidification treatment: effect of pH, mixing and aeration

    DEFF Research Database (Denmark)

    Dai, Xiao-Rong; Blanes-Vidal, Victoria

    2013-01-01

    setup consisting of nine dynamic flux chambers. Three pH levels (pH = 6.0, pH = 5.8 and pH = 5.5), combined with short-term aeration and venting (with an inert gas) treatments were studied. Acidification reduced average NH(3) emissions from swine slurry stored after acidification treatment compared...... to emissions during storage of non-acidified slurry. The reduction were 50%, 62% and 77% when pH was reduce to 6.0, 5.8 and 5.5, respectively. However, it had no significant effect on average CO(2) and H(2)S emissions during storage of slurry after acidification. Aeration of the slurry for 30 min had no effect...

  20. Endoscopic treatment of prepatellar bursitis.

    Science.gov (United States)

    Huang, Yu-Chih; Yeh, Wen-Lin

    2011-03-01

    Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory.

  1. Average energy expended per ion pair, exciton enhanced ionization (Jesse effect), electron drift velocity, average electron energy and scintillation in rare gas liquids

    International Nuclear Information System (INIS)

    Doke, T.; Hitachi, A.; Hoshi, Y.; Masuda, K.; Hamada, T.

    1977-01-01

    Precise measurements of W-values, the average energy expended per electron-hole pair in liquid Ar and Xe, were made by the electron-pulse method, and that in liquid Kr by the steady conduction current method. The results showed that the W-values were clearly smaller than those in gaseous Ar, Xe and Kr as predicted by Doke. The results can be explained by the conduction bands which exist in these rare gas liquids as well as in the solid state. The enhanced ionization yield was observed for Xe-doped liquid Ar, and it was attributed to the ionizing excitation transfer process from Ar excitons to doped Xe. This is very similar to the Jesse effect in the gas phase. The saturated value of the enhanced ionization was in good agreement with the theoretical value, and it provides strong evidence for the existence of the exciton states in liquid Ar. Fano factors in liquid Ar, Kr, Xe and Xe-doped liquid Ar have been estimated from the Fano Formula, and they were smaller than those in the gas phase. The drift velocity of electrons in liquid Ar, liquid Ar-gas mixtures and liquid Xe have been measured with gridded ionization chambers. The average electron energy in liquid Ar has been measured. The electron-induced scintillations of liquid Xe and Ar have been studied. (Kato, T.)

  2. Vaginal HDR-afterloading in the treatment of endometrial carcinoma - analysis of side effects and relapse rates

    International Nuclear Information System (INIS)

    Weiss, E.; Arnold-Bofinger, H.; Weidner, N.; Hirnle, P.; Bamberg, M.

    1996-01-01

    Introduction: In a retrospective analysis side effects, relapse rates and the value of in vivo dosimetry for vaginal HDR-brachytherapy (BT) in women with endometrial carcinoma are evaluated. Material and Methods: From 1987 to 1993 124 women received vaginal HDR-BT (Ir-192) only for adjuvant treatment of early endometrial carcinoma. The usual fractionation was 1x7 Gy per week applied to the surface of the vaginal cylinder to a total dose of 21 Gy. During BT we performed in vivo dosimetry using bladder and rectal probes. The measured doses per patient in the bladder ranged from 1.5 to 9.8 Gy, 6.7 Gy in the mean. In the rectum the mean dose was 8.2 Gy (1.7 to 13.8 Gy). Results: The analysis of side effects shows that only 23 of 124 women (18 %) reported any problems at all. 13 women (10 %) noticed dysuria or pollakisuria for a maximum of 6 weeks. The average measured bladder dose in those patients was 5.3 Gy, (below the average bladder dose of 6.7 Gy). Diarrhea was reported in 3 patients (2 %), in those the average measured rectal dose was 6.8 Gy (lower than the average rectal dose of 8.2 Gy). 6 women (5 %) received antibiotic treatment because of bacteriuria. Of all patients 10 (8%) had a pelvic relapse, 3 in the vagina only. 5 women showed distant metastases during follow-up (3 of those having also a local relapse). Discussion and Conclusion: With only 2 % vaginal relapses HDR-BT is a save method to reduce the probability of vaginal metastases of endometrial carcinoma in an adjuvant setting. Moreover the incidence of acute side effects is low, no lasting complications were seen in our patients. There existed no correlation between the incidence of side effects and the measured in vivo doses in bladder and rectum, questioning the future usage in the era of well advanced BT-planning systems

  3. Averaging and sampling for magnetic-observatory hourly data

    Directory of Open Access Journals (Sweden)

    J. J. Love

    2010-11-01

    Full Text Available A time and frequency-domain analysis is made of the effects of averaging and sampling methods used for constructing magnetic-observatory hourly data values. Using 1-min data as a proxy for continuous, geomagnetic variation, we construct synthetic hourly values of two standard types: instantaneous "spot" measurements and simple 1-h "boxcar" averages. We compare these average-sample types with others: 2-h average, Gaussian, and "brick-wall" low-frequency-pass. Hourly spot measurements provide a statistically unbiased representation of the amplitude range of geomagnetic-field variation, but as a representation of continuous field variation over time, they are significantly affected by aliasing, especially at high latitudes. The 1-h, 2-h, and Gaussian average-samples are affected by a combination of amplitude distortion and aliasing. Brick-wall values are not affected by either amplitude distortion or aliasing, but constructing them is, in an operational setting, relatively more difficult than it is for other average-sample types. It is noteworthy that 1-h average-samples, the present standard for observatory hourly data, have properties similar to Gaussian average-samples that have been optimized for a minimum residual sum of amplitude distortion and aliasing. For 1-h average-samples from medium and low-latitude observatories, the average of the combination of amplitude distortion and aliasing is less than the 5.0 nT accuracy standard established by Intermagnet for modern 1-min data. For medium and low-latitude observatories, average differences between monthly means constructed from 1-min data and monthly means constructed from any of the hourly average-sample types considered here are less than the 1.0 nT resolution of standard databases. We recommend that observatories and World Data Centers continue the standard practice of reporting simple 1-h-average hourly values.

  4. Laser treatment of amateur tattoos in Arabs in Kuwait: effectiveness and safety.

    Science.gov (United States)

    Qasem, Kholoud Darwish; Alotaibi, Mohammad Fehan

    2012-04-01

    Laser treatment of amateur tattoos on Fitzpatrick type V skin produces a considerable risk of complications because of the increased incidence of adverse pigmentary changes. The principle of selective photothermolysis predicts that the Q-switched alexandrite laser should be effective in removing tattoo ink with minimal side effects in patients with skin phototype V. To study the effectiveness of the Q-switched alexandrite (755 nm, 50 ns) laser in the treatment of amateur tattoos in Arabs in Kuwait. One hundred patients, each with multiple tattoos, were treated until total clearance. Fluences used ranged from 5 to 7 J/cm(2) with a spot size of 3 mm. Clinical evaluation was performed at baseline and at each follow-up visit until dyspigmentation resolved. Total clearing was observed in all tattoos after an average of six sessions. Both tattoo clearing and post-laser hypopigmentation (29%) and hyperpigmentation (38%) increased with higher fluences. In this prospective study, our findings suggest that the Q-switched alexandrite laser is an effective laser in removing amateur tattoos in patients with skin phototype V, but with a high incidence of pigmentary changes.

  5. Salecker-Wigner-Peres clock and average tunneling times

    International Nuclear Information System (INIS)

    Lunardi, Jose T.; Manzoni, Luiz A.; Nystrom, Andrew T.

    2011-01-01

    The quantum clock of Salecker-Wigner-Peres is used, by performing a post-selection of the final state, to obtain average transmission and reflection times associated to the scattering of localized wave packets by static potentials in one dimension. The behavior of these average times is studied for a Gaussian wave packet, centered around a tunneling wave number, incident on a rectangular barrier and, in particular, on a double delta barrier potential. The regime of opaque barriers is investigated and the results show that the average transmission time does not saturate, showing no evidence of the Hartman effect (or its generalized version).

  6. Effects of measurement procedure and equipment on average room acoustic measurements

    DEFF Research Database (Denmark)

    Gade, Anders Christian; Bradley, J S; Siebein, G W

    1993-01-01

    This paper reports the results of a measurement tour of nine U.S. concert halls. Three measurements teams, from the University of Florida, the National Research Council of Canada, and the Technical University of Denmark, made parallel sets of measurements using their own equipment and procedures........ [Work partially supported by the Concert Hall Research Group.]......This paper reports the results of a measurement tour of nine U.S. concert halls. Three measurements teams, from the University of Florida, the National Research Council of Canada, and the Technical University of Denmark, made parallel sets of measurements using their own equipment and procedures....... In some of the halls measurements were repeated using the procedures of the other teams to make it possible to separate the effects of different equipment and different procedures. The paper will present position-averaged results from the three teams and will discuss reasons for the differences observed...

  7. Average configuration of the geomagnetic tail

    International Nuclear Information System (INIS)

    Fairfield, D.H.

    1979-01-01

    Over 3000 hours of Imp 6 magnetic field data obtained between 20 and 33 R/sub E/ in the geomagnetic tail have been used in a statistical study of the tail configuration. A distribution of 2.5-min averages of B/sub z/ as a function of position across the tail reveals that more flux crosses the equatorial plane near the dawn and dusk flanks (B-bar/sub z/=3.γ) than near midnight (B-bar/sub z/=1.8γ). The tail field projected in the solar magnetospheric equatorial plane deviates from the x axis due to flaring and solar wind aberration by an angle α=-0.9 Y/sub SM/-2.7, where Y/sub SM/ is in earth radii and α is in degrees. After removing these effects, the B/sub y/ component of the tail field is found to depend on interplanetary sector structure. During an 'away' sector the B/sub y/ component of the tail field is on average 0.5γ greater than that during a 'toward' sector, a result that is true in both tail lobes and is independent of location across the tail. This effect means the average field reversal between northern and southern lobes of the tail is more often 178 0 rather than the 180 0 that is generally supposed

  8. The Effect of Tamsulosin in the Medical Treatment of Distal Ureteral Stones

    Science.gov (United States)

    Alizadeh, M.; Magsudi, M.

    2014-01-01

    Introduction: Renal stones are common disorders that affect approximately 5% to 10% of the population and the incidence of renal stones is rising. Treatment of ureteral stones is an important part of urologists and minimally invasive procedures such as ESWL and ureteroscopy effectiveness has been proven in various studies. However, these methods are not completely safe and are expensive and can be complicated. Purpose of this study is to evaluate the effectiveness of tamsulosin in the medical treatment of distal ureteral stones. Patients and methods: A total of 96 patients with distal ureteral stones or UVj are randomly divided into two study group (50 patients) and control group (46 patients). Patients in the control group allowed to freely consuming fluids (hydration) and indomethacin 100 mg PRN. Study group in addition to indomethacin and daily analgesic 0.4 mg tamsulosin was administered. All subjects in terms of analgesic dose, duration of expulsion and expulsion were studied. Results: Spontaneous expulsion of stone was occurred in 62.5% (30 patients out of 46) of control group patients and 82% (41 patients out of 50) that there was no significant difference (P>0.05). Average time to fix the stone in control group 4.7±8.03 days (range 2 to 28 days) and in the study group, 3.7±5.70 days (range 1 to 23 days) is significantly different (P>0.05). The average amount of analgesic consumption in the control group was 2.3±4.31and in the study group was 1.48±2.15 that showed significant differences (Ptamsulosin to conservative treatment of distal ureteral stones in the distal ureteral stone expulsion showed no significant difference between the two groups, but the reduction in the duration of expulsion, reduce pain and reduce the need for analgesic has been beneficial. PMID:25363178

  9. Effect of atmospheric plasma treatment on seed germination of rice (Oryza sativa L.)

    Science.gov (United States)

    Penado, Keith Nealson M.; Mahinay, Christian Lorenz S.; Culaba, Ivan B.

    2018-01-01

    Multiple methods of improving plant development have been utilized over the past decades. Despite these improvements, there still exists a need for better planting methods due to the increasing population of a global community. Studies have reported that plasma treatment affects the growth and germination of a variety of plant species, including a multitude of grains which often takes the bulk in the diet of the average human being. This study explores the effect of atmospheric air plasma jet treatment on the seed germination of rice (Oryza sativa L.). The seeds were treated using an atmospheric air plasma jet for 1, 2, and 3 s. The effect of plasma exposure shows a reduction of trichomes on the surface of the seed. This caused a possible increase in wettability which significantly affected the seed germ length but did not affect the seed germination count after the germination period of 72 h.

  10. [Cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of rheumatoid arthritis].

    Science.gov (United States)

    Salinas-Escudero, Guillermo; Vargas-Valencia, Juan; García-García, Erika Gabriela; Munciño-Ortega, Emilio; Galindo-Suárez, Rosa María

    2013-01-01

    to conduct cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of moderate or severe rheumatoid arthritis in patients with previous unresponse to immune selective anti-inflammatory derivatives failure. a pharmacoeconomic model based on decision analysis to assess the clinical outcome after giving etanercept, infliximab, adalimumab or tocilizumab to treat moderate or severe rheumatoid arthritis was employed. Effectiveness of medications was assessed with improvement rates of 20 % or 70 % of the parameters established by the American College of Rheumatology (ACR 20 and ACR 70). the model showed that etanercept had the most effective therapeutic response rate: 79.7 % for ACR 20 and 31.4 % for ACR 70, compared with the response to other treatments. Also, etanercept had the lowest cost ($149,629.10 per patient) and had the most cost-effective average ($187,740.40 for clinical success for ACR 20 and $476,525.80 for clinical success for ACR 70) than the other biologic therapies. we demonstrated that treatment with etanercept is more effective and less expensive compared to the other drugs, thus making it more efficient therapeutic option both in terms of means and incremental cost-effectiveness ratios for the treatment of rheumatoid arthritis.

  11. A budget-impact and cost-effectiveness model for second-line treatment of major depression.

    Science.gov (United States)

    Malone, Daniel C

    2007-07-01

    Depressed patients who initially fail to achieve remission when placed on a selective serotonin reuptake inhibitor (SSRI) may require a second treatment. The purpose of this study was to evaluate the effectiveness, cost, cost-effectiveness, and budget impact of second-line pharmacologic treatment for major depressive disorder (MDD). A cost-effectiveness analysis was conducted to evaluate second-line therapies (citalopram, escitalopram, fluoxetine, paroxetine, paroxetine controlled release [CR], sertraline, and venlafaxine extended release [XR]) for the treatment of depression. Effectiveness data were obtained from published clinical studies. The primary outcome was remission defined as a score of 7 or less on the Hamilton Rating Scale for Depression (HAM-D) or a score of 10 or less on the montgomery-Asberg Depression Rating Scale (MADRS) depression rating scales. The wholesale acquisition cost (WAC) for medications and medical treatment costs for depression were included. The perspective was derived from a managed care organization (MCO) with 500,000 members, a 1.9% annual incidence of depression, and treatment duration of 6 months. Assumptions included: second-line treatment is not as effective as first-line treatment, WAC price reflects MCO costs, and side effects were identical. Sensitivity analyses were conducted to determine variables that influenced the results. Second-line remission rates were 20.4% for venlafaxine XR, 16.9% for sertraline, 16.4% for escitalopram, 15.1% for generic SSRIs (weighted average), and 13.6% for paroxetine CR. Pharmacy costs ranged from $163 for generic SSRIs to $319 for venlafaxine SR. Total cost per patient achieving remission was $14,275 for venlafaxine SR, followed by $16,100 for escitalopram. The incremental cost-effectiveness ratio (ICER) for venlafaxine SR compared with generic SSRIs was $2,073 per patient achieving remission, followed by escitalopram with an ICER of $3,566. The model was most sensitive to other therapies

  12. Lateral dispersion coefficients as functions of averaging time

    International Nuclear Information System (INIS)

    Sheih, C.M.

    1980-01-01

    Plume dispersion coefficients are discussed in terms of single-particle and relative diffusion, and are investigated as functions of averaging time. To demonstrate the effects of averaging time on the relative importance of various dispersion processes, and observed lateral wind velocity spectrum is used to compute the lateral dispersion coefficients of total, single-particle and relative diffusion for various averaging times and plume travel times. The results indicate that for a 1 h averaging time the dispersion coefficient of a plume can be approximated by single-particle diffusion alone for travel times <250 s and by relative diffusion for longer travel times. Furthermore, it is shown that the power-law formula suggested by Turner for relating pollutant concentrations for other averaging times to the corresponding 15 min average is applicable to the present example only when the averaging time is less than 200 s and the tral time smaller than about 300 s. Since the turbulence spectrum used in the analysis is an observed one, it is hoped that the results could represent many conditions encountered in the atmosphere. However, as the results depend on the form of turbulence spectrum, the calculations are not for deriving a set of specific criteria but for demonstrating the need in discriminating various processes in studies of plume dispersion

  13. Topical perfluorodecalin resolves immediate whitening reactions and allows rapid effective multiple pass treatment of tattoos.

    Science.gov (United States)

    Reddy, Kavitha K; Brauer, Jeremy A; Anolik, Robert; Bernstein, Leonard; Brightman, Lori; Hale, Elizabeth; Karen, Julie; Weiss, Elliot; Geronemus, Roy G

    2013-02-01

    Laser tattoo removal using multiple passes per session, with each pass delivered after spontaneous resolution of whitening, improves tattoo fading in a 60-minute treatment time. Our objective was to evaluate the safety and efficacy of topical perfluorodecalin (PFD) in facilitating rapid effective multiple-pass tattoo removal. In a randomized, controlled study using Q-switched ruby or Nd:YAG laser, 22 previously treated tattoos were treated with 3 passes using PFD to resolve whitening after each pass ("R0 method"). In previously untreated symmetric tattoos, seven were treated over half of the tattoo with the R20 method, and the opposite half with 4 passes using PFD (R0 method); two were treated over half with a single pass and the opposite half with 4 passes using PFD (R0 method); and six treated over half with a single pass followed by PFD and the opposite half with a single pass alone. Blinded dermatologists rated tattoo fading at 1-3 months. Optical coherence tomography (OCT) imaging of whitening was performed in two tattoos. Topical PFD clinically resolved immediate whitening reactions within a mean 5 seconds (range 3-10 seconds). Tattoos treated with the R0 method demonstrated excellent fading in an average total treatment time of 5 minutes. Tattoo areas treated with the R0 method demonstrated equal fading compared to the R20 method, and improved fading compared to a single pass method. OCT imaging of whitening demonstrated epidermal and dermal hyper-reflective "bubbles" that dissipated until absent at 9-10 minutes after PFD application, and at 20 minutes without intervention. Multiple-pass tattoo removal using PFD to deliver rapid sequential passes (R0 method) appears equally effective as the R20 method, in a total treatment time averaging 5 minutes, and more effective than single pass treatment. OCT-visualized whitening-associated "bubbles," upon treatment with PFD, resolve twice as rapidly as spontaneous resolution. Copyright © 2012 Wiley

  14. Reconstruction versus conservative treatment after rupture of the anterior cruciate ligament: cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Farshad Mazda

    2011-11-01

    Full Text Available Abstract Background The decision whether to treat conservatively or reconstruct surgically a torn anterior cruciate ligament (ACL is an ongoing subject of debate. The high prevalence and associated public health burden of torn ACL has led to continuous efforts to determine the best therapeutic approach. A critical evaluation of benefits and expenditures of both treatment options as in a cost effectiveness analysis seems well-suited to provide valuable information for treating physicians and healthcare policymakers. Methods A literature review identified four of 7410 searched articles providing sufficient outcome probabilities for the two treatment options for modeling. A transformation key based on the expert opinions of 25 orthopedic surgeons was used to derive utilities from available evidence. The cost data for both treatment strategies were based on average figures compiled by Orthopaedic University Hospital Balgrist and reinforced by Swiss national statistics. A decision tree was constructed to derive the cost-effectiveness of each strategy, which was then tested for robustness using Monte Carlo simulation. Results Decision tree analysis revealed a cost effectiveness of 16,038 USD/0.78 QALY for ACL reconstruction and 15,466 USD/0.66 QALY for conservative treatment, implying an incremental cost effectiveness of 4,890 USD/QALY for ACL reconstruction. Sensitivity analysis of utilities did not change the trend. Conclusion ACL reconstruction for reestablishment of knee stability seems cost effective in the Swiss setting based on currently available evidence. This, however, should be reinforced with randomized controlled trials comparing the two treatment strategies.

  15. The Short-Term Effect of Integrated Complementary and Alternative Medicine Treatment in Inpatients Diagnosed with Lumbar Intervertebral Disc Herniation: A Prospective Observational Study.

    Science.gov (United States)

    Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Jung, Jaehoon; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk

    2016-07-01

    This study aimed to investigate the short-term effect of hospital-based intensive nonsurgical treatment in lumbar intervertebral disc herniation (IDH) inpatients admitted to an integrated hospital that offers both complementary and alternative medicine (CAM) and conventional medicine treatment. A prospective observational study. A private Korean medicine hospital inpatient setting in Korea. A total of 524 inpatients diagnosed with lumbar IDH admitted from June 1, 2012, to May 31, 2013. The participants received treatment according to a CAM treatment protocol (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation) and conventional medicine treatment as needed. Numeric rating scale (NRS) of low back pain (LBP) and leg pain, Oswestry Disability Index (ODI), and patient global impression of change. The study also assessed whether improvement was obtained over minimal clinically important difference (MCID) in LBP or leg pain. The average hospital stay was 24.4 ± 13.2 days. The majority of patients received CAM treatment and a few selected conventional medicine, such as pain killers (22.7%; 4.2 ± 3.0 administrations) or nerve blocks (14.1%; 1.4 ± 0.7 sessions). At discharge, the average reduction in NRS was 3.18 ± 2.29 (95% confidence interval [CI], 2.99-3.38) for LBP and 2.61 ± 2.60 (95% CI, 2.38-2.83) for leg pain the average reduction in ODI was 19.45 ± 19.53 (95% CI, 17.77-21.12). Two-hundred and seventy patients (51.5%) showed improvement over MCID in both NRS and ODI, 150 (28.6%) in either NRS or ODI, and 104 (19.8%) in neither. Integrated CAM treatment during hospitalization was effective for patients with lumbar IDH who had severe LBP and disability. However, these results must be investigated further to assess whether the effects surpass those seen with placebo and are cost-effective.

  16. High-Average, High-Peak Current Injector Design

    CERN Document Server

    Biedron, S G; Virgo, M

    2005-01-01

    There is increasing interest in high-average-power (>100 kW), um-range FELs. These machines require high peak current (~1 kA), modest transverse emittance, and beam energies of ~100 MeV. High average currents (~1 A) place additional constraints on the design of the injector. We present a design for an injector intended to produce the required peak currents at the injector, eliminating the need for magnetic compression within the linac. This reduces the potential for beam quality degradation due to CSR and space charge effects within magnetic chicanes.

  17. Effect of mastitis treatment and somatic cell counts on milk yield in Danish organic dairy cows.

    Science.gov (United States)

    Bennedsgaard, T W; Enevoldsen, C; Thamsborg, S M; Vaarst, M

    2003-10-01

    Production and disease data from 17,488 lactations in 48 Danish organic dairy herds from 1997 to 2001 were analyzed to obtain estimates on the effect of somatic cell counts (SCC) and mastitis treatment on milk production. A multilevel three-parameter piecewise random coefficients linear model with energy-corrected milk (ECM) as dependent variable and herd, lactation, and test days as levels, was used to model the lactation curve. Covariates related to production, SCC, veterinary treatments, and reproductive performance in the previous lactation as well as information on other diseases in the current lactation were included to describe the production capacity of the individual cow. The average daily milk production at herd level was 20.8, 24.2, and 25.8 kg of ECM/d in first, second, and third or later lactation. The estimates for production losses were on average 0.2, 0.3, and 0.4 kg of ECM/d in first, second, and third or later lactation with each twofold increase in SCC between 100,000 and 1,500,000 cells/ml. The effect varied with the stage of lactation and was nonsignificant around 60 d postpartum and highest at the end of the lactation. The production losses in cows treated for mastitis varied with parity and stage of lactation and were modified by the SCC after treatment. For a cow in third lactation with a SCC below 100,000 cells/ ml before treatment at days in milk = 15, the predicted loss was 435 kg of ECM, including a loss of 135 kg of ECM because of higher SCC compared with the level before treatment. Most of the variation in production related to SCC and mastitis was at the lactation level, and no significant differences were found between herds grouped according to milk production level, SCC, or prevalence of mastitis treatment.

  18. Effect of the personality traits of the patient on pain perception and attitude toward orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Abhijeet Kadu

    2015-01-01

    Full Text Available Objective: The objective was to evaluate the relationship between personality traits, pain perception, and person′s attitude toward orthodontic treatment. Materials and Methods: The sample comprised of two groups: Group 1 consisted of 100 treated subjects (50 males, 50 females; average age, 16.07 ± 1.36 years, and Group 2 consisted of 100 untreated subjects (50 males, 50 females; average age, 16.07 ± 1.41 years. The instrument for data collection was a questionnaire that included an assessment of patients′ personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitude toward orthodontic treatment. Results: Gender and treatment status did not affect pain perception and attitude of a person toward orthodontic treatment. There was a strong relationship between pain perception and attitude with Pearson′s correlation of 0.367 and P ≤ 0.0001. With one unit increase in attitude there was 0.43 units increase in pain. Patients with high levels of trait neuroticism (P = 0.01 and low levels of trait conscientiousness (P = 0.02 experienced more pain. Patients with high levels of trait conscientiousness showed better attitude (P = 0.01. Conclusion: Personality traits, neuroticism, and conscientiousness have effect on pain perception and attitude of patients toward orthodontic treatment. Patients with better attitude experienced less pain and patients with less pain exhibited better attitude.

  19. Comparison of the effectiveness of compression stockings and layer compression systems in venous ulceration treatment

    Science.gov (United States)

    Jawień, Arkadiusz; Cierzniakowska, Katarzyna; Cwajda-Białasik, Justyna; Mościcka, Paulina

    2010-01-01

    Introduction The aim of the research was to compare the dynamics of venous ulcer healing when treated with the use of compression stockings as well as original two- and four-layer bandage systems. Material and methods A group of 46 patients suffering from venous ulcers was studied. This group consisted of 36 (78.3%) women and 10 (21.70%) men aged between 41 and 88 years (the average age was 66.6 years and the median was 67). Patients were randomized into three groups, for treatment with the ProGuide two-layer system, Profore four-layer compression, and with the use of compression stockings class II. In the case of multi-layer compression, compression ensuring 40 mmHg blood pressure at ankle level was used. Results In all patients, independently of the type of compression therapy, a few significant statistical changes of ulceration area in time were observed (Student’s t test for matched pairs, p ulceration area in each of the successive measurements was observed in patients treated with the four-layer system – on average 0.63 cm2/per week. The smallest loss of ulceration area was observed in patients using compression stockings – on average 0.44 cm2/per week. However, the observed differences were not statistically significant (Kruskal-Wallis test H = 4.45, p > 0.05). Conclusions A systematic compression therapy, applied with preliminary blood pressure of 40 mmHg, is an effective method of conservative treatment of venous ulcers. Compression stockings and prepared systems of multi-layer compression were characterized by similar clinical effectiveness. PMID:22419941

  20. An application of commercial data averaging techniques in pulsed photothermal experiments

    International Nuclear Information System (INIS)

    Grozescu, I.V.; Moksin, M.M.; Wahab, Z.A.; Yunus, W.M.M.

    1997-01-01

    We present an application of data averaging technique commonly implemented in many commercial digital oscilloscopes or waveform digitizers. The technique was used for transient data averaging in the pulsed photothermal radiometry experiments. Photothermal signals are surrounded by an important amount of noise which affect the precision of the measurements. The effect of the noise level on photothermal signal parameters in our particular case, fitted decay time, is shown. The results of the analysis can be used in choosing the most effective averaging technique and estimating the averaging parameter values. This would help to reduce the data acquisition time while improving the signal-to-noise ratio

  1. EFFECT OF THERMO-MECHANICAL TREATMENT ON PROPERTIES OF PARICA PLYWOODS (Schizolobium amazonicum Huber ex Ducke

    Directory of Open Access Journals (Sweden)

    Mírian de Almeida Costa

    Full Text Available ABSTRACT Thermo-mechanical treatment is a technique for wood modification in which samples are densified by means of heat and mechanical compression, applied perpendicularly to fibers, which under different combinations of time, temperature, and pressure increases wood density and thus improve some of its properties. This study aimed to treat thermo-mechanically parica plywood and observe the effects on its physical and mechanical properties. Specimens were submitted to two treatments, 120 and 150 ºC, remaining under pressure for seven minutes and, subsequently, under zero pressure for 15 minutes. Results showed a significant increase in specific mass from 0.48 g cm-3 to an average of 0.56 g cm-3, and a compression ratio of about 31.7% on average. Physical properties also varied significantly and results showed that treated samples swelled and absorbed more water than those untreated, leading to a greater thickness non-return rate. This indicates the proposed thermal treatments did not release the internal compressive stress generated during panel pressing, not improving its dimensional stability as a result. On the other hand, mechanical properties were positively affected, leading to an increase of 27.5% and 51.8% in modulus of rupture after treatments at 120 and 150 ºC, respectively. Modulus of elasticity and glue-line shear strength did not vary statistically and Janka hardness was 29.7% higher after treatment at 150 ºC.

  2. Effect of 3 Key Factors on Average End to End Delay and Jitter in MANET

    Directory of Open Access Journals (Sweden)

    Saqib Hakak

    2015-01-01

    Full Text Available A mobile ad-hoc network (MANET is a self-configuring infrastructure-less network of mobile devices connected by wireless links where each node or mobile device is independent to move in any desired direction and thus the links keep moving from one node to another. In such a network, the mobile nodes are equipped with CSMA/CA (carrier sense multiple access with collision avoidance transceivers and communicate with each other via radio. In MANETs, routing is considered one of the most difficult and challenging tasks. Because of this, most studies on MANETs have focused on comparing protocols under varying network conditions. But to the best of our knowledge no one has studied the effect of other factors on network performance indicators like throughput, jitter and so on, revealing how much influence a particular factor or group of factors has on each network performance indicator. Thus, in this study the effects of three key factors, i.e. routing protocol, packet size and DSSS rate, were evaluated on key network performance metrics, i.e. average delay and average jitter, as these parameters are crucial for network performance and directly affect the buffering requirements for all video devices and downstream networks.

  3. Effectiveness of Educational Technology in Promoting Quality of Life and Treatment Adherence in Hypertensive People.

    Directory of Open Access Journals (Sweden)

    Ana Célia Caetano de Souza

    Full Text Available The objective of this study was to test the effectiveness of an educational intervention with use of educational technology (flipchart to promote quality of life (QOL and treatment adherence in people with hypertension. It was an intervention study of before-and-after type conducted with 116 hypertensive people registered in Primary Health Care Units. The educational interventions were conducted using the flipchart educational technology. Quality of life was assessed through the MINICHAL (lowest score = better QOL and the QATSH (higher score = better adherence was used to assess the adherence to hypertension treatment. Both were measured before and after applying the intervention. In the analysis, we used the Student's t-test for paired data. The average baseline quality of life was 11.66 ± 7.55, and 7.71 ± 5.72 two months after the intervention, showing a statistically significant reduction (p <0.001 and mean of differences of 3.95. The average baseline adherence to treatment was 98.03 ± 7.08 and 100.71 ± 6.88 two months after the intervention, which is statistically significant (p < 0.001, and mean of differences of 2.68. The conclusion was that the educational intervention using the flipchart improved the total score of quality of life in the scores of physical and mental domains, and increased adherence to hypertension treatment in people with the disease.

  4. Effectiveness of bridge V.A.C. dressings in the treatment of diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Aziz Nather

    2011-03-01

    Full Text Available Objectives: This is a prospective study of the clinical efficacy of the V.A.C. Granufoam Bridge Dressing for the treatment of diabetic foot ulcers. Materials and methods: Five consecutive patients with diabetic foot ulcers were treated with V.A.C. Granufoam Bridge Dressings and studied over a period of 22–48 days. The indications for treatment included diabetic patients with open ray amputation wounds and wounds post-drainage for abscess with exposed deep structures. Clinical outcome was measured in terms of reduction in wound dimensions, presence of wound granulation, microbial clearance, and development of wound complications. Results: Our results showed that with V.A.C. therapy, wound healing occurred in all patients. The number of dressings required ranged from 8 to 10. The baseline average wound size was 23.1 cm2. Wound areas shrunk by 18.4–41.7%. All subjects achieved 100% wound bed granulation with an average length of treatment of 33 days. Microbial clearance was achieved in all cases. All wounds healed by secondary intention in one case and four cases required split-thickness skin grafting. Conclusion: The V.A.C. Granufoam Bridge Dressing is effective in the treatment of diabetic foot ulcers. It promotes reduction of wound area, wound bed granulation, and microbial clearance. By allowing placement of the suction pad outside the foot, it allowed patients to wear protective shoes and to walk non-weight bearing with crutches during V.A.C. therapy.

  5. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    1999-01-01

    In this article two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very offten the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belo...... approximations to the Riemannian metric, and that the subsequent corrections are inherient in the least squares estimation. Keywords: averaging rotations, Riemannian metric, matrix, quaternion......In this article two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very offten the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...

  6. Histological analysis of effects of 24% EDTA gel for nonsurgical treatment of periodontal tissues.

    Science.gov (United States)

    de Vasconcellos, Luana Marotta Reis; Ricardo, Lucilene Hernandes; Balducci, Ivan; de Vasconcellos, Luis Gustavo Oliveira; Carvalho, Yasmin Rodarte

    2006-12-01

    The aim of this study was to investigate, by means of histological and histomorphometric analysis, the effects of 24% ethylenediaminetetraacetic acid (EDTA) gel in periodontal tissue when used in combination with conventional periodontal treatment. Periodontitis was induced in the 2nd upper left permanent molars of 45 male Wistar rats by means of ligature. After 5 weeks, this was removed and debridement was performed. The animals were then randomly divided into 3 groups; group 1: mechanical treatment, group 2: mechanical treatment and EDTA gel application for 2 min, and group 3: mechanical treatment and placebo gel application for 2 min. After the treatment, rinsing was done with 0.9% saline solution for 1 min in all cases, followed by root notching in the deepest part of the pocket. After 4, 10, and 28 days the animals were sacrificed. The averages obtained were evaluated by means of test two-way analysis of variance (ANOVA) and Tukey statistical tests (P 24% EDTA gel did not interfere with periodontal tissue repair when used in combination with conventional periodontal treatment.

  7. The Effect of Cumulus Cloud Field Anisotropy on Domain-Averaged Solar Fluxes and Atmospheric Heating Rates

    Science.gov (United States)

    Hinkelman, Laura M.; Evans, K. Franklin; Clothiaux, Eugene E.; Ackerman, Thomas P.; Stackhouse, Paul W., Jr.

    2006-01-01

    Cumulus clouds can become tilted or elongated in the presence of wind shear. Nevertheless, most studies of the interaction of cumulus clouds and radiation have assumed these clouds to be isotropic. This paper describes an investigation of the effect of fair-weather cumulus cloud field anisotropy on domain-averaged solar fluxes and atmospheric heating rate profiles. A stochastic field generation algorithm was used to produce twenty three-dimensional liquid water content fields based on the statistical properties of cloud scenes from a large eddy simulation. Progressively greater degrees of x-z plane tilting and horizontal stretching were imposed on each of these scenes, so that an ensemble of scenes was produced for each level of distortion. The resulting scenes were used as input to a three-dimensional Monte Carlo radiative transfer model. Domain-average transmission, reflection, and absorption of broadband solar radiation were computed for each scene along with the average heating rate profile. Both tilt and horizontal stretching were found to significantly affect calculated fluxes, with the amount and sign of flux differences depending strongly on sun position relative to cloud distortion geometry. The mechanisms by which anisotropy interacts with solar fluxes were investigated by comparisons to independent pixel approximation and tilted independent pixel approximation computations for the same scenes. Cumulus anisotropy was found to most strongly impact solar radiative transfer by changing the effective cloud fraction, i.e., the cloud fraction when the field is projected on a surface perpendicular to the direction of the incident solar beam.

  8. Benchmarking statistical averaging of spectra with HULLAC

    Science.gov (United States)

    Klapisch, Marcel; Busquet, Michel

    2008-11-01

    Knowledge of radiative properties of hot plasmas is important for ICF, astrophysics, etc When mid-Z or high-Z elements are present, the spectra are so complex that one commonly uses statistically averaged description of atomic systems [1]. In a recent experiment on Fe[2], performed under controlled conditions, high resolution transmission spectra were obtained. The new version of HULLAC [3] allows the use of the same model with different levels of details/averaging. We will take advantage of this feature to check the effect of averaging with comparison with experiment. [1] A Bar-Shalom, J Oreg, and M Klapisch, J. Quant. Spectros. Rad. Transf. 65, 43 (2000). [2] J. E. Bailey, G. A. Rochau, C. A. Iglesias et al., Phys. Rev. Lett. 99, 265002-4 (2007). [3]. M. Klapisch, M. Busquet, and A. Bar-Shalom, AIP Conference Proceedings 926, 206-15 (2007).

  9. Average-energy games

    Directory of Open Access Journals (Sweden)

    Patricia Bouyer

    2015-09-01

    Full Text Available Two-player quantitative zero-sum games provide a natural framework to synthesize controllers with performance guarantees for reactive systems within an uncontrollable environment. Classical settings include mean-payoff games, where the objective is to optimize the long-run average gain per action, and energy games, where the system has to avoid running out of energy. We study average-energy games, where the goal is to optimize the long-run average of the accumulated energy. We show that this objective arises naturally in several applications, and that it yields interesting connections with previous concepts in the literature. We prove that deciding the winner in such games is in NP inter coNP and at least as hard as solving mean-payoff games, and we establish that memoryless strategies suffice to win. We also consider the case where the system has to minimize the average-energy while maintaining the accumulated energy within predefined bounds at all times: this corresponds to operating with a finite-capacity storage for energy. We give results for one-player and two-player games, and establish complexity bounds and memory requirements.

  10. The cost-effectiveness of an intensive treatment protocol for severe dyslexia in children.

    Science.gov (United States)

    Hakkaart-van Roijen, Leona; Goettsch, Wim G; Ekkebus, Michel; Gerretsen, Patty; Stolk, Elly A

    2011-08-01

    Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued by proxies using a general quality-of-life instrument (EQ-5D). We considered medical cost and non-medical cost (e.g. remedial teaching). The model computed cost per successful treatment and cost per quality adjusted life year (QALY) in time. About 75% of the total costs was related to diagnostic tests to distinguish between children with severe dyslexia and children who have reading difficulties for other reasons. The costs per successful treatment of severe dyslexia were €36 366. Successful treatment showed a quality-of-life gain of about 11%. At primary school, the average cost per QALY for severe dyslexia amounted to €58 647. In the long term, the cost per QALY decreased to €26 386 at secondary school and €17 663 thereafter. The results of this study provide evidence that treatment of severe dyslexia is cost-effective when the investigated protocol is followed. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Chemical Industry Waste water Treatment

    International Nuclear Information System (INIS)

    Nasr, F.A.; Doma, H.S.; El-Shafai, S.A.; Abdel-HaJim, H.S.

    2004-01-01

    Treatment of chemical industrial wastewater from building and construction chemicals factory and plastic shoes manufacturing factory was investigated. The two factories discharge their wastewater into the public sewerage network. The results showed the wastewater discharged from the building and construction chemicals factory was highly contaminated with organic compounds. The average values of COD and BOD were 2912 and 150 mg O 2 /l. Phenol concentration up to 0.3 mg/l was detected. Chemical treatment using lime aided with ferric chloride proved to be effective and produced an effluent characteristics in compliance with Egyptian permissible limits. With respect to the other factory, industrial wastewater was mixed with domestic wastewater in order to lower the organic load. The COD, BOD values after mixing reached 5239 and 2615 mg O 2 /l. The average concentration of phenol was 0.5 mg/l. Biological treatment using activated sludge or rotating biological contactor (RBe) proved to be an effective treatment system in terms of producing an effluent characteristic within the permissible limits set by the law

  12. [Current prevention and treatment strategies for osteoporosis. Fracture-oriented, effective, low side effects and inexpensive].

    Science.gov (United States)

    Bartl, R; Bartl, C

    2015-12-01

    Osteoporosis is still an underdiagnosed and insufficiently therapied widespread disease in Germany. Of the estimated 7 million osteoporosis patients only 1.5 million receive a guideline conform diagnosis and even less receive appropriate treatment. Some 90 % of patients are provided with analgesics but only 10 % receive an effective therapy, although efficacious, well-tested and affordable medications are available. In addition, approximately one half of the patients terminate treatment after only 1 year although according to the results of recent studies the duration of therapy should be at least 3-5 years. In view of the increasing average life expectancy, a consistent management for prevention of fractures associated with osteoporosis is always most important for society, even if only for reasons of costs. Achievement of this target depends on four circumstances: clarification of the origin of osteoporosis and fractures (bone consciousness), prophylaxis of bone loss and fractures (primary prevention), consistent guideline conform diagnostics and therapy (secondary and tertiary prevention) and cooperation of all disciplines in medicine (bone is everybody's business). This article describes the current state of diagnostics (bone density measurement with dual X-ray absorptiometry, FRAX®), prophylaxis of fractures (screening program) and therapy (use of economic and effective medications with low side effects). Novel medications are already undergoing clinical testing and a "healing" of bone reduction with restoration of the normal bone structure is to be expected.

  13. The Effect of Fungicides for Seed Treatment on Germination of Barley

    Directory of Open Access Journals (Sweden)

    Vesna Stevanović

    2009-01-01

    Full Text Available The application of chemicals, such as fungicides for seed treatment, is one of the most reliable and perhaps most efficient measures for integrated preservation of crops, and its practicing has become a legal obligation for all seed producers. This investigation was carried out in the laboratory for seed quality and phytopathology of the Small Grains Research Center in Kragujevac. The objective was to establish the effect of fungicides on germination energy and seed germinability (determined after treatments. Two varieties were tested due to a possibility of specific sensitivities of some varieties, so that the results acquired on one variety would not necessarily be valid for another one. Fungicides based on active ingredients from the triasol chemical group had different effects on the energy of germination of barley seeds. Applying Raxil S040-FS, the average germination of barley seeds was 79.3% for the variety Record, and 91.3% for the Grand variety. The variety Record achieved a lower value than the minimum for barley seed germination (88% stipulated by the Rules on Seed Quality of Agricultural Crops.Regardless of barley type, the product Raxil S040-FS showed a statistically significant effect on the number of atypical seedlings and increase in the number of non-germinated seeds, compared to the control.

  14. Polarized Line Formation in Arbitrary Strength Magnetic Fields Angle-averaged and Angle-dependent Partial Frequency Redistribution

    Energy Technology Data Exchange (ETDEWEB)

    Sampoorna, M.; Nagendra, K. N. [Indian Institute of Astrophysics, Koramangala, Bengaluru 560 034 (India); Stenflo, J. O., E-mail: sampoorna@iiap.res.in, E-mail: knn@iiap.res.in, E-mail: stenflo@astro.phys.ethz.ch [Institute of Astronomy, ETH Zurich, CH-8093 Zurich (Switzerland)

    2017-08-01

    Magnetic fields in the solar atmosphere leave their fingerprints in the polarized spectrum of the Sun via the Hanle and Zeeman effects. While the Hanle and Zeeman effects dominate, respectively, in the weak and strong field regimes, both these effects jointly operate in the intermediate field strength regime. Therefore, it is necessary to solve the polarized line transfer equation, including the combined influence of Hanle and Zeeman effects. Furthermore, it is required to take into account the effects of partial frequency redistribution (PRD) in scattering when dealing with strong chromospheric lines with broad damping wings. In this paper, we present a numerical method to solve the problem of polarized PRD line formation in magnetic fields of arbitrary strength and orientation. This numerical method is based on the concept of operator perturbation. For our studies, we consider a two-level atom model without hyperfine structure and lower-level polarization. We compare the PRD idealization of angle-averaged Hanle–Zeeman redistribution matrices with the full treatment of angle-dependent PRD, to indicate when the idealized treatment is inadequate and what kind of polarization effects are specific to angle-dependent PRD. Because the angle-dependent treatment is presently computationally prohibitive when applied to realistic model atmospheres, we present the computed emergent Stokes profiles for a range of magnetic fields, with the assumption of an isothermal one-dimensional medium.

  15. An Effective Web Presence for Substance Abuse Treatment Facilities.

    Science.gov (United States)

    Link, Thomas W; Hefner, Jennifer L; Ford, Eric W; Huerta, Timothy R

    2016-01-01

    Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page. The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry. This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score. The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites. The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.

  16. Averaging of nonlinearity-managed pulses

    International Nuclear Information System (INIS)

    Zharnitsky, Vadim; Pelinovsky, Dmitry

    2005-01-01

    We consider the nonlinear Schroedinger equation with the nonlinearity management which describes Bose-Einstein condensates under Feshbach resonance. By using an averaging theory, we derive the Hamiltonian averaged equation and compare it with other averaging methods developed for this problem. The averaged equation is used for analytical approximations of nonlinearity-managed solitons

  17. Average Soil Water Retention Curves Measured by Neutron Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Chu-Lin [ORNL; Perfect, Edmund [University of Tennessee, Knoxville (UTK); Kang, Misun [ORNL; Voisin, Sophie [ORNL; Bilheux, Hassina Z [ORNL; Horita, Juske [Texas Tech University (TTU); Hussey, Dan [NIST Center for Neutron Research (NCRN), Gaithersburg, MD

    2011-01-01

    Water retention curves are essential for understanding the hydrologic behavior of partially-saturated porous media and modeling flow transport processes within the vadose zone. In this paper we report direct measurements of the main drying and wetting branches of the average water retention function obtained using 2-dimensional neutron radiography. Flint sand columns were saturated with water and then drained under quasi-equilibrium conditions using a hanging water column setup. Digital images (2048 x 2048 pixels) of the transmitted flux of neutrons were acquired at each imposed matric potential (~10-15 matric potential values per experiment) at the NCNR BT-2 neutron imaging beam line. Volumetric water contents were calculated on a pixel by pixel basis using Beer-Lambert s law after taking into account beam hardening and geometric corrections. To remove scattering effects at high water contents the volumetric water contents were normalized (to give relative saturations) by dividing the drying and wetting sequences of images by the images obtained at saturation and satiation, respectively. The resulting pixel values were then averaged and combined with information on the imposed basal matric potentials to give average water retention curves. The average relative saturations obtained by neutron radiography showed an approximate one-to-one relationship with the average values measured volumetrically using the hanging water column setup. There were no significant differences (at p < 0.05) between the parameters of the van Genuchten equation fitted to the average neutron radiography data and those estimated from replicated hanging water column data. Our results indicate that neutron imaging is a very effective tool for quantifying the average water retention curve.

  18. Describing treatment effects to patients.

    Science.gov (United States)

    Moxey, Annette; O'Connell, Dianne; McGettigan, Patricia; Henry, David

    2003-11-01

    To examine the impact of different presentations of equivalent information (framing) on treatment decisions faced by patients. A systematic review of the published literature was conducted. English language publications allocating participants to different frames were retrieved using electronic and bibliographic searches. Two reviewers examined each article for inclusion, and assessed methodological quality. Study characteristics were tabulated and where possible, relative risks (RR; 95% confidence intervals) were calculated to estimate intervention effects. Thirty-seven articles, yielding 40 experimental studies, were included. Studies examined treatment (N = 24), immunization (N = 5), or health behavior scenarios (N = 11). Overall, active treatments were preferred when outcomes were described in terms of relative rather than absolute risk reductions or number needed to treat. Surgery was preferred to other treatments when treatment efficacy was presented in a positive frame (survival) rather than a negative frame (mortality) (relative risk [RR] = 1.51, 95% confidence interval [CI], 1.39 to 1.64). Framing effects were less obvious for immunization and health behavior scenarios. Those with little interest in the behavior at baseline were influenced by framing, particularly when information was presented as gains. In studies judged to be of good methodological quality and/or examining actual decisions, the framing effect, although still evident, was less convincing compared to the results of all included studies. Framing effects varied with the type of scenario, responder characteristics, scenario manipulations, and study quality. When describing treatment effects to patients, expressing the information in more than one way may present a balanced view to patients and enable them to make informed decisions.

  19. High Pressure Processing Treatment of Fresh-Cut Carrots: Effect of Presoaking in Calcium Salts on Quality Parameters

    Directory of Open Access Journals (Sweden)

    Yong Yu

    2018-01-01

    Full Text Available Effect of high pressure (HP treatment (200–600 MPa; 0–20 min on quality of fresh-cut carrot slices was evaluated after presoaking in selected calcium salt solutions (1% calcium chloride, 1% calcium lactate, 1% calcium gluconate, and distilled water as control for one hour. Results showed that calcium chloride (CaCl2 solution pretreatment was most effective for preserving the hardness of carrot slices at 400 and 600 MPa and this treatment also resulted in the least amount of color change in carrots, followed by calcium lactate, gluconate, and control pretreatments. The average sensory evaluation scores during 9 days of refrigerated storage at 4°C in control, CaCl2, calcium lactate, and calcium gluconate presoaking treatments followed by HP treatment were 6.4 ± 0.5, 8.0 ± 0.5, 7.8 ± 0.4, and 7.6 ± 0.3, respectively, on a zero to 9 scale for quality.

  20. Development of equations to predict the influence of floor space on average daily gain, average daily feed intake and gain : feed ratio of finishing pigs.

    Science.gov (United States)

    Flohr, J R; Dritz, S S; Tokach, M D; Woodworth, J C; DeRouchey, J M; Goodband, R D

    2018-05-01

    Floor space allowance for pigs has substantial effects on pig growth and welfare. Data from 30 papers examining the influence of floor space allowance on the growth of finishing pigs was used in a meta-analysis to develop alternative prediction equations for average daily gain (ADG), average daily feed intake (ADFI) and gain : feed ratio (G : F). Treatment means were compiled in a database that contained 30 papers for ADG and 28 papers for ADFI and G : F. The predictor variables evaluated were floor space (m2/pig), k (floor space/final BW0.67), Initial BW, Final BW, feed space (pigs per feeder hole), water space (pigs per waterer), group size (pigs per pen), gender, floor type and study length (d). Multivariable general linear mixed model regression equations were used. Floor space treatments within each experiment were the observational and experimental unit. The optimum equations to predict ADG, ADFI and G : F were: ADG, g=337.57+(16 468×k)-(237 350×k 2)-(3.1209×initial BW (kg))+(2.569×final BW (kg))+(71.6918×k×initial BW (kg)); ADFI, g=833.41+(24 785×k)-(388 998×k 2)-(3.0027×initial BW (kg))+(11.246×final BW (kg))+(187.61×k×initial BW (kg)); G : F=predicted ADG/predicted ADFI. Overall, the meta-analysis indicates that BW is an important predictor of ADG and ADFI even after computing the constant coefficient k, which utilizes final BW in its calculation. This suggests including initial and final BW improves the prediction over using k as a predictor alone. In addition, the analysis also indicated that G : F of finishing pigs is influenced by floor space allowance, whereas individual studies have concluded variable results.

  1. Facial averageness and genetic quality: Testing heritability, genetic correlation with attractiveness, and the paternal age effect.

    Science.gov (United States)

    Lee, Anthony J; Mitchem, Dorian G; Wright, Margaret J; Martin, Nicholas G; Keller, Matthew C; Zietsch, Brendan P

    2016-01-01

    Popular theory suggests that facial averageness is preferred in a partner for genetic benefits to offspring. However, whether facial averageness is associated with genetic quality is yet to be established. Here, we computed an objective measure of facial averageness for a large sample ( N = 1,823) of identical and nonidentical twins and their siblings to test two predictions from the theory that facial averageness reflects genetic quality. First, we use biometrical modelling to estimate the heritability of facial averageness, which is necessary if it reflects genetic quality. We also test for a genetic association between facial averageness and facial attractiveness. Second, we assess whether paternal age at conception (a proxy of mutation load) is associated with facial averageness and facial attractiveness. Our findings are mixed with respect to our hypotheses. While we found that facial averageness does have a genetic component, and a significant phenotypic correlation exists between facial averageness and attractiveness, we did not find a genetic correlation between facial averageness and attractiveness (therefore, we cannot say that the genes that affect facial averageness also affect facial attractiveness) and paternal age at conception was not negatively associated with facial averageness. These findings support some of the previously untested assumptions of the 'genetic benefits' account of facial averageness, but cast doubt on others.

  2. Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

    Science.gov (United States)

    Ma, Yunbei; Zhou, Xiao-Hua

    2017-02-01

    For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

  3. Benefits of dominance over additive models for the estimation of average effects in the presence of dominance

    NARCIS (Netherlands)

    Duenk, Pascal; Calus, Mario P.L.; Wientjes, Yvonne C.J.; Bijma, Piter

    2017-01-01

    In quantitative genetics, the average effect at a single locus can be estimated by an additive (A) model, or an additive plus dominance (AD) model. In the presence of dominance, the AD-model is expected to be more accurate, because the A-model falsely assumes that residuals are independent and

  4. A systematic review of cost-effectiveness studies of prevention and treatment for eating disorders.

    Science.gov (United States)

    Le, Long Khanh-Dao; Hay, Phillipa; Mihalopoulos, Cathrine

    2018-04-01

    Eating disorders are serious mental disorders and are associated with substantial economic and social burden. The aim of this study is to undertake a systematic review of the cost-effectiveness studies of both preventive and treatment interventions for eating disorder. Electronic databases (including the Cochrane Controlled Trial Register, MEDLINE, PsycINFO, Academic Search Complete, Global Health, CINAHL complete, Health Business Elite, Econlit, Health Policy Reference Center and ERIC) were searched for published cost-effectiveness studies of eating disorder prevention and treatment including papers published up to January 2017. The quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. In all, 13 studies met the review inclusion criteria as full cost-effectiveness studies and 8 were published since 2011. The studies included three modelled and one trial-based study focused on prevention, two trial-based and one modelled study for anorexia nervosa treatment and three trial-based studies for bulimia nervosa treatment. The remaining studies targeted binge-eating disorder or non-specific eating disorder treatment. The average percent of CHEERS checklist items reported was 71% (standard deviation 21%). Eating disorder interventions were mainly cost-saving or more effective and more costly compared to comparators; however, some results did not reach statistical significance. In the two studies that achieved 100% CHEERS checklist, one study reported that a cognitive dissonance intervention might be cost-effective for prevention of anorexia nervosa and bulimia nervosa with a 90% participation rate and the second study supported lisdexamfetamine to be cost-effective in the treatment of binge-eating disorder. Insufficient evidence for long-term cost-effectiveness (e.g. over 2 years) was found. Cost-effectiveness studies in eating disorder appear to be increasing in number over the last 6 years. Findings

  5. Extracurricular Activities and Their Effect on the Student's Grade Point Average: Statistical Study

    Science.gov (United States)

    Bakoban, R. A.; Aljarallah, S. A.

    2015-01-01

    Extracurricular activities (ECA) are part of students' everyday life; they play important roles in students' lives. Few studies have addressed the question of how student engagements to ECA affect student's grade point average (GPA). This research was conducted to know whether the students' grade point average in King Abdulaziz University,…

  6. Regional averaging and scaling in relativistic cosmology

    International Nuclear Information System (INIS)

    Buchert, Thomas; Carfora, Mauro

    2002-01-01

    Averaged inhomogeneous cosmologies lie at the forefront of interest, since cosmological parameters such as the rate of expansion or the mass density are to be considered as volume-averaged quantities and only these can be compared with observations. For this reason the relevant parameters are intrinsically scale-dependent and one wishes to control this dependence without restricting the cosmological model by unphysical assumptions. In the latter respect we contrast our way to approach the averaging problem in relativistic cosmology with shortcomings of averaged Newtonian models. Explicitly, we investigate the scale-dependence of Eulerian volume averages of scalar functions on Riemannian three-manifolds. We propose a complementary view of a Lagrangian smoothing of (tensorial) variables as opposed to their Eulerian averaging on spatial domains. This programme is realized with the help of a global Ricci deformation flow for the metric. We explain rigorously the origin of the Ricci flow which, on heuristic grounds, has already been suggested as a possible candidate for smoothing the initial dataset for cosmological spacetimes. The smoothing of geometry implies a renormalization of averaged spatial variables. We discuss the results in terms of effective cosmological parameters that would be assigned to the smoothed cosmological spacetime. In particular, we find that on the smoothed spatial domain B-bar evaluated cosmological parameters obey Ω-bar B-bar m + Ω-bar B-bar R + Ω-bar B-bar A + Ω-bar B-bar Q 1, where Ω-bar B-bar m , Ω-bar B-bar R and Ω-bar B-bar A correspond to the standard Friedmannian parameters, while Ω-bar B-bar Q is a remnant of cosmic variance of expansion and shear fluctuations on the averaging domain. All these parameters are 'dressed' after smoothing out the geometrical fluctuations, and we give the relations of the 'dressed' to the 'bare' parameters. While the former provide the framework of interpreting observations with a 'Friedmannian bias

  7. Effect of post-sintering treatment on properties of Bi-based high Tc superconductors

    International Nuclear Information System (INIS)

    Nagai, Masayuki; Kozuka, Akira; Morishita, Ken; Nishino, Tadashi; Hattori, Takeo; Takata, Masasuke

    1989-01-01

    A new method to obtain the pure 110K phase in the system Bi-Sr-Ca-Cu-O was examined employing post-sintering treatment. The mixture of Bi 2 O 3 , SrCO 3 , CaCO 3 and CuO with the basic composition of Bi/Sr/Ca/Cu=2/2/1/2 was calcined. The resulting powder was soaked in ethanol containing copper acetate and calcium acetate, the amounts of which were determined to give the composition of Bi/Sr/Ca/Cu=2/2/2/3 after sintering. The resistivity was measured by the d.c. four probe method in a cryostat. The current level was maintained at 50 mA and the voltage drop was determined by averaging the values in the forward and reverse directions. The zero T c ranged from 65 to 69K for the samples after sintering, while that ranged from 69 to 71K for those with post-sintering treatment. The effect of the treatment was not drastic but significant. Modified post-sintering treatment is being examined and the results are reported in the symposium

  8. Effects of antenna placement and antibiotic treatment on loss of simulated transmitters and mortality in hybrid striped bass

    Science.gov (United States)

    Isely, J.J.; Young, S.P.; Jones, T.A.; Schaffler, James J.

    2002-01-01

    We compared the effects of two antenna placements (trailing and nontrailing) and antibiotic treatments (treated and nontreated) on mortality and transmitter loss in hybrid striped bass Morone saxatilis ?? M. chrysops (364 ?? 28 mm total length, 645 ?? 129 g [mean ?? SD]) implanted with simulated transmitters and held in the laboratory for 90 d. Although antibiotic treatment significantly increased the time to first mortality in fish surgically implanted with simulated transmitters (by an average of 14 d), we did not detect an effect on cumulative mortality. We also did not detect an effect of antenna type on the time to first mortality, but cumulative mortality was higher in the trailing antenna groups (50%) than in the nontrailing antenna groups (12%). Three transmitters were expelled during the study, all from trailing-antenna treatment groups, indicating a significant effect of antenna placement on the level of transmitter expulsion. Antibiotic treatment appears to be effective in preventing initial postsurgical infection; however, the antenna may serve as a continuous source of irritation and route of infection into the body cavity. The potential for infection and mortality in experimental animals must be weighed against the improved performance of transmitters with trailing antennas.

  9. Characterizing individual painDETECT symptoms by average pain severity

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2016-07-01

    -severity levels can serve as proxies to determine treatment effects, thus indicating probabilities for more favorable outcomes on pain symptoms. Keywords: neuropathic pain, painDETECT, pain severity, psychometric properties

  10. Canada’s 2010 Tax Competitiveness Ranking: Moving to the Average but Biased Against Services

    Directory of Open Access Journals (Sweden)

    Duanjie Chen

    2011-02-01

    Full Text Available For the first time since 1975 (the year Canada’s marginal effective tax rates were first measured, Canada has become the most tax-competitive country among G-7 states with respect to taxation of capital investment. Even more remarkably, Canada accomplished this feat within a mere six years, having previously been the least taxcompetitive G-7 member. Even in comparison to strongly growing emerging economies, Canada’s 2010 marginal effective tax rate on capital is still above average. The planned reductions in federal and provincial corporate taxes by 2013 will reduce Canada’s effective tax rate on new investments to 18.4 percent, below the Organization for Economic Co-operation and Development (OECD 2010 average and close to the average of the 50 non-OECD countries studied. This remarkable change in Canada’s tax competitiveness must be maintained in the coming years, as countries are continually reducing their business taxation despite the recent fiscal pressures arising from the 2008-9 downturn in the world economy. Many countries have forged ahead with significant reforms designed to increase tax competitiveness and improve tax neutrality including Greece, Israel, Japan, New Zealand, Taiwan and the United Kingdom. The continuing bias in Canada’s corporate income tax structure favouring manufacturing and processing business warrants close scrutiny. Measured by the difference between the marginal effective tax rate on capital between manufacturing and the broad range of service sectors, Canada has the greatest gap in tax burdens between manufacturing and services among OECD countries. Surprisingly, preferential tax treatment (such as fast write-off and investment tax credits favouring only manufacturing and processing activities has become the norm in Canada, although it does not exist in most developed economies.

  11. Determination of the diagnostic x-ray tube practical peak voltage (PPV) from average or average peak voltage measurements

    Energy Technology Data Exchange (ETDEWEB)

    Hourdakis, C J, E-mail: khour@gaec.gr [Ionizing Radiation Calibration Laboratory-Greek Atomic Energy Commission, PO Box 60092, 15310 Agia Paraskevi, Athens, Attiki (Greece)

    2011-04-07

    The practical peak voltage (PPV) has been adopted as the reference measuring quantity for the x-ray tube voltage. However, the majority of commercial kV-meter models measure the average peak, U-bar{sub P}, the average, U-bar, the effective, U{sub eff} or the maximum peak, U{sub P} tube voltage. This work proposed a method for determination of the PPV from measurements with a kV-meter that measures the average U-bar or the average peak, U-bar{sub p} voltage. The kV-meter reading can be converted to the PPV by applying appropriate calibration coefficients and conversion factors. The average peak k{sub PPV,kVp} and the average k{sub PPV,Uav} conversion factors were calculated from virtual voltage waveforms for conventional diagnostic radiology (50-150 kV) and mammography (22-35 kV) tube voltages and for voltage ripples from 0% to 100%. Regression equation and coefficients provide the appropriate conversion factors at any given tube voltage and ripple. The influence of voltage waveform irregularities, like 'spikes' and pulse amplitude variations, on the conversion factors was investigated and discussed. The proposed method and the conversion factors were tested using six commercial kV-meters at several x-ray units. The deviations between the reference and the calculated - according to the proposed method - PPV values were less than 2%. Practical aspects on the voltage ripple measurement were addressed and discussed. The proposed method provides a rigorous base to determine the PPV with kV-meters from U-bar{sub p} and U-bar measurement. Users can benefit, since all kV-meters, irrespective of their measuring quantity, can be used to determine the PPV, complying with the IEC standard requirements.

  12. The difference between alternative averages

    Directory of Open Access Journals (Sweden)

    James Vaupel

    2012-09-01

    Full Text Available BACKGROUND Demographers have long been interested in how compositional change, e.g., change in age structure, affects population averages. OBJECTIVE We want to deepen understanding of how compositional change affects population averages. RESULTS The difference between two averages of a variable, calculated using alternative weighting functions, equals the covariance between the variable and the ratio of the weighting functions, divided by the average of the ratio. We compare weighted and unweighted averages and also provide examples of use of the relationship in analyses of fertility and mortality. COMMENTS Other uses of covariances in formal demography are worth exploring.

  13. Cost-effectiveness of elbasvir/grazoprevir use in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and chronic kidney disease in the United States.

    Science.gov (United States)

    Elbasha, E; Greaves, W; Roth, D; Nwankwo, C

    2017-04-01

    Among patients with chronic kidney disease (CKD) in the United States, HCV infection causes significant morbidity and mortality and results in substantial healthcare costs. A once-daily oral regimen of elbasvir/grazoprevir (EBR/GZR) for 12 weeks was found to be a safe and efficacious treatment for HCV in patients with CKD. We evaluated the cost-effectiveness of EBR/GZR in treatment-naïve and treatment-experienced CKD patients compared with no treatment (NoTx) and pegylated interferon plus ribavirin (peg-IFN/RBV) using a computer-based model of the natural history of chronic HCV genotype 1 infection, CKD and liver disease. Data on baseline characteristics of the simulated patients were obtained from NHANES, 2000-2010. Model inputs were estimated from published studies. Cost of treatment with EBR/GZR and peg-INF/RBV were based on wholesale acquisition cost. All costs were from a third-party payer perspective and were expressed in 2015 U.S. dollars. We estimated lifetime incidence of liver-related complications, liver transplantation, kidney transplantation, end-stage live disease mortality and end-stage renal disease mortality; lifetime quality-adjusted life years (QALY); and incremental cost-utility ratios (ICUR). The model predicted that EBR/GZR will significantly reduce the incidence of liver-related complications and prolong life in patients with chronic HCV genotype 1 infection and CKD compared with NoTx or use of peg-IFN/RBV. EBR/GZR-based regimens resulted in higher average remaining QALYs and higher costs (11.5716, $191 242) compared with NoTx (8.9199, $156 236) or peg-INF/RBV (10.2857, $186 701). Peg-IFN/RBV is not cost-effective, and the ICUR of EBR/GZR compared with NoTx was $13 200/QALY. Treatment of a patient on haemodialysis with EBR/GZR resulted in a higher ICUR ($217 000/QALY). Assuming a threshold of $100 000 per QALY gained for cost-effectiveness, use of elbasvir/grazoprevir to treat an average patient with CKD can be considered cost-effective

  14. Parameterization of Time-Averaged Suspended Sediment Concentration in the Nearshore

    Directory of Open Access Journals (Sweden)

    Hyun-Doug Yoon

    2015-11-01

    Full Text Available To quantify the effect of wave breaking turbulence on sediment transport in the nearshore, the vertical distribution of time-averaged suspended sediment concentration (SSC in the surf zone was parameterized in terms of the turbulent kinetic energy (TKE at different cross-shore locations, including the bar crest, bar trough, and inner surf zone. Using data from a large-scale laboratory experiment, a simple relationship was developed between the time-averaged SSC and the time-averaged TKE. The vertical variation of the time-averaged SSC was fitted to an equation analogous to the turbulent dissipation rate term. At the bar crest, the proposed equation was slightly modified to incorporate the effect of near-bed sediment processes and yielded reasonable agreement. This parameterization yielded the best agreement at the bar trough, with a coefficient of determination R2 ≥ 0.72 above the bottom boundary layer. The time-averaged SSC in the inner surf zone showed good agreement near the bed but poor agreement near the water surface, suggesting that there is a different sedimentation mechanism that controls the SSC in the inner surf zone.

  15. Understanding placebo, nocebo, and iatrogenic treatment effects.

    Science.gov (United States)

    Bootzin, Richard R; Bailey, Elaine T

    2005-07-01

    Placebo and nonplacebo treatments have both positive and negative effects on patient outcomes. To better understand the patterning of treatment effects, three specific interventions will be discussed that are reported to produce more harm than benefit: critical incident stress debriefing, group therapy for adolescents with conduct disorders, and psychotherapy for dissociative identity disorder. In each case, there is an interaction between mechanisms thought to underlie both placebo and specific treatment effects. Mechanisms hypothesized to underlie placebo and nocebo effects include patient expectancy, self-focused attention to symptoms, motivation to change, and sociocultural role-enactment cues. In the three treatments discussed, specific mechanisms interact with nonspecific mechanisms to produce iatrogenic effects. To advance knowledge, it is important both to specify the theory of treatment and its expected outcomes and to put the theory to test. Only with attention to the empirical findings from programmatic research of specific and nonspecific effects and their interaction is it possible to improve the outcomes of treatment beyond the status quo.

  16. Normal tissue adverse side effects in radiotherapy cancer patients and applicability of predictive radiosensitivity tests for new radiation treatment decision

    International Nuclear Information System (INIS)

    Di Giorgio, Marina; Vallerga, Maria B.; Radl, Analia; Sardi, Mabel

    2008-01-01

    Full text: Around 5 % -7 % of cancer patients develop adverse side effects, which include acute effects, late effects and cancer induction to radiation therapy in normal tissues in the treatment field. Such effects are of particular interest as the cancer patient population that reaches prolonged survival has increased with the improvements in cancer therapy and health care. These adverse reactions are mainly influenced by deficiencies in DNA repair pathways. However, tissue response to IR could be modified by several treatment- and patient- related factors. Numerous studies have been carried out to evaluate the correlation between clinical and cellular radiosensitivity, by in vitro tests. Previous own studies, characterizing DNA repair capacity in peripheral lymphocytes of cancer patients through cytokinesis blocked micronucleus test and alkaline single-cell microgel electrophoresis (comet), indicated that such assays correlated with the clinical radiation signs of radiosensitivity and showed the predictive potential of both techniques in the identification of radiosensitivity subgroups. In this paper, retrospective studies are conducted in 10 representative cases, which had developed acute or late toxicity in previous treatments and at present require new radiation treatments due to secondary malignancies or recurrence. Samples were in vitro irradiated with 2 Gy. MN data were analyzed comparing expected MN frequencies with values observed after in vitro irradiation. DNA repair capacity was evaluated through comet assay for initial damage and after specific times of repair (0-120 minutes). Captured images were analyzed by CASP image analysis software. Repair capacity was quantified by the Olive tail moment. Weibull alpha parameter was applied to describe DNA damage at the different evaluated repair times after in vitro irradiation and fitted by a mono-exponential model to describe the kinetic profile. In every evaluated patient a correlation between mean half

  17. Normal tissue adverse side effects in radiotherapy cancer patients and applicability of predictive radiosensitivity tests for new radiation treatment decision

    International Nuclear Information System (INIS)

    Di Giorgio, M.; Vallerga, M.B.; Radl, A.; Sardi, M.

    2011-01-01

    Around 5%-7% of cancer patients develop adverse side effects, which include acute effects, late effects and cancer induction to radiation therapy in normal tissues in the treatment field. Such effects are of particular interest as the cancer patient population that reaches prolonged survival has increased with the improvements in cancer therapy and health care. These adverse reactions are mainly influenced by deficiencies in DNA repair pathways. However, tissue response to IR could be modified by several treatment- and patient- related factors. Numerous studies have been carried out to evaluate the correlation between clinical and cellular radiosensitivity, by in vitro tests. Previous own studies, characterizing DNA repair capacity in peripheral lymphocytes of cancer patients through cytokinesis blocked micronucleus test and alkaline single-cell microgel electrophoresis (comet), indicated that such assays correlated with the clinical radiation signs of radiosensitivity and showed the predictive potential of both techniques in the identification of radiosensitivity subgroups. In this paper, retrospective studies are conducted in 10 representative cases, which had developed acute or late toxicity in previous treatments and at present require new radiation treatments due to secondary malignancies or recurrence. Samples were in vitro irradiated with 2 Gy. MN data were analyzed comparing expected MN frequencies with values observed after in vitro irradiation. DNA repair capacity was evaluated through comet assay for initial damage and after specific times of repair (0-120 minutes). Captured images were analyzed by CASP image analysis software. Repair capacity was quantified by the Olive tail moment. Weibull alpha parameter was applied to describe DNA damage at the different evaluated repair times after in vitro irradiation and fitted by a mono-exponential model to describe the kinetic profile. In every evaluated patient a correlation between mean half-time (T1/2) and

  18. Nonparametric Bounds and Sensitivity Analysis of Treatment Effects

    Science.gov (United States)

    Richardson, Amy; Hudgens, Michael G.; Gilbert, Peter B.; Fine, Jason P.

    2015-01-01

    This paper considers conducting inference about the effect of a treatment (or exposure) on an outcome of interest. In the ideal setting where treatment is assigned randomly, under certain assumptions the treatment effect is identifiable from the observable data and inference is straightforward. However, in other settings such as observational studies or randomized trials with noncompliance, the treatment effect is no longer identifiable without relying on untestable assumptions. Nonetheless, the observable data often do provide some information about the effect of treatment, that is, the parameter of interest is partially identifiable. Two approaches are often employed in this setting: (i) bounds are derived for the treatment effect under minimal assumptions, or (ii) additional untestable assumptions are invoked that render the treatment effect identifiable and then sensitivity analysis is conducted to assess how inference about the treatment effect changes as the untestable assumptions are varied. Approaches (i) and (ii) are considered in various settings, including assessing principal strata effects, direct and indirect effects and effects of time-varying exposures. Methods for drawing formal inference about partially identified parameters are also discussed. PMID:25663743

  19. A Cost-Effectiveness Analysis of Seminatural Wetlands and Activated Sludge Wastewater-Treatment Systems

    Science.gov (United States)

    Mannino, Ilda; Franco, Daniel; Piccioni, Enrico; Favero, Laura; Mattiuzzo, Erika; Zanetto, Gabriele

    2008-01-01

    A cost-effectiveness analysis was performed to evaluate the competitiveness of seminatural Free Water Surface (FWS) wetlands compared to traditional wastewater-treatment plants. Six scenarios of the service costs of three FWS wetlands and three different wastewater-treatment plants based on active sludge processes were compared. The six scenarios were all equally effective in their wastewater-treatment capacity. The service costs were estimated using real accounting data from an experimental wetland and by means of a market survey. Some assumptions had to be made to perform the analysis. A reference wastewater situation was established to solve the problem of the different levels of dilution that characterize the inflow water of the different systems; the land purchase cost was excluded from the analysis, considering the use of public land as shared social services, and an equal life span for both seminatural and traditional wastewater-treatment plants was set. The results suggest that seminatural systems are competitive with traditional biotechnological systems, with an average service cost improvement of 2.1-fold to 8-fold, according to the specific solution and discount rate. The main improvement factor was the lower maintenance cost of the seminatural systems, due to the self-regulating, low artificial energy inputs and the absence of waste to be disposed. In this work, only the waste-treatment capacity of wetlands was considered as a parameter for the economic competitiveness analysis. Other goods/services and environmental benefits provided by FWS wetlands were not considered.

  20. Variation of High-Intensity Therapeutic Ultrasound (HITU) Pressure Field Characterization: Effects of Hydrophone Choice, Nonlinearity, Spatial Averaging and Complex Deconvolution.

    Science.gov (United States)

    Liu, Yunbo; Wear, Keith A; Harris, Gerald R

    2017-10-01

    Reliable acoustic characterization is fundamental for patient safety and clinical efficacy during high-intensity therapeutic ultrasound (HITU) treatment. Technical challenges, such as measurement variation and signal analysis, still exist for HITU exposimetry using ultrasound hydrophones. In this work, four hydrophones were compared for pressure measurement: a robust needle hydrophone, a small polyvinylidene fluoride capsule hydrophone and two fiberoptic hydrophones. The focal waveform and beam distribution of a single-element HITU transducer (1.05 MHz and 3.3 MHz) were evaluated. Complex deconvolution between the hydrophone voltage signal and frequency-dependent complex sensitivity was performed to obtain pressure waveforms. Compressional pressure (p + ), rarefactional pressure (p - ) and focal beam distribution were compared up to 10.6/-6.0 MPa (p + /p - ) (1.05 MHz) and 20.65/-7.20 MPa (3.3 MHz). The effects of spatial averaging, local non-linear distortion, complex deconvolution and hydrophone damage thresholds were investigated. This study showed a variation of no better than 10%-15% among hydrophones during HITU pressure characterization. Published by Elsevier Inc.

  1. Personality does not predict treatment preference, treatment experience does: a study of four complementary pain treatments.

    Science.gov (United States)

    Blasche, Gerhard; Melchart, Herbert; Leitner, Daniela; Marktl, Wolfgang

    2007-10-01

    The aim of the present study was to determine the extent to which personality and treatment experience affect patients' appraisals of 4 complementary treatments for chronic pain. A total of 232 chronic pain patients (164 females, 68 males, average age 56.6 years) visiting a spa clinic in Austria returned a questionnaire on patient characteristics and personality (autonomy, depressiveness, assertiveness, self-control) as well as attitudes towards (i.e. appealing, effective, pleasant) and experience of the treatments. Results were analysed by use of linear regression analysis and confidence intervals. Although all treatments were appraised positively, the passive treatments (thermal water tub baths, classical massage) were favoured more than the active treatments (relaxation training or exercise therapy). Treatment appraisal was not predicted by any of the personality traits but to a large extent by treatment experience. Relaxing, not unpleasant treatments were the most highly esteemed treatments. How strenuous or tiring a treatment was only had a minor effect on its appraisal. Neither do dependent, passive patients prefer passive treatments, nor do conscientious patients prefer active treatments. Instead, the appraisal of treatments that induce specific somatosensory sensations is largely determined by treatment experiences, i.e. what the treatment feels like. Despite the popularity of CAM which encompasses many experientially intensive treatments, treatment experience has to date been a neglected topic of treatment research.

  2. Effect of treatment duration on surface nanocrystallization induced by fast multiple rotation rolling and its thermal stability

    Energy Technology Data Exchange (ETDEWEB)

    Chui Pengfei; Liu Yi; Liang Yanjie; Li Yang [Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials (Ministry of Education), Shandong University, Jinan 250061 (China); Fan Suhua [Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials (Ministry of Education), Shandong University, Jinan 250061 (China); Shandong Women' s University, Jinan 250300 (China); Sun Kangning, E-mail: sunkangning@sdu.edu.cn [Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials (Ministry of Education), Shandong University, Jinan 250061 (China)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer Effect of treatment time on surface nanocrystallization of a low carbon steel. Black-Right-Pointing-Pointer The grain size decreases gradually with the increase of treatment duration. Black-Right-Pointing-Pointer The microhardness of FMRR treated sample reaches 284 HV. Black-Right-Pointing-Pointer The nanocrystalline layer is stable during annealing treatment up to 400 Degree-Sign C. - Abstract: A nanocrystalline surface layer of low carbon steel induced by fast multiple rotation rolling (FMRR) was determined by optical microscopy and transmission electron microscopy. The results show that the grain size decreases gradually with the increase of treatment duration. Equiaxed nanocrystalline with the average grain size about 20 nm is obtained in the top surface layer after FMRR treatment for 30 min. With the increase of treatment duration (60 min), the average grain size further reduces to about 9 nm. At the same time, the microhardness of surface layer for treated sample is improved correspondingly owing to grain refinement and work-hardening. Compared with original sample, the microhardness of FMRR treated sample is increased by more than 200%. After annealing treatment, the investigation of thermal stability of nanocrystalline layer indicates that the grains begin to grow obviously at annealing for 400 Degree-Sign C, and abnormal grain growth also occurs in individual grains. Due to grain growth and stress relaxation during annealing, the microhardness slightly decreases at 400 Degree-Sign C. In spite of this, the majority of grains are still nanocrystalline, ranging from about 30 to 60 nm. It demonstrates that the nanocrystalline layer has high thermal stability.

  3. Influence of coma aberration on aperture averaged scintillations in oceanic turbulence

    Science.gov (United States)

    Luo, Yujuan; Ji, Xiaoling; Yu, Hong

    2018-01-01

    The influence of coma aberration on aperture averaged scintillations in oceanic turbulence is studied in detail by using the numerical simulation method. In general, in weak oceanic turbulence, the aperture averaged scintillation can be effectively suppressed by means of the coma aberration, and the aperture averaged scintillation decreases as the coma aberration coefficient increases. However, in moderate and strong oceanic turbulence the influence of coma aberration on aperture averaged scintillations can be ignored. In addition, the aperture averaged scintillation dominated by salinity-induced turbulence is larger than that dominated by temperature-induced turbulence. In particular, it is shown that for coma-aberrated Gaussian beams, the behavior of aperture averaged scintillation index is quite different from the behavior of point scintillation index, and the aperture averaged scintillation index is more suitable for characterizing scintillations in practice.

  4. Comparison of Interpolation Methods as Applied to Time Synchronous Averaging

    National Research Council Canada - National Science Library

    Decker, Harry

    1999-01-01

    Several interpolation techniques were investigated to determine their effect on time synchronous averaging of gear vibration signals and also the effects on standard health monitoring diagnostic parameters...

  5. Bayesian model averaging and weighted average least squares : Equivariance, stability, and numerical issues

    NARCIS (Netherlands)

    De Luca, G.; Magnus, J.R.

    2011-01-01

    In this article, we describe the estimation of linear regression models with uncertainty about the choice of the explanatory variables. We introduce the Stata commands bma and wals, which implement, respectively, the exact Bayesian model-averaging estimator and the weighted-average least-squares

  6. The association between estimated average glucose levels and fasting plasma glucose levels in a rural tertiary care centre

    Directory of Open Access Journals (Sweden)

    Raja Reddy P

    2013-01-01

    Full Text Available The level of hemoglobin A1c (HbA1c, also known as glycated hemoglobin, determines how well a patient’s blood glucose level has been controlled over the previous 8-12 weeks. HbA1c levels help patients and doctors understand whether a particular diabetes treatment is working and whether adjustments need to be made to the treatment. Because the HbA1c level is a marker of blood glucose for the previous 60- 90 days, average blood glucose levels can be estimated using HbA1c levels. Aim in the present study was to investigate the relationship between estimated average glucose levels, as calculated by HbA1c levels, and fasting plasma glucose levels. Methods: Type 2 diabetes patients attending medicine outpatient department of RL Jalappa hospital, Kolar between March 2010 and July 2012 were taken. The estimated glucose levels (mg/dl were calculated using the following formula: 28.7 x HbA1c-46.7. Glucose levels were determined using the hexokinase method. HbA1c levels were determined using an HPLC method. Correlation and independent t- test was the test of significance for quantitative data. Results: A strong positive correlation between fasting plasma glucose level and estimated average blood glucose levels (r=0.54, p=0.0001 was observed. The difference was statistically significant. Conclusion: Reporting the estimated average glucose level together with the HbA1c level is believed to assist patients and doctors determine the effectiveness of blood glucose control measures.

  7. Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation.

    Science.gov (United States)

    Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

    2014-01-01

    Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate.

  8. Wavelength dependence of the effects of turbulence on average refraction angles in occultations by planetary atmospheres

    International Nuclear Information System (INIS)

    Haugstad, B.S.; Eshleman, V.R.

    1979-01-01

    Two recent adjacently published papers on the average effects of turbulence in radio and optical occultation studies of planetary atmospheres appear to disagree on the question of wavelength dependence. It is demonstrated here that in deriving a necessary condition for the applicability of their method. Hubbard and Jokipii neglect a factor which is proportional to the square of the ratio of the atmospheric or local Fresnel zone radius and the inner scale of turbulence. They also fail to establish sufficient conditions, thereby omitting as a further factor the square of the ratio of atmospheric scale height and the local Fresnel zone radius. The total descrepancy, which numerically is typically within several orders of magnitude of 10 11 for radio and 10 7 for optical occultations, means that their results correspond to geometrical optics and not to wave optics as claimed. Thus their results are inherently inapplicable in a discussion of the wavelength dependence of any parameter, such as the bias in the average refraction angle treated by Eshleman and Haugstad. We note that for power spectra characterized by the (--p) exponent of the turbulence wavenumber, the average turbulence-induced bias in refraction angles depends on the radiation wavelength as lambda/sup( p/--4)/2, or as lambda/sup en-dash1/6/ for Kolmogorov turbulence. Other features of the Hubbard-Jokipii analysis are also discussed

  9. Treatment of lymphatic nodes metastasis in advanced cancer with interventional chemotherapy combined radiotherapy

    International Nuclear Information System (INIS)

    Xia Shian; Guo Weijian; Wu Guohua; Lin Qing; Jiang Mawei; Yao Yuan

    2000-01-01

    Objective: To evaluate the clinical effects of treatment with interventional chemotherapy combined radiotherapy for lymphatic nodes metastasis in advanced cancer. Methods: Treated with interventional chemotherapy for 27 cases of lymphatic rode metastasis once a month with average 2-3 times totally. Simultaneously treated with linear accelerator radiotherapy with average dose of 40-50 Gy/20-25 times/4-5 weeks. Results: To evaluate the clinical effects after finished the whole treatment program two months later. CR + PR reached 77.8% (24/27). All patients showed tolerance to accept the treatment. Conclusion: Treatment for lymphatic node metastasis in advanced cancer with interventional chemotherapy combined radiation therapy seems to be a valuable way

  10. The average action for scalar fields near phase transitions

    International Nuclear Information System (INIS)

    Wetterich, C.

    1991-08-01

    We compute the average action for fields in two, three and four dimensions, including the effects of wave function renormalization. A study of the one loop evolution equations for the scale dependence of the average action gives a unified picture of the qualitatively different behaviour in various dimensions for discrete as well as abelian and nonabelian continuous symmetry. The different phases and the phase transitions can be infered from the evolution equation. (orig.)

  11. Cloud-based design of high average power traveling wave linacs

    Science.gov (United States)

    Kutsaev, S. V.; Eidelman, Y.; Bruhwiler, D. L.; Moeller, P.; Nagler, R.; Barbe Welzel, J.

    2017-12-01

    The design of industrial high average power traveling wave linacs must accurately consider some specific effects. For example, acceleration of high current beam reduces power flow in the accelerating waveguide. Space charge may influence the stability of longitudinal or transverse beam dynamics. Accurate treatment of beam loading is central to the design of high-power TW accelerators, and it is especially difficult to model in the meter-scale region where the electrons are nonrelativistic. Currently, there are two types of available codes: tracking codes (e.g. PARMELA or ASTRA) that cannot solve self-consistent problems, and particle-in-cell codes (e.g. Magic 3D or CST Particle Studio) that can model the physics correctly but are very time-consuming and resource-demanding. Hellweg is a special tool for quick and accurate electron dynamics simulation in traveling wave accelerating structures. The underlying theory of this software is based on the differential equations of motion. The effects considered in this code include beam loading, space charge forces, and external magnetic fields. We present the current capabilities of the code, provide benchmarking results, and discuss future plans. We also describe the browser-based GUI for executing Hellweg in the cloud.

  12. Effect comparison of metformin with insulin treatment for gestational diabetes: a meta-analysis based on RCTs.

    Science.gov (United States)

    Li, Genxia; Zhao, Shujun; Cui, Shihong; Li, Lei; Xu, Yajuan; Li, Yuanyuan

    2015-07-01

    To compare the effects of metformin with insulin on maternal and neonatal outcomes in gestational diabetes mellitus (GDM). A literature search in PUBMED, EMBASE, Science Direct, Springer link, and Cochrane library was conducted using the following search terms: "Gestational Diabetes" or "GDM", and "insulin" and "metformin". Quality assessment of included studies was determined with Quality Assessment of Diagnostic Accuracy Studies. Review Manger 5.2 was used to analyze mean difference (MD)/risk ratio (RR) and 95 % confidence interval (CI) in random-effects model or fixed-effects model depending on the level of heterogeneity. A total of 11 studies were identified. There was no significant difference of the effect on maternal outcomes between the two treatments in glycohemoglobin A1c levels (P = 0.37), fasting blood glucose (P = 0.66), and the incidence of preeclampsia (P = 0.26); whereas, significantly reduced results were found in the metformin group in pregnancy-induced hypertension (PIH) rate (RR = 0.53, 95 % CI 0.31-0.90, P = 0.02), average weight gains after enrollment (MD = -1.28, 95 % CI -1.54 to -1.01, P metformin presented significantly lower average birth weights (MD = -44.35, 95 % CI -85.79 to -2.90, P = 0.04), incidence of hypoglycemia (RR = 0.69, 95 % CI 0.55-0.87, P = 0.001) and neonatal intensive care unit (NICU) (RR = 0.82, 95 % CI 0.67-0.99, P = 0.04). Metformin can significantly reduce several adverse maternal and neonatal outcomes including PIH rate, incidence of hypoglycemia and NICU, thus it may be an effective and safe alternative or additional treatment to insulin for GDM women.

  13. Differential effectiveness of placebo treatments

    DEFF Research Database (Denmark)

    Meissner, Karin; Fässler, Margrit; Rücker, Gerta

    2013-01-01

    IMPORTANCE When analyzing results of randomized clinical trials, the treatment with the greatest specific effect compared with its placebo control is considered to be the most effective one. Although systematic variations of improvements in placebo control groups would have important implications...... relevant sources through February 2012 and contacted the authors to identify randomized clinical trials on the prophylaxis of migraine with an observation period of at least 8 weeks after randomization that compared an experimental treatment with a placebo control group. We calculated pooled random-effects...... and sham surgery are associated with higher responder ratios than oral pharmacological placebos. Clinicians who treat patients with migraine should be aware that a relevant part of the overall effect they observe in practice might be due to nonspecific effects and that the size of such effects might differ...

  14. Effect of pioglitazone treatment on behavioral symptoms in autistic children

    Directory of Open Access Journals (Sweden)

    Edelson Stephen M

    2007-01-01

    Full Text Available Abstract Introduction Autism is complex neuro-developmental disorder which has a symptomatic diagnosis in patients characterized by disorders in language/communication, behavior, and social interactions. The exact causes for autism are largely unknown, but is has been speculated that immune and inflammatory responses, particularly those of Th2 type, may be involved. Thiazolidinediones (TZDs are agonists of the peroxisome proliferator activated receptor gamma (PPARγ, a nuclear hormone receptor which modulates insulin sensitivity, and have been shown to induce apoptosis in activated T-lymphocytes and exert anti-inflammatory effects in glial cells. The TZD pioglitazone (Actos is an FDA-approved PPARγ agonist used to treat type 2 diabetes, with a good safety profile, currently being tested in clinical trials of other neurological diseases including AD and MS. We therefore tested the safety and therapeutic potential of oral pioglitazone in a small cohort of children with diagnosed autism. Case description The rationale and risks of taking pioglitazone were explained to the parents, consent was obtained, and treatment was initiated at either 30 or 60 mg per day p.o. A total of 25 children (average age 7.9 ± 0.7 year old were enrolled. Safety was assessed by measurements of metabolic profiles and blood pressure; effects on behavioral symptoms were assessed by the Aberrant Behavior Checklist (ABC, which measures hyperactivity, inappropriate speech, irritability, lethargy, and stereotypy, done at baseline and after 3–4 months of treatment. Discussion and evaluation In a small cohort of autistic children, daily treatment with 30 or 60 mg p.o. pioglitazone for 3–4 months induced apparent clinical improvement without adverse events. There were no adverse effects noted and behavioral measurements revealed a significant decrease in 4 out of 5 subcategories (irritability, lethargy, stereotypy, and hyperactivity. Improved behaviors were inversely

  15. Effects of Video-Based and Applied Problems on the Procedural Math Skills of Average- and Low-Achieving Adolescents.

    Science.gov (United States)

    Bottge, Brian A.; Heinrichs, Mary; Chan, Shih-Yi; Mehta, Zara Dee; Watson, Elizabeth

    2003-01-01

    This study examined effects of video-based, anchored instruction and applied problems on the ability of 11 low-achieving (LA) and 26 average-achieving (AA) eighth graders to solve computation and word problems. Performance for both groups was higher during anchored instruction than during baseline, but no differences were found between instruction…

  16. EFFECT OF SIMVASTATIN TREATMENT ON BONE MINERAL DENSITY IN HYPERCHOLESTEROLEMIC POSTMENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Irena Jankovic

    2005-04-01

    Full Text Available Statins are able to reduce cardiovascular morbidity and mortality mainly through their hypocholesterolemic effect. Beyond the inhibition of cholesterol synthesis, the identification of pleiotropic mechanisms has motivated many studies to evaluate the effects of statin use on bone mineral density (BMD modification.The aim of our study was to evaluate whether simvastatin treatment (20 mg/d could modify BMD in hypercholesterolemic women (n=28 after one-year treatment as compared with a control group treated only with a diet (n=11. The exclusion criteria was current or previous therapy with statins, bisphosphonates and/or estrogens. The following parameters were determined at the beginning and after one year, and those are: total cholesterol, triglycerides, HDL-C and LDL-C (Friedewald equation. The BMD was measured at the lumbar spine by dual energy x-ray absorpiometry (DEXA.In the simvastatin treated group, BMD showed an insignificant 2,812% increase after 12 months, respectively (0,965+0,111 v 0,992+0,110, P>0,05. The group treated only with hypolipidic diet demonstrated a 3,45% decrease in BMD (respectively, 1,042+0,181 v 1.006+0,182; P>0,05 after 12 months. Nevertheless, the comparison of average BMD changes between the two examined groups during one year showed a significant value diference (-0,027+0,037 v 0,036+0,036; P<0,0006.As partly suggested by retrospective or observational data, this longitudinal study indicates that simvastatin treatment achieves a beneficial effect on BMD.

  17. Calculating ensemble averaged descriptions of protein rigidity without sampling.

    Science.gov (United States)

    González, Luis C; Wang, Hui; Livesay, Dennis R; Jacobs, Donald J

    2012-01-01

    Previous works have demonstrated that protein rigidity is related to thermodynamic stability, especially under conditions that favor formation of native structure. Mechanical network rigidity properties of a single conformation are efficiently calculated using the integer body-bar Pebble Game (PG) algorithm. However, thermodynamic properties require averaging over many samples from the ensemble of accessible conformations to accurately account for fluctuations in network topology. We have developed a mean field Virtual Pebble Game (VPG) that represents the ensemble of networks by a single effective network. That is, all possible number of distance constraints (or bars) that can form between a pair of rigid bodies is replaced by the average number. The resulting effective network is viewed as having weighted edges, where the weight of an edge quantifies its capacity to absorb degrees of freedom. The VPG is interpreted as a flow problem on this effective network, which eliminates the need to sample. Across a nonredundant dataset of 272 protein structures, we apply the VPG to proteins for the first time. Our results show numerically and visually that the rigidity characterizations of the VPG accurately reflect the ensemble averaged [Formula: see text] properties. This result positions the VPG as an efficient alternative to understand the mechanical role that chemical interactions play in maintaining protein stability.

  18. The Effect of Organic Loading Rate on Milk WastewaterTreatment Using Sequencing Batch Reactor (SBR

    Directory of Open Access Journals (Sweden)

    Hooman Hajiabadi

    2009-09-01

    Full Text Available In this study, four aerobic sequencing batch reactors (SBRs were operated under the same conditions for the treatment of milk wastewater at different organic loading rates (OLRs. Cylindrical Plexiglas reactors were run for 56 days (including 21 days of acclimatization and 35 days of data gathering. Effective volume, influent wastewater flowrate, and sludge retention time (SRT of reactors were 5.5 L, 3.5 L/d, and 10 d, respectively. The average COD removal efficiency for the reactors R1, R2, R3, and R4 with influent OLRave values of 633, 929, 1915, and 3261 gCOD/m3d were 95, 96, 95, and 82 percent, respectively. The average effluent suspended solid (SS for all reactors was lower than 44 mg/L. Also, except for R4 with an average effluent turbidity of 270 NTU, other reactors met the Iranian wastewater emission standard (50 NTU. In addition, the average sludge volume index of reactors R1 to R3 was found to be lower than 67 mL/g. According to the results, the overall variation of COD removal efficiency versus influent OLR shows a decreasing rate with a correlation factor of 0.8 (R2.

  19. Comparison of the Cost-Effectiveness of Biologic Drugs Used for Moderate-to-Severe Psoriasis Treatment in the United States.

    Science.gov (United States)

    Wu, Jashin J; Feldman, Steven R; Rastogi, Shipra; Menges, Brandy; Lingohr-Smith, Melissa; Lin, Jay

    2018-04-16

    To compare the cost-effectiveness of the newly approved biologic drug, brodalumab, with other commonly used biologics for the treatment of moderate-to-severe psoriasis in the U.S. An economic model was constructed in Excel to compare average costs to achieve Psoriasis Area and Severity Index (PASI) 75, 90, and 100 among moderate-to-severe psoriasis patients treated with biologics. Total annual costs to health plans associated with treatment with 5 different biologics were estimated and cost-effectiveness compared using the estimated average cost per PASI 75, PASI 90, and PASI 100. Total annual costs to a health plan per patient with adalimumab, brodalumab, ixekizumab, secukinumab, and ustekinumab were estimated at $51,246, $38,538, $65,484, $57,510, and $57,013. Mean annual treatment costs per PASI 75, 90, and 100 were the lowest for brodalumab, with the annual cost per PASI 75 for brodalumab, adalimumab, ixekizumab, secukinumab, and ustekinumab estimated at $48,782, $82,655, $77,957, $75,671, and $87,243, per PASI 90 at $51,383, $119,178, $94,904, $108,509, and $130,615, and per PASI 100 at $87,585, $284,702, $176,983, $205,393, and $366,645. Brodalumab, which had the lowest drug cost and high drug efficacy, was associated with the lowest cost per PASI 75, 90, and 100 among the biologics evaluated.

  20. Average contraction and synchronization of complex switched networks

    International Nuclear Information System (INIS)

    Wang Lei; Wang Qingguo

    2012-01-01

    This paper introduces an average contraction analysis for nonlinear switched systems and applies it to investigating the synchronization of complex networks of coupled systems with switching topology. For a general nonlinear system with a time-dependent switching law, a basic convergence result is presented according to average contraction analysis, and a special case where trajectories of a distributed switched system converge to a linear subspace is then investigated. Synchronization is viewed as the special case with all trajectories approaching the synchronization manifold, and is thus studied for complex networks of coupled oscillators with switching topology. It is shown that the synchronization of a complex switched network can be evaluated by the dynamics of an isolated node, the coupling strength and the time average of the smallest eigenvalue associated with the Laplacians of switching topology and the coupling fashion. Finally, numerical simulations illustrate the effectiveness of the proposed methods. (paper)

  1. How to average logarithmic retrievals?

    Directory of Open Access Journals (Sweden)

    B. Funke

    2012-04-01

    Full Text Available Calculation of mean trace gas contributions from profiles obtained by retrievals of the logarithm of the abundance rather than retrievals of the abundance itself are prone to biases. By means of a system simulator, biases of linear versus logarithmic averaging were evaluated for both maximum likelihood and maximum a priori retrievals, for various signal to noise ratios and atmospheric variabilities. These biases can easily reach ten percent or more. As a rule of thumb we found for maximum likelihood retrievals that linear averaging better represents the true mean value in cases of large local natural variability and high signal to noise ratios, while for small local natural variability logarithmic averaging often is superior. In the case of maximum a posteriori retrievals, the mean is dominated by the a priori information used in the retrievals and the method of averaging is of minor concern. For larger natural variabilities, the appropriateness of the one or the other method of averaging depends on the particular case because the various biasing mechanisms partly compensate in an unpredictable manner. This complication arises mainly because of the fact that in logarithmic retrievals the weight of the prior information depends on abundance of the gas itself. No simple rule was found on which kind of averaging is superior, and instead of suggesting simple recipes we cannot do much more than to create awareness of the traps related with averaging of mixing ratios obtained from logarithmic retrievals.

  2. Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study.

    Science.gov (United States)

    Wanitphakdeedecha, Rungsima; Manuskiatti, Woraphong

    2006-12-01

    Very few therapeutic options have proven effective in the treatment of cellulite. To evaluate the effectiveness and adverse effects of a bipolar radiofrequency (RF), infrared (IR) heat and pulsatile suction device for the treatment of cellulite. Twelve subjects were treated with the RF-light-based device. All subjects were treated twice weekly for a total number of eight to nine treatments. Subjects were evaluated using standardized photographs, and measurements of body weight and circumference of treatment sites at baseline, immediately after the last treatment, and four weeks and one year after the last treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = 75% improvement) were judged independently by two non-treating dermatologists after the series of treatment. The average body weights at baseline, immediately after the last treatment, and four weeks and one year after the complete treatment were 56.30, 56.05, 56.23, and 56.53 kg, respectively. The average circumferential reductions of the abdomen and thigh at the last treatment visit were 5.17 +/- 1.04 cm (6.32%+/- 1.82%) and 3.50 +/- 2.16 cm (6.23 +/- 3.58%), respectively. At four weeks after the last treatment, the average circumferential reductions of the abdomen and thigh were sustained at 3.17 +/- 2.75 cm (4.04%+/- 3.69%) and 3.50 +/- 2.04 cm (6.26%+/- 3.52%), respectively. At one year follow-up visit, the average circumferential reductions of the abdomen and thigh were maintained at 3.83 +/- 0.76 cm (4.64%+/- 1.15%) and 3.13 +/- 3.54 (5.50%+/- 6.12%), respectively. Average clinical improvement scores of the abdomen and thigh after the series of treatments were 0.75 (corresponding to approximately 25% improvement), and 1.75 (corresponding to approximately 50% improvement), respectively. A bipolar RF, IR heat and pulsatile suction device provides a beneficial effect on reduction of abdomen and thigh circumference, and smoothening of the cellulite.

  3. The consequences of time averaging for measuring temporal species turnover in the fossil record

    Science.gov (United States)

    Tomašových, Adam; Kidwell, Susan

    2010-05-01

    Modeling time averaging effects with simple simulations allows us to evaluate the magnitude of change in temporal species turnover that is expected to occur in long (paleoecological) time series with fossil assemblages. Distinguishing different modes of metacommunity dynamics (such as neutral, density-dependent, or trade-off dynamics) with time-averaged fossil assemblages requires scaling-up time-averaging effects because the decrease in temporal resolution and the decrease in temporal inter-sample separation (i.e., the two main effects of time averaging) substantially increase community stability relative to assemblages without or with weak time averaging. Large changes in temporal scale that cover centuries to millennia can lead to unprecedented effects on temporal rate of change in species composition. Temporal variation in species composition monotonically decreases with increasing duration of time-averaging in simulated fossil assemblages. Time averaging is also associated with the reduction of species dominance owing to the temporal switching in the identity of dominant species. High degrees of time averaging can cause that community parameters of local fossil assemblages converge to parameters of metacommunity rather that to parameters of individual local non-averaged communities. We find that the low variation in species composition observed among mollusk and ostracod subfossil assemblages can be explained by time averaging alone, and low temporal resolution and reduced temporal separation among assemblages in time series can thus explain a substantial part of the reduced variation in species composition relative to unscaled predictions of neutral model (i.e., species do not differ in birth, death, and immigration rates on per capita basis). The structure of time-averaged assemblages can thus provide important insights into processes that act over larger temporal scales, such as evolution of niches and dispersal, range-limit dynamics, taxon cycles, and

  4. Effects of average uncertainty and trial-type frequency on choice response time: A hierarchical extension of Hick/Hyman Law.

    Science.gov (United States)

    Mordkoff, J Toby

    2017-12-01

    Hick/Hyman Law is the linear relationship between average uncertainty and mean response time across entire blocks of trials. While unequal trial-type frequencies within blocks can be used to manipulate average uncertainty, the current version of the law does not apply to or account for the differences in mean response time across the different trial types contained in a block. Other simple predictors of the effects of trial-type frequency also fail to produce satisfactory fits. In an attempt to resolve this limitation, the present work takes a hierarchical approach, first fitting the block-level data using average uncertainty (i.e., Hick/Hyman Law is given priority), then fitting the remaining trial-level differences using various versions of trial-type frequency. The model that employed the relative probability of occurrence as the second-layer predictor produced very strong fits, thereby extending Hick/Hyman Law to the level of trial types within blocks. The advantages and implications of this hierarchical model are briefly discussed.

  5. Non-self-averaging nucleation rate due to quenched disorder

    International Nuclear Information System (INIS)

    Sear, Richard P

    2012-01-01

    We study the nucleation of a new thermodynamic phase in the presence of quenched disorder. The quenched disorder is a generic model of both impurities and disordered porous media; both are known to have large effects on nucleation. We find that the nucleation rate is non-self-averaging. This is in a simple Ising model with clusters of quenched spins. We also show that non-self-averaging behaviour is straightforward to detect in experiments, and may be rather common. (fast track communication)

  6. Effects of electrokinetic treatment of a heavy metal contaminated soil on soil enzyme activities

    International Nuclear Information System (INIS)

    Cang Long; Zhou Dongmei; Wang Quanying; Wu Danya

    2009-01-01

    There is a growing concern on the potential application of a direct current (DC) electric field to soil for removing contaminants, but little is known about its impact on soil enzyme activities. This study investigated the change of enzyme activities of a heavy metal contaminated soil before and after electrokinetic (EK) treatments at lab-scale and the mechanisms of EK treatment to affect soil enzyme activities were explored. After treatments with 1-3 V cm -1 of voltage gradient for 420 h, soil pH, electrical conductivity (EC), soil organic carbon, dissolved organic carbon (DOC), soil heavy metal concentration and enzyme activities were analyzed. The results showed that the average removal efficiencies of soil copper were about 65% and 83% without and with pH control of catholyte, respectively, and all the removal efficiencies of cadmium were above 90%. The soil invertase and catalase activities increased and the highest invertase activity was as 170 times as the initial one. The activities of soil urease and acidic phosphatase were lower than the initial ones. Bivariate correlation analyses indicated that the soil invertase and acidic phosphatase activities were significantly correlated with soil pH, EC, and DOC at P < 0.05, but the soil urease activities had no correlation with the soil properties. On the other hand, the effects of DC electric current on solution invertase and catalase enzyme protein activities indicated that it had negative effect on solution catalase activity and little effect on solution invertase activity. From the change of invertase and catalase activities in soil and solution, the conclusion can be drawn that the dominant effect mechanism is the change of soil properties by EK treatments.

  7. Effects of electrokinetic treatment of a heavy metal contaminated soil on soil enzyme activities

    Energy Technology Data Exchange (ETDEWEB)

    Cang Long [State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008 (China); Graduate School of the Chinese Academy of Sciences, Beijing 100049 (China); Zhou Dongmei, E-mail: dmzhou@issas.ac.cn [State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008 (China); Wang Quanying; Wu Danya [State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008 (China); Graduate School of the Chinese Academy of Sciences, Beijing 100049 (China)

    2009-12-30

    There is a growing concern on the potential application of a direct current (DC) electric field to soil for removing contaminants, but little is known about its impact on soil enzyme activities. This study investigated the change of enzyme activities of a heavy metal contaminated soil before and after electrokinetic (EK) treatments at lab-scale and the mechanisms of EK treatment to affect soil enzyme activities were explored. After treatments with 1-3 V cm{sup -1} of voltage gradient for 420 h, soil pH, electrical conductivity (EC), soil organic carbon, dissolved organic carbon (DOC), soil heavy metal concentration and enzyme activities were analyzed. The results showed that the average removal efficiencies of soil copper were about 65% and 83% without and with pH control of catholyte, respectively, and all the removal efficiencies of cadmium were above 90%. The soil invertase and catalase activities increased and the highest invertase activity was as 170 times as the initial one. The activities of soil urease and acidic phosphatase were lower than the initial ones. Bivariate correlation analyses indicated that the soil invertase and acidic phosphatase activities were significantly correlated with soil pH, EC, and DOC at P < 0.05, but the soil urease activities had no correlation with the soil properties. On the other hand, the effects of DC electric current on solution invertase and catalase enzyme protein activities indicated that it had negative effect on solution catalase activity and little effect on solution invertase activity. From the change of invertase and catalase activities in soil and solution, the conclusion can be drawn that the dominant effect mechanism is the change of soil properties by EK treatments.

  8. Comparison of treatment effect sizes from pivotal and postapproval trials of novel therapeutics approved by the FDA based on surrogate markers of disease: a meta-epidemiological study.

    Science.gov (United States)

    Wallach, Joshua D; Ciani, Oriana; Pease, Alison M; Gonsalves, Gregg S; Krumholz, Harlan M; Taylor, Rod S; Ross, Joseph S

    2018-03-21

    The U.S. Food and Drug Administration (FDA) often approves new drugs based on trials that use surrogate markers for endpoints, which involve certain trade-offs and may risk making erroneous inferences about the medical product's actual clinical effect. This study aims to compare the treatment effects among pivotal trials supporting FDA approval of novel therapeutics based on surrogate markers of disease with those observed among postapproval trials for the same indication. We searched Drugs@FDA and PubMed to identify published randomized superiority design pivotal trials for all novel drugs initially approved by the FDA between 2005 and 2012 based on surrogate markers as primary endpoints and published postapproval trials using the same surrogate markers or patient-relevant outcomes as endpoints. Summary ratio of odds ratios (RORs) and difference between standardized mean differences (dSMDs) were used to quantify the average difference in treatment effects between pivotal and matched postapproval trials. Between 2005 and 2012, the FDA approved 88 novel drugs for 90 indications based on one or multiple pivotal trials using surrogate markers of disease. Of these, 27 novel drugs for 27 indications were approved based on pivotal trials using surrogate markers as primary endpoints that could be matched to at least one postapproval trial, for a total of 43 matches. For nine (75.0%) of the 12 matches using the same non-continuous surrogate markers as trial endpoints, pivotal trials had larger treatment effects than postapproval trials. On average, treatment effects were 50% higher (more beneficial) in the pivotal than the postapproval trials (ROR 1.5; 95% confidence interval CI 1.01-2.23). For 17 (54.8%) of the 31 matches using the same continuous surrogate markers as trial endpoints, pivotal trials had larger treatment effects than the postapproval trials. On average, there was no difference in treatment effects between pivotal and postapproval trials (dSMDs 0.01; 95

  9. Coping with Cosmetic Effects of Cancer Treatment

    Science.gov (United States)

    ... Search English Español Coping With Cosmetic Effects of Cancer Treatment KidsHealth / For Parents / Coping With Cosmetic Effects of Cancer Treatment What's in this article? Hair Loss Skin Problems ...

  10. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    2001-01-01

    In this paper two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very often the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong ...... approximations to the Riemannian metric, and that the subsequent corrections are inherent in the least squares estimation.......In this paper two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very often the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...

  11. Waif goodbye! Average-size female models promote positive body image and appeal to consumers.

    Science.gov (United States)

    Diedrichs, Phillippa C; Lee, Christina

    2011-10-01

    Despite consensus that exposure to media images of thin fashion models is associated with poor body image and disordered eating behaviours, few attempts have been made to enact change in the media. This study sought to investigate an effective alternative to current media imagery, by exploring the advertising effectiveness of average-size female fashion models, and their impact on the body image of both women and men. A sample of 171 women and 120 men were assigned to one of three advertisement conditions: no models, thin models and average-size models. Women and men rated average-size models as equally effective in advertisements as thin and no models. For women with average and high levels of internalisation of cultural beauty ideals, exposure to average-size female models was associated with a significantly more positive body image state in comparison to exposure to thin models and no models. For men reporting high levels of internalisation, exposure to average-size models was also associated with a more positive body image state in comparison to viewing thin models. These findings suggest that average-size female models can promote positive body image and appeal to consumers.

  12. Cost-effectiveness of root caries preventive treatments.

    Science.gov (United States)

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-01-01

    With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. [Comparison of the effectiveness and cost of treatment with humid environment as compared to traditional cure. Clinical trial on primary care patients with venous leg ulcers and pressure ulcers].

    Science.gov (United States)

    Capillas Pérez, R; Cabré Aguilar, V; Gil Colomé, A M; Gaitano García, A; Torra i Bou, J E

    2000-01-01

    The discovery of moist environment dressings as alternatives to the traditional treatments based on exposing wounds to air, opened new expectations for the care and treatment of chronic wounds. Over the years, these expectations have led to the availability of new moist environment dressings which have made it possible to improve the care provided to patients suffering this kind of wounds, as well as providing important reasons to weigh in terms of cost-benefit-effectiveness at the time of selecting which type of treatment should be employed. The lack of comparative analysis among traditional treatments and moist environment treatments for chronic wounds among patients receiving primary health care led the authors to perform an analysis comparing these aforementioned options of treatment on patients suffering venous leg ulcers or pressure ulcers. The authors designed a Randomized Clinical Trial involving patients receiving ambulatory care in order to compare the effectiveness and cost-benefit of traditional versus moist environment dressing during the treatment of patients suffering stage II or III pressure ulcers or venous leg ulcers. In this trial, variables related to effectiveness of both treatments, as well as their costs were analyzed. 70 wounds were included in this Randomized Clinical Trial, 41 were venous leg ulcers of which 21 received a moist environment treatment while 20 received traditional cure, the other 29 wounds were pressure ulcers of which 15 received moist environment dressings treatment and 14 received traditional dressings. No statistically significant differences were found among the defining variables for these lesions in either group under treatment. In the venous leg ulcer study group, the authors conclusions were an average of 18.13 days, 16.33 treatment sessions and a cost of 10,616 pesetas to heal one square centimeter of the initial surface area of a wound on patients treated with traditional treatment compared to an average of 18

  14. MINIMAL INVASIVE PLATE OSTEOSYNTHESIS- AN EFFECTIVE TREATMENT METHOD FOR DISTAL TIBIA INTRAARTICULAR (PILON FRACTURES- AN 18 MONTHS FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Saket Jati

    2016-12-01

    Full Text Available BACKGROUND Tibial pilon fracture though requires operative treatment is difficult to manage. Conventional osteosynthesis is not suitable, because distal tibia is subcutaneous bone with poor vascularity. Closed reduction and Minimally Invasive Plate Osteosynthesis (MIPO for distal tibia has emerged as an alternative treatment option because it respects fracture biology and haematoma and also provides biomechanically stable construct. The aim of the study is to evaluate the results of minimally invasive plate osteosynthesis using locking plates in treating tibial pilon fractures in terms of fracture union, restoration of ankle function and complications. MATERIALS AND METHODS 30 patients with closed tibial pilon fractures (Ruedi and Allgower type I (14, type II (13, type III (3 treated with MIPO with Locking Compression Plates (LCP were prospectively followed for average duration of 18 months. RESULTS Average duration of injury-hospital and injury-surgery interval was as 12.05 hrs. and 3.50 days, respectively. All fractures got united with an average duration of 20.8 weeks (range 14-28 weeks. Olerud and Molander score was used for evaluation at 3 months, 6 months and 18 months. One patient had union with valgus angulation of 15 degrees, but no nonunion was found. CONCLUSION The present study shows that MIPO with LCP is an effective treatment method in terms of union time and complications rate for tibial pilon fracture promoting early union and early weight bearing.

  15. Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients.

    Science.gov (United States)

    Duarte, Priscila Silveira; Miyazaki, Maria Cristina; Blay, Sergio Luís; Sesso, Ricardo

    2009-08-01

    Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). In a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. In both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. The intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive-behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.

  16. BENEFICIAL EFFECTS OF LEVOTHYROXINE IN THE TREATMENT OF SUBCLINICAL HYPOTHYROIDISM

    Directory of Open Access Journals (Sweden)

    Mulic Mersudin

    2016-12-01

    Full Text Available Introduction:Increased cardiovascular risk in thyroid dysfunction is associated with disorders of lipid and lipoproteins, endothelial dysfunction, metabolic, hormonal, hemodynamic changes and coagulation disorders. Subclinical hypothyroidism is characterized by a suprarnormal level of TSH with normal levels of thyroid hormones. The correlation between subclinical hypothyroidism of the lipid profile and cardiovascular outcomes remains unclear. Several intervention studies assessed the effect of levothyroxine therapy on the lipid profile of patients with subclinical hypothyroidism and obtained conflicting results. The aim of the research is to determine whether subclinical hypothyroidism is associated with the atherogenic lipid profile and whether these changes are reversible after the introduction of the L-thyroxine replacement therapy. Method: The study included 51 patients over 50 years of age with subclinical hypothyroidism. All the participants were subjected to an examination programme which included a detailed anamnesis and physical examination, laboratory tests (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, T3, T4, TSH. After eight weeks of levothyroxine therapy, the same laboratory parameters were determined in the patients. Results: Subjects with subclinical hypothyroidism had high average values: TSH (12.77 + 2.78 mIU / ml, total cholesterol (7.55 ± 0.79 mmol / l, LDL cholesterol (5.03 ± 0.61 mmol / l, triglycerides (2.48 ± 1.01 mmol / l; and the average value of HDL cholesterol was within reference values (1.12 ± 0.21 mmol / l. After eight weeks of levothyroxine replacement therapy, there was a statistically significant reduction of average values (p <0.0001: TSH (3.83 ± 1.33 mIU / ml, total cholesterol (6.28 ± 0.96 mmol / l, LDL cholesterol ( 4.03 ± 0.70 mmol / mmol / l l, triglycerides (1.98 ± 0.87 mmol / l; and the average value of HDL cholesterol increased significantly (p <0.0001 (1.32 ± 0.22 mmol

  17. Fertility effects of cancer treatment.

    Science.gov (United States)

    Marsden, Donald E; Hacker, Neville

    2003-01-01

    Cancer sufferers are a subfertile group, and most treatments have the potential to adversely affect gonadal function. As cancer treatment becomes more effective and survival rates improve there are more cancer survivors in the reproductive age group for whom parenting is an important consideration. This article outlines the effects on fertility of cancer treatments and techniques to minimise the risk of infertility. The overall prospects for younger cancer sufferers to either retain their fertility or have genetic offspring is now better than ever before, due to advances in assisted reproductive technology, the appropriate use of fertility sparing surgery and other techniques to reduce the toxicity of therapy on the reproductive organs. These advances raise new moral and ethical concerns that must be considered before advising cancer sufferers of the options for preserving reproductive capacity.

  18. Calculating ensemble averaged descriptions of protein rigidity without sampling.

    Directory of Open Access Journals (Sweden)

    Luis C González

    Full Text Available Previous works have demonstrated that protein rigidity is related to thermodynamic stability, especially under conditions that favor formation of native structure. Mechanical network rigidity properties of a single conformation are efficiently calculated using the integer body-bar Pebble Game (PG algorithm. However, thermodynamic properties require averaging over many samples from the ensemble of accessible conformations to accurately account for fluctuations in network topology. We have developed a mean field Virtual Pebble Game (VPG that represents the ensemble of networks by a single effective network. That is, all possible number of distance constraints (or bars that can form between a pair of rigid bodies is replaced by the average number. The resulting effective network is viewed as having weighted edges, where the weight of an edge quantifies its capacity to absorb degrees of freedom. The VPG is interpreted as a flow problem on this effective network, which eliminates the need to sample. Across a nonredundant dataset of 272 protein structures, we apply the VPG to proteins for the first time. Our results show numerically and visually that the rigidity characterizations of the VPG accurately reflect the ensemble averaged [Formula: see text] properties. This result positions the VPG as an efficient alternative to understand the mechanical role that chemical interactions play in maintaining protein stability.

  19. Lagrangian averaging with geodesic mean.

    Science.gov (United States)

    Oliver, Marcel

    2017-11-01

    This paper revisits the derivation of the Lagrangian averaged Euler (LAE), or Euler- α equations in the light of an intrinsic definition of the averaged flow map as the geodesic mean on the volume-preserving diffeomorphism group. Under the additional assumption that first-order fluctuations are statistically isotropic and transported by the mean flow as a vector field, averaging of the kinetic energy Lagrangian of an ideal fluid yields the LAE Lagrangian. The derivation presented here assumes a Euclidean spatial domain without boundaries.

  20. The effect of wind shielding and pen position on the average daily weight gain and feed conversion rate of grower/finisher pigs

    DEFF Research Database (Denmark)

    Jensen, Dan B.; Toft, Nils; Cornou, Cécile

    2014-01-01

    of the effects of wind shielding, linear mixed models were fitted to describe the average daily weight gain and feed conversion rate of 1271 groups (14 individuals per group) of purebred Duroc, Yorkshire and Danish Landrace boars, as a function of shielding (yes/no), insert season (winter, spring, summer, autumn...... groups placed in the 1st and 4th pen (p=0.0001). A similar effect was not seen on smaller pigs. Pen placement appears to have no effect on feed conversion rate.No interaction effects between shielding and distance to the corridor could be demonstrated. Furthermore, in models including both factors......). The effect could not be tested for Yorkshire and Danish Landrace due to lack of data on these breeds. For groups of pigs above the average start weight, a clear tendency of higher growth rates at greater distances from the central corridor was observed, with the most significant differences being between...

  1. Flexible time domain averaging technique

    Science.gov (United States)

    Zhao, Ming; Lin, Jing; Lei, Yaguo; Wang, Xiufeng

    2013-09-01

    Time domain averaging(TDA) is essentially a comb filter, it cannot extract the specified harmonics which may be caused by some faults, such as gear eccentric. Meanwhile, TDA always suffers from period cutting error(PCE) to different extent. Several improved TDA methods have been proposed, however they cannot completely eliminate the waveform reconstruction error caused by PCE. In order to overcome the shortcomings of conventional methods, a flexible time domain averaging(FTDA) technique is established, which adapts to the analyzed signal through adjusting each harmonic of the comb filter. In this technique, the explicit form of FTDA is first constructed by frequency domain sampling. Subsequently, chirp Z-transform(CZT) is employed in the algorithm of FTDA, which can improve the calculating efficiency significantly. Since the signal is reconstructed in the continuous time domain, there is no PCE in the FTDA. To validate the effectiveness of FTDA in the signal de-noising, interpolation and harmonic reconstruction, a simulated multi-components periodic signal that corrupted by noise is processed by FTDA. The simulation results show that the FTDA is capable of recovering the periodic components from the background noise effectively. Moreover, it can improve the signal-to-noise ratio by 7.9 dB compared with conventional ones. Experiments are also carried out on gearbox test rigs with chipped tooth and eccentricity gear, respectively. It is shown that the FTDA can identify the direction and severity of the eccentricity gear, and further enhances the amplitudes of impulses by 35%. The proposed technique not only solves the problem of PCE, but also provides a useful tool for the fault symptom extraction of rotating machinery.

  2. Occlusal consequence of using average condylar guidance settings: An in vitro study.

    Science.gov (United States)

    Lee, Wonsup; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom

    2017-04-01

    A simplified mounting technique that adopts an average condylar guidance has been advocated. Despite this, the experimental explanation of how average settings differ from individual condylar guidance remains unclear. The purpose of this in vitro study was to examine potential occlusal error by using average condylar guidance settings during nonworking side movement of the articulator. Three-dimensional positions of the nonworking side maxillary first molar at various condylar and incisal settings were traced using a laser displacement sensor attached to the motorized stages with biaxial freedom of movement. To examine clinically relevant occlusal consequences of condylar guidance setting errors, the vertical occlusal error was defined as the vertical-axis positional difference between the average setting trace and the other condylar guidance setting trace. In addition, the respective contribution of the condylar and incisal guidance to the position of the maxillary first molar area was analyzed by multiple regression analysis using the resultant coordinate data. Alteration from individual to average settings led to a positional difference in the maxillary first molar nonworking side movement. When the individual setting was lower than average, vertical occlusal error occurred, which might cause occlusal interference. The vertical occlusal error ranged from -2964 to 1711 μm. In addition, the occlusal effect of incisal guidance was measured as a partial regression coefficient of 0.882, which exceeded the effect of condylar guidance, 0.431. Potential occlusal error as a result of adopting an average condylar guidance setting was observed. The occlusal effect of incisal guidance doubled the effect of condylar guidance. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. [Short-term curative effects of Tantalum rod treatment in early avascular necrosis].

    Science.gov (United States)

    Ye, Fu-Sheng; Ni, Zhe-Ji; Chu, Xiao-Bing; He, Bang-Jian; Li, Ju; Tong, Pei-Jian

    2013-08-01

    To explore the recent clinical curative effect of Tantalum rod in treating the early avascular necrosis. From January 2008 to November 2008, the 25 patients (39 hips) with early avascular necrosis accepted tantalum rod placement and included 9 males (11 hips) and 16 females (28 hips) with an average age of 37 years old ranging from 18 to 74 years old. Four patients (6 hips) caused by Alcoholic, 6 patients (8 hips) by hormone, 2 cases (2 hips) by traumatic, 13 cases (23 hips) by idiopathic. Steinberg preoperative stage involved 7 hips in period I, 24 hips in period II, 8 hips in period III. Curative effect analysis included preoperative and postoperative Harris score, radiographic changes and hip replacement for follow-up to accept the end of the femoral head survival rate. All patients were followed up for 6 to 47 months (averaged 37.4 months). All 12 hips imaging appeard progress,including tantalum rod exit in 1 hip, hip hemiarthroplasty collapse in 3 hips, the area increased to avascular necrosis in 8 hips. Six hips accepted total hip replacement, including imaging progress in 5 hips (41.7%, 5/12), no imaging progress in 1 hip (3.7%,1/27). All hips' Kaplan-Meier survival curves showed 6-month survival rate was (97.4 +/- 2.5)% after tantalum stick insertion, 1-year survival rate was (94.7 +/- 3.6), and 2-year survival rate was (88.6 +/- 5.4)%, 3-year survival rate was (72.5 +/- 11.2). It is effective for treatment of avascular necrosis of femoral head in Steinberg I and II by Tantalum rod, and it can effectively relieve femoral head replacement time.

  4. Average of delta: a new quality control tool for clinical laboratories.

    Science.gov (United States)

    Jones, Graham R D

    2016-01-01

    Average of normals is a tool used to control assay performance using the average of a series of results from patients' samples. Delta checking is a process of identifying errors in individual patient results by reviewing the difference from previous results of the same patient. This paper introduces a novel alternate approach, average of delta, which combines these concepts to use the average of a number of sequential delta values to identify changes in assay performance. Models for average of delta and average of normals were developed in a spreadsheet application. The model assessed the expected scatter of average of delta and average of normals functions and the effect of assay bias for different values of analytical imprecision and within- and between-subject biological variation and the number of samples included in the calculations. The final assessment was the number of patients' samples required to identify an added bias with 90% certainty. The model demonstrated that with larger numbers of delta values, the average of delta function was tighter (lower coefficient of variation). The optimal number of samples for bias detection with average of delta was likely to be between 5 and 20 for most settings and that average of delta outperformed average of normals when the within-subject biological variation was small relative to the between-subject variation. Average of delta provides a possible additional assay quality control tool which theoretical modelling predicts may be more valuable than average of normals for analytes where the group biological variation is wide compared with within-subject variation and where there is a high rate of repeat testing in the laboratory patient population. © The Author(s) 2015.

  5. Effectiveness of propanolol for treatment of infantile haemangioma

    DEFF Research Database (Denmark)

    Andersen, Ida Gillberg; Rechnitzer, Catherine; Charabi, Birgitte

    2014-01-01

    : This study was retrospective and based on a review of children treated for IH with propranolol from the 2010-2012 period at Rigshospitalet. RESULTS: Overall, propranolol was effective in all but one child (97%). The majority of the children (84%) were treated with an initial dose of 1 mg/kg/day, which...... was considered sufficient in most cases (71%). Children who started treatment before five months of age had a significantly better response than children who started treatment at a later age. No relation was found between location of IH and the effect of treatment. There were only few and mild side effects....... CONCLUSION: Propranolol is effective in the treatment of IH and it has only few and mild side effects. In most cases, a low dose of 1 mg/kg/day was sufficient. Early initiation of treatment is recommended as the response to treatment was better in younger children and because early initiation helps prevent...

  6. Average spectral power changes at the hippocampal electroencephalogram in schizophrenia model induced by ketamine.

    Science.gov (United States)

    Sampaio, Luis Rafael L; Borges, Lucas T N; Silva, Joyse M F; de Andrade, Francisca Roselin O; Barbosa, Talita M; Oliveira, Tatiana Q; Macedo, Danielle; Lima, Ricardo F; Dantas, Leonardo P; Patrocinio, Manoel Cláudio A; do Vale, Otoni C; Vasconcelos, Silvânia M M

    2018-02-01

    The use of ketamine (Ket) as a pharmacological model of schizophrenia is an important tool for understanding the main mechanisms of glutamatergic regulated neural oscillations. Thus, the aim of the current study was to evaluate Ket-induced changes in the average spectral power using the hippocampal quantitative electroencephalography (QEEG). To this end, male Wistar rats were submitted to a stereotactic surgery for the implantation of an electrode in the right hippocampus. After three days, the animals were divided into four groups that were treated for 10 consecutive days with Ket (10, 50, or 100 mg/kg). Brainwaves were captured on the 1st or 10th day, respectively, to acute or repeated treatments. The administration of Ket (10, 50, or 100 mg/kg), compared with controls, induced changes in the hippocampal average spectral power of delta, theta, alpha, gamma low or high waves, after acute or repeated treatments. Therefore, based on the alterations in the average spectral power of hippocampal waves induced by Ket, our findings might provide a basis for the use of hippocampal QEEG in animal models of schizophrenia. © 2017 Société Française de Pharmacologie et de Thérapeutique.

  7. The B-dot Earth Average Magnetic Field

    Science.gov (United States)

    Capo-Lugo, Pedro A.; Rakoczy, John; Sanders, Devon

    2013-01-01

    The average Earth's magnetic field is solved with complex mathematical models based on mean square integral. Depending on the selection of the Earth magnetic model, the average Earth's magnetic field can have different solutions. This paper presents a simple technique that takes advantage of the damping effects of the b-dot controller and is not dependent of the Earth magnetic model; but it is dependent on the magnetic torquers of the satellite which is not taken into consideration in the known mathematical models. Also the solution of this new technique can be implemented so easily that the flight software can be updated during flight, and the control system can have current gains for the magnetic torquers. Finally, this technique is verified and validated using flight data from a satellite that it has been in orbit for three years.

  8. Effectiveness of shock wave therapy as an alternative to the rotator cuff injury treatment

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín Del Gordo-D´Amato

    2016-02-01

    Full Text Available Rotator cuff injuries are reason for consultation frequent in elderly patients. Most of the time there are no background traumatic acute generating progressive limitations in activities of daily living (ADLS. The objective of this study is to show results in tendonitis of the rotator cuff, in patients treated with extracorporeal shock wave therapy (ESWT. It is a prospective descriptive observational study which presents clinical and functional outcomes in patients with described lesion, treated with ESWT with poor response to conventional treatments and clinical pictures of longstanding through implementing visual analog scale (VAS of pain and evaluation of range of motion. The greater presence of lesion is present in women 63.6%. Mostly affected shoulder was right in a 63.6%. Found significant changes in VAS pre and post treatment with averages of 7.9 and 0.5 respectively and different statistical p < 0.001. We were conclude that the ESWT is an effective method in the treatment of the tendonitis of the rotator cuff with relief from pain and return to functional levels.

  9. Spacetime averaging of exotic singularity universes

    International Nuclear Information System (INIS)

    Dabrowski, Mariusz P.

    2011-01-01

    Taking a spacetime average as a measure of the strength of singularities we show that big-rips (type I) are stronger than big-bangs. The former have infinite spacetime averages while the latter have them equal to zero. The sudden future singularities (type II) and w-singularities (type V) have finite spacetime averages. The finite scale factor (type III) singularities for some values of the parameters may have an infinite average and in that sense they may be considered stronger than big-bangs.

  10. Average use of Alcohol and Binge Drinking in Pregnancy: Neuropsychological Effects at Age 5

    DEFF Research Database (Denmark)

    Kilburn, Tina R.

    Objectives The objective of this PhD. was to examine the relation between low weekly average maternal alcohol consumption and ‘Binge drinking' (defined as intake of 5 or more drinks per occasion) during pregnancy and information processing time (IPT) in children aged five years. Since a method...... that provided detailed information on maternal alcohol drinking patterns before and during pregnancy and other lifestyle factors. These women were categorized in groups of prenatally average alcohol intake and binge drinking, timing and number of episodes. At the age of five years the children of these women...... and number of episodes) and between simple reaction time (SRT) and alcohol intake or binge drinking (timing and number of episodes) during pregnancy. Conclusion This was one of the first studies investigating IPT and prenatally average alcohol intake and binge drinking in early pregnancy. Daily prenatal...

  11. Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain.

    Science.gov (United States)

    Turk, Dennis C

    2002-01-01

    Chronic pain is a prevalent and costly problem. This review addresses the question of the clinical effectiveness and cost-effectiveness of the most common treatments for patients with chronic pain. Representative published studies that evaluate the clinical effectiveness of pharmacological treatments, conservative (standard) care, surgery, spinal cord stimulators, implantable drug delivery systems (IDDSs), and pain rehabilitation programs (PRPs) are examined and compared. The cost-effectiveness of these treatment approaches is also considered. Outcome criteria including pain reduction, medication use, health care consumption, functional activities, and closure of disability compensation cases are examined. In addition to clinical effectiveness, the cost-effectiveness of PRPs, conservative care, surgery, spinal cord stimulators, and IDDSs are compared using costs to return a treated patient to work to illustrate the relative expenses for each of these treatments. There are limitations to the success of all the available treatments. The author urges caution in interpreting the results, particularly in comparisons between treatments and across studies, because there are broad differences in the pain syndromes and inclusion criteria used, the drug dosages, comparability of treatments, the definition of "chronic" used, the outcome criteria selected to determine success, and societal differences. None of the currently available treatments eliminates pain for the majority of patients. Pain rehabilitation programs provide comparable reduction in pain to alternative pain treatment modalities, but with significantly better outcomes for medication use, health care utilization, functional activities, return to work, closure of disability claims, and with substantially fewer iatrogenic consequences and adverse events. Surgery, spinal cord stimulators, and IDDSs appear to have substantial benefits on some outcome criteria for carefully selected patients. These modalities are

  12. Testing averaged cosmology with type Ia supernovae and BAO data

    Energy Technology Data Exchange (ETDEWEB)

    Santos, B.; Alcaniz, J.S. [Departamento de Astronomia, Observatório Nacional, 20921-400, Rio de Janeiro – RJ (Brazil); Coley, A.A. [Department of Mathematics and Statistics, Dalhousie University, Halifax, B3H 3J5 Canada (Canada); Devi, N. Chandrachani, E-mail: thoven@on.br, E-mail: aac@mathstat.dal.ca, E-mail: chandrachaniningombam@astro.unam.mx, E-mail: alcaniz@on.br [Instituto de Astronomía, Universidad Nacional Autónoma de México, Box 70-264, México City, México (Mexico)

    2017-02-01

    An important problem in precision cosmology is the determination of the effects of averaging and backreaction on observational predictions, particularly in view of the wealth of new observational data and improved statistical techniques. In this paper, we discuss the observational viability of a class of averaged cosmologies which consist of a simple parametrized phenomenological two-scale backreaction model with decoupled spatial curvature parameters. We perform a Bayesian model selection analysis and find that this class of averaged phenomenological cosmological models is favored with respect to the standard ΛCDM cosmological scenario when a joint analysis of current SNe Ia and BAO data is performed. In particular, the analysis provides observational evidence for non-trivial spatial curvature.

  13. Testing averaged cosmology with type Ia supernovae and BAO data

    International Nuclear Information System (INIS)

    Santos, B.; Alcaniz, J.S.; Coley, A.A.; Devi, N. Chandrachani

    2017-01-01

    An important problem in precision cosmology is the determination of the effects of averaging and backreaction on observational predictions, particularly in view of the wealth of new observational data and improved statistical techniques. In this paper, we discuss the observational viability of a class of averaged cosmologies which consist of a simple parametrized phenomenological two-scale backreaction model with decoupled spatial curvature parameters. We perform a Bayesian model selection analysis and find that this class of averaged phenomenological cosmological models is favored with respect to the standard ΛCDM cosmological scenario when a joint analysis of current SNe Ia and BAO data is performed. In particular, the analysis provides observational evidence for non-trivial spatial curvature.

  14. The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Daniela Nogueira Prado de Souza

    2012-02-01

    Full Text Available INTRODUCTION: Antibiotic-associated diarrhea (AAD is an important side effect of this specific class of drugs. The objective of this study was to investigate the effect of the use of probiotics in the treatment of AAD. METHODS: A group of hospitalized patients, who contracted diarrhea during or after 7 days of suspension of antimicrobial medication, was blindly randomized to receive a standardized diet associated with the use of the probiotics (Lactobacillus casei and Bifidobacterium breve or its corresponding placebo, three times a day. RESULTS: Seventy patients were studied. For the experimental (n=35 and control (n=35 groups, respectively, the average time of treatment was 5.06±2.18 and 5.49±3.17 days (p=0.95, and the average duration of diarrhea, among those who were healed, was 4.87±2.13 and 4.52±2.55 days (p=0.36. Four (11.4% patients who received probiotics and ten (28.6% who received the placebo were not cured (p=0.13, and relapse rates were similar between both groups. Seven patients from each group, in addition to diarrhea, presented cases of bloating and/or abdominal cramps and/or vomiting (p=1.00. CONCLUSIONS: In this light, it is concluded that L. casei associated with B. breve, in the administered dosage and frequency, has no effect on the antibiotic-associated diarrhea. Similar studies need to be conducted with higher doses of these or other probiotics.

  15. The analysis of the effective of preserving sacral nerve root during surgical treatment of chordoma

    International Nuclear Information System (INIS)

    Ji Yiming; Chen Kangwu; Yang Huilin; Zhu Lifan

    2010-01-01

    Objective: To analyze the effective of preserving sacral nerve root during surgical treatment of sacral chordoma. Methods: This retrospective study included 30 cases of sacral chordomas. All the cases were operated with posterior approach. The blood loss and blood transfusion during operation, the drainged blood after operation were reviewed. The sphincter muscle function of bladder and bowl were observed. Results: Tremendous reduction of blood loss during surgery was found in all cases, the blood loss was 1280 ml in average, the blood transfusion was 1080 ml in average, the drainged blood after ope-ration was 650 ml. Nine patients whose sacral nerve roots had been reserved bilaterally at and above S 3 level, the sphincter muscle function of bladder and bowl was good, whereas the function of sphincter muscle impaired in the other 21 patients and in one case colostomy and ureterocutaneostomy were used. Conclusion: Preoperative arterial embolization is effective method and can lead to excellent results. Even if the tumor is relatively huge and the upper resection margin is as high as at S 1 or S 2 level, the tumor can be removed successfully by posterior approach. Sacral nerve should be preserved as possible. (authors)

  16. The long-term effects of a life-prolonging heat treatment on the Drosophila melanogaster transcriptome suggest that heat shock proteins extend lifespan

    DEFF Research Database (Denmark)

    Sarup, Pernille Merete; Sørensen, Peter; Loeschcke, Volker

    2014-01-01

    Heat-induced hormesis, i.e. the beneficial effect of mild heat-induced stress, increases the average lifespan of many organisms. This effect, which depends on the heat shock factor, decreases the log mortality rate weeks after the stress has ceased. To identify candidate genes that mediate......-treated flies. Several hsp70 probe sets were up-regulated 1.7–2-fold in the mildly stressed flies weeks after the last heat treatment (P shock protein, Hsp70, is reported to return to normal levels of expression shortly after heat stress. We...... conclude that the heat shock response, and Hsp70 in particular, may be central to the heat-induced increase in the average lifespan in flies that are exposed to mild heat stress early in life....

  17. Predicting therapy success for treatment as usual and blended treatment in the domain of depression.

    Science.gov (United States)

    van Breda, Ward; Bremer, Vincent; Becker, Dennis; Hoogendoorn, Mark; Funk, Burkhardt; Ruwaard, Jeroen; Riper, Heleen

    2018-06-01

    In this paper, we explore the potential of predicting therapy success for patients in mental health care. Such predictions can eventually improve the process of matching effective therapy types to individuals. In the EU project E-COMPARED, a variety of information is gathered about patients suffering from depression. We use this data, where 276 patients received treatment as usual and 227 received blended treatment, to investigate to what extent we are able to predict therapy success. We utilize different encoding strategies for preprocessing, varying feature selection techniques, and different statistical procedures for this purpose. Significant predictive power is found with average AUC values up to 0.7628 for treatment as usual and 0.7765 for blended treatment. Adding daily assessment data for blended treatment does currently not add predictive accuracy. Cost effectiveness analysis is needed to determine the added potential for real-world applications.

  18. Siblings' Perceptions of Differential Treatment, Fairness, and Jealousy and Adolescent Adjustment: A Moderated Indirect Effects Model.

    Science.gov (United States)

    Loeser, Meghan K; Whiteman, Shawn D; McHale, Susan M

    2016-08-01

    Youth's perception of parents' differential treatment (PDT) are associated with maladjustment during adolescence. Although the direct relations between PDT and youth's maladjustment have been well established, the mechanisms underlying these associations remain unclear. We addressed this gap by examining whether sibling jealousy accounted for the links between PDT and youth's depressive symptoms, self-worth, and risky behaviors. Additionally, we examined whether youth's perceptions of fairness regarding their treatment as well as the gender constellation of the dyad moderated these indirect relations (i.e., moderated-indirect effects). Participants were first- and second-born adolescent siblings ( M = 15.96, SD = .72 years for older siblings, M = 13.48, SD = 1.02 years for younger siblings) and their parents from 197 working and middle class European American families. Data were collected via home interviews. A series of Conditional Process Analyses revealed significant indirect effects of PDT through sibling jealousy to all three adjustment outcomes. Furthermore, perceptions of fairness moderated the relations between PDT and jealousy, such that the indirect effects were only significant at low (-1 SD ) and average levels of fairness. At high levels of fairness (+1 SD ) there was no association between PDT, jealousy, and youth adjustment. Taken together, results indicate that youth and parents would benefit from engaging in clear communication regarding the reasoning for the occurrence of differential treatment, likely maximizing youth and parent perceptions of that treatment as being fair, and in turn mitigating sibling jealousy and maladjustment.

  19. Siblings’ Perceptions of Differential Treatment, Fairness, and Jealousy and Adolescent Adjustment: A Moderated Indirect Effects Model

    Science.gov (United States)

    Loeser, Meghan K.; Whiteman, Shawn D.; McHale, Susan M.

    2016-01-01

    Youth's perception of parents’ differential treatment (PDT) are associated with maladjustment during adolescence. Although the direct relations between PDT and youth's maladjustment have been well established, the mechanisms underlying these associations remain unclear. We addressed this gap by examining whether sibling jealousy accounted for the links between PDT and youth's depressive symptoms, self-worth, and risky behaviors. Additionally, we examined whether youth's perceptions of fairness regarding their treatment as well as the gender constellation of the dyad moderated these indirect relations (i.e., moderated-indirect effects). Participants were first- and second-born adolescent siblings (M = 15.96, SD = .72 years for older siblings, M = 13.48, SD = 1.02 years for younger siblings) and their parents from 197 working and middle class European American families. Data were collected via home interviews. A series of Conditional Process Analyses revealed significant indirect effects of PDT through sibling jealousy to all three adjustment outcomes. Furthermore, perceptions of fairness moderated the relations between PDT and jealousy, such that the indirect effects were only significant at low (−1 SD) and average levels of fairness. At high levels of fairness (+1 SD) there was no association between PDT, jealousy, and youth adjustment. Taken together, results indicate that youth and parents would benefit from engaging in clear communication regarding the reasoning for the occurrence of differential treatment, likely maximizing youth and parent perceptions of that treatment as being fair, and in turn mitigating sibling jealousy and maladjustment. PMID:27867295

  20. Passive quantum error correction of linear optics networks through error averaging

    Science.gov (United States)

    Marshman, Ryan J.; Lund, Austin P.; Rohde, Peter P.; Ralph, Timothy C.

    2018-02-01

    We propose and investigate a method of error detection and noise correction for bosonic linear networks using a method of unitary averaging. The proposed error averaging does not rely on ancillary photons or control and feedforward correction circuits, remaining entirely passive in its operation. We construct a general mathematical framework for this technique and then give a series of proof of principle examples including numerical analysis. Two methods for the construction of averaging are then compared to determine the most effective manner of implementation and probe the related error thresholds. Finally we discuss some of the potential uses of this scheme.

  1. Average expansion rate and light propagation in a cosmological Tardis spacetime

    Energy Technology Data Exchange (ETDEWEB)

    Lavinto, Mikko; Räsänen, Syksy [Department of Physics, University of Helsinki, and Helsinki Institute of Physics, P.O. Box 64, FIN-00014 University of Helsinki (Finland); Szybka, Sebastian J., E-mail: mikko.lavinto@helsinki.fi, E-mail: syksy.rasanen@iki.fi, E-mail: sebastian.szybka@uj.edu.pl [Astronomical Observatory, Jagellonian University, Orla 171, 30-244 Kraków (Poland)

    2013-12-01

    We construct the first exact statistically homogeneous and isotropic cosmological solution in which inhomogeneity has a significant effect on the expansion rate. The universe is modelled as a Swiss Cheese, with dust FRW background and inhomogeneous holes. We show that if the holes are described by the quasispherical Szekeres solution, their average expansion rate is close to the background under certain rather general conditions. We specialise to spherically symmetric holes and violate one of these conditions. As a result, the average expansion rate at late times grows relative to the background, \\ie backreaction is significant. The holes fit smoothly into the background, but are larger on the inside than a corresponding background domain: we call them Tardis regions. We study light propagation, find the effective equations of state and consider the relation of the spatially averaged expansion rate to the redshift and the angular diameter distance.

  2. Effectiveness of electroconvulsive therapy in patients with treatment resistant schizophrenia: A retrospective study.

    Science.gov (United States)

    Grover, Sandeep; Chakrabarti, Subho; Hazari, Nandita; Avasthi, Ajit

    2017-03-01

    This study aimed to evaluate the effectiveness of electroconvulsive therapy (ECT) among patients with treatment resistant schizophrenia (TRS). Records of patients who had received ECT were reviewed to identify patients with TRS who were administered ECT in combination with clozapine. Socio-demographic, clinical data and ECT details were extracted. The most common diagnosis was of paranoid schizophrenia (49%) followed by undifferentiated schizophrenia (36%). A-fifth (22%) of the patients were judged to have poor response to clozapine. The mean number of ECTs given were 13.97 (SD-7.67) and mean clozapine dose was 287.5mgs/day (SD-100.1). About two-thirds (63%) of the patients showed >30% reduction in scores on different symptom-rating scales with combined use of clozapine and ECT. Among clozapine non-responders, approximately 69% responded to the combination. Post-ECT rise in blood pressure was the most common side effect (16.9%) followed by prolonged seizures (7%). Long-term follow-up data was available for 47 out of the 59 patients. More than two-third (N=34; 72%) followed-up for an average of 30 months (SD 32.3; range: 1-120), maintained well with continued clozapine treatment. To conclude, results of this study further endorse the effectiveness, safety and long-term benefits of the clozapine-ECT combination in TRS and clozapine-refractory schizophrenia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. Marginal versus Average Beta of Equity under Corporate Taxation

    OpenAIRE

    Lund, Diderik

    2009-01-01

    Even for fully equity-financed firms there may be substantial effects of taxation on the after-tax cost of capital. Among the few studies of these effects, even fewer identify all effects correctly. When marginal investment is taxed together with inframarginal, marginal beta differs from average if there are investment-related deductions like depreciation. To calculate asset betas, one should not only 'unlever observed equity betas, but 'untax' and 'unaverage' them. Risky tax claims are value...

  4. Beyond total treatment effects in randomised controlled trials: Baseline measurement of intermediate outcomes needed to reduce confounding in mediation investigations.

    Science.gov (United States)

    Landau, Sabine; Emsley, Richard; Dunn, Graham

    2018-06-01

    Random allocation avoids confounding bias when estimating the average treatment effect. For continuous outcomes measured at post-treatment as well as prior to randomisation (baseline), analyses based on (A) post-treatment outcome alone, (B) change scores over the treatment phase or (C) conditioning on baseline values (analysis of covariance) provide unbiased estimators of the average treatment effect. The decision to include baseline values of the clinical outcome in the analysis is based on precision arguments, with analysis of covariance known to be most precise. Investigators increasingly carry out explanatory analyses to decompose total treatment effects into components that are mediated by an intermediate continuous outcome and a non-mediated part. Traditional mediation analysis might be performed based on (A) post-treatment values of the intermediate and clinical outcomes alone, (B) respective change scores or (C) conditioning on baseline measures of both intermediate and clinical outcomes. Using causal diagrams and Monte Carlo simulation, we investigated the performance of the three competing mediation approaches. We considered a data generating model that included three possible confounding processes involving baseline variables: The first two processes modelled baseline measures of the clinical variable or the intermediate variable as common causes of post-treatment measures of these two variables. The third process allowed the two baseline variables themselves to be correlated due to past common causes. We compared the analysis models implied by the competing mediation approaches with this data generating model to hypothesise likely biases in estimators, and tested these in a simulation study. We applied the methods to a randomised trial of pragmatic rehabilitation in patients with chronic fatigue syndrome, which examined the role of limiting activities as a mediator. Estimates of causal mediation effects derived by approach (A) will be biased if one of

  5. Cost-effectiveness analysis of potentially curative and combination treatments for hepatocellular carcinoma with person-level data in a Canadian setting.

    Science.gov (United States)

    Thein, Hla-Hla; Isaranuwatchai, Wanrudee; Qiao, Yao; Wong, Kenny; Sapisochin, Gonzalo; Chan, Kelvin K W; Yoshida, Eric M; Earle, Craig C

    2017-09-01

    Patients with early-stage hepatocellular carcinoma (HCC) are potential candidates for curative treatments such as radiofrequency ablation (RFA), surgical resection (SR), or liver transplantation (LT), which have demonstrated a significant survival benefit. We aimed to estimate the cost-effectiveness of curative and combination treatment strategies among patients diagnosed with HCC during 2002-2010. This study used Ontario Cancer Registry-linked administrative data to estimate effectiveness and costs (2013 USD) of the treatment strategies from the healthcare payer's perspective. Multiple imputation by logistic regression was used to handle missing data. A net benefit regression approach of baseline important covariates and propensity score adjustment were used to calculate incremental net benefit to generate incremental cost-effectiveness ratio (ICER) and uncertainty measures. Among 2,222 patients diagnosed with HCC, 10.5%, 14.1%, and 10.3% received RFA, SR, and LT monotherapy, respectively; 0.5-3.1% dual treatments; and 0.5% triple treatments. Compared with no treatment (53.2%), transarterial chemoembolization (TACE) + RFA (average $2,465, 95% CI: -$20,000-$36,600/quality-adjusted life years [QALY]) or RFA monotherapy ($15,553, 95% CI: $3,500-$28,500/QALY) appears to be the most cost-effective modality with lowest ICER value. The cost-effectiveness acceptability curve showed that if the relevant threshold was $50,000/QALY, RFA monotherapy and TACE+ RFA would have a cost-effectiveness probability of 100%. Strategies using LT delivered the most additional QALYs and became cost-effective at a threshold of $77,000/QALY. Our findings found that TACE+ RFA dual treatment or RFA monotherapy appears to be the most cost-effective curative treatment for patients with potential early stage of HCC in Ontario. These findings highlight the importance of identifying and measuring differential benefits, costs, and cost-effectiveness of alternative HCC curative treatments in

  6. An effective approach using blended learning to assist the average students to catch up with the talented ones

    Directory of Open Access Journals (Sweden)

    Baijie Yang

    2013-03-01

    Full Text Available Because the average students are the prevailing part of the student population, it is important but difficult for the educators to help average students by improving their learning efficiency and learning outcome in school tests. We conducted a quasi-experiment with two English classes taught by one teacher in the second term of the first year of a junior high school. The experimental class was composed of average students (N=37, while the control class comprised talented students (N=34. Therefore the two classes performed differently in English subject with mean difference of 13.48 that is statistically significant based on the independent sample T-Test analysis. We tailored the web-based intelligent English instruction system, called Computer Simulation in Educational Communication (CSIEC and featured with instant feedback, to the learning content in the experiment term, and the experimental class used it one school hour per week throughout the term. This blended learning setting with the focus on vocabulary and dialogue acquisition helped the students in the experimental class improve their learning performance gradually. The mean difference of the final test between the two classes was decreased to 3.78, while the mean difference of the test designed for the specially drilled vocabulary knowledge was decreased to 2.38 and was statistically not significant. The student interview and survey also demonstrated the students’ favor to the blended learning system. We conclude that the long-term integration of this content oriented blended learning system featured with instant feedback into ordinary class is an effective approach to assist the average students to catch up with the talented ones.

  7. Effect of parameters in moving average method for event detection enhancement using phase sensitive OTDR

    Science.gov (United States)

    Kwon, Yong-Seok; Naeem, Khurram; Jeon, Min Yong; Kwon, Il-bum

    2017-04-01

    We analyze the relations of parameters in moving average method to enhance the event detectability of phase sensitive optical time domain reflectometer (OTDR). If the external events have unique frequency of vibration, then the control parameters of moving average method should be optimized in order to detect these events efficiently. A phase sensitive OTDR was implemented by a pulsed light source, which is composed of a laser diode, a semiconductor optical amplifier, an erbium-doped fiber amplifier, a fiber Bragg grating filter, and a light receiving part, which has a photo-detector and high speed data acquisition system. The moving average method is operated with the control parameters: total number of raw traces, M, number of averaged traces, N, and step size of moving, n. The raw traces are obtained by the phase sensitive OTDR with sound signals generated by a speaker. Using these trace data, the relation of the control parameters is analyzed. In the result, if the event signal has one frequency, then the optimal values of N, n are existed to detect the event efficiently.

  8. Mesoscale simulations of shock compaction of a granular ceramic: effects of mesostructure and mixed-cell strength treatment

    Science.gov (United States)

    Derrick, J. G.; LaJeunesse, J. W.; Davison, T. M.; Borg, J. P.; Collins, G. S.

    2018-04-01

    The shock response of granular materials is important in a variety of contexts but the precise dynamics of grains during compaction is poorly understood. Here we use 2D mesoscale numerical simulations of the shock compaction of granular tungsten carbide to investigate the effect of internal structure within the particle bed and ‘stiction’ between grains on the shock response. An increase in the average number of contacts with other particles, per particle, tends to shift the Hugoniot to higher shock velocities, lower particle velocities and lower densities. This shift is sensitive to inter-particle shear resistance. Eulerian shock physics codes approximate friction between, and interlocking of, grains with their treatment of mixed cell strength (stiction) and here we show that this has a significant effect on the shock response. When studying the compaction of particle beds it is not common to quantify the pre-compaction internal structure, yet our results suggest that such differences should be taken into account, either by using identical beds or by averaging results over multiple experiments.

  9. The effect of the behavior of an average consumer on the public debt dynamics

    Science.gov (United States)

    De Luca, Roberto; Di Mauro, Marco; Falzarano, Angelo; Naddeo, Adele

    2017-09-01

    An important issue within the present economic crisis is understanding the dynamics of the public debt of a given country, and how the behavior of average consumers and tax payers in that country affects it. Starting from a model of the average consumer behavior introduced earlier by the authors, we propose a simple model to quantitatively address this issue. The model is then studied and analytically solved under some reasonable simplifying assumptions. In this way we obtain a condition under which the public debt steadily decreases.

  10. Renormalization, averaging, conservation laws and AdS (in)stability

    International Nuclear Information System (INIS)

    Craps, Ben; Evnin, Oleg; Vanhoof, Joris

    2015-01-01

    We continue our analytic investigations of non-linear spherically symmetric perturbations around the anti-de Sitter background in gravity-scalar field systems, and focus on conservation laws restricting the (perturbatively) slow drift of energy between the different normal modes due to non-linearities. We discover two conservation laws in addition to the energy conservation previously discussed in relation to AdS instability. A similar set of three conservation laws was previously noted for a self-interacting scalar field in a non-dynamical AdS background, and we highlight the similarities of this system to the fully dynamical case of gravitational instability. The nature of these conservation laws is best understood through an appeal to averaging methods which allow one to derive an effective Lagrangian or Hamiltonian description of the slow energy transfer between the normal modes. The conservation laws in question then follow from explicit symmetries of this averaged effective theory.

  11. Effect of treatment with natalizumab on ability to work in people with multiple sclerosis: productivity gain based on direct measurement of work capacity before and after 1 year of treatment.

    Science.gov (United States)

    Olofsson, Sara; Wickström, Anne; Häger Glenngård, Anna; Persson, Ulf; Svenningsson, Anders

    2011-10-01

    Sweden is a high endemic region for multiple sclerosis (MS), a neurologic disorder characterized by repeated inflammatory episodes affecting the CNS. The disease has its peak age of onset at approximately 30 years and affects women twice as often as men. The young age of onset makes MS one of the major causes of reduced capacity to work due to neurologic disease in Western society. Natalizumab (Tysabri®) is among the new generation of biologic drugs for the treatment of MS. Clinical studies have demonstrated that natalizumab is an effective treatment for preventing relapses and inflammatory activity. The aim of the study was to estimate the monetary value of treatment with natalizumab on the ability to work in patients with MS in Sweden, based on a direct measurement of weekly hours worked before and after 1 year of treatment with natalizumab. A sample of patients, consisting of all patients who had started treatment with natalizumab during the period June 2007-May 2008, was identified through the Swedish Multiple Sclerosis Register (SMSreg). Data about sex, age, disease severity, and disease duration were collected from the register. Data about type of work and work capacity (number of hours worked per week) were collected retrospectively through a postal questionnaire. The average hours worked per week was estimated at baseline (2 weeks before treatment started) and at follow-up (50 weeks after treatment started), and the change was assigned an economic value using the human capital approach. This study showed that after 50 weeks of treatment with natalizumab, people with MS increased their productivity by 3.3 hours per week on average (p productivity gain (p = 0.025 and p = 0.002, respectively). A shorter duration of illness and a lower age at the start of treatment were significantly associated with a greater productivity gain after 50 weeks of treatment with natalizumab, which indicates that it is more beneficial to initiate efficient therapy early

  12. Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia.

    Science.gov (United States)

    Luciani, Silvana; Gonzales, Miguel; Munoz, Sergio; Jeronimo, Jose; Robles, Sylvia

    2008-05-01

    To assess the effectiveness of cryotherapy treatment delivered by general practitioners in primary care settings, as part of a screen-and-treat approach for cervical cancer prevention. Women aged between 25 and 49 years residing in San Martin, Peru, who were positive on visual inspection screening were treated, if eligible, with cryotherapy following biopsy. At 12 months post cryotherapy treatment the participants were evaluated for treatment effectiveness and examined by visual inspection and Papanicolaou test and, if positive, referred to a gynecologist for colposcopy and biopsy. Cryotherapy treatment was performed for 1398 women; of these, 531 (38%) had a histology result of cervical intraepithelial neoplasia (CIN). Cryotherapy effectively cured CIN in 418 (88%) women, including 49 (70%) women with a baseline diagnosis of CIN 3. Cryotherapy is an effective treatment for cervical precancerous lesions; it can easily be administered by general practitioners in primary care settings following visual inspection screening.

  13. Parents' Reactions to Finding Out That Their Children Have Average or above Average IQ Scores.

    Science.gov (United States)

    Dirks, Jean; And Others

    1983-01-01

    Parents of 41 children who had been given an individually-administered intelligence test were contacted 19 months after testing. Parents of average IQ children were less accurate in their memory of test results. Children with above average IQ experienced extremely low frequencies of sibling rivalry, conceit or pressure. (Author/HLM)

  14. Comparison of power pulses from homogeneous and time-average-equivalent models

    International Nuclear Information System (INIS)

    De, T.K.; Rouben, B.

    1995-01-01

    The time-average-equivalent model is an 'instantaneous' core model designed to reproduce the same three dimensional power distribution as that generated by a time-average model. However it has been found that the time-average-equivalent model gives a full-core static void reactivity about 8% smaller than the time-average or homogeneous models. To investigate the consequences of this difference in static void reactivity in time dependent calculations, simulations of the power pulse following a hypothetical large-loss-of-coolant accident were performed with a homogeneous model and compared with the power pulse from the time-average-equivalent model. The results show that there is a much smaller difference in peak dynamic reactivity than in static void reactivity between the two models. This is attributed to the fact that voiding is not complete, but also to the retardation effect of the delayed-neutron precursors on the dynamic flux shape. The difference in peak reactivity between the models is 0.06 milli-k. The power pulses are essentially the same in the two models, because the delayed-neutron fraction in the time-average-equivalent model is lower than in the homogeneous model, which compensates for the lower void reactivity in the time-average-equivalent model. (author). 1 ref., 5 tabs., 9 figs

  15. Evaluations of average level spacings

    International Nuclear Information System (INIS)

    Liou, H.I.

    1980-01-01

    The average level spacing for highly excited nuclei is a key parameter in cross section formulas based on statistical nuclear models, and also plays an important role in determining many physics quantities. Various methods to evaluate average level spacings are reviewed. Because of the finite experimental resolution, to detect a complete sequence of levels without mixing other parities is extremely difficult, if not totally impossible. Most methods derive the average level spacings by applying a fit, with different degrees of generality, to the truncated Porter-Thomas distribution for reduced neutron widths. A method that tests both distributions of level widths and positions is discussed extensivey with an example of 168 Er data. 19 figures, 2 tables

  16. Telemedicine diabetes consultations are cost-effective, and effects on essential diabetes treatment parameters are similar to conventional treatment

    DEFF Research Database (Denmark)

    Levin, Klaus; Madsen, Jette R; Petersen, Inge

    2013-01-01

    been offered expert diabetes care using teleconsultations. This article describes the impact of the telemedicine solution on essential diabetes treatment parameters, patient satisfaction, and cost-effectiveness. METHODS: Telemedicine consultations were conducted with the patient and nurse specialist...... in transportation time (7 h). Reductions in traveling costs and saved working days were the most important factors in making the telemedicine set-up economically efficient. CONCLUSION: Telemedicine consultation for remote outpatient diabetes control is feasible, and the interdisciplinary interventions achieved high...... treatment quality results in essential diabetes treatment parameters. In addition, the telemedicine set-up was associated with improved cost-effectiveness and patient satisfaction....

  17. Effect of various solvents on the viscosity-average molecular weight of poly (vinyl acetate)

    International Nuclear Information System (INIS)

    Rehman, W.U.; But, M.A.; Chughtai, A.; Jamil, T.; Sattar, A.

    2006-01-01

    Solution polymerization of Vinyl Acetate was carried out in various solvents (benzene, toluene, ethyl acetate, acetonitrile). Dilute solution viscometry was used to determine the viscosity-average molecular weight of the resulting Poly (Vinyl Acetate) (PV Ac) in each case. The viscosity-average molecular weight (M,J of PVAc was found to increase in the order benzene < toluene < ethyl acetate < acetonitrile, It was concluded that under the same reaction conditions (polymerization time, initiator quantity, solvent/monomer ratio, temperature), acetonitrile served as the best solvent for solution. polymerization of Vinyl Acetate monomer. (author)

  18. Effectiveness of Educational Technology in Promoting Quality of Life and Treatment Adherence in Hypertensive People.

    Science.gov (United States)

    de Souza, Ana Célia Caetano; Moreira, Thereza Maria Magalhaes; Oliveira, Edmar Souza de; Menezes, Anaíze Viana Bezerra de; Loureiro, Aline Maria Oliveira; Silva, Camila Brasileiro de Araújo; Linard, Jair Gomes; Almeida, Italo Lennon Sales de; Mattos, Samuel Miranda; Borges, José Wicto Pereira

    2016-01-01

    The objective of this study was to test the effectiveness of an educational intervention with use of educational technology (flipchart) to promote quality of life (QOL) and treatment adherence in people with hypertension. It was an intervention study of before-and-after type conducted with 116 hypertensive people registered in Primary Health Care Units. The educational interventions were conducted using the flipchart educational technology. Quality of life was assessed through the MINICHAL (lowest score = better QOL) and the QATSH (higher score = better adherence) was used to assess the adherence to hypertension treatment. Both were measured before and after applying the intervention. In the analysis, we used the Student's t-test for paired data. The average baseline quality of life was 11.66 ± 7.55, and 7.71 ± 5.72 two months after the intervention, showing a statistically significant reduction (p educational intervention using the flipchart improved the total score of quality of life in the scores of physical and mental domains, and increased adherence to hypertension treatment in people with the disease.

  19. Averaged RMHD equations

    International Nuclear Information System (INIS)

    Ichiguchi, Katsuji

    1998-01-01

    A new reduced set of resistive MHD equations is derived by averaging the full MHD equations on specified flux coordinates, which is consistent with 3D equilibria. It is confirmed that the total energy is conserved and the linearized equations for ideal modes are self-adjoint. (author)

  20. Towards a framework for treatment effectiveness in schizophrenia

    Directory of Open Access Journals (Sweden)

    Juckel G

    2014-09-01

    Full Text Available Georg Juckel,1 Andrea de Bartolomeis,2 Philip Gorwood,3 Sergey Mosolov,4 Luca Pani,5 Alessandro Rossi,6 Julio Sanjuan7 1Department of Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany; 2Laboratory of Molecular Psychiatry and Unit of Treatment Resistant Psychosis, University School of Medicine of Naples Federico II, Napoli, Italy; 3Groupe Hospitalier Sainte-Anne (CMME, Paris-Descartes University, Paris, France; 4Moscow Research Institute of Psychiatry, Moscow, Russia; 5Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy; 6Università de L’Aquila, L’Aquila, Italy; 7Clinic Hospital, Spanish Mental Health Network (CIBERSAM, University of Valencia, Valencia, Spain Introduction: Prompt administration of antipsychotic treatment that is adhered to is essential for the optimal treatment of schizophrenia. Many patients have benefited from the advent of second-generation antipsychotics, which can offer good symptomatic control with reduced incidence of extrapyramidal symptoms, although with higher risk of metabolic side effects. It is unsurprising that accounts as to whether first- and second-generation antipsychotics differ in their efficacy vary, since treatment effectiveness is a broad notion and difficult to define. Objectives: Numerous factors may be used to gauge treatment effectiveness and, while it has largely been defined in terms of improvements in four domains (symptoms of disease, treatment burden, disease burden, and health and wellness, the real-world clinical utility of this consensus is unclear. Therefore, this article aims to provide a framework that can aid psychiatrists in making assessments about treatment effectiveness. Methods and results: A panel of 12 psychiatrists and psychopharmacologists convened to develop and propose an accessible and globally-applicable framework for assessing the effectiveness of antipsychotic treatments in patients with schizophrenia

  1. Average accelerator simulation Truebeam using phase space in IAEA format

    International Nuclear Information System (INIS)

    Santana, Emico Ferreira; Milian, Felix Mas; Paixao, Paulo Oliveira; Costa, Raranna Alves da; Velasco, Fermin Garcia

    2015-01-01

    In this paper is used a computational code of radiation transport simulation based on Monte Carlo technique, in order to model a linear accelerator of treatment by Radiotherapy. This work is the initial step of future proposals which aim to study several treatment of patient by Radiotherapy, employing computational modeling in cooperation with the institutions UESC, IPEN, UFRJ e COI. The Chosen simulation code is GATE/Geant4. The average accelerator is TrueBeam of Varian Company. The geometric modeling was based in technical manuals, and radiation sources on the phase space for photons, provided by manufacturer in the IAEA (International Atomic Energy Agency) format. The simulations were carried out in equal conditions to experimental measurements. Were studied photons beams of 6MV, with 10 per 10 cm of field, focusing on a water phantom. For validation were compared dose curves in depth, lateral profiles in different depths of the simulated results and experimental data. The final modeling of this accelerator will be used in future works involving treatments and real patients. (author)

  2. From conventional averages to individual dose painting in radiotherapy for human tumors: challenge to non-uniformity

    International Nuclear Information System (INIS)

    Maciejewski, B.; Rodney Withers, H.

    2004-01-01

    The exploitation of a number of current clinical trials and reports on outcomes after radiation therapy (i.e. breast, head and neck, prostate) in clinical practice reflects many limitations for conventional techniques and dose-fractionation schedules and for 'average' conclusions. Even after decades of evolution of radiation therapy we still do not know how to optimize treatment for the individual patient and only have 'averages' and ill-defined 'probabilities' to guide treatment prescription. Wide clinical and biological heterogeneity within the groups of patients recruited into clinical trials with a few-fold variation in tumour volume within one stage of disease is obvious. Basic radiobiological guidelines concerning average cell killing of uniformly distributed and equally radiosensitive tumour cells arose from elegant but idealistic in vitro experiments and seem to be of uncertain validity. Therefore, we are confronted with more dilemmas than dogmas. Nonlinearity and in homogeneity of human tumour pattern and response to irradiation are discussed. The purpose of this paper is to present and discuss various aspects of non-uniform tumour cell targeted radiotherapy using conformal and dose intensity modulated techniques. (author)

  3. Reproducing multi-model ensemble average with Ensemble-averaged Reconstructed Forcings (ERF) in regional climate modeling

    Science.gov (United States)

    Erfanian, A.; Fomenko, L.; Wang, G.

    2016-12-01

    Multi-model ensemble (MME) average is considered the most reliable for simulating both present-day and future climates. It has been a primary reference for making conclusions in major coordinated studies i.e. IPCC Assessment Reports and CORDEX. The biases of individual models cancel out each other in MME average, enabling the ensemble mean to outperform individual members in simulating the mean climate. This enhancement however comes with tremendous computational cost, which is especially inhibiting for regional climate modeling as model uncertainties can originate from both RCMs and the driving GCMs. Here we propose the Ensemble-based Reconstructed Forcings (ERF) approach to regional climate modeling that achieves a similar level of bias reduction at a fraction of cost compared with the conventional MME approach. The new method constructs a single set of initial and boundary conditions (IBCs) by averaging the IBCs of multiple GCMs, and drives the RCM with this ensemble average of IBCs to conduct a single run. Using a regional climate model (RegCM4.3.4-CLM4.5), we tested the method over West Africa for multiple combination of (up to six) GCMs. Our results indicate that the performance of the ERF method is comparable to that of the MME average in simulating the mean climate. The bias reduction seen in ERF simulations is achieved by using more realistic IBCs in solving the system of equations underlying the RCM physics and dynamics. This endows the new method with a theoretical advantage in addition to reducing computational cost. The ERF output is an unaltered solution of the RCM as opposed to a climate state that might not be physically plausible due to the averaging of multiple solutions with the conventional MME approach. The ERF approach should be considered for use in major international efforts such as CORDEX. Key words: Multi-model ensemble, ensemble analysis, ERF, regional climate modeling

  4. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    Peirce, Jessica M; Petry, Nancy M; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C; Royer-Malvestuto, Charlotte; Roll, John M; Cohen, Allan; Copersino, Marc L; Kolodner, Ken; Li, Rui

    2006-02-01

    Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial. Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was 120 dollars per participant. An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

  5. The effectiveness of samarium-153 (153Sm) lexidronam (EDTMP) in treatment of bone metastases

    International Nuclear Information System (INIS)

    Ma Yubo; Huang Gang; Liu Jianjun

    2004-01-01

    Objectives: To evaluate the effectiveness of samarium-153 (153Sm) lexidronam (EDTMP) in treatment of bone metastases. Methods: 380 patients with bone metastases were studied (221 men, 159 women; average age 65.3 y; ranged 27-91 y; average weight 59.3 kg, ranged 39-95 kg). The tumor types were prostate carcinoma (n=155), pulmonary carcinoma (n=92), breast cancer (n=57), gastric carcinoma (n=12), colorectal carcinoma (n=22), nasopharyngeal carcinoma (n=8), lymphoma (n=8), hepatic carcinoma (n=6), ovary carcinoma (n=4) and others (n=16). All patients were received 135Sm-EDTMP 0.8 or 1.0 mCi/kg during 1 to 7 course of treatment. Patients and physician evaluations were used to assess pain relief. Numbers of metastatic foci and activity of ROIs were used to observe post-therapy change in bone scanning. Results: In 380 patients, pain relief was observed in 257 patients (67.6%). Persistence of pain relief was seen through 2 to 24 weeks. The mean relief time is 5.8±3.4 weeks. KPS score was higher 10% than pre-therapy (71.2%±9.6% Vs 80.9%±10.3%, p<0.001). Numbers of metastatic foci (11.2+8.8 Vs 8.4±5.7, p<0.001) and activity of ROIs (3.28±2.04 Vs 2.15±0.94, p<0.01) were less than pre-therapy. Bone marrow suppression was mild and reversible (5.87±1.56 Vs 4.94±1.16 x 109/L). Conclusions: 153Sm-EDTMP provided relief of pain associated with bone metastases and inhibition of metastatic foci. As a relief drug of painful bone metastases, 153Sm-EDTMP is safe and effective. (authors)

  6. Effective physical treatment for chronic low back pain.

    Science.gov (United States)

    Maher, C G

    2004-01-01

    It is now feasible to adopt an evidence-based approach when providing physical treatment for patients with chronic LBP. A summary of the efficacy of a range of physical treatments is provided in Table 1. The evidence-based primary care options are exercise, laser, massage, and spinal manipulation; however, the latter three have small or transient effects that limit their value as therapies for chronic LBP. In contrast, exercise produces large reductions in pain and disability, a feature that suggests that exercise should play a major role in the management of chronic LBP. Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered. Outside of primary care, multidisciplinary treatment or functional restoration is effective; however, the high cost probably means that these programs should be reserved for patients who do not respond to cheaper treatment options for chronic LBP. Although there are now effective treatment options for chronic LBP, it needs to be acknowledged that the problem of chronic LBP is far from solved. Though treatments can provide marked improvements in the patient's condition, the available evidence suggests that the typical chronic LBP patient is left with some residual pain and disability. Developing new, more powerful treatments and refining the current group of known effective treatments is the challenge for the future.

  7. Effect of urea treatment on digestibility and utilization of sorghum straw

    Directory of Open Access Journals (Sweden)

    Nianogo A.J.

    1999-01-01

    Full Text Available Nine male goats and nine castrated lambs were randomly divided into three groups of six animals to receive one of three experimental diets in a digestion trial. Diet S, provided chopped sorghum straw (SS, 28/ concentrate (C and 10/ Dolichos lablab hay (D. Diet Su1 provided SS containing 2/ urea, 24/ C and 12/ D, and diet Sue1 provided SS treated to contain 2/ urea and ensiled for 28 days, plus 25/ C and 14/ D. Twenty four lambs were randomly divided into three groups of eight animals to receive one of three diets in a 56-day growth trial; diet S2 provided SS plus 60/ C; diet Su2 provided SS containing 2/ urea plus 60/ C, and diet Sue2 provided SS treated to contain 2/ urea and ensiled for 28 days, plus 60/ C. The digestion trial showed higher (P<.05 daily intake of dry matter, organic matter, crude protein and neutral detergent fiber for S, than for Sue1 and Su1. Dry matter intake was 55.93; 39.42 and 42.34 g[kgE0.75E-1 for S1, Su1 and Sue1, respectively. Dry matter intake was slightly higher for lambs [50 g[kgE0.75E-1] than for goats [42 g[kE0.75E-1]. There was no effect of dietary treatments on apparent nutrient digestibility. During the growth trial, intake of straw varied from 17.97 (S2 to 24.78 g[kgE0.75E-1 (Sue2, but differences were not significant. Daily gain did not differ between treatments. Total feed intake and feed efficiency were only slightly affected by dietary treatments. Average feed intake was 4.36/ of body weight. High concentrate intakes may have upset the effect of urea treatment and silo fermentation in this study.

  8. Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews.

    Science.gov (United States)

    Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar

    2017-06-19

    Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of

  9. Modeling the cost-effectiveness of ilaprazole versus omeprazole for the treatment of newly diagnosed duodenal ulcer patients in China.

    Science.gov (United States)

    Xuan, J W; Song, R L; Xu, G X; Lu, W Q; Lu, Y J; Liu, Z

    2016-11-01

    To evaluate the cost-effectiveness of 10 mg ilaprazole once-daily vs 20 mg omeprazole once-daily to treat newly-diagnosed duodenal ulcer patients in China. A decision tree model was constructed and the treatment impact was projected up to 1 year. The CYP2C19 polymorphism distribution in the Chinese population, the respective cure rates in the CYP2C19 genotype sub-groups, the impact of Duodenal Ulcer (DU) on utility value and drug-related side-effect data were obtained from the literature. The total costs of medications were calculated to estimate the treatment costs based on current drug retail prices in China. Expert surveys were conducted when published data were not available. Probabilistic sensitivity analysis was performed to gauge the robustness of the results. Ilaprazole, when compared with omeprazole, achieved a better overall clinical efficacy. For the overall population, ilaprazole achieved an incremental cost effectiveness ratio (ICER) of ¥132 056 per QALY gained. This is less than the WHO recommended threshold of 3-times the average GDP per capita in China (2014). Furthermore, sub-group analysis showed that ilaprazole is cost-effective in every province in CYP2C19 hetEM patients and in the most developed provinces in CYP2C19 homEM patients. Probabilistic sensitivity analysis suggests that the results are robust with 97% probability that ilaprozole is considered cost-effective when a threshold of 3-times China's average GDP per capita is considered. This study didn't have the data of ilaprazole combined with Hp eradication therapy. Caution should be taken when extrapolating these findings to DU patients with an Hp eradication therapy. The cost-effectiveness analysis results demonstrated that ilaprazole would be considered a cost-effective therapy, compared with omeprazole, in Chinese DU patients based on the efficacy projections in various CYP2C19 polymorphism types.

  10. Treatment effect, postoperative complications, and their reasons in juvenile thoracic and lumbar spinal tuberculosis surgery.

    Science.gov (United States)

    He, Qing-Yi; Xu, Jian-Zhong; Zhou, Qiang; Luo, Fei; Hou, Tianyong; Zhang, Zehua

    2015-10-01

    Fifty-four juvenile cases under 18 years of age with thoracic and lumbar spinal tuberculosis underwent focus debridement, deformity correction, bone graft fusion, and internal fixation. The treatment effects, complications, and reasons were analyzed retrospectively. There were 54 juvenile cases under 18 years of age with thoracolumbar spinal tuberculosis. The average age was 9.2 years old, and the sample comprised 38 males and 16 females. The disease types included 28 thoracic cases, 17 thoracolumbar cases, and 9 lumbar cases. Nerve function was evaluated with the Frankel classification. Thirty-six cases were performed with focus debridement and deformity correction and were supported with allograft or autograft in mesh and fixed with pedicle screws from a posterior approach. Eight cases underwent a combined anterior and posterior surgical approach. Nine cases underwent osteotomy and deformity correction, and one case received focus debridement. The treatment effects, complications, and bone fusions were tracked for an average of 52 months. According to the Frankel classification, paralysis was improved from 3 cases of B, 8 cases of C, 18 cases of D, and 25 cases of E preoperatively. This improvement was found in 3 cases of C, 6 cases of D, and 45 cases of E at a final follow-up postoperatively. No nerve dysfunction was aggravated. VAS was improved from 7.8 ± 1.7 preoperatively to 3.2 ± 2.1 at final follow-up postoperatively. ODI was improved from 77.5 ± 17.3 preoperatively to 28.4 ± 15.9 at final follow-up postoperatively. Kyphosis Cobb angle improved from 62.2° ± 3.7° preoperatively to 37° ± 2.4° at final follow-up postoperatively. Both of these are significant improvements, and all bone grafts were fused. Complications related to the operation occurred in 31.5% (17/54) of cases. Six cases suffered postoperative aggravated kyphosis deformity, eight cases suffered proximal kyphosis deformity, one case suffered pedicle penetration

  11. Effect of carprofen treatment following experimentally induced Escherichia coli mastitis in primiparous cows.

    Science.gov (United States)

    Vangroenweghe, F; Duchateau, L; Boutet, P; Lekeux, P; Rainard, P; Paape, M J; Burvenich, C

    2005-07-01

    Acute Escherichia coli mastitis is one of the major sources of economic loss in the dairy industry due to reduced milk production, treatment costs, discarded milk, and occasional fatal disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used as adjunctive therapy to antibiotics. The objective of the current study was to evaluate the effect of carprofen treatment following infusion of Escherichia coli into the mammary glands of primiparous cows during the periparturient period. Severity of mastitis was scored based on the average milk production in the uninfected quarters on d +2 postinoculation and a clinical severity score. Carprofen was administered intravenously at 9 h postchallenge, when clinical signs of mastitis appeared. In previous work, efficacy of NSAIDs was mainly evaluated using clinical symptoms. In the present study, the effect of carprofen on innate immune response was also assessed by quantification of inflammatory mediators. All primiparous cows reacted as moderate responders throughout the experimental period. Primiparous cows were intramammarily inoculated with 1 x 10(4) cfu of E. coli P4:O32 in 2 left quarters. Analysis of blood and milk parameters, including IL-8, complement component C5a, lipopolysaccharide-binding protein (LBP), soluble CD14, prostaglandin E2, and thromboxane B2 was performed from d 0 to d +6 relative to intramammary inoculation. Rectal temperature in carprofen-treated animals was lower than in control animals at 3 and 6 h posttreatment. Treatment also restored the decreased reticulorumen motility that occurs during E. coli mastitis to preinfection levels faster than in control animals. Carprofen treatment resulted in an earlier normalization of the clinical severity score. Eicosanoid (prostaglandin E2 and thromboxane B2) production in milk tended to be inhibited by carprofen. No significant differences in the kinetic patterns of somatic cell count, IL-8, complement component C5a, LBP, and soluble CD14 were

  12. Average Distance Travelled To School by Primary and Secondary ...

    African Journals Online (AJOL)

    This study investigated average distance travelled to school by students in primary and secondary schools in Anambra, Enugu, and Ebonyi States and effect on attendance. These are among the top ten densely populated and educationally advantaged States in Nigeria. Research evidences report high dropout rates in ...

  13. Impact of trees on pollutant dispersion in street canyons: A numerical study of the annual average effects in Antwerp, Belgium.

    Science.gov (United States)

    Vranckx, Stijn; Vos, Peter; Maiheu, Bino; Janssen, Stijn

    2015-11-01

    Effects of vegetation on pollutant dispersion receive increased attention in attempts to reduce air pollutant concentration levels in the urban environment. In this study, we examine the influence of vegetation on the concentrations of traffic pollutants in urban street canyons using numerical simulations with the CFD code OpenFOAM. This CFD approach is validated against literature wind tunnel data of traffic pollutant dispersion in street canyons. The impact of trees is simulated for a variety of vegetation types and the full range of approaching wind directions at 15° interval. All these results are combined using meteo statistics, including effects of seasonal leaf loss, to determine the annual average effect of trees in street canyons. This analysis is performed for two pollutants, elemental carbon (EC) and PM10, using background concentrations and emission strengths for the city of Antwerp, Belgium. The results show that due to the presence of trees the annual average pollutant concentrations increase with about 8% (range of 1% to 13%) for EC and with about 1.4% (range of 0.2 to 2.6%) for PM10. The study indicates that this annual effect is considerably smaller than earlier estimates which are generally based on a specific set of governing conditions (1 wind direction, full leafed trees and peak hour traffic emissions). Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Improving sensitivity in micro-free flow electrophoresis using signal averaging

    Science.gov (United States)

    Turgeon, Ryan T.; Bowser, Michael T.

    2009-01-01

    Microfluidic free-flow electrophoresis (μFFE) is a separation technique that separates continuous streams of analytes as they travel through an electric field in a planar flow channel. The continuous nature of the μFFE separation suggests that approaches more commonly applied in spectroscopy and imaging may be effective in improving sensitivity. The current paper describes the S/N improvements that can be achieved by simply averaging multiple images of a μFFE separation; 20–24-fold improvements in S/N were observed by averaging the signal from 500 images recorded for over 2 min. Up to an 80-fold improvement in S/N was observed by averaging 6500 images. Detection limits as low as 14 pM were achieved for fluorescein, which is impressive considering the non-ideal optical set-up used in these experiments. The limitation to this signal averaging approach was the stability of the μFFE separation. At separation times longer than 20 min bubbles began to form at the electrodes, which disrupted the flow profile through the device, giving rise to erratic peak positions. PMID:19319908

  15. Intra-event isotope and raindrop size data of tropical rain reveal effects concealed by event averaged data

    Science.gov (United States)

    Managave, S. R.; Jani, R. A.; Narayana Rao, T.; Sunilkumar, K.; Satheeshkumar, S.; Ramesh, R.

    2016-08-01

    Evaporation of rain is known to contribute water vapor, a potent greenhouse gas, to the atmosphere. Stable oxygen and hydrogen isotopic compositions (δ18O and, δD, respectively) of precipitation, usually measured/presented as values integrated over rain events or monthly mean values, are important tools for detecting evaporation effects. The slope ~8 of the linear relationship between such time-averaged values of δD and δ18O (called the meteoric water line) is widely accepted as a proof of condensation under isotopic equilibrium and absence of evaporation of rain during atmospheric fall. Here, through a simultaneous investigation of the isotopic and drop size distributions of seventeen rain events sampled on an intra-event scale at Gadanki (13.5°N, 79.2°E), southern India, we demonstrate that the evaporation effects, not evident in the time-averaged data, are significantly manifested in the sub-samples of individual rain events. We detect this through (1) slopes significantly less than 8 for the δD-δ18O relation on intra-event scale and (2) significant positive correlations between deuterium excess ( d-excess = δD - 8*δ18O; lower values in rain indicate evaporation) and the mass-weighted mean diameter of the raindrops ( D m ). An estimated ~44 % of rain is influenced by evaporation. This study also reveals a signature of isotopic equilibration of rain with the cloud base vapor, the processes important for modeling isotopic composition of precipitation. d-excess values of rain are modified by the post-condensation processes and the present approach offers a way to identify the d-excess values least affected by such processes. Isotope-enabled global circulation models could be improved by incorporating intra-event isotopic data and raindrop size dependent isotopic effects.

  16. Oculomotor and neuropsychological effects of antipsychotic treatment for schizophrenia

    Directory of Open Access Journals (Sweden)

    Kristian S. Hill

    2009-04-01

    Full Text Available Cognitive enhancement has become an important target for drug therapies in schizophrenia. Treatment development in this area requires assessment approaches that are sensitive to procognitive effects of antipsychotic and adjunctive treatments. Ideally, new treatments will have translational characteristics for parallel human and animal research. Previous studies of antipsychotic effects on cognition have relied primarily on paper-and-pencil neuropsychological testing. No study has directly compared neurophysiological biomarkers and neuropsychological testing as strategies for assessing cognitive effects of antipsychotic treatment early in the course of schizophrenia. Anti psychotic-naive patients with schizophrenia were tested before treatment with risperidone and again 6 weeks later. Matched healthy participants were tested over a similar time period. Test-retest reliability, effect sizes of within-subject change, and multivariate/univariate analysis of variance were used to compare 3 neurophysiological tests (visually guided saccade, memory-guided saccade, and antisaccade with neuropsychological tests covering 4 cognitive domains (executive function, attention, memory, and manual motor function. While both measurement approaches showed robust neurocognitive impairments in patients prior to risperidone treatment, oculomotor biomarkers were more sensitive to treatment-related effects on neurocognitive function than traditional neuropsychological measures. Further, unlike the pattern of modest generalized cognitive improvement suggested by neuropsychological measures, the oculomotor findings revealed a mixed pattern of beneficial and adverse treatment related effects. These findings warrant further investigation regarding the utility of neurophysiological biomarkers for assessing cognitive outcomes of antipsychotic treatment in clinical trials and in early-phase drug development.

  17. Strengthened glass for high average power laser applications

    International Nuclear Information System (INIS)

    Cerqua, K.A.; Lindquist, A.; Jacobs, S.D.; Lambropoulos, J.

    1987-01-01

    Recent advancements in high repetition rate and high average power laser systems have put increasing demands on the development of improved solid state laser materials with high thermal loading capabilities. The authors have developed a process for strengthening a commercially available Nd doped phosphate glass utilizing an ion-exchange process. Results of thermal loading fracture tests on moderate size (160 x 15 x 8 mm) glass slabs have shown a 6-fold improvement in power loading capabilities for strengthened samples over unstrengthened slabs. Fractographic analysis of post-fracture samples has given insight into the mechanism of fracture in both unstrengthened and strengthened samples. Additional stress analysis calculations have supported these findings. In addition to processing the glass' surface during strengthening in a manner which preserves its post-treatment optical quality, the authors have developed an in-house optical fabrication technique utilizing acid polishing to minimize subsurface damage in samples prior to exchange treatment. Finally, extension of the strengthening process to alternate geometries of laser glass has produced encouraging results, which may expand the potential or strengthened glass in laser systems, making it an exciting prospect for many applications

  18. 40 CFR 600.510-12 - Calculation of average fuel economy and average carbon-related exhaust emissions.

    Science.gov (United States)

    2010-07-01

    ... and average carbon-related exhaust emissions. 600.510-12 Section 600.510-12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF... Transportation. (iv) [Reserved] (2) Average carbon-related exhaust emissions will be calculated to the nearest...

  19. Cost-effective treatment for the couple with infertility.

    Science.gov (United States)

    Van Voorhis, B J; Syrop, C H

    2000-12-01

    Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated.

  20. An Experimental Study Related to Planning Abilities of Gifted and Average Students

    Directory of Open Access Journals (Sweden)

    Marilena Z. Leana-Taşcılar

    2016-02-01

    Full Text Available Gifted students differ from their average peers in psychological, social, emotional and cognitive development. One of these differences in the cognitive domain is related to executive functions. One of the most important executive functions is planning and organization ability. The aim of this study was to compare planning abilities of gifted students with those of their average peers and to test the effectiveness of a training program on planning abilities of gifted students and average students. First, students’ intelligence and planning abilities were measured and then assigned to either experimental or control group. The groups were matched by intelligence and planning ability (experimental: (13 gifted and 8 average; control: 14 gifted and 8 average. In total 182 students (79 gifted and 103 average participated in the study. Then, a training program was implemented in the experimental group to find out if it improved students’ planning ability. Results showed that boys had better planning abilities than girls did, and gifted students had better planning abilities than their average peers did. Significant results were obtained in favor of the experimental group in the posttest scores

  1. A counterfactual impact evaluation of a bilingual program on students' grade point average at a spanish university.

    Science.gov (United States)

    Arco-Tirado, J L; Fernández-Martín, F; Ramos-García, A M; Littvay, L; Villoria, J; Naranjo, J A

    2018-02-21

    This observational study intends to estimate the causal effects of an English as a Medium of Instruction (EMI) program (as predictor) on students Grade Point Average (GPA) (as outcome) at a particular University in Spain by using a Counterfactual Impact Evaluation (CIE). The need to address the crucial question of causal inferences in EMI programs to produce credible evidences of successful interventions contrasts, however, with the absence of experimental or quasi-experimental research and evaluation designs in the field. CIE approach is emerging as a methodologically viable solution to bridge that gap. The program evaluated here consisted in delivering an EMI program in a Primary Education Teacher Training Degree group. After achieving balance on the observed covariates and recreating a situation that would have been expected in a randomized experiment, three matching approaches such as genetic matching, nearest neighbor matching and Coarsened Exact Matching were used to analyze observational data from a total of 1288 undergraduate students, including both treatment and control group. Results show unfavorable effects of the bilingual group treatment condition. Potential interpretations and recommendations are provided in order to strengthen future causal evidences of bilingual education programs' effectiveness in Higher Education. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. [Contingency management in opioid substitution treatment].

    Science.gov (United States)

    Specka, M; Böning, A; Scherbaum, N

    2011-07-01

    The majority of opiate-dependent patients in substitution treatment show additional substance-related disorders. Concomitant use of heroin, alcohol, benzodiazepines or cocaine compromises treatment success. Concomitant drug use may be treated by using contingency management (CM) which is based on learning theory. In CM, abstinence from drugs, as verified by drug screenings, is reinforced directly and contingently. Reinforcers used in CM studies with substituted patients were, amongst others, vouchers and take-home privileges. Studies in the USA show a medium average effect of CM on drug consumption rates and abstinence. The effects decrease markedly after the end of the intervention. We discuss whether CM is applicable within the German substitution treatment system and how it can be combined with other interventions such as selective detoxification treatments or cognitive-behavioural programmes. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Instrumental variable estimation of treatment effects for duration outcomes

    NARCIS (Netherlands)

    G.E. Bijwaard (Govert)

    2007-01-01

    textabstractIn this article we propose and implement an instrumental variable estimation procedure to obtain treatment effects on duration outcomes. The method can handle the typical complications that arise with duration data of time-varying treatment and censoring. The treatment effect we

  4. A time-averaged cosmic ray propagation theory

    International Nuclear Information System (INIS)

    Klimas, A.J.

    1975-01-01

    An argument is presented, which casts doubt on our ability to choose an appropriate magnetic field ensemble for computing the average behavior of cosmic ray particles. An alternate procedure, using time-averages rather than ensemble-averages, is presented. (orig.) [de

  5. Effects of in situ plasma treatment on optical and electrical properties of index-matched transparent conducting oxide layer

    International Nuclear Information System (INIS)

    Lim, Yong Hwan; Yoo, Hana; Choi, Bum Ho; Kim, Young Baek; Lee, Jong Ho; Shin, Dong Chan

    2010-01-01

    We investigated the effects of in situ plasma-treatment on optical and electrical properties of index-matched indium tin oxide (IMITO) thin film. To render the IMITO-coated surface hydrophilic and study the optical and electrical characteristics, we performed in situ oxygen plasma post-treatment without breaking vacuum. The 94.6% transmittance in the visible wavelength range (400-700 nm) increased on average to 96.4% and the maximum transmittance reached 98% over a broad wavelength range. The surface roughness and sheet resistance improved from 0.9 nm and 200 Ω/sq to 0.0905 nm and 100 Ω/sq, respectively, by in situ plasma post-treatment. We confirmed by contact angle measurement that the hydrophobic IMITO surface was altered to hydrophilic. The improved optical and electrical characteristics of in situ plasma-treated IMITO makes it adequate for high-resolution liquid crystal on silicon displays.

  6. Electrical method for the measurements of volume averaged electron density and effective coupled power to the plasma bulk

    Science.gov (United States)

    Henault, M.; Wattieaux, G.; Lecas, T.; Renouard, J. P.; Boufendi, L.

    2016-02-01

    Nanoparticles growing or injected in a low pressure cold plasma generated by a radiofrequency capacitively coupled capacitive discharge induce strong modifications in the electrical parameters of both plasma and discharge. In this paper, a non-intrusive method, based on the measurement of the plasma impedance, is used to determine the volume averaged electron density and effective coupled power to the plasma bulk. Good agreements are found when the results are compared to those given by other well-known and established methods.

  7. Beyond the treatment effect: Evaluating the effects of patient preferences in randomised trials.

    Science.gov (United States)

    Walter, S D; Turner, R; Macaskill, P; McCaffery, K J; Irwig, L

    2017-02-01

    The treatments under comparison in a randomised trial should ideally have equal value and acceptability - a position of equipoise - to study participants. However, it is unlikely that true equipoise exists in practice, because at least some participants may have preferences for one treatment or the other, for a variety of reasons. These preferences may be related to study outcomes, and hence affect the estimation of the treatment effect. Furthermore, the effects of preferences can sometimes be substantial, and may even be larger than the direct effect of treatment. Preference effects are of interest in their own right, but they cannot be assessed in the standard parallel group design for a randomised trial. In this paper, we describe a model to represent the impact of preferences on trial outcomes, in addition to the usual treatment effect. In particular, we describe how outcomes might differ between participants who would choose one treatment or the other, if they were free to do so. Additionally, we investigate the difference in outcomes depending on whether or not a participant receives his or her preferred treatment, which we characterise through a so-called preference effect. We then discuss several study designs that have been proposed to measure and exploit data on preferences, and which constitute alternatives to the conventional parallel group design. Based on the model framework, we determine which of the various preference effects can or cannot be estimated with each design. We also illustrate these ideas with some examples of preference designs from the literature.

  8. The effect of different physiotherapy interventions in post-BTX-A treatment of children with cerebral palsy.

    Science.gov (United States)

    Desloovere, K; De Cat, J; Molenaers, G; Franki, I; Himpens, E; Van Waelvelde, H; Fagard, K; Van den Broeck, C

    2012-01-01

    To distinguish the effects of different physiotherapeutic programs in a post BTX-A regime for children with Cerebral Palsy (CP). Retrospective, controlled intervention study. A group of 38 children (X¯ = 7y7m, GMFCS I-III, 27 bilateral, 11 unilateral CP) receiving an individually defined Neurodevelopment Treatment (NDT) program, was matched and compared to a group of children with the same age, GMFCS and diagnosis, receiving more conventional physiotherapy treatment. All patients received selective tone-reduction by means of multilevel BTX-A injections and adequate follow-up treatment, including physiotherapy. Three-dimensional gait analyses and clinical examination was performed pre and two months post-injection. Treatment success was defined using the Goal Attainment Scale (GAS). Both groups' mean converted GAS scores were above 50. The average converted GAS score was higher in the group of children receiving NDT than in the group receiving conventional physiotherapy (p physiotherapy group. Especially for the goals based on gait analyses (p children with bilateral CP (p physiotherapy approach. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  9. Effects of Cancer Treatment on Fertility (For Parents)

    Science.gov (United States)

    ... Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Effects of Cancer Treatment on Fertility KidsHealth / For Parents / Effects of Cancer Treatment on ...

  10. Improving consensus structure by eliminating averaging artifacts

    Directory of Open Access Journals (Sweden)

    KC Dukka B

    2009-03-01

    Full Text Available Abstract Background Common structural biology methods (i.e., NMR and molecular dynamics often produce ensembles of molecular structures. Consequently, averaging of 3D coordinates of molecular structures (proteins and RNA is a frequent approach to obtain a consensus structure that is representative of the ensemble. However, when the structures are averaged, artifacts can result in unrealistic local geometries, including unphysical bond lengths and angles. Results Herein, we describe a method to derive representative structures while limiting the number of artifacts. Our approach is based on a Monte Carlo simulation technique that drives a starting structure (an extended or a 'close-by' structure towards the 'averaged structure' using a harmonic pseudo energy function. To assess the performance of the algorithm, we applied our approach to Cα models of 1364 proteins generated by the TASSER structure prediction algorithm. The average RMSD of the refined model from the native structure for the set becomes worse by a mere 0.08 Å compared to the average RMSD of the averaged structures from the native structure (3.28 Å for refined structures and 3.36 A for the averaged structures. However, the percentage of atoms involved in clashes is greatly reduced (from 63% to 1%; in fact, the majority of the refined proteins had zero clashes. Moreover, a small number (38 of refined structures resulted in lower RMSD to the native protein versus the averaged structure. Finally, compared to PULCHRA 1, our approach produces representative structure of similar RMSD quality, but with much fewer clashes. Conclusion The benchmarking results demonstrate that our approach for removing averaging artifacts can be very beneficial for the structural biology community. Furthermore, the same approach can be applied to almost any problem where averaging of 3D coordinates is performed. Namely, structure averaging is also commonly performed in RNA secondary prediction 2, which

  11. Improved treatment of radiation effects on the skin

    International Nuclear Information System (INIS)

    Wandl, E.O.; Kaercher, K.H.; Wandl-Hainberger, I.

    1985-01-01

    The treatment concept developed by K.H. Kaercher was extended by a therapy using Elasten S cream. In the course of a highvoltage therapy using fast electrons or cobalt-60, interesting aspects in the treatment and progression of the radiation reactions of the skin were established. The dermato-therapeutic principles layed down by K.H. Kaercher with the treatment palette used hitherto, have without doubt invariably proven their value. The exclusive powder treatment, however, may be made more practical by application of the new treatment cream in accordance with the intervals in radiation treatment or as a basic treatment towards the end of therapy. Furthermore it is ideally suited for the care and after-treatment of skin, strained by radiation. It reduces considerably the remaining visible radiation reactions. The treatment with powder and emulsion has for more than 10 years proven effective. After the excellent results of the new cream during radiation treatment, additional positive effects are expected in a long-term trial which will be reported on separately. (orig.) [de

  12. SU-E-T-174: Evaluation of the Optimal Intensity Modulated Radiation Therapy Plans Done On the Maximum and Average Intensity Projection CTs

    Energy Technology Data Exchange (ETDEWEB)

    Jurkovic, I [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Stathakis, S; Li, Y; Patel, A; Vincent, J; Papanikolaou, N; Mavroidis, P [Cancer Therapy and Research Center University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States)

    2014-06-01

    Purpose: To determine the difference in coverage between plans done on average intensity projection and maximum intensity projection CT data sets for lung patients and to establish correlations between different factors influencing the coverage. Methods: For six lung cancer patients, 10 phases of equal duration through the respiratory cycle, the maximum and average intensity projections (MIP and AIP) from their 4DCT datasets were obtained. MIP and AIP datasets had three GTVs delineated (GTVaip — delineated on AIP, GTVmip — delineated on MIP and GTVfus — delineated on each of the 10 phases and summed up). From the each GTV, planning target volumes (PTV) were then created by adding additional margins. For each of the PTVs an IMRT plan was developed on the AIP dataset. The plans were then copied to the MIP data set and were recalculated. Results: The effective depths in AIP cases were significantly smaller than in MIP (p < 0.001). The Pearson correlation coefficient of r = 0.839 indicates strong degree of positive linear relationship between the average percentage difference in effective depths and average PTV coverage on the MIP data set. The V2 0 Gy of involved lung depends on the PTV coverage. The relationship between PTVaip mean CT number difference and PTVaip coverage on MIP data set gives r = 0.830. When the plans are produced on MIP and copied to AIP, r equals −0.756. Conclusion: The correlation between the AIP and MIP data sets indicates that the selection of the data set for developing the treatment plan affects the final outcome (cases with high average percentage difference in effective depths between AIP and MIP should be calculated on AIP). The percentage of the lung volume receiving higher dose depends on how well PTV is covered, regardless of on which set plan is done.

  13. Effects of Maitland manual therapy on the treatment of pain syndromes of the cervical spine

    Directory of Open Access Journals (Sweden)

    Ireneusz Dzierżek

    2017-03-01

    Full Text Available Introduction: The aim of this study was evaluate the effect of Maitland's manual therapy on selected motor function parameters in cervical spine pain syndromes. Material and Methods: 30 subjects were enrolled, in the age from 27 to 66, including 15 men and 15 women with chronic functional cervical spine syndrome who had a 10-day physiotherapy cycle that did not produce the expected results. The study included: pain assessment in the Dziak scale, measurements of mobility of the cervical spine and shoulder joints, functional evaluation by Hautanta, De`Klein, Jackson, and palpation of muscle irritation. Results: A comparison of average pain scores before and after therapy indicated that the pain level after treatment decreased (p 0.05. There has been a decrease in positive clinical trials and muscle irritation after therapy. Conclusions: Maitland manual therapy is effective in the treatment of cervical spine pain syndromes. The technique results in a significant increase in the mobility of the cervical spine as well as an improvement in the functional state of the cervical segment without affecting the mobility of the shoulder ridge. There was a decrease in palpate tenderness of the soft tissue studied.

  14. Role of spatial averaging in multicellular gradient sensing.

    Science.gov (United States)

    Smith, Tyler; Fancher, Sean; Levchenko, Andre; Nemenman, Ilya; Mugler, Andrew

    2016-05-20

    Gradient sensing underlies important biological processes including morphogenesis, polarization, and cell migration. The precision of gradient sensing increases with the length of a detector (a cell or group of cells) in the gradient direction, since a longer detector spans a larger range of concentration values. Intuition from studies of concentration sensing suggests that precision should also increase with detector length in the direction transverse to the gradient, since then spatial averaging should reduce the noise. However, here we show that, unlike for concentration sensing, the precision of gradient sensing decreases with transverse length for the simplest gradient sensing model, local excitation-global inhibition. The reason is that gradient sensing ultimately relies on a subtraction of measured concentration values. While spatial averaging indeed reduces the noise in these measurements, which increases precision, it also reduces the covariance between the measurements, which results in the net decrease in precision. We demonstrate how a recently introduced gradient sensing mechanism, regional excitation-global inhibition (REGI), overcomes this effect and recovers the benefit of transverse averaging. Using a REGI-based model, we compute the optimal two- and three-dimensional detector shapes, and argue that they are consistent with the shapes of naturally occurring gradient-sensing cell populations.

  15. A depth-averaged debris-flow model that includes the effects of evolving dilatancy. I. physical basis

    Science.gov (United States)

    Iverson, Richard M.; George, David L.

    2014-01-01

    To simulate debris-flow behaviour from initiation to deposition, we derive a depth-averaged, two-phase model that combines concepts of critical-state soil mechanics, grain-flow mechanics and fluid mechanics. The model's balance equations describe coupled evolution of the solid volume fraction, m, basal pore-fluid pressure, flow thickness and two components of flow velocity. Basal friction is evaluated using a generalized Coulomb rule, and fluid motion is evaluated in a frame of reference that translates with the velocity of the granular phase, vs. Source terms in each of the depth-averaged balance equations account for the influence of the granular dilation rate, defined as the depth integral of ∇⋅vs. Calculation of the dilation rate involves the effects of an elastic compressibility and an inelastic dilatancy angle proportional to m−meq, where meq is the value of m in equilibrium with the ambient stress state and flow rate. Normalization of the model equations shows that predicted debris-flow behaviour depends principally on the initial value of m−meq and on the ratio of two fundamental timescales. One of these timescales governs downslope debris-flow motion, and the other governs pore-pressure relaxation that modifies Coulomb friction and regulates evolution of m. A companion paper presents a suite of model predictions and tests.

  16. Automobile fuel economy : potential effects of increasing the corporate average fuel economy standards

    Science.gov (United States)

    2000-08-01

    Between 1981 and 1999, the average price of gasoline, adjusted for inflation, declined more than 60 percent. During the same period, the U.S. transportation sector's consumption of oil rose from less than 10 million to nearly 13 million barrels per d...

  17. Effect of soil fortified by polyurethane foam on septic tank effluent treatment.

    Science.gov (United States)

    Nie, J Y; Zhu, N W; Lin, K M; Song, F Y

    2011-01-01

    Fortified soil was made up of a mixture at a mass ratio 4/1000-6/1000 of sponge and natural soil according to the results of column experiment. The fortified soil had bigger porosity and higher hydraulic conductivity than the natural soil. The columns packed with 900 mm of the fortified soil endured a flow rate equivalent to 100 L/m(2)/d of septic tank effluent and the average chemical oxygen demand, nitrogen, and phosphorus removal rates were around 92%, 75% and 96%, respectively. After 100 weeks of operation, the saturated hydraulic conductivity of the fortified soil kept higher than 0.2 m/d. The bigger porosity of sponge improved the effective porosity, and the bigger specific surface area of sponge acted as an ideal support for biomat growth and ensured the sewage treatment performance of the fortified soil. The comparable performance was due to a similar and sufficient degree of soil clogging genesis coupled with bioprocesses that effectively purified the septic tank effluent given the adequate retention times.

  18. The association of long-term treatment-related side effects with cancer-specific and general quality of life among prostate cancer survivors.

    Science.gov (United States)

    Davis, Kimberly M; Kelly, Scott P; Luta, George; Tomko, Catherine; Miller, Anthony B; Taylor, Kathryn L

    2014-08-01

    To examine the association between treatment-related side effects and cancer-specific and general quality of life (QOL) among long-term prostate cancer survivors. Within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we conducted telephone interviews with prostate cancer survivors (N = 518) who were 5-10 years after diagnosis. We assessed demographic and clinical information, sexual, urinary, and bowel treatment-related side effects (Expanded Prostate Cancer Index Composite), cancer-specific QOL (Functional Assessment of Cancer Therapy--total score), and general QOL (the Medical Outcomes Study Short Form 12's physical and mental subscales). Participants were aged 74.6 years on average, primarily White (88.4%), and married (81.7%). Pearson correlation coefficients between the 3 treatment-related side effect domains (urinary, sexual, and bowel) and QOL ranged between 0.14 and 0.42 (P functioning and greater bowel side effects were independently associated with poorer cancer-specific QOL (P functions were also associated with poorer general QOL on the Medical Outcomes Study Short Form 12's physical component summary and mental component summary (P side effects demonstrated the strongest association with all QOL outcomes. Treatment-related side effects persisted for up to 10 years after diagnosis and continued to be associated with men's QOL. These results suggest that each of the treatment-related side effects was independently associated with cancer-specific QOL. Compared with the other Expanded Prostate Cancer Index Composite domains, bowel side effects had the strongest association with cancer-specific and general QOL. These associations emphasize the tremendous impact that bowel side effects continue to have for men many years after their initial diagnosis. Copyright © 2014. Published by Elsevier Inc.

  19. Advanced pulse oximeter signal processing technology compared to simple averaging. I. Effect on frequency of alarms in the operating room.

    Science.gov (United States)

    Rheineck-Leyssius, A T; Kalkman, C J

    1999-05-01

    To determine the effect of a new signal processing technique (Oxismart, Nellcor, Inc., Pleasanton, CA) on the incidence of false pulse oximeter alarms in the operating room (OR). Prospective observational study. Nonuniversity hospital. 53 ASA physical status I, II, and III consecutive patients undergoing general anesthesia with tracheal intubation. In the OR we compared the number of alarms produced by a recently developed third generation pulse oximeter (Nellcor Symphony N-3000) with Oxismart signal processing technique and a conventional pulse oximeter (Criticare 504). Three pulse oximeters were used simultaneously in each patient: a Nellcor pulse oximeter, a Criticare with the signal averaging time set at 3 seconds (Criticareaverage3s) and a similar unit with the signal averaging time set at 21 seconds (Criticareaverage21s). For each pulse oximeter, the number of false (artifact) alarms was counted. One false alarm was produced by the Nellcor (duration 55 sec) and one false alarm by the Criticareaverage21s monitor (5 sec). The incidence of false alarms was higher in Criticareaverage3s. In eight patients, Criticareaverage3s produced 20 false alarms (p signal processing compared with the Criticare monitor with the longer averaging time of 21 seconds.

  20. Effect of safe environmental pre and post harvest treatments and irradiation on handling of some fruits

    International Nuclear Information System (INIS)

    Nawito, M.A.A.

    2008-01-01

    The present study was carried out during two successive seasons of 2005 and 2006 seasons on M ontakhab El-Kanater g uavas and H achiya p ersimmons.two different experiments were studied, the first one for pre harvest and second post harvest. Regarding pre harvest experiment,hand or chemical flower thinning by urea or ethrel and date of fruit picking (maturity) were evaluated on both guavas and persimmons.All flower thinning treatments increased fruit set,total yield,average fruit weight and decreased fruit abscission.However,a great effect on fruit quality and chemical compositions were also found with flower thinning treatments. Chemical flower thinning was more effective than hand thinning in improving yield and quality in M ontakhab El-Kanater g uavas and H achiya p ersimmons. However,early maturation(120 and 150 days for guava and persimmon respect.) produced poor fruit quality.Whereas, medium maturity(130 and 180 days for guava and persimmon respect.) produced fruit with high quality.However,late picking(140 and 210 days for guava and persimmon respect.) produced fruits with less marketability. On the other side, post harvest treatments including irradiation of fruits with or without pre-cooling process at 0.2,0.4,and 0.8 K.Gy for guavas and 1.5, 2.5 and 3.5 K.Gy for persimmons. Also,hot water at 45 degree C, fungicide at 0.5 and 1.0 g/L.and ethanol vapor at 25 and 50% were evaluated on both fruits. The obtained data were evaluated on discarded fruits %, weight loss %, fruit firmness,fruit marketability, total soluble solids,acidity,L-ascorbic acid (guava), tannins (persimmon), total sugars and fruit respiration. All supplementary refrigeration treatments improved fruit quality during cold storage but ethanol vapor either 25 or 50 % were more effective than other treatments

  1. Effect of safe environmental pre and post harvest treatments and irradiation on handling of some fruits

    Energy Technology Data Exchange (ETDEWEB)

    Nawito, M A.A. [National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo (Egypt)

    2008-07-01

    The present study was carried out during two successive seasons of 2005 and 2006 seasons on{sup M}ontakhab El-Kanater{sup g}uavas and{sup H}achiya{sup p}ersimmons.two different experiments were studied, the first one for pre harvest and second post harvest. Regarding pre harvest experiment,hand or chemical flower thinning by urea or ethrel and date of fruit picking (maturity) were evaluated on both guavas and persimmons.All flower thinning treatments increased fruit set,total yield,average fruit weight and decreased fruit abscission.However,a great effect on fruit quality and chemical compositions were also found with flower thinning treatments. Chemical flower thinning was more effective than hand thinning in improving yield and quality in {sup M}ontakhab El-Kanater{sup g}uavas and {sup H}achiya{sup p}ersimmons. However,early maturation(120 and 150 days for guava and persimmon respect.) produced poor fruit quality.Whereas, medium maturity(130 and 180 days for guava and persimmon respect.) produced fruit with high quality.However,late picking(140 and 210 days for guava and persimmon respect.) produced fruits with less marketability. On the other side, post harvest treatments including irradiation of fruits with or without pre-cooling process at 0.2,0.4,and 0.8 K.Gy for guavas and 1.5, 2.5 and 3.5 K.Gy for persimmons. Also,hot water at 45 degree C, fungicide at 0.5 and 1.0 g/L.and ethanol vapor at 25 and 50% were evaluated on both fruits. The obtained data were evaluated on discarded fruits %, weight loss %, fruit firmness,fruit marketability, total soluble solids,acidity,L-ascorbic acid (guava), tannins (persimmon), total sugars and fruit respiration. All supplementary refrigeration treatments improved fruit quality during cold storage but ethanol vapor either 25 or 50 % were more effective than other treatments.

  2. 40 CFR 76.11 - Emissions averaging.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Emissions averaging. 76.11 Section 76.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General...

  3. A practical guide to averaging functions

    CERN Document Server

    Beliakov, Gleb; Calvo Sánchez, Tomasa

    2016-01-01

    This book offers an easy-to-use and practice-oriented reference guide to mathematical averages. It presents different ways of aggregating input values given on a numerical scale, and of choosing and/or constructing aggregating functions for specific applications. Building on a previous monograph by Beliakov et al. published by Springer in 2007, it outlines new aggregation methods developed in the interim, with a special focus on the topic of averaging aggregation functions. It examines recent advances in the field, such as aggregation on lattices, penalty-based aggregation and weakly monotone averaging, and extends many of the already existing methods, such as: ordered weighted averaging (OWA), fuzzy integrals and mixture functions. A substantial mathematical background is not called for, as all the relevant mathematical notions are explained here and reported on together with a wealth of graphical illustrations of distinct families of aggregation functions. The authors mainly focus on practical applications ...

  4. The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study.

    Science.gov (United States)

    Drew, Benjamin T; Conaghan, Philip G; Smith, Toby O; Selfe, James; Redmond, Anthony C

    2017-08-04

    Targeted treatment, matched according to specific clinical criteria e.g. hip muscle weakness, may result in better outcomes for people with patellofemoral pain (PFP). However, to ensure the success of future trials, a number of questions on the feasibility of a targeted treatment need clarification. The aim of the study was to explore the feasibility of matched treatment (MT) compared to usual care (UC) management for a subgroup of people with PFP determined to have hip weakness and to explore the mechanism of effect for hip strengthening. In a pragmatic, randomised controlled feasibility study, 24 participants with PFP (58% female; mean age 29 years) were randomly allocated to receive either MT aimed specifically at hip strengthening, or UC over an eight-week period. The primary outcomes were feasibility outcomes, which included rates of adherence, attrition, eligibility, missing data and treatment efficacy. Secondary outcomes focused on the mechanistic outcomes of the intervention, which included hip kinematics. Conversion to consent (100%), missing data (0%), attrition rate (8%) and adherence to both treatment and appointments (>90%) were deemed successful endpoints. The analysis of treatment efficacy showed that the MT group reported a greater improvement for the Global Rating of Change Scale (62% vs. 9%) and the Anterior Knee Pain Scale (-5.23 vs. 1.18) but no between-group differences for either average or worst pain. Mechanistic outcomes showed a greatest reduction in peak hip internal rotation angle for the MT group (13.1% vs. -2.7%). This feasibility study indicates that a definitive randomised controlled trial investigating a targeted treatment approach is achievable. Findings suggest the mechanism of effect of hip strengthening may be to influence kinematic changes in hip function in the transverse plane. This study was registered retrospectively. ISRCTN74560952 . Registration date: 2017-02-06.

  5. 7 CFR 51.2561 - Average moisture content.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Average moisture content. 51.2561 Section 51.2561... STANDARDS) United States Standards for Grades of Shelled Pistachio Nuts § 51.2561 Average moisture content. (a) Determining average moisture content of the lot is not a requirement of the grades, except when...

  6. Methotrexate is an effective treatment for chronic uveitis associated with juvenile idiopathic arthritis.

    Science.gov (United States)

    Foeldvari, Ivan; Wierk, Angela

    2005-02-01

    To assess the effectiveness of methotrexate (MTX) in the treatment of juvenile idiopathic arthritis (JIA) associated uveitis, which is still one of the most common causes of visual impairment. A retrospective chart review of patients with the diagnosis of uveitis associated with JIA between July 1, 2002, and December 31, 2002. Four hundred sixty-seven patients with JIA were followed. Thirty-eight had uveitis: 31 associated with oligoarticular JIA and 7 with psoriatic JIA. Twenty-five of the 38 patients received MTX; in 23 patients uveitis was the indication for MTX therapy. In the MTX treated group 46/50 eyes had uveitis, the mean (range) age at onset of uveitis was 7.82 years (1.8-15.8), and the mean age at onset of arthritis was 7.25 years (1.25-15.7). MTX treatment was started an average of 11.4 months (0-72) after the onset of uveitis. The mean MTX dose was 15.6 mg/m2. Remission occurred after 4.25 months (1-12). Mean duration of remission was 10.3 months (3-27). The total duration of MTX therapy was 661 months and patients were in remission for 417/661 months. In 6 patients MTX was discontinued after 12 months of remission. Four patients were still in remission after 7.5 months (1-14). MTX seems to be an effective therapy for JIA associated uveitis.

  7. Effectiveness of complementary and self-help treatments for anxiety disorders.

    Science.gov (United States)

    Jorm, Anthony F; Christensen, Helen; Griffiths, Kathleen M; Parslow, Ruth A; Rodgers, Bryan; Blewitt, Kelly A

    2004-10-04

    To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. Systematic literature search using PubMed, PsycLit, and the Cochrane Library. 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders.

  8. Computation of the bounce-average code

    International Nuclear Information System (INIS)

    Cutler, T.A.; Pearlstein, L.D.; Rensink, M.E.

    1977-01-01

    The bounce-average computer code simulates the two-dimensional velocity transport of ions in a mirror machine. The code evaluates and bounce-averages the collision operator and sources along the field line. A self-consistent equilibrium magnetic field is also computed using the long-thin approximation. Optionally included are terms that maintain μ, J invariance as the magnetic field changes in time. The assumptions and analysis that form the foundation of the bounce-average code are described. When references can be cited, the required results are merely stated and explained briefly. A listing of the code is appended

  9. Dosimetric Effects Of Different Treatment Tables During Radiotherapy

    International Nuclear Information System (INIS)

    Murkovic, M.; Grego, T.; Bibic, J.

    2015-01-01

    The aim of our study was to measure the effect of mega-voltage photon beam attenuation when treating patients through carbon fibre treatment table with and without the carbon laminate base plate on it. We also examined the ability of XiO treatment planning system in modelling this effect. Direct attenuation measurements were made for two treatment tables, Siemens TxT 550 treatment table with TT-A table top and Elekta Precise table with iBEAM evo table top. On both treatment tables we used Orfit Base Plate (32301). Measurements were taken for two photon energies (6 MV and 18 MV), at two different field sizes (5 x 5 cm 2 and 10 x 10 cm 2 ) and different gantry angles in 50 intervals using stationary water phantom and Farmer type ionization chamber. These values were compared to values calculated in XiO. In order to account for the effect of table and base plate during treatment planning in XiO, customized table and base plate templates were develop in Focal planning system. To construct these customized templates, table and base plate contours as well as respective relative electron density's to water were obtained on CT scanner. The largest attenuation effect was seen for oblique treatment angles using low energy and small field sizes, 6.6 percent for the Elekta table top and 8.4 percent for Siemens table top. In this paper we show that customized table and base plate templates introduced in the patient treatment plan can accurately model the attenuation due to their presence to within 0.3 percent. Since dose modifications due to such carbon fiber accessories can be significant, it can be concluded that introduction of customized table and base plate templates into TPS brings an important improvement to patient treatment planning, and should be included in dose calculations whenever possible. (author).

  10. Average is Over

    Science.gov (United States)

    Eliazar, Iddo

    2018-02-01

    The popular perception of statistical distributions is depicted by the iconic bell curve which comprises of a massive bulk of 'middle-class' values, and two thin tails - one of small left-wing values, and one of large right-wing values. The shape of the bell curve is unimodal, and its peak represents both the mode and the mean. Thomas Friedman, the famous New York Times columnist, recently asserted that we have entered a human era in which "Average is Over" . In this paper we present mathematical models for the phenomenon that Friedman highlighted. While the models are derived via different modeling approaches, they share a common foundation. Inherent tipping points cause the models to phase-shift from a 'normal' bell-shape statistical behavior to an 'anomalous' statistical behavior: the unimodal shape changes to an unbounded monotone shape, the mode vanishes, and the mean diverges. Hence: (i) there is an explosion of small values; (ii) large values become super-large; (iii) 'middle-class' values are wiped out, leaving an infinite rift between the small and the super large values; and (iv) "Average is Over" indeed.

  11. Cost Effectiveness of Stapled Haemorrhoidopexy and Traditional Excisional Surgery for the Treatment of Haemorrhoidal Disease.

    Science.gov (United States)

    Kilonzo, Mary M; Brown, Steven R; Bruhn, Hanne; Cook, Jonathan A; Hudson, Jemma; Norrie, John; Watson, Angus J M; Wood, Jessica

    2017-08-25

    Our objective was to compare the cost effectiveness of stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH) in the treatment of grade II-IV haemorrhoidal disease from the perspective of the UK national health service. An economic evaluation was conducted alongside an open, two-arm, parallel-group, pragmatic, multicentre, randomised controlled trial conducted in several hospitals in the UK. Patients were randomised into either SH or TH surgery between January 2011 and August 2014 and were followed up for 24 months. Intervention and subsequent resource use data were collected using case review forms and questionnaires. Benefits were collected using the EQ-5D-3L (EuroQoL-five dimensions-three levels) instrument. The primary economic outcome was incremental cost measured in pounds (£), year 2016 values, relative to the incremental benefit, which was estimated using quality-adjusted life-years (QALYs). Cost and benefits accrued in the second year were discounted at 3.5%. The base-case analysis was based on imputed data. Uncertainty was explored using univariate sensitivity analyses. Participants (n = 777) were randomised to SH (n = 389) or TH (n = 388). The mean cost of SH was £337 (95% confidence interval [CI] 251-423) higher than that of TH and the mean QALYs were -0.070 (95% CI -0.127 to -0.011) lower than for TH. The base-case cost-utility analysis indicated that SH has zero probability of being cost effective at both the £20,000 and the £30,000 threshold. Results from the sensitivity analyses were similar to those from the base-case analysis. The evidence suggests that, on average, the total mean costs over the 24-month follow-up period were significantly higher for the SH arm than for the TH arm. The QALYs were also, on average, significantly lower for the SH arm. These results were supported by the sensitivity analyses. Therefore, in terms of cost effectiveness, TH is a superior surgical treatment for the management of grade II

  12. Non-sky-averaged sensitivity curves for space-based gravitational-wave observatories

    International Nuclear Information System (INIS)

    Vallisneri, Michele; Galley, Chad R

    2012-01-01

    The signal-to-noise ratio (SNR) is used in gravitational-wave observations as the basic figure of merit for detection confidence and, together with the Fisher matrix, for the amount of physical information that can be extracted from a detected signal. SNRs are usually computed from a sensitivity curve, which describes the gravitational-wave amplitude needed by a monochromatic source of given frequency to achieve a threshold SNR. Although the term 'sensitivity' is used loosely to refer to the detector's noise spectral density, the two quantities are not the same: the sensitivity includes also the frequency- and orientation-dependent response of the detector to gravitational waves and takes into account the duration of observation. For interferometric space-based detectors similar to LISA, which are sensitive to long-lived signals and have constantly changing position and orientation, exact SNRs need to be computed on a source-by-source basis. For convenience, most authors prefer to work with sky-averaged sensitivities, accepting inaccurate SNRs for individual sources and giving up control over the statistical distribution of SNRs for source populations. In this paper, we describe a straightforward end-to-end recipe to compute the non-sky-averaged sensitivity of interferometric space-based detectors of any geometry. This recipe includes the effects of spacecraft motion and of seasonal variations in the partially subtracted confusion foreground from Galactic binaries, and it can be used to generate a sampling distribution of sensitivities for a given source population. In effect, we derive error bars for the sky-averaged sensitivity curve, which provide a stringent statistical interpretation for previously unqualified statements about sky-averaged SNRs. As a worked-out example, we consider isotropic and Galactic-disk populations of monochromatic sources, as observed with the 'classic LISA' configuration. We confirm that the (standard) inverse-rms average sensitivity

  13. The effects of raloxifene treatment on oxidative status in brain tissues and learning process of ovariectomized rats

    Directory of Open Access Journals (Sweden)

    Süreyya Osmanova

    2011-01-01

    Full Text Available Background: The effects of estrogene on central nervous system are still controversial. Objective: We aimed to investigate the effects of raloxifene on the antioxidant enzyme [superoxide dismutase (SOD and catalase (CAT] activities and malondialdehyde (MDA levels in brain homogenates of ovariectomized female rats and its effect on cognitive process of learning.Materials and Methods: Female Sprague Dawley rats (n=24 were divided into three groups. Three weeks after ovariectomy; nonovariectomized group (control group (n=8 was given physiological saline (SP as placebo. First ovariectomized group (n=8 received raloxifene 1mg/kg dissolved in a 1% solution of carboxymethylcellulose (CMC subcutaneusly (sc and second group of ovariectomized rats were given 1 % CMC 1mg/kg (sc every day for 14 days. Learning behaviors of rats were evaluated in active avoidence cage with using sound and electrical stimulation. The levels of oxidative stress (MDA and antioxidant enzymes (SOD, CAT in different regions of the brain homogenates were compared between three groups of decapitated rats.Results: Raloxifene had a significant attenuating effect on the levels of MDA in brain tissues suggesting raloxifene’s effect against lipid peroxidation at the end of training days. With the comparison of brain regions, cortex showed the highest average activity of SOD and CAT and cerebellum had the lowest average levels for both. Its effects on learning and cognitive process with active avoidence task were considered insignificant.Conclusion: Raloxifene treatment may have preventive effects for the brain against oxidative stress and lipid peroxidation in rats

  14. A benchmark test of computer codes for calculating average resonance parameters

    International Nuclear Information System (INIS)

    Ribon, P.; Thompson, A.

    1983-01-01

    A set of resonance parameters has been generated from known, but secret, average values; the parameters have then been adjusted to mimic experimental data by including the effects of Doppler broadening, resolution broadening and statistical fluctuations. Average parameters calculated from the dataset by various computer codes are compared with each other, and also with the true values. The benchmark test is fully described in the report NEANDC160-U (NEA Data Bank Newsletter No. 27 July 1982); the present paper is a summary of this document. (Auth.)

  15. A prospective randomized study of the efficacy and cost-effectiveness of high and low dose regimens of I-131 treatment in hyperthyroidism.

    Science.gov (United States)

    Pusuwan, Pawana; Tuntawiroon, Malulee; Sritongkul, Nopamol; Chaudakshetrin, Pachee; Nopmaneejumruslers, Cherdchai; Komoltri, Chulalak; Thepamongkhol, Kullathorn; Khiewvan, Benjapa; Tuchinda, Pongpija; Sriussadaporn, Sutin

    2011-03-01

    To compare the efficacy and cost-effectiveness of high and low dose regimens of I-131 treatment in patients with hyperthyroidism. One hundred fifty patients with proven hyperthyroidism were randomly allocated into the high (74 patients) and low (76 patients) dose regimen of I-131 treatment. Four patients of the high dose group and one patient of the low dose group were excluded because of lost follow-up. A gland-specific dosage was calculated on the estimated weight of thyroid gland and 24-hour I-131 uptake. The high and low I-131 dose regimens were 150 microCi/gm and 100 microCi/gm, respectively. The first mean radioiodine activity administered to the high and low dose group was 10.2 and 8 mCi, respectively. Repeated treatment was given to 25 patients of the high dose group and 40 patients of the low dose group. Clinical outcome and calculated costs for outpatient attendances, and laboratory tests together with initial and subsequent treatments were evaluated for one year after I-131 treatment. Elimination of hyperthyroidism that resulted in either euthyroidism or hypothyroidism was classified as therapeutic success. The cost effectiveness was also compared. At 6 months after treatment, 45 (64.3%) patients receiving high dose and 59 (78.7%) patients receiving low dose were hyperthyroidism. Clinical outcome at one year showed persistence of hyperthyroidism in 21 (30%) patients of the high dose regimen and 36 (48%) patients of the low dose regimen. At one year post treatment, it was demonstrated that the high dose regimen could eliminate hyperthyroidism in a significantly shorter time than the low dose regimen, i.e., 259.6 days and 305.5 days, respectively, p = 0.008). For the persistent hyperthyroid patients, the average total cost of treatment in the low dose group was significantly higher than that of the high dose group, i.e., 13,422.78 baht and 10,942.79 baht, respectively; p = 0.050). A high dose regimen of radioactive iodine treatment is more effective than

  16. [Laser thermokeratoplasty in the treatment of hyperopia in children].

    Science.gov (United States)

    Kulikova, I L; Pashtaev, N P; Suslikov, S V

    2006-01-01

    The effectiveness, safety, and stability of multimodality treatment for hyperopia, hyperopic and mixed astigmatism complicated by amblyopia and anisometropia were studied in 117 patients (117 eyes) aged 9 to 16 years, by using the new laser units "Lik-100" and "Glasser" at 1.54 microm. The patients were divided into 3 groups: 1) 43 patients (43 eyes) with hyperopia, spheric anisometropia and amblyopia; 2) 38 patients (38 eyes) with hyperopia, simple and complicated hyperopic astigmatism, astigmatic anisometropia, and amblyopia; 3) 36 patients (36 eyes) with hyperopia, simple and complicated hyperopic astigmatism, mixed anisometropia, and amblyopia. All the groups underwent multimodality treatment involving laser thermokeratoplasty and drug therapy for amblyopia. In children and adolescents, the refraction effect was 2.99 and 3.61 (mean 3.37 +/- 0.60) diopters, respectively. Astigmatism diminished by 2.01 diopters (63%) in children and by 2.62 diopters (79%) in adolescents (mean 2/35 diopters). The predictability of a refraction effect in the range of +/- 0.5 diopters averaged 77% in all the groups. Anisometropia diminished by an average of 2.88 +/- 0.8 diopters, which was 85% of the baseline data (the upper range of residual refraction was not more than 1.5 diopters. In all the groups, uncorrectable visual acuity increased by an average of 0.36 diopters (0.43 and 0.4 diopters in children and adolescents, respectively); correctable visual acuity increased by an average of 0.22 diopters (0.36 and 0.31 diopters in children and adolescents, respectively). Loss of correctable visual acuity lines did not greater than 2.7% (5 eyes). That of endothelial cells was not more than 6-8%. The angle of squint strabismus could be decreased or corrected in 79% after treatment. Binocular vision restored in 57%.

  17. Analysis of litter size and average litter weight in pigs using a recursive model

    DEFF Research Database (Denmark)

    Varona, Luis; Sorensen, Daniel; Thompson, Robin

    2007-01-01

    An analysis of litter size and average piglet weight at birth in Landrace and Yorkshire using a standard two-trait mixed model (SMM) and a recursive mixed model (RMM) is presented. The RMM establishes a one-way link from litter size to average piglet weight. It is shown that there is a one......-to-one correspondence between the parameters of SMM and RMM and that they generate equivalent likelihoods. As parameterized in this work, the RMM tests for the presence of a recursive relationship between additive genetic values, permanent environmental effects, and specific environmental effects of litter size......, on average piglet weight. The equivalent standard mixed model tests whether or not the covariance matrices of the random effects have a diagonal structure. In Landrace, posterior predictive model checking supports a model without any form of recursion or, alternatively, a SMM with diagonal covariance...

  18. Derivation of a volume-averaged neutron diffusion equation; Atomos para el desarrollo de Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez R, R.; Espinosa P, G. [UAM-Iztapalapa, Av. San Rafael Atlixco 186, Col. Vicentina, Mexico D.F. 09340 (Mexico); Morales S, Jaime B. [UNAM, Laboratorio de Analisis en Ingenieria de Reactores Nucleares, Paseo Cuauhnahuac 8532, Jiutepec, Morelos 62550 (Mexico)]. e-mail: rvr@xanum.uam.mx

    2008-07-01

    This paper presents a general theoretical analysis of the problem of neutron motion in a nuclear reactor, where large variations on neutron cross sections normally preclude the use of the classical neutron diffusion equation. A volume-averaged neutron diffusion equation is derived which includes correction terms to diffusion and nuclear reaction effects. A method is presented to determine closure-relationships for the volume-averaged neutron diffusion equation (e.g., effective neutron diffusivity). In order to describe the distribution of neutrons in a highly heterogeneous configuration, it was necessary to extend the classical neutron diffusion equation. Thus, the volume averaged diffusion equation include two corrections factor: the first correction is related with the absorption process of the neutron and the second correction is a contribution to the neutron diffusion, both parameters are related to neutron effects on the interface of a heterogeneous configuration. (Author)

  19. Pharmacoeconomic evaluation of antimuscarinic agents for the treatment of overactive bladder.

    Science.gov (United States)

    Ko, Yu; Malone, Daniel C; Armstrong, Edward P

    2006-12-01

    To compare the cost-effectiveness of various antimuscarinic agents for the treatment of overactive bladder (OAB). A decision-analysis model was developed and included clinical outcomes (i.e., therapy continued or discontinued, treatment success or failure, OAB-induced comorbidities) and costs for drugs and treatment of OAB-induced comorbidities (i.e., urinary tract infections, fractures, depression, and skin infections). Treatment success was defined as complete continence. A systematic MEDLINE literature search from January 1990-January 2006 identified English-language articles concerning the eight antimuscarinic drugs: darifenacin, solifenacin, trospium, immediate-release oxybutynin, extended-release oxybutynin, transdermal oxybutynin, immediate-release tolterodine, and extended-release tolterodine. Probabilities and cost data for these drugs were retrieved from the literature, and drug costs were based on 2005 average wholesale prices. The analysis was constructed from a payer's perspective. The time frame for the model was 3 months. Expected costs for each patient with OAB ranged from $3373 when treated with solifenacin to $3769 when treated with immediate-release oxybutynin. The average cost/patient with continued and successful treatment was lowest for solifenacin ($6863). Solifenacin dominated all other antimuscarinic agents because they were associated with high costs and low effectiveness. Success rates were the key parameters driving the sensitivity analysis. Among various antimuscarinic agents, solifenacin 5 mg had the lowest costs and highest effectiveness in the treatment of OAB.

  20. Neuroimaging in aphasia treatment research: Standards for establishing the effects of treatment

    Science.gov (United States)

    Kiran, Swathi; Ansaldo, Ana; Bastiaanse, Roelien; Cherney, Leora R.; Howard, David; Faroqi-Shah, Yasmeen; Meinzer, Marcus; Thompson, Cynthia K

    2012-01-01

    The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms associated with treatment-induced language recovery in aphasia, using functional magnetic resonance imaging (fMRI). We present both group and single-subject experimental or case-series design options for doing this and address advantages and disadvantages of each. We also discuss general components of and requirements for treatment research studies, including operational definitions of variables, criteria for defining behavioral change and treatment efficacy, and reliability of measurement. Important considerations that are unique to neuroimaging-based treatment research are addressed, pertaining to the relation between the selected treatment approach and anticipated changes in language processes/functions and how such changes are hypothesized to map onto the brain. PMID:23063559

  1. The average size of ordered binary subgraphs

    NARCIS (Netherlands)

    van Leeuwen, J.; Hartel, Pieter H.

    To analyse the demands made on the garbage collector in a graph reduction system, the change in size of an average graph is studied when an arbitrary edge is removed. In ordered binary trees the average number of deleted nodes as a result of cutting a single edge is equal to the average size of a

  2. Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness.

    Science.gov (United States)

    Roby, Brianne Barnett; Mattingly, Jameson; Jensen, Emily L; Gao, Dexiang; Chan, Kenny H

    2015-02-01

    Juvenile recurrent parotitis (JRP) is characterized by recurrent painful swelling of the parotid gland that occurs in the pediatric population. Sialendoscopy with and without ductal corticosteroid infusion (DCI) has been found to be effective in the treatment of JRP and autoimmune parotitis. To determine the utility of instrumentation vs pharmacotherapy alone for juvenile recurrent parotitis. A retrospective medical record review of pediatric patients undergoing DCI without sialendoscopy at a tertiary pediatric hospital was conducted. The medical records were reviewed to determine the frequency of parotitis events before and after treatment. A multiquestion telephone survey of patients and their parents who underwent the procedure was then conducted to determine patient satisfaction. Ductal corticosteroid infusion with hydrocortisone through catheter inserted in the parotid duct. Frequency of symptoms before and after treatment and parental satisfaction with the treatment. Twelve patients with a mean age of 6.7 years were identified. The mean duration and frequency of symptoms before the procedure were 22 months and every 2 months, respectively. Five patients had a recurrence, on average 4 months after the procedure. Four patients underwent repeated surgical procedures. All had a longer duration between episodes compared with before DCI. Eight parents participated in the survey on satisfaction with the procedure, and 75% reported improvement in their child's life postprocedure. Current literature shows sialendoscopy with corticosteroid application is successful in treating JRP, but it is unclear whether corticosteroid application alone would treat JRP equally. This study shows that DCI alone has similar results as sialendoscopy with corticosteroid application, indicating that it is the corticosteroid application and not the sialendoscopy causing improvement in symptoms. Because JRP must be differentiated from sialolithiasis, we recommend ultrasonography of the

  3. SARS: systematic review of treatment effects.

    Directory of Open Access Journals (Sweden)

    Lauren J Stockman

    2006-09-01

    Full Text Available BACKGROUND: The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO expert panel on SARS treatment requested a systematic review and comprehensive summary of treatments used for SARS-infected patients in order to guide future treatment and identify priorities for research. METHODS AND FINDINGS: In response to the WHO request we conducted a systematic review of the published literature on ribavirin, corticosteroids, lopinavir and ritonavir (LPV/r, type I interferon (IFN, intravenous immunoglobulin (IVIG, and SARS convalescent plasma from both in vitro studies and in SARS patients. We also searched for clinical trial evidence of treatment for acute respiratory distress syndrome. Sources of data were the literature databases MEDLINE, EMBASE, BIOSIS, and the Cochrane Central Register of Controlled Trials (CENTRAL up to February 2005. Data from publications were extracted and evidence within studies was classified using predefined criteria. In total, 54 SARS treatment studies, 15 in vitro studies, and three acute respiratory distress syndrome studies met our inclusion criteria. Within in vitro studies, ribavirin, lopinavir, and type I IFN showed inhibition of SARS-CoV in tissue culture. In SARS-infected patient reports on ribavirin, 26 studies were classified as inconclusive, and four showed possible harm. Seven studies of convalescent plasma or IVIG, three of IFN type I, and two of LPV/r were inconclusive. In 29 studies of steroid use, 25 were inconclusive and four were classified as causing possible harm. CONCLUSIONS: Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage

  4. The effect of temperature on the average volume of Barkhausen jump on Q235 carbon steel

    Science.gov (United States)

    Guo, Lei; Shu, Di; Yin, Liang; Chen, Juan; Qi, Xin

    2016-06-01

    On the basis of the average volume of Barkhausen jump (AVBJ) vbar generated by irreversible displacement of magnetic domain wall under the effect of the incentive magnetic field on ferromagnetic materials, the functional relationship between saturation magnetization Ms and temperature T is employed in this paper to deduce the explicit mathematical expression among AVBJ vbar, stress σ, incentive magnetic field H and temperature T. Then the change law between AVBJ vbar and temperature T is researched according to the mathematical expression. Moreover, the tensile and compressive stress experiments are carried out on Q235 carbon steel specimens at different temperature to verify our theories. This paper offers a series of theoretical bases to solve the temperature compensation problem of Barkhausen testing method.

  5. Cost effectiveness of Tuberculosis Treatment from the Patients ...

    African Journals Online (AJOL)

    ... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

  6. A virtual pebble game to ensemble average graph rigidity.

    Science.gov (United States)

    González, Luis C; Wang, Hui; Livesay, Dennis R; Jacobs, Donald J

    2015-01-01

    The body-bar Pebble Game (PG) algorithm is commonly used to calculate network rigidity properties in proteins and polymeric materials. To account for fluctuating interactions such as hydrogen bonds, an ensemble of constraint topologies are sampled, and average network properties are obtained by averaging PG characterizations. At a simpler level of sophistication, Maxwell constraint counting (MCC) provides a rigorous lower bound for the number of internal degrees of freedom (DOF) within a body-bar network, and it is commonly employed to test if a molecular structure is globally under-constrained or over-constrained. MCC is a mean field approximation (MFA) that ignores spatial fluctuations of distance constraints by replacing the actual molecular structure by an effective medium that has distance constraints globally distributed with perfect uniform density. The Virtual Pebble Game (VPG) algorithm is a MFA that retains spatial inhomogeneity in the density of constraints on all length scales. Network fluctuations due to distance constraints that may be present or absent based on binary random dynamic variables are suppressed by replacing all possible constraint topology realizations with the probabilities that distance constraints are present. The VPG algorithm is isomorphic to the PG algorithm, where integers for counting "pebbles" placed on vertices or edges in the PG map to real numbers representing the probability to find a pebble. In the VPG, edges are assigned pebble capacities, and pebble movements become a continuous flow of probability within the network. Comparisons between the VPG and average PG results over a test set of proteins and disordered lattices demonstrate the VPG quantitatively estimates the ensemble average PG results well. The VPG performs about 20% faster than one PG, and it provides a pragmatic alternative to averaging PG rigidity characteristics over an ensemble of constraint topologies. The utility of the VPG falls in between the most

  7. Impact of Treatment Integrity on Intervention Effectiveness

    Science.gov (United States)

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  8. Effect of heat treatment on antimycotic activity of Sahara honey

    Directory of Open Access Journals (Sweden)

    Moussa Ahmed

    2014-11-01

    Full Text Available Objective: To evaluate the influence of the temperature on honey colour, polyphenol contents and antimycotic capacity and to evaluate the correlation between these parameters. Methods: Sahara honey were heated up to 25, 50, 75 and 100 °C for 15, 30 and 60 min, and their colour intensity, polyphenol contents and antimycotic capacity. The Folin-Ciocalteu test was used to determine the total polyphenol contents (TPC. The antimycotic activity was evaluated both by agar diffusion method and micro wells dilution method against the Candida albicans (C. albicans and Candida glabrata (C. glabrata. Results: Initial values for TPC in Sahara honey ranged from 0.55 to 1.14 mg of gallic acid per kg of honey, with the average value of 0.78 mg of gallic acid per kg of honey. The TPC values after heat-treatment were 0.54 to 1.54 with the average value of 1.49 mg. The minimal inhibitory concentrations before heat-treatment of Sahara honey against C. albicans and C. glabrata ranged from 3.06%-12.5% and 50% respectively. After heat-treatment the minimal inhibitory concentrations between 12.5% and 50% for C. albicans and C. glabrata, respectively. The diameters of inhibition zones of Sahara honey with 50% concentration varied from (12.67-15.00 mm by C. albicans to (14.33-15.67 mm by C. glabrata. The diameters of inhibition zones after heat-treatment at 25 and 50 °C for 15.30 and 60 min ranged from (2.00-18.67 mm by C. albicans to (8.00-16.67 mm by C. glabrata. Statistically significant relations between the TPC and the colour intensity of Sahara honey (r=0.99, P<0.05. Furthermore, the results showed that the TPC and colour is not correlated with the antimycotic capacity. Conclusions: To our knowledge this is the first report on the antimycotic capacity of Sahara honey.

  9. Women with breast cancer report substantially more disease- and treatment-related side or late effects than registered by clinical oncologists: a cross-sectional study of a standard follow-up program in an oncological department.

    Science.gov (United States)

    Ellegaard, Mai-Britt Bjørklund; Grau, Cai; Zachariae, Robert; Jensen, Anders Bonde

    2017-08-01

    Follow-up after breast cancer treatment is standard due to the risk of development of new primary cancers and recurrent disease. The aim of the present study was to evaluate a standard follow-up program in an oncological department by assessing: (1) Symptoms or signs of new primary cancer or recurrent disease, (2) Disease- and treatment-related physical and psychosocial side or late effects, and (3) relevant actions by oncology staff. In a cross-sectional study, 194 women who came for follow-up visit after treatment for primary surgery were included. The clinical oncologists registered symptoms and signs of recurrent disease or new primary cancer. Side or late effects were both assessed by patient and the clinical oncologists. Loco-regional or distant signs of recurrent disease were suspected in eight (5%) patients. Further examinations revealed no disease recurrence. Most patients (93%) reported some degree of side or late effects. Statistically significant more side or late effects were reported by the women (average: 6.9) than registered by the clinical oncologists (average: 2.4), p effects were hot flushes (35%), fatigue (32%), and sleep disturbance (31%). None of the scheduled or additional visits resulted in detection of recurrent disease. Furthermore, the majority of patients reported side or late effects. Statistically significant more women reported side or late effects than registered by the clinical oncologists. This suggests the need for rethinking of the follow-up programs with more emphasis upon side or late effects of the treatment.

  10. The Effect of Mechanochemical Treatment of the Cellulose on Characteristics of Nanocellulose Films

    Science.gov (United States)

    Barbash, V. A.; Yaschenko, O. V.; Alushkin, S. V.; Kondratyuk, A. S.; Posudievsky, O. Y.; Koshechko, V. G.

    2016-09-01

    The development of the nanomaterials with the advanced functional characteristics is a challenging task because of the growing demand in the market of the optoelectronic devices, biodegradable plastics, and materials for energy saving and energy storage. Nanocellulose is comprised of the nanosized cellulose particles, properties of which depend on characteristics of plant raw materials as well as methods of nanocellulose preparation. In this study, the effect of the mechanochemical treatment of bleached softwood sulfate pulp on the optical and mechanical properties of nanocellulose films was assessed. It was established that the method of the subsequent grinding, acid hydrolysis and ultrasound treatment of cellulose generated films with the significant transparency in the visible spectral range (up to 78 % at 600 nm), high Young's modulus (up to 8.8 GPa), and tensile strength (up to 88 MPa) with increased ordering of the packing of the cellulose macromolecules. Morphological characterization was done using the dynamic light scattering (DLS) analyzer and transmission electron microscopy (TEM). The nanocellulose particles had an average diameter of 15-30 nm and a high aspect ratio in the range 120-150. The crystallinity was increased with successive treatments as shown by the X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis. The thermal degradation behavior of cellulose samples was explored by thermal gravimetric analysis (TGA).

  11. Decision-theoretic designs for a series of trials with correlated treatment effects using the Sarmanov multivariate beta-binomial distribution.

    Science.gov (United States)

    Hee, Siew Wan; Parsons, Nicholas; Stallard, Nigel

    2018-03-01

    The motivation for the work in this article is the setting in which a number of treatments are available for evaluation in phase II clinical trials and where it may be infeasible to try them concurrently because the intended population is small. This paper introduces an extension of previous work on decision-theoretic designs for a series of phase II trials. The program encompasses a series of sequential phase II trials with interim decision making and a single two-arm phase III trial. The design is based on a hybrid approach where the final analysis of the phase III data is based on a classical frequentist hypothesis test, whereas the trials are designed using a Bayesian decision-theoretic approach in which the unknown treatment effect is assumed to follow a known prior distribution. In addition, as treatments are intended for the same population it is not unrealistic to consider treatment effects to be correlated. Thus, the prior distribution will reflect this. Data from a randomized trial of severe arthritis of the hip are used to test the application of the design. We show that the design on average requires fewer patients in phase II than when the correlation is ignored. Correspondingly, the time required to recommend an efficacious treatment for phase III is quicker. © 2017 The Author. Biometrical Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. The Effect of Diode Laser Treatment for Root Canal Disinfection on Fracture Resistance and Micro-hardness of the Tooth

    International Nuclear Information System (INIS)

    Elmiligy, H.H; Diab, A.H.; Sabet, N.E.; Saafan, A.M.

    2014-01-01

    This study evaluated the effect of diode laser treatment for root canal disinfection on fracture resistance and micro-hardness of the tooth. Sixty freshly extracted mandibular and maxillary premolars were accessed under coolant then root canals were flared up to apical preparation size 40 MFA coupled with 5.25% NaOCl as an irrigant. Teeth were divided into two groups, control group (group I) and lased group (group II) that was lased by diode laser with average power 2 w through fibrooptic into the canal 2 mm shorter than the apex. Each tooth was embedded in acrylic block, and then subjected to the fracture resistance test. Each root was then sectioned transversely and polished to record dentin Vickers hardness. Data was analysed with student t-test then with linear regression test. The Lased samples presented a significantly higher resistance to fracture than unlased samples. There was no statistically significant differences found between Vickers hardness (HV) of lased and unlased samples and there was no relation between fracture resistance and microhardness. Diode laser (980 nm) treatment had no adverse effect on dentin microhardness, also it increased the fracture resistance of dentin. Diode laser (980 nm) treatment could attain better function ability and maintenance of tooth after endodontic treatment.

  13. [ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE].

    Science.gov (United States)

    Zhang, Zhiwen; Cai, Xianhua; Wei, Shijun; Liu, Ximing

    2015-03-01

    To investigate the operative method and short-term effectiveness in the surgical treatment of Maisonneuve fracture. Between January 2010 and February 2013, 23 patients with Maisonneuve fracture were treated. There were 14 males and 9 females with an average age of 40.3 years (range, 30-68 years). The causes of injuries were falling injury in 11 patients, sports related injury in 5 patients, traffic accident injury in 4 patients, and falling injury from height in 3 patients. The interval between injury and operation was 7-10 days (mean, 8.5 days). All of fractures were closed. Three patients had combined injury of deltoid ligament. The surgical procedures included surgical reduction and fixation of medial malleolus fracture and posterior malleolus fracture, repair of the deltoid ligament with ground anchor suture, and fixation of the disrupted distal tibiofibular syndesmosis. All incisions achieved primary healing, no postoperative complications such as infection occurred. Twenty-one patients were followed up 24-36 months (mean, 26.5 months). No patients complained of pain, tenderness, and obvious swelling of the ankle. At 3-6 months (mean, 4.6 months) after operation, X-ray films showed bony union of fractures and normal mortises in 21 patients. And no traumatic arthritis was observed with reliable fixation. The range of motion of ankle dorsi flexion and plantar flexion was 30-40 degrees) (mean, 34.5 degrees) Baird-Jackson anide functional score was 85-100 (mean, 94); 16 cases were rated as excellent, 4 as good, and 1 as fair with an excellent and good rate of 95.2%. Surgical treatments of Maisonneuve fracture include surgical reduction and fixation of the medial malleolus and posterior malleolus, repair of the deltoid ligament and fixation of the disrupted distal tibiofibular syndesmosis, and good effectiveness can be achieved.

  14. Cost-effectiveness analysis of optimal strategy for tumor treatment

    International Nuclear Information System (INIS)

    Pang, Liuyong; Zhao, Zhong; Song, Xinyu

    2016-01-01

    We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

  15. Delineation of facial archetypes by 3d averaging.

    Science.gov (United States)

    Shaweesh, Ashraf I; Thomas, C David L; Bankier, Agnes; Clement, John G

    2004-10-01

    The objective of this study was to investigate the feasibility of creating archetypal 3D faces through computerized 3D facial averaging. A 3D surface scanner Fiore and its software were used to acquire the 3D scans of the faces while 3D Rugle3 and locally-developed software generated the holistic facial averages. 3D facial averages were created from two ethnic groups; European and Japanese and from children with three previous genetic disorders; Williams syndrome, achondroplasia and Sotos syndrome as well as the normal control group. The method included averaging the corresponding depth (z) coordinates of the 3D facial scans. Compared with other face averaging techniques there was not any warping or filling in the spaces by interpolation; however, this facial average lacked colour information. The results showed that as few as 14 faces were sufficient to create an archetypal facial average. In turn this would make it practical to use face averaging as an identification tool in cases where it would be difficult to recruit a larger number of participants. In generating the average, correcting for size differences among faces was shown to adjust the average outlines of the facial features. It is assumed that 3D facial averaging would help in the identification of the ethnic status of persons whose identity may not be known with certainty. In clinical medicine, it would have a great potential for the diagnosis of syndromes with distinctive facial features. The system would also assist in the education of clinicians in the recognition and identification of such syndromes.

  16. To quantum averages through asymptotic expansion of classical averages on infinite-dimensional space

    International Nuclear Information System (INIS)

    Khrennikov, Andrei

    2007-01-01

    We study asymptotic expansions of Gaussian integrals of analytic functionals on infinite-dimensional spaces (Hilbert and nuclear Frechet). We obtain an asymptotic equality coupling the Gaussian integral and the trace of the composition of scaling of the covariation operator of a Gaussian measure and the second (Frechet) derivative of a functional. In this way we couple classical average (given by an infinite-dimensional Gaussian integral) and quantum average (given by the von Neumann trace formula). We can interpret this mathematical construction as a procedure of 'dequantization' of quantum mechanics. We represent quantum mechanics as an asymptotic projection of classical statistical mechanics with infinite-dimensional phase space. This space can be represented as the space of classical fields, so quantum mechanics is represented as a projection of 'prequantum classical statistical field theory'

  17. Evaluating facial pores and skin texture after low-energy nonablative fractional 1440-nm laser treatments.

    Science.gov (United States)

    Saedi, Nazanin; Petrell, Kathleen; Arndt, Kenneth; Dover, Jeffrey

    2013-01-01

    The fractionated nonablative 1440-nm laser creates microscopic thermal wounds within the epidermis and the dermis and is used clinically to improve tone, texture, and color of skin. We sought to investigate the use of this device to treat facial pores and to improve skin texture. Twenty patients received 6 treatments at the highest tolerable energy level performed 2 weeks apart. Photographic assessments using the VISIA-CR (Canfield Scientific Inc, Fairfield, NJ) imaging system were performed. The pore score was calculated, which is the percentage of the skin surface that has detected pores. Subjective measurements (0-4 scale) were recorded by both the subject and investigator regarding pore appearance, skin texture, and overall skin appearance. Treatment discomfort was scored by patients (1-10 scale). After 6 treatments there was a significant reduction in pore score (P pore score at baseline was 2.059 ± 0.8 and 2 weeks after the final treatment it was 1.700 ± 0.8, resulting in a 17% average reduction in pore score. Study investigators reported average scores being 1.95 ± 0.3 for improved pore appearance and 2.75 ± 0.2 for improved overall appearance (0-4 scale). Subjects noted average scores of 1.9 ± 0.5 for improvement of the appearance of pores and 2.85 ± 0.4 for improvement of overall appearance (0-4 scale). The average discomfort score during treatments was reported to be 4.6 ± 0.1 (1-10 scale). There were no serious adverse effects or long-term side effects. Small sample size and limited follow-up are study limitations. A series of treatments with the nonablative low-energy fractional 1440-nm laser appears to be safe and effective for reducing detectable pores and improving overall skin appearance. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Time-dependence and averaging techniques in atomic photoionization calculations

    International Nuclear Information System (INIS)

    Scheibner, K.F.

    1984-01-01

    Two distinct problems in the development and application of averaging techniques to photoionization calculations are considered. The first part of the thesis is concerned with the specific problem of near-resonant three-photon ionization in hydrogen, a process for which no cross section exists. Effects of the inclusion of the laser pulse characteristics (both temporal and spatial) on the dynamics of the ionization probability and of the metastable state probability are examined. It is found, for example, that the ionization probability can decrease with increasing field intensity. The temporal profile of the laser pulse is found to affect the dynamics very little, whereas the spatial character of the pulse can affect the results drastically. In the second part of the thesis techniques are developed for calculating averaged cross sections directly without first calculating a detailed cross section. Techniques are developed whereby the detailed cross section never has to be calculated as an intermediate step, but rather, the averaged cross section is calculated directly. A variation of the moment technique and a new method based on the stabilization technique are applied successfully to atomic hydrogen and helium

  19. Effect of short-term intensive atorvastatin treatment on interventional treatment effect and cardiac function of patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Yu Lei

    2016-06-01

    Full Text Available Objective: To study the effect of short-term intensive atorvastatin treatment on interventional treatment effect and cardiac function of patients with acute coronary syndrome. Methods: A total of 104 cases of patients with acute coronary syndrome who received PCI treatment in Emergency Department of our hospital from May 2014 to November 2015 were retrospectively analyzed and divided into intensive group and routine group according to different atorvastatin treatment methods, and then biochemical indexes, cardiac ultrasound indicators and inflammatory indexes of two groups were compared. Results: Serum TG, TC, LDL-C, hs- CRP, LDH, α-HBDH, CK and CK-MB content of intensive group were significantly lower than those of routine group while HDL-C content was higher than that of routine group; E/ A ratio and LVEF of intensive group were higher than those of routine group while Tei index, systolic index and diastolic index were lower than those of routine group; TLR4 and NF-kB expression levels in peripheral blood as well as TNF-α and IL-6 content in serum of intensive group were significantly lower than those of routine group. Conclusion: Short-term intensive atorvastatin treatment improves the interventional treatment effect of patients with acute coronary syndrome, and can reduce myocardial injury, improve cardiac diastolic and systolic function and inhibit the inflammation mediated by TLR4/NF-kB.

  20. Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview.

    Science.gov (United States)

    Papageorgiou, Spyridon N; Höchli, Damian; Eliades, Theodore

    2017-11-01

    The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

  1. Adverse effects of orthodontic treatment: A clinical perspective

    Science.gov (United States)

    Talic, Nabeel F.

    2011-01-01

    Orthodontic treatment is associated with a number of adverse effects, such as root resorption, pain, pulpal changes, periodontal disease, and temporomandibular dysfunction (TMD). Orthodontists should be aware of these effects and associated risk factors. Risk factors linked to root resorption include the duration of treatment, length, and shape of the root, trauma history, habits, and genetic predisposition. PMID:24151415

  2. Effectiveness of an intensive multidisciplinary headache treatment program.

    Science.gov (United States)

    Gunreben-Stempfle, Birgit; Griessinger, Norbert; Lang, Eberhard; Muehlhans, Barbara; Sittl, Reinhard; Ulrich, Kathrin

    2009-07-01

    To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P tension-type headache days (P tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology

  3. Site-specific dissociation dynamics of H2/D2 on Ag(111) and Co(0001) and the validity of the site-averaging model

    International Nuclear Information System (INIS)

    Hu, Xixi; Jiang, Bin; Xie, Daiqian; Guo, Hua

    2015-01-01

    Dissociative chemisorption of polyatomic molecules on metal surfaces involves high-dimensional dynamics, of which quantum mechanical treatments are computationally challenging. A promising reduced-dimensional approach approximates the full-dimensional dynamics by a weighted average of fixed-site results. To examine the performance of this site-averaging model, we investigate two distinct reactions, namely, hydrogen dissociation on Co(0001) and Ag(111), using accurate first principles potential energy surfaces (PESs). The former has a very low barrier of ∼0.05 eV while the latter is highly activated with a barrier of ∼1.15 eV. These two systems allow the investigation of not only site-specific dynamical behaviors but also the validity of the site-averaging model. It is found that the reactivity is not only controlled by the barrier height but also by the topography of the PES. Moreover, the agreement between the site-averaged and full-dimensional results is much better on Ag(111), though quantitative in neither system. Further quasi-classical trajectory calculations showed that the deviations can be attributed to dynamical steering effects, which are present in both reactions at all energies

  4. [Chronic pain patients' readiness to change after multimodal treatment. Short- and long-term effects].

    Science.gov (United States)

    Küchler, A; Sabatowski, R; Kaiser, U

    2012-12-01

    Patients' readiness to behavioural changes according to the transtheoretical model (TTM) and criteria of treatment outcome are positively associated and have in part already been confirmed. For a stable effect of therapeutic treatment, patients' readiness to change seems indispensable for an independent and active pain management. Thus, in addition to an enhanced quality of life, increasing patients' motivation is a declared objective of the treatment at Dresden's Comprehensive Pain Center. In this study, it was examined how the readiness to change develops in the course of and during the 2 years following the multimodal treatment program. Furthermore, associations between outcome criteria of the treatment and patients' readiness to change were explored. The database constitutes 169 patients who took part in a 4-week interdisciplinary, partially residential pain treatment. Beside the Freiburg Pain Stages questionnaire ("Frieburger Fragebogen - Stadien der Bewältigung chronischer Schmerzen", FF-STABS), a comprehensive pain diagnostic inventory including the Pain Disability Index (PDI), the SF-36 questionnaire, and the Hospital Anxiety and Depression Scale (HADS) was completed at six different time points (beginning of treatment, end of treatment, booster session after 10 weeks, after 6, 12, and 24 months). The statistical analyses were performed with SPSS 16.0 including nonparametric analyses and variance analyses. Significant differences in the level of readiness to change between the beginning of treatment and all follow-up measures were observed. The average patients' readiness to change was still higher after 2 years than at the first measurement. However, a differentiated consideration revealed a small portion of patients who showed no change or even a reduction of motivation. After an additional week (booster session), the stages of readiness to change remained stable, irrespective of the direction of the previous change. Regarding therapeutic outcome

  5. The effect of Al–8B grain refiner and heat treatment conditions on the microstructure, mechanical properties and dry sliding wear behavior of an Al–12Zn–3Mg–2.5Cu aluminum alloy

    International Nuclear Information System (INIS)

    Alipour, M.; Azarbarmas, M.; Heydari, F.; Hoghoughi, M.; Alidoost, M.; Emamy, M.

    2012-01-01

    Highlights: ► The effect of Al–8B on the properties of aluminum alloy was studied. ► Al–8B is an effective in reducing the grain and reagent fine microstructure. ► Al–8B is an effective in optimization of properties. -- Abstract: In this study the effect of Al–8B grain refiner on the structural and properties of Al–12Zn–3Mg–2.5Cu aluminum alloy were investigated. The optimum amount for B containing grain refiner was selected as 3.75 wt.%. The results showed that B containing grain refiner is more effective in reducing average grain size of the alloy. T6 heat treatment was applied for all specimens before tensile testing. Significant improvements in mechanical properties were obtained with the addition of grain refiner combined with T6 heat treatment. After the heat treatment, the average tensile strength increased from 479 MPa to 537 MPa for sample refined with 3.75 wt.% Al–8B. The fractography of the fractured faces and microstructure evolution was characterized by scanning electron microscopy and optical microscopy. Dry sliding wear performance of the alloy was examined in normal atmospheric conditions. The experimental results showed that the T6 heat treatment considerably improved the resistance of Al–12Zn–3Mg–2.5Cu aluminum alloy to the dry sliding wear.

  6. Chemotherapeutic treatment of naturally acquired generalized demodicosis.

    Science.gov (United States)

    Folz, S D; Kratzer, D D; Conklin, R D; Nowakowski, L H; Kakuk, T J; Rector, D L

    1983-08-01

    Fifty-two dogs naturally parasitized with Demodex canis and having the generalized form of the disease were utilized to evaluate the efficacy and safety of single or multiple topical treatments with a liquid concentrate formulation of amitraz. Ten dogs (5 treated, 5 controls) were utilized to evaluate a single treatment. A single topical treatment with the miticide did not significantly reduce the incidence of dogs with mites, however, significant clinical improvement resulted. Side-effects were not observed after treatment. Forty-two dogs (26 treated, 16 controls) were utilized to evaluate multiple topical treatments with the liquid concentrate. A series of 3-6 treatments was applied topically at 14-day intervals. The dogs treated with the miticide received an average of 4.5 topical treatments. All (100%) of the dogs responded clinically, and the mean rate of improvement at four weeks post-treatment was 99.1%. Most dogs (96.2%) were cleared of mites after 3-6 treatments, and Mitaban did not cause any dermatologic, ocular, or other clinical side-effects. Multiple treatments with the liquid concentrate were highly efficacious and safe for treatment of generalized demodicosis. Control dogs did not improve clinically and retained mite populations.

  7. Self-similarity of higher-order moving averages

    Science.gov (United States)

    Arianos, Sergio; Carbone, Anna; Türk, Christian

    2011-10-01

    In this work, higher-order moving average polynomials are defined by straightforward generalization of the standard moving average. The self-similarity of the polynomials is analyzed for fractional Brownian series and quantified in terms of the Hurst exponent H by using the detrending moving average method. We prove that the exponent H of the fractional Brownian series and of the detrending moving average variance asymptotically agree for the first-order polynomial. Such asymptotic values are compared with the results obtained by the simulations. The higher-order polynomials correspond to trend estimates at shorter time scales as the degree of the polynomial increases. Importantly, the increase of polynomial degree does not require to change the moving average window. Thus trends at different time scales can be obtained on data sets with the same size. These polynomials could be interesting for those applications relying on trend estimates over different time horizons (financial markets) or on filtering at different frequencies (image analysis).

  8. Determinants of College Grade Point Averages

    Science.gov (United States)

    Bailey, Paul Dean

    2012-01-01

    Chapter 2: The Role of Class Difficulty in College Grade Point Averages. Grade Point Averages (GPAs) are widely used as a measure of college students' ability. Low GPAs can remove a students from eligibility for scholarships, and even continued enrollment at a university. However, GPAs are determined not only by student ability but also by the…

  9. Observations on the Prevalence, Characteristics, and Effects of Self-Treatment

    Directory of Open Access Journals (Sweden)

    Shuangge eMa

    2016-04-01

    Full Text Available Aims: When facing illness, a person may choose self-treatment as an alternative to hospital (and primary care-based treatment. Despite its important role in healthcare, the study on self-treatment remains limited. The goal is to collectively report the observations in the literature on the prevalence, characteristics, and effects of self-treatment.Methods: Extensive literature search was conducted, and relevant information was extracted.Results: Published studies have reported that in some regions, the prevalence of self-treatment is high and varies across illness conditions and treatment approaches. Self-medication is the most popular self-treatment approach. Multiple regional, demographic, personal, cultural and religious factors have been implicated in the pursuit of self-treatment. In addition, accessibility of healthcare also plays a role. Self-treatment in general has a positive clinical and financial effect. However there have been concerns on abuse and possible negative effects. Conclusions: This article reviews observations made in recent studies on several important aspects of self-treatment. Comprehensive and systematic study is still lacking. Interventions are needed to solve several problems associated with self-treatment.

  10. Rotational averaging of multiphoton absorption cross sections

    Energy Technology Data Exchange (ETDEWEB)

    Friese, Daniel H., E-mail: daniel.h.friese@uit.no; Beerepoot, Maarten T. P.; Ruud, Kenneth [Centre for Theoretical and Computational Chemistry, University of Tromsø — The Arctic University of Norway, N-9037 Tromsø (Norway)

    2014-11-28

    Rotational averaging of tensors is a crucial step in the calculation of molecular properties in isotropic media. We present a scheme for the rotational averaging of multiphoton absorption cross sections. We extend existing literature on rotational averaging to even-rank tensors of arbitrary order and derive equations that require only the number of photons as input. In particular, we derive the first explicit expressions for the rotational average of five-, six-, and seven-photon absorption cross sections. This work is one of the required steps in making the calculation of these higher-order absorption properties possible. The results can be applied to any even-rank tensor provided linearly polarized light is used.

  11. Self-stigma and treatment effectiveness in patients with anxiety disorders – a mediation analysis

    Directory of Open Access Journals (Sweden)

    Ociskova M

    2018-01-01

    Full Text Available Marie Ociskova,1 Jan Prasko,1 Kristyna Vrbova,1 Petra Kasalova,1 Michaela Holubova,1 Ales Grambal,1 Klara Machu2 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc, 2Department of Psychology, Faculty of Arts, University of Ostrava, Ostrava, The Czech Republic Goal: The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. Method: Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2±12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT or short psychodynamic therapy. The selection to the psychotherapy was not randomized. All individuals completed several scales – Beck Depression Inventory, the second edition (BDI-II, Beck Anxiety Inventory (BAI, Dissociative Experience Scale (DES, Sheehan Disability Scale (SDS, subjective Clinical Global Impression (subjCGI, and The Internalized Stigma of Mental Illness Scale (ISMI. A senior psychiatrist filled out the objective CGI (objCGI. Results: The patients significantly improved in the severity of anxiety (BAI, depression (BDI-II, and overall severity of the mental disorder (objCGI. The self-stigma predicted a lower change of the objCGI, but not a change of the anxiety and depressive symptoms severity. Anxiety, depressive symptoms, dissociation, and disability were assessed as possible mediators of the relationship between the self-stigma and the treatment change. None of them were significant. Conclusion: Self-stigma lowers the effectiveness of the combined treatment of anxiety disorders. Future research should explore other possible mediators influencing this relationship. Keywords: self-stigma, anxiety disorders, treatment

  12. Cost-effectiveness in Clostridium difficile treatment decision-making.

    Science.gov (United States)

    Nuijten, Mark Jc; Keller, Josbert J; Visser, Caroline E; Redekop, Ken; Claassen, Eric; Speelman, Peter; Pronk, Marja H

    2015-11-16

    To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection (CDI). CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for coverage decisions and guideline development in CDI. The model included pharmacotherapy with oral metronidazole or oral vancomycin, which is the mainstay for pharmacological treatment of CDI and is recommended by most treatment guidelines. A design for a patient-based cost-effectiveness model was developed, which can be used to estimate the cost-effectiveness of current and future treatment strategies in CDI. Patient-based outcomes were extrapolated to the population by including factors like, e.g., person-to-person transmission, isolation precautions and closing and cleaning wards of hospitals. The proposed framework for a population-based CDI model may be used for clinical and health economic assessments of CDI guidelines and coverage decisions for emerging treatments for CDI.

  13. A Group Neighborhood Average Clock Synchronization Protocol for Wireless Sensor Networks

    Science.gov (United States)

    Lin, Lin; Ma, Shiwei; Ma, Maode

    2014-01-01

    Clock synchronization is a very important issue for the applications of wireless sensor networks. The sensors need to keep a strict clock so that users can know exactly what happens in the monitoring area at the same time. This paper proposes a novel internal distributed clock synchronization solution using group neighborhood average. Each sensor node collects the offset and skew rate of the neighbors. Group averaging of offset and skew rate value are calculated instead of conventional point-to-point averaging method. The sensor node then returns compensated value back to the neighbors. The propagation delay is considered and compensated. The analytical analysis of offset and skew compensation is presented. Simulation results validate the effectiveness of the protocol and reveal that the protocol allows sensor networks to quickly establish a consensus clock and maintain a small deviation from the consensus clock. PMID:25120163

  14. Clinical Effects of Novel Nanoscaled Core Decompression Rods Combined with Umbilical Cord Mesenchymal Stem Cells on the Treatment of Early Osteonecrosis of the Femoral Head

    Directory of Open Access Journals (Sweden)

    Hongyang Gao

    2015-01-01

    Full Text Available Osteonecrosis of the femoral head (ONFH is one of the most common diseases in orthopedics. In this study, we investigated the clinical effects of novel nanoscaled core decompression rods combined with mesenchymal stem cells on the treatment of the ONFH. 12 adult patients with early ONFH (at the stage of Ficat II received the treatment using the implantation of novel nanoscaled core decompression rods combined with umbilical cord mesenchymal stem cells. The grade of the patients’ hip was scored by Harris marking system before and after the surgery, and then paired t-test was done. We assessed the curative efficiency based on the change of the patients before and after the surgery. In particular, the survival rate of femoral head was assessed at 12 months after the surgery. The results demonstrated that according to the standard of Harris Scoring, the average grade of hip joint before the surgery was 54.16 ± 4.23 points while average grade of hip joint at 12 months after the surgery was 85.28 ± 3.65 points. So, the implantation of the novel nanoscaled core decompression rods combined with mesenchymal stem cells had satisfactory clinical effects, suggesting that this implantation should be effective to treat early ONFH.

  15. Ergodic averages via dominating processes

    DEFF Research Database (Denmark)

    Møller, Jesper; Mengersen, Kerrie

    2006-01-01

    We show how the mean of a monotone function (defined on a state space equipped with a partial ordering) can be estimated, using ergodic averages calculated from upper and lower dominating processes of a stationary irreducible Markov chain. In particular, we do not need to simulate the stationary...... Markov chain and we eliminate the problem of whether an appropriate burn-in is determined or not. Moreover, when a central limit theorem applies, we show how confidence intervals for the mean can be estimated by bounding the asymptotic variance of the ergodic average based on the equilibrium chain....

  16. Effects of conventional high-voltage irradiation and proton irradiation as adjuncts to surgical measures in acromegaly with particular attention being given to the further course of illness with and without drug treatment

    International Nuclear Information System (INIS)

    Lutz, B.S.

    1986-01-01

    Comparisons of effectiveness and side-effect levels were carried out between conventional high-voltage irradiation and proton irradiation being used as adjunctive treatment in 56 patients suffering from acromegaly, whose STH levels had failed to return to normal (STH > 4.5 ng/ml) after surgery. For the evaluation of the results it was also of importance, if the patients were subjected to drug treatment or allowed to recover spontaneously during follow-up. The two therapeutic strategies were found to be equally potent. In both patient groups, the decreases in STH achieved over 4.5 to 5 years averaged 80%. Proton irradiation was associated with a higher rate of injuries to the anterior lobe of the pituitary, while the damage caused by conventional irradiation mostly was of a more severe nature (like generalised attacks). On an average, the STH levels of patients under treatment with dopamine agonists were reduced by approx. 67% within three years. In the group of patients receiving no further treatment in spite of sustained STH elevations (spontaneous recoveries) after surgery, 76.5% were found to have normal STH basal values by that time. (ECB) [de

  17. Endoscopic laser treatment for rectosigmoid villous adenoma: factors effecting the results

    Science.gov (United States)

    Brunetaud, Jean Marc; Maunoury, Vincent; Cochelard, Dominique; Boniface, Brigitte

    1994-12-01

    This present work reports the long term results after endoscopic laser treatment in 474 patients with benign rectosigmoid villous adenomas revealed by biopsy. Two types of wavelength were used: The 1.06 micrometers infrared light from the Nd:YAG laser and the green light from the argon laser or the Nd:YAG frequency doubled laser. In some patients, both wavelengths were used. Treatment was completed in 415 patients. Total tumor destruction was obtained in 92.8% of them, a carcinoma was detected in 6.5% on biopsy specimens obtained during laser treatment, and benign villous tissue persisted in 0.7%. During the average 30 mo. follow up period of the patients with total tumor destruction, 18% had a tumor recurrence. Treatment was well tolerated with a 1.8% complication rate (one perforation, one hemorrhage, and 7 stenosis requiring dilatation). Because treatment is long and difficult and cancer rate is high, endoscopic laser should be limited in patients with a circumferential villous adenoma to nonsurgical candidates. The risk of complication after surgery (some being fatal) has to be balanced against the risk of undetected carcinoma in the other patients and the indication for endoscopic laser treatment should be discussed case by case.

  18. A quantitative method to evaluate microbial electrolysis cell effectiveness for energy recovery and wastewater treatment

    KAUST Repository

    Ivanov, Ivan

    2013-10-01

    Microbial electrolysis cells (MECs) are potential candidates for sustainable wastewater treatment as they allow for recovery of the energy input by producing valuable chemicals such as hydrogen gas. Evaluating the effectiveness of MEC treatment for different wastewaters requires new approaches to quantify performance, and the establishment of specific procedures and parameters to characterize the outcome of fed-batch treatability tests. It is shown here that Coulombic efficiency can be used to directly calculate energy consumption relative to wastewater treatment in terms of COD removal, and that the average current, not maximum current, is a better metric to evaluate the rate of the bioelectrochemical reactions. The utility of these methods was demonstrated using simulated current profiles and actual wastewater tests. Industrial and domestic wastewaters were evaluated using small volume MECs, and different inoculation strategies. The energy needed for treatment was 2.17kWhkgCOD-1 for industrial wastewater and 2.59kWhkgCOD-1 for domestic wastewater. When these wastewaters were combined in equal amounts, the energy required was reduced to 0.63kWhkgCOD-1. Acclimation of the MEC to domestic wastewater, prior to tests with industrial wastewaters, was the easiest and most direct method to optimize MEC performance for industrial wastewater treatment. A pre-acclimated MEC accomplished the same removal (1847 ± 53 mg L-1) as reactor acclimated to only the industrial wastewater (1839 ± 57 mg L-1), but treatment was achieved in significantly less time (70 h versus 238 h). © 2013, Hydrogen Energy Publications, LLC. Published by Elsevier Ltd. All rights reserved.

  19. Preference for Averageness in Faces Does Not Generalize to Non-Human Primates

    Directory of Open Access Journals (Sweden)

    Olivia B. Tomeo

    2017-07-01

    Full Text Available Facial attractiveness is a long-standing topic of active study in both neuroscience and social science, motivated by its positive social consequences. Over the past few decades, it has been established that averageness is a major factor influencing judgments of facial attractiveness in humans. Non-human primates share similar social behaviors as well as neural mechanisms related to face processing with humans. However, it is unknown whether monkeys, like humans, also find particular faces attractive and, if so, which kind of facial traits they prefer. To address these questions, we investigated the effect of averageness on preferences for faces in monkeys. We tested three adult male rhesus macaques using a visual paired comparison (VPC task, in which they viewed pairs of faces (both individual faces, or one individual face and one average face; viewing time was used as a measure of preference. We did find that monkeys looked longer at certain individual faces than others. However, unlike humans, monkeys did not prefer the average face over individual faces. In fact, the more the individual face differed from the average face, the longer the monkeys looked at it, indicating that the average face likely plays a role in face recognition rather than in judgments of facial attractiveness: in models of face recognition, the average face operates as the norm against which individual faces are compared and recognized. Taken together, our study suggests that the preference for averageness in faces does not generalize to non-human primates.

  20. Effectiveness and safety of topical tacrolimus in treatment of vitiligo

    Directory of Open Access Journals (Sweden)

    Ghasem Rahmatpour Rokni

    2017-01-01

    Full Text Available Vitiligo is one of the most primitive well-known dermatoid disorders with different suggested therapies. Therefore, this study investigated the efficiency and safety of topical tacrolimus in treatment of patients with vitiligo. This study was a clinical randomized designed study pre- post-test method, has been conducted on thirty cases with vitiligo who have referred to polyclinic and dermatology clinic. Participant′s evaluated and demographic information recorded in designed checklist. In the next stage, the disease activity scored by vitiligo index disease activity system. Photography and depigmentation percent has recorded before treatment and further in 4 th , 8 th , 12 th , 16 th , 20 th , and 24 th weeks. Finally, gathered data compared through SPSS-20 software. The final sample comprised 30 persons including: 12 men (40% and 18 women (60%. The average of patient′s age in this study was 26/13 ΁ 18/20 (2-76-year-old. Eleven persons was ≤15 years old and rest was older than 15. Sixty-six lesions have funded in patients that maximum has accrued on face and neck (37/87% and trunk (21/21%. In addition, minimum of lesions is related to genitalia (9/09%. In the in 4 th , 8 th , 12 th , 16 th weeks, improvement in face and neck had increased significantly, into the past weeks. In the 20 th and 24 th weeks, the improvement has increased although it was not significant enhancement. Also about trunk, in the 4 th week the improvement does not have significant increasing in compare to the past week. In the eighth, 12 th , 16 th , 20 th , and 24 th weeks the improvement has been increased significantly in compare to the past weeks. Although in the case of limbs and genitalia, the improvement was lower. There was no significant difference between male and females and age. Although the improvement was, slow in older persons. Study results, has presented applying topical tacrolimus in vitiligo, particularly in face and neck, could be effective and

  1. Parent perspectives on information about late effects of childhood cancer treatment and their role in initial treatment decision making.

    Science.gov (United States)

    Greenzang, Katie A; Dauti, Angela; Mack, Jennifer W

    2018-06-01

    Though most childhood cancer survivors experience late effects of treatment, we know little about parent preferences for late effects information during therapy, or how parents weigh late effects when making treatment decisions. Our objective was to explore how parents of children with cancer consider late effects in initial treatment decision making and during active cancer treatment. Semistructured interviews were conducted with 12 parents of children with cancer who were actively receiving treatment at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Interviews were audio-recorded, transcribed verbatim, and qualitatively analyzed using thematic analysis. Ten of 12 parents reported that they had to decide between two or more treatment options for their child's cancer. Of those, 50% (5/10) considered late effects to be an important factor in their decision making. Most parents wanted early and detailed information about their child's risk of late effects to make treatment decisions and to feel prepared for the future. However, a few parents felt too overwhelmed to focus on late effects at diagnosis. While many recalled extensive late effects information in informed consent discussions, some parents felt these issues were minimally addressed. Parents desire detailed information about late effects to make informed treatment decisions and prepare for the future. Despite the role of late effects in treatment decision making, some parents feel that late effects are either inadequately addressed or too overwhelming to process at diagnosis. Parents may benefit from early assessment of their information needs and a return to these issues over time. © 2018 Wiley Periodicals, Inc.

  2. Closed treatment of overriding distal radial fractures without reduction in children.

    Science.gov (United States)

    Crawford, Scott N; Lee, Lorrin S K; Izuka, Byron H

    2012-02-01

    Traditionally, distal radial fractures with marked displacement and angulation have been treated with closed or open reduction techniques. Reduction maneuvers generally require analgesia and sedation, which increase hospital time, cost, patient risk, and the surgeon's time. In our study, a treatment protocol for pediatric distal radial fractures was used in which the fracture was left shortened in an overriding position and a cast was applied without an attempt at anatomic fracture reduction. Consecutive patients three to ten years of age presenting between 2004 and 2009 with a closed overriding fracture of the distal radial metaphysis were followed prospectively. Our protocol consisted of no analgesia, no sedation, and a short arm fiberglass cast gently molded to correct only angulation. Patients were followed for at least one year. All parents or guardians were given a questionnaire assessing their satisfaction with the treatment. Financial analysis was performed with use of Current Procedural Terminology codes and the average total cost of care. Fifty-one children with an average age of 6.9 years were included in the study. Initial radial shortening averaged 5.0 mm. Initial sagittal and coronal angulation averaged 4.0° and 3.2°, respectively. The average duration of casting was forty-two days. Residual sagittal and coronal angulation at the time of final follow-up averaged 2.2° and 0.8°, respectively. All fifty-one patients achieved clinical and radiographic union with a full range of wrist motion. All parents and guardians answered the questionnaire and were satisfied with the treatment. Cost analysis demonstrated that closed reduction with the patient under conscious sedation or general anesthesia is nearly five to six times more expensive than the treatment used in this study. Adding percutaneous pin fixation increases costs nearly ninefold. This treatment protocol presents an alternative approach to overriding distal radial fractures in children and

  3. Cost-Effectiveness Analysis of Pharmacotherapy for Hematemesis-Melena Treatment in Hospitalized Patients with Hepatic Cirrhosis

    Directory of Open Access Journals (Sweden)

    Doddy de Queljoe

    2013-04-01

    Full Text Available BACKGROUND: Acute variceal haemorrhage is a complication of cirrhosis that can be life threatening. It is a pharmacist’s duty to ensure therapeutic and pharmaceutical care which is not only safe and effective for the patient but also is cost-effective in order to attain improvement of the patient’s quality of life. Therefore, pharmacoeconomic evaluation especially cost-effectiveness analysis (CEA, which compares costs and consequences of drug therapy, is needed. This study was aimed to evaluate the therapeutic cost-effectiveness of hematemesis-melena treatment in hepatic cirrhotic patients. METHODS: A total of 42 patients receiving vitamin K and vitamin K-transamin were studied retrospectively from patients’ medical records in 2 years and analyzed with cost-effectiveness grid and average cost-effectiveness ratio (ACER based on Child-Turcotte-Pugh (CTP Score. RESULTS: Cost-effectiveness grid was dominant for vitamin K in patients with CTP Score A. ACER analysis showed a lower score for vitamin K in all patients included CTP Score classification. There was no significant difference in duration of cessation of bleeding treatment in patients with vitamin K compared with vitamin K-transamin in patients with CTP Score A and B, while significant difference was found in patients with CTP Score C. CONCLUSIONS: Vitamin K appeared to be more cost effective as compared with vitamin K-transamin in all patients. The use of vitamin K had greater benefit than the combination with transamin in all patients and CTP Score classification, and thus should be considered as a primary therapy. Therefore, transamin addition as an alternative therapy for hepatic cirrhosis patients with hematemesis-melena should be considered. KEYWORDS: CEA, cost-effectiveness analysis, child-turcotte-pugh score, hepatic cirrhosis, hematemesismelena, vitamin K, transamin.

  4. The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis.

    Science.gov (United States)

    Barrett, Kody K; Lee, Christopher; Myung, Karen; Johnston, Charles; Shah, Suken A; Akbarnia, Behrooz A; Skaggs, David L

    2016-09-01

    This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery. Data were retrospectively collected on 66 EOS patients without confounding respiratory issues or oxygen dependence who were treated with GRs at 5 institutions. Average age at initial surgery was 5.5 years. Patients were followed for a minimum of 2 years (average 3.7 y). Preoperative and postoperative Hgb and Hct levels were converted to Z-scores based on age-adjusted mean blood indices and were compared using a paired t test. The prevalence of elevated Hgb and Hct levels (Z-score >2) preoperatively was 15% (10/66) and 19% (12/64), respectively. The average Hgb Z-score decreased from 0.20 to -0.31 (P=0.005) 6 to 24 months following surgery and the Hct Z-score decreased from 0.31 to -0.28 (P=0.002) 6 to 24 months following surgery. Following distraction-based GR treatment of children with EOS there was a significant decrease in both their Hgb and Hct. This is a physiological marker of decreased hypoxemia and improved pulmonary function. Level III-therapeutic study.

  5. [The effect of nutritional therapy in the treatment of laryngeal cancer].

    Science.gov (United States)

    Botella Romero, F; Simal Antón, A; Motilla Valeriano, T; Martínez Montero, P; Mata Castro, N; González Martí, F

    1995-01-01

    Laryngeal cancer constitutes and important problem from the nutritional point of view, both due to the effect of the tumor itself as due to the aggressive treatment to which the majority of these patients are subjected. To evaluate the incidence of nutritional support on the morbid-mortality and on the number of hospitalization days, we compare a group A of 61 patients diagnosed with laryngeal squamous cell carcinoma, who received treatment from the Department of Nutrition, with another, similar group B, who received a standard diet. a complete evaluation of the nutritional status was done (anthropometric biochemical and immunological parameters) one day prior to the surgery and two weeks after. The differences of age (61 vs 63 years), cigarette smoking (31 vs 34), excessive alcohol ingestion (34 vs 29), location of the tumor and type of surgery, were not significant. The nutritional treatment used in group A was enteral nutrition by means of a 12-F polyurethane naso-gastric tube, while in group B it was the ground up culinary diet through a large caliber naso-gastric tube. There were no significant differences in the mortality (1/0) or in the surgical complications (9/10); nevertheless, the average number of hospital days was clearly lower in group A (18 days) compared to group B (24 days) (p < 0.005). The evolution of the evaluation parameters of the nutritional status was analyzed, as well as the administered dietary formulae, added medication, and the complications of the technique. Regulated nutritional support may contribute to the decrease of the hospitalization period of patients operated on for laryngeal cancer.

  6. [Effect of the estrogen antagonist tamoxifen in the treatment of advanced mastocarcinoma (author's transl)].

    Science.gov (United States)

    Szepesi, T; Kärcher, K H

    1977-12-01

    Today the endocrin therapy of the advanced mastocarcinoma is in common use. Besides the already known therapy by estrogens, androgens, gestagens, and steroids, Tamoxifen, and estrogen antagonist, is a very promising therapeutic drug. In the presented study, Tamoxifen was submitted to a critical clinical control during a period of one year from 1st October 1975 until 1st October 1976. After a three months' treatment, a rate of 41% of objective remissions could be obtained. The criteria of success were estimated according to the scheme of Karnofsky. The average remission time is 5,5 months. By a determination of the estrogen receptors it would be possible to realize a therapeutic selection and to achieve a higher remission rate. The authors made an interesting observation, i.e. a probably immuno-stimulating effect which, however, still has to be submitted to further examinations. The side effects are described in detail and the indications are established. Its is astonishing that the subjective ameliorations, i.e. cessation of pains in case of generalized formation of metastases in the bones are much more frequent than the objective remissions. We came to the conclusion that the treatment by Tamoxifen is a valuable alternative in the therapy of the mastocarcinoma, above all in the postmenopausal period if the disease is advanced and incurable.

  7. Thin-plate spline analysis of the effects of face mask treatment in children with maxillary retrognathism.

    Science.gov (United States)

    Chang, Jenny Zwei-Chieng; Liu, Pao-Hsin; Chen, Yi-Jane; Yao, Jane Chung-Chen; Chang, Hong-Po; Chang, Chih-Han; Chang, Frank Hsin-Fu

    2006-02-01

    Face mask therapy is indicated for growing patients who suffer from maxillary retrognathia. Most previous studies used conventional cephalometric analysis to evaluate the effects of face mask treatment. Cephalometric analysis has been shown to be insufficient for complex craniofacial configurations. The purpose of this study was to investigate changes in the craniofacial structure of children with maxillary retrognathism following face mask treatment by means of thin-plate spline analysis. Thirty children with skeletal Class III malocclusions who had been treated with face masks were compared with a group of 30 untreated gender-matched, age-matched, observation period-matched, and craniofacial configuration-matched subjects. Average geometries, scaled to an equivalent size, were generated by means of Procrustes analysis. Thin-plate spline analysis was then performed for localization of the shape changes. Face mask treatment induced a forward displacement of the maxilla, a counterclockwise rotation of the palatal plane, a horizontal compression of the anterior border of the symphysis and the condylar region, and a downward deformation of the menton. The cranial base exhibited a counterclockwise deformation as a whole. We conclude that thin-plate spline analysis is a valuable supplement to conventional cephalometric analysis.

  8. Integrated MRSA-Management (IMM with prolonged decolonization treatment after hospital discharge is effective: a single centre, non-randomised open-label trial

    Directory of Open Access Journals (Sweden)

    Bernhard Jahn

    2016-06-01

    Full Text Available Abstract Background Guidelines for the control of hospital-acquired MRSA include decolonization measures to end MRSA carrier status in colonized and infected patients. Successful decolonization typically requires up to 22 days of treatment, which is longer than the average hospital length of stay (LOS. Incomplete decolonization is therefore common, with long-term MRSA carriage as a consequence. To overcome this, we developed an integrated MRSA Management (IMM by extending MRSA decolonization to the outpatient and domestic setting. The protocol makes use of polyhexanide-based products, in view of reported qac-mediated resistance to chlorhexidine in S. aureus and MRSA. Methods This is a prospective, single centre, controlled, non-randomized, open-label study to evaluate the efficiency of the IMM concept. The outcome of guideline-approved decolonization during hospital stay only (control group; n = 201 was compared to the outcome following IMM treatment whereby decolonization was continued after discharge in the domestic setting or in a long-term care facility (study group; n = 99. As a secondary outcome, the effect of MRSA-status of skin alterations was assessed. Results The overall decolonization rate was 47 % in the IMM patient group compared to 12 % in the control group (p  0.05. For patients with skin alterations (e.g. wounds and entry sites, decolonization success was 50 % if the skin alterations were MRSA-negative at baseline, compared to 22 % success for patients entering the study with MRSA-positive skin alterations (p < 0.01. Conclusions The IMM strategy offers an MRSA decolonization protocol that is feasible in the domestic setting and is equally effective compared with inpatient decolonization treatment when hospital LOS is long enough to complete the treatment. Moreover, for patients with average LOS, decolonization rates obtained with IMM are significantly higher than for in-hospital treatment. IMM is a promising

  9. Effects of spot parameters in pencil beam scanning treatment planning.

    Science.gov (United States)

    Kraan, Aafke Christine; Depauw, Nicolas; Clasie, Ben; Giunta, Marina; Madden, Tom; Kooy, Hanne M

    2018-01-01

    Spot size σ (in air at isocenter), interspot spacing d, and spot charge q influence dose delivery efficiency and plan quality in Intensity Modulated Proton Therapy (IMPT) treatment planning. The choice and range of parameters varies among different manufacturers. The goal of this work is to demonstrate the influence of the spot parameters on dose quality and delivery in IMPT treatment plans, to show their interdependence, and to make practitioners aware of the spot parameter values for a certain facility. Our study could help as a guideline to make the trade-off between treatment quality and time in existing PBS centers and in future systems. We created plans for seven patients and a phantom, with different tumor sites and volumes, and compared the effect of small-, medium-, and large-spot widths (σ = 2.5, 5, and 10 mm) and interspot distances (1σ, 1.5σ, and 1.75σ) on dose, spot charge, and treatment time. Moreover, we quantified how postplanning charge threshold cuts affect plan quality and the total number of spots to deliver, for different spot widths and interspot distances. We show the effect of a minimum charge (or MU) cutoff value for a given proton delivery system. Spot size had a strong influence on dose: larger spots resulted in more protons delivered outside the target region. We observed dose differences of 2-13 Gy (RBE) between 2.5 mm and 10 mm spots, where the amount of extra dose was due to dose penumbra around the target region. Interspot distance had little influence on dose quality for our patient group. Both parameters strongly influence spot charge in the plans and thus the possible impact of postplanning charge threshold cuts. If such charge thresholds are not included in the treatment planning system (TPS), it is important that the practitioner validates that a given combination of lower charge threshold, interspot spacing, and spot size does not result in a plan degradation. Low average spot charge occurs for small spots, small interspot

  10. Tendon surveillance requirements - average tendon force

    International Nuclear Information System (INIS)

    Fulton, J.F.

    1982-01-01

    Proposed Rev. 3 to USNRC Reg. Guide 1.35 discusses the need for comparing, for individual tendons, the measured and predicted lift-off forces. Such a comparison is intended to detect any abnormal tendon force loss which might occur. Recognizing that there are uncertainties in the prediction of tendon losses, proposed Guide 1.35.1 has allowed specific tolerances on the fundamental losses. Thus, the lift-off force acceptance criteria for individual tendons appearing in Reg. Guide 1.35, Proposed Rev. 3, is stated relative to a lower bound predicted tendon force, which is obtained using the 'plus' tolerances on the fundamental losses. There is an additional acceptance criterion for the lift-off forces which is not specifically addressed in these two Reg. Guides; however, it is included in a proposed Subsection IWX to ASME Code Section XI. This criterion is based on the overriding requirement that the magnitude of prestress in the containment structure be sufficeint to meet the minimum prestress design requirements. This design requirement can be expressed as an average tendon force for each group of vertical hoop, or dome tendons. For the purpose of comparing the actual tendon forces with the required average tendon force, the lift-off forces measured for a sample of tendons within each group can be averaged to construct the average force for the entire group. However, the individual lift-off forces must be 'corrected' (normalized) prior to obtaining the sample average. This paper derives the correction factor to be used for this purpose. (orig./RW)

  11. Effects of unplanned treatment interruptions on HIV treatment failure– results from TAHOD

    Science.gov (United States)

    Jiamsakul, Awachana; Kerr, Stephen J.; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L. H.; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

    2016-01-01

    Objectives Treatment interruptions (TI) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Methods Patients initiating cART between 2006-2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Co-variables with p30 days were associated with failure (31-180 days HR=2.66, 95%CI (1.70-4.16); 181-365 days HR=6.22, 95%CI (3.26-11.86); and >365 days HR=9.10, 95% CI (4.27-19.38), all pfailure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. PMID:26950901

  12. Strategies for maximizing clinical effectiveness in the treatment of schizophrenia.

    Science.gov (United States)

    Tandon, Rajiv; Targum, Steven D; Nasrallah, Henry A; Ross, Ruth

    2006-11-01

    The ultimate clinical objective in the treatment of schizophrenia is to enable affected individuals to lead maximally productive and personally meaningful lives. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services directed towards enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. In this review, we provide a conceptual framework for considering approaches for maximizing the effectiveness of the array of treatments and other services towards promoting recovery of persons with schizophrenia. We discuss pharmacological, psychological, and social strategies that decrease the burden of the disease of schizophrenia on affected individuals and their families while adding the least possible burden of treatment. In view of the multitude of treatments necessary to optimize outcomes for individuals with schizophrenia, effective coordination of these services is essential. In addition to providing best possible clinical assessment and pharmacological treatment, the psychiatrist must function as an effective leader of the treatment team. To do so, however, the psychiatrist must be knowledgeable about the range of available services, must have skills in clinical-administrative leadership, and must accept the responsibility of coordinating the planning and delivery of this multidimensional array of treatments and services. Finally, the effectiveness of providing optimal individualized treatment/rehabilitation is best gauged by measuring progress on multiple effectiveness domains. Approaches for efficient and reliable assessment are discussed.

  13. Average Bandwidth Allocation Model of WFQ

    Directory of Open Access Journals (Sweden)

    Tomáš Balogh

    2012-01-01

    Full Text Available We present a new iterative method for the calculation of average bandwidth assignment to traffic flows using a WFQ scheduler in IP based NGN networks. The bandwidth assignment calculation is based on the link speed, assigned weights, arrival rate, and average packet length or input rate of the traffic flows. We prove the model outcome with examples and simulation results using NS2 simulator.

  14. MOSFET detectors in quality assurance of tomotherapy treatments.

    Science.gov (United States)

    Cherpak, Amanda; Studinski, Ryan C N; Cygler, Joanna E

    2008-02-01

    The purpose of this work was to characterize metal oxide semiconductor field-effect transistors (MOSFETs) in a 6 MV conventional linac and investigate their use for quality assurance of radiotherapy treatments with a tomotherapy Hi-Art unit. High sensitivity and standard sensitivity MOSFETs were first calibrated and then tested for reproducibility, field size dependence, and accuracy of measuring surface dose in a 6 MV beam as well as in a tomotherapy Hi-Art unit. In vivo measurements were performed on both a RANDO phantom and several head and neck cancer patients treated with tomotherapy and compared to TLD measurements and treatment plan doses to evaluate the performance of MOSFETs in a high gradient radiation field. The average calibration factor found was 0.345+/-2.5%cGy/mV for the high sensitivity MOSFETs tested and 0.901+/-2.4%cGy/mV for the standard sensitivity MOSFETs. MOSFET measured surface doses had an average agreement with ion chamber measurements of 1.55% for the high sensitivity MOSFET and 5.23% for the standard sensitivity MOSFET when averaged over all trials and field sizes tested. No significant dependence on field size was found for the standard sensitivity MOSFETs, however a maximum difference of 5.34% was found for the high sensitivity MOSFET calibration factors in the field sizes tested. Measurements made with MOSFETS on head and neck patients treated on a tomotherapy Hi-Art unit had an average agreement of (3.26+/-0.03)% with TLD measurements, however the average of the absolute difference between the MOSFET measurements and the treatment plan skin doses was (12.2+/-7.5)%. The MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1.4% to 6.6%. Similar results were found from trials using a RANDO phantom. The MOSFETs performed well when used in the tomotherapy Hi-Art unit and did not increase the overall treatment set-up time when used for patient measurements. It was found that MOSFETs

  15. The Chicken Soup Effect: The Role of Recreation and Intramural Participation in Boosting Freshman Grade Point Average

    Science.gov (United States)

    Gibbison, Godfrey A.; Henry, Tracyann L.; Perkins-Brown, Jayne

    2011-01-01

    Freshman grade point average, in particular first semester grade point average, is an important predictor of survival and eventual student success in college. As many institutions of higher learning are searching for ways to improve student success, one would hope that policies geared towards the success of freshmen have long term benefits…

  16. Late effects of treatment of cancer in infancy

    International Nuclear Information System (INIS)

    Pastore, G.; Antonelli, R.; Fine, W.; Li, F.P.; Sallan, S.E.

    1982-01-01

    Eighty-six children were diagnosed with cancer in infancy, followed for at lest 5 years, and assessed for late effects of disease and therapy. One child subsequently died from respiratory failure and 3 died from second primary cancers. Another patient survived second primary cancers of the skin. The high frequency of new cancers (4 observed, 0.09 expected) was attributable to host susceptibility factors and treatment effects. Kyphoscoliosis was diagnosed in 44 patients, 40 of whom had received radiotherapy to the spine. Other patients had neurologic deficits, pulmonary fibrosis, hypoplastic breasts, bowel adhesions, thyroid nodules, musculoskeletal defects, and liver fibrosis associated with tumor therapy. Sequelae of cancer were more common after treatment in infancy than in later childhood. Improved treatments and knowledge of natural history can reduce adverse effects of therapy

  17. On various validity criteria for the configuration average in collisional-radiative codes

    Energy Technology Data Exchange (ETDEWEB)

    Poirier, M [Commissariat a l' Energie Atomique, Service ' Photons, Atomes et Molecules' , Centre d' Etudes de Saclay, F91191 Gif-sur-Yvette Cedex (France)

    2008-01-28

    The characterization of out-of-local-thermal-equilibrium plasmas requires the use of collisional-radiative kinetic equations. This leads to the solution of large linear systems, for which statistical treatments such as configuration average may bring considerable simplification. In order to check the validity of this procedure, a criterion based on the comparison between a partial-rate systems and the Saha-Boltzmann solution is discussed in detail here. Several forms of this criterion are discussed. The interest of these variants is that they involve each type of relevant transition (collisional or radiative), which allows one to check separately the influence of each of these processes on the configuration-average validity. The method is illustrated by a charge-distribution analysis in carbon and neon plasmas. Finally, it is demonstrated that when the energy dispersion of every populated configuration is smaller than the electron thermal energy, the proposed criterion is fulfilled in each of its forms.

  18. Colorectal cancer screening for average-risk North Americans: an economic evaluation.

    Directory of Open Access Journals (Sweden)

    Steven J Heitman

    Full Text Available BACKGROUND: Colorectal cancer (CRC fulfills the World Health Organization criteria for mass screening, but screening uptake is low in most countries. CRC screening is resource intensive, and it is unclear if an optimal strategy exists. The objective of this study was to perform an economic evaluation of CRC screening in average risk North American individuals considering all relevant screening modalities and current CRC treatment costs. METHODS AND FINDINGS: An incremental cost-utility analysis using a Markov model was performed comparing guaiac-based fecal occult blood test (FOBT or fecal immunochemical test (FIT annually, fecal DNA every 3 years, flexible sigmoidoscopy or computed tomographic colonography every 5 years, and colonoscopy every 10 years. All strategies were also compared to a no screening natural history arm. Given that different FIT assays and collection methods have been previously tested, three distinct FIT testing strategies were considered, on the basis of studies that have reported "low," "mid," and "high" test performance characteristics for detecting adenomas and CRC. Adenoma and CRC prevalence rates were based on a recent systematic review whereas screening adherence, test performance, and CRC treatment costs were based on publicly available data. The outcome measures included lifetime costs, number of cancers, cancer-related deaths, quality-adjusted life-years gained, and incremental cost-utility ratios. Sensitivity and scenario analyses were performed. Annual FIT, assuming mid-range testing characteristics, was more effective and less costly compared to all strategies (including no screening except FIT-high. Among the lifetimes of 100,000 average-risk patients, the number of cancers could be reduced from 4,857 to 1,393 [corrected] and the number of CRC deaths from 1,782 [corrected] to 457, while saving CAN$68 per person. Although screening patients with FIT became more expensive than a strategy of no screening when the

  19. A Group Neighborhood Average Clock Synchronization Protocol for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Lin Lin

    2014-08-01

    Full Text Available Clock synchronization is a very important issue for the applications of wireless sensor networks. The sensors need to keep a strict clock so that users can know exactly what happens in the monitoring area at the same time. This paper proposes a novel internal distributed clock synchronization solution using group neighborhood average. Each sensor node collects the offset and skew rate of the neighbors. Group averaging of offset and skew rate value are calculated instead of conventional point-to-point averaging method. The sensor node then returns compensated value back to the neighbors. The propagation delay is considered and compensated. The analytical analysis of offset and skew compensation is presented. Simulation results validate the effectiveness of the protocol and reveal that the protocol allows sensor networks to quickly establish a consensus clock and maintain a small deviation from the consensus clock.

  20. Early treatment with GH alone in Turner syndrome: prepubertal catch-up growth and waning effect.

    Science.gov (United States)

    Wasniewska, Malgorzata; De Luca, Filippo; Bergamaschi, Rosalba; Guarneri, Maria Pia; Mazzanti, Laura; Matarazzo, Patrizia; Petri, Antonella; Crisafulli, Giuseppe; Salzano, Giuseppina; Lombardo, Fortunato

    2004-11-01

    In order to ascertain the advantages of early GH treatment in Turner syndrome (TS), we started a prospective study aimed at evaluating prepubertal height gain in a cohort of 29 girls who were treated with the same pro-kilo GH dose (1.0 IU/kg per week) since they were less than 6 years old and for at least 5 years before entering puberty. Following a minimum of 6 months of baseline observations, 29 girls with TS were enrolled for this prospective study provided that they (a) were less than 6 years old, (b) were below -1.0 standard deviation score (SDS) for height, (c) had a projected adult height (PAH) lower than the respective target height (TH) and (d) had a height velocity (HV) lower than -1.0 SDS. All the selected girls underwent a 5-year treatment with biosynthetic GH at a stable dose of 1.0 IU/kg per week and were periodically measured during the treatment period in order to evaluate height, HV and PAH. After a dramatic acceleration during the 1st year, HV was attenuated during the subsequent years, reaching its nadir at the 5th year. Height deficiency under therapy progressively decreased from entry onwards, shifting from -2.4+/-0.7 to -1.0+/-1.2 SDS. In the same period, mean PAH progressively increased, although after 5 years it remained lower than the average TH. (a) An effective growth-promoting strategy in TS should be based on early GH treatment, as suggested by our results. (b) This strategy could result in a prepubertal normalization of height, thus allowing the appropriate timing for the induction of puberty. (c) An initial GH dose of 1.0 IU/kg per week may be suitable during the first years of therapy, as shown by our data documenting an important waning effect of GH therapy only after the 4th year of treatment. (d) No acceleration of bone maturation was observed under this treatment regimen.

  1. Medical nutrition therapy as a potential complementary treatment for psoriasis--five case reports.

    Science.gov (United States)

    Brown, Amy C; Hairfield, Michelle; Richards, Douglas G; McMillin, David L; Mein, Eric A; Nelson, Carl D

    2004-09-01

    This research evaluated five case studies of patients with psoriasis following a dietary regimen. There is no cure for psoriasis and the multiple treatments currently available only attempt to reduce the severity of symptoms. Treatments range from topical applications, systemic therapies, and phototherapy; while some are effective, many are associated with significant adverse effects. There is a need for effective, affordable therapies with fewer side effects that address the causes of the disorder. Evaluation consisted of a study group of five patients diagnosed with chronic plaque psoriasis (two men and three women, average age 52 years; range 40-68 years) attending a 10-day, live-in program during which a physician assessed psoriasis symptoms and bowel permeability. Subjects were then instructed on continuing the therapy protocol at home for six months. The dietary protocol, based on Edgar Cayce readings, included a diet of fresh fruits and vegetables, small amounts of protein from fish and fowl, fiber supplements, olive oil, and avoidance of red meat, processed foods, and refined carbohydrates. Saffron tea and slippery elm bark water were consumed daily. The five psoriasis cases, ranging from mild to severe at the study onset, improved on all measured outcomes over a six-month period when measured by the Psoriasis Area and Severity Index (PASI) (average pre- and post-test scores were 18.2 and 8.7, respectively), the Psoriasis Severity Scale (PSS) (average pre- and post-test scores were 14.6 and 5.4, respectively), and the lactulose/mannitol test of intestinal permeability (average pre- and post-test scores were 0.066 to 0.026, respectively). These results suggest a dietary regimen based on Edgar Cayce's readings may be an effective medical nutrition therapy for the complementary treatment of psoriasis; however, further research is warranted to confirm these results.

  2. Cost-effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts: economic evaluation alongside a randomised controlled trial (EVerT trial

    Directory of Open Access Journals (Sweden)

    Stamuli Eugena

    2012-02-01

    Full Text Available Abstract Background Plantar warts (verrucae are extremely common. Although many will spontaneously disappear without treatment, treatment may be sought for a variety of reasons such as discomfort. There are a number of different treatments for cutaneous warts, with salicylic acid and cryotherapy using liquid nitrogen being two of the most common forms of treatment. To date, no full economic evaluation of either salicylic acid or cryotherapy has been conducted based on the use of primary data in a pragmatic setting. This paper describes the cost-effectiveness analysis which was conducted alongside a pragmatic multicentre, randomised trial evaluating the clinical effectiveness of cryotherapy versus 50% salicylic acid of the treatment of plantar warts. Methods A cost-effectiveness analysis was undertaken alongside a pragmatic multicentre, randomised controlled trial assessing the clinical effectiveness of 50% salicylic acid and cryotherapy using liquid nitrogen at 12 weeks after randomisation of patients. Cost-effectiveness outcomes were expressed as the additional cost required to completely cure the plantar warts of one additional patient. A NHS perspective was taken for the analysis. Results Cryotherapy costs on average £101.17 (bias corrected and accelerated (BCA 95% CI: 85.09-117.26 more per participant over the 12 week time-frame, while there is no additional benefit, in terms of proportion of patients healed compared with salicylic acid. Conclusions Cryotherapy is more costly and no more effective than salicylic acid. Trial registration Current Controlled Trials ISRCTN18994246 [controlled-trials.com] and National Research Register N0484189151.

  3. Cost-effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts: economic evaluation alongside a randomised controlled trial (EVerT trial)

    Science.gov (United States)

    2012-01-01

    Abstract Background Plantar warts (verrucae) are extremely common. Although many will spontaneously disappear without treatment, treatment may be sought for a variety of reasons such as discomfort. There are a number of different treatments for cutaneous warts, with salicylic acid and cryotherapy using liquid nitrogen being two of the most common forms of treatment. To date, no full economic evaluation of either salicylic acid or cryotherapy has been conducted based on the use of primary data in a pragmatic setting. This paper describes the cost-effectiveness analysis which was conducted alongside a pragmatic multicentre, randomised trial evaluating the clinical effectiveness of cryotherapy versus 50% salicylic acid of the treatment of plantar warts. Methods A cost-effectiveness analysis was undertaken alongside a pragmatic multicentre, randomised controlled trial assessing the clinical effectiveness of 50% salicylic acid and cryotherapy using liquid nitrogen at 12 weeks after randomisation of patients. Cost-effectiveness outcomes were expressed as the additional cost required to completely cure the plantar warts of one additional patient. A NHS perspective was taken for the analysis. Results Cryotherapy costs on average £101.17 (bias corrected and accelerated (BCA) 95% CI: 85.09-117.26) more per participant over the 12 week time-frame, while there is no additional benefit, in terms of proportion of patients healed compared with salicylic acid. Conclusions Cryotherapy is more costly and no more effective than salicylic acid. Trial registration Current Controlled Trials ISRCTN18994246 [controlled-trials.com] and National Research Register N0484189151. PMID:22369511

  4. Investigation of timing effects in modified composite quadrupolar echo pulse sequences by mean of average Hamiltonian theory

    Science.gov (United States)

    Mananga, Eugene Stephane

    2018-01-01

    The utility of the average Hamiltonian theory and its antecedent the Magnus expansion is presented. We assessed the concept of convergence of the Magnus expansion in quadrupolar spectroscopy of spin-1 via the square of the magnitude of the average Hamiltonian. We investigated this approach for two specific modified composite pulse sequences: COM-Im and COM-IVm. It is demonstrated that the size of the square of the magnitude of zero order average Hamiltonian obtained on the appropriated basis is a viable approach to study the convergence of the Magnus expansion. The approach turns to be efficient in studying pulse sequences in general and can be very useful to investigate coherent averaging in the development of high resolution NMR technique in solids. This approach allows comparing theoretically the two modified composite pulse sequences COM-Im and COM-IVm. We also compare theoretically the current modified composite sequences (COM-Im and COM-IVm) to the recently published modified composite pulse sequences (MCOM-I, MCOM-IV, MCOM-I_d, MCOM-IV_d).

  5. Joint Action of Thermal and Gamma-Irradiation Treatment on Some Biological Aspects of the Almond Moth, Ephestia cautella (Walker)

    International Nuclear Information System (INIS)

    Mohamed, H.A.; Abd El-Ghaffar, M.M.; El Sebai, O.A.; Gad, H.A.; Alm El-Din, M.M.S.; Hazaa, A.M.

    2012-01-01

    The present study deals with the effect of a three sub-sterilizing doses of gamma radiation 100, 150 and 200 Gy on the almond moth Ephestia cautella among P1, F1 and F2 generations, and combined effect of 150 Gy plus 10, 20 and 32 degree C. Different biological aspects as mating ability, average number of spermatophores per mated female, percentage of mated female with sperm, average number of eggs and egg hatch percentage were studied. Generally, irradiation did not affect either mating ability or average number of spermatophores. Also, the percentage of mated female with sperms was did not clearly affected at parental generation, While at F1 generation the irradiation was clearly affect on sperm transfer, this effect fluctuated to reach its lowest value at 150 Gy . In the combined treatment, the mating percentage was clearly reduced among P1 generation while it was slightly reduced in F1 treated female. The average number of spermatophores was around the control value at P1, F1 and F2 generation, where mated female with sperm was sharply reduced. Average numbers of deposited eggs were not significantly among different treatments but it was significantly different from control through P1 and F1 generation, egg hatch percentage was significantly different in different treatments compared with control

  6. Study on characteristics of the aperture-averaging factor of atmospheric scintillation in terrestrial optical wireless communication

    Science.gov (United States)

    Shen, Hong; Liu, Wen-xing; Zhou, Xue-yun; Zhou, Li-ling; Yu, Long-Kun

    2018-02-01

    In order to thoroughly understand the characteristics of the aperture-averaging effect of atmospheric scintillation in terrestrial optical wireless communication and provide references for engineering design and performance evaluation of the optics system employed in the atmosphere, we have theoretically deduced the generally analytic expression of the aperture-averaging factor of atmospheric scintillation, and numerically investigated characteristics of the apertureaveraging factor under different propagation conditions. The limitations of the current commonly used approximate calculation formula of aperture-averaging factor have been discussed, and the results showed that the current calculation formula is not applicable for the small receiving aperture under non-uniform turbulence link. Numerical calculation has showed that aperture-averaging factor of atmospheric scintillation presented an exponential decline model for the small receiving aperture under non-uniform turbulent link, and the general expression of the model was given. This model has certain guiding significance for evaluating the aperture-averaging effect in the terrestrial optical wireless communication.

  7. On the average configuration of the geomagnetic tail

    International Nuclear Information System (INIS)

    Fairfield, D.H.

    1978-03-01

    Over 3000 hours of IMP-6 magnetic field data obtained between 20 and 33 R sub E in the geomagnetic tail have been used in a statistical study of the tail configuration. A distribution of 2.5 minute averages of B sub Z as a function of position across the tail reveals that more flux crosses the equatorial plane near the dawn and dusk flanks than near midnight. The tail field projected in the solar magnetospheric equatorial plane deviates from the X axis due to flaring and solar wind aberration by an angle alpha = -0.9 y sub SM - 1.7, where y/sub SM/ is in earth radii and alpha is in degrees. After removing these effects the Y component of the tail field is found to depend on interplanetary sector structure. During an away sector the B/sub Y/ component of the tail field is on average 0.5 gamma greater than that during a toward sector, a result that is true in both tail lobes and is independent of location across the tail

  8. Scale dependence of the average potential around the maximum in Φ4 theories

    International Nuclear Information System (INIS)

    Tetradis, N.; Wetterich, C.

    1992-04-01

    The average potential describes the physics at a length scale k - 1 by averaging out the degrees of freedom with characteristic moments larger than k. The dependence on k can be described by differential evolution equations. We solve these equations for the nonconvex part of the potential around the origin in φ 4 theories, in the phase with spontaneous symmetry breaking. The average potential is real and approaches the convex effective potential in the limit k → 0. Our calculation is relevant for processes for which the shape of the potential at a given scale is important, such as tunneling phenomena or inflation. (orig.)

  9. Effect of hydrogen plasma treatment on the surface morphology, microstructure and electronic transport properties of nc-Si:H

    International Nuclear Information System (INIS)

    Dutta, P.; Paul, S.; Galipeau, D.; Bommisetty, V.

    2010-01-01

    Hydrogenated nanocrystalline silicon (nc-Si:H) films, deposited by reactive radio-frequency sputtering with 33% hydrogen dilution in argon at 200 o C, were treated with low-power hydrogen plasma at room temperature at various power densities (0.1-0.5 W/cm 2 ) and durations (10 s-10 min). Plasma treatment reduced the surface root mean square roughness and increased the average grain size. This was attributed to the mass transport of Si atoms on the surface by surface and grain boundary diffusion. Plasma treatment under low power density (0.1 W/cm 2 ) for short duration (10 s) caused a significant enhancement of crystalline volume fraction and electrical conductivity, compared to as-deposited film. While higher power (0.5 W/cm 2 ) hydrogen plasma treatment for longer durations (up to 10 min) caused moderate improvement in crystalline fraction and electrical properties; however, the magnitude of improvement is not significant compared to low-power (0.1 W/cm 2 )/short-duration (10 s) plasma exposure. The results indicate that low-power hydrogen plasma treatment at room temperature can be an effective tool to improve the structural and electrical properties of nc-Si:H.

  10. Effect of modified lumbosacral orthoses on treatment of patients with spondylolysis

    Directory of Open Access Journals (Sweden)

    Mahmoud Bahramizadeh

    2009-08-01

    Full Text Available Introduction: In this study, the effect of modified lumbo sacral orthoses on lordosis andlumbosacral angle and reliving pain and functional disability was investigated.Materials and Methods: 30 patients (19 females, 11 males with spondylolysis (aged between 22-57 years were sampled in a simple randomized manner. They had a history of low back pain for 30.7(in average months. Modified lumbo sacral orthoses was prescribed for 3 months (23 hours daily.The brace was unique, bridged between xyphoid process to pubic symphysis anteriorly and seventhlumbar vertebrae to gluteal prminency posteriorly.Results: Our results show that 3-months using the modified lumbo sacral orthoses resulted insignificant decrement in pain and improvement in functional ability of patients. Although lordosis andlumbosacral angles decreased to 2.21 and 0.92 degrees, respectively, but these changes were notsignificant. Finally, patients with the lower duration of low back pain showed better results.Conclusion: Our findings indicate that the modified lumbosacral orthoses, as a non-invasiveprocedure, can be used for conservative treatments in spondylolysis patients.

  11. Effect of the personality traits of the patient on pain perception and attitude toward orthodontic treatment

    OpenAIRE

    Abhijeet Kadu; Sukhbir S Chopra; Balakrishnan Jayan; Gagan Deep Kochar

    2015-01-01

    Objective: The objective was to evaluate the relationship between personality traits, pain perception, and person′s attitude toward orthodontic treatment. Materials and Methods: The sample comprised of two groups: Group 1 consisted of 100 treated subjects (50 males, 50 females; average age, 16.07 ± 1.36 years), and Group 2 consisted of 100 untreated subjects (50 males, 50 females; average age, 16.07 ± 1.41 years). The instrument for data collection was a questionnaire that included an assessm...

  12. An averaging battery model for a lead-acid battery operating in an electric car

    Science.gov (United States)

    Bozek, J. M.

    1979-01-01

    A battery model is developed based on time averaging the current or power, and is shown to be an effective means of predicting the performance of a lead acid battery. The effectiveness of this battery model was tested on battery discharge profiles expected during the operation of an electric vehicle following the various SAE J227a driving schedules. The averaging model predicts the performance of a battery that is periodically charged (regenerated) if the regeneration energy is assumed to be converted to retrievable electrochemical energy on a one-to-one basis.

  13. Fluctuations of wavefunctions about their classical average

    International Nuclear Information System (INIS)

    Benet, L; Flores, J; Hernandez-Saldana, H; Izrailev, F M; Leyvraz, F; Seligman, T H

    2003-01-01

    Quantum-classical correspondence for the average shape of eigenfunctions and the local spectral density of states are well-known facts. In this paper, the fluctuations of the quantum wavefunctions around the classical value are discussed. A simple random matrix model leads to a Gaussian distribution of the amplitudes whose width is determined by the classical shape of the eigenfunction. To compare this prediction with numerical calculations in chaotic models of coupled quartic oscillators, we develop a rescaling method for the components. The expectations are broadly confirmed, but deviations due to scars are observed. This effect is much reduced when both Hamiltonians have chaotic dynamics

  14. Average and local structure of α-CuI by configurational averaging

    International Nuclear Information System (INIS)

    Mohn, Chris E; Stoelen, Svein

    2007-01-01

    Configurational Boltzmann averaging together with density functional theory are used to study in detail the average and local structure of the superionic α-CuI. We find that the coppers are spread out with peaks in the atom-density at the tetrahedral sites of the fcc sublattice of iodines. We calculate Cu-Cu, Cu-I and I-I pair radial distribution functions, the distribution of coordination numbers and the distribution of Cu-I-Cu, I-Cu-I and Cu-Cu-Cu bond-angles. The partial pair distribution functions are in good agreement with experimental neutron diffraction-reverse Monte Carlo, extended x-ray absorption fine structure and ab initio molecular dynamics results. In particular, our results confirm the presence of a prominent peak at around 2.7 A in the Cu-Cu pair distribution function as well as a broader, less intense peak at roughly 4.3 A. We find highly flexible bonds and a range of coordination numbers for both iodines and coppers. This structural flexibility is of key importance in order to understand the exceptional conductivity of coppers in α-CuI; the iodines can easily respond to changes in the local environment as the coppers diffuse, and a myriad of different diffusion-pathways is expected due to the large variation in the local motifs

  15. Experimental demonstration of squeezed-state quantum averaging

    DEFF Research Database (Denmark)

    Lassen, Mikael Østergaard; Madsen, Lars Skovgaard; Sabuncu, Metin

    2010-01-01

    We propose and experimentally demonstrate a universal quantum averaging process implementing the harmonic mean of quadrature variances. The averaged variances are prepared probabilistically by means of linear optical interference and measurement-induced conditioning. We verify that the implemented...

  16. Apathy in Alzheimer’s Disease: Any Effective Treatment?

    Directory of Open Access Journals (Sweden)

    Raffaele Rea

    2014-01-01

    Full Text Available Objective. This review has evaluated the effectiveness of pharmacological treatment of apathy in patients with Alzheimer’s disease (AD. Methods. A systematic literature search was conducted on published clinical trials assessing the effects of pharmacological treatment on apathy in AD over the last 10 years. Results. Fourteen studies considered of good quality were included in the analysis (4 randomized controlled trials, 9 open-label studies, and 1 retrospective analysis. Cholinesterase inhibitors were investigated in 9 studies, monoaminergic compounds such as methylphenidate and modafinil in two trials and one trial, respectively, and Ginkgo biloba (EGb 761 extract and citalopram in one study each. Cholinesterase inhibitors did not show statistical significant effect in 1 RCT study but were associated to improvement in 3 open-label studies. Methylphenidate elicited a small but significant activity accompanied by relevant side effects such as high blood pressure, cough, and osteoarticular pain. EGb 761 was well tolerated and countered apathy. Other treatments induced modest improvements or were ineffective. Conclusions. Apathy treatment remains a challenge and there is no evident advantage of any specific pharmacotherapy tested so far. The development of controlled studies according to updated guidelines for the diagnosis of apathy in patients with AD is desirable.

  17. Stochastic Averaging and Stochastic Extremum Seeking

    CERN Document Server

    Liu, Shu-Jun

    2012-01-01

    Stochastic Averaging and Stochastic Extremum Seeking develops methods of mathematical analysis inspired by the interest in reverse engineering  and analysis of bacterial  convergence by chemotaxis and to apply similar stochastic optimization techniques in other environments. The first half of the text presents significant advances in stochastic averaging theory, necessitated by the fact that existing theorems are restricted to systems with linear growth, globally exponentially stable average models, vanishing stochastic perturbations, and prevent analysis over infinite time horizon. The second half of the text introduces stochastic extremum seeking algorithms for model-free optimization of systems in real time using stochastic perturbations for estimation of their gradients. Both gradient- and Newton-based algorithms are presented, offering the user the choice between the simplicity of implementation (gradient) and the ability to achieve a known, arbitrary convergence rate (Newton). The design of algorithms...

  18. High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study.

    Science.gov (United States)

    Bai, Y; Luo, X; Li, Q; Yin, N; Fu, X; Zhang, H; Qi, H

    2016-04-01

    To evaluate the safety and efficiency of high-intensity focused ultrasound (HIFU) in the treatment of placenta accreta after vaginal delivery. Enrolled into this study between September 2011 and September 2013 were 12 patients who had been diagnosed with placenta accreta following vaginal delivery and who had stable vital signs. All patients were treated using an ultrasound-guided HIFU treatment system. As indication of the effectiveness of the treatment we considered decreased vascular index on color Doppler imaging, decrease in size of residual placenta compared with pretreatment size on assessment by three-dimensional ultrasound with Virtual Organ Computer-aided Analysis, reduced signal intensity and degree of enhancement on magnetic resonance imaging and avoidance of hysterectomy following treatment. To assess the safety of HIFU treatment, we recorded side effects, hemorrhage, infection, sex steroid levels, return of menses and subsequent pregnancy. Patients were followed up in this preliminary study until December 2013. The 12 patients receiving HIFU treatment had an average postpartum hospital stay of 6.8 days and an average period of residual placental involution of 36.9 days. HIFU treatment did not apparently increase the risk of infection or hemorrhage and no patient required hysterectomy. In all patients menstruation recommenced after an average of 80.2 days, and sex steroid levels during the middle luteal phase of the second menstrual cycle were normal. Two patients became pregnant again during the follow-up period. This preliminary study suggests that ultrasound-guided HIFU is a safe and effective non-invasive method to treat placenta accreta patients after vaginal delivery who have stable vital signs and desire to preserve fertility. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  19. 20 CFR 404.220 - Average-monthly-wage method.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Average-monthly-wage method. 404.220 Section... INSURANCE (1950- ) Computing Primary Insurance Amounts Average-Monthly-Wage Method of Computing Primary Insurance Amounts § 404.220 Average-monthly-wage method. (a) Who is eligible for this method. You must...

  20. Activated sludge and activated carbon treatment of a wood preserving effluent containing pentachlorophenol

    National Research Council Canada - National Science Library

    Guo, P. H. M

    1980-01-01

    ...; however, PCP removal averaged only 35% and the effluent was toxic to rainbow trout. Treatment of the activated sludge effluent by carbon adsorption resulted in effective PCP removal and non-toxic effluents...

  1. Effects O2 plasma surface treatment on the electrical properties of the ITO substrate

    International Nuclear Information System (INIS)

    Hong, Jin-Woong; Oh, Dong-Hoon; Shim, Sang-Min; Lee, Young-Sang; Kang, Yong-Gil; Shin, Jong-Yeol

    2012-01-01

    The indium-tin-oxide (ITO) substrate is used as a transparent electrode in organic light-emitting diodes (OLEDs) and organic photovoltaic cells. The effect of an O 2 plasma surface treatment on the electrical properties of the ITO substrate was examined. The four-point probe method, an atomic force microscope (AFM), a LCR meter, a Cole-Cole plot, and a conductive mechanism analysis were used to assess the properties of the treated ITO substrates. The four-point probe method and the AFM study revealed a lower ITO surface resistance of 17.6 Ω/sq and an average roughness of 2 nm, respectively, for a substrate treated by a plasma at 250 W for 40 s. The lower surface resistance of the ITO substrate treated at 250 W for 40 s was confirmed by using a LCR meter. An amorphous fluoropolymer (AF) was deposited on an ITO substrate treated under the optimal conditions and on a non-plasma treated ITO substrate as well. The potential barriers for charge injection in these devices were 0.25 eV and 0.15 eV, respectively, indicating a 0.1-eV decrease due to the plasma treatment.

  2. Endoscopic bursectomy for the treatment of septic pre-patellar bursitis: a case series.

    Science.gov (United States)

    Dillon, John P; Freedman, Ilan; Tan, James S M; Mitchell, David; English, Shaun

    2012-07-01

    Operative treatment for septic pre-patellar bursitis generally involves open debridement in addition to an extended course of intravenous antibiotics. Skin necrosis and wound breakdown are potential complications of this procedure in addition to scar sensitivity and a prolonged recovery. We report endoscopic bursectomy for the treatment of septic pre-patellar bursitis in eight patients over a 3-year period. All patients had microbiological confirmation of an infective process. The average age was 36 years (23-68 years). The average hospital stay was 6 days (4-9 days). No patient had a recurrence or complained of tenderness or hypoaesthesia around their wound. No patient experienced wound complications or skin necrosis. The average return to work time was 18 days (7-22 days). We conclude that endoscopic bursectomy is a safe and effective treatment for septic pre-patellar bursitis with a shortened hospital stay and a quicker return to work than conventional open debridement.

  3. [Treatment outcome of alcoholics in a general hospital alcoholic clinic: effects of adopting moderation as a practical treatment goal].

    Science.gov (United States)

    Muto, Takeo; Sunami, Takashi; Cho, Sachiko; Miyashita, Aya; Tsurumaru, Aiko; Yuzuriha, Takefumi

    2013-02-01

    It's almost 50 years since medical treatment for alcoholism began to be practiced in Japan in 1960s. Since then, treatment goal for alcohol use disorders has always been absolute abstinence, and only severe cases have been treated. Recently, many people are concerned about lifestyle-related diseases, suicides, depression, and drunken-driving accidents. Reduction in alcohol consumption of heavy drinkers began to draw attention, and brief motivational intervention study was launched at last in 2007 in Japan. In 2009 we set up alcohol clinic in a general hospital in order that the alcoholics may get easier access to their treatments. The basic roles of our alcohol satellite clinicare as follows: 1. Assessment and diagnosis of patient's alcohol-related problem are our primary role. 2. Referral to a specialized hospital is offered in case special treatments for alcohol dependence are needed. 3. Our standard treatment is a brief intervention, not exceeding 3 sessions, to enhance the patients' self-efficacy. 4. Our treatment goal is not limited to total abstinence. Moderation of drinking can also be a goal. We examined the treatment outcome to verify these roles and meanings. Of all the patients visited this hospital from 2009 to 2011, 77 patients were diagnosed as alcohol dependent. Out of those 77 patients, 21 patients set up a moderation of drinking as their temporal treatment goal and 10 achieved good outcome at the inquiry point of 8 to 41 (average: 22) months after intervention. This result suggests that moderation can be a practical treatment goal in some alcoholics.

  4. Cost-effectiveness of emergency department-initiated treatment for opioid dependence.

    Science.gov (United States)

    Busch, Susan H; Fiellin, David A; Chawarski, Marek C; Owens, Patricia H; Pantalon, Michael V; Hawk, Kathryn; Bernstein, Steven L; O'Connor, Patrick G; D'Onofrio, Gail

    2017-11-01

    In a recent randomized trial, patients with opioid dependence receiving brief intervention, emergency department (ED)-initiated buprenorphine and ongoing follow-up in primary care with buprenorphine (buprenorphine) were twice as likely to be engaged in addiction treatment compared with referral to community-based treatment (referral) or brief intervention and referral (brief intervention). Our aim was to evaluate the relative cost-effectiveness of these three methods of intervening on opioid dependence in the ED. Measured health-care use was converted to dollar values. We considered a health-care system perspective and constructed cost-effectiveness acceptability curves that indicate the probability each treatment is cost-effective under different thresholds of willingness-to-pay for outcomes studied. An urban ED in the United States. Opioid-dependent patients aged 18 years or older. Self-reported 30-day assessment data were used to construct cost-effectiveness acceptability curves for patient engagement in formal addiction treatment at 30 days and the number of days illicit opioid-free in the past week. Considering only health-care system costs, cost-effectiveness acceptability curves indicate that at all positive willingness-to-pay values, ED-initiated buprenorphine treatment was more cost-effective than brief intervention or referral. For example, at a willingness-to-pay threshold of $1000 for 30-day treatment engagement, we are 79% certain ED-initiated buprenorphine is most cost-effective compared with other studied treatments. Similar results were found for days illicit opioid-free in the past week. Results were robust to secondary analyses that included patients with missing cost data, included crime and patient time costs in the numerator, and to changes in unit price estimates. In the United States, emergency department-initiated buprenorphine intervention for patients with opioid dependence provides high value compared with referral to community

  5. Effects of residential wastewater treatment systems on ground-water quality in west-central Jefferson County, Colorado

    Science.gov (United States)

    Hall, Dennis C.; Hillier, D.E.; Nickum, Edward; Dorrance, W.G.

    1981-01-01

    The use of residential wastewater-treatment systems in Evergreen Meadows, Marshdale, and Herzman Mesa, Colo., has degraded ground-water quality to some extent in each community. Age of community; average lot size; slope of land surface; composition, permeability, and thickness of surficial material; density, size , and orientation of fractures; maintenance of wastewater-treatment systems; and presence of animals are factors possibly contributing to the degradation of ground-water quality. When compared with effluent from aeration-treatment tanks, effluent fom septic-treatment tanks is characterized by greater biochemical oxygen demand and greater concentrations of detergents. When compared with effluent from septic-treatment tanks, effluent from aeration-treatment tanks is characterized by greater concentrations of dissolved oxygen, nitrite, nitrate, sulfate, and dissolved solids. (USGS)

  6. Treatment of Erectile Dysfunction in Type 2 Diabetic Men

    Directory of Open Access Journals (Sweden)

    V.Ye. Luchytskyi

    2015-11-01

    Full Text Available Background. One of the most frequent complications of diabetes in men is erectile dysfunction. Phosphodiesterase-5 inhibitors (IPDE-5: sildenafil, vardenafil and tadalafil are the drugs of choice for the treatment of erectile dysfunction. Objective. To study the effectiveness and safety of treatment of erectile dysfunction with inhibitor of phosphodiesterase 5 in type 2 diabetic men. Material and methods. The study involved 89 men aged 39–69 years old. Рatients with type 2 diabetes mellitus and erectile dysfunction with diabetes duration of 1–12 years were examined in a state of diabetes mellitus compensation (average glycated hemoglobin 7.3 ± 1.1 %. Sildenafil 100 mg on demand before coitus during 12 weeks led to the significant growth rate of domain of «Erectile function» on 10.54 score. Sildenafil was effective in 76.2 % of patients. Increment of such parameter as erectile function during tadalafil treatment was 9.81 scores. Efficacy of tadalafil was 73.1 %. Application of vardenafil led to the improvement of erectile function to an average of 25.22 ± 1.80 scores. Efficacy of vardenafil in our patients was 76.2 %. Conclusions. The study confirmed the high efficiency of three IPDE-5 as the first-line drugs for the treatment of erectile dysfunction in men with diabetes. All three drugs were used in maximum doses, as lower doses are not always effective enough. All patients with reduced blood levels of total testosterone should receive replacement therapy to achieve levels of testosterone within the normal hormone fluctuations. Further study of the effects IPDE-5 in type 2 diabetic men are necessary to improve their effectiveness.

  7. Recidivism after treatment in a forensic youth-psychiatric setting: the effect of treatment characteristics

    NARCIS (Netherlands)

    van der Put, C.E.; Asscher, J.J.; Stams, G.J.J.M.; van der Laan, P.H.; Breuk, R.; Jongman, E.; Doreleijers, T.

    2013-01-01

    The aim of this study was to examine the effect of treatment characteristics on recidivism in a forensic youth-psychiatric outpatient clinic. The treatment offered comprised functional family therapy (FFT), individual cognitive behavioural therapy (CBT), or CBT in combination with parent training.

  8. Light-cone averaging in cosmology: formalism and applications

    International Nuclear Information System (INIS)

    Gasperini, M.; Marozzi, G.; Veneziano, G.; Nugier, F.

    2011-01-01

    We present a general gauge invariant formalism for defining cosmological averages that are relevant for observations based on light-like signals. Such averages involve either null hypersurfaces corresponding to a family of past light-cones or compact surfaces given by their intersection with timelike hypersurfaces. Generalized Buchert-Ehlers commutation rules for derivatives of these light-cone averages are given. After introducing some adapted ''geodesic light-cone'' coordinates, we give explicit expressions for averaging the redshift to luminosity-distance relation and the so-called ''redshift drift'' in a generic inhomogeneous Universe

  9. Effect of the averaging volume and algorithm on the in situ electric field for uniform electric- and magnetic-field exposures

    International Nuclear Information System (INIS)

    Hirata, Akimasa; Takano, Yukinori; Fujiwara, Osamu; Kamimura, Yoshitsugu

    2010-01-01

    The present study quantified the volume-averaged in situ electric field in nerve tissues of anatomically based numeric Japanese male and female models for exposure to extremely low-frequency electric and magnetic fields. A quasi-static finite-difference time-domain method was applied to analyze this problem. The motivation of our investigation is that the dependence of the electric field induced in nerve tissue on the averaging volume/distance is not clear, while a cubical volume of 5 x 5 x 5 mm 3 or a straight-line segment of 5 mm is suggested in some documents. The influence of non-nerve tissue surrounding nerve tissue is also discussed by considering three algorithms for calculating the averaged in situ electric field in nerve tissue. The computational results obtained herein reveal that the volume-averaged electric field in the nerve tissue decreases with the averaging volume. In addition, the 99th percentile value of the volume-averaged in situ electric field in nerve tissue is more stable than that of the maximal value for different averaging volume. When including non-nerve tissue surrounding nerve tissue in the averaging volume, the resultant in situ electric fields were not so dependent on the averaging volume as compared to the case excluding non-nerve tissue. In situ electric fields averaged over a distance of 5 mm were comparable or larger than that for a 5 x 5 x 5 mm 3 cube depending on the algorithm, nerve tissue considered and exposure scenarios. (note)

  10. Musical hallucinations: review of treatment effects

    Directory of Open Access Journals (Sweden)

    Jan eCoebergh

    2015-06-01

    Full Text Available AbstractBackground: Despite an increased scientific interest in musical hallucinations throughout the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analysed the treatment results in relation to the aetiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion and other pathology, epilepsy or intoxication.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct aetiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g. more acoustic stimulation are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being more helpful than antiepileptics (which are still better than antipsychotics. The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication is the main aetiological factor, it is important to stop or switch the

  11. Bounds on Average Time Complexity of Decision Trees

    KAUST Repository

    Chikalov, Igor

    2011-01-01

    In this chapter, bounds on the average depth and the average weighted depth of decision trees are considered. Similar problems are studied in search theory [1], coding theory [77], design and analysis of algorithms (e.g., sorting) [38]. For any diagnostic problem, the minimum average depth of decision tree is bounded from below by the entropy of probability distribution (with a multiplier 1/log2 k for a problem over a k-valued information system). Among diagnostic problems, the problems with a complete set of attributes have the lowest minimum average depth of decision trees (e.g, the problem of building optimal prefix code [1] and a blood test study in assumption that exactly one patient is ill [23]). For such problems, the minimum average depth of decision tree exceeds the lower bound by at most one. The minimum average depth reaches the maximum on the problems in which each attribute is "indispensable" [44] (e.g., a diagnostic problem with n attributes and kn pairwise different rows in the decision table and the problem of implementing the modulo 2 summation function). These problems have the minimum average depth of decision tree equal to the number of attributes in the problem description. © Springer-Verlag Berlin Heidelberg 2011.

  12. Assessment of different pre-treatment methods for the removal of limonene in citrus waste and their effect on methane potential and methane production rate.

    Science.gov (United States)

    Ruiz, Begoña; de Benito, Amparo; Rivera, José Daniel; Flotats, Xavier

    2016-12-01

    The objective of this study was to assess the limonene removal efficiency of three pre-treatment methods when applied to citrus waste and to evaluate their effects on the biochemical methane potential and the methane production rate using batch anaerobic tests. The methods tested were based on removal (biological pretreatment by fungi) or recovery (steam distillation and ethanol extraction) of limonene. All the treatments decreased the concentration of limonene in orange peel, with average efficiencies of 22%, 44% and 100% for the biological treatment, steam distillation and ethanol extraction, respectively. By-products from limonene biodegradation by fungi exhibited an inhibitory effect also, not making interesting the biological pretreatment. The methane potential and production rate of the treated orange peel increased significantly after applying the recovery strategies, which separated and recovered simultaneously other inhibitory components of the citrus essential oil. Apart from the high recovery efficiency of the ethanol extraction process, it presented a favourable energy balance. © The Author(s) 2016.

  13. Averaging operations on matrices

    Indian Academy of Sciences (India)

    2014-07-03

    Jul 3, 2014 ... Role of Positive Definite Matrices. • Diffusion Tensor Imaging: 3 × 3 pd matrices model water flow at each voxel of brain scan. • Elasticity: 6 × 6 pd matrices model stress tensors. • Machine Learning: n × n pd matrices occur as kernel matrices. Tanvi Jain. Averaging operations on matrices ...

  14. Effect of post-implant edema on prostate brachytherapy treatment margins

    International Nuclear Information System (INIS)

    Reed, Daniel R.; Wallner, Kent; Ford, Eric; Mueller, Amy; Merrick, Gregory; Maki, Jeffrey; Sutlief, Steven; Butler, Wayne

    2005-01-01

    Purpose: To determine if postimplant prostate brachytherapy treatment margins calculated on Day 0 differ substantially from those calculated on Day 30. Methods: Thirty patients with 1997 American Joint Commission on Cancer clinical stage T1-T2 prostatic carcinoma underwent prostate brachytherapy with I-125 prescribed to 144 Gy. Treatment planning methods included using loose seeds in a modified peripheral loading pattern and treatment margins (TMs) of 5-8 mm. Postimplant plain radiographs, computed tomography scans, and magnetic resonance scans were obtained 1-4 hours after implantation (Day 0). A second set of imaging studies was obtained at 30 days after implantation (Day 30) and similarly analyzed. Treatment margins were measured as the radial distance in millimeters from the prostate edge to the 100% isodose line. The TMs were measured and tabulated at 90 o intervals around the prostate periphery at 0.6-cm intervals. Each direction was averaged to obtain the mean anterior, posterior, left, and right margins. Results: The mean overall TM increased from 2.6 mm (±2.3) on Day 0 to 3.5 mm (±2.4) on Day 30. The mean anterior margin increased from 1.2 mm on Day 0 to 1.8 mm on Day 30. The posterior margin increased from 1.2 mm on Day 0 to 2.8 mm on Day 30. The lateral treatment margins increased most over time, with mean right treatment margin increasing from 3.9 mm on Day 0 to 4.7 mm on Day 30. Conclusion: Treatment margins appear to be durable in the postimplant period, with a clinically insignificant increase from Day 0 to Day 30

  15. 20 CFR 404.221 - Computing your average monthly wage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Computing your average monthly wage. 404.221... DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Average-Monthly-Wage Method of Computing Primary Insurance Amounts § 404.221 Computing your average monthly wage. (a) General. Under the average...

  16. Exploiting scale dependence in cosmological averaging

    International Nuclear Information System (INIS)

    Mattsson, Teppo; Ronkainen, Maria

    2008-01-01

    We study the role of scale dependence in the Buchert averaging method, using the flat Lemaitre–Tolman–Bondi model as a testing ground. Within this model, a single averaging scale gives predictions that are too coarse, but by replacing it with the distance of the objects R(z) for each redshift z, we find an O(1%) precision at z<2 in the averaged luminosity and angular diameter distances compared to their exact expressions. At low redshifts, we show the improvement for generic inhomogeneity profiles, and our numerical computations further verify it up to redshifts z∼2. At higher redshifts, the method breaks down due to its inability to capture the time evolution of the inhomogeneities. We also demonstrate that the running smoothing scale R(z) can mimic acceleration, suggesting that it could be at least as important as the backreaction in explaining dark energy as an inhomogeneity induced illusion

  17. Initiating antiretroviral therapy for HIV at a patient's first clinic visit: a cost-effectiveness analysis of the rapid initiation of treatment randomized controlled trial.

    Science.gov (United States)

    Long, Lawrence C; Maskew, Mhairi; Brennan, Alana T; Mongwenyana, Constance; Nyoni, Cynthia; Malete, Given; Sanne, Ian; Fox, Matthew P; Rosen, Sydney

    2017-07-17

    Determine the cost and cost-effectiveness of single-visit (same-day) antiretroviral treatment (ART) initiation compared to standard of care initiation. Cost-effectiveness analysis of individually randomized (1 : 1) pragmatic trial of single-visit initiation, which increased viral suppression at 10 months by 26% [relative risk (95% confidence interval) 1.26 (1.05-1.50)]. Primary health clinic in Johannesburg, South Africa. HIV positive, adult, nonpregnant patients not yet on ART or known to be eligible who presented at the clinic 8 May 2013 to 29 August 2014. Same-day ART initiation using point-of-care laboratory instruments and accelerated clinic procedures to allow treatment-eligible patients to receive antiretroviral medications at the same visit as testing HIV positive or having an eligible CD4 cell count. Comparison was to standard of care ART initiation, which typically required three to five additional clinic visits. Average cost per patient enrolled and per patient achieving the primary outcome of initiated 90 days or less and suppressed 10 months or less, and production cost per patient achieving primary outcome (all costs per primary outcome patients). The average cost per patient enrolled, per patient achieving the primary outcome, and production cost were $319, $487, and $738 in the standard arm and $451, $505, and $707 in the rapid arm. Same-day treatment initiation was more effective than standard initiation, more expensive per patient enrolled, and less expensive to produce a patient achieving the primary outcome. Omitting point-of-care laboratory tests at initiation and focusing on high-volume clinics have the potential to reduce costs substantially and should be evaluated in routine settings.

  18. Modeling and analyzing the effects of heat treatment on the characteristics of magnesium alloy joint welded by the tungsten-arc inert gas welding

    International Nuclear Information System (INIS)

    Tsai, Te-Chang; Chou, Chih-Chung; Tsai, Deng-Maw; Chiang, Ko-Ta

    2011-01-01

    Highlights: → The mathematical model was provided to study the effect of heat treatment on the magnesium alloy welded joint. → The solution strengthening effect of β-phase Mg 17 Al 12 gain promotes the strengthening matrix and ductility of hcp-α-phase Mg. → The average size and proportion of α-phase Mg grain decreases with the increase of the tempering time and temperature. → An increase in the high value of tempering temperature and tempering time leads to increase the maximum tensile strength. → The values of the elongation increases with increasing in both the value of tempering temperature and tempering time. -- Abstract: The objective of this paper is to present the mathematical models for modeling and analysis of the effects of heat treatment on the characteristics of magnesium alloy joint welded by the tungsten-arc inert gas (TIG) welding. The process of heat treatment adopts the tempering process with varying processing parameters, including tempering temperature and tempering time. The microstructure and mechanical properties of the welded joint are considered in the characteristic evaluation and explored by experiment. An experimental plan of the face-centered central composite design (CCD) based on the response surface methodology (RSM) has been employed to carry out the experimental study. The results of analysis of variance (ANOVA) and comparisons of experimental data show that the mathematical models of the value of the maximum tensile strength and elongation are fairly well fitted with the experimental values with a 95% confidence interval. In the tempering process, the microstructure of welded joint in the weld bead displays two main microstructures of hcp-α-phase Mg and bcc-β-phase Mg 17 Al 12 . Results show that the average size and proportion of α-phase Mg grains decreases with the increase of the tempering time and temperature. But, the increase of the tempering time and temperature promote increasing the average size and

  19. Side effects of endobronchial laser treatment

    Energy Technology Data Exchange (ETDEWEB)

    Dierkesmann, R.; Huzly, A.

    1985-03-01

    Side effects that have occurred in over 250 endobronchial laser treatments are reported. The laser has been used in severe tracheal and in bronchial obstructions. In two cases significant bleeding had to be treated with tamponade. In one patient an emphysema of the mediastinum developed, in 2 further patients a small pneumothorax. Perforation of the airway was not detected and no special treatment was necessary. Three patients with life-threatening tracheal stenoses and one patient with severe stenosis of both the mainstem bronchi due to metastasis in the bifurcation lymph node had a large defect in the tracheal or bronchial wall with a deep necrosis five to twelve weeks after laser treatment; all these patients had extensive radiotherapy in addition. One patient died due to severe respiratory insufficiency, probably caused by smoke intoxication. After the laser treatment, rubber-like fibrin-rich plaques may develop, which can lead to life-threatening obstructions of the airway. It is recommended that laser bronchoscopy should be performed with the rigid bronchoscope. After treatment of tracheal lesion an endoscopic check must be performed within 24 hours. The combination of laser treatment and radiotherapy seems to involve a certain risk of large defects in the bronchial wall due to necrosis of the tumor.

  20. Obesity - an indication for GLP-1 treatment?

    DEFF Research Database (Denmark)

    Torekov, S S; Madsbad, S; Holst, Jens Juul

    2011-01-01

    Obesity is common and associated with a high rate of morbidity and mortality; therefore, treatment is of great interest. At present, bariatric surgery is the only truly successful treatment of severe obesity. Mimicking one of the effects of bariatric surgery, namely the increased secretion...... of glucagon-like peptide (GLP)-1, by artificially increasing the levels of GLP-1 might prove successful as obesity treatment. Recent studies have shown that GLP-1 is a physiological regulator of appetite and food intake. The effect on food intake and satiety is preserved in obese subjects and GLP-1 may...... therefore have a therapeutic potential. The GLP-1 analogues result in a moderate average weight loss, which is clinically relevant in relation to reducing the risk of type 2 diabetes and cardiovascular disease. Inspired by the hormone profile after gastric bypass, a future strategy in obesity drug...

  1. Profiles of Juvenile Male Incest Perpetrators: Preliminary Treatment Implications.

    Science.gov (United States)

    Nanjundappa, G.; And Others

    1987-01-01

    Evaluated the effects on participants' self-image of sexual offenses they had committed. Subjects (N=6) were male adolescents convicted of child molestation in a residential treatment and care facility. Results suggested subjects (who were themselves victims of family violence) perceived an above average self-image and handled their problems by…

  2. Insomnia as an expression of obstructive sleep apnea syndrome--the effect of treatment with nocturnal ventilatory support.

    Science.gov (United States)

    Mendes, M Saldanha; dos Santos, J Moutinho

    2015-01-01

    Obstructive sleep apnea syndrome (OSAS) and insomnia often coexist, and it is estimated that nearly half of those who suffer from the former report symptoms of the latter. The fact that these patients have no other causes of insomnia indicates that it is a sign of OSAS. The aim of the study is to evaluate the effectiveness of nocturnal ventilatory support (NVS) in the treatment of insomnia secondary to OSAS. In order to conduct the retrospective study, the authors reviewed the medical records of patients with insomnia and OSAS that had received NVS. Patients with psychiatric disorders, sleep movement disorders, psycho-physiological insomnia, circadian rhythm sleep disorders, inadequate sleep hygiene, use and abuse of hypnotic agents, stimulants, antidepressants, anxiolytics and alcohol, were excluded. For the selected patients, the effects of NVS in terms of clinical signs and symptoms of insomnia, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and number of sleep hours were analyzed, before and after treatment with NVS. After reviewing 1241 medical records, 56 patients were selected, with a mean age of 60.9±10.0 years. Twenty-two (39.3%) suffered from intermediate insomnia, 19 (33.9%) had initial insomnia, eight (14.3%) had the mixed type, and seven patients (12.5%) had terminal insomnia. The majority of patients (n=48; 85.7%) were treated with auto-titrating continuous positive airway pressure (APAP). Forty-four patients (78.6%) overcame insomnia; insomnia symptoms persisted in nine (16.1%), and three (5.4%) patients abandoned during the medical follow-up. There was an association between the type of insomnia and its resolution and, in percentage terms patients with the mixed type did not manage to overcome insomnia symptoms (75%). There was a statistically significant difference between patients that overcame insomnia and those who did not in terms of the average time which elapsed between the initiation of treatment with NVS and compliance

  3. Isolated and synergistic effects of PM10 and average temperature on cardiovascular and respiratory mortality.

    Science.gov (United States)

    Pinheiro, Samya de Lara Lins de Araujo; Saldiva, Paulo Hilário Nascimento; Schwartz, Joel; Zanobetti, Antonella

    2014-12-01

    OBJECTIVE To analyze the effect of air pollution and temperature on mortality due to cardiovascular and respiratory diseases. METHODS We evaluated the isolated and synergistic effects of temperature and particulate matter with aerodynamic diameter mortality of individuals > 40 years old due to cardiovascular disease and that of individuals > 60 years old due to respiratory diseases in Sao Paulo, SP, Southeastern Brazil, between 1998 and 2008. Three methodologies were used to evaluate the isolated association: time-series analysis using Poisson regression model, bidirectional case-crossover analysis matched by period, and case-crossover analysis matched by the confounding factor, i.e., average temperature or pollutant concentration. The graphical representation of the response surface, generated by the interaction term between these factors added to the Poisson regression model, was interpreted to evaluate the synergistic effect of the risk factors. RESULTS No differences were observed between the results of the case-crossover and time-series analyses. The percentage change in the relative risk of cardiovascular and respiratory mortality was 0.85% (0.45;1.25) and 1.60% (0.74;2.46), respectively, due to an increase of 10 μg/m3 in the PM10 concentration. The pattern of correlation of the temperature with cardiovascular mortality was U-shaped and that with respiratory mortality was J-shaped, indicating an increased relative risk at high temperatures. The values for the interaction term indicated a higher relative risk for cardiovascular and respiratory mortalities at low temperatures and high temperatures, respectively, when the pollution levels reached approximately 60 μg/m3. CONCLUSIONS The positive association standardized in the Poisson regression model for pollutant concentration is not confounded by temperature, and the effect of temperature is not confounded by the pollutant levels in the time-series analysis. The simultaneous exposure to different levels of

  4. Isolated and synergistic effects of PM10 and average temperature on cardiovascular and respiratory mortality

    Directory of Open Access Journals (Sweden)

    Samya de Lara Lins de Araujo Pinheiro

    2014-12-01

    Full Text Available OBJECTIVE To analyze the effect of air pollution and temperature on mortality due to cardiovascular and respiratory diseases. METHODS We evaluated the isolated and synergistic effects of temperature and particulate matter with aerodynamic diameter 40 years old due to cardiovascular disease and that of individuals > 60 years old due to respiratory diseases in Sao Paulo, SP, Southeastern Brazil, between 1998 and 2008. Three methodologies were used to evaluate the isolated association: time-series analysis using Poisson regression model, bidirectional case-crossover analysis matched by period, and case-crossover analysis matched by the confounding factor, i.e., average temperature or pollutant concentration. The graphical representation of the response surface, generated by the interaction term between these factors added to the Poisson regression model, was interpreted to evaluate the synergistic effect of the risk factors. RESULTS No differences were observed between the results of the case-crossover and time-series analyses. The percentage change in the relative risk of cardiovascular and respiratory mortality was 0.85% (0.45;1.25 and 1.60% (0.74;2.46, respectively, due to an increase of 10 μg/m3 in the PM10 concentration. The pattern of correlation of the temperature with cardiovascular mortality was U-shaped and that with respiratory mortality was J-shaped, indicating an increased relative risk at high temperatures. The values for the interaction term indicated a higher relative risk for cardiovascular and respiratory mortalities at low temperatures and high temperatures, respectively, when the pollution levels reached approximately 60 μg/m3. CONCLUSIONS The positive association standardized in the Poisson regression model for pollutant concentration is not confounded by temperature, and the effect of temperature is not confounded by the pollutant levels in the time-series analysis. The simultaneous exposure to different levels of

  5. Modelling the effects of treatment and quarantine on measles

    Science.gov (United States)

    Beay, Lazarus Kalvein

    2018-03-01

    Treatment and quarantine are efforts to cure as well as to overcome the spread of diseases including measles. The spread of measles can be expressed by mathematical modelling in the form of nonlinear dynamical systems. In this study was conducted on the spread of measles by considering the effect of treatment and quarantine on the infected individuals. By using the basic reproduction number of the model, can be analyzed the effects of treatment and quarantine to reduce the spread of measles. Basic reproduction number of models is monotonically descreasing as treatment and quarantine increasing. Numerical simulations conducted on the analysis of the results. The results showed that treatment and quarantine was given to infected individuals who were infectious has a major influence to eliminate measles from the system.

  6. Study of Blood Leptin Levels before and After Treatment with Metformin in Diabetes Type Ii Patients

    Directory of Open Access Journals (Sweden)

    R Didehdar

    2005-04-01

    Full Text Available Introduction: Leptin is a fat tissue hormone that has 176 amino acids with a molecular weight of 16 KD . Leptin has effects on the hypothalamus and peripheral tissues resulting in decreased food absorption and increased energy consumption that finally reduces the body weight and BMI. The aim of this research was to investigate the blood levels of leptin before and after treatment with Metformin in type II diabetic patients. Methods: 25 type II diabetic patients without any previous drug treatment history were investigated. This study was a clinical trail before and after treatment with Metformin. Results: There was no particular difference in BMI, average body weight, fat mass and free fat mass before and after treatment. Similarly, the difference in concentration levels of blood glucose, cholesterol, tri-glycerides and LDL-cholesterol before and after treatment was not statistically significant. Also, there was no difference in the average concentration of leptin and insulin before and after treatment Conclusion: This result showed that although metformin decreased glucose and lipid levels during the treatment period, (1 month it did not have an effect on leptin, Insulin and other related factors during treatment.;

  7. POEM is a cost-effective procedure: cost-utility analysis of endoscopic and surgical treatment options in the management of achalasia.

    Science.gov (United States)

    Miller, Heidi J; Neupane, Ruel; Fayezizadeh, Mojtaba; Majumder, Arnab; Marks, Jeffrey M

    2017-04-01

    Achalasia is a rare motility disorder of the esophagus. Treatment is palliative with the goal of symptom remission and slowing the progression of the disease. Treatment options include per oral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LM) and endoscopic treatments such as pneumatic dilation (PD) and botulinum toxin type A injections (BI). We evaluate the economics and cost-effectiveness of treating achalasia. We performed cost analysis for POEM, LM, PD and BI at our institution from 2011 to 2015. Cost of LM was set to 1, and other procedures are presented as percentage change. Cost-effectiveness was calculated based on cost, number of interventions required for optimal results for dilations and injections and efficacy reported in the current literature. Incremental cost-effectiveness ratio was calculated by a cost-utility analysis using quality-adjusted life year gained, defined as a symptom-free year in a patient with achalasia. Average number of interventions required was 2.3 dilations or two injections for efficacies of 80 and 61 %, respectively. POEM cost 1.058 times the cost of LM, and PD and BI cost 0.559 and 0.448 times the cost of LM. Annual cost per cure over a period of 4 years for POEM, and LM were consistently equivalent, trending the same as PD although this has a lower initial cost. The cost per cure of BI remains stable over 3 years and then doubles. The cost-effectiveness of POEM and LM is equivalent. Myotomy, either surgical or endoscopic, is more cost-effective than BI due to high failure rates of the economical intervention. When treatment is being considered BI should be utilized in patients with less than 2-year life expectancy. Pneumatic dilations are cost-effective and are an acceptable approach to treatment of achalasia, although myotomy has a lower relapse rate and is cost-effective compared to PD after 2 years.

  8. Averaging in SU(2) open quantum random walk

    International Nuclear Information System (INIS)

    Ampadu Clement

    2014-01-01

    We study the average position and the symmetry of the distribution in the SU(2) open quantum random walk (OQRW). We show that the average position in the central limit theorem (CLT) is non-uniform compared with the average position in the non-CLT. The symmetry of distribution is shown to be even in the CLT

  9. Averaging in SU(2) open quantum random walk

    Science.gov (United States)

    Clement, Ampadu

    2014-03-01

    We study the average position and the symmetry of the distribution in the SU(2) open quantum random walk (OQRW). We show that the average position in the central limit theorem (CLT) is non-uniform compared with the average position in the non-CLT. The symmetry of distribution is shown to be even in the CLT.

  10. Similarity-based distortion of visual short-term memory is due to perceptual averaging.

    Science.gov (United States)

    Dubé, Chad; Zhou, Feng; Kahana, Michael J; Sekuler, Robert

    2014-03-01

    A task-irrelevant stimulus can distort recall from visual short-term memory (VSTM). Specifically, reproduction of a task-relevant memory item is biased in the direction of the irrelevant memory item (Huang & Sekuler, 2010a). The present study addresses the hypothesis that such effects reflect the influence of neural averaging under conditions of uncertainty about the contents of VSTM (Alvarez, 2011; Ball & Sekuler, 1980). We manipulated subjects' attention to relevant and irrelevant study items whose similarity relationships were held constant, while varying how similar the study items were to a subsequent recognition probe. On each trial, subjects were shown one or two Gabor patches, followed by the probe; their task was to indicate whether the probe matched one of the study items. A brief cue told subjects which Gabor, first or second, would serve as that trial's target item. Critically, this cue appeared either before, between, or after the study items. A distributional analysis of the resulting mnemometric functions showed an inflation in probability density in the region spanning the spatial frequency of the average of the two memory items. This effect, due to an elevation in false alarms to probes matching the perceptual average, was diminished when cues were presented before both study items. These results suggest that (a) perceptual averages are computed obligatorily and (b) perceptual averages are relied upon to a greater extent when item representations are weakened. Implications of these results for theories of VSTM are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Mode-Specific Effects among Three Treatments for Depression.

    Science.gov (United States)

    Imber, Stanley D.; And Others

    1990-01-01

    Randomly assigned 250 depressed outpatients to interpersonal psychotherapy, cognitive-behavioral therapy, imipramine plus clinical management, or pill placebo plus clinical management treatments. All treatments demonstrated significant symptom reduction with few differences in general outcomes. None of the therapies produced consistent effects on…

  12. Effect of physical treatment on Trichoderma reesei cells

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1984-01-01

    The effect of physical treatment such as freezing and gamma-ray irradiation on Trichoderma reesei cells was studied. The decrease phenomena of cellulase production, which was observed in the culture of the cells using wheat bran extract, was improved by physical treatment. (author)

  13. Determining average yarding distance.

    Science.gov (United States)

    Roger H. Twito; Charles N. Mann

    1979-01-01

    Emphasis on environmental and esthetic quality in timber harvesting has brought about increased use of complex boundaries of cutting units and a consequent need for a rapid and accurate method of determining the average yarding distance and area of these units. These values, needed for evaluation of road and landing locations in planning timber harvests, are easily and...

  14. Average Revisited in Context

    Science.gov (United States)

    Watson, Jane; Chick, Helen

    2012-01-01

    This paper analyses the responses of 247 middle school students to items requiring the concept of average in three different contexts: a city's weather reported in maximum daily temperature, the number of children in a family, and the price of houses. The mixed but overall disappointing performance on the six items in the three contexts indicates…

  15. Effective treatment strategies against Ebola virus

    Directory of Open Access Journals (Sweden)

    Amina Yaqoob

    2015-08-01

    Full Text Available Ebola virus (EBOV, a member of order Mononegavirales is most famous for causing the endemics of hemorrhagic fever in different countries of the world. Various effective treatment for EBOV are available presently but different clinical trials and experimental studies on animal models are ongoing for this purpose. Results from different studies showed that selective vaccines and therapeutic drugs have potential to interfere the viral life events within host cell in order to inhibit its replication. Various pre-clinical trials in this regard are proved successful on non-human primates (NHPs and found to be significant in inhibiting EBOV infections. It is the need of hour to develop effective vaccines against Ebola virus to combat this problem as soon as possible. The present article is a brief review on potential treatment strategies against Ebola virus.

  16. Unexpected Decrease in Milk Production after Fenbendazole Treatment of Dairy Cows during Early Grazing Season.

    Science.gov (United States)

    Ravinet, Nadine; Chartier, Christophe; Bareille, Nathalie; Lehebel, Anne; Ponnau, Adeline; Brisseau, Nadine; Chauvin, Alain

    2016-01-01

    Gastrointestinal nematodes (GIN) infection can impair milk production (MP) in dairy cows. To investigate whether MP would be optimized by spring targeted-selective anthelmintic treatment in grazing cows, we assessed (1) the effect on MP of an anthelmintic treatment applied 1.5 to 2 months after turn-out, and (2) herd and individual indicators associated with the post-treatment MP response. A randomized controlled clinical trial was conducted in 13 dairy farms (578 cows) in western France in spring 2012. In each herd, lactating cows of the treatment group received fenbendazole orally, control cows remained untreated. Daily cow MP was recorded from 2 weeks before until 15 weeks after treatment. Individual serum pepsinogen and anti-Ostertagia antibody levels (expressed as ODR), faecal egg count and bulk tank milk (BTM) Ostertagia ODR were measured at treatment time. Anthelmintic treatment applied during the previous housing period was recorded for each cow. In each herd, information regarding heifers' grazing and anthelmintic treatment history was collected to assess the Time of Effective Contact (TEC, in months) with GIN infective larvae before the first calving. The effect of treatment on weekly MP averages and its relationships with herd and individual indicators were studied using linear mixed models with two nested random effects (cow within herd). Unexpectedly, spring treatment had a significant detrimental effect on MP (-0.92 kg/cow/day on average). This negative MP response was particularly marked in high producing cows, in cows not treated during the previous housing period or with high pepsinogen levels, and in cows from herds with a high TEC or a high BTM ODR. This post-treatment decrease in MP may be associated with immuno-inflammatory mechanisms. Until further studies can assess whether this unexpected result can be generalized, non-persistent treatment of immunized adult dairy cows against GIN should not be recommended in early grazing season.

  17. Unexpected Decrease in Milk Production after Fenbendazole Treatment of Dairy Cows during Early Grazing Season

    Science.gov (United States)

    Ravinet, Nadine; Chartier, Christophe; Bareille, Nathalie; Lehebel, Anne; Ponnau, Adeline; Brisseau, Nadine; Chauvin, Alain

    2016-01-01

    Gastrointestinal nematodes (GIN) infection can impair milk production (MP) in dairy cows. To investigate whether MP would be optimized by spring targeted-selective anthelmintic treatment in grazing cows, we assessed (1) the effect on MP of an anthelmintic treatment applied 1.5 to 2 months after turn-out, and (2) herd and individual indicators associated with the post-treatment MP response. A randomized controlled clinical trial was conducted in 13 dairy farms (578 cows) in western France in spring 2012. In each herd, lactating cows of the treatment group received fenbendazole orally, control cows remained untreated. Daily cow MP was recorded from 2 weeks before until 15 weeks after treatment. Individual serum pepsinogen and anti-Ostertagia antibody levels (expressed as ODR), faecal egg count and bulk tank milk (BTM) Ostertagia ODR were measured at treatment time. Anthelmintic treatment applied during the previous housing period was recorded for each cow. In each herd, information regarding heifers’ grazing and anthelmintic treatment history was collected to assess the Time of Effective Contact (TEC, in months) with GIN infective larvae before the first calving. The effect of treatment on weekly MP averages and its relationships with herd and individual indicators were studied using linear mixed models with two nested random effects (cow within herd). Unexpectedly, spring treatment had a significant detrimental effect on MP (-0.92 kg/cow/day on average). This negative MP response was particularly marked in high producing cows, in cows not treated during the previous housing period or with high pepsinogen levels, and in cows from herds with a high TEC or a high BTM ODR. This post-treatment decrease in MP may be associated with immuno-inflammatory mechanisms. Until further studies can assess whether this unexpected result can be generalized, non-persistent treatment of immunized adult dairy cows against GIN should not be recommended in early grazing season. PMID

  18. Advanced pulse oximeter signal processing technology compared to simple averaging. II. Effect on frequency of alarms in the postanesthesia care unit.

    Science.gov (United States)

    Rheineck-Leyssius, A T; Kalkman, C J

    1999-05-01

    To determine the effect of a new pulse oximeter (Nellcor Symphony N-3000, Pleasanton, CA) with signal processing technique (Oxismart) on the incidence of false alarms in the postanesthesia care unit (PACU). Prospective study. Nonuniversity hospital. 603 consecutive ASA physical status I, II, and III patients recovering from general or regional anesthesia in the PACU. We compared the number of alarms produced by a recently developed "third"-generation pulse oximeter (Nellcor Symphony N-3000) with Oxismart signal processing technique and a conventional pulse oximeter (Criticare 504, Waukesha, WI). Patients were randomly assigned to either a Nellcor pulse oximeter or a Criticare with the signal averaging time set at either 12 or 21 seconds. For each patient the number of false (artifact) alarms was counted. The Nellcor generated one false alarm in 199 patients and 36 (in 31 patients) "loss of pulse" alarms. The conventional pulse oximeter with the averaging time set at 12 seconds generated a total of 32 false alarms in 17 of 197 patients [compared with the Nellcor, relative risk (RR) 0.06, confidence interval (CI) 0.01 to 0.25] and a total of 172 "loss of pulse" alarms in 79 patients (RR 0.39, CI 0.28 to 0.55). The conventional pulse oximeter with the averaging time set at 21 seconds generated 12 false alarms in 11 of 207 patients (compared with the Nellcor, RR 0.09, CI 0.02 to 0.48) and a total of 204 "loss of pulse" alarms in 81 patients (RR 0.40, CI 0.28 to 0.56). The lower incidence of false alarms of the conventional pulse oximeter with the longest averaging time compared with the shorter averaging time did not reach statistical significance (false alarms RR 0.62, CI 0.3 to 1.27; "loss of pulse" alarms RR 0.98, CI 0.77 to 1.3). To date, this is the first report of a pulse oximeter that produced almost no false alarms in the PACU.

  19. Site-specific dissociation dynamics of H{sub 2}/D{sub 2} on Ag(111) and Co(0001) and the validity of the site-averaging model

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Xixi [Department of Chemistry and Chemical Biology, University of New Mexico, Albuquerque, New Mexico 87131 (United States); Institute of Theoretical and Computational Chemistry, Key Laboratory of Mesoscopic Chemistry, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China); Jiang, Bin [Department of Chemistry and Chemical Biology, University of New Mexico, Albuquerque, New Mexico 87131 (United States); Department of Chemical Physics, University of Science and Technology of China, Hefei 230026 (China); Xie, Daiqian, E-mail: dqxie@nju.edu.cn, E-mail: hguo@unm.edu [Institute of Theoretical and Computational Chemistry, Key Laboratory of Mesoscopic Chemistry, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China); Synergetic Innovation Center of Quantum Information and Quantum Physics, University of Science and Technology of China, Hefei, Anhui 230026 (China); Guo, Hua, E-mail: dqxie@nju.edu.cn, E-mail: hguo@unm.edu [Department of Chemistry and Chemical Biology, University of New Mexico, Albuquerque, New Mexico 87131 (United States)

    2015-09-21

    Dissociative chemisorption of polyatomic molecules on metal surfaces involves high-dimensional dynamics, of which quantum mechanical treatments are computationally challenging. A promising reduced-dimensional approach approximates the full-dimensional dynamics by a weighted average of fixed-site results. To examine the performance of this site-averaging model, we investigate two distinct reactions, namely, hydrogen dissociation on Co(0001) and Ag(111), using accurate first principles potential energy surfaces (PESs). The former has a very low barrier of ∼0.05 eV while the latter is highly activated with a barrier of ∼1.15 eV. These two systems allow the investigation of not only site-specific dynamical behaviors but also the validity of the site-averaging model. It is found that the reactivity is not only controlled by the barrier height but also by the topography of the PES. Moreover, the agreement between the site-averaged and full-dimensional results is much better on Ag(111), though quantitative in neither system. Further quasi-classical trajectory calculations showed that the deviations can be attributed to dynamical steering effects, which are present in both reactions at all energies.

  20. Effect of Bauhinia holophylla treatment in Streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Pinheiro, Marcelo S; Rodrigues, Luhara S; S, Leila; Moraes-Souza, Rafaianne Q; Soares, Thaigra S; Américo, Madileine F; Campos, Kleber E; Damasceno, Débora C; Volpato, Gustavo T

    2017-01-01

    Bauhinia holophylla, commonly known as "cow's hoof", is widely used in Brazilian folk medicine for the diabetes treatment. Therefore, the aim of this study was at evaluating the aqueous extract effect of Bauhinia holophylla leaves treatment on the streptozotocin-induced diabetic rats. Diabetes was induced by Streptozotocin (40 mg/Kg) in female Wistar rats. Oral administration of aqueous extract of Bauhinia holophylla leaves was given to non-diabetic and diabetic rats at a dose of 400 mg/kg during 21 days. On day 17 of treatment, the Oral Glucose Tolerance Test was performed to determine the area under the curve. At the end of the treatment, the animals were anesthetized and blood was collected for serum biochemical parameters analysis. After treatment with Bauhinia holophylla extract, non-diabetic and diabetic rats presented no glycemic changes. On the other hand, the plant treatment decreased body weight and increased ALT and AST activities. In conclusion, the treatment with aqueous extract of B. holophylla leaves given to diabetic rats presented no hypoglycemic effect in nondiabetic animals and no antidiabetic effect in diabetic animals with the doses studied. In addition, the diabetic animals treated with the B. holophylla extract showed inconvenient effects and its indiscriminate consumption requires particular carefulness.

  1. Treatment of textiles industrial wastewater by electron beam and biological treatment (sbr)

    International Nuclear Information System (INIS)

    Khomsaton Abu Bakar; Khairul Zaman Mohd Dahlan; Zulkafli Ghazali; Ting Teo Ming

    2008-08-01

    Study of treating textiles industrial wastewater with combined of electron beam and Tower Style Biological Treatment (TSB) was investigated in Korea. In this project, textiles wastewater was also treated with electron beam, but hybrid with Sequencing Batch Reactor (SBR). The purpose of this research is to develop combined electron beam treatment with existing biological treatment facility (SBR), of textile industries in Malaysia. The objectives of this project are to determine the effective irradiation parameter for treatment and to identify effective total retention time in SBR system. To achieve the objective, samples fill in polypropyle tray were irradiated at 1 MeV, 20 mA and 1 MeV ,5 mA at doses 11, 20, 30, 40 and 50 kGy respectively. Raw effluent and two series of irradiated effluent at 1 MeV 20 mA (11, 20, 30, 40 and 50 kGy) and 1 MeV 5 mA (11, 20, 30, 40 and 50 kGy) were then treated in SBR system. Samples were analysed at 6, 14 and 20 hrs after aeration in the SBR. The results show that, average reduction in BOD was about 2-11% after irradiated at 5 mA, and the percentage increased to 21-73% after treatment in SBR system. At 20 mA, BOD reduced to 7-29% during irradiation and the value increased to 57-87% after treatment in SBR system. (Author)

  2. Sleep Disturbance During Smoking Cessation: Withdrawal or Side Effect of Treatment?

    Science.gov (United States)

    Ashare, Rebecca L; Lerman, Caryn; Tyndale, Rachel F; Hawk, Larry W; George, Tony P; Cinciripini, Paul; Schnoll, Robert A

    2017-06-01

    The nicotine-metabolite ratio (NMR) predicts treatment response and is related to treatment side effect severity. Sleep disturbance may be one important side effect, but understanding sleep disturbance effects on smoking cessation is complicated by the fact that nicotine withdrawal also produces sleep disturbance. To evaluate the effects of withdrawal and treatment side effects on sleep disturbance. This is a secondary analysis of data from a clinical trial (Lerman et al., 2015) of 1,136 smokers randomised to placebo ( n = 363), transdermal nicotine (TN; n = 381), or varenicline ( n = 392) and stratified based on NMR (559 slow metabolisers; 577 normal metabolisers). Sleep disturbance was assessed at baseline and at 1-week following the target quit date (TQD). We also examined whether sleep disturbance predicted 7-day point-prevalence abstinence at end-of-treatment (EOT). The varenicline and TN groups exhibited greater increases in sleep disturbance (vs. placebo; treatment × time interaction; p = 0.005), particularly among those who quit smoking at 1-week post-TQD. There was a main effect of NMR ( p = 0.04), but no interactions with treatment. TN and varenicline attenuated withdrawal symptoms unrelated to sleep (vs. placebo). Greater baseline sleep disturbance predicted relapse at EOT ( p = 0.004). Existing treatments may not mitigate withdrawal-related sleep disturbance and adjunctive treatments that target sleep disturbance may improve abstinence rates.

  3. Implementation of large-scale average geostrophic wind shear in WAsP12.1

    DEFF Research Database (Denmark)

    Floors, Rogier Ralph; Troen, Ib; Kelly, Mark C.

    The vertical extrapolation model described in the European Wind Atlas Troen and Petersen (1989) is modified to take into account large-scale average geostrophic wind shear to describe the effect of horizontal temperature gradients on the geostrophic wind. The method is implemented by extracting...... the average geostrophic wind shear from Climate Forecast System Reanalysis (CFSR) data and the values of nearest grid point are automatically used in the WAsP 12.1 user interface to provide better AEP predictions....

  4. Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review.

    Science.gov (United States)

    Mouhayar, Youssef; Yin, Ophelia; Mumford, Sunni L; Segars, James H

    2017-06-01

    The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective. PubMed, Embase, and Cochrane libraries were used to identify publications reporting pregnancy rates after hysteroscopic polypectomy. Studies were required to have a polypectomy treatment group and control group of patients with polyps that were not resected. The charges of infertility treatments and polypectomy were obtained through infertility organizations and a private healthcare cost reporting website. These charges were applied to a decision tree model over the range of pregnancy rates observed in the representative studies to calculate an average cost per clinical or ongoing pregnancy. A sensitivity analysis was conducted to assess cost savings of polypectomy over a range of pregnancy rates and polypectomy costs. Pre-treatment office or operative hysteroscopic polypectomy ultimately saved €6658 ($7480) and €728 ($818), respectively, of the average cost per clinical pregnancy in women treated with four cycles of intrauterine insemination. Polypectomy prior to intrauterine insemination was cost-effective for clinical pregnancy rates greater than 30.2% for office polypectomy and 52.6% for operative polypectomy and for polypectomy price <€4414 ($4959). Office polypectomy or operative polypectomy saved €15,854 ($17,813) and €6644 ($7465), respectively, from the average cost per ongoing pregnancy for in vitro fertilization/intracytoplasmic sperm injection treated women and was cost-effective for ongoing pregnancy rates

  5. Trend of Average Wages as Indicator of Hypothetical Money Illusion

    Directory of Open Access Journals (Sweden)

    Julian Daszkowski

    2010-06-01

    Full Text Available The definition of wage in Poland not before 1998 includes any value of social security contribution. Changed definition creates higher level of reported wages, but was expected not to influence the take home pay. Nevertheless, the trend of average wages, after a short period, has returned to its previous line. Such effect is explained in the term of money illusion.

  6. Timescale Halo: Average-Speed Targets Elicit More Positive and Less Negative Attributions than Slow or Fast Targets

    Science.gov (United States)

    Hernandez, Ivan; Preston, Jesse Lee; Hepler, Justin

    2014-01-01

    Research on the timescale bias has found that observers perceive more capacity for mind in targets moving at an average speed, relative to slow or fast moving targets. The present research revisited the timescale bias as a type of halo effect, where normal-speed people elicit positive evaluations and abnormal-speed (slow and fast) people elicit negative evaluations. In two studies, participants viewed videos of people walking at a slow, average, or fast speed. We find evidence for a timescale halo effect: people walking at an average-speed were attributed more positive mental traits, but fewer negative mental traits, relative to slow or fast moving people. These effects held across both cognitive and emotional dimensions of mind and were mediated by overall positive/negative ratings of the person. These results suggest that, rather than eliciting greater perceptions of general mind, the timescale bias may reflect a generalized positivity toward average speed people relative to slow or fast moving people. PMID:24421882

  7. Physical therapy treatments for low back pain in children and adolescents: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Calvo-Muñoz Inmaculada

    2013-02-01

    Full Text Available Abstract Background Low back pain (LBP in adolescents is associated with LBP in later years. In recent years treatments have been administered to adolescents for LBP, but it is not known which physical therapy treatment is the most efficacious. By means of a meta-analysis, the current study investigated the effectiveness of the physical therapy treatments for LBP in children and adolescents. Methods Studies in English, Spanish, French, Italian and Portuguese, and carried out by March 2011, were selected by electronic and manual search. Two independent researchers coded the moderator variables of the studies, and performed the effect size calculations. The mean effect size index used was the standardized mean change between the pretest and posttest, and it was applied separately for each combination of outcome measures, (pain, disability, flexibility, endurance and mental health and measurement type (self-reports, and clinician assessments. Results Eight articles that met the selection criteria enabled us to define 11 treatment groups and 5 control groups using the group as the unit of analysis. The 16 groups involved a total sample of 334 subjects at the posttest (221 in the treatment groups and 113 in the control groups. For all outcome measures, the average effect size of the treatment groups was statistically and clinically significant, whereas the control groups had negative average effect sizes that were not statistically significant. Conclusions Of all the physical therapy treatments for LBP in children and adolescents, the combination of therapeutic physical conditioning and manual therapy is the most effective. The low number of studies and control groups, and the methodological limitations in this meta-analysis prevent us from drawing definitive conclusions in relation to the efficacy of physical therapy treatments in LBP.

  8. Econometric modelling of Serbian current account determinants: Jackknife Model Averaging approach

    Directory of Open Access Journals (Sweden)

    Petrović Predrag

    2014-01-01

    Full Text Available This research aims to model Serbian current account determinants for the period Q1 2002 - Q4 2012. Taking into account the majority of relevant determinants, using the Jackknife Model Averaging approach, 48 different models have been estimated, where 1254 equations needed to be estimated and averaged for each of the models. The results of selected representative models indicate moderate persistence of the CA and positive influence of: fiscal balance, oil trade balance, terms of trade, relative income and real effective exchange rates, where we should emphasise: (i a rather strong influence of relative income, (ii the fact that the worsening of oil trade balance results in worsening of other components (probably non-oil trade balance of CA and (iii that the positive influence of terms of trade reveals functionality of the Harberger-Laursen-Metzler effect in Serbia. On the other hand, negative influence is evident in case of: relative economic growth, gross fixed capital formation, net foreign assets and trade openness. What particularly stands out is the strong effect of relative economic growth that, most likely, reveals high citizens' future income growth expectations, which has negative impact on the CA.

  9. Effectiveness of Acupuncture in the Treatment of Gulf War Illness

    Science.gov (United States)

    2013-01-01

    325. 7 Wigers SH, Stiles TC, Vogael PA. Effects of aerobic exercise versus stress management treatment in fibromyalgia : a 4.5 year prospective study... Treatment of Gulf War Illness PRINCIPAL INVESTIGATOR: Lisa Conboy, M.A., M.S., ScD...December 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Effectiveness of Acupuncture in the Treatment of Gulf War Illness 5b. GRANT NUMBER W81XWH

  10. THERAPEUTIC EFFECTS OF A COGNITIVE-BEHAVIOURAL TREATMENT WITH JUVENILE OFFENDERS

    Directory of Open Access Journals (Sweden)

    Antonio Andrés-Pueyo

    2012-07-01

    Full Text Available Several treatment evaluations have highlighted the effectiveness of cognitive-behavioural programmes with both youth and adult offenders. This paper describes the application and assessment of a cognitive-behavioural treatment (adapted to Spanish from Ross and Fabiano’s Reasoning & Rehabilitation Programme with juvenile offenders serving community orders in an educational measure called in Spanish ‘libertad vigilada’ (similar to parole. The intervention comprised six different therapeutic components: self-control, cognitive restructuring, problem solving, social skills/assertiveness, values/empathy, and relapse prevention. Treatment effectiveness was tested using a quasi-experimental design involving two groups and pre/post evaluation. The results show that the programme was effective (with low to moderate effect sizes in improving participants’ social skills and self-esteem, as well as in reducing their aggressiveness. However, the intervention had no positive influence on empathy, cognitive distortions or impulsiveness. These results are in line with those of many other correctional studies, in which the treatment applied had a significant but partial effect on participants.

  11. Investigation Effects of Magnetetic Impurity Doping on Average Magnetization of Semiconducting Carbon Nanotubes

    Directory of Open Access Journals (Sweden)

    Saeedeh Ghafourian

    2011-01-01

    Full Text Available Single wall carbon nanotubes (SWCNT extensively are attractive from both theoretical and experimental point of view, due to its technological applications such as nano electronics devises. SWCNT are created by rolling a graphen sheet into a cyclindrical form. We have investigated the possibility of making a ferromagnetic semiconductor zigzag SWCNT by doping magnetic impurities. We found by increasing magnetic impurities doping on a zigzag SWCNT, average magnetization is increased and one can make a ferromagnetic semiconductor

  12. 47 CFR 80.759 - Average terrain elevation.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Average terrain elevation. 80.759 Section 80.759 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.759 Average terrain elevation. (a)(1) Draw radials...

  13. Effect of average diurnal barn airspace temperatures on prediction of their development during the day

    Directory of Open Access Journals (Sweden)

    Gustav Chládek

    2011-01-01

    Full Text Available A year-round (i.e. 365 days experiment was performed at the Mendel University Training Farm in Žabčice, Czech Republic (GPS 49°0’51.967”N and 16°36’14.614”E, the altitude 179 m with the aim to quantify the effect of the variation of average diurnal barn airspace temperatures on prediction of their changes during the day. Barn airspace temperatures were monitored daily in one-hour intervals and the recorded values were used for calculations of average diurnal temperatures. These were classified into 7 categories (i.e. below 0 °C; 0.1 to 5 °C; 5.1 to 10 °C; 10.1 to 15 °C; 15.1 to 20 °C; 20.1 to 25 °C and above 25 °C. Regarding this classification system, all differences between temperatures measured at identical hours but within various limits were statistically highly significant. The statistical analysis involved also the calculation of the third degree polynomial regression equations, which enabled to characterise the relationship between the temperature and the hour of measurement within the aforementioned categories of diurnal temperatures. Individual equations were markedly different and ranged from y = − 0.0019x3 + 0.0596x2 − 0.3797x − 1.2169 (for temperatures below 0 °C to y = − 0.0108x3 + 0.3297x2 − 1.9367x + 24.3931 (for temperatures above 25 °C. Correlation coefficients (r and coefficients of determination (R2 of these regression equations were generally very high and ranged from 0.872 to 0.976 and from 0.760 to 0.953, respectively. Regarding high values of both coefficients it can be concluded that the calculated equations enable a good and reliable prediction of the diurnal development of barn airspace temperatures.

  14. Area-averaged surface fluxes and their time-space variability over the FIFE experimental domain

    Science.gov (United States)

    Smith, E. A.; Hsu, A. Y.; Crosson, W. L.; Field, R. T.; Fritschen, L. J.; Gurney, R. J.; Kanemasu, E. T.; Kustas, W. P.; Nie, D.; Shuttleworth, W. J.

    1992-01-01

    The underlying mean and variance properties of surface net radiation, sensible-latent heat fluxes and soil heat flux are studied over the densely instrumented grassland region encompassing FIFE. Flux variability is discussed together with the problem of scaling up to area-averaged fluxes. Results are compared and contrasted for cloudy and clear situations and examined for the influence of surface-induced biophysical controls (burn and grazing treatments) and topographic controls (aspect ratios and slope factors).

  15. A microbial fuel cell–membrane bioreactor integrated system for cost-effective wastewater treatment

    International Nuclear Information System (INIS)

    Wang, Yong-Peng; Liu, Xian-Wei; Li, Wen-Wei; Li, Feng; Wang, Yun-Kun; Sheng, Guo-Ping; Zeng, Raymond J.; Yu, Han-Qing

    2012-01-01

    Highlights: ► An MFC–MBR integrated system for wastewater treatment and electricity generation. ► Stable electricity generation during 1000-h continuous operation. ► Low-cost electrode, separator and filter materials were adopted. -- Abstract: Microbial fuel cell (MFC) and membrane bioreactor (MBR) are both promising technologies for wastewater treatment, but both with limitations. In this study, a novel MFC–MBR integrated system, which combines the advantages of the individual systems, was proposed for simultaneous wastewater treatment and energy recovery. The system favored a better utilization of the oxygen in the aeration tank of MBR by the MFC biocathode, and enabled a high effluent quality. Continuous and stable electricity generation, with the average current of 1.9 ± 0.4 mA, was achieved over a long period of about 40 days. The maximum power density reached 6.0 W m −3 . Moreover, low-cost materials were used for the reactor construction. This integrated system shows great promise for practical wastewater treatment application.

  16. Toxic Stress: Effects, Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Hillary A. Franke

    2014-11-01

    Full Text Available Children who experience early life toxic stress are at risk of long-term adverse health effects that may not manifest until adulthood. This article briefly summarizes the findings in recent studies on toxic stress and childhood adversity following the publication of the American Academy of Pediatrics (AAP Policy Report on the effects of toxic stress. A review of toxic stress and its effects is described, including factors of vulnerability, resilience, and the relaxation response. An integrative approach to the prevention and treatment of toxic stress necessitates individual, community and national focus.

  17. Increasing average period lengths by switching of robust chaos maps in finite precision

    Science.gov (United States)

    Nagaraj, N.; Shastry, M. C.; Vaidya, P. G.

    2008-12-01

    Grebogi, Ott and Yorke (Phys. Rev. A 38, 1988) have investigated the effect of finite precision on average period length of chaotic maps. They showed that the average length of periodic orbits (T) of a dynamical system scales as a function of computer precision (ɛ) and the correlation dimension (d) of the chaotic attractor: T ˜ɛ-d/2. In this work, we are concerned with increasing the average period length which is desirable for chaotic cryptography applications. Our experiments reveal that random and chaotic switching of deterministic chaotic dynamical systems yield higher average length of periodic orbits as compared to simple sequential switching or absence of switching. To illustrate the application of switching, a novel generalization of the Logistic map that exhibits Robust Chaos (absence of attracting periodic orbits) is first introduced. We then propose a pseudo-random number generator based on chaotic switching between Robust Chaos maps which is found to successfully pass stringent statistical tests of randomness.

  18. Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.

    Science.gov (United States)

    Attias, Samuel; Keinan Boker, Lital; Arnon, Zahi; Ben-Arye, Eran; Bar'am, Ayala; Sroka, Gideon; Matter, Ibrahim; Somri, Mostafa; Schiff, Elad

    2016-03-01

    Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, peffective than individualized CAM (Peffective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Effects of post-heat treatment on microstructure and properties of laser cladded composite coatings on titanium alloy substrate

    Science.gov (United States)

    Li, G. J.; Li, J.; Luo, X.

    2015-01-01

    The composite coatings were produced on the Ti6Al4V alloy substrate by laser cladding. Subsequently, the coatings were heated at 500 °C for 1 h and 2 h and then cooled in air. Effects of post-heat treatment on microstructure, microhardness and fracture toughness of the coatings were investigated by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy dispersive spectroscopy (EDS), optical microscopy (OM). Wear resistance of the coatings was evaluated under the dry sliding reciprocating friction condition at room temperature. The results indicated that the coatings mainly consist of a certain amount of coarse white equiaxed WC particles surrounded by the white-bright W2C, a great deal of fine dark spherical TiC particles and the matrix composed of the α(Ti), Ti2Ni and TiNi phases. Effects of the post-heat treatment on phase constituents and microstructure of the coatings were almost negligible due to the low temperature. However, the post-heat treatment could decrease the residual stress and increase fracture toughness of the coatings, and fracture toughness of the coatings was improved from 2.77 MPa m1/2 to 3.80 MPa m1/2 and 4.43 MPa m1/2 with the heat treatment for 1 h and 2 h, respectively. The mutual role would contribute to the reduction in cracking susceptibility. Accompanied with the increase in fracture toughness, microhardness of the coatings was reduced slightly. The dominant wear mechanism for all the coatings was abrasive wear, characterized by micro-cutting or micro-plowing. The heat treatment could significantly decrease the average friction coefficient and reduce the fluctuation of the friction coefficient with the change in sliding time. The appropriate heat treatment time (approximately 1 h) had a minimal effect on wear mass loss and volume loss. Moreover, the improvement in fracture toughness will also be beneficial to wear resistance of the coatings under the long service.

  20. Assessment of specific absorbed fractions for photons and electrons using average adult Japanese female phantom

    International Nuclear Information System (INIS)

    Manabe, Kentaro; Sato, Kaoru; Takahashi, Fumiaki

    2016-12-01

    In the 2007 Recommendations of the International Commission on Radiological Protection (ICRP), the procedure for calculating effective doses was modified as follows. Equivalent doses are evaluated using the male and female voxel phantoms on the basis of reference anatomical data of Caucasians, and effective doses are calculated using sex-averaged equivalent doses in applying tissue weighting factors. Specific absorbed fractions (SAFs), which are essential data for calculating internal doses, depend on the body weights, organ masses, and positional relations of organs of the phantoms. Then, the dose coefficients, which are committed effective doses per unit intake of radionuclides, developed by ICRP on the basis of the 2007 Recommendations reflect the physical characteristics of Caucasians and are averaged over the sexes. Meanwhile, the physiques of adult Japanese are generally smaller than those of adult Caucasians, and organ masses are also different from each other. Therefore, dose coefficients reflecting Japanese physical characteristics are different from those of ICRP. Knowledge of the influence of race differences on dose coefficients is important to apply the sex averaged dose coefficients of ICRP to the Japanese system of radiation protection. SAF data based on phantoms which have Japanese physical characteristics is essential for assessment of the dose coefficients reflecting Japanese physical characteristics. The Japan Atomic Energy Agency constructed average adult Japanese phantoms, JM-103 (male) and JF-103 (female), and is developing a dose estimation method for internal exposure using these phantoms. This report provides photon and electron SAFs of JF-103. The data of this report and the previously published data of JM-103 are applicable to evaluate sex-specific and sex-averaged dose coefficients reflecting the physical characteristics of the average adult Japanese for intakes of radionuclides emitting photons and electrons. Appendix as CD-ROM. (J.P.N.)