Comparative Antioxidant, Antiproliferative and Apoptotic Effects of ...

African Journals Online (AJOL)

Purpose: To determine and compare the antioxidant, antiproliferative and apoptotic effects of leaf infusions of Ilex laurina and Ilex paraguariensis in colon cancer cells. Methods: Antioxidant activity was determined by ORAC (Oxygen Radical Absorbance Capacity) and FRAP (Ferric Reducing Antioxidant Power). Cytotoxic ...

Preliminary Competencies for Comparative Effectiveness Research

OpenAIRE

Segal, Jodi B.; Kapoor, Wishwa; Carey, Timothy; Mitchell, Pamela H.; Murray, Michael D.; Saag, Kenneth G.; Schumock, Glen; Jonas, Daniel; Steinman, Michael; Weinberger, Morris; Filart, Rosemarie; Selker, Harry

2012-01-01

The Clinical and Translational Science Award (CTSA) Workgroup for Comparative Effectiveness Research (CER) Education, Training, and Workforce Development identified a need to delineate the competencies that practitioners and users of CER for patient centered outcomes research, should acquire. With input from CTSA representatives and collaborators, we began by describing the workforce. We recognize the workforce that conduct CER and the end users who use CER to improve the health of individual...

Comparative effectiveness of malaria preventive measures on ...

African Journals Online (AJOL)

The burden of malaria and its associated problems in pregnancy can be reduced by the use of different malaria preventive measures. This study was conducted to determine the comparative effectiveness of three different malaria preventive measures on populations of parturient in Abeokuta, Ogun State, Nigeria.

COMPARATIVE EFFECTIVENESS RESEARCH AND ITS APPLICATION TO NURSING EDUCATION

Directory of Open Access Journals (Sweden)

Claire Su-Yeon Park

2016-07-01

Full Text Available This in-depth integrative literature review aimed to investigate comparative effectiveness research (CER methodologies applicable to nursing research and to propose a CER design relevant to nursing education. Integration and synthesis were conducted from August 20 to December 15, 2013 and from October 20 to December 05, 2015 using electronic databases and refereed published books. The key words were “comparative effectiveness research,” “education,” “patient outcomes,” “effectiveness,” “cost-effectiveness,” and “efficiency.” All selected literatures were initially scrutinized by the principal investigator in terms of scientific rigor and then synthesized on an ongoing basis. CER methodologies in nursing research were presented to be significant in terms of enabling the distinctiveness of the nursing profession to stand out. Three CER methodologies applicable to nursing research—a Pragmatic Clinical Trial, Observational Comparative Effectiveness Research and Cost Effectiveness Research—revealed each of their distinguishable strengths and weaknesses compared to the Randomized Controlled Trial. For ethical considerations, the importance of ensuring “equipoise” was identified. Lastly, in a head to head comparison of two nursing education programs, a single blind, randomized crossover study design was proposed as a type of Pragmatic Clinical Trial utilizing cost-utility analysis. A mixed method Analysis of Covariance and a Doubly Multivariate Repeated Analysis of Covariance were suggested as relevant statistical analyses. Considering that CER is still inchoate in nursing research and nurse scientists’ endeavors to address the gap are urgent, this study is compelling in that it proposed a rigorous CER design not only directly applicable to nursing education, but also to other disciplines in education.

Instrumental variable methods in comparative safety and effectiveness research.

Science.gov (United States)

Brookhart, M Alan; Rassen, Jeremy A; Schneeweiss, Sebastian

2010-06-01

Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial.

Instrumental variable methods in comparative safety and effectiveness research†

Science.gov (United States)

Brookhart, M. Alan; Rassen, Jeremy A.; Schneeweiss, Sebastian

2010-01-01

Summary Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial. PMID:20354968

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study

Science.gov (United States)

Nikolakopoulou, Adriani; Mavridis, Dimitris; Furukawa, Toshi A; Cipriani, Andrea; Tricco, Andrea C; Straus, Sharon E; Siontis, George C M; Egger, Matthias

2018-01-01

Abstract Objective To examine whether the continuous updating of networks of prospectively planned randomised controlled trials (RCTs) (“living” network meta-analysis) provides strong evidence against the null hypothesis in comparative effectiveness of medical interventions earlier than the updating of conventional, pairwise meta-analysis. Design Empirical study of the accumulating evidence about the comparative effectiveness of clinical interventions. Data sources Database of network meta-analyses of RCTs identified through searches of Medline, Embase, and the Cochrane Database of Systematic Reviews until 14 April 2015. Eligibility criteria for study selection Network meta-analyses published after January 2012 that compared at least five treatments and included at least 20 RCTs. Clinical experts were asked to identify in each network the treatment comparison of greatest clinical interest. Comparisons were excluded for which direct and indirect evidence disagreed, based on side, or node, splitting test (Pmeta-analysis. The frequency and time to strong evidence was compared against the null hypothesis between pairwise and network meta-analyses. Results 49 comparisons of interest from 44 networks were included; most (n=39, 80%) were between active drugs, mainly from the specialties of cardiology, endocrinology, psychiatry, and rheumatology. 29 comparisons were informed by both direct and indirect evidence (59%), 13 by indirect evidence (27%), and 7 by direct evidence (14%). Both network and pairwise meta-analysis provided strong evidence against the null hypothesis for seven comparisons, but for an additional 10 comparisons only network meta-analysis provided strong evidence against the null hypothesis (P=0.002). The median time to strong evidence against the null hypothesis was 19 years with living network meta-analysis and 23 years with living pairwise meta-analysis (hazard ratio 2.78, 95% confidence interval 1.00 to 7.72, P=0.05). Studies directly comparing

Comparative Analysis of the Effects of Organization Development ...

African Journals Online (AJOL)

Comparative Analysis of the Effects of Organization Development Interventions on Organizational Leadership and Management Practice: A Case Of Green Earth Program (GEP) ... Journal of Language, Technology & Entrepreneurship in Africa.

Comparative Effectiveness of Different Types of Cervical Laminoplasty

OpenAIRE

Heller, John G.; Raich, Annie L.; Dettori, Joseph R.; Riew, K. Daniel

2013-01-01

Study Design Systematic review. Study Rationale Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical ...

Comparative Antioxidant, Antiproliferative and Apoptotic Effects of ...

African Journals Online (AJOL)

Purpose: To determine and compare the antioxidant, antiproliferative and apoptotic effects of leaf infusions of Ilex laurina ... Both plant infusions inhibited viability and cell growth of SW480 and SW620 cells. .... 100 g of dry extract, from a gallic acid calibration curve [9]. ..... antioxidant capacity and in vitro inhibition of colon.

Comparative effects of imipramine, sertraline, nifedipine, furosemide ...

African Journals Online (AJOL)

The objective of the study was to evaluate the comparative effects of imipramine, sertraline, nifedipine, furosemide and bumetanide on ingestive behavior in rodents. Twelve groups (with six in each group) of male mice (25 to 35 g) were used in the experiments. They were housed in labelled plastic cages in the departmental ...

Impact of antimicrobial wipes compared with hypochlorite solution on environmental surface contamination in a health care setting: A double-crossover study.

Science.gov (United States)

Siani, Harsha; Wesgate, Rebecca; Maillard, Jean-Yves

2018-05-11

Antimicrobial wipes are increasingly used in health care settings. This study evaluates, in a clinical setting, the efficacy of sporicidal wipes versus a cloth soaked in a 1,000 ppm chlorine solution. A double-crossover study was performed on 2 different surgical and cardiovascular wards in a 1,000-bed teaching hospital over 29 weeks. The intervention period that consisted of surface decontamination with the preimpregnated wipe or cloth soaked in chlorine followed a 5-week baseline assessment of microbial bioburden on surfaces. Environmental samples from 11 surfaces were analyzed weekly for their microbial content. A total of 1,566 environmental samples and 1,591 ATP swabs were analyzed during the trial. Overall, there were significant differences in the recovery of total aerobic bacteria (P < .001), total anaerobic bacteria (P < .001), and ATP measurement (P < .001) between wards and between the different parts of the crossover study. Generally, the use of wipes produced the largest reduction in the total aerobic and anaerobic counts when compared with the baseline data or the use of 1,000 ppm chlorine. Collectively, the introduction of training plus daily wipe disinfection significantly reduced multidrug-resistant organisms recovered from surfaces. Reversion to using 1,000 ppm chlorine resulted in the number of sites positive for multidrug-resistant organisms rising again. This double-crossover study is the first controlled field trial comparison of using preimpregnated wipes versus cotton cloth dipped into a bucket of hypochlorite to decrease surface microbial bioburden. The results demonstrate the superiority of the preimpregnated wipes in significantly decreasing microbial bioburden from high-touch surfaces. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Comparing Hall Effect and Field Effect Measurements on the Same Single Nanowire.

Science.gov (United States)

Hultin, Olof; Otnes, Gaute; Borgström, Magnus T; Björk, Mikael; Samuelson, Lars; Storm, Kristian

2016-01-13

We compare and discuss the two most commonly used electrical characterization techniques for nanowires (NWs). In a novel single-NW device, we combine Hall effect and back-gated and top-gated field effect measurements and quantify the carrier concentrations in a series of sulfur-doped InP NWs. The carrier concentrations from Hall effect and field effect measurements are found to correlate well when using the analysis methods described in this work. This shows that NWs can be accurately characterized with available electrical methods, an important result toward better understanding of semiconductor NW doping.

The value-based medicine comparative effectiveness and cost-effectiveness of penetrating keratoplasty for keratoconus.

Science.gov (United States)

Roe, Richard H; Lass, Jonathan H; Brown, Gary C; Brown, Melissa M

2008-10-01

To perform a base case, comparative effectiveness, and cost-effectiveness (cost-utility) analysis of penetrating keratoplasty for patients with severe keratoconus. Visual acuity data were obtained from a large, retrospective multicenter study in which patients with keratoconus with less than 20/40 best corrected visual acuity and/or the inability to wear contact lenses underwent penetrating keratoplasty, with an average follow-up of 2.1 years. The results were combined with other retrospective studies investigating complication rates of penetrating keratoplasty. The data were then incorporated into a cost-utility model using patient preference-based, time trade-off utilities, computer-based decision analysis, and a net present value model to account for the time value of outcomes and money. The comparative effectiveness of the intervention is expressed in quality-of-life gain and QALYs (quality-adjusted life-years), and the cost-effectiveness results are expressed in the outcome of $/QALY (dollars spent per QALY). Penetrating keratoplasty in 1 eye for patients with severe keratoconus results in a comparative effectiveness (value gain) of 16.5% improvement in quality of life every day over the 44-year life expectancy of the average patient with severe keratoconus. Discounting the total value gain of 5.36 QALYs at a 3% annual discount rate yields 3.05 QALYs gained. The incremental cost for penetrating keratoplasty, including all complications, is $5934 ($5913 discounted at 3% per year). Thus, the incremental cost-utility (discounted at 3% annually) for this intervention is $5913/3.05 QALYs = $1942/QALY. If both eyes undergo corneal transplant, the total discounted value gain is 30% and the overall cost-utility is $2003. Surgery on the second eye confers a total discounted value gain of 2.5 QALYs, yielding a quality-of-life gain of 11.6% and a discounted cost-utility of $2238/QALY. Penetrating keratoplasty for patients with severe keratoconus seems to be a

Cutting-edge technology for public health workforce training in comparative effectiveness research.

Science.gov (United States)

Salinas-Miranda, Abraham A; Nash, Michelle C; Salemi, Jason L; Mbah, Alfred K; Salihu, Hamisu M

2013-06-01

A critical mass of public health practitioners with expertise in analytic techniques and best practices in comparative effectiveness research is needed to fuel informed decisions and improve the quality of health care. The purpose of this case study is to describe the development and formative evaluation of a technology-enhanced comparative effectiveness research learning curriculum and to assess its potential utility to improve core comparative effectiveness research competencies among the public health workforce. Selected public health experts formed a multidisciplinary research collaborative and participated in the development and evaluation of a blended 15-week comprehensive e-comparative effectiveness research training program, which incorporated an array of health informatics technologies. Results indicate that research-based organizations can use a systematic, flexible, and rapid means of instructing their workforce using technology-enhanced authoring tools, learning management systems, survey research software, online communities of practice, and mobile communication for effective and creative comparative effectiveness research training of the public health workforce.

Comparable effects of exercise and analgesics for pain secondary to knee osteoarthritis

DEFF Research Database (Denmark)

Henriksen, Marius; Hansen, Julie B; Klokker, Louise

2016-01-01

administered analgesics for pain in patients with knee osteoarthritis. METHODS: The Cochrane Database of systematic reviews was searched for meta-analyses of randomized controlled studies comparing exercise or analgesics with a control group (placebo or usual care) and with pain as an outcome. Individual study......AIM: Evidence of comparative effectiveness of different treatment approaches is important for clinical decision-making, yet absent for most recommended treatments of knee osteoarthritis pain. The objective of this study was to estimate the comparative effectiveness of exercise versus orally...... estimates were identified and effect sizes were calculated from group differences. We combined study-level effects on pain with a random effects meta-analysis and compared effect sizes between exercise trials and trials with analgesic interventions. RESULTS: We included six Cochrane reviews (four...

Pterostilbene Is a Potential Candidate for Control of Blackleg in Canola.

Directory of Open Access Journals (Sweden)

Joshua C O Koh

Full Text Available Two stilbenes, resveratrol and pterostilbene, exhibit antifungal activity against Leptosphaeria maculans, the fungal pathogen responsible for blackleg (stem canker in canola (Brassica napus. In vitro studies on the effect of these stilbenes on L. maculans mycelial growth and conidia germination showed that pterostilbene is a potent fungicide and sporicide, but resveratrol only exerted minor inhibition on L. maculans. Cell viability of hyphae cultures was markedly reduced by pterostilbene and SYTOX green staining showed that cell membrane integrity was compromised. We demonstrate that pterostilbene exerts fungicidal activity across 10 different L. maculans isolates and the compound confers protection to the blackleg-susceptible canola cv. Westar seedlings. The potential of pterostilbene as a control agent against blackleg in canola is discussed.

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study.

Science.gov (United States)

Nikolakopoulou, Adriani; Mavridis, Dimitris; Furukawa, Toshi A; Cipriani, Andrea; Tricco, Andrea C; Straus, Sharon E; Siontis, George C M; Egger, Matthias; Salanti, Georgia

2018-02-28

To examine whether the continuous updating of networks of prospectively planned randomised controlled trials (RCTs) ("living" network meta-analysis) provides strong evidence against the null hypothesis in comparative effectiveness of medical interventions earlier than the updating of conventional, pairwise meta-analysis. Empirical study of the accumulating evidence about the comparative effectiveness of clinical interventions. Database of network meta-analyses of RCTs identified through searches of Medline, Embase, and the Cochrane Database of Systematic Reviews until 14 April 2015. Network meta-analyses published after January 2012 that compared at least five treatments and included at least 20 RCTs. Clinical experts were asked to identify in each network the treatment comparison of greatest clinical interest. Comparisons were excluded for which direct and indirect evidence disagreed, based on side, or node, splitting test (Pmeta-analyses were performed for each selected comparison. Monitoring boundaries of statistical significance were constructed and the evidence against the null hypothesis was considered to be strong when the monitoring boundaries were crossed. A significance level was defined as α=5%, power of 90% (β=10%), and an anticipated treatment effect to detect equal to the final estimate from the network meta-analysis. The frequency and time to strong evidence was compared against the null hypothesis between pairwise and network meta-analyses. 49 comparisons of interest from 44 networks were included; most (n=39, 80%) were between active drugs, mainly from the specialties of cardiology, endocrinology, psychiatry, and rheumatology. 29 comparisons were informed by both direct and indirect evidence (59%), 13 by indirect evidence (27%), and 7 by direct evidence (14%). Both network and pairwise meta-analysis provided strong evidence against the null hypothesis for seven comparisons, but for an additional 10 comparisons only network meta-analysis provided

Comparative effectiveness research: Challenges for medical journals

Directory of Open Access Journals (Sweden)

Tovey David

2010-04-01

Full Text Available Abstract Editors from a number of medical journals lay out principles for journals considering publication of Comparative Effectiveness Research (CER. In order to encourage dissemination of this editorial, this article is freely available in PLoS Medicine and will be also published in Medical Decision Making, Croatian Medical Journal, The Cochrane Library, Trials, The American Journal of Managed Care, and Journal of Clinical Epidemiology.

Comparing sensitivity of ecotoxicological effect endpoints between laboratory and field

DEFF Research Database (Denmark)

Selck, H.; Riemann, B.; Christoffersen, K.

2002-01-01

multispecies field tests using tributyltin (TBT) and linear alkylbenzene sulfonates (LAS) were compared with published laboratory single-species test results and measured in situ concentrations. Extrapolation methods were evaluated by comparing predicted no-effect concentrations (PNECs), calculated by AF...

Comparing Effectiveness of Undergraduate Course Delivery: A Student Perspective

Science.gov (United States)

Koenig, Robert J.

2009-01-01

Higher education students can and do take courses delivered in a variety of ways. But, to date, little research has been done on the effectiveness of different delivery modes. This study sought to fill that void by comparing the effectiveness of three undergraduate course delivery modes: classroom, online, and video conference at a technical…

Comparative Clinical Study on the Effectiveness of Homeopathic ...

African Journals Online (AJOL)

Purpose: To investigate the effectiveness of homeopathic combination remedy compared with standard maintenance therapy for the treatment of dengue fever. Method: A total of 50 patients with dengue fever were divided into two equal groups. Group 1 was treated with homeopathic combination remedy for consecutive 6 ...

Chemical toxicity of uranium hexafluoride compared to acute effects of radiation

International Nuclear Information System (INIS)

McGuire, S.A.

1991-02-01

The chemical effects from acute exposures to uranium hexafluoride are compared to the nonstochastic effects from acute radiation doses of 25 rems to the whole body and 300 rems to the thyroid. The analysis concludes that an intake of about 10 mg of uranium in soluble form is roughly comparable, in terms of early effects, to an acute whole body dose of 25 rems because both are just below the threshold for significant nonstochastic effects. Similarly, an exposure to hydrogen fluoride at a concentration of 25 mg/m 3 for 30 minutes is roughly comparable because there would be no significant nonstochastic effects. For times t other than 30 minutes, the concentration C of hydrogen fluoride considered to have the same effect can be calculated using a quadratic equation: C = 25 mg/m 3 (30 min/t). The purpose of these analyses is to provide information for developing design and siting guideline based on chemical toxicity for enrichment plants using uranium hexafluoride. These guidelines are to be similar, in terms of stochastic health effects, to criteria in NRC regulations of nuclear power plants, which are based on radiation doses. 26 refs., 1 fig., 5 tabs

Chemical toxicity of uranium hexafluoride compared to acute effects of radiation

Energy Technology Data Exchange (ETDEWEB)

McGuire, S.A.

1991-02-01

The chemical effects from acute exposures to uranium hexafluoride are compared to the nonstochastic effects from acute radiation doses of 25 rems to the whole body and 300 rems to the thyroid. The analysis concludes that an intake of about 10 mg of uranium in soluble form is roughly comparable, in terms of early effects, to an acute whole body dose of 25 rems because both are just below the threshold for significant nonstochastic effects. Similarly, an exposure to hydrogen fluoride at a concentration of 25 mg/m{sup 3} for 30 minutes is roughly comparable because there would be no significant nonstochastic effects. For times t other than 30 minutes, the concentration C of hydrogen fluoride considered to have the same effect can be calculated using a quadratic equation: C = 25 mg/m{sup 3} (30 min/t). The purpose of these analyses is to provide information for developing design and siting guideline based on chemical toxicity for enrichment plants using uranium hexafluoride. These guidelines are to be similar, in terms of stochastic health effects, to criteria in NRC regulations of nuclear power plants, which are based on radiation doses. 26 refs., 1 fig., 5 tabs.

Study design elements for rigorous quasi-experimental comparative effectiveness research.

Science.gov (United States)

Maciejewski, Matthew L; Curtis, Lesley H; Dowd, Bryan

2013-03-01

Quasi-experiments are likely to be the workhorse study design used to generate evidence about the comparative effectiveness of alternative treatments, because of their feasibility, timeliness, affordability and external validity compared with randomized trials. In this review, we outline potential sources of discordance in results between quasi-experiments and experiments, review study design choices that can improve the internal validity of quasi-experiments, and outline innovative data linkage strategies that may be particularly useful in quasi-experimental comparative effectiveness research. There is an urgent need to resolve the debate about the evidentiary value of quasi-experiments since equal consideration of rigorous quasi-experiments will broaden the base of evidence that can be brought to bear in clinical decision-making and governmental policy-making.

Comparative Effect of Graphic Organiser and Expository teaching ...

African Journals Online (AJOL)

This paper focused on the comparative effects of graphic organiser and expository teaching strategies on the achievement of senior secondary school students in Economics. Graphic organiser is a teaching strategy used to visualise the structure of knowledge, instead of describing all concepts and their relations in text as in ...

Comparative study on the pathogenic effects of Diminazine ...

African Journals Online (AJOL)

The study was conducted in goats to compare the pathogenic effects of .... membrane was examined, the rectal temperature of the goats was recorded ... the plasma layer, the content was expressed on the slide and covered with slip. ... measure analysis of variance in SPSS version 15.0 (2000). ..... Canadanian Journal of.

Comparative effectiveness of inter-simple sequence repeat and ...

African Journals Online (AJOL)

A study to compare the effectiveness of inter-simple sequence repeats (ISSR) and randomly amplified polymorphic DNA (RAPD) profiling was carried out with a total of 65 DNA samples using 12 species of Indian Garcinia. ISSR and RAPD profiling were performed with 19 and 12 primers, respectively. ISSR markers ...

Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement.

Science.gov (United States)

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

2012-03-01

AIMS: Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. MATERIALS #ENTITYSTARTX00026; METHODS: The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. RESULTS: Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The 'analytic-deliberative' conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. CONCLUSION: While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER.

Comparative toxicity effect of bush tea leaves ( Hyptis suaveolens ...

African Journals Online (AJOL)

Hyptis suaveolens) were compared for their toxicity effect on the larvae of the yellow fever mosquito Aedes aegypti collected from disused tyres beside College of Natural Sciences building University of Agriculture, Abeokuta, Nigeria.

Modern needs in health technology assessment: a study of comparative effectiveness

Directory of Open Access Journals (Sweden)

A. V. Pavlysh

2013-01-01

Full Text Available Health technology assessment is a key component of healthcare decision making in most of the developed countries. Comparative effectiveness research as one of the elements of such assessment is becoming increasingly important in recent years. It is based on the effectiveness analysis of health technologies in real clinical practice setting. The authors have analyzed publications dedicated to these issues and showed the main methods of such study, its peculiarities, advantages and disadvantages. It has been revealed that the most frequently used designs of expert analysis are observational and pragmatic randomized studies. The main recommendations on analyzing comparative effectiveness are given in view of the literary data.

Comparative Antitussive Effects of Medicinal Plants and Their Constituents.

Science.gov (United States)

Saadat, Saeideh; Shakeri, Farzaneh; Boskabady, Mohammad Hossein

2018-01-15

Context • The cough is a protective reflex, with 2 types, one being more sensitive to mechanical stimulation and the other to chemical stimulation, such as sulfur dioxide, ammonia, citric acid, and capsaicin. Some evidence is available that suppressant therapy is most effective when used for the short-term reduction of coughing. Today, use of herbal drugs is increasing all over the world for various ailments, including to provide antitussive activity. Objective • The study intended to review the antitussive effects of various extracts, some fractions, and some constituents of the studied medicinal plants. Design • Various databases, including the Medline, Science Direct, Scopus, and Google Scholar, were searched for studies published between 1978 and 2015, using the keywords antitussive and cough and the names of various medicinal plants and their constituents. Setting • The study took place in the districts related to Mashhad University of Medical Sciences (Mashhad, Iran). Outcome Measures • The antitussive effects of medicinal plants and their constituents were normalized to 50 mg/kg and 1 mg/mL against various cough stimulants and compared. Results • The most potent antitussive effect was observed for Nigella sativa and Linum usitatissimum on coughs induced by sulfur dioxide. Artemisia absinthium showed a higher antitussive effect on cough induced by ammonia compared with the other studied medicinal plants. The antitussive effects of Cuminum cyminum and Glycyrrhiza glabra were more potent on cough induced by citric acid than other medicinal plants. Conclusions • These results suggest the therapeutic potential of the studied medicinal plants as antitussive therapies. However, only a few clinical studies have examined the antitussive effects of medicinal plants, and more clinical studies are needed. The underlying mechanisms of the antitussive effects of medicinal plants should be also examined in further studies.

"Families" in International Context: Comparing Institutional Effects across Western Societies

Science.gov (United States)

Cooke, Lynn Prince; Baxter, Janeen

2010-01-01

We review comparative evidence of institutional effects on families in Western societies. We focus on 2 key aspects of family life: gendered divisions of labor and people's transitions into, within, and out of relationships. Many individual-level models assume the effects are robust across countries. The international evidence over the past decade…

Comparative effectiveness of non-print media and live CME

Directory of Open Access Journals (Sweden)

Kuldeep Singh

2015-01-01

Full Text Available Continuing Medical Education is an integral ingredient of professional development of health care providers. The educational activity can be delivered by different modes. Here we share our experience of using Digital Video Disc (DVD of a CME on Sleep Medicine as an alternative and cost effective mode.Objective: To assess improvement in knowledge and competencies in terms of comparative effectiveness of a model CME program using validated non-print medium for medical education.Methods: Recorded and validated DVD of talks delivered at NAMS-AIIMS Regional Symposium on Sleep Medicine was played to the participants in presence of one of the content experts. Video scripts of talk were also distributed to the participants. The assessment of participants and program evaluation of this CME was compared to the previously held live CME.Results: Eighty nine participants completed both pre and post test. Mean score increased from 9.91± 3.5 to 14.09 ± 2.85. Pass percentage based on an arbitrary cut off of 50%, increased from 8.3 to 43.8 (p< 0.001. Among the live CME group, mean score improved from 12.1±4.6 to 18.3 ± 3.8. Comparative analysis between live and DVD based CME showed improvement in scores of 6.17 and 4.18 respectively while pass percentage of 84.7 and 43.8 post CME among two modes were significant. The program evaluation showed identical level of satisfaction in all parameters except they were less satisfied vis-a-vis 'organizers made use of any critical comments I made' since all locally available resource persons were not present. Activity could be completed at just half the cost of live CME.Conclusions: The educational background and selection process of UG students between two medical institutes were strikingly different. While students at one institute were selected by highly competitive exam at All India level, the students at other institute were selected through state level competitive examination. In spite of that, results showed

Comparative effectiveness research and medical informatics.

Science.gov (United States)

D'Avolio, Leonard W; Farwell, Wildon R; Fiore, Louis D

2010-12-01

As is the case for environmental, ecological, astronomical, and other sciences, medical practice and research finds itself in a tsunami of data. This data deluge, due primarily to the introduction of digitalization in routine medical care and medical research, affords the opportunity for improved patient care and scientific discovery. Medical informatics is the subdiscipline of medicine created to make greater use of information in order to improve healthcare. The 4 areas of medical informatics research (information access, structure, analysis, and interaction) are used as a framework to discuss the overlap in information needs of comparative effectiveness research and potential contributions of medical informatics. Examples of progress from the medical informatics literature and the Veterans Affairs Healthcare System are provided. Published by Elsevier Inc.

The policy debate over public investment in comparative effectiveness research.

Science.gov (United States)

Rich, Eugene C

2009-06-01

Policy makers across the political spectrum, as well as many clinicians and physician professional associations, have proposed that better information on comparative clinical effectiveness should be a key element of any solution to the US health-care cost crisis. This superficial consensus hides intense disagreements over critical issues essential to any new public effort to promote more comparative effectiveness research (CER). This article reviews the background for these disputes, summarizes the different perspectives represented by policy makers and advocates, and offers a framework to aid both practicing and academic internists in understanding the key elements of the emerging debate. Regarding the fundamental question of "what is CER," disagreements rage over whether value or cost effectiveness should be a consideration, and how specific patient perspectives should be reflected in the development and the use of such research. The question of how to pay for CER invokes controversies over the role of the market in producing such information and the private (e.g., insurers and employers) versus public responsibility for its production. The financing debate further highlights the high stakes of comparative effectiveness research, and the risks of stakeholder interests subverting any public process. Accordingly there are a range of proposals for the federal government's role in prioritization, development, and dissemination of CER. The internal medicine community, with its long history of commitment to scientific medical practice and its leadership in evidence-based medicine, should have a strong interest and play an active role in this debate.

Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations.

Science.gov (United States)

Osso, Diane; Kanani, Nehal

2013-02-01

Antiseptic mouth rinses are widely recommended and marketed to improve oral health. This article summarizes current studies on the comparative effectiveness of selected antiseptic mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily exposure, including salivary flow rate, oral cancer and wear of composite restorations. Electronic database searches were conducted using Google Scholar and PubMed to identify articles comparing the effectiveness of 4 commercially marketed antiseptic mouth rinses differing in active ingredients (0.12% chlorhexidine gluconate, essential oils (menthol, thymol and eucalyptol) and methyl salicylate, 0.7% cetylpyridinium chloride and 20% aloe vera gel) for controlling plaque and gingivitis. Criteria for inclusion included controlled clinical trials and systematic reviews appearing in English language publications evaluating the comparative effectiveness of the mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily usage. The majority of studies have shown mouth rinses containing chlorhexidine gluconate or essential oils and methyl salicylate provide clinically significant anti-gingivitis and anti-plaque benefits. Cetylpyridinium chloride has been found to provide only limited clinical benefits compared to inactive control mouth rinse. Inadequate evidence is available to evaluate the clinical effectiveness of aloe vera gel. Chlorhexidine, essential oils and cetylpyridinium have been found to be safe. However, limited data are available on the effects of the mouth rinse on wear patterns of dental restorations. Studies reviewed reported no significant difference in salivary flow rate related to alcohol based mouth rinse. Research supports the effectiveness of antiseptic mouth rinses in reducing plaque and gingivitis as an adjunct to home care. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing periodontitis or the

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid.

Science.gov (United States)

Hawley, Brie; Casey, Megan; Virji, Mohammed Abbas; Cummings, Kristin J; Johnson, Alyson; Cox-Ganser, Jean

2017-12-15

Cleaning and disinfecting products consisting of a mixture of hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are widely used as sporicidal agents in health care, childcare, agricultural, food service, and food production industries. HP and PAA are strong oxidants and their mixture is a recognized asthmagen. However, few exposure assessment studies to date have measured HP, PAA, and AA in a health care setting. In 2015, we performed a health and exposure assessment at a hospital where a new sporicidal product, consisting of HP, PAA, and AA was introduced 16 months prior. We collected 49 full-shift time-weighted average (TWA) air samples and analyzed samples for HP, AA, and PAA content. Study participants were observed while they performed cleaning duties, and duration and frequency of cleaning product use was recorded. Acute upper airway, eye, and lower airway symptoms were recorded in a post-shift survey (n = 50). A subset of 35 cleaning staff also completed an extended questionnaire that assessed symptoms reported by workers as regularly occurring or as having occurred in the previous 12 months. Air samples for HP (range: 5.5 to 511.4 ppb) and AA (range: 6.7 to 530.3 ppb) were all below established US occupational exposure limits (OEL). To date, no full-shift TWA OEL for PAA has been established in the United States, however an OEL of 0.2 ppm has been suggested by several research groups. Air samples for PAA ranged from 1.1 to 48.0 ppb and were well below the suggested OEL of 0.2 ppm. Hospital cleaning staff using a sporicidal product containing HP, PAA, and AA reported work-shift eye (44%), upper airway (58%), and lower airway (34%) symptoms. Acute nasal and eye irritation were significantly positively associated with increased exposure to the mixture of the two oxidants: HP and PAA, as well as the total mixture (TM)of HP, PAA, and AA. Shortness of breath when hurrying on level ground or walking up a slight hill was significantly associated

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Science.gov (United States)

Hawley, Brie; Casey, Megan; Virji, Mohammed Abbas; Cummings, Kristin J.; Johnson, Alyson; Cox-Ganser, Jean

2017-01-01

Cleaning and disinfecting products consisting of a mixture of hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are widely used as sporicidal agents in health care, childcare, agricultural, food service, and food production industries. HP and PAA are strong oxidants and their mixture is a recognized asthmagen. However, few exposure assessment studies to date have measured HP, PAA, and AA in a health care setting. In 2015, we performed a health and exposure assessment at a hospital where a new sporicidal product, consisting of HP, PAA, and AA was introduced 16 months prior. We collected 49 full-shift time-weighted average (TWA) air samples and analyzed samples for HP, AA, and PAA content. Study participants were observed while they performed cleaning duties, and duration and frequency of cleaning product use was recorded. Acute upper airway, eye, and lower airway symptoms were recorded in a post-shift survey (n = 50). A subset of 35 cleaning staff also completed an extended questionnaire that assessed symptoms reported by workers as regularly occurring or as having occurred in the previous 12 months. Air samples for HP (range: 5.5 to 511.4 ppb) and AA (range: 6.7 to 530.3 ppb) were all below established US occupational exposure limits (OEL). To date, no full-shift TWA OEL for PAA has been established in the United States, however an OEL of 0.2 ppm has been suggested by several research groups. Air samples for PAA ranged from 1.1 to 48.0 ppb and were well below the suggested OEL of 0.2 ppm. Hospital cleaning staff using a sporicidal product containing HP, PAA, and AA reported work-shift eye (44%), upper airway (58%), and lower airway (34%) symptoms. Acute nasal and eye irritation were significantly positively associated with increased exposure to the mixture of the two oxidants: HP and PAA, as well as the total mixture (TM) of HP, PAA, and AA. Shortness of breath when hurrying on level ground or walking up a slight hill was significantly associated

Comparative Effects of Tri-Polar Eclectic Teaching Approach on ...

African Journals Online (AJOL)

This is an experimental study that examined the comparative effects of Tripolar Interactionist teaching strategy on the academic performance of Junior Secondary School III students of Adeyemi Demonstration secondary School Ondo in social studies. The instrument used for the study includes scheme of work, lesson notes ...

Preference-based comparative effectiveness and cost–effectiveness: a review and relevance of value-based medicine for vitreoretinal interventions.

Science.gov (United States)

Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

2012-05-01

This analysis discusses the comparative effectiveness and cost-effectiveness of vitreoretinal interventions, measured in quality-adjusted life years (QALYs) and percentage patient value (PPV gain, or improvement in quality of life and/or length of life). The material is relevant since the Patient Protection and Affordable Care Act enacted by Congress with the support of the President has emphasized the critical importance of patient-based preferences. The majority of preference-based, comparative effectiveness and cost-effectiveness vitreoretinal interventions assessed in the US healthcare literature are Value-Based Medicine analyses, thus comparable. These interventions confer a mean patient (human) value gain (improvement in quality of life) of 8.3% [SD 6.3%, 95% confidence interval (CI) + 2.6%]. The average cost-utility of these vitreoretinal interventions is US$23 026/QALY (SD US$24 508, 95% CI + US$8770). Most vitreoretinal interventions are very cost effective using a conventional US standard of US$50 000/QALY as the upper anchor for a very cost-effective intervention, and the World Health Organization of approximately US$142 200/QALY as the upper anchor for a cost-effective intervention. Most vitreoretinal interventions confer considerable patient value and are very cost effective. Further standardization across healthcare is needed in the preference-based, comparative and cost-utility (cost-effectiveness) arena. The metrics of PPV (percentage patient value) gain and US$/PPV (dollars expended per percentage patient value gain) or financial value gain may be more user-friendly than the QALY.

Comparative effects of Potash Sodium Chloride (PSC) mixture and ...

African Journals Online (AJOL)

Honey (Mellifica sp) is produced by Apis mellifera africana, widely consumed without prescription or restriction, and has been shown to possess wound healing and antitusive properties. Comparative study of the effects of honey paste and Potash Sodium Chloride (PSC) mixture on the healing of incisional wound on albino ...

Comparing the effect of bioflocculant with synthetic polymers on ...

African Journals Online (AJOL)

This study was aimed at introducing a novel bioflocculant to enhance anaerobic granulation in a UASB reactor for lowstrength synthetic wastewater and comparing the effect with synthetic polymers. A laboratory-scale study was undertaken to achieve this goal. Four identical UASB reactors were operated in parallel in the ...

A Comparative Effectiveness Education Trial for Lifestyle Health Behavior Change in African Americans

Science.gov (United States)

Halbert, Chanita Hughes; Bellamy, Scarlett; Briggs, Vanessa; Delmoor, Ernestine; Purnell, Joseph; Rogers, Rodney; Weathers, Benita; Johnson, Jerry C.

2017-01-01

Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a…

Composite scores in comparative effectiveness research: counterbalancing parsimony and dimensionality in patient-reported outcomes.

Science.gov (United States)

Schwartz, Carolyn E; Patrick, Donald L

2014-07-01

When planning a comparative effectiveness study comparing disease-modifying treatments, competing demands influence choice of outcomes. Current practice emphasizes parsimony, although understanding multidimensional treatment impact can help to personalize medical decision-making. We discuss both sides of this 'tug of war'. We discuss the assumptions, advantages and drawbacks of composite scores and multidimensional outcomes. We describe possible solutions to the multiple comparison problem, including conceptual hierarchy distinctions, statistical approaches, 'real-world' benchmarks of effectiveness and subgroup analysis. We conclude that comparative effectiveness research should consider multiple outcome dimensions and compare different approaches that fit the individual context of study objectives.

Comparative effectiveness of different types of cervical laminoplasty.

Science.gov (United States)

Heller, John G; Raich, Annie L; Dettori, Joseph R; Riew, K Daniel

2013-10-01

Study Design Systematic review. Study Rationale Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical laminoplasty? KQ2: In adults with cervical myelopathy from OPLL or spondylosis, are postoperative complications, including pain and infection, different for the use of miniplates versus the use of no plates following laminoplasty? KQ3: Do these results vary based on early active postoperative cervical motion? Materials and Methods A systematic review of the English-language literature was undertaken for articles published between 1970 and March 11, 2013. Electronic databases and reference lists of key articles were searched to identify studies evaluating (1) open door cervical laminoplasty and French door cervical laminoplasty and (2) the use of miniplates or no plates in cervical laminoplasty for the treatment of cervical spondylotic myelopathy or OPLL in adults. Studies involving traumatic onset, cervical fracture, infection, deformity, or neoplasms were excluded, as were noncomparative studies. Two independent reviewers (A.L.R., J.R.D.) assessed the level of evidence quality using the Grades of Recommendations Assessment, Development and Evaluation system, and disagreements were resolved by consensus. Results We identified three studies (one of class of evidence [CoE] II and two of CoE III) meeting our inclusion criteria comparing open door cervical laminoplasty with French door laminoplasty and two studies (one CoE II and one CoE III) comparing the use of miniplates with no plates. Data from one randomized controlled trial (RCT) and two retrospective cohort

Simulating changes to emergency care resources to compare system effectiveness.

Science.gov (United States)

Branas, Charles C; Wolff, Catherine S; Williams, Justin; Margolis, Gregg; Carr, Brendan G

2013-08-01

To apply systems optimization methods to simulate and compare the most effective locations for emergency care resources as measured by access to care. This study was an optimization analysis of the locations of trauma centers (TCs), helicopter depots (HDs), and severely injured patients in need of time-critical care in select US states. Access was defined as the percentage of injured patients who could reach a level I/II TC within 45 or 60 minutes. Optimal locations were determined by a search algorithm that considered all candidate sites within a set of existing hospitals and airports in finding the best solutions that maximized access. Across a dozen states, existing access to TCs within 60 minutes ranged from 31.1% to 95.6%, with a mean of 71.5%. Access increased from 0.8% to 35.0% after optimal addition of one or two TCs. Access increased from 1.0% to 15.3% after optimal addition of one or two HDs. Relocation of TCs and HDs (optimal removal followed by optimal addition) produced similar results. Optimal changes to TCs produced greater increases in access to care than optimal changes to HDs although these results varied across states. Systems optimization methods can be used to compare the impacts of different resource configurations and their possible effects on access to care. These methods to determine optimal resource allocation can be applied to many domains, including comparative effectiveness and patient-centered outcomes research. Copyright © 2013 Elsevier Inc. All rights reserved.

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.

Comparing fixed effects and covariance structure estimators for panel data

DEFF Research Database (Denmark)

Ejrnæs, Mette; Holm, Anders

2006-01-01

In this article, the authors compare the traditional econometric fixed effect estimator with the maximum likelihood estimator implied by covariance structure models for panel data. Their findings are that the maximum like lipoid estimator is remarkably robust to certain types of misspecifications...

Practical guide to understanding Comparative Effectiveness Research (CER).

Science.gov (United States)

Neely, J Gail; Sharon, Jeffrey D; Graboyes, Evan M; Paniello, Randal C; Nussenbaum, Brian; Grindler, David J; Dassopoulos, Themistocles

2013-12-01

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

A Study of the Social Effects in a Comparative Assessment among the Electricity Generating Systems

International Nuclear Information System (INIS)

Kim, Kil Yoo; Kim, Tae Woon

2007-01-01

A comparative assessment among 7 electricity generating systems by considering their environmental impacts, risks, health effects, and social effects was studied last year. The compared electricity generating systems are nuclear, coal, LNG, hydro, oil, wind, photovoltaic (=solar) ones. In last year's work, the social effects were handled by a public acceptance based on an aversion. However, in this paper, the social effects were also studied by a preference in view of the 'willingness to pay' (WTP). With the new social effects study, a comparative analysis of the 7 electricity generation systems was performed in this paper

Quantifying and Comparing Effects of Climate Engineering Methods on the Earth System

Science.gov (United States)

Sonntag, Sebastian; Ferrer González, Miriam; Ilyina, Tatiana; Kracher, Daniela; Nabel, Julia E. M. S.; Niemeier, Ulrike; Pongratz, Julia; Reick, Christian H.; Schmidt, Hauke

2018-02-01

To contribute to a quantitative comparison of climate engineering (CE) methods, we assess atmosphere-, ocean-, and land-based CE measures with respect to Earth system effects consistently within one comprehensive model. We use the Max Planck Institute Earth System Model (MPI-ESM) with prognostic carbon cycle to compare solar radiation management (SRM) by stratospheric sulfur injection and two carbon dioxide removal methods: afforestation and ocean alkalinization. The CE model experiments are designed to offset the effect of fossil-fuel burning on global mean surface air temperature under the RCP8.5 scenario to follow or get closer to the RCP4.5 scenario. Our results show the importance of feedbacks in the CE effects. For example, as a response to SRM the land carbon uptake is enhanced by 92 Gt by the year 2100 compared to the reference RCP8.5 scenario due to reduced soil respiration thus reducing atmospheric CO2. Furthermore, we show that normalizations allow for a better comparability of different CE methods. For example, we find that due to compensating processes such as biogeophysical effects of afforestation more carbon needs to be removed from the atmosphere by afforestation than by alkalinization to reach the same global warming reduction. Overall, we illustrate how different CE methods affect the components of the Earth system; we identify challenges arising in a CE comparison, and thereby contribute to developing a framework for a comparative assessment of CE.

Comparing the effect of various pipe materials on biofilm formation ...

African Journals Online (AJOL)

Comparing the effect of various pipe materials on biofilm formation in chlorinated and combined chlorine-chloraminated water systems. ... The capability of bacterial regrowth occurring on the surface of test pipe materials during this period was linked to the depletion of the concentration of monochloramine residual.

Comparative Effects Of “Do It” Creativity And Emotional Mastery ...

African Journals Online (AJOL)

This study investigated the comparative effects of “DO IT” creativity and Emotional Mastery techniques in fostering emotional intelligence among adolescents with physical impairments in Oyo State, Nigeria. There were ninety participants randomly selected from three special institutions in the state, namely: Cheshire High ...

How well do commonly used data presentation formats support comparative effectiveness evaluations?

Science.gov (United States)

Dolan, James G; Qian, Feng; Veazie, Peter J

2012-01-01

Good decisions depend on an accurate understanding of the comparative effectiveness of decision alternatives. The best way to convey data needed to support these comparisons is unknown. To determine how well 5 commonly used data presentation formats convey comparative effectiveness information. The study was an Internet survey using a factorial design. Participants consisted of 279 members of an online survey panel. Study participants compared outcomes associated with 3 hypothetical screening test options relative to 5 possible outcomes with probabilities ranging from 2 per 5000 (0.04%) to 500 per 1000 (50%). Data presentation formats included a table, a "magnified" bar chart, a risk scale, a frequency diagram, and an icon array. Outcomes included the number of correct ordinal judgments regarding the more likely of 2 outcomes, the ratio of perceived versus actual relative likelihoods of the paired outcomes, the intersubject consistency of responses, and perceived clarity. The mean number of correct ordinal judgments was 12 of 15 (80%), with no differences among data formats. On average, there was a 3.3-fold difference between perceived and actual likelihood ratios (95% confidence interval = 3.0-3.6). Comparative judgments based on flowcharts, icon arrays, and tables were all significantly more accurate and consistent than those based on risk scales and bar charts (P charts, and flow diagrams. None of the data presentation formats studied can reliably provide patients, especially those with low subjective numeracy, with an accurate understanding of comparative effectiveness information.

The economics of comparative effectiveness studies: societal and private perspectives and their implications for prioritizing public investments in comparative effectiveness research.

Science.gov (United States)

Meltzer, David; Basu, Anirban; Conti, Rena

2010-01-01

Comparative effectiveness research (CER) can provide valuable information for patients, providers and payers. These stakeholders differ in their incentives to invest in CER. To maximize benefits from public investments in CER, it is important to understand the value of CER from the perspectives of these stakeholders and how that affects their incentives to invest in CER. This article provides a conceptual framework for valuing CER, and illustrates the potential benefits of such studies from a number of perspectives using several case studies. We examine cases in which CER provides value by identifying when one treatment is consistently better than others, when different treatments are preferred for different subgroups, and when differences are small enough that decisions can be made based on price. We illustrate these findings using value-of-information techniques to assess the value of research, and by examining changes in pharmaceutical prices following publication of a comparative effectiveness study. Our results suggest that CER may have high societal value but limited private return to providers or payers. This suggests the importance of public efforts to promote the production of CER. We also conclude that value-of-information tools may help inform policy decisions about how much public funds to invest in CER and how to prioritize the use of available public funds for CER, in particular targeting public CER spending to areas where private incentives are low relative to social benefits.

Differences among consumer segments with regard to perceptions of comparative effectiveness research.

Science.gov (United States)

Williams, Sunyna S; Frost, Sloane L

2014-11-01

To examine differences among health-related decision-making consumer segments with regard to knowledge, skills, attitudes, and behaviors pertinent to comparative effectiveness research. Data were collected via an online survey from 603 adults with chronic conditions. Consumer segment was determined using a two-item tool. Active consumers (high skills and motivation) reported the highest levels of engagement in various behaviors. Passive consumers (low skills and motivation) reported the lowest levels of engagement in various behaviors. High-effort consumers (low skills, high motivation) reported more positive attitudes and opinions and more engagement in various behaviors than did complacent consumers (high skills, low motivation). Effective translation and dissemination of comparative effectiveness research will require the development of approaches tailored to consumers with varying levels of skills and motivation.

Radon as a medicine. Therapeutic effectiveness, biological mechanism and comparative risk assessment

International Nuclear Information System (INIS)

Deetjen, Peter; Falkenbach, Albrecht; Harder, Dietrich; Joeckel, Hans; Kaul, Alexander; Philipsborn, Henning von

2014-01-01

Proofs of the therapeutic efficiency of balneological radon applications administered to patients suffering from rheumatic diseases, investigations into the biological action mechanism associated with the alpha particles emitted by radon and its radioactive daughter products, and the comparative risk assessment of radon treatment and medicinal pain therapy have been the research projects whose results are summarized in this book. Controlled clinical studies, if possible performed as prospective, randomized and placebo-controlled double blind studies, have given evidence that the therapeutic effects of balneological radon applications - long-lasting pain reduction and reduced consumption of medicines compared with controls - are significantly persisting over many post-treatment months. The molecular and cellular mechanism of action underlying these long-lasting therapeutic effects has been identified as the down-regulation of cellular immune responses, initiated by cellular apoptosis sequential to low alpha particle doses and by the subsequent release of anti-inflammatory cytokines. The unwanted side-effects of non-steroidal anti-rheumatic drug treatments have to be compared with the absence of side effects from the balneological radon applications which merely involve radiation doses well below the mean value and the fluctuation width of the annual doses attributable to everybody's natural radiation exposure.

Radon as a medicine. Therapeutic effectiveness, biological mechanism and comparative risk assessment

Energy Technology Data Exchange (ETDEWEB)

Deetjen, Peter; Falkenbach, Albrecht; Harder, Dietrich; Joeckel, Hans; Kaul, Alexander; Philipsborn, Henning von

2014-07-01

Proofs of the therapeutic efficiency of balneological radon applications administered to patients suffering from rheumatic diseases, investigations into the biological action mechanism associated with the alpha particles emitted by radon and its radioactive daughter products, and the comparative risk assessment of radon treatment and medicinal pain therapy have been the research projects whose results are summarized in this book. Controlled clinical studies, if possible performed as prospective, randomized and placebo-controlled double blind studies, have given evidence that the therapeutic effects of balneological radon applications - long-lasting pain reduction and reduced consumption of medicines compared with controls - are significantly persisting over many post-treatment months. The molecular and cellular mechanism of action underlying these long-lasting therapeutic effects has been identified as the down-regulation of cellular immune responses, initiated by cellular apoptosis sequential to low alpha particle doses and by the subsequent release of anti-inflammatory cytokines. The unwanted side-effects of non-steroidal anti-rheumatic drug treatments have to be compared with the absence of side effects from the balneological radon applications which merely involve radiation doses well below the mean value and the fluctuation width of the annual doses attributable to everybody's natural radiation exposure.

COMPARATIVE ANALYSIS OF QUANTUM EFFECTS IN NANOSCALE MULTIGATE MOSFETS USING VARIATIONAL APPROACH

Directory of Open Access Journals (Sweden)

V. PALANICHAMY

2015-02-01

Full Text Available In this work, the performance of multiple-gate SOI MOSFETs is analysed using variational approach including quantum effects. An analytical model is derived to accounting the quantum effects at the silicon (Si/silicon dioxide (SiO2 interface. A general procedure is used for calculating the quantum inversion charge density. Using this inversion charge density, the drain current is obtained. Our model results are compared with the simulation results and its shows very good agreement. Our results highlighted that cylindrical surrounding gate MOSFET is a good candidate to obtain the high drain current compared with other two devices.

Comparative analysis of two community stressors' long-term mental health effects

International Nuclear Information System (INIS)

Dew, M.A.; Bromet, E.J.; Schulberg, H.C.

1987-01-01

The investigation directly compared the long-term mental health consequences of two community-wide stressors, the Three Mile Island (TMI) nuclear accident and widespread unemployment due to layoff, in demographically comparable samples of women. Results showed a marked degree of similarity in the stressors' effects: Levels of subclinical symptomatology were elevated to similar degrees in each sample during the year following stressor onset, and symptom levels remained elevated in each sample 2 to 3 1/2 years later. Moreover, variables identified as predictors of enduring psychological distress were virtually identical for the two samples. Additional analyses revealed that the mental health status of unemployed husbands mediated the negative psychological effects of layoff on their wives. Implications of these results for understanding the long-term consequences of exposure to community-wide stress are discussed

Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

Science.gov (United States)

Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

2011-11-01

Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparative effectiveness research for the clinician researcher: a framework for making a methodological design choice.

Science.gov (United States)

Williams, Cylie M; Skinner, Elizabeth H; James, Alicia M; Cook, Jill L; McPhail, Steven M; Haines, Terry P

2016-08-17

Comparative effectiveness research compares two active forms of treatment or usual care in comparison with usual care with an additional intervention element. These types of study are commonly conducted following a placebo or no active treatment trial. Research designs with a placebo or non-active treatment arm can be challenging for the clinician researcher when conducted within the healthcare environment with patients attending for treatment.A framework for conducting comparative effectiveness research is needed, particularly for interventions for which there are no strong regulatory requirements that must be met prior to their introduction into usual care. We argue for a broader use of comparative effectiveness research to achieve translatable real-world clinical research. These types of research design also affect the rapid uptake of evidence-based clinical practice within the healthcare setting.This framework includes questions to guide the clinician researcher into the most appropriate trial design to measure treatment effect. These questions include consideration given to current treatment provision during usual care, known treatment effectiveness, side effects of treatments, economic impact, and the setting in which the research is being undertaken.

Comparative effectiveness of the SNaP™ Wound Care System.

Science.gov (United States)

Hutton, David W; Sheehan, Peter

2011-04-01

Diabetic lower extremity wounds cause substantial burden to healthcare systems, costing tens of thousands of dollars per episode. Negative pressure wound therapy (NPWT) devices have been shown to be cost-effective at treating these wounds, but the traditional devices use bulky electrical pumps that require a durable medical equipment rental-based procurement process. The Spiracur SNaP™ Wound Care System is an ultraportable NPWT system that does not use an electric pump and is fully disposable. It has superior healing compared to standard of care with modern dressings and comparable healing to traditional NPWT devices while giving patients greater mobility and giving clinicians a simpler procurement process. We used a mathematical model to analyse the costs of the SNaP™ system and compare them to standard of care and electrically powered NPWT devices. When compared to standard of care, the SNaP™ system saves over $9000 per wound treated and more than doubles the number of patients healed. The SNaP system has similar healing time to powered NPWT devices, but saves $2300 in Medicare payments or $2800 for private payers per wound treated. Our analysis shows that the SNaP™ system could save substantial treatment costs in addition to allowing patients greater freedom and mobility. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review

DEFF Research Database (Denmark)

Hyllested, M; Jones, S; Pedersen, J L

2002-01-01

BACKGROUND: Quantitative reviews of postoperative pain management have demonstrated that the number of patients needed to treat for one patient to achieve at least 50% pain relief (NNT) is 2.7 for ibuprofen (400 mg) and 4.6 for paracetamol (1000 mg), both compared with placebo. However, direct...... comparisons between paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) have not been extensively reviewed. The aims of this review are (i) to compare the analgesic and adverse effects of paracetamol with those of other NSAIDs in postoperative pain, (ii) to compare the effects of combined...... paracetamol and NSAID with those of either drug alone, and (iii) to discuss whether the adverse effects of NSAIDs in short-term use are justified by their analgesic effects, compared with paracetamol. METHODS: Medline (1966 to January 2001) and the Cochrane Library (January 2001) were used to perform...

Comparing interactive videodisc training effectiveness to traditional training methods

International Nuclear Information System (INIS)

Kenworthy, N.W.

1987-01-01

Videodisc skills training programs developed by Industrial Training Corporation are being used and evaluated by major industrial facilities. In one such study, interactive videodisc training programs were compared to videotape and instructor-based training to determine the effectiveness of videodisc in terms of performance, training time and trainee attitudes. Results showed that when initial training was done using the interactive videodisc system, trainee performance was superior to the performance of trainees using videotape, and approximately equal to the performance of those trained by an instructor. When each method was used in follow-up training, interactive videodisc was definitely the most effective. Results also indicate that training time can be reduced using interactive videodisc. Attitudes of both trainees and instructors toward the interactive videodisc training were positive

Comparative Study on the Effects of Crude Extracts of Pterocarpus ...

African Journals Online (AJOL)

A comparative study on the effects of crude extracts of pterocarpus soyauxii and Telfairia occidentalis on haematological parameters of albino wistar rats was carried out. Forty nine albino rats of both sexes, weighing between 150 and 250 g were used for the study. The rats were divided into seven groups of seven rats each.

Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination.

Science.gov (United States)

Clark, Nereyda P; Marks, John G; Sandow, Pamela R; Seleski, Christine E; Logan, Henrietta L

2014-04-01

This study compared the effectiveness of different methods of instruction for the oral and pharyngeal cancer examination. A group of thirty sophomore students at the University of Florida College of Dentistry were randomly assigned to three training groups: video instruction, a faculty-led hands-on instruction, or both video and hands-on instruction. The training intervention involved attending two sessions spaced two weeks apart. The first session used a pretest to assess students' baseline didactic knowledge and clinical examination technique. The second session utilized two posttests to assess the comparative effectiveness of the training methods on didactic knowledge and clinical technique. The key findings were that students performed the clinical examination significantly better with the combination of video and faculty-led hands-on instruction (p<0.01). All students improved their clinical exam skills, knowledge, and confidence in performing the oral and pharyngeal cancer examination independent of which training group they were assigned. Utilizing both video and interactive practice promoted greater performance of the clinical technique on the oral and pharyngeal cancer examination.

A call for action: comparative effectiveness research in asthma

OpenAIRE

Krishnan, Jerry A.; Schatz, Michael X.; Apter, Andrea J.

2010-01-01

Comparative effectiveness research (CER) has received considerable research attention in recent months, and efforts to promote CER are part of the newly enacted Patient Protection and Affordable Care Act. In this paper, we define CER, how it complements traditional efficacy research in asthma, and discuss how CER can help provide the basis for rational decision-making about the care of individual patients with asthma and how best to deliver this care in real-world settings. We present informa...

PRIVATE MANUFACTURERS’ THRESHOLDS TO INVEST IN COMPARATIVE EFFECTIVENESS TRIALS

OpenAIRE

Basu, Anirban; Meltzer, David

2012-01-01

The recent rush of enthusiasm for public investment in comparative effectiveness research (CER) in the United States has focused attention on these public investments. However, little attention has been given to how changing public investment in CER may affect private manufacturers’ incentives for CER, which has long been a major source of CER. In this work, based on a simple revenue maximizing economic framework, we generate predictions on thresholds to invest in CER for a private manufactur...

13 Comparative Effects of Cassava Starch and Simple Sugar in ...

African Journals Online (AJOL)

Arc. Usman A. Jalam

Abstract. Comparative effects of simple laboratory quality sugar and cassava starch on grade C35 concrete were studied in the laboratory. The simple white sugar was used at concentrations of 0 to 1% by weight of cement in concrete cured at 3, 7, 14 and 28 days using ordinary Portland cement. Cassava starch of the same ...

75 FR 41867 - Request for Information on Development of an Inventory of Comparative Effectiveness Research

Science.gov (United States)

2010-07-19

... Federal Coordinating Council for Comparative Effectiveness Research, which defined CER as the: Conduct and... stakeholders; and assist in identifying priorities and gaps for future research. The goal is to routinize the... Comparative Effectiveness Research AGENCY: Office of the Assistant Secretary for Planning and Evaluation...

The cost-effectiveness of single-row compared with double-row arthroscopic rotator cuff repair.

Science.gov (United States)

Genuario, James W; Donegan, Ryan P; Hamman, Daniel; Bell, John-Erik; Boublik, Martin; Schlegel, Theodore; Tosteson, Anna N A

2012-08-01

Interest in double-row techniques for arthroscopic rotator cuff repair has increased over the last several years, presumably because of a combination of literature demonstrating superior biomechanical characteristics and recent improvements in instrumentation and technique. As a result of the increasing focus on value-based health-care delivery, orthopaedic surgeons must understand the cost implications of this practice. The purpose of this study was to examine the cost-effectiveness of double-row arthroscopic rotator cuff repair compared with traditional single-row repair. A decision-analytic model was constructed to assess the cost-effectiveness of double-row arthroscopic rotator cuff repair compared with single-row repair on the basis of the cost per quality-adjusted life year gained. Two cohorts of patients (one with a tear of row compared with single-row arthroscopic rotator cuff repair was $571,500 for rotator cuff tears of row repair was less than $287 for small or moderate tears and less than $352 for large or massive tears compared with the cost of single-row repair, then double-row repair would represent a cost-effective surgical alternative. On the basis of currently available data, double-row rotator cuff repair is not cost-effective for any size rotator cuff tears. However, variability in the values for costs and probability of retear can have a profound effect on the results of the model and may create an environment in which double-row repair becomes the more cost-effective surgical option. The identification of the threshold values in this study may help surgeons to determine the most cost-effective treatment.

Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial

Science.gov (United States)

Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

2018-01-01

Abstract Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Design Prospective, randomized, 52 week, single blind comparative effectiveness trial. Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016. Participants 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Interventions Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. Main outcome measures The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. Results FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with

Comparative effects of commercial lime (CaCO 3 ) and ground ...

African Journals Online (AJOL)

Greenhouse study was carried out to investigate the comparative effect of commercial lime (CaCO3) and ground eggshell on the uptake of calcium and dry matter yield of maize in an ultisol of Southeastern Nigeria using maize (variety Oba supper 92) as the test crop. The soil was acidic and deficient in N, O.C., K, Ca and ...

Radiation effects, nuclear energy and comparative risks

International Nuclear Information System (INIS)

Gopinath, D.V.

2007-01-01

Nuclear energy had a promising start as an unlimited, inexpensive and environmentally benign source of energy for electricity generation. However, over the decades its growth was severely retarded due to concerns about its possible detrimental effects on the well-being of mankind and the environment. Since such concerns are essentially due to the gigantic magnitude of radioactivity and ionizing radiations associated with nuclear energy, this article starts with a comprehensive account of effects of the ionizing radiation on living systems. Quantitative description of types of radiation exposure and their varied effects is given. The origin, type and magnitude of mutagenic effects of radiation are described. The concept of radiation risk factors, basis for their evaluation and their currently accepted values are presented. With this background, origin and magnitude of radioactivity and associated ionizing radiations in nuclear reactors are presented and the elaborate measures to contain them are described. It is recognized that notwithstanding all the measures taken in the nuclear industry, certain amount of radiation exposure, however small, is inevitable and the values, based on the experience world over, are presented. Estimated health risk due to such exposures is evaluated. For a comparative analysis, risks in other options of electricity generation such as hydel and fossil-fuelled plants are described. It is seen that on an overall basis, the nuclear option is no more risky than the other commonly employed options, and is in fact, significantly less. Lastly, since every option of electricity generation entails some risk, the case of 'no addition of electricity, and its impact on the society are considered. Based on the analysis of extensive data provided by UNDP on the human development parameters for different countries in the world, it is shown that at least for developing countries, any option of addition of electricity would be far more desirable than the

Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.

Science.gov (United States)

Wang, Chenchen; Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

2018-03-21

To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Prospective, randomized, 52 week, single blind comparative effectiveness trial. Urban tertiary care academic hospital in the United States between March 2012 and September 2016. 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient's global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient's global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group

Degradation of natural habitats by roads: Comparing land-take and noise effect zone

International Nuclear Information System (INIS)

Madadi, Hossein; Moradi, Hossein; Soffianian, Alireza; Salmanmahiny, Abdolrassoul; Senn, Josef; Geneletti, Davide

2017-01-01

Roads may act as barriers, negatively influencing the movement of animals, thereby causing disruption in landscapes. Roads cause habitat loss and fragmentation not only through their physical occupation, but also through traffic noise. The aim of this study is to provide a method to quantify the habitat degradation including habitat loss and fragmentation due to road traffic noise and to compare it with those of road land-take. Two types of fragmentation effects are determined: structural fragmentation (based on road land-take only), and functional fragmentation (noise effect zone fragmentation, buffer using a threshold of 40 dB). Noise propagation for roads with a traffic volume of more than 1000 vehicles per day was simulated by Calculation of Road Traffic Noise (CRTN) model. Habitat loss and fragmentation through land-take and noise effect zone were calculated and compared in Zagros Mountains in western Iran. The study area is characterized by three main habitat types (oak forest, scattered woodland and temperate grassland) which host endangered and protected wildlife species. Due to topographic conditions, land cover type, and the traffic volume in the region, the noise effect zone ranged from 50 to 2000 m which covers 18.3% (i.e. 516,929.95 ha) of the total study area. The results showed that the habitat loss due to noise effect zone is dramatically higher than that due to road land-take only (35% versus 1.04% of the total area). Temperate grasslands lost the highest proportion of the original area by both land-take and noise effect zone, but most area was lost in scattered woodland as compared to the other two habitat types. The results showed that considering the noise effect zone for habitat fragmentation resulted in an increase of 25.8% of the area affected (316,810 ha) as compared to using the land-take only (555,874 ha vs. 239,064 ha, respectively). The results revealed that the degree of habitat fragmentation is increasing by considering the noise

Epidemiological survey of the effects of low level radiation dose: a comparative assessment

Energy Technology Data Exchange (ETDEWEB)

Rose, K.S.B.

1993-10-01

This volume presents the collations tables of a six volume comparative epidemiological survey of the effects of low level radiation dose. Data are collated for the effects observed in the following irradiated groups:- Preconception irradiation, intra-uterine irradiation, childhood irradiation, adult irradiation. (UK).

Comparative effectiveness of correction strategies in connected discourse tracking.

Science.gov (United States)

Lunato, K E; Weisenberger, J M

1994-10-01

The effectiveness of four correction strategies commonly used in connected discourse tracking was investigated in the present study. The strategies were 1) verbatim repetition of a word or phrase; 2) use of antonyms or synonyms as cues; 3) use of phonemic cues, with no whole word repetition; and 4) going back or ahead in the text, with no repetition of the missed segment. Four normal-hearing adults served as listeners. Live-voice presentation of text by two female talkers was employed for all conditions. Listeners were tested in two stimulus presentation modes, speechreading alone and speechreading plus a multichannel tactile aid. Results indicated that strategy 1, repetition of the missed segment, produced the highest tracking rates, significantly higher than any of the other strategies. Strategy 2 produced the lowest tracking rates. Strategies 1 and 3 yielded the lowest percentage of initially missed words, or blockages, and strategy 4 the highest percentage. Significantly higher tracking rates were found under the speechreading plus tactile aid presentation mode, compared with speechreading alone. Further, tracking rates increased significantly from the beginning to the end of training. Data were compared with a more typical CDT task, in which all correction strategies were operative, and results showed little difference in tracking rates between this task and the constrained CDT employing only strategy 1. Overall, results suggest that simple repetition of missed segments is an effective correction strategy for CDT and argue for its inclusion in computer-assisted tracking implementations.

Predicting the Effects of Comparable Worth Programs on Female Labor Supply.

Science.gov (United States)

Nakamura, Alice; Nakamura, Masao

1989-01-01

Surveys theories in labor economics about how the female labor supply is affected by the wage offers that women receive. Summarizes the implications concerning expected effects of comparable worth wage adjustments on female labor supply. Examines empirical evidence pertaining to the theory of female labor supply. (JS)

Global comparative healthcare effectiveness research: Evaluating sustainable programmes in low & middle resource settings

Directory of Open Access Journals (Sweden)

Rajesh Balkrishnan

2013-01-01

Full Text Available The need to focus healthcare expenditures on innovative and sustainable health systems that efficiently use existing effective therapies are the major drivers stimulating Comparative Effectiveness Research (CER across the globe. Lack of adequate access and high cost of essential medicines and technologies in many countries increases morbidity and mortality and cost of care that forces people and families into poverty due to disability and out-of-pocket expenses. This review illustrates the potential of value-added global health care comparative effectiveness research in shaping health systems and health care delivery paradigms in the "global south". Enabling the development of effective CER systems globally paves the way for tangible local and regional definitions of equity in health care because CER fosters the sharing of critical assets, resources, skills, and capabilities and the development of collaborative of multi-sectorial frameworks to improve health outcomes and metrics globally.

Hepatitis C Treatment Regimens Are Cost-Effective: But Compared With What?

Science.gov (United States)

Mattingly, T Joseph; Slejko, Julia F; Mullins, C Daniel

2017-11-01

Numerous economic models have been published evaluating treatment of chronic hepatitis C virus (HCV) infection, but none provide a comprehensive comparison among new antiviral agents. Evaluate the cost-effectiveness of all recommended therapies for treatment of genotypes 1 and 4 chronic HCV. Using data from clinical trials, observational analyses, and drug pricing databases, Markov decision models were developed for HCV genotypes 1 and 4 to compare all recommended drugs from the perspective of the third-party payer over a 5-, 10-, and 50-year time horizon. A probabilistic sensitivity analysis (PSA) was conducted by assigning distributions for clinical cure, age entering the model, costs for each health state, and quality-adjusted life years (QALYs) for each health state in a Monte Carlo simulation of 10 000 repetitions of the model. In the lifetime model for genotype 1, effects ranged from 18.08 to 18.40 QALYs and total costs ranged from $88 107 to $184 636. The lifetime model of genotype 4 treatments had a range of effects from 18.23 to 18.43 QALYs and total costs ranging from $87 063 to $127 637. Grazoprevir/elbasvir was the optimal strategy followed by velpatasvir/sofosbuvir as the second-best strategy in most simulations for both genotypes 1 and 4, with drug costs and efficacy of grazoprevir/elbasvir as the primary model drivers. Grazoprevir/elbasvir was cost-effective compared with all strategies for genotypes 1 and 4. Effects for all strategies were similar with cost of drug in the initial year driving the results.

We can do better than effective dose for estimating or comparing low-dose radiation risks

International Nuclear Information System (INIS)

Brenner, D.J.

2012-01-01

The effective dose concept was designed to compare the generic risks of exposure to different radiation fields. More commonly these days, it is used to estimate or compare radiation-induced cancer risks. For various reasons, effective dose represents flawed science: for instance, the tissue-specific weighting factors used to calculate effective dose are a subjective mix of different endpoints; and the marked and differing age and gender dependencies for different health detriment endpoints are not taken into account. This paper suggests that effective dose could be replaced with a new quantity, ‘effective risk’, which, like effective dose, is a weighted sum of equivalent doses to different tissues. Unlike effective dose, where the tissue-dependent weighting factors are a set of generic, subjective committee-defined numbers, the weighting factors for effective risk are simply evaluated tissue-specific lifetime cancer risks per unit equivalent dose. Effective risk, which has the potential to be age and gender specific if desired, would perform the same comparative role as effective dose, be just as easy to estimate, be less prone to misuse, be more directly understandable, and would be based on solid science. An added major advantage is that it gives the users some feel for the actual numerical values of the radiation risks they are trying to control.

Does Acupuncture Needling Induce Analgesic Effects Comparable to Diffuse Noxious Inhibitory Controls?

Directory of Open Access Journals (Sweden)

Juerg Schliessbach

2012-01-01

Full Text Available Diffuse noxious inhibitory control (DNIC is described as one possible mechanism of acupuncture analgesia. This study investigated the analgesic effect of acupuncture without stimulation compared to nonpenetrating sham acupuncture (NPSA and cold-pressor-induced DNIC. Forty-five subjects received each of the three interventions in a randomized order. The analgesic effect was measured using pressure algometry at the second toe before and after each of the interventions. Pressure pain detection threshold (PPDT rose from 299 kPa (SD 112 kPa to 364 kPa (SD 144, 353 kPa (SD 135, and 467 kPa (SD 168 after acupuncture, NPSA, and DNIC test, respectively. There was no statistically significant difference between acupuncture and NPSA at any time, but a significantly higher increase of PPDT in the DNIC test compared to acupuncture and NPSA. PPDT decreased after the DNIC test, whereas it remained stable after acupuncture and NPSA. Acupuncture needling at low pain stimulus intensity showed a small analgesic effect which did not significantly differ from placebo response and was significantly less than a DNIC-like effect of a painful noninvasive stimulus.

Comparative antibacterial effectiveness of alcohol and herbal based commercially available hand antiseptics

Directory of Open Access Journals (Sweden)

K Vipin Jain

2013-01-01

Full Text Available Background: Human skin is a reservoir of numerous microorganisms. Even though hand washing with soap and water alone reduces the microbial load, the complementary uses of hand antiseptics enhance the antimicrobial effect. Aim: To compare the antimicrobial effectiveness of two commercially available hand antiseptics, routinely used in dental practice, after hand washing with antiseptic soap. Method: A clinical trial with cross over design was carried out on 12 health care workers (HCWs. The antibacterial effectiveness of two hand antiseptics (Alcohol based -Sterillium and Herbal Based-Himalaya′s ′Pure Hands′ compared using fingerprint contact sampling on blood agar. Bacterial samples were obtained before and after hand washing (with antiseptic soap and after hand disinfection. The data was tabulated and analyzed using one way ANOVA and Tukey′s post hoc test for pair-wise comparison. Result: There was a slight decrease in the Colony forming units (CFUs count following use of antiseptic soap when compared to the baseline values. A statistically significant reduction (p<0.000 in the CFUs count was seen following use of both hand antiseptics but the mean number of CFUs reduction was more in case of alcohol based hand antiseptic(sterillium than herbal based hand antiseptic(Himalaya′s ′PureHands". Conclusion: Using alcohol based antiseptic soap before hygienic hand disinfection will provide maximum benefit in reducing the microbial count.

Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.

Science.gov (United States)

Lewis, Ruth A; Williams, Nefyn H; Sutton, Alex J; Burton, Kim; Din, Nafees Ud; Matar, Hosam E; Hendry, Maggie; Phillips, Ceri J; Nafees, Sadia; Fitzsimmons, Deborah; Rickard, Ian; Wilkinson, Clare

2015-06-01

There are numerous treatment approaches for sciatica. Previous systematic reviews have not compared all these strategies together. To compare the clinical effectiveness of different treatment strategies for sciatica simultaneously. Systematic review and network meta-analysis. We searched 28 electronic databases and online trial registries, along with bibliographies of previous reviews for comparative studies evaluating any intervention to treat sciatica in adults, with outcome data on global effect or pain intensity. Network meta-analysis methods were used to simultaneously compare all treatment strategies and allow indirect comparisons of treatments between studies. The study was funded by the UK National Institute for Health Research Health Technology Assessment program; there are no potential conflict of interests. We identified 122 relevant studies; 90 were randomized controlled trials (RCTs) or quasi-RCTs. Interventions were grouped into 21 treatment strategies. Internal and external validity of included studies was very low. For overall recovery as the outcome, compared with inactive control or conventional care, there was a statistically significant improvement following disc surgery, epidural injections, nonopioid analgesia, manipulation, and acupuncture. Traction, percutaneous discectomy, and exercise therapy were significantly inferior to epidural injections or surgery. For pain as the outcome, epidural injections and biological agents were significantly better than inactive control, but similar findings for disc surgery were not statistically significant. Biological agents were significantly better for pain reduction than bed rest, nonopioids, and opioids. Opioids, education/advice alone, bed rest, and percutaneous discectomy were inferior to most other treatment strategies; although these findings represented large effects, they were statistically equivocal. For the first time, many different treatment strategies for sciatica have been compared in the

The Effect of External Representations on Compare Word Problems: Supporting Mental Model Construction

Science.gov (United States)

Munez, David; Orrantia, Josetxu; Rosales, Javier

2013-01-01

This study explored the effectiveness of external representations presented together with compare word problems, and whether such effectiveness was moderated by working memory. Participants were 49 secondary school students. Each participant solved 48 problems presented in 4 presentation types that included 2 difficulty treatments (number of steps…

Revisiting the effect of colonial institutions on comparative economic development.

Directory of Open Access Journals (Sweden)

Valentina A Assenova

Full Text Available European settler mortality has been proposed as an instrument to predict the causal effect of colonial institutions on differences in economic development. We examine the relationship between mortality, temperature, and economic development in former European colonies in Asia, Africa, and the Americas. We find that (i European settler mortality rates increased with regional temperatures and (ii economic output decreased with regional temperatures. Conditioning on the continent of settlement and accounting for colonies that were not independent as of 1900 undermines the causal effect of colonial institutions on comparative economic development. Our findings run counter to the institutions hypothesis of economic development, showing instead that geography affected both historic mortality rates and present-day economic output.

Falsification Testing of Instrumental Variables Methods for Comparative Effectiveness Research.

Science.gov (United States)

Pizer, Steven D

2016-04-01

To demonstrate how falsification tests can be used to evaluate instrumental variables methods applicable to a wide variety of comparative effectiveness research questions. Brief conceptual review of instrumental variables and falsification testing principles and techniques accompanied by an empirical application. Sample STATA code related to the empirical application is provided in the Appendix. Comparative long-term risks of sulfonylureas and thiazolidinediones for management of type 2 diabetes. Outcomes include mortality and hospitalization for an ambulatory care-sensitive condition. Prescribing pattern variations are used as instrumental variables. Falsification testing is an easily computed and powerful way to evaluate the validity of the key assumption underlying instrumental variables analysis. If falsification tests are used, instrumental variables techniques can help answer a multitude of important clinical questions. © Health Research and Educational Trust.

Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes.

Science.gov (United States)

Hall, Wayne

2017-04-01

The claim that the adverse health effects of cannabis are much less serious than those of alcohol has been central to the case for cannabis legalisation. Regulators in US states that have legalised cannabis have adopted regulatory models based on alcohol. This paper critically examines the claim about adverse health effects and the wisdom of regulating cannabis like alcohol. First, it compares what we know about the adverse health effects of alcohol and cannabis. Second, it discusses the uncertainties about the long term health effects of sustained daily cannabis use. Third, it speculates about how the adverse health effects of cannabis may change after legalisation. Fourth, it questions the assumption that alcohol provides the best regulatory model for a legal cannabis market. Fifth, it outlines the major challenges in regulating cannabis under the liberal alcohol-like regulatory regimes now being introduced. Copyright © 2016 Elsevier B.V. All rights reserved.

Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion.

Science.gov (United States)

Olfert, Jordan A P; Penz, Erika D; Manns, Braden J; Mishra, Eleanor K; Davies, Helen E; Miller, Robert F; Luengo-Fernandez, Ramon; Gao, Song; Rahman, Najib M

2017-05-01

Malignant pleural effusion is associated with morbidity and mortality. A randomized controlled trial previously compared clinical outcomes and resource use with indwelling pleural catheter (IPC) and talc pleurodesis in this population. Using unpublished quality of life data, we estimate the cost-effectiveness of IPC compared with talc pleurodesis. Healthcare utilization and costs were captured during the trial. Utility weights produced by the EuroQol Group five-dimensional three-level questionnaire and survival were used to determine quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness ratio (ICER) was calculated over the 1-year trial period. Sensitivity analysis used patient survival data and modelled additional nursing time required per week for catheter drainage. Utility scores, cost and QALYs gained did not differ significantly between groups. The ICER for IPC compared with talc was favorable at $US10 870 per QALY gained. IPC was less costly with a probability exceeding 95% of being cost-effective when survival was pleural effusion in patients without history of prior pleurodesis, with consideration for patient survival, support and preferences. © 2016 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

Essure hysteroscopic sterilization versus interval laparoscopic bilateral tubal ligation: a comparative effectiveness review.

Science.gov (United States)

Ouzounelli, Myrsini; Reaven, Nancy L

2015-01-01

A comparative effectiveness analysis was performed to examine the risks and benefits of laparoscopic bilateral tubal ligation compared with hysteroscopic sterilization using the Essure Permanent Birth Control System (Bayer HealthCare AG, Whippany, NJ). Existing evidence shows that both LBTL and Essure are safe and effective methods of female sterilization. Both have high rates of efficacy and low rates of complications although when complications do occur, those related to the Essure procedure are more likely to be minor in nature. The analysis was limited by the restricted number of studies involving head-to-head comparisons of the 2 approaches. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

A comparative study of the effect of diet and soda carbonated drinks ...

African Journals Online (AJOL)

EB

2013-09-03

Sep 3, 2013 ... Objectives: A comparative effect of the diet and regular soda carbonated drinks on the histology of the cerebellum of ... contains caffeine, depending on the quantities .... and health: a systematic review and meta-analysis.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

Science.gov (United States)

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

Comparative Effectiveness of Two Walking Interventions on Participation, Step Counts, and Health.

Science.gov (United States)

Smith-McLallen, Aaron; Heller, Debbie; Vernisi, Kristin; Gulick, Diana; Cruz, Samantha; Snyder, Richard L

2017-03-01

To (1) compare the effects of two worksite-based walking interventions on employee participation rates; (2) compare average daily step counts between conditions, and; (3) examine the effects of increases in average daily step counts on biometric and psychologic outcomes. We conducted a cluster-randomized trial in which six employer groups were randomly selected and randomly assigned to condition. Four manufacturing worksites and two office-based worksite served as the setting. A total of 474 employees from six employer groups were included. A standard walking program was compared to an enhanced program that included incentives, feedback, competitive challenges, and monthly wellness workshops. Walking was measured by self-reported daily step counts. Survey measures and biometric screenings were administered at baseline and 3, 6, and 9 months after baseline. Analysis used linear mixed models with repeated measures. During 9 months, participants in the enhanced condition averaged 726 more steps per day compared with those in the standard condition (p women (-2.1 lbs.), and reductions in body mass index (-0.41 men, -0.31 women). Higher step counts were also associated with improvements in mood, having more energy, and higher ratings of overall health. An enhanced walking program significantly increases participation rates and daily step counts, which were associated with weight loss and reductions in body mass index.

Comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: a randomized trial

Science.gov (United States)

Background: Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis. Objective: To compare Tai Chi with standard physical therapy f...

Recent controversies on comparative effectiveness research investigations: Challenges, opportunities, and pitfalls.

Science.gov (United States)

Kirpalani, Haresh; Truog, William E; D'Angio, Carl T; Cotten, Michael

2016-10-01

The purpose of comparative effectiveness research (CER) is to improve health outcomes by developing and disseminating evidence-based information about which currently available interventions and practices are most effective for patients. Randomized Controlled Trials (RCT) are the hallmark of scientific proof, and have been used to compare interventions used in variable ways by different clinicians (comparative effectiveness RCTs, CER-RCTs). But such CER-RCTs have at times generated controversy. Usually the background for the CER-RCT is a range of "standard therapy" or "standard of care." This may have been adopted on observational data alone, or pilot data. At times, such prior data may derive from populations that differ from the population in which the widely variable standard approach is being applied. We believe that controversies related to these CER-RCTs result from confusing "accepted" therapies and "rigorously evaluated therapies." We first define evidence-based medicine and consider how well neonatology conforms to that definition. We then contrast the approach of testing new therapies and those already existing and widely adopted, as in CER-RCTs. We next examine a central challenge in incorporating the control arm within CER-RCTs and aspects of the "titrated" trial. We finally briefly consider some ethical issues that have arisen, and discuss the wide range of neonatology practices that could be tested by CER-RCTs or alternative CER-based strategies that might inform practice. Throughout, we emphasize the lack of awareness of the lay community, and indeed many researchers or commentators, in appreciating the wide variation of standard of care. There is a corresponding need to identify the best uses of available resources that will lead to the best outcomes for our patients. We conclude that CER-RCTs are an essential methodology in modern neonatology to address many unanswered questions and test unproven therapies in newborn care. Copyright © 2016

Recent Controversies on Comparative Effectiveness Research Investigations: Challenges, Opportunities and Pitfalls

Science.gov (United States)

Kirpalani, Haresh; Truog, William E.; D'Angio, Carl T.; Cotten, M.

2016-01-01

The purpose of comparative effectiveness research (CER) is to improve health outcomes by developing and disseminating evidence-based information about which currently available interventions and practices are most effective for patients. While Randomized Controlled Trials (RCT) are the hallmark of scientific proof, when they have been used to compare interventions used in variable ways by different clinicians (Comparative Effectiveness RCTs, CER RCTs) they have at times, generated controversy. Usually the background for the CER RCT is a range of ‘standard therapy’ or ‘standard of care’. This may have been adopted on observational data alone, pilot data. At times, such prior data may derive from populations that differ from the population in which the widely variable standard approach is being applied. We believe controversies related to these CER-RCTs result from confusing ‘accepted’ therapies and ‘rigorously evaluated therapies”. We first define evidence based medicine, and consider how well neonatology conforms to that definition. We then contrast the approach of testing new therapies and those already existing and widely adopted, as in CER-RCTs. We next examine a central challenge in incorporating the control arm within CER, and aspects of the ‘titrated’ trial. We finally briefly consider some ethical issues that have arisen, and briefly discuss the wide range of neonatology practices that could be subject to CER-RCTs or alternative CER-based strategies that might inform practice in the absence of RCTs. Throughout, we emphasize the lack of awareness of the lay community, and indeed many researchers or commentators, in appreciating the wide variation of standard of care. There is a corresponding need to identify the best uses of available resources that will lead to the best outcomes for our patients. We conclude that CER is an essential methodology in modern neonatology to address many unanswered questions and test unproven therapies in

Evaluation of Expedient Decontamination Options with Activated Peroxide-based Liquid Sporicides

Science.gov (United States)

2013-02-05

Figure 2-1) that are typical of the materials found in residential dwellings and meet industry standards or specifications for indoor use. Documented...Anthrax inhalation and lethal human infection. Lancet, 2002. 359(9307): p. 710-1. 14. Glassman, H.N., Industrial inhalation anthrax. Bacteriol. Rev...Begin by donning PPE (gloves, lab coat, and protective eyewear ). 2. Clean the workspace by wiping with pAB, next with DI water , and lastly with a 70

Comparative effectiveness of colony-stimulating factors in febrile neutropenia prophylaxis: how results are affected by research design.

Science.gov (United States)

Henk, Henry J; Li, Xiaoyan; Becker, Laura K; Xu, Hairong; Gong, Qi; Deeter, Robert G; Barron, Richard L

2015-01-01

To examine the impact of research design on results in two published comparative effectiveness studies. Guidelines for comparative effectiveness research have recommended incorporating disease process in study design. Based on the recommendations, we develop a checklist of considerations and apply the checklist in review of two published studies on comparative effectiveness of colony-stimulating factors. Both studies used similar administrative claims data, but different methods, which resulted in directionally different estimates. Major design differences between the two studies include: whether the timing of intervention in disease process was identified and whether study cohort and outcome assessment period were defined based on this temporal relationship. Disease process and timing of intervention should be incorporated into the design of comparative effectiveness studies.

An overview of methods for comparative effectiveness research.

Science.gov (United States)

Meyer, Anne-Marie; Wheeler, Stephanie B; Weinberger, Morris; Chen, Ronald C; Carpenter, William R

2014-01-01

Comparative effectiveness research (CER) is a broad category of outcomes research encompassing many different methods employed by researchers and clinicians from numerous disciplines. The goal of cancer-focused CER is to generate new knowledge to assist cancer stakeholders in making informed decisions that will improve health care and outcomes of both individuals and populations. There are numerous CER methods that may be used to examine specific questions, including randomized controlled trials, observational studies, systematic literature reviews, and decision sciences modeling. Each has its strengths and weaknesses. To both inform and serve as a reference for readers of this issue of Seminars in Radiation Oncology as well as the broader oncology community, we describe CER and several of the more commonly used approaches and analytical methods. © 2013 Published by Elsevier Inc.

Comparative Effects of Retinoic Acid or Glycolic Acid Vehiculated in Different Topical Formulations

Science.gov (United States)

Maia Campos, Patrícia Maria Berardo Gonçalves; Gaspar, Lorena Rigo; Gonçalves, Gisele Mara Silva; Pereira, Lúcia Helena Terenciane Rodrigues; Semprini, Marisa; Lopes, Ruberval Armando

2015-01-01

Retinoids and hydroxy acids have been widely used due to their effects in the regulation of growth and in the differentiation of epithelial cells. However, besides their similar indication, they have different mechanisms of action and thus they may have different effects on the skin; in addition, since the topical formulation efficiency depends on vehicle characteristics, the ingredients of the formulation could alter their effects. Thus the objective of this study was to compare the effects of retinoic acid (RA) and glycolic acid (GA) treatment on the hairless mouse epidermis thickness and horny layer renewal when added in gel, gel cream, or cream formulations. For this, gel, gel cream, and cream formulations (with or without 6% GA or 0.05% RA) were applied in the dorsum of hairless mice, once a day for seven days. After that, the skin was analyzed by histopathologic, morphometric, and stereologic techniques. It was observed that the effects of RA occurred independently from the vehicle, while GA had better results when added in the gel cream and cream. Retinoic acid was more effective when compared to glycolic acid, mainly in the cell renewal and the exfoliation process because it decreased the horny layer thickness. PMID:25632398

Cost-effectiveness of Bezlotoxumab Compared With Placebo for the Prevention of Recurrent Clostridium difficile Infection.

Science.gov (United States)

Prabhu, Vimalanand S; Dubberke, Erik R; Dorr, Mary Beth; Elbasha, Elamin; Cossrow, Nicole; Jiang, Yiling; Marcella, Stephen

2018-01-18

Clostridium difficile infection (CDI) is the most commonly recognized cause of recurrent diarrhea. Bezlotoxumab, administered concurrently with antibiotics directed against C. difficile (standard of care [SoC]), has been shown to reduce the recurrence of CDI, compared with SoC alone. This study aimed to assess the cost-effectiveness of bezlotoxumab administered concurrently with SoC, compared with SoC alone, in subgroups of patients at risk of recurrence of CDI. A computer-based Markov health state transition model was designed to track the natural history of patients infected with CDI. A cohort of patients entered the model with either a mild/moderate or severe CDI episode, and were treated with SoC antibiotics together with either bezlotoxumab or placebo. The cohort was followed over a lifetime horizon, and costs and utilities for the various health states were used to estimate incremental cost-effectiveness ratios (ICERs). Both deterministic and probabilistic sensitivity analyses were used to test the robustness of the results. The cost-effectiveness model showed that, compared with placebo, bezlotoxumab was associated with 0.12 quality-adjusted life-years (QALYs) gained and was cost-effective in preventing CDI recurrences in the entire trial population, with an ICER of $19824/QALY gained. Compared with placebo, bezlotoxumab was also cost-effective in the subgroups of patients aged ≥65 years (ICER of $15298/QALY), immunocompromised patients (ICER of $12597/QALY), and patients with severe CDI (ICER of $21430/QALY). Model-based results demonstrated that bezlotoxumab was cost-effective in the prevention of recurrent CDI compared with placebo, among patients receiving SoC antibiotics for treatment of CDI. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Comparative effectiveness of personalized lifestyle management strategies for cardiovascular disease risk reduction

NARCIS (Netherlands)

P. Chu (Paula); A. Pandya; J.A. Salomon (Joshua A); S.J. Goldie (Sue J); Hunink, M.G.M. (M.G. Myriam)

2015-01-01

textabstractBackground-Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year

Towards Comparative Leadership

DEFF Research Database (Denmark)

Jensen, Merete Storgaard

Globalization is the imitation and adaptation of knowledgesolutions or innovations, as they are diffused from one country to another” (Peter Jarvis 2007) Conducting comparative, educational research of school leadership that effects student achievement in an international perspective is of scient......Globalization is the imitation and adaptation of knowledgesolutions or innovations, as they are diffused from one country to another” (Peter Jarvis 2007) Conducting comparative, educational research of school leadership that effects student achievement in an international perspective...... is of scientific value in qualifying the international and national knowledgebase on effective school leadership. In a methodological perspective comparative analysis in an international setting creates specifically a scientific demand of comparability and a theory based leadership - framework to guide...... the empirical, qualitative research of effective leadership....

Is the perceived placebo effect comparable between adults and children? A meta-regression analysis.

Science.gov (United States)

Janiaud, Perrine; Cornu, Catherine; Lajoinie, Audrey; Djemli, Amina; Cucherat, Michel; Kassai, Behrouz

2017-01-01

A potential larger perceived placebo effect in children compared with adults could influence the detection of the treatment effect and the extrapolation of the treatment benefit from adults to children. This study aims to explore this potential difference, using a meta-epidemiological approach. A systematic review of the literature was done to identify trials included in meta-analyses evaluating a drug intervention with separate data for adults and children. The standardized mean change and the proportion of responders (binary outcomes) were used to calculate the perceived placebo effect. A meta-regression analysis was conducted to test for the difference between adults and children of the perceived placebo effect. For binary outcomes, the perceived placebo effect was significantly more favorable in children compared with adults (β = 0.13; P = 0.001). Parallel group trials (β = -1.83; P < 0.001), subjective outcomes (β = -0.76; P < 0.001), and the disease type significantly influenced the perceived placebo effect. The perceived placebo effect is different between adults and children for binary outcomes. This difference seems to be influenced by the design, the disease, and outcomes. Calibration of new studies for children should consider cautiously the placebo effect in children.

Comparing the Effects of Elementary Music and Visual Arts Lessons on Standardized Mathematics Test Scores

Science.gov (United States)

King, Molly Elizabeth

2016-01-01

The purpose of this quantitative, causal-comparative study was to compare the effect elementary music and visual arts lessons had on third through sixth grade standardized mathematics test scores. Inferential statistics were used to compare the differences between test scores of students who took in-school, elementary, music instruction during the…

Supporting Imagers' VOICE: A National Training Program in Comparative Effectiveness Research and Big Data Analytics.

Science.gov (United States)

Kang, Stella K; Rawson, James V; Recht, Michael P

2017-12-05

Provided methodologic training, more imagers can contribute to the evidence basis on improved health outcomes and value in diagnostic imaging. The Value of Imaging Through Comparative Effectiveness Research Program was developed to provide hands-on, practical training in five core areas for comparative effectiveness and big biomedical data research: decision analysis, cost-effectiveness analysis, evidence synthesis, big data principles, and applications of big data analytics. The program's mixed format consists of web-based modules for asynchronous learning as well as in-person sessions for practical skills and group discussion. Seven diagnostic radiology subspecialties and cardiology are represented in the first group of program participants, showing the collective potential for greater depth of comparative effectiveness research in the imaging community. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Comparing the relative cost-effectiveness of diagnostic studies: a new model

International Nuclear Information System (INIS)

Patton, D.D.; Woolfenden, J.M.; Wellish, K.L.

1986-01-01

We have developed a model to compare the relative cost-effectiveness of two or more diagnostic tests. The model defines a cost-effectiveness ratio (CER) for a diagnostic test as the ratio of effective cost to base cost, only dollar costs considered. Effective cost includes base cost, cost of dealing with expected side effects, and wastage due to imperfect test performance. Test performance is measured by diagnostic utility (DU), a measure of test outcomes incorporating the decision-analytic variables sensitivity, specificity, equivocal fraction, disease probability, and outcome utility. Each of these factors affecting DU, and hence CER, is a local, not universal, value; these local values strongly affect CER, which in effect becomes a property of the local medical setting. When DU = +1 and there are no adverse effects, CER = 1 and the patient benefits from the test dollar for dollar. When there are adverse effects effective cost exceeds base cost, and for an imperfect test DU 1. As DU approaches 0 (worthless test), CER approaches infinity (no effectiveness at any cost). If DU is negative, indicating that doing the test at all would be detrimental, CER also becomes negative. We conclude that the CER model is a useful preliminary method for ranking the relative cost-effectiveness of diagnostic tests, and that the comparisons would best be done using local values; different groups might well arrive at different rankings. (Author)

COMPARATIVE EFFECTIVENESS OF DIFFERENT METHODS OF CANDIDAL DYSBACTERIOSIS THERAPY

Directory of Open Access Journals (Sweden)

S.V. Nikolaeva

2009-01-01

Full Text Available The study of effectiveness of different methods of microbiological disorders correction in children after 3 years old with candidal dysbacteriosis are presented in this article. The study compared probiotical sour milk-made stuff («Actimel» and sour milk-made stuff, not fortified with probiotical cultures («Rastishka» and traditional kefir. It was shown that an inclusion of probiotical sour milkmade stuff in diet of children with candidal dysbacteriosis results in normalization of lacto- and bifidobacteria level and decreasing of Candida level.Key words: children, candidal dysbacteriosis, probiotics.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(6:31-35

Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

Science.gov (United States)

Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

2014-11-01

Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparing the effects of shallomin lotion and cryotherapy on treating plane warts

Directory of Open Access Journals (Sweden)

Reza Yaaghubi

2018-01-01

Full Text Available Background: Wart is a common transferable skin disease that is caused by human papilloma virus. Choosing the best treatment method can vary based on age, therapeutic goal, complications, and wart place. Due to antibacterial effect of shallomin (hirtifolium Boiss extract and since its effect has not been studied yet, it was compared to cryotherapy therapeutic methods for treating patients with plane warts. Methods: The present study was a randomized clinical trial that was carried out on 40 patients. Sampling was conducted simply by 4 block randomization method. The selected patients were assigned into two Groups of A and B. Data analysis was conducted by descriptive methods, and then, statistical tests including Chi-square, Fisher's exact test, and t-test were run to determine the relationship between qualitative and quantitative variables. In so doing, SPSS software version 16.0 was utilized. Results: Comparing the means showed that as opposed to cryotherapy, shallomin could not lead to a significant decrease in the size and number of warts. Conclusion: According to the results of this study, which is the first and the only investigation into the effects of shallomin on treating plane warts, it can be stated that despite of its antibacterial, antifungal, and anti-herpetic properties, shallamin cannot be a clinically effective option for treating plane warts.

Comparative animal experimental studies of the effects of different radiopharmaceuticals on the electroencephalogram

International Nuclear Information System (INIS)

Bretschneider, T.; Gundlach, H.J.; Krueger, M.; Reincke, R.; Schwebke, R.

1979-01-01

Some of the radiopharmaceuticals recently recommended for isotope cisternography were compared as to their effects on the bioelectric activity. Relaxed cats did not reveal any effects of 198 Au or 169 Yb-Ca-DTPA on the bioelectric activity. Following suboccipital administration, 169 Yb-DTPA and 131 I-HSA caused changes of the electroencephalogram in one of 7 and 6 cases, respectively. (author)

Comparative effectiveness research (CER): a summary of AHRQ's CER on therapies for rheumatoid arthritis.

Science.gov (United States)

Oderda, Gary M; Balfe, Lisa M

2011-01-01

In recent years, the U.S. government has designated funding of several large-scale initiatives for comparative effectiveness research (CER) in health care. The American Recovery and Reinvestment Act (ARRA) of 2009 apportioned more than $1 billion to support CER programs administered by the Department of Health and Human Services (DHHS), the National Institutes of Health (NIH), and the Agency for Healthcare Research and Quality (AHRQ). CER is generally defined as the undertaking of original research or systematic reviews of published literature in order to compare the benefits and risks of different approaches to preventing, diagnosing, or treating diseases. These approaches may include diagnostic tests, medications, medical devices, and surgeries. The overall goals of CER are to support informed health care decisions by patients, clinicians, payers, and policy makers and to apply its evidence to ultimately improve the quality, effectiveness, and efficiency of health care. To (a) provide managed care professionals with general definitions of CER, specifically as it is administered by AHRQ; (b) discuss the importance of CER to clinical and managed care pharmacists; and (c) summarize key methods and findings from AHRQ's 2007 comparative effectiveness review on therapies for rheumatoid arthritis (RA). As supported by AHRQ, CER is conducted in order to synthesize comprehensive evidence on the comparative benefits and harms of treatment interventions. The findings from comparative effectiveness reviews can thus contribute to informing therapeutic strategies and treatment decisions. In 2007, a multitude of RA treatment options and studies motivated AHRQ to commission a systematic comparative effectiveness review. Conducted by investigators at the RTI-University of North Carolina Evidence-Based Practice Center, the review included comparisons of synthetic disease-modifying antirheumatic drugs (DMARDs), biologic agents, synthetic DMARDs versus biologic agents, and various

COMPARING BEHAVIORAL DOSE-EFFECT CURVES FOR HUMANS AND LABORATORY ANIMALS ACUTELY EXPOSED TO TOLUENE.

Science.gov (United States)

The utility of laboratory animal data in toxicology depends upon the ability to generalize the results quantitatively to humans. To compare the acute behavioral effects of inhaled toluene in humans to those in animals, dose-effect curves were fitted by meta-analysis of published...

Payer decision-making with limited comparative and cost effectiveness data: the case of new pharmacological treatments for gout.

Science.gov (United States)

Meltzer, Michele; Pizzi, Laura T; Jutkowitz, Eric

2012-08-01

The need for comparative effectiveness (CE) data continues to grow, fuelled by market demand as well as health reform. There may be an assumption that new drugs result in improved efficacy compared with the standard of care, therefore warranting premium prices. Gout treatment has recently become controversial, as expensive new drugs enter the market with limited CE data. The authors reviewed published clinical trials and conducted a cost effectiveness analysis on a new drug (febuxostat) versus the standard (allopurinol) to illustrate the limitations in using these data to inform evidence-based decision-making. Although febuxostat trials included allopurinol as a comparator, methodological limitations make comparative effectiveness evaluations difficult. However, when available trial data were input to a decision analytic model, the authors found that a significant reduction in febuxostat cost would be required in order for it to dominate allopurinol in cost effectiveness analysis. This case exemplifies the challenges of using clinical trial data in comparative and cost effectiveness analyses.

Comparative effectiveness of liraglutide in the treatment of type 2 diabetes

Directory of Open Access Journals (Sweden)

Rigato M

2014-03-01

Full Text Available Mauro Rigato, Gian Paolo Fadini Department of Medicine, University Hospital of Padova, Padova, Italy Abstract: Type 2 diabetes is characterized by a progressive decline in beta cell function, with consequent worsening of glycemic control. The ideal antihyperglycemic treatment should achieve good and sustained glycemic control, with a low risk of hypoglycemia and no weight gain. This paper reviews the efficacy and tolerability of liraglutide, a glucagon-like peptide-1 receptor agonist approved for the treatment of type 2 diabetes. Once-daily injection of liraglutide (at doses of 1.2 mg and 1.8 mg, as monotherapy or in combination with one or two oral antihyperglycemic agents, was associated with greater improvements in glycemic control compared with active comparators or placebo in several controlled, randomized Phase III trials, including the six trials of the LEAD (Liraglutide Effect and Action in Diabetes program. Liraglutide also improved beta cell function, body weight, systolic blood pressure, and lipid profile, thereby achieving many of the goals of ideal antihyperglycemic therapy. Liraglutide was generally well tolerated in the Phase III trials. The most common adverse events were nausea, vomiting, and diarrhea, usually of mild to moderate intensity. The observed rate of pancreatitis was low and comparable with that of the general diabetic population. In conclusion, although most trials were relatively short and focused on surrogate endpoints, liraglutide emerges as an effective and well tolerated treatment for type 2 diabetes, carrying a low risk of hypoglycemia, weight loss, and possible reduction of cardiovascular risk. Keywords: body weight, hypoglycemia, cardiovascular, incretin

Electrophysiological study for comparing the effect of biological activity between type A botulinum toxins in rat gastrocnemius muscle.

Science.gov (United States)

Kim, C-S; Jang, W S; Son, I P; Nam, S H; Kim, Y I; Park, K Y; Kim, B J; Kim, M N

2013-09-01

New cosmetic applications and products based on the effects of botulinum toxin (BTX) treatment have stimulated demand for this class of natural compounds. This demand generates the need for appropriate standardized protocols to test and compare the effectiveness of new BTX preparations. Based on the previously described electrophysiological methods, we measured and compared the inhibitory effects of two BTX type A (BTX-A) preparations on neuromuscular transmission through split-body test. The effectiveness was evaluated in terms of the compound muscle action potential (CMAP) and conduction velocity after BTX-A injection. We used a split-body method to compare two different BTX-As in the rat. Based on the changes in the CMAP, the two different BTX-As induced paralytic effect on the rat tibialis anterior muscle. However, the two different BTX-A preparations did not differ significantly in effectiveness and did not induce a delay in conduction velocity. The new BTX-A preparation used in this electrophysiological study had similar effect compared with the previously marketed BTX-A.[AQ: Please approve the edits made to the sentence "The new BTX-A preparation…") We propose that a split-body electrophysiological protocol will be useful in establishing the comparative effectiveness of new BTX products.

A comparative study of the effect of diet and soda carbonated drinks ...

African Journals Online (AJOL)

EB

2013-09-03

Sep 3, 2013 ... Objectives: A comparative effect of the diet and regular soda carbonated drinks on the histology of the cerebellum of female albino Wistar rats was ... contains caffeine, depending on the quantities consumed5. Caffeine is linked ... consumption might result in seizures, memory loss, dizziness, headache and ...

The comparative study of the effect of some radionuclides on chlorella populations

International Nuclear Information System (INIS)

Shvobene, R.Ya.; Marchyulenene, D.P.; Shuliene, R.I.

1984-01-01

In this report the data are presented of the comparative study of physiological and genetic effects on chlorella populations (Chlorella vUlgaris Beijer, strain LARG-1) of 90 Sr, 137 Cs and 144 Ce (equal concentrations) distinguished by the radiation dose produced, the physico-chemical properties, and the levels of accumulation and deposition thereof in plant cells. The effects of the radionuclides on chlorella populations were estimated with a reference to the rate of photosynthesis, cell density, and the number of mutant and lethally affected cells

Comparative Effects of Injectable and Oral Hormonal Contraceptives on Lipid Profile

OpenAIRE

Adebayor Adegoke; Pascal C. Eneh; Roseanne Okafor; Benjamin N. Okolonkwo; Solomon A. Braide; Chukwubike U.Okeke; Holy Brown; Ngozika B. Okwandu

2012-01-01

Background and AimsThe continual use of hormonal contraceptives among women within reproductive age has been on the increase. The effects of these contraceptives on lipid metabolism vary depending on the type of hormonal contraceptive. This study was carried out among Nigerian women, to compare theeffects of injectable hormonal contraceptives to that of combined oral contraceptives on lipid profile (triglyceride, total cholesterol, high density lipoprotein-cholesterol and low density lipo-pro...

Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

Science.gov (United States)

Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

2014-01-01

While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

Data sources for heart failure comparative effectiveness research.

Science.gov (United States)

Xian, Ying; Hammill, Bradley G; Curtis, Lesley H

2013-01-01

Existing data sources for heart failure research offer advantages and disadvantages for CER. Clinical registries collect detailed information about disease presentation, treatment, and outcomes on a large number of patients and provide the "real-world" population that is the hallmark of CER. Data are not collected longitudinally, however, and follow-up is often limited. Large administrative datasets provide the broadest population coverage with longitudinal outcomes follow-up but lack clinical detail. Linking clinical registries with other databases to assess longitudinal outcomes holds great promise. The Federal Coordinating Council for Comparative Effectiveness Research recommends further efforts on longitudinal linking of administrative or EHR-based databases, patient registries, private sector databases (particularly those with commercially insured populations that are not covered under federal and state databases), and other relevant data sources containing pharmacy, laboratory, adverse events, and mortality information. Advancing the infrastructure to provide robust, scientific data resources for patient-centered CER must remain a priority. Copyright © 2013 Elsevier Inc. All rights reserved.

Reduction in Clostridium difficile environmental contamination by hospitalized patients treated with fidaxomicin.

Science.gov (United States)

Biswas, J S; Patel, A; Otter, J A; Wade, P; Newsholme, W; van Kleef, E; Goldenberg, S D

2015-07-01

Fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with Clostridium difficile infection (CDI). This study investigated whether fidaxomicin for treatment of all patients with CDI reduced C. difficile environmental contamination. Surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. Patients treated with fidaxomicin were less likely to contaminate their environment (25/68, 36.8%) than patients treated with metronidazole and/or vancomycin (38/66 57.6%) (P = 0.02). Treatment with fidaxomicin was associated with reduced environmental contamination with C. difficile. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparing and counting logs in direct and effective methods of QCD resummation

Energy Technology Data Exchange (ETDEWEB)

Almeida, Leandro G. [Laboratoire de Physique Théorique, Université Paris-Sud 11 and CNRS,91405 Orsay Cedex (France); Institut de Biologie de l’École Normale Supérieure (IBENS),Inserm 1024-CNRS 8197, 46 rue d’Ulm, 75005 Paris (France); Ellis, Stephen D. [Department of Physics, University of Washington,Seattle, WA 98195 (United States); Lee, Christopher [Theoretical Division, MS B283, Los Alamos National Laboratory,Los Alamos, NM 87544 (United States); Sterman, George [C.N. Yang Institute for Theoretical Physics, Stony Brook University,Stony Brook, NY 11794 (United States); Sung, Ilmo [Department of Applied Physics, New York University,Brooklyn, NY 11201 (United States); Queens College, City University of New York,Flushing, NY 11367 (United States); Walsh, Jonathan R. [Lawrence Berkeley National Laboratory, University of California,Berkeley, CA 94720 (United States); Berkeley Center for Theoretical Physics, University of California,Berkeley, CA 94720 (United States)

2014-04-29

We compare methods to resum logarithms in event shape distributions as they have been used in perturbative QCD directly and in effective field theory. We demonstrate that they are equivalent. In showing this equivalence, we are able to put standard soft-collinear effective theory (SCET) formulae for cross sections in momentum space into a novel form more directly comparable with standard QCD formulae, and endow the QCD formulae with dependence on separated hard, jet, and soft scales, providing potential ways to improve estimates of theoretical uncertainty. We show how to compute cross sections in momentum space to keep them as accurate as the corresponding expressions in Laplace space. In particular, we point out that that care is required in truncating differential distributions at N{sup k}LL accuracy to ensure they match the accuracy of the corresponding cumulant or Laplace transform. We explain how to avoid such mismatches at N{sup k}LL accuracy, and observe why they can also be avoided by working to N{sup k}LL{sup ′} accuracy.

A comparative study of the effect of diet and soda carbonated drinks ...

African Journals Online (AJOL)

A comparative study of the effect of diet and soda carbonated drinks on the histology of the cerebellum of adult female albino Wistar rats. ... African Health Sciences ... Group B was administered 50 ml of regular soda (RS), and group C was administered 50 ml of diet soda (DS) each per day for 21 days, and the rats were ...

Comparative effectiveness of mepolizumab and omalizumab in severe asthma: An indirect treatment comparison.

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Cockle, Sarah M; Stynes, Gillian; Gunsoy, Necdet B; Parks, Daniel; Alfonso-Cristancho, Rafael; Wex, Jaro; Bradford, Eric S; Albers, Frank C; Willson, Jenny

2017-02-01

Severe asthma is a heterogeneous disease. Patients with both eosinophilic and allergic asthma phenotypes may be eligible for treatment with mepolizumab and omalizumab. Evidence on the relative effectiveness of these treatments in this 'overlap' population would be informative for clinical and payer decision making. A systematic literature review and indirect treatment comparison (Bayesian framework) were performed to assess the comparative effectiveness and tolerability of mepolizumab and omalizumab, as add-ons to standard of care. Studies included in the primary analysis were double-blind, randomized controlled trials, ≥12 weeks' duration enrolling patients with severe asthma with a documented exacerbation history and receiving high-dose inhaled corticosteroids plus ≥1 additional controller. Two populations were examined: patients potentially eligible for 1) both treatments (Overlap population) and 2) either treatment (Trial population). In the Overlap population, no differences between treatments in clinically significant exacerbations and exacerbations requiring hospitalization were found, although trends favored mepolizumab (rate ratio [RR]:0.66 [95% credible intervals (Crl):0.37,1.19]; 0.19[0.02,2.32], respectively). In the Trial population, mepolizumab treatment produced greater reductions in clinically significant exacerbations (RR:0.63 [95% CrI:0.45,0.89]) but not exacerbations requiring hospitalization compared with omalizumab (RR:0.58 [95% Crl: 0.16,2.13]), although the trend favored mepolizumab. Both treatments had broadly comparable effects on lung function, and similar tolerability profiles. Whilst this analysis has limitations due to a restricted evidence base and residual heterogeneity, it showed that in patients with severe asthma, mepolizumab seems to be at least as effective as omalizumab and that the tolerability profiles of the two treatments did not meaningfully differentiate. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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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.

Consensus of recommendations guiding comparative effectiveness research methods.

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Morton, Jacob B; McConeghy, Robert; Heinrich, Kirstin; Gatto, Nicolle M; Caffrey, Aisling R

2016-12-01

Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations. We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap. We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents. We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

AHRQ series paper 3: identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the effective health-care program.

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Whitlock, Evelyn P; Lopez, Sarah A; Chang, Stephanie; Helfand, Mark; Eder, Michelle; Floyd, Nicole

2010-05-01

This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality's Effective Health Care (EHC) program. The EHC program seeks to align its research topic selection with the overall goals of the program, impartially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are "appropriate") to determine how "important" topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the "potential value and impact" of a comparative effectiveness systematic review. As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthesized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness.

Cost-effectiveness of azacitidine compared with low-doses of chemotherapy (LDC in myelodysplastic syndrome (MDS

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Myrna Candelaria-Hernández

2017-06-01

Full Text Available ABSTRACTIntroductionMyelodysplastic syndrome (MDS comprises a group of clonal hematological disorders, characterized by ineffective hematopoiesis and progressive bone marrow failure. It increases the risk of transformation to acute myeloid leukemia (AML. Therapeutic benefit should include overall survival increase (OS, hematological improvement, transfusion dependence and time to progression to AML decrease.ObjectiveAssess, from a Mexican health-care perspective, the cost-effectiveness of azacitidine compared with low-doses of chemotherapy (LDC plus best supportive care (BSC for the treatment of adult patients with intermediate-2 and high-risk MDS, who are not eligible for hematopoietic stem-cell transplantation. We developed a cost-effectiveness survival analysis model of three stages: MDS, AML, and death. OS and costs are extrapolated beyond three-year time horizon. Discount rate of 5% was applied. To estimate the model cycle probability transition to mortality state, survival curves were constructed for each treatment arm using individual patient-level data from Study AZA-001. Unitary costs are from public price list, and profiles for the management of MDS and AML were collected separately using a structured questionnaire. Probabilistic sensitivity analyses (PSA were conducted by simultaneously sampling from estimated probability distributions of model parameters.ResultsOverall survival was projected to increase by 72.26 weeks with azacitidine. Incremental expected total costs for azacitidine compared to LDC was MXN$68,045. However, the cost of the drug therapy was lower with azacitidine. The incremental cost-effectiveness ratio (ICER for azacitidine compared to LDC was MXN$48,932 per life-year gained (LYG. PSA showed that azacitidine was a highly cost-effective option in 96.49% of the simulated cases in MXN$180,000/LYG willingness-to-pay.ConclusionsCompared with LDC, azacitidine represents a cost-effective treatment alternative in patients

Comparing Effects of Biologic Agents in Treating Patients with Rheumatoid Arthritis: A Multiple Treatment Comparison Regression Analysis.

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Ingunn Fride Tvete

Full Text Available Rheumatoid arthritis patients have been treated with disease modifying anti-rheumatic drugs (DMARDs and the newer biologic drugs. We sought to compare and rank the biologics with respect to efficacy. We performed a literature search identifying 54 publications encompassing 9 biologics. We conducted a multiple treatment comparison regression analysis letting the number experiencing a 50% improvement on the ACR score be dependent upon dose level and disease duration for assessing the comparable relative effect between biologics and placebo or DMARD. The analysis embraced all treatment and comparator arms over all publications. Hence, all measured effects of any biologic agent contributed to the comparison of all biologic agents relative to each other either given alone or combined with DMARD. We found the drug effect to be dependent on dose level, but not on disease duration, and the impact of a high versus low dose level was the same for all drugs (higher doses indicated a higher frequency of ACR50 scores. The ranking of the drugs when given without DMARD was certolizumab (ranked highest, etanercept, tocilizumab/ abatacept and adalimumab. The ranking of the drugs when given with DMARD was certolizumab (ranked highest, tocilizumab, anakinra/rituximab, golimumab/ infliximab/ abatacept, adalimumab/ etanercept [corrected]. Still, all drugs were effective. All biologic agents were effective compared to placebo, with certolizumab the most effective and adalimumab (without DMARD treatment and adalimumab/ etanercept (combined with DMARD treatment the least effective. The drugs were in general more effective, except for etanercept, when given together with DMARDs.

Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only

NARCIS (Netherlands)

Vijgen, Sylvia M. C.; Westerhuis, Michelle E. M. H.; Opmeer, Brent C.; Visser, Gerard H. A.; Moons, Karl G. M.; Porath, Martina M.; Oei, Guid S.; van Geijn, Herman P.; Bolte, Antoinette C.; Willekes, Christine; Nijhuis, Jan G.; van Beek, Erik; Graziosi, Giuseppe C. M.; Schuitemaker, Nico W. E.; van Lith, Jan M. M.; van den Akker, Eline S. A.; Drogtrop, Addy P.; van Dessel, Hendrikus J. H. M.; Rijnders, Robbert J. P.; Oosterbaan, Herman P.; Mol, Ben Willem J.; Kwee, Anneke

2011-01-01

To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric

Comparing antifungal effects of Zatariamultiflora and Punicagranatum extract with Nystatin on Candida Albicans

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F. Nouri

2016-12-01

Full Text Available Background: Despite all the progress that has been made in the manufacture of synthetic drugs, herbal drugs are increasingly taken into account. This is due to the growing belief that they have fewer side effects compared to synthetic ones. Objective: To compare the antifungal effects of extracts of Zatariamultiflora and Punicagranatum with Nystatin on Candida Albicans. Methods: This inviro trial accomplished in the school of dentistry of Tehran University in 2012. From the mouths of 25 patients with denture stomatitis were sampled using sterile swabs. Candida Albicans strains were isolated from samples and standard Candida Albicans PTCC 5027 were cultured too. Then extract of Zatariamultiflora and Punicagranatum to be obtained and antifungal of extract studied with disk diffusion method. Antifungal power of each of the extracts on the inhibition zone diameter was created in the medium. Data were analyzed by ANOVA and Friedman statistical tests. Findings: Results showed extracts of Zataria and pomegranate flowers have antifungal significant effects (P<0.001. Diameter of inhabitation zone was 17.66±./75 mm in Nystatin group and in the Zataria and pomegranate flowers extracts groups was lower (P<0.001. None of the negative control disc did inhibition zone in the medium. Conclusion: With due attention of Zataria and pomegranate flowers extracts exhibited antifungal effects on Candida Albincans.

MODELLING OF FINANCIAL EFFECTIVENESS AND COMPARATIVE ANALYSIS OF PUBLIC-PRIVATE PARTNERSHIP PROJECTS AND PUBLIC PROCUREMENT

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Kuznetsov Aleksey Alekseevich

2017-10-01

Full Text Available The article substantiates the necessity of extension and development of tools for methodological evaluation of effectiveness of public-private partnership (PPP projects both individually and in comparison of effectiveness of various mechanisms of projects realization on the example of traditional public procurement. The author proposed an original technique of modelling cash flows of private and public partners when realizing the projects based on PPP and on public procurement. The model enables us promptly and with sufficient accuracy to reveal comparative advantages of project forms of PPP and public procurement, and also assess financial effectiveness of the PPP projects for each partner. The modelling is relatively straightforward and reliable. The model also enables us to evaluate public partner's expenses for availability, find the terms and thresholds for interest rates of financing attracted by the partners and for risk probabilities to ensure comparative advantage of PPP project. Proposed criteria of effectiveness are compared with methodological recommendations provided by the Ministry of Economic Development of the Russian Federation. Subject: public and private organizations, financial institutions, development institutions and their theoretical and practical techniques for effectiveness evaluation of public-private partnership (PPP projects. Complexity of effectiveness evaluation and the lack of unified and accepted methodology are among the factors that limit the development of PPP in the Russian Federation nowadays. Research objectives: development of methodological methods for assessing financial efficiency of PPP projects by creating and justifying application of new principles and methods of modelling, and also criteria for effectiveness of PPP projects both individually and in comparison with the public procurement. Materials and methods: open database of ongoing PPP projects in the Russian Federation and abroad was used. The

Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction.

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Chu, Paula; Pandya, Ankur; Salomon, Joshua A; Goldie, Sue J; Hunink, M G Myriam

2016-03-29

Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Comparative Effectiveness of Treatments for Binge-Eating Disorder: Systematic Review and Network Meta-Analysis.

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Peat, Christine M; Berkman, Nancy D; Lohr, Kathleen N; Brownley, Kimberly A; Bann, Carla M; Cullen, Katherine; Quattlebaum, Mary J; Bulik, Cynthia M

2017-09-01

Psychological and pharmacological interventions for binge-eating disorder have previously demonstrated efficacy (compared with placebo or waitlist control); thus, we aimed to expand that literature with a review of comparative effectiveness. We searched MEDLINE,® EMBASE,® Cochrane Library, Academic OneFile, CINAHL® for binge-eating disorder treatment articles and selected studies using predetermined inclusion and exclusion criteria. Data were sufficient for network meta-analysis comparing two pharmacological interventions; psychological interventions were analysed qualitatively. In all, 28 treatment comparisons were included in this review: one pharmacological comparison (second-generation antidepressants versus lisdexamfetamine) and 26 psychological comparisons. Only three statistically significant differences emerged: lisdexamfetamine was better at increasing binge abstinence than second-generation antidepressants; therapist-led cognitive behavioural therapy was better at reducing binge-eating frequency than behavioural weight loss, but behavioural weight loss was better at reducing weight. The majority of other treatment comparisons revealed few significant differences between groups. Thus, patients and clinicians can choose from several effective treatment options. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

NARCIS (Netherlands)

Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

2001-01-01

OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

The effects of physiotherapy for female urinary incontinence: individual compared with group treatment.

NARCIS (Netherlands)

Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

2001-01-01

OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

Comparative cardiopulmonary effects of particulate matter- and ozone-enhanced smog atmospheres in mice

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This study was conducted to compare the cardiac effects of particulate matter (PM)-enhanced and ozone(O3)-enhanced smog atmospheres in mice. We hypothesized that O3-enhanced smog would cause greater cardiac dysfunction than PM-enhanced smog due to the higher concentrations of irr...

Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis.

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Cook, David A; Hamstra, Stanley J; Brydges, Ryan; Zendejas, Benjamin; Szostek, Jason H; Wang, Amy T; Erwin, Patricia J; Hatala, Rose

2013-01-01

Although technology-enhanced simulation is increasingly used in health professions education, features of effective simulation-based instructional design remain uncertain. Evaluate the effectiveness of instructional design features through a systematic review of studies comparing different simulation-based interventions. We systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, key journals, and previous review bibliographies through May 2011. We included original research studies that compared one simulation intervention with another and involved health professions learners. Working in duplicate, we evaluated study quality and abstracted information on learners, outcomes, and instructional design features. We pooled results using random effects meta-analysis. From a pool of 10,903 articles we identified 289 eligible studies enrolling 18,971 trainees, including 208 randomized trials. Inconsistency was usually large (I2 > 50%). For skills outcomes, pooled effect sizes (positive numbers favoring the instructional design feature) were 0.68 for range of difficulty (20 studies; p simulation-based education.

Comparative effect of coffee robusta and coffee arabica (Qahwa) on memory and attention.

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Alharbi, Waheeb D M; Azmat, Aisha; Ahmed, Muhammad

2018-04-13

The comparative effects of coffee robusta and coffee arabica (Qahwa) on different attention and memory related assignments were measured in a double-blind study of 300 healthy young adult women who were randomly assigned to one of three different drinks: Group I (coffee robusta sachet dissolved in 100 ml of hot water): Group II (coffee arabica): and group III (100 ml water only). Cognitive function was assessed by standardized tests. Several monitoring cognitive tests and tasks were specifically chosen and performed to investigate the comparative effects of coffee robusta (CR) and coffee arabica (Qahwa; AC) on sleepiness (sleep and clear headed scale), attention (trail A & B, symbol digit, letter cancellation), general cognitive ability (stroop test) and memory (card test). Data was interpreted by analysis of variance (ANOVA). The present study revealed that coffee robusta has beneficial effects on attention, general cognitive ability and memory. Higher though non-significant cognitive scores were associated with coffee robusta consumption. Although, consumption of coffee arabica (Qahwa) has significant effects (P < 0.05) on sleepiness, attention, general cognitive ability and memory and it significantly improve reaction time and correct responses. Since different tasks were related to the sustained attention and working memory processes, results would suggest that coffee arabica (qahwa) could increase the memory and efficiency of the attentional system might be due to the presence of chlorogenic acids (CGA) which are found in less quantity in coffee robusta. However, more studies using larger samples and different tasks are necessary to better understand the effects of coffee robusta and arabica (Qahwa) on attention and memory.

Thermo-Kinetic Investigation of Comparative Ligand Effect on Cysteine Iron Redox Reaction

OpenAIRE

Rizvi, Masood Ahmad; Teshima, Norio; Maqsood, Syed Raashid; Akhoon, Showket Ahmad; Peerzada, Ghulam Mustafa

2015-01-01

Transition metal ions in their free state bring unwanted biological oxidations generating oxidative stress. The ligand modulated redox potential can be indispensable in prevention of such oxidative stress by blocking the redundant bio-redox reactions. In this study we investigated the comparative ligand effect on the thermo-kinetic aspects of biologically important cysteine iron (III) redox reaction using spectrophotometric and potentiometric methods. The results were corroborated...

Effects of stimulus order on discrimination processes in comparative and equality judgements: data and models.

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Dyjas, Oliver; Ulrich, Rolf

2014-01-01

In typical discrimination experiments, participants are presented with a constant standard and a variable comparison stimulus and their task is to judge which of these two stimuli is larger (comparative judgement). In these experiments, discrimination sensitivity depends on the temporal order of these stimuli (Type B effect) and is usually higher when the standard precedes rather than follows the comparison. Here, we outline how two models of stimulus discrimination can account for the Type B effect, namely the weighted difference model (or basic Sensation Weighting model) and the Internal Reference Model. For both models, the predicted psychometric functions for comparative judgements as well as for equality judgements, in which participants indicate whether they perceived the two stimuli to be equal or not equal, are derived and it is shown that the models also predict a Type B effect for equality judgements. In the empirical part, the models' predictions are evaluated. To this end, participants performed a duration discrimination task with comparative judgements and with equality judgements. In line with the models' predictions, a Type B effect was observed for both judgement types. In addition, a time-order error, as indicated by shifts of the psychometric functions, and differences in response times were observed only for the equality judgement. Since both models entail distinct additional predictions, it seems worthwhile for future research to unite the two models into one conceptual framework.

Comparing the effects of low-dose contraceptive pills to control dysfunctional uterine bleeding by oral and vaginal methods.

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Mehrabian, Ferdous; Abbassi, Fariba

2013-09-01

Background and Objective : Contraceptive pills are generally taken orally and can cause side effects such as nausea, vomiting and hypertension. The vaginal use of these pills can reduce such complications. Our objective was to compare the efficacy and side effects of low dose contraceptive pills by oral and vaginal route in the management of dysfunctional uterine bleeding-(DUB) Methods: This comparative observational study was conducted at Beheshti and Alzahra (SA) teaching hospitals, affiliated to Isfahan University of Medical Sciences in 2010-2011. One hundred women who presented with DUB were randomly assigned into two groups of equal number, receiving the low dose oral contraceptive pills by oral or vaginal route for three month. The amount and duration of bleeding were compared at the beginning and at the end of the study and side effects by these two methods compared. The results of this study showed that both oral and vaginal routes effectively reduced the duration and amount of bleeding due to DUB after three courses of treatment. This effect was better in the vaginal method compared with oral administration (P = 0.03). Regarding the side effects, nausea and vomiting were significantly higher in the oral group than in the vaginal group (P = 0.03). Vulvovaginitis infection was more frequent in the vaginal group than in the oral group (P = 0.03). Low dose contraceptive pills are effective in reducing the amount, time, and duration of bleeding in patients with DUB. In addition, reduction of gastrointestinal side effects by vaginal route helps to use these pills by the patient with proper training of physicians, midwives and patients.

Effectiveness of the homeopathic preparation Zeel compared with carprofen in dogs with osteoarthritis.

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Neumann, Stephan; Stolt, Pelle; Braun, Gabriele; Hellmann, Klaus; Reinhart, Erich

2011-01-01

The authors compared the symptomatic effectiveness of a complex homeopathic preparation Zeel (1-3 tablets orally per day depending on body weight) to carprofen (4 mg/kg body weight) in dogs (n=68) aged >1 yr diagnosed with osteoarthritis in a multicenter, prospective, observational open-label cohort study in 12 German veterinary clinics. The active treatment period was 56 days. Symptomatic effectiveness, lameness, stiffness of movements, and pain on palpation were evaluated by treating veterinarians and owners. Clinical signs of osteoarthritis improved significantly (Pcarprofen group.

Effectiveness of the Gold Standard Programme compared with other smoking cessation interventions in Denmark

DEFF Research Database (Denmark)

Rasmussen, Mette; Fernández, Esteve; Tønnesen, Hanne

2017-01-01

Objectives: We compared the effectiveness of the Gold Standard Programme (a comprehensive smoking cessation intervention commonly used in Denmark) with other face-to-face smoking cessation programmes in Denmark after implementation in real life, and we identified factors associated with successful...... did not want further contact, who intentionally were not followed up or who lacked information about the intervention they received were excluded. A total of 46 287 smokers were included. Interventions: Various real-life smoking cessation interventions were identified and compared: The Gold Standard...... smokers. The follow-up rate was 74%. Women were less likely to remain abstinent, OR 0.83 (CI 0.79 to 0.87). Short interventions were more effective among men. After adjusting for confounders, the Gold Standard Programme was the only intervention with significant results across sex, increasing the odds...

Stakeholder engagement for comparative effectiveness research in cancer care: experience of the DEcIDE Cancer Consortium.

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Greenberg, Caprice C; Wind, Jennifer K; Chang, George J; Chen, Ronald C; Schrag, Deborah

2013-03-01

Stakeholder input is a critical component of comparative effectiveness research. To ensure that the research activities of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network, supported by the Agency for Healthcare Research and Quality, translate into the greatest impact for everyday practice and policy-making in cancer, we were tasked with soliciting stakeholder input regarding priority areas in cancer-related comparative effectiveness research for the DEcIDE Cancer Consortium. Given the increasing emphasis on stakeholder engagement in research, many investigators are facing a similar task, yet there is limited literature to guide such efforts, particularly in cancer care. To help fill this gap, we present our approach to operationalizing stakeholder engagement and discuss it in the context of other recent developments in the area. We describe challenges encountered in convening stakeholders from multiple vantage points to prioritize topics and strategies used to mitigate these barriers. We offer several recommendations regarding how to best solicit stakeholder input to inform comparative effectiveness research in cancer care. These recommendations can inform other initiatives currently facing the challenges of engaging stakeholders in priority setting for cancer.

The effects of ionizing radiation on food, compared to the effects of conventional food treatment: A literature study. Pt. 1

International Nuclear Information System (INIS)

Leister, W.; Boegl, K.W.

1987-08-01

The extent and quality of changes due to irradiation is described and compared with conventional methods. Effects of radiation treatment on vegetable products as well as pork, beef, any type of fish and poultry product are compared with conventional thermic, micro-wave or smoke treatments, drying processes, ethylene oxide gas treatment, as well as effects from storage, temperature and sealed packaging. In this context the influences of the different treatment methods on various food components and on sensory, physical-chemical or biochemical characteristics were compared. The following tendencies were observed: conventional treatment methods produce partly more pronounced changes than irradiation with standard doses. Heat treatment, for instance, results in a greater weight loss, in altered sugar content, and in higher content of carbonyl and aldehyde releasing compounds. Gas treatment will cut the volatile oil content in half, while it remains nearly constant after irradiation. However, in some cases, an irradiation with standard doses may cause changes which should not be disregarded. In onions, for instance, irradiation is causing a stronger decomposition during storage than only cold storage. (orig./MG) [de

Comparative Thermal Aging Effects on PM-HIP and Forged Inconel 690

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Bullens, Alexander L.; Bautista, Esteban; Jaye, Elizabeth H.; Vas, Nathaniel L.; Cain, Nathan B.; Mao, Keyou; Gandy, David W.; Wharry, Janelle P.

2018-03-01

This study compares thermal aging effects in Inconel 690 (IN690) produced by forging and powder metallurgy with hot isostatic pressing (PM-HIP). Isothermal aging is carried out over 400-800°C for up to 1000 h and then metallography and nanoindentation are utilized to relate grain microstructure with hardness and yield strength. The PM-HIP IN690 maintains a constant grain size through all aging conditions, while the forged IN690 exhibits limited grain growth at the highest aging temperature and longest aging time. The PM-HIP IN690 exhibits comparable mechanical integrity as the forged material throughout aging: hardness and yield strength are unchanged with 100 h aging, but increase after 1000 h aging at all temperatures. In both the PM-HIP and forged IN690, the Hall-Petch relationship for Ni-based superalloys predicts yield strength for 0-100 h aged specimens, but underestimates yield strength in the 1000 h aged specimens because of thermally induced precipitation.

Estimating the cost-effectiveness of stroke units in France compared with conventional care.

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Launois, R; Giroud, M; Mégnigbêto, A C; Le Lay, K; Présenté, G; Mahagne, M H; Durand, I; Gaudin, A F

2004-03-01

The incidence of stroke in France is estimated at between 120 000 and 150 000 cases per year. This modeling study assessed the clinical and economic benefits of establishing specialized stroke units compared with conventional care. Data from the Dijon stroke registry were used to determine healthcare trajectories according to the degree of autonomy and organization of patient care. The relative risks of death or institutionalization or death or dependence after passage through a stroke unit were compared with conventional care. These risks were then inserted with the costing data into a Markov model to estimate the cost-effectiveness of stroke units. Patients cared for in a stroke unit survive more trimesters without sequelae in the 5 years after hospitalization than those cared for conventionally (11.6 versus 8.28 trimesters). The mean cost per patient at 5 years was estimated at 30 983 for conventional care and 34 638 in a stroke unit. An incremental cost-effectiveness ratio for stroke units of 1359 per year of life gained without disability was estimated. The cost-effectiveness ratio for stroke units is much lower than the threshold (53 400 ) of acceptability recognized by the international scientific community. This finding justifies organizational changes in the management of stroke patients and the establishment of stroke units in France.

Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study

NARCIS (Netherlands)

Koivisto, J.; Schulze, D.; Wolff, J.E.H.; Rottke, D.

2014-01-01

Objectives: The objective of this study was to compare the performance of metal oxide semiconductor field-effect transistor (MOSFET) technology dosemeters with thermoluminescent dosemeters (TLDs) (TLD 100; Thermo Fisher Scientific, Waltham, MA) in the maxillofacial area. Methods: Organ and effective

Cost effectiveness of pediatric pneumococcal conjugate vaccines: a comparative assessment of decision-making tools.

Science.gov (United States)

Chaiyakunapruk, Nathorn; Somkrua, Ratchadaporn; Hutubessy, Raymond; Henao, Ana Maria; Hombach, Joachim; Melegaro, Alessia; Edmunds, John W; Beutels, Philippe

2011-05-12

Several decision support tools have been developed to aid policymaking regarding the adoption of pneumococcal conjugate vaccine (PCV) into national pediatric immunization programs. The lack of critical appraisal of these tools makes it difficult for decision makers to understand and choose between them. With the aim to guide policymakers on their optimal use, we compared publicly available decision-making tools in relation to their methods, influential parameters and results. The World Health Organization (WHO) requested access to several publicly available cost-effectiveness (CE) tools for PCV from both public and private provenance. All tools were critically assessed according to the WHO's guide for economic evaluations of immunization programs. Key attributes and characteristics were compared and a series of sensitivity analyses was performed to determine the main drivers of the results. The results were compared based on a standardized set of input parameters and assumptions. Three cost-effectiveness modeling tools were provided, including two cohort-based (Pan-American Health Organization (PAHO) ProVac Initiative TriVac, and PneumoADIP) and one population-based model (GlaxoSmithKline's SUPREMES). They all compared the introduction of PCV into national pediatric immunization program with no PCV use. The models were different in terms of model attributes, structure, and data requirement, but captured a similar range of diseases. Herd effects were estimated using different approaches in each model. The main driving parameters were vaccine efficacy against pneumococcal pneumonia, vaccine price, vaccine coverage, serotype coverage and disease burden. With a standardized set of input parameters developed for cohort modeling, TriVac and PneumoADIP produced similar incremental costs and health outcomes, and incremental cost-effectiveness ratios. Vaccine cost (dose price and number of doses), vaccine efficacy and epidemiology of critical endpoint (for example

CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials

OpenAIRE

Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

2010-01-01

ABSTRACT Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of kn...

Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Compared With Radiofrequency Ablation for Inoperable Colorectal Liver Metastases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Gill, Beant; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Roberts, Mark S. [Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

2016-07-15

Purpose: To conduct a cost-effectiveness analysis to determine whether stereotactic body radiation therapy (SBRT) is a cost-effective therapy compared with radiofrequency ablation (RFA) for patients with unresectable colorectal cancer (CRC) liver metastases. Methods and Materials: A cost-effectiveness analysis was conducted using a Markov model and 1-month cycle over a lifetime horizon. Transition probabilities, quality of life utilities, and costs associated with SBRT and RFA were captured in the model on the basis of a comprehensive literature review and Medicare reimbursements in 2014. Strategies were compared using the incremental cost-effectiveness ratio, with effectiveness measured in quality-adjusted life years (QALYs). To account for model uncertainty, 1-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay threshold of $100,000 per QALY gained. Results: In base case analysis, treatment costs for 3 fractions of SBRT and 1 RFA procedure were $13,000 and $4397, respectively. Median survival was assumed the same for both strategies (25 months). The SBRT costs $8202 more than RFA while gaining 0.05 QALYs, resulting in an incremental cost-effectiveness ratio of $164,660 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of median survival from both treatments. Stereotactic body radiation therapy was economically reasonable if better survival was presumed (>1 month gain) or if used for large tumors (>4 cm). Conclusions: If equal survival is assumed, SBRT is not cost-effective compared with RFA for inoperable colorectal liver metastases. However, if better local control leads to small survival gains with SBRT, this strategy becomes cost-effective. Ideally, these results should be confirmed with prospective comparative data.

Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Compared With Radiofrequency Ablation for Inoperable Colorectal Liver Metastases

International Nuclear Information System (INIS)

Kim, Hayeon; Gill, Beant; Beriwal, Sushil; Huq, M. Saiful; Roberts, Mark S.; Smith, Kenneth J.

2016-01-01

Purpose: To conduct a cost-effectiveness analysis to determine whether stereotactic body radiation therapy (SBRT) is a cost-effective therapy compared with radiofrequency ablation (RFA) for patients with unresectable colorectal cancer (CRC) liver metastases. Methods and Materials: A cost-effectiveness analysis was conducted using a Markov model and 1-month cycle over a lifetime horizon. Transition probabilities, quality of life utilities, and costs associated with SBRT and RFA were captured in the model on the basis of a comprehensive literature review and Medicare reimbursements in 2014. Strategies were compared using the incremental cost-effectiveness ratio, with effectiveness measured in quality-adjusted life years (QALYs). To account for model uncertainty, 1-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay threshold of $100,000 per QALY gained. Results: In base case analysis, treatment costs for 3 fractions of SBRT and 1 RFA procedure were $13,000 and $4397, respectively. Median survival was assumed the same for both strategies (25 months). The SBRT costs $8202 more than RFA while gaining 0.05 QALYs, resulting in an incremental cost-effectiveness ratio of $164,660 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of median survival from both treatments. Stereotactic body radiation therapy was economically reasonable if better survival was presumed (>1 month gain) or if used for large tumors (>4 cm). Conclusions: If equal survival is assumed, SBRT is not cost-effective compared with RFA for inoperable colorectal liver metastases. However, if better local control leads to small survival gains with SBRT, this strategy becomes cost-effective. Ideally, these results should be confirmed with prospective comparative data.

Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium.

Science.gov (United States)

Hiligsmann, Mickaël; Reginster, Jean-Yves

2011-10-01

Denosumab has recently been shown to be well tolerated, to increase bone mineral density (BMD) and to significantly reduce the risk of hip, vertebral and non-vertebral fractures in the FREEDOM (Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months) trial. It is becoming increasingly important to evaluate not only the therapeutic value of a new drug but also the cost effectiveness compared with the most relevant treatment alternatives. The objective of this study was to estimate the cost effectiveness of denosumab compared with oral bisphosphonates (branded and generic drugs) in the treatment of post-menopausal osteoporotic women in Belgium. Cost effectiveness of 3 years of treatment with denosumab was compared with branded risedronate and branded and generic alendronate using an updated version of a previously validated Markov microsimulation model. The model was populated with relevant cost, adherence and epidemiological data for Belgium from a payer perspective and the results were presented as costs per QALY gained (&U20AC;, year 2009 values). Analyses were performed in populations (aged ≥60 years) in which osteoporosis medications are currently reimbursed in many European countries, i.e. those with BMD T-score of -2.5 or less or prevalent vertebral fracture. Patients receiving denosumab were assumed to have a 46% lower risk of discontinuation than those receiving oral bisphosphonates, and the effect of denosumab after treatment cessation was assumed to decline linearly to zero over a maximum of 1 year. Denosumab was cost effective compared with all other therapies, assuming a willingness to pay of &U20AC;40 000 per QALY gained. In particular, denosumab was found to be cost effective compared with branded alendronate and risedronate at a threshold value of &U20AC;30 000 per QALY and denosumab was dominant (i.e. lower cost and greater effectiveness) compared with risedronate from the age of 70 years in women with a T-score of -2.5 or

Use of comparative effectiveness research in drug coverage and pricing decisions: a six-country comparison.

Science.gov (United States)

Sorenson, Corinna

2010-07-01

Comparative effectiveness research (CER) has assumed an increasing role in drug coverage and, in some cases, pricing decisions in Europe, as decision-makers seek to obtain better value for money. This issue brief comparatively examines the use of CER across six countries--Denmark, England, France, Germany, the Netherlands, and Sweden. With CER gaining traction in the United States, these international experiences offer insights and potential lessons. Investing in CER can help address the current gap in publicly available, credible, up-to-date, and scientifically based comparative information on the effectiveness of drugs and other health interventions. This information can be used to base coverage and pricing decisions on evidence of value, thereby facilitating access to and public and private investment in the most beneficial new drugs and technologies. In turn, use of CER creates incentives for more efficient, high-quality health care and encourages development of innovative products that offer measurable value to patients.

Faculty Satisfaction with Distance Education: A Comparative Analysis on Effectiveness of Undergraduate Course Delivery Modes

Science.gov (United States)

Koenig, Robert J.

2010-01-01

Higher education faculty can and do teach courses delivered in a variety of ways. But, to date, little research has been done on the effectiveness of different delivery modes. This study sought to fill that void by comparing the effectiveness of three undergraduate course delivery modes: classroom, online, and video conference at a technical…

Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial.

Science.gov (United States)

Kempe, Allison; Saville, Alison; Dickinson, L Miriam; Eisert, Sheri; Reynolds, Joni; Herrero, Diana; Beaty, Brenda; Albright, Karen; Dibert, Eva; Koehler, Vicky; Lockhart, Steven; Calonge, Ned

2013-06-01

We compared the effectiveness and cost-effectiveness of population-based recall (Pop-recall) versus practice-based recall (PCP-recall) at increasing immunizations among preschool children. This cluster-randomized trial involved children aged 19 to 35 months needing immunizations in 8 rural and 6 urban Colorado counties. In Pop-recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In PCP-recall counties, practices were invited to attend webinar training using CIIS and offered financial support for mailings. The percentage of up-to-date (UTD) and vaccine documentation were compared 6 months after recall. A mixed-effects model assessed the association between intervention and whether a child became UTD. Ten of 195 practices (5%) implemented recall in PCP-recall counties. Among children needing immunizations, 18.7% became UTD in Pop-recall versus 12.8% in PCP-recall counties (P immunization rates in preschool children.

A comparative study of the effect of soft and hard cervical collars on static postural

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Minoo Khalkhali Zavieh

2013-01-01

Full Text Available AbstractBackground and Aim: Using cervical collars is one of the treatment methods for releaving cervical pain. The effect of limb orthotics on proprioception and postural stability has been suggested. There is not sufficient studies about the effect of cervical collars on static and dynamic stability, and the effect of soft and hard collars have not been compared with one another. The objective of this study is investigating and comparing the immediate effect of soft and hard cervical collars on static postural stability in healthy young subjects. Methods & Materials: In standing position on firm surface with closed eyes, both soft and hard collars decreased the stability and there was not any significant difference among collars. In standing positions on soft surface with closed and opened eyes, using none of the soft and hard collars did not change the stability. This quasi experimental study through repeated measure method has been conducted on 65 healthy young male and female college students. Static stability was evaluated by modified Clinical Test for Sensory Interaction and Balance (CTSIB in conditions without collar and by soft and hard cervical collars and were compared between the conditions. Results: Conclusion: Our results suggest that in static conditions, without vision, both collars decrease the stability in healthy young subjects. So considering the evaluation of stability and prevention of balance disturbance during the collar prescription seems to be necessary.

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment.

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Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

2015-06-01

This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

Directory of Open Access Journals (Sweden)

Saeed Imani

2015-11-01

Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

Stakeholder engagement in comparative effectiveness research: how will we measure success?

Science.gov (United States)

Lavallee, Danielle C; Williams, Carla J; Tambor, Ellen S; Deverka, Patricia A

2012-09-01

Stakeholder engagement in comparative effectiveness research continues to gain national attention. While various methods are used to gather stakeholder expertise and form recommendations, evaluation of the stakeholder experience is often missing. The lack of evaluation prohibits assessing how effective and meaningful engagement practices are for enhancing research efforts and limits the ability to identify areas for future improvement. We propose that an evaluation plan of engagement processes be developed before stakeholder involvement begins and be required as part of a request for proposal or research grant where stakeholder input is being sought. Furthermore, we recommend the inclusion of six meta-criteria that represent normative goals of multiple studies: respect, trust, legitimacy, fairness, competence and accountability. To aid in the development of future evaluations, we have developed definitions for and matched specific examples of measuring each meta-criterion to serve a guide for others in the field.

75 FR 990 - HHS Intent To Publish Grant and Contract Solicitations for Comparative Effectiveness Research...

Science.gov (United States)

2010-01-07

... Prescription Drug, Improvement, and Modernization Act of 2003, (2) 100 Institute of Medicine topic... Coordinating Council for Comparative Effectiveness Research (FCC), and the Institute of Medicine Report on CER...

Establishing the infrastructure to conduct comparative effectiveness research toward the elimination of disparities: a community-based participatory research framework.

Science.gov (United States)

Wilson, Danyell S; Dapic, Virna; Sultan, Dawood H; August, Euna M; Green, B Lee; Roetzheim, Richard; Rivers, Brian

2013-11-01

In Tampa, Florida, researchers have partnered with community- and faith-based organizations to create the Comparative Effectiveness Research for Eliminating Disparities (CERED) infrastructure. Grounded in community-based participatory research, CERED acts on multiple levels of society to enhance informed decision making (IDM) of prostate cancer screening among Black men. CERED investigators combined both comparative effectiveness research and community-based participatory research to design a trial examining the effectiveness of community health workers and a digitally enhanced patient decision aid to support IDM in community settings as compared with "usual care" for prostate cancer screening. In addition, CERED researchers synthesized evidence through the development of systematic literature reviews analyzing the effectiveness of community health workers in changing knowledge, attitudes and behaviors of African American adults toward cancer prevention and education. An additional systematic review analyzed chemoprevention agents for prostate cancer as an emerging technique. Both of these reviews, and the comparative effectiveness trial supporting the IDM process, add to CERED's goal of providing evidence to eliminate cancer health disparities.

COMPARATIVE EFFECT OF STATIC AND DYNAMIC STRETCHING EXERCISE TO IMPROVE FLEXIBILITY OF HAMSTRING MUSCLES AMONG NON ATHLETES

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Jibi Paul

2014-10-01

Full Text Available Background: Stretching exercises have been routinely used in persons with hamstring tightness and athletes to increase flexibility of muscle and to reduce joint injuries. Many studies have reported effect of static and dynamic stretching on flexibility of this muscle. Finding the best method to improve flexibility of hamstring muscle is important for athletes and individuals to reduce their injuries. Objective of the study was to find out the effect of static stretching exercise and dynamic stretching exercise on flexibility of hamstring muscle and also to compare the effect of static and dynamic stretching exercise on flexibility of hamstring muscle. Methods: This was a comparative experimental study with seventy four female healthy subjects from physiotherapy department of KPJ Healthcare University College, Malaysia. Convenient sampling method used to select the samples. The subjects were selected by inclusion criteria and randomly divided equally in to two with 37 subjects in each group. Static stretching exercise and dynamic stretching exercise were given as intervention program for four weeks respectively for experimental and control group. Pre and post data of restricted range of movement for knee extension was measured using goniometry and documented separately for both group. Result: In experimental and control group, pre-post statistical analysis found significant effect in increase of hamstring flexibility with P<0.0001, for right and left side. Comparative study between experimental and control group found that static stretching exercise have significant effect in increase of hamstring flexibility for right and left side with P<0.04. Conclusion: This study concluded that static stretching exercise is more effective to improve hamstring flexibility compared to dynamic stretching exercise.

Assessing the comparative effectiveness of newly marketed medications: methodological challenges and implications for drug development.

Science.gov (United States)

Schneeweiss, S; Gagne, J J; Glynn, R J; Ruhl, M; Rassen, J A

2011-12-01

Comparative-effectiveness research (CER) aims to produce actionable evidence regarding the effectiveness and safety of medical products and interventions as they are used outside of controlled research settings. Although CER evidence regarding medications is particularly needed shortly after market approval, key methodological challenges include (i) potential bias due to channeling of patients to the newly marketed medication because of various patient-, physician-, and system-related factors; (ii) rapid changes in the characteristics of the user population during the early phase of marketing; and (iii) lack of timely data and the often small number of users in the first few months of marketing. We propose a mix of approaches to generate comparative-effectiveness data in the early marketing period, including sequential cohort monitoring with secondary health-care data and propensity score (PS) balancing, as well as extended follow-up of phase III and phase IV trials, indirect comparisons of placebo-controlled trials, and modeling and simulation of virtual trials.

Comparing Single Case Design Overlap-Based Effect Size Metrics from Studies Examining Speech Generating Device Interventions

Science.gov (United States)

Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

2016-01-01

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with…

Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

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Lau Darren

2010-09-01

Full Text Available Abstract Background Recently, several new endoscopic treatments have been used to treat patients with Barrett's esophagus with high grade dysplasia. This systematic review aimed to determine the safety and effectiveness of these treatments compared with esophagectomy. Methods A comprehensive literature search was undertaken to identify studies of endoscopic treatments for Barrett's esophagus or early stage esophageal cancer. Information from the selected studies was extracted by two independent reviewers. Study quality was assessed and information was tabulated to identify trends or patterns. Results were pooled across studies for each outcome. Safety (occurrence of adverse events and effectiveness (complete eradication of dysplasia were compared across different treatments. Results The 101 studies that met the selection criteria included 8 endoscopic techniques and esophagectomy; only 12 were comparative studies. The quality of evidence was generally low. Methods and outcomes were inconsistently reported. Protocols, outcomes measured, follow-up times and numbers of treatment sessions varied, making it difficult to calculate pooled estimates. The surgical mortality rate was 1.2%, compared to 0.04% in 2831 patients treated endoscopically (1 death. Adverse events were more severe and frequent with esophagectomy, and included anastomotic leaks (9.4%, wound infections (4.1% and pulmonary complications (4.1%. Four patients (0.1% treated endoscopically experienced bleeding requiring transfusions. The stricture rate with esophagectomy (5.3% was lower than with porfimer sodium photodynamic therapy (18.5%, but higher than aminolevulinic acid (ALA 60 mg/kg PDT (1.4%. Dysphagia and odynophagia varied in frequency across modalities, with the highest rates reported for multipolar electrocoagulation (MPEC. Photosensitivity, an adverse event that occurs only with photodynamic therapy, was experienced by 26.4% of patients who received porfimer sodium. Some

Randomized, Evaluator-Blinded Study Comparing Safety and Effect of Two Hyaluronic Acid Gels for Lips Enhancement.

Science.gov (United States)

Hilton, Said; Sattler, Gerhard; Berg, Anna-Karin; Samuelson, Ulf; Wong, Cindy

2018-02-01

Hyaluronic acid (HA) fillers may differ in terms of gel characteristics and ease of use and it is of interest whether this might affect safety and duration of effect. To compare the long-term safety and effect of 2 HA fillers produced by 2 different technologies for lip enhancement. Subjects with very thin to moderately thick lips were randomized and treated with HA-RK (N = 31) or HA-JV (N = 29) to improve lip fullness by ≥ 1 grade on a 5-point scale, using a maximum of 3 mL of product. A smaller volume of HA-RK compared with HA-JV was required to improve lip fullness by ≥ 1 grade (mean: 1.54 mL vs 1.94 mL, p < .001). Despite the smaller volume, lip fullness and global aesthetic improvement were comparably sustained in both groups. At 6 months, 60.0% versus 57.7% of subjects (HA-RK vs HA-JV) had improved lip fullness. At 12 months, 71.4% versus 76.0% had aesthetic improvement (blinded evaluations) and 85.7% versus 86.2% felt more attractive. Both products were well tolerated. Both products achieved durable improvement in lip fullness and aesthetic appearance. A significantly smaller amount of HA-RK was required compared with HA-JV to achieve optimal treatment effect.

Firm insoles effectively reduce hemolysis in runners during long distance running - a comparative study.

Science.gov (United States)

Janakiraman, Kamal; Shenoy, Shweta; Sandhu, Jaspal Singh

2011-06-09

Shock absorbing insoles are effective in reducing the magnitude and rate of loading of peak impact forces generated at foot strike during running, whereas the foot impact force during running has been considered to be an important cause of intravascular hemolysis in long distance runners. Objective of this study was to evaluate the intravascular hemolysis during running and compare the effect of two different types of insoles (Soft and Firm) on hemolysis. Twenty male long and middle distance runners volunteered to participate in this study. We selected two insoles (Soft and Firm) according to their hardness level (SHORE 'A' scale). Participants were randomly assigned to the soft insole (group 1) and firm insole (group 2) group with ten athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjucated bilirubin (mg/dl), lactate dehydrogenase (μ/ml), hemoglobin (g/l) and serum ferritin (ng/ml) as indicators of hemolysis. Our study revealed a significant increase in the mean values of unconjucated bilirubin (P firm insoles effectively reduces the amount of hemolysis in runners compared to soft insoles.

Comparing the Effectivities of Chitosan Citrate and Chitosan Acetate in Eradicating Enterococcus faecalis Biofilm

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Uppalavanna Witedja

2018-01-01

Full Text Available Introduction: Adequate biomechanical preparations, antibacterial irrigants, and intracanal medications to promote the elimination of bacteria and their products are required to succeed root canal treatment. Enterococcus faecalis with its biofilm is known as an important etiological agent in endodontic treatment failures. Chitosan, as a natural product, has an antibacterial activity and is considered less toxic to the periapical tissue than other irrigants. However, the use of this natural product needs to be examined to determine its effectiveness as a root canal irrigant in endodontic treatment; this can be done by comparing it with the most common endodontic irrigant (NaOCl 5.25% as a positive control. Objective: The objective of the study was to compare the effectiveness between 1–3% chitosan acetate (CA and 1–3% chitosan citrate (CC against E. faecalis biofilm formation after treatment for 15, 30, and 60 minutes. Methods: The study was conducted using 12 groups, including 1–3% CA, 1–3% CC, and control groups. E. faecalis biofilms in 96-well plates were exposed to each sample for 15, 30, or 60 minutes. Subsequently, the biofilms were stained with crystal violet solution, and the optical density value was measured using a microtiter plate reader at a wavelength of 600nm. Results: CA and CC were effective in eradicating E. faecalis biofilm. However, the levels of effectiveness of CC and CA depended on the concentration and application time. Three-way analysis of variance (ANOVA showed a significant difference between the irrigants (F = 5.92; p<0.05 and three application times (F = 6.50; p< 0.05. The CA was effective in eradicating biofilm after 15 minutes of application, whereas the CC was more effective after 30 and 60 minutes of application. Conclusion: CC and CA are both effective in eradicating E. faecalis biofilm.

Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

Science.gov (United States)

Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

2015-03-01

To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

Cost-effectiveness analysis of left atrial appendage occlusion compared with pharmacological strategies for stroke prevention in atrial fibrillation.

Science.gov (United States)

Lee, Vivian Wing-Yan; Tsai, Ronald Bing-Ching; Chow, Ines Hang-Iao; Yan, Bryan Ping-Yen; Kaya, Mehmet Gungor; Park, Jai-Wun; Lam, Yat-Yin

2016-08-31

Transcatheter left atrial appendage occlusion (LAAO) is a promising therapy for stroke prophylaxis in non-valvular atrial fibrillation (NVAF) but its cost-effectiveness remains understudied. This study evaluated the cost-effectiveness of LAAO for stroke prophylaxis in NVAF. A Markov decision analytic model was used to compare the cost-effectiveness of LAAO with 7 pharmacological strategies: aspirin alone, clopidogrel plus aspirin, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban. Outcome measures included quality-adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratios (ICERs). Base-case data were derived from ACTIVE, RE-LY, ARISTOTLE, ROCKET-AF, PROTECT-AF and PREVAIL trials. One-way sensitivity analysis varied by CHADS2 score, HAS-BLED score, time horizons, and LAAO costs; and probabilistic sensitivity analysis using 10,000 Monte Carlo simulations was conducted to assess parameter uncertainty. LAAO was considered cost-effective compared with aspirin, clopidogrel plus aspirin, and warfarin, with ICER of US$5,115, $2,447, and $6,298 per QALY gained, respectively. LAAO was dominant (i.e. less costly but more effective) compared to other strategies. Sensitivity analysis demonstrated favorable ICERs of LAAO against other strategies in varied CHADS2 score, HAS-BLED score, time horizons (5 to 15 years) and LAAO costs. LAAO was cost-effective in 86.24 % of 10,000 simulations using a threshold of US$50,000/QALY. Transcatheter LAAO is cost-effective for prevention of stroke in NVAF compared with 7 pharmacological strategies. The transcatheter left atrial appendage occlusion (LAAO) is considered cost-effective against the standard 7 oral pharmacological strategies including acetylsalicylic acid (ASA) alone, clopidogrel plus ASA, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban for stroke prophylaxis in non-valvular atrial fibrillation management.

Comparative effects of gamma-rays and electron beams on peroxide formation in phosphatidylcholine

International Nuclear Information System (INIS)

Todoriki, S.; Hayashi, T.

1994-01-01

Phosphatidylcholine was irradiated in the state of a film or liposome with gamma-rays or electron beams, and the amount of peroxide was determined to compare the effects of the two types of radiation. The amounts of peroxide formed in both the film and liposome with gamma-rays were significantly larger than those with electron beams, when the samples were irradiated at the same dose. Proteins such as bacteriorhodopsin reduced the degree of peroxide formation in liposome, and the effect of gamma-rays was much larger than that of electron beams, even in the presence of protein. The results of the present investigation indicate that the effects of gamma-rays on peroxide formation in phosphatidylcholine were significantly larger than those of electron beams, irrespective of the state of the lipid

Effect of S186 for decoporated radiostrontium compared with BADE in rats

International Nuclear Information System (INIS)

Zhang Meizhen; Luo Meichu; Chen Guibao; Liu Shijing; Tong Shungao; Sun Meizhen

1995-01-01

The efficacy of S186 for decorporated radiostrontium compared with BADE in rats was studied. The experimental results showed that administered S186 (in 100∼800 mg/kg) increased the 85+89 Sr excretion in urine and reduced 85+89 Sr retention in body being distinctly superior to that of the equal dose BADE (P<0.05). When administered the dose of S186 that was the half dose of BADE could produce the same effect of BADE for removing radiostrontium

A CTSA Agenda to Advance Methods for Comparative Effectiveness Research

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Helfand, Mark; Tunis, Sean; Whitlock, Evelyn P.; Pauker, Stephen G.; Basu, Anirban; Chilingerian, Jon; Harrell Jr., Frank E.; Meltzer, David O.; Montori, Victor M.; Shepard, Donald S.; Kent, David M.

2011-01-01

Abstract Clinical research needs to be more useful to patients, clinicians, and other decision makers. To meet this need, more research should focus on patient‐centered outcomes, compare viable alternatives, and be responsive to individual patients’ preferences, needs, pathobiology, settings, and values. These features, which make comparative effectiveness research (CER) fundamentally patient‐centered, challenge researchers to adopt or develop methods that improve the timeliness, relevance, and practical application of clinical studies. In this paper, we describe 10 priority areas that address 3 critical needs for research on patient‐centered outcomes (PCOR): (1) developing and testing trustworthy methods to identify and prioritize important questions for research; (2) improving the design, conduct, and analysis of clinical research studies; and (3) linking the process and outcomes of actual practice to priorities for research on patient‐centered outcomes. We argue that the National Institutes of Health, through its clinical and translational research program, should accelerate the development and refinement of methods for CER by linking a program of methods research to the broader portfolio of large, prospective clinical and health system studies it supports. Insights generated by this work should be of enormous value to PCORI and to the broad range of organizations that will be funding and implementing CER. Clin Trans Sci 2011; Volume 4: 188–198 PMID:21707950

Comparative Effectiveness of After-School Programs to Increase Physical Activity

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Sabina B. Gesell

2013-01-01

Full Text Available Background. We conducted a comparative effectiveness analysis to evaluate the difference in the amount of physical activity children engaged in when enrolled in a physical activity-enhanced after-school program based in a community recreation center versus a standard school-based after-school program. Methods. The study was a natural experiment with 54 elementary school children attending the community ASP and 37 attending the school-based ASP. Accelerometry was used to measure physical activity. Data were collected at baseline, 6 weeks, and 12 weeks, with 91% retention. Results. At baseline, 43% of the multiethnic sample was overweight/obese, and the mean age was 7.9 years (SD = 1.7. Linear latent growth models suggested that the average difference between the two groups of children at Week 12 was 14.7 percentage points in moderate-vigorous physical activity (P<.001. Cost analysis suggested that children attending traditional school-based ASPs—at an average cost of $17.67 per day—would need an additional daily investment of $1.59 per child for 12 weeks to increase their moderate-vigorous physical activity by a model-implied 14.7 percentage points. Conclusions. A low-cost, alternative after-school program featuring adult-led physical activities in a community recreation center was associated with increased physical activity compared to standard-of-care school-based after-school program.

Effectiveness testing of some vegetal extracts comparing with clasical anthelmintics

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Ilie M.S.,

2007-12-01

Full Text Available We have tested the efficacy of some vegetal extracts (Parazitol –Medica Laboratories, a natural product with an anthelmintic effect and a Cucurbita sp. oil extract compared to the classic anthelmintics (Rombendazol – Romvac and Dehelman – KRKA Slovenia at domestic poultry, whose parasitical status had been previously established through animal killing and necropsies. Parazitol and the pumpkin oil have had a lower efficacy than the levamisole and albendazole upon the species Ascaridia galli. Heterakis gallinarum was not affected by the pumpkin oil. Parazitol have a moderate efficacy (36%, while levamisole and albendazole were very efficient (100%. The treatments with albendazole upon the cestods belonging to the genus Raillietina have had a 100% efficacy. In cestods, Parazitol had a better efficacy (57% than the pumpkin oil (14%.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations

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Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-01-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438

Pharmacokinetics in Mouse and Comparative Effects of Frondosides in Pancreatic Cancer

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Jasem Al Shemaili

2016-06-01

Full Text Available The frondosides are triterpenoid glycosides from the Atlantic sea cucumber Cucumaria frondosa. Frondoside A inhibits growth, invasion, metastases and angiogenesis and induces apoptosis in diverse cancer types, including pancreatic cancer. We compared the growth inhibitory effects of three frondosides and their aglycone and related this to the pharmocokinetics and route of administration. Frondoside A potently inhibited growth of pancreatic cancer cells with an EC50 of ~1 µM. Frondoside B was less potent (EC50 ~2.5 µM. Frondoside C and the aglycone had no effect. At 100 µg/kg, frondoside A administered to CD2F1 mice as an i.v. bolus, the Cpmax was 129 nM, Cltb was 6.35 mL/min/m2, and half-life was 510 min. With i.p. administration the Cpmax was 18.3 nM, Cltb was 127 mL/min/m2 and half-life was 840 min. Oral dosing was ineffective. Frondoside A (100 µg/kg/day i.p. markedly inhibited growth cancer xenografts in nude mice. The same dose delivered by oral gavage had no effect. No evidence of acute toxicity was seen with frondoside A. Frondoside A is more potent inhibitor of cancer growth than other frondosides. The glycoside component is essential for bioactivity. Frondoside A is only effective when administered systemically. Based on the current and previous studies, frondoside A appears safe and may be valuable in the treatment of cancer.

Investigation of comparative effectiveness research in Asia, Europe, and North America.

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Patel, Isha; Rarus, Rachel; Tan, Xi; Lee, E K; Guy, Jason; Ahmad, Akram; Chang, Jongwha

2015-01-01

Comparative effectiveness research (CER) is an important branch of pharmacoeconomics that systematically studies and evaluates the cost-effectiveness of medical interventions. CER plays instrumental roles in guiding government public health policy programs and insurance. Countries throughout the world use different methods of CER to help make medical decisions based on providing optimal therapy at a reduced cost. Expenses to the healthcare system continue to rise, and CER is one-way in which expenses could be curbed in the future by applying cost-effectiveness evidence to clinical decisions. China, India, South Korea, and the United Kingdom are of essential focus because these country's economies and health care expenses continue to expand. The structures and use of CER are diverse throughout these countries, and each is of prime importance. By conducting this thorough comparison of CER in different nations, strategies and organizational setups from different countries can be applied to help guide public health and medical decision-making in order to continue to expand the establishment and role of CER programs. The patient-centered medical home has been created to help reduce costs in the primary care sector and to help improve the effectiveness of therapy. Barriers to CER are also important as many stakeholders need to be able to work together to provide the best CER evidence. The advancement of CER in multiple countries throughout the world provides a possible way of reducing costs to the healthcare system in an age of expanding expenses.

Comparing the effects of aerobic exercise and Foeniculum vulgare on pre-menstrual syndrome

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Hassan Pazoki

2016-03-01

Full Text Available Introduction: Premenstrual syndrome (PMS has been identified by a number of psychological and physical symptoms which occur cyclically in the luteal phase of the menstrual cycle. The present study has been carried out to compare the effects of regular exercise and Foeniculum vulgare extract (fennel together and separately on PMS in high school girls. Materials and methods: In this randomized clinical trial 48 students aged 16–18 years were selected by filling the daily record of severity of problem questionnaire (DRSP-Q. The participants were divided into four equal groups: the first group received fennel, the second group had aerobic exercise, the third group received fennel along with exercise and the last group was control group without fennel and exercise. Participants filled DRSP-Q three times: the first menstrual cycle before the intervention, the first menstrual cycle after four weeks and finally the first menstrual cycle after eight weeks of intervention. Results: After 8 weeks of intervention the severity of PMS symptoms reduced significantly in experimental groups (fennel, exercise and fennel + exercise compared to control group (P < 0.05. Meanwhile, there were not any significant differences in age, body mass index, age at menarche, age at dysmenorrhea onset and duration of menstruation among the four groups. Discussions: The result of this study indicated that fennels and exercise could reduce the severity of premenstrual syndrome. In addition, fennel extract and exercise together seem to be more effective on symptoms of anxiety and depression compared with using them alone.

Relations and effects of transformational leadership: a comparative analysis with traditional leadership styles.

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Molero, Fernando; Cuadrado, Isabel; Navas, Marisol; Morales, J Francisco

2007-11-01

This study has two main goals: (a) to compare the relationship between transformational leadership and other important leadership styles (i.e., democratic versus autocratic or relations- and task-oriented leadership) and (b) to compare the effects of transformational leadership and the other styles on some important organizational outcomes such as employees' satisfaction and performance. For this purpose, a sample of 147 participants, working in 35 various work-teams, was used. Results show high correlations between transformational leadership, relations-oriented, democratic, and task-oriented leadership. On the other hand, according to the literature, transformational leadership, especially high levels, significantly increases the percentage of variance accounted for by other leadership styles in relevant organizational outcome variables (subordinates' performance, satisfaction and extra effort).

Comparative analysis of nonperturbative effects in B→Xulνl decays

International Nuclear Information System (INIS)

Kniehl, Bernd A.; Kramer, Gustav; Yang Jifeng

2007-01-01

In order to extract the Cabibbo-Kobayashi-Maskawa matrix element |V ub | from B→X u lν l decays, the overwhelming background from B→X c lν l decays must be reduced by appropriate acceptance cuts. We study the nonperturbative effects due to the motion of the b quark inside the B meson on the phenomenologically relevant decay distributions of B→X u lν l in the presence of such cuts in a comparative analysis based on shape functions and the parton model in the light cone limit. Comparisons with recent data from the CLEO, BABAR, and BELLE collaborations favor the shape-function approach

A Comparative Study on Power Point Presentation and Traditional Lecture Method in Material Understandability, Effectiveness and Attitude

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Sewasew, Daniel; Mengestle, Missaye; Abate, Gebeyehu

2015-01-01

The aim of this study was to compare PPT and traditional lecture method in material understandability, effectiveness and attitude among university students. Comparative descriptive survey research design was employed to answer the research questions raised. Four hundred and twenty nine participants were selected randomly using stratified sampling…

Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

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Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

2013-01-01

Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

Targeted Therapies Compared to Dacarbazine for Treatment of BRAFV600E Metastatic Melanoma: A Cost-Effectiveness Analysis

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Vanessa Shih

2015-01-01

Full Text Available Purpose. Two BRAFV600E targeted therapies, dabrafenib and vemurafenib, have received US approval for treatment of metastatic melanoma in BRAFV600E patients, a mutation that affects ~50% of patients. We evaluated the cost-effectiveness of BRAF inhibitors and traditional chemotherapy for treatment of metastatic melanoma. Methods. A Markov model was developed using a societal perspective. Transition probabilities were derived from two Phase III registration trials comparing each BRAF inhibitor against dacarbazine. Costs were obtained from literature, national databases, and Medicare fee schedules. Utilities were obtained from published literature. Deterministic and probabilistic sensitivity analyses were run to test the impact of uncertainties. Results. The incremental cost-effectiveness ratio of dabrafenib was $149,035/QALY compared to dacarbazine. Vemurafenib was dominated by dabrafenib. Probabilistic sensitivity analysis showed that, at a willingness-to-pay (WTP threshold of ≤$100,000/QALY, dacarbazine was the optimal treatment in ~85% of simulations. At a WTP threshold of ≥$150,000/QALY, dabrafenib was the optimal treatment. Conclusion. Compared with dacarbazine, dabrafenib and vemurafenib were not cost-effective at a willingness-to-pay threshold of $100,000/QALY. Dabrafenib is more efficient compared to vemurafenib. With few treatment options, dabrafenib is an option for qualifying patients if the overall cost of dabrafenib is reduced to $30,000–$31,000 or a WTP threshold of ≥$150,000/QALY is considered. More comparative data is needed.

The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy.

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Wong, Martin C S; Ching, Jessica Y L; Chan, Victor C W; Sung, Joseph J Y

2015-09-04

Faecal immunochemical tests (FITs) and colonoscopy are two common screening tools for colorectal cancer(CRC). Most cost-effectiveness studies focused on survival as the outcome, and were based on modeling techniques instead of real world observational data. This study evaluated the cost-effectiveness of these two tests to detect colorectal neoplastic lesions based on data from a 5-year community screening service. The incremental cost-effectiveness ratio (ICER) was assessed based on the detection rates of neoplastic lesions, and costs including screening compliance, polypectomy, colonoscopy complications, and staging of CRC detected. A total of 5,863 patients received yearly FIT and 4,869 received colonoscopy. Compared with FIT, colonoscopy detected notably more adenomas (23.6% vs. 1.6%) and advanced lesions or cancer (4.2% vs. 1.2%). Using FIT as control, the ICER of screening colonoscopy in detecting adenoma, advanced adenoma, CRC and a composite endpoint of either advanced adenoma or stage I CRC was US$3,489, US$27,962, US$922,762 and US$23,981 respectively. The respective ICER was US$3,597, US$439,513, -US$2,765,876 and US$32,297 among lower-risk subjects; whilst the corresponding figure was US$3,153, US$14,852, US$184,162 and US$13,919 among higher-risk subjects. When compared to FIT, colonoscopy is considered cost-effective for screening adenoma, advanced neoplasia, and a composite endpoint of advanced neoplasia or stage I CRC.

A meta-analysis of the effectiveness of albendazole compared with metronidazole as treatments for infections with Giardia duodenalis.

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Shahram Solaymani-Mohammadi

2010-05-01

Full Text Available Metronidazole is the most commonly used drug for the treatment of giardiasis in humans. In spite of its therapeutic efficacy for giardiasis, low patient compliance, especially in children, side effects, and the emergence of metronidazole-resistant strains may restrict its use. Albendazole has been used to treat Giardia duodenalis infections in recent years. However, efficacy studies in vivo and in vitro have produced diverse results as to its effectiveness. A moderately benign side effect profile, combined with established efficacy against many helminths, renders it promising for treatment of giardiasis in humans.We performed a search in the PubMed, Scopus, EMBASE, the ISI Web of Science, LILIACS, and Cochrane Controlled Trials Register for trials published before February 2010 as well as in references of relevant research and review articles. Eight randomized clinical trials (including 900 patients comparing the effectiveness of albendazole with that of metronidazole were included in meta-analysis. After extracting and validating the data, the pooled risk ratio (RR was calculated using an inverse-variance random-effects model. Albendazole was found to be equally as effective as metronidazole in the treatment of giardiasis in humans (RR 0.97; 95% CI, 0.93, 1.01. In addition, safety analysis suggested that patients treated with albendazole had a lower risk of adverse effects compared with those who received metronidazole (RR 0.36; 95% CI, 0.10, 1.34, but limitations of the sample size precluded a definite conclusion.The effectiveness of albendazole, when given as a single dose of 400 mg/day for 5 days, was comparable to that of metronidazole. Patients treated with albendazole tended to have fewer side effects compared with those who took metronidazole. Given the safety, effectiveness, and low costs of albendazole, this drug could be potentially used as an alternative and/or a replacement for the existing metronidazole therapy protocols in the

The Varied Educational Effects of Parent-Child Communication: A Comparative Study of Fourteen Countries

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Park, Hyunjoon

2008-01-01

In this article, the author compares the ways in which parent-child communication--a major indicator of parental involvement--influences children's educational achievement across 14 countries. Using data from the Programme for International Student Assessment (PISA), the author examines the extent to which social class differences in the effect of…

What Are the Perceived Effects of Telecollaboration Compared to Other Communication-Scenarios with Peers?

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Nissen, Elke

2016-01-01

What are the perceived effects of Telecollaboration (TC), compared to other types of communication-scenarios with peers (i.e. local peers in small groups and Erasmus students abroad)? This is the question this exploratory study tackles within a blended language learning course. The analysis of students' perceptions paints a rather contrastive…

comparative study on the effects of cadmium and gamma radiation on three aspergillus species

International Nuclear Information System (INIS)

Adam, Y.M.; Abulyazid, I.; Fathi, I.A.

2004-01-01

The effect of cadmium on the ability of fungi to survive in the rhizosphere of Ambrosia miritima plant at different concentrations was studied. With respect to the frequency of occurrence of Aspergillus species in the field even at the highest Cd concentration, the following sequence of decreasing tolerance to Cd was obtained: A. tamarii > A. sydowi > A. niger. On studying the effect of different concentrations of Cd in vitro culture on the growth parameters (dry weight and mycelial linear growth) of these three selected fungi, it was noticed that the most tolerant fungus was A. tamarii, while A. sydowi was moderately tolerant and A. niger was sensitive to the effect of Cd. Amino acids analysis revealed that Cd treatment was accompanied with increasing in the total free amino acids contents of both A. tamarii and A. sydowi compared to A. niger cells, where a reduction in this component was observed. Moreover, SDS-PAGE indicated high content of protein under Cd stress compared to non-treated culture of both A. tamarii and A. sydowi. In contrast, a decrease in protein content in Cd-treated cells of A. niger was recorded. Furthermore, SDS-PAGE revealed that Cd treated fungal cells of A. tamarii can synthesized new three stress proteins (hsp 's) while A. sydowi synthesized new four stress proteins. In cell culture of A. niger, cadmium induced new four stress proteins. Regarding the nucleic acids (RNA and DNA) content, it is clear that presence of Cd led to significant decrease in the RNA contents of the three tested fungi, while only the DNA content of A. niger was significantly decreased by Cd treatment compared to the corresponding control. The data also showed that Cd-gamma radiation combination acted synergistically at the low doses of gamma radiation, while an antagonistic effect was recorded at the higher one for both A. tamarii and A. sydowi. Both treatments acted synergistically at all doses of gamma radiation on the growth of A. niger

The Economic Effects of Cognitive and Educational Differences Among Low-Ability and Blue-Collar Origin Men: A Comparative Analysis.

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Olneck, Michael R.

This study used five data sets to investigate the effects of measured cognitive skills on educational attainment, and the effects of cognitive skills and educational attainment on occupational status and earning among men with low test scores, as compared to men with high test scores, and among men with blue-collar fathers, as compared to men with…

Stigma, Discrimination, Treatment Effectiveness and Policy Support: Comparing Public Views about Drug Addiction with Mental Illness

Science.gov (United States)

Barry, Colleen L; McGinty, Emma Elizabeth; Pescosolido, Bernice; Goldman, Howard H.

2014-01-01

Objective This study compares current public attitudes about drug addiction with attitudes about mental illness. Methods A web-based national public opinion survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support. Results Respondents hold significantly more negative views toward persons with drug addiction compared to those with mental illness. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them on a job. Respondents were more willing to accept discriminatory practices, more skeptical about the effectiveness of available treatments, and more likely to oppose public policies aimed at helping persons with drug addiction. Conclusions Drug addiction is often treated as a sub-category of mental illness, and health insurance benefits group these conditions together under the rubric of behavioral health. Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches for advancing stigma reduction and public policy. PMID:25270497

SU-E-J-192: Comparative Effect of Different Respiratory Motion Management Systems

Energy Technology Data Exchange (ETDEWEB)

Nakajima, Y; Kadoya, N; Ito, K; Kanai, T; Jingu, K [Tohoku University School of Medicine, Sendai, Miyagi (Japan); Kida, S [Tohoku University Hospital, Sendai City, Miyagi (Japan); Kishi, K; Sato, K [Tohoku University Hospital, Sendai, Miyagi (Japan); Dobashi, S; Takeda, K [Tohoku University, Sendai, Miyagi (Japan)

2015-06-15

Purpose: Irregular breathing can influence the outcome of four-dimensional computed tomography imaging for causing artifacts. Audio-visual biofeedback systems associated with patient-specific guiding waveform are known to reduce respiratory irregularities. In Japan, abdomen and chest motion self-control devices (Abches), representing simpler visual coaching techniques without guiding waveform are used instead; however, no studies have compared these two systems to date. Here, we evaluate the effectiveness of respiratory coaching to reduce respiratory irregularities by comparing two respiratory management systems. Methods: We collected data from eleven healthy volunteers. Bar and wave models were used as audio-visual biofeedback systems. Abches consisted of a respiratory indicator indicating the end of each expiration and inspiration motion. Respiratory variations were quantified as root mean squared error (RMSE) of displacement and period of breathing cycles. Results: All coaching techniques improved respiratory variation, compared to free breathing. Displacement RMSEs were 1.43 ± 0.84, 1.22 ± 1.13, 1.21 ± 0.86, and 0.98 ± 0.47 mm for free breathing, Abches, bar model, and wave model, respectively. Free breathing and wave model differed significantly (p < 0.05). Period RMSEs were 0.48 ± 0.42, 0.33 ± 0.31, 0.23 ± 0.18, and 0.17 ± 0.05 s for free breathing, Abches, bar model, and wave model, respectively. Free breathing and all coaching techniques differed significantly (p < 0.05). For variation in both displacement and period, wave model was superior to free breathing, bar model, and Abches. The average reduction in displacement and period RMSE compared with wave model were 27% and 47%, respectively. Conclusion: The efficacy of audio-visual biofeedback to reduce respiratory irregularity compared with Abches. Our results showed that audio-visual biofeedback combined with a wave model can potentially provide clinical benefits in respiratory management

SU-E-J-192: Comparative Effect of Different Respiratory Motion Management Systems

International Nuclear Information System (INIS)

Nakajima, Y; Kadoya, N; Ito, K; Kanai, T; Jingu, K; Kida, S; Kishi, K; Sato, K; Dobashi, S; Takeda, K

2015-01-01

Purpose: Irregular breathing can influence the outcome of four-dimensional computed tomography imaging for causing artifacts. Audio-visual biofeedback systems associated with patient-specific guiding waveform are known to reduce respiratory irregularities. In Japan, abdomen and chest motion self-control devices (Abches), representing simpler visual coaching techniques without guiding waveform are used instead; however, no studies have compared these two systems to date. Here, we evaluate the effectiveness of respiratory coaching to reduce respiratory irregularities by comparing two respiratory management systems. Methods: We collected data from eleven healthy volunteers. Bar and wave models were used as audio-visual biofeedback systems. Abches consisted of a respiratory indicator indicating the end of each expiration and inspiration motion. Respiratory variations were quantified as root mean squared error (RMSE) of displacement and period of breathing cycles. Results: All coaching techniques improved respiratory variation, compared to free breathing. Displacement RMSEs were 1.43 ± 0.84, 1.22 ± 1.13, 1.21 ± 0.86, and 0.98 ± 0.47 mm for free breathing, Abches, bar model, and wave model, respectively. Free breathing and wave model differed significantly (p < 0.05). Period RMSEs were 0.48 ± 0.42, 0.33 ± 0.31, 0.23 ± 0.18, and 0.17 ± 0.05 s for free breathing, Abches, bar model, and wave model, respectively. Free breathing and all coaching techniques differed significantly (p < 0.05). For variation in both displacement and period, wave model was superior to free breathing, bar model, and Abches. The average reduction in displacement and period RMSE compared with wave model were 27% and 47%, respectively. Conclusion: The efficacy of audio-visual biofeedback to reduce respiratory irregularity compared with Abches. Our results showed that audio-visual biofeedback combined with a wave model can potentially provide clinical benefits in respiratory management

Cost-effectiveness of endobronchial valve treatment in patients with severe emphysema compared to standard medical care.

Science.gov (United States)

Hartman, Jorine E; Klooster, Karin; Groen, Henk; Ten Hacken, Nick H T; Slebos, Dirk-Jan

2018-03-25

Bronchoscopic lung volume reduction using endobronchial valves (EBV) is an effective new treatment option for severe emphysema patients without interlobar collateral ventilation. The objective of this study was to perform an economic evaluation including the costs and cost-effectiveness of EBV treatment compared with standard medical care (SoC) from the hospital perspective in the short term and long term. For the short-term evaluation, incremental cost-effectiveness ratios (ICER) were calculated based on the 6-month end point data from the STELVIO randomized trial. For the long-term evaluation, a Markov simulation model was constructed based on STELVIO and literature. The clinical outcome data were quality-adjusted life-years (QALY) based on the EuroQol5-Dimensions (EQ5D) questionnaire, the 6-min walking distance (6MWD) and the St George's Respiratory Questionnaire (SGRQ). The mean difference between the EBV group and controls was €16 721/patient. In the short-term (6 months), costs per additional QALY was €205 129, the ICER for 6MWD was €160 and for SGRQ was €1241. In the long term, the resulting cost-effectiveness ratios indicate additional costs of €39 000 per QALY gained with a 5-year time horizon and €21 500 per QALY gained at 10 years. In comparison, historical costs per additional QALY 1 year after the coil treatment are €738 400, 5 years after lung volume reduction surgery are €48 415 and 15 years after double-lung transplantation are €29 410. The positive clinical effects of EBV treatment are associated with increased costs compared with SoC. Our results suggest that the EBV treatment has a favourable cost-effectiveness profile, also when compared with other treatment modalities for this patient group. © 2018 Asian Pacific Society of Respirology.

Neural signature of tDCS, tPCS and their combination: Comparing the effects on neural plasticity

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Thibaut, Aurore; Russo, Cristina; Morales-Quezada, Leon; Hurtado-Puerto, Aura; Deitos, Alícia; Freedman, Steven; Carvalho, Sandra; Fregni, Felipe

2017-01-01

Transcranial pulsed current stimulation (tPCS) and transcranial direct current stimulation (tDCS) are two noninvasive neuromodulatory brain stimulation techniques whose effects on human brain and behavior have been studied individually. In the present study we aimed to quantify the effects of tDCS and tPCS, individually and in combination, on cortical activity, sensitivity and pain-related assessments in healthy individuals in order to understand their neurophysiological mechanisms and potential applications in clinical populations. A total of 48 healthy individuals participated in this randomized double blind sham controlled study. Participants were randomized to receive a single stimulation session of either: active or sham tPCS and active or sham tDCS. Quantitative electroencephalography (qEEG), sensitivity and pain assessments were used before and after each stimulation session. We observed that tPCS had a higher effect on power, as compared to tDCS, in several bandwidths on various cortical regions: the theta band in the parietal region (p = 0.021), the alpha band in the temporal (p = 0.009), parietal (p = 0.0063), and occipital (p tDCS significantly decreased power in the low beta bandwidth of the frontal (p = 0.0006), central (p = 0.0001), and occipital (p = 0.0003) regions, when compared to sham stimulation. Additionally, tDCS significantly increased power in high beta over the temporal (p = 0.0015) and parietal (p = 0.0007) regions, as compared to sham. We found no effect on sensitivity or pain-related assessments. We concluded that tPCS and tDCS have different neurophysiological mechanisms, elicit distinct signatures, and that the combination of the two leads to no effect or a decrease on qEEG power. Further studies are required to examine the effects of these techniques on clinical populations in which EEG signatures have been found altered. PMID:27765610

Comparative effectiveness of long term drug treatment strategies to prevent asthma exacerbations: network meta-analysis

NARCIS (Netherlands)

Loymans, Rik J. B.; Gemperli, Armin; Cohen, Judith; Rubinstein, Sidney M.; Sterk, Peter J.; Reddel, Helen K.; Jüni, Peter; ter Riet, Gerben

2014-01-01

To determine the comparative effectiveness and safety of current maintenance strategies in preventing exacerbations of asthma. Systematic review and network meta-analysis using Bayesian statistics. Cochrane systematic reviews on chronic asthma, complemented by an updated search when appropriate.

Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.

Science.gov (United States)

Kahwati, Leila; Viswanathan, Meera; Golin, Carol E; Kane, Heather; Lewis, Megan; Jacobs, Sara

2016-05-04

Interventions to improve medication adherence are diverse and complex. Consequently, synthesizing this evidence is challenging. We aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. We used data from 60 studies in a completed systematic review to examine the combinations of nine behavior change techniques (increasing knowledge, increasing awareness, changing attitude, increasing self-efficacy, increasing intention formation, increasing action control, facilitation, increasing maintenance support, and motivational interviewing) among studies demonstrating improvements in adherence. Among the 60 studies, 34 demonstrated improved medication adherence. Among effective studies, increasing patient knowledge was a necessary but not sufficient technique. We identified seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 %) of the effective studies. The intervention configuration that included increasing knowledge and self-efficacy was the most empirically relevant, accounting for 17 studies (50 %) and uniquely accounting for 15 (44 %). This analysis extends the completed review findings by identifying multiple combinations of behavior change techniques that improve adherence. Our findings offer direction for policy makers, practitioners, and future comparative effectiveness research on improving adherence.

The metabolic and performance effects of caffeine compared to coffee during endurance exercise.

Science.gov (United States)

Hodgson, Adrian B; Randell, Rebecca K; Jeukendrup, Asker E

2013-01-01

There is consistent evidence supporting the ergogenic effects of caffeine for endurance based exercise. However, whether caffeine ingested through coffee has the same effects is still subject to debate. The primary aim of the study was to investigate the performance enhancing effects of caffeine and coffee using a time trial performance test, while also investigating the metabolic effects of caffeine and coffee. In a single-blind, crossover, randomised counter-balanced study design, eight trained male cyclists/triathletes (Mean ± SD: Age 41 ± 7 y, Height 1.80 ± 0.04 m, Weight 78.9 ± 4.1 kg, VO2 max 58 ± 3 ml • kg(-1) • min(-1)) completed 30 min of steady-state (SS) cycling at approximately 55% VO2max followed by a 45 min energy based target time trial (TT). One hour prior to exercise each athlete consumed drinks consisting of caffeine (5 mg CAF/kg BW), instant coffee (5 mg CAF/kg BW), instant decaffeinated coffee or placebo. The set workloads produced similar relative exercise intensities during the SS for all drinks, with no observed difference in carbohydrate or fat oxidation. Performance times during the TT were significantly faster (~5.0%) for both caffeine and coffee when compared to placebo and decaf (38.35 ± 1.53, 38.27 ± 1.80, 40.23 ± 1.98, 40.31 ± 1.22 min respectively, pperformance times were similar for both caffeine and coffee. Average power for caffeine and coffee during the TT was significantly greater when compared to placebo and decaf (294 ± 21 W, 291 ± 22 W, 277 ± 14 W, 276 ± 23 W respectively, pcaffeine (5 mg/kg/BW) and coffee (5 mg/kg/BW) consumed 1 h prior to exercise can improve endurance exercise performance.

Comparative Effect of Memory and Cognitive Strategies Training on EFL Intermediate Learners' Vocabulary Learning

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Banisaeid, Maryam

2013-01-01

The present study was conducted to compare the effect of memory and cognitive strategies training on vocabulary learning of intermediate proficiency group of Iranian learners of English as a foreign language. It is to check how memory and cognitive strategies training affect word learning of EFL intermediate learners (N = 60) who were homogenized…

A Study of the Comparative Effectiveness of Zoology Prerequisites at Slippery Rock State College.

Science.gov (United States)

Morrison, William Sechler

This study compared the effectiveness of three sequences of prerequisite courses required before taking zoology. Sequence 1 prerequisite courses consisted of general biology and human biology; Sequence 2 consisted of general biology; and Sequence 3 required cell biology. Zoology students in the spring of 1972 were pretest and a posttest. The mean…

Comparative Evaluation of Effect of Water Absorption on the Surface Properties of Heat Cure Acrylic: An in vitro Study

OpenAIRE

Chandu, G S; Asnani, Pooja; Gupta, Siddarth; Faisal Khan, Mohd.

2015-01-01

Background: Use of alkaline peroxide denture cleanser with different temperature of water could cause a change in surface hardness of the acrylic denture and also has a bleaching effect. The purpose of the study was to determine the effect of increased water content during thermal cycling of hot water-treated acrylic on the surface hardness of acrylic denture base when compared to warm water treated acrylic. And to compare the bleaching effect of alkaline peroxide solution on the acrylic dent...

Comparing the effect of pressure and temperature on ion mobilities

International Nuclear Information System (INIS)

Tabrizchi, Mahmoud; Rouholahnejad, Fereshteh

2005-01-01

The effect of pressure on ion mobilities has been investigated and compared with that of temperature. In this connection, an ion mobility spectrometry (IMS) cell, which employs a corona discharge as the ionization source, has been designed and constructed to allow varying pressure inside the drift region. IMS spectra were recorded at various pressures ranging from 15 Torr up to atmospheric pressure. The results show that IMS peaks shift perfectly linear with pressure which is in excellent agreement with the ion mobility theory. However, experimental ion mobilities versus temperature show deviation from the theoretical trend. The deviation is attributed to formation of clusters. The different behaviour of pressure and temperature was explained on the basis of the different impact of pressure and temperature on hydration and clustering of ions. Pressure affects the clustering reactions linearly but temperature affects it exponentially

The Comparative Effectiveness of Variants of Construction of Electricity Export Projects

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Anatoly Vladimirovich Lagerev

2014-06-01

Full Text Available The study describes a methodological approach that evaluates the comparative efficiency of construction of export-oriented power plants and transmission lines taking into account the development of power industry in the region and uncertainty (ambiguity of initial information. At the first stage the authors determine socio-economic effects of each project of construction of export-oriented power plants. With the help of optimization models they choose options that can guarantee the balanced and cost-effective development of the regional electric power system. Then using a simulation model the researchers assess commercial viability of previously selected projects. The article applies this approach for selecting the preferred option of electricity export from Eastern Siberia to China. This study shows that the project of CPP based on Kovykta natural gas with electricity transmission line to Chinese border (near Zabaikalsk is more preferable one in comparison with other projects (CPP based on Kansk-Achinsk coal in Krasnoyarsky krai; CPP based on coal in the Republic of Buryatia and Zabaikalsky krai (Olon-Shibirskaya CPP; New Kharanorskaya CPP; CPP based on Mugunsky coal in Irkutskaya oblast

Comparing Repetition Priming Effects in Words and Arithmetic Equations: Robust Priming Regardless of Color or Response Hand Change

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Ailsa Humphries

2018-01-01

Full Text Available Previous studies have shown that stimulus repetition can lead to reliable behavioral improvements. Although this repetition priming (RP effect has been reported in a number of paradigms using a variety of stimuli including words, objects, and faces, only a few studies have investigated mathematical cognition involving arithmetic computation, and no prior research has directly compared RP effects in a linguistic task with an arithmetic task. In two experiments, we used a within-subjects design to investigate and compare the magnitude of RP, and the effects of changing the color or the response hand for repeated, otherwise identical, stimuli in a word and an arithmetic categorization task. The results show that the magnitude of RP was comparable between the two tasks and that changing the color or the response hand had a negligible effect on priming in either task. These results extended previous findings in mathematical cognition. They also indicate that priming does not vary with stimulus domain. The implications of the results were discussed with reference to both facilitation of component processes and episodic memory retrieval of stimulus–response binding.

Comparing Repetition Priming Effects in Words and Arithmetic Equations: Robust Priming Regardless of Color or Response Hand Change.

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Humphries, Ailsa; Chen, Zhe; Neumann, Ewald

2017-01-01

Previous studies have shown that stimulus repetition can lead to reliable behavioral improvements. Although this repetition priming (RP) effect has been reported in a number of paradigms using a variety of stimuli including words, objects, and faces, only a few studies have investigated mathematical cognition involving arithmetic computation, and no prior research has directly compared RP effects in a linguistic task with an arithmetic task. In two experiments, we used a within-subjects design to investigate and compare the magnitude of RP, and the effects of changing the color or the response hand for repeated, otherwise identical, stimuli in a word and an arithmetic categorization task. The results show that the magnitude of RP was comparable between the two tasks and that changing the color or the response hand had a negligible effect on priming in either task. These results extended previous findings in mathematical cognition. They also indicate that priming does not vary with stimulus domain. The implications of the results were discussed with reference to both facilitation of component processes and episodic memory retrieval of stimulus-response binding.

The Cost-Effectiveness of Conventional Discectomy Compared to Other Surgical Techniques for Lumbar Disk Herniation. A Systematic Review

DEFF Research Database (Denmark)

Thorsen, May Tone; Ødegaard-Olsen, Øystein; Leboeuf-Yde, Charlotte

2018-01-01

Background: The current study reviews the literature on the cost-effectiveness of conventional diskectomy compared to other surgical techniques, by assessing studies with economical evaluation and studies using proxy measures of cost-effectiveness. Methods: In April 2016, a comprehensive search w...... studies. The available evidence, however, suggests that any cost-effectiveness difference between conventional diskectomy and the alternatives is unlikely to be great.......Background: The current study reviews the literature on the cost-effectiveness of conventional diskectomy compared to other surgical techniques, by assessing studies with economical evaluation and studies using proxy measures of cost-effectiveness. Methods: In April 2016, a comprehensive search......-four articles were included in the review, 9 retrieved from the original search, and an additional 15 from reference lists. Four studies included an economical evaluation and 20 reported proxy measures of cost-effectiveness. The quality of studies varied considerably and results were ambiguous; the four...

Anticonflict effect of alpidem as compared with the benzodiazepine alprazolam in rats.

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Hascoët, M; Bourin, M

1997-02-01

A comparative study between two drugs acting on the GABAA receptor, alprazolam and alpidem was undertaken, using simple tests such as measurement of spontaneous locomotor activity, four plates test and rotarod in mice. Additional conflict test was further performed using a new conflict paradigm where the opportunity existed for rats to choose during punished periods between immediate, punished reinforcement and delayed non-punished reinforcement. The benzodiazepine alprazolam, demonstrated, as expected, strong anxiolytic effects in mice and increased punished response in rats at non sedative doses (0.5, 1 mg/kg). High doses of alprazolam decreased spontaneous locomotor activity and induced myorelaxant effects in mice. Alpidem, an imidazopyridine derivative, induced motor impairment in mice and only very weak anxiolytic effects in the four plates test in mice (4 mg/kg) and in punished procedure in rats (32 mg/kg). As alprazolam is a full agonist for the GABAA receptor complex and alpidem is a partial agonist acting with specificity on omega 1 GABAA receptor subtypes, the results are discussed. Activity on omega 1 receptor subtypes is perhaps not sufficient in order to obtain a true anti-conflict effect and compounds such as alpidem only relieve some of the symptoms of anxiety disorders.

Comparative effectiveness of fourth-line anti-hypertensive agents in resistant hypertension: A systematic review and meta-analysis.

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Sinnott, Sarah-Jo; Tomlinson, Laurie A; Root, Adrian A; Mathur, Rohini; Mansfield, Kathryn E; Smeeth, Liam; Douglas, Ian J

2017-02-01

Aim We assessed the effectiveness of fourth-line mineralocorticoid receptor antagonists in comparison with other fourth-line anti-hypertensive agents in resistant hypertension. Methods and results We systematically searched Medline, EMBASE and the Cochrane library from database inception until January 2016. We included randomised and non-randomised studies that compared mineralocorticoid receptor antagonists with other fourth-line anti-hypertensive agents in patients with resistant hypertension. The outcome was change in systolic blood pressure, measured in the office, at home or by ambulatory blood pressure monitoring. Secondary outcomes were changes in serum potassium and occurrence of hyperkalaemia. We used random effects models and assessed statistical heterogeneity using the I 2 test and corresponding 95% confidence intervals. From 2,506 records, 5 studies met our inclusion criteria with 755 included patients. Two studies were randomised and three were non-randomised. Comparative fourth-line agents included bisoprolol, doxazosin, furosemide and additional blockade of the renin angiotensin-aldosterone system. Using data from randomised studies, mineralocorticoid receptor antagonists reduced blood pressure by 7.4 mmHg (95%CI 3.2 - 11.6) more than the active comparator. When limited to non-randomised studies, mineralocorticoid receptor antagonists reduced blood pressure by 11.9 mmHg (95% CI 9.3 - 14.4) more than the active comparator. Conclusion On the basis of this meta-analysis, mineralocorticoid receptor antagonists reduce blood pressure more effectively than other fourth-line agents in resistant hypertension. Effectiveness stratified by ethnicity and comorbidities, in addition to information on clinical outcomes such as myocardial infarction and stroke, now needs to be determined.

A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache.

Directory of Open Access Journals (Sweden)

Jeffrey L Jackson

Full Text Available To compare the effectiveness and side effects of migraine prophylactic medications.We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models.PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014.We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration.Placebo controlled trials included alpha blockers (n = 9, angiotensin converting enzyme inhibitors (n = 3, angiotensin receptor blockers (n = 3, anticonvulsants (n = 32, beta-blockers (n = 39, calcium channel blockers (n = 12, flunarizine (n = 7, serotonin reuptake inhibitors (n = 6, serotonin norepinephrine reuptake inhibitors (n = 1 serotonin agonists (n = 9 and tricyclic antidepressants (n = 11. In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82, -flunarizine (-1.1 headaches/month (ha/month, 95% CI: -1.6 to -0.67, fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17, metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46, pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21, propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62, topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73 and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8. Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril, two angiotensin receptor blockers (candesartan, telmisartan, two anticonvulsants (lamotrigine, levetiracetam, and several beta-blockers (atenolol, bisoprolol, timolol. Network meta-analysis found amitriptyline to be better than several other medications including candesartan, fluoxetine, propranolol, topiramate and valproate and no different than

A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache

Science.gov (United States)

2015-01-01

Objective To compare the effectiveness and side effects of migraine prophylactic medications. Design We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models. Data Sources PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014. Eligibility Criteria for Selecting Studies We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration. Results Placebo controlled trials included alpha blockers (n = 9), angiotensin converting enzyme inhibitors (n = 3), angiotensin receptor blockers (n = 3), anticonvulsants (n = 32), beta-blockers (n = 39), calcium channel blockers (n = 12), flunarizine (n = 7), serotonin reuptake inhibitors (n = 6), serotonin norepinephrine reuptake inhibitors (n = 1) serotonin agonists (n = 9) and tricyclic antidepressants (n = 11). In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82), -flunarizine (-1.1 headaches/month (ha/month), 95% CI: -1.6 to -0.67), fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17), metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46), pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21), propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62), topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73) and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8). Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril), two angiotensin receptor blockers (candesartan, telmisartan), two anticonvulsants (lamotrigine, levetiracetam), and several beta-blockers (atenolol, bisoprolol, timolol). Network meta-analysis found amitriptyline to be better than several other medications including

Creating a Common Data Model for Comparative Effectiveness with the Observational Medical Outcomes Partnership.

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FitzHenry, F; Resnic, F S; Robbins, S L; Denton, J; Nookala, L; Meeker, D; Ohno-Machado, L; Matheny, M E

2015-01-01

Adoption of a common data model across health systems is a key infrastructure requirement to allow large scale distributed comparative effectiveness analyses. There are a growing number of common data models (CDM), such as Mini-Sentinel, and the Observational Medical Outcomes Partnership (OMOP) CDMs. In this case study, we describe the challenges and opportunities of a study specific use of the OMOP CDM by two health systems and describe three comparative effectiveness use cases developed from the CDM. The project transformed two health system databases (using crosswalks provided) into the OMOP CDM. Cohorts were developed from the transformed CDMs for three comparative effectiveness use case examples. Administrative/billing, demographic, order history, medication, and laboratory were included in the CDM transformation and cohort development rules. Record counts per person month are presented for the eligible cohorts, highlighting differences between the civilian and federal datasets, e.g. the federal data set had more outpatient visits per person month (6.44 vs. 2.05 per person month). The count of medications per person month reflected the fact that one system's medications were extracted from orders while the other system had pharmacy fills and medication administration records. The federal system also had a higher prevalence of the conditions in all three use cases. Both systems required manual coding of some types of data to convert to the CDM. The data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data. The need to manually code subsets of data limited the conversion. However, once the native data was converted to the CDM, both systems were then able to use the same queries to identify cohorts. Thus, the CDM minimized the effort to develop cohorts and analyze the results across the sites.

Design of VA Cooperative Study #591: CERV-PTSD, comparative effectiveness research in veterans with PTSD.

Science.gov (United States)

Schnurr, Paula P; Chard, Kathleen M; Ruzek, Josef I; Chow, Bruce K; Shih, Mei-Chiung; Resick, Patricia A; Foa, Edna B; Marx, Brian P; Huang, Grant D; Lu, Ying

2015-03-01

CERV-PTSD is a randomized controlled trial of two of the most effective treatments for PTSD, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). Despite solid evidence that both treatments are effective, there is limited evidence about their effectiveness relative to one another. The primary objective is to compare the effectiveness of PE and CPT for reducing PTSD symptom severity in a healthcare system that offers both treatments. The secondary objective is to compare the effectiveness of PE and CPT for reducing the severity of comorbid mental health problems and service utilization as well as improving functioning and quality of life. The tertiary objective is to examine whether discrepancy between patient preferences and treatment assignment reduces the effectiveness of each treatment. Exploratory analyses will examine whether demographic and clinical characteristics predict differential response to PE and CPT. The study is designed to randomize 900 male and female veterans with PTSD due to any traumatic military event to receive PE or CPT. The standard dose of treatment is 12 weekly sessions but veterans who improve more rapidly may finish in fewer sessions and veterans who improve more slowly may have additional sessions. The primary outcome is improvement in PTSD symptoms, measured during and after treatment and then 3 and 6 months later. As a large multi-site trial with men and women, CERV-PTSD is designed to advance the delivery of care for PTSD by providing conclusive information about whether one treatment is better than the other, overall, and for different types of patients. Published by Elsevier Inc.

Epidemiological surveys on the effects of low-level radiation dose: a comparative assessment

International Nuclear Information System (INIS)

Rose, K.S.B.

1988-01-01

In this report, the health effects of low-level doses of radiation are considered by reference to published epidemiological surveys. The work was carried out with three objectives in mind: 1. to provide a comprehensive and critical review of the subject; 2. to seek consistent indications of particular health effects by collating results and comparing with those from surveys at moderate-level doses; 3. to provide an authoritative view on the epidemiology of low-level radiation-induced health effects. Vol E (DRAFT A) is appended and contains group collation tables. Epidemiological surveys can be conveniently divided into four classes (A, B, C, D) according to the phase of life when irradiation occurs or the effect is diagnosed. The first of the classes (A) is addressed here; this class is concerned with possible effects arising from radiation received by a parent before conception. Possible effects of preconception irradiation were identified under four broad groupings. These are Down's syndrome, ''Indicators of Reproductive Damage'' (mainly Primary Sterility, Congenital Abnormalities, Sex Ratio, Fetal Mortality, Infant Mortality), Childhood Malignancies, and Chromosomal Changes in Abortuses. Information about each survey, and comparisons with results from moderate-level dose surveys, are contained in synopses that are set out in the Appendix. (author)

Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

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Nasir Nur-Azida

2010-06-01

Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment.

Science.gov (United States)

Ramakrishnan, Subasree; Mekala, Shailaja; Mamidipudi, Annapurna; Yareeda, Sireesha; Mridula, Rukmini; Bak, Thomas H; Alladi, Suvarna; Kaul, Subhash

2017-01-01

Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust. © 2017 S. Karger AG, Basel.

International comparison of comparative effectiveness research in five jurisdictions: insights for the US.

Science.gov (United States)

Levy, Adrian R; Mitton, Craig; Johnston, Karissa M; Harrigan, Brian; Briggs, Andrew H

2010-01-01

Spurred by a desire to improve quality of care and to understand the relative value of medical treatments, there has been a recent surge of interest in publicly funded comparative effectiveness research (CER) in the US. As health technology assessment (HTA) shares some of the same goals as CER, and publicly funded HTA has been a feature within other industrialized countries for many years, a review of HTA activities in some of these countries can be a helpful source of information for the US debate. Informed by a literature review, and in two cases augmented by informant interviews, we reviewed the organization of HTA activities in five jurisdictions: Canada, Sweden, Scotland, the Netherlands and Australia. We provide a summary description of the healthcare system in each country as well as a description of the key features of their HTA bodies, with a particular focus on the processes of HTA for listing medications on public formularies. Four of the committees evaluating medications for formulary inclusion are funded by, but remain at arm's length from, the government (Canada, Australia, Sweden and Scotland), while the process is fully embedded within the government in the Netherlands. Each of these jurisdictions has a stated preference for comparative outcomes evidence from randomized controlled trials, but will, under certain circumstances, accept randomized evidence using surrogate markers, other comparators that are not directly relevant or non-randomized evidence. Health technology evaluation committees largely comprise health professionals, with public representatives included in the Canadian, Australian and Scottish committees. Scotland is the only one of the five jurisdictions reviewed to have industry representation on the evaluation committee. We identified seven characteristics that are shared across the jurisdictions reviewed and that potentially serve as insights for development of CER in the US: (i) the process must be responsive to stakeholders

Teachers' Perceptions of Effective Teaching: A Comparative Study of Elementary School Teachers from China and the USA

Science.gov (United States)

Meng, Lingqi; Muñoz, Marco

2016-01-01

This international study investigated Chinese and American elementary school teachers' perceptions of effective teaching. The sample comprised Chinese (n = 108) and US (n = 110) participating teachers. The Effective Teaching Quality Survey (ETQS) was adopted for this comparative education research, an instrument that operationalized Stronge's…

Comparative study of the antitumor effect of natural monoterpenes: relationship to cell cycle analysis

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Abdeslam Jaafari

2012-06-01

Full Text Available Monoterpenes have been identified as responsible of important therapeutic effects of plant-extracts. In this work, we try to compare the cytotoxic effect of six monoterpenes (carvacrol, thymol, carveol, carvone, eugenol and isopulegol as well as their molecular mechanisms. The in vitro antitumor activity of the tested products, evaluated against five tumor cell lines, show that the carvacrol is the most cytotoxic monoterpene. The investigation of an eventual synergistic effect of the six natural monoterpenes with two anticancer drugs revealed that there is a significant synergy between them (p<5%. On the other hand, the effect of the tested products on cell cycle progression was examined by flow cytometry after DNA staining in order to investigate the molecular mechanism of their cytotoxic activity. The results revealed that carvacrol and carveol stopped the cell cycle progression in S phase; however, thymol and isopulegol stopped it in G0/G1 phase. Regarding carvone and eugenol, no effect on cell cycle was observed.

Comparative effectiveness of gamma-rays and electron beams in food irradiation

International Nuclear Information System (INIS)

Hayashi, Toru

1991-01-01

Ionizing radiations which can be used for the treatment of foods are gamma-rays from Co-60 and Cs-137, accelerated electrons from a machine at an energy of 10 MeV or lower and X-rays from a machine at an energy of 5 MeV or lower. The Joint FAO/IAEA/WHO Expert Committee on the Wholesomeness of Irradiated Food held in 1980 concluded that the foods irradiated at overall average doses up to 10 kGy with the radiation listed above are wholesome for human consumption. While most of the commercial food irradiations are conducted with gamma-rays from Co-60, accelerated electrons are increasingly utilized for treating foods. An important difference between gamma-rays and accelerated electrons is the penetration capacity in materials. The penetration capacity of gamma-rays is much higher than that of accelerated electrons. Another important difference is the dose rate. The dose rates of gamma-rays from commercial Co-60 sources are 1-100 Gy/min, while those of electron beams from electron accelerators are 10 3 -10 6 Gy/s. Ideally a comparison of the effect of different types of ionizing radiation should be carried out at the same dose rate but this has been difficult due to the design of irradiators. It is very difficult to draw a definite conclusion on the difference in the effectiveness in food irradiation between gamma-rays and electron beams based on published data. This chapter deals with as many reports as possible on the comparative effectiveness of gamma-rays and electron beams and on the effect of dose rate on chemical reactions and living organisms, whether or not they demonstrate any dependency of the effect of irradiation on dose rate and type of radiation. (author)

Comparing the Effects of Group and Home-based Physical Activity on Mental Health in the Elderly.

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Mortazavi, Seyede Salehe; Shati, Mohsen; Ardebili, Hassan Eftekhar; Mohammad, Kazem; Beni, Reza Dorali; Keshteli, A H

2013-11-01

The present study focuses on comparing the effects of home-based (HB) and group-based (GB) physical activity on mental health in a sample of older adults in Shahr-e-kord. In this quasi-experimental study, a twice-weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups (HB and GB). The outcome, mental health, was measured with the 28-item General Health Questionnaire (GHQ-28). Mental health status improved after participation in the physical activity program. The decrease in GHQ-28 total score in GB group, 3 months after intervention, was 3.61 ± 2.28 (P effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.

Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals.

Science.gov (United States)

Han, Kyu-Tae; Kim, Sun Jung; Lee, Seo Yoon; Park, Eun-Cheol

2014-01-01

After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

Effects of Worked Examples, Example-Problem Pairs, and Problem-Example Pairs Compared to Problem Solving

NARCIS (Netherlands)

Van Gog, Tamara; Kester, Liesbeth; Paas, Fred

2010-01-01

Van Gog, T., Kester, L., & Paas, F. (2010, August). Effects of worked examples, example-problem pairs, and problem-example pairs compared to problem solving. Paper presented at the Biannual EARLI SIG meeting of Instructional design and Learning and instruction with computers, Ulm, Germany.

Comparing treatment effects after adjustment with multivariable Cox proportional hazards regression and propensity score methods

NARCIS (Netherlands)

Martens, Edwin P; de Boer, Anthonius; Pestman, Wiebe R; Belitser, Svetlana V; Stricker, Bruno H Ch; Klungel, Olaf H

PURPOSE: To compare adjusted effects of drug treatment for hypertension on the risk of stroke from propensity score (PS) methods with a multivariable Cox proportional hazards (Cox PH) regression in an observational study with censored data. METHODS: From two prospective population-based cohort

Cost-effectiveness of nurse-delivered cognitive behavioural therapy (CBT) compared to supportive listening (SL) for adjustment to multiple sclerosis.

Science.gov (United States)

Mosweu, I; Moss-Morris, R; Dennison, L; Chalder, T; McCrone, P

2017-10-10

Cognitive Behavioural Therapy (CBT) reduces distress in multiple sclerosis, and helps manage adjustment, but cost-effectiveness evidence is lacking. An economic evaluation was conducted within a multi-centre trial. 94 patients were randomised to either eight sessions of nurse-led CBT or supportive listening (SL). Costs were calculated from the health, social and indirect care perspectives, and combined with additional quality-adjusted life years (QALY) or improvement on the GHQ-12 score, to explore cost-effectiveness at 12 months. CBT had higher mean health costs (£1610, 95% CI, -£187 to 3771) and slightly better QALYs (0.0053, 95% CI, -0.059 to 0.103) compared to SL but these differences were not statistically significant. This yielded £301,509 per QALY improvement, indicating that CBT is not cost-effective according to established UK NHS thresholds. The extra cost per patient improvement on the GHQ-12 scale was £821 from the same perspective. Using a £20,000, threshold, CBT in this format has a 9% probability of being cost effective. Although subgroup analysis of patients with clinical levels of distress at baseline showed an improvement in the position of CBT compared to SL, CBT was still not cost-effective. Nurse delivered CBT is more effective in reducing distress among MS patients compared to SL, but is highly unlikely to be cost-effective using a preference-based measure of health (EQ-5D). Results from a disease-specific measure (GHQ-12) produced comparatively lower Incremental Cost-Effectiveness Ratios, but there is currently no acceptable willingness-to-pay threshold for this measure to guide decision-making.

SNARC Effects with Numerical and Non-Numerical Symbolic Comparative Judgments: Instructional and Cultural Dependencies

Science.gov (United States)

Shaki, Samuel; Petrusic, William M.; Leth-Steensen, Craig

2012-01-01

With English-language readers in an experiment requiring pairwise comparative judgments of the sizes of animals, the nature of the association between the magnitudes of the animal pairs and the left or right sides of response (i.e., the SNARC effect) was reversed depending on whether the participants had to choose either the smaller or the larger…

Thermo-Kinetic Investigation of Comparative Ligand Effect on Cysteine Iron Redox Reaction

Directory of Open Access Journals (Sweden)

Masood Ahmad Rizvi

2015-03-01

Full Text Available Transition metal ions in their free state bring unwanted biological oxidations generating oxidative stress. The ligand modulated redox potential can be indispensable in prevention of such oxidative stress by blocking the redundant bio-redox reactions. In this study we investigated the comparative ligand effect on the thermo-kinetic aspects of biologically important cysteine iron (III redox reaction using spectrophotometric and potentiometric methods. The results were corroborated with the complexation effect on redox potential of iron(III-iron(II redox couple. The selected ligands were found to increase the rate of cysteine iron (III redox reaction in proportion to their stability of iron (II complex (EDTA < terpy < bipy < phen. A kinetic profile and the catalytic role of copper (II ions by means of redox shuttle mechanism for the cysteine iron (III redox reaction in presence of 1,10-phenanthroline (phen ligand is also reported.

Inhibitory Effect of Curcumin on Candida-albicans compared with Nystatin: an in-vitro Study

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Neda Babaii

2016-10-01

Full Text Available Introduction: Curcumin is the active ingredient in the traditional herbal remedy and dietary spice turmeric (Curcuma longa. Curcumin has a surprisingly wide range of beneficial properties, including anti-inflammatory, antioxidant, chemopreventive and chemotherapeutic activity. on basis of recent studies; it has antifungal and antibacterial effects. The aim of this study was in-vitro evaluation of antifungal effect of curcumin on candida albicans and comparing it with nystatin. Methods: after preparing curcumin powder, 3 laboratory methods were used to evaluate antifungal effect. The first method was cell count technique, used to evaluate the amount of candida albicans after time, in different concentrations of curcumin in Dimethyl sulfoxide (DMSO. The second was cup bioassay, in which inhibitory a zone of curcumin in DMSO was evaluated in sabouraud culture plates; and in third method, inhibitory zones of dried disks; which contained curcumin in DMSO were evaluated. Results: the result of all three methods showed that curcumin has antifungal effect and this effect increases in more concentrations. Conclusion: curcumin has apparent and dose dependent antifungal effect on candida albicans.

Effects of microwaves on changes in foodstuffs as compared with conventional heat treatment. Pt. 2

International Nuclear Information System (INIS)

Kalb, M.; Dehne, L.; Boegl, W.

1980-01-01

It is purpose of this study to contribute to the discussion and to answer the question as to whether changes are caused by microwave-heating of foodstuffs, which differ from those caused by conventional heating. This is achieved by summarizing extensive test materials. In the relevant literature, a great number of tests are listed on the cooking and reheating of foodstuffs by means of micro-waves, as compared to conventional methods. The subject of these tests is the determination of quantitative changes of certain ingredients (vitamins, fatty acids etc.) and sensory characteristics (flavour, colour etc.) due to the different heating methods. In addition to cooking and heating, a more comprehensive use of microwaves in preparation of food is discussed in this study. Works on the thawing, blanching, freeze-drying, and pasteurization are taken into account when comparing the different heating methods. Moreover, this study includes a comaprison as to the formation of volatile aromatic compounds, the thermic decomposition of pesticide residues, and the physiological effect of lipids. It was determined that there is no indication of radiation-specific effects, i. e. athermic effects, of microwaves contained in any of the studies reviewed up to now. (orig./MG) [de

Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes

DEFF Research Database (Denmark)

Tao, L; Wilson, E C F; Wareham, N J

2015-01-01

, falling to £37 500 over 30 years. The ICER fell below £30 000 only when the intervention cost was below £631 per patient: we estimated the cost at £981. Conclusion Given conventional thresholds of cost-effectiveness, the intensive treatment delivered in ADDITION was not cost-effective compared......Aims To examine the short- and long-term cost-effectiveness of intensive multifactorial treatment compared with routine care among people with screen-detected Type 2 diabetes. Methods Cost–utility analysis in ADDITION-UK, a cluster-randomized controlled trial of early intensive treatment in people...... at 3.5%). Adjusted incremental QALYs were 0.0000, – 0.0040, 0.0140 and 0.0465 over the same time horizons. Point estimate incremental cost-effectiveness ratios (ICERs) suggested that the intervention was not cost-effective although the ratio improved over time: the ICER over 10 years was £82 250...

A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease.

Science.gov (United States)

Pillai, Nadia; Dusheiko, Mark; Burnand, Bernard; Pittet, Valérie

2017-01-01

Inflammatory bowel disease (IBD) is a chronic disease placing a large health and economic burden on health systems worldwide. The treatment landscape is complex with multiple strategies to induce and maintain remission while avoiding long-term complications. The extent to which rising treatment costs, due to expensive biologic agents, are offset by improved outcomes and fewer hospitalisations and surgeries needs to be evaluated. This systematic review aimed to assess the cost-effectiveness of treatment strategies for IBD. A systematic literature search was performed in March 2017 to identify economic evaluations of pharmacological and surgical interventions, for adults diagnosed with Crohn's disease (CD) or ulcerative colitis (UC). Costs and incremental cost-effectiveness ratios (ICERs) were adjusted to reflect 2015 purchasing power parity (PPP). Risk of bias assessments and a narrative synthesis of individual study findings are presented. Forty-nine articles were included; 24 on CD and 25 on UC. Infliximab and adalimumab induction and maintenance treatments were cost-effective compared to standard care in patients with moderate or severe CD; however, in patients with conventional-drug refractory CD, fistulising CD and for maintenance of surgically-induced remission ICERs were above acceptable cost-effectiveness thresholds. In mild UC, induction of remission using high dose mesalazine was dominant compared to standard dose. In UC refractory to conventional treatments, infliximab and adalimumab induction and maintenance treatment were not cost-effective compared to standard care; however, ICERs for treatment with vedolizumab and surgery were favourable. We found that, in general, while biologic agents helped improve outcomes, they incurred high costs and therefore were not cost-effective, particularly for use as maintenance therapy. The cost-effectiveness of biologic agents may improve as market prices fall and with the introduction of biosimilars. Future research

Health technology assessment and comparative effectiveness research: a pharmaceutical industry perspective.

Science.gov (United States)

Hao, Yanni; Thomas, Adrian

2013-08-01

We briefly review the characteristics of several established health technology assessment (HTA) programs in industrialized societies including Germany, the UK and France. Special attention is paid on two issues: the position of HTA in coverage decision making and the role of economic assessment in evaluation processes. Although law makers in the USA have barred the use of NICE's cost/quality-adjusted life year or similar health economics approaches by public payers for coverage decision making, there are suggestions of prioritizing relative efficacy evaluation over economic assessment under a comparative effectiveness research (CER) framework to inform payment rates of public payers (an approach similar to German and French HTA processes). However, such an approach is unlikely to prove viable. It should also be noted that, if cost considerations are made explicit in US CER policy decisions, CER may become an unsustainable approach undermined by a conflicting emphasis on both cost containment and a demand for costly comparative evidence. On the other hand, properly designed CER initiatives can serve as a facilitator of more efficient research activities and drug development models. With these points in mind, the likely pathway of US CER is explored and the plausible impact on industry innovation is discussed.

Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.

Directory of Open Access Journals (Sweden)

Nilay D Shah

Full Text Available BACKGROUND: Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. METHODS AND FINDINGS: Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40-80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5-7.6 for males and 6.5-7.5 for females; a larger range of differences were observed for expected cost per event avoided (ranges, $117,269-$157,186 for males and $115,999-$163,775 for females. Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. CONCLUSIONS: International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs.

Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: a randomized clinical trialComparative effects of car

Directory of Open Access Journals (Sweden)

Fariba Raygan

2017-02-01

Full Text Available BACKGROUND: This study was conducted to establish the comparative effects of carbohydrate versus fat restriction on metabolic indices in Type 2 diabetic (T2D patients with coronary heart disease (CHD. METHODS: This randomized, clinical trial was done among 56 overweight persons with T2D and CHD aged 40-85 years old. The patients were randomly allocated to take either a high-carbohydrate (HC diet (60-65% carbohydrates and 20-25% fats (n = 28 or a restricted carbohydrate (RC diet (43-49% carbohydrate and 36-40% fats (n = 28 for 8 weeks to determine metabolic status. RESULTS: After 8 weeks of treatment, RC diet decreased fasting plasma glucose (FPG (−11.5 ± 28.3 vs. +7.0 ± 26.9 mg/dl, P = 0.010 and high-sensitivity C-reactive protein (hs-CRP (−564.3 ± 1280.1 vs. +286.1 ± 1789.2 ng/ml, P = 0.040 compared with a HC diet. Moreover, compared with a HC diet, RC diet increased total antioxidant capacity (TAC (+274.8 ± 111.5 vs. +20.2 ± 82.5 mmol/l, P < 0.001 and glutathione (GSH levels (+51.6 ± 111.5 vs. −32.6 ± 88.5 µmol/l, P = 0.003. No significant alterations between the two groups were found in terms of their effect on other metabolic profiles. CONCLUSION: RC diet in overweight T2D with CHD had beneficial effects on FPG, hs-CRP, TAC, and GSH values. 

Specific spheres of application of ionising radiation effects, some realized results and comparative advantages

International Nuclear Information System (INIS)

Benderac, R.

2007-01-01

The papers discusses some results of ionizing radiation effects in realization of non-destructive methods, achieved progress from the aspect of innovation, comparative results with previously used methods, etc. A review is given of methods based on alpha-radiography, auto-alpha radiography, beta-radiography, X-ray-fluorescent analysis, X- and gamma radiography, and photos of specific samples of neutron radiography [sr

Effects of plasma radiation on wound healing compared with X-ray

Energy Technology Data Exchange (ETDEWEB)

Azorin V, E.; Pena E, R. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Azorin V, J. C., E-mail: erica.azorin@inin.gob.mx [Universidad de Guanajuato, Campus Leon, Departamento de Ingenieria Fisica, Blvd. Prol. Calz. de los Heroes No. 908, Col. La Martinica, Leon, Guanajuato (Mexico)

2015-10-15

Full text: The radiation emitted by the plasma needle has shown high efficiency in the inactivation of microorganisms and the acceleration of the healing process; apparently such effects are related to the antioxidant activity, induction of cell damage and the generation of free radicals. To take advantage of plasma clinical applications it is essential to understand the cellular mechanisms activated by the exposure of human cells to radiation emitted by cold plasma. In this work we present the results of the characterization of the responses of human skin fibroblasts exposed to the radiation emitted by a plasma by varying the magnitude of flow, electrical power, time and composition of the cell culture medium comparing it with the response of these fibroblasts to low energy X-rays. (Author)

Effects of plasma radiation on wound healing compared with X-ray

International Nuclear Information System (INIS)

Azorin V, E.; Pena E, R.; Azorin V, J. C.

2015-10-01

Full text: The radiation emitted by the plasma needle has shown high efficiency in the inactivation of microorganisms and the acceleration of the healing process; apparently such effects are related to the antioxidant activity, induction of cell damage and the generation of free radicals. To take advantage of plasma clinical applications it is essential to understand the cellular mechanisms activated by the exposure of human cells to radiation emitted by cold plasma. In this work we present the results of the characterization of the responses of human skin fibroblasts exposed to the radiation emitted by a plasma by varying the magnitude of flow, electrical power, time and composition of the cell culture medium comparing it with the response of these fibroblasts to low energy X-rays. (Author)

Cost-effectiveness of vedolizumab compared with conventional therapy for ulcerative colitis patients in the UK

Directory of Open Access Journals (Sweden)

Wilson MR

2017-10-01

Full Text Available Michele R Wilson,1 Ismail Azzabi Zouraq,2 Helene Chevrou-Severac,2 Ross Selby,3 Matthew C Kerrigan4 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Takeda Pharmaceuticals International AG, Zurich, Switzerland; 3Takeda UK Ltd., Bucks, UK; 4PHMR Limited, London, UK Objective: To examine the clinical and economic impact of vedolizumab compared with conventional therapy in the treatment of moderately-to-severely active ulcerative colitis (UC in the UK based on results of the GEMINI I trial. Methods: A decision-analytic model in Microsoft Excel was used to compare vedolizumab with conventional therapy (aminosalicylates, corticosteroids, immunomodulators for the treatment of patients with UC in the UK. We considered the following three populations: the overall intent-to-treat population from the GEMINI I trial, patients naïve to anti-TNF therapy, and those who had failed anti-TNF-therapy. Population characteristics and efficacy data were obtained from the GEMINI I trial. Other inputs (eg, unit costs, probability of surgery, mortality were obtained from published literature. Time horizon was a lifetime horizon, with costs and outcomes discounted by 3.5% per year. One-way and probabilistic sensitivity analyses were conducted to measure the impact of parameter uncertainty. Results: Vedolizumab had incremental cost-effectiveness ratios of £4,095/quality-adjusted life-year (QALY, £4,423/QALY, and £5,972/QALY compared with conventional therapy in the intent-to-treat, anti-TNF-naïve, and anti-TNF-failure populations, respectively. Patients on vedolizumab accrued more QALYs while incurring more costs than patients on conventional therapy. The sensitivity analyses showed that the results were most sensitive to induction response and transition probabilities for each treatment. Conclusion: The results suggest that vedolizumab results in more QALYs and may be a cost-effective treatment option compared with conventional therapy for both anti

Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method.

Science.gov (United States)

Eeren, Hester V; Goossens, Lucas M A; Scholte, Ron H J; Busschbach, Jan J V; van der Rijken, Rachel E A

2018-01-09

Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.

Investigating the visual span in comparative search: the effects of task difficulty and divided attention.

Science.gov (United States)

Pomplun, M; Reingold, E M; Shen, J

2001-09-01

In three experiments, participants' visual span was measured in a comparative visual search task in which they had to detect a local match or mismatch between two displays presented side by side. Experiment 1 manipulated the difficulty of the comparative visual search task by contrasting a mismatch detection task with a substantially more difficult match detection task. In Experiment 2, participants were tested in a single-task condition involving only the visual task and a dual-task condition in which they concurrently performed an auditory task. Finally, in Experiment 3, participants performed two dual-task conditions, which differed in the difficulty of the concurrent auditory task. Both the comparative search task difficulty (Experiment 1) and the divided attention manipulation (Experiments 2 and 3) produced strong effects on visual span size.

The comparative effect of fasting with and without caloric restriction in Rat on oxidative stress parameters

OpenAIRE

Nurina Tyagita; Taufiqurrachman Nasihun; Titiek Sumarawati

2016-01-01

Introduction: Fasting, like Islamic Ramadan Fasting, has been associated with health benefits. Islamic Ramadan fasting, a form of caloric restriction (CR) or alternate day fasting that. Studies suggest a comparable effect of ADF and caloric restriction. Despite the fact that fasting can be considered as a form of dietary restriction, fasters tend to have difficulty to reduce their food intake during non-fasting period by overeating leading to the excessive calorie intake. To compare the effec...

Comparative study of the effects of bupropion and escitalopram on Internet gaming disorder.

Science.gov (United States)

Song, Jinuk; Park, Jeong Ha; Han, Doug Hyun; Roh, Sungwon; Son, Ji Hyun; Choi, Tae Young; Lee, Hyuk; Kim, Tae Ho; Lee, Young Sik

2016-11-01

We compared the efficacy of bupropion and escitalopram treatments in Internet gaming disorder (IGD) patients. We recruited 119 adolescents and adults with IGD. We treated these participants for 6 weeks in three groups as follows: 44 participants were treated with bupropion SR (bupropion group), 42 participants were treated with escitalopram (escitalopram group), and 33 patients without any medication were observed in the community (observation group). At baseline and at the 6-week follow-up visit, all subjects were evaluated using the Clinical Global Impression-Severity Scale, the Young Internet Addiction Scale, the Beck Depression Inventory, the ADHD Rating Scale, and the Behavioral Inhibition and Activation Scales. Both the escitalopram group and the bupropion group showed improvement on all clinical symptom scales after 6 weeks of treatment compared to the observation group. Additionally, the bupropion group showed greater improvement on scores for the Clinical Global Impression-Severity Scale, the Young Internet Addiction Scale, the ADHD Rating Scale, and the Behavioral Inhibition Scale than the escitalopram group. Both bupropion and escitalopram were effective in treating and managing IGD symptoms. Moreover, bupropion appeared to be more effective than escitalopram in improving attention and impulsivity in IGD patients. In addition, attention and impulsivity seem to be important for the management of IGD. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis

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Peixia Cheng

2018-03-01

Full Text Available Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR and 95% credible interval (95% CrI were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77 followed by interventions combining education and exercise (EDU + EXC (OR: 0.65, 95% CrI: 0.38 to 1.00 and interventions combining exercise and hazard assessment and modification (EXC + HAM (OR: 0.66, 95% CrI: 0.40 to 1.04. The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34. Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations.

CHoosing Options for Insomnia in Cancer Effectively (CHOICE): Design of a patient centered comparative effectiveness trial of acupuncture and cognitive behavior therapy for insomnia.

Science.gov (United States)

Garland, Sheila N; Gehrman, Philip; Barg, Frances K; Xie, Sharon X; Mao, Jun J

2016-03-01

Insomnia is a prevalent and persistent side effect of cancer, which if left unaddressed, can be unremitting and negatively influence physical and mental well-being. Acupuncture and Cognitive Behavioral Therapy (CBT) are commonly used non-pharmacological treatments that are efficacious for treating insomnia in cancer patients; however, little is known about the comparative effectiveness of these options. The goal of personalized medicine is to determine which treatments are most effective for which individuals, and patient preference for treatment is a particularly important contributor to adherence and outcomes. Here we describe the design of a clinical trial that begins to determine how best to personalize the treatment of insomnia for cancer survivors. This project is a randomized controlled comparative effectiveness trial with a nested qualitative study comparing acupuncture and CBT for insomnia and co-morbid symptoms in a heterogeneous sample of 160 cancer survivors. The primary aim is to determine which treatment is associated with the largest reduction in insomnia severity. The secondary aim is to examine the demographic, clinical, and psychological characteristics that predict and/or moderate treatment effect. Patients will receive ten treatments of acupuncture or 7 sessions of CBT over eight weeks and complete validated patient-reported outcome measures of sleep and co-morbid symptoms at baseline, mid-treatment, post-treatment, and at three-months to assess durability of effect. The results of the proposed study have the potential to improve healthcare outcomes by helping cancer survivors and their caregivers make informed and evidence-based decisions, leading to patient-centered and personalized care for cancer survivors with insomnia. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparative study on effect of blending, thermal barrier coating ...

African Journals Online (AJOL)

The brake thermal efficiency, specific fuel consumption, carbon monoxide, unburned hydrocarbon and oxides of nitrogen emissions of both diesel and UOME and its blends were measured before and after coating and the results are compared. B20 fuelled biodiesel and PSZ coated engine provides almost comparable ...

Comparative performance of high-fidelity training models for flexible ureteroscopy: Are all models effective?

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Shashikant Mishra

2011-01-01

Full Text Available Objective: We performed a comparative study of high-fidelity training models for flexible ureteroscopy (URS. Our objective was to determine whether high-fidelity non-virtual reality (VR models are as effective as the VR model in teaching flexible URS skills. Materials and Methods: Twenty-one trained urologists without clinical experience of flexible URS underwent dry lab simulation practice. After a warm-up period of 2 h, tasks were performed on a high-fidelity non-VR (Uro-scopic Trainer TM ; Endo-Urologie-Modell TM and a high-fidelity VR model (URO Mentor TM . The participants were divided equally into three batches with rotation on each of the three stations for 30 min. Performance of the trainees was evaluated by an expert ureteroscopist using pass rating and global rating score (GRS. The participants rated a face validity questionnaire at the end of each session. Results: The GRS improved statistically at evaluation performed after second rotation (P<0.001 for batches 1, 2 and 3. Pass ratings also improved significantly for all training models when the third and first rotations were compared (P<0.05. The batch that was trained on the VR-based model had more improvement on pass ratings on second rotation but could not achieve statistical significance. Most of the realistic domains were higher for a VR model as compared with the non-VR model, except the realism of the flexible endoscope. Conclusions: All the models used for training flexible URS were effective in increasing the GRS and pass ratings irrespective of the VR status.

Comparing welfare effects of different regulation schemes: An application to the electricity distribution industry

International Nuclear Information System (INIS)

Kopsakangas-Savolainen, Maria; Svento, Rauli

2010-01-01

We compare the welfare effects of different regulation schemes of electricity distribution utilities. The compared regulation schemes are Fixed Price regulation, Cost of Service regulation, Menu of Cost-Contingent Contracts and Simple Menu of Contracts. In our calculations we utilize the information of a firm's potential to improve cost efficiency. The firm-specific cost information of Finnish electricity distribution utilities is obtained by using various Stochastic Frontier models. Our basic result is that welfare can be improved by changing the Cost of Service regulation scheme to the Menu of Contracts regulation. Welfare also increases in the case of Fixed Price regulation and Simple Menu of Contract regulation. There is however, a significant difference among regulation regimes on how this improved welfare is distributed to consumers and producers.

Comparing Efficacy and Side Effects of Memantine vs. Risperidone in the Treatment of Autistic Disorder.

Science.gov (United States)

Nikvarz, Nikvarz; Alaghband-Rad, Javad; Tehrani-Doost, Mehdi; Alimadadi, Abbas; Ghaeli, Padideh

2017-01-01

Introduction: This study was aimed to compare the efficacy and side effects of memantine, an antagonist of the NMDA receptor of glutamate, with risperidone given the fact that glutamate has been noted for its possible effects in the pathogenesis of autism. Risperidone, an atypical antipsychotic, has been approved by FDA for the management of irritability associated with autism. Methods: 30 children, aged 4-17 years, entered an 8-week, randomized trial. Patients were randomly assigned to receive either risperidone or memantine. Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Clinical Global Impressions - Improvement (CGI-I) and Clinical Global Impression-Severity (CGI-S) scales were used to assess behavioral symptoms of the patients. Results: Both risperidone and memantine reduced the scores of 4 subscales of ABC as well as the 10-item and the total score of CARS significantly. However, differences between the 2 drugs in the scores of each evaluating scale were not found to be significant. Relatively, larger number of patients on risperidone showed "very much improvement" when assessed by CGI-I scale when compared with those on memantine. Discussion and conclusion: The present study suggests that memantine may have beneficial effects in the treatment of many core symptoms of autism. Therefore, memantine may be considered as a potential medication in the treatment of those autistic children who do not respond or cannot tolerate side effects of risperidone. © Georg Thieme Verlag KG Stuttgart · New York.

Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

Science.gov (United States)

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Bm, Berman

2012-10-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.

Science.gov (United States)

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

2018-02-01

Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.

Comparative Research of Residents’ Effect Perception and Participation Capacity and Willingness on Pro-poor Tourism

Institute of Scientific and Technical Information of China (English)

Guoqing; HUANG; Hong; SHU

2014-01-01

In this article,comparative research on residents’ effect perception,participation capacity and willingness on Pro-poor Tourism( PPT) is given based on the questionnaire carried out in Wulong County and Fengjie County in Three Gorges Area,Chongqing,China. Some technologies,such as SPSS 13. 0,ANOVA and T-test are applied to analyze the data and results show Wulong residents’ perception behavior is better than that of Fengjie residents. Moreover,the residents with different demographic characteristics have different participation behavior.Finally,multiple regression analysis is applied to identify the key factors influencing residents’ perception behavior,that is participation willingness and positive economic effect perception,positive social and cultural effect perception and participation capacity.

Cost-effectiveness of Low-dose Submicron Diclofenac Compared With Generic Diclofenac.

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Mladsi, Deirdre; Ronquest, Naoko; Odom, Dawn; Miles, LaStella; Saag, Kenneth

2016-11-01

NSAIDs are commonly prescribed for the treatment of pain and inflammation. Despite the effectiveness of NSAIDs, concerns exist regarding their tolerability. Worldwide health authorities, including the European Medicines Agency, Health Canada, and the US Food and Drug Administration, have advised that NSAIDs be prescribed at the lowest effective dosage and for the shortest duration. Effective lowering of NSAID dosage without compromising pain relief has been demonstrated in randomized, controlled trials of the recently approved NSAID lower-dose submicron diclofenac. Building on previously published work from an independently published systematic review and meta-analysis, a linear dose-toxicity relationship between diclofenac dose and serious gastrointestinal (GI) events was recently demonstrated, indicating that reductions in adverse events (AEs) may be seen even with modest dose reductions in many patients. The objective of the present study was to estimate the potential reduction in risk for NSAID dose-related AEs, corresponding savings in health care costs, and the incremental cost-effectiveness of submicron diclofenac compared with generic diclofenac in the United States. Our decision-analytic cost-effectiveness model considered a subset of potential AEs that may be avoided by lowering NSAID dosage. To estimate the expected reductions in upper GI bleeding/perforation and major cardiovascular events with submicron diclofenac, our model used prediction equations estimated by meta-regressions using data from systematic literature reviews. Utilities, lifetime costs, and health outcomes associated with AEs were estimated using data from the literature. The face validity of the model structure and inputs was confirmed by clinical experts in the United States. Results were evaluated in 1-way and probabilistic sensitivity analyses. The model predicted that submicron diclofenac versus generic diclofenac could reduce the occurrence of modeled GI events (by 18

Impact of vaccine herd-protection effects in cost-effectiveness analyses of childhood vaccinations. A quantitative comparative analysis.

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Holubar, Marisa; Stavroulakis, Maria Christina; Maldonado, Yvonne; Ioannidis, John P A; Contopoulos-Ioannidis, Despina

2017-01-01

Inclusion of vaccine herd-protection effects in cost-effectiveness analyses (CEAs) can impact the CEAs-conclusions. However, empirical epidemiologic data on the size of herd-protection effects from original studies are limited. We performed a quantitative comparative analysis of the impact of herd-protection effects in CEAs for four childhood vaccinations (pneumococcal, meningococcal, rotavirus and influenza). We considered CEAs reporting incremental-cost-effectiveness-ratios (ICERs) (per quality-adjusted-life-years [QALY] gained; per life-years [LY] gained or per disability-adjusted-life-years [DALY] avoided), both with and without herd protection, while keeping all other model parameters stable. We calculated the size of the ICER-differences without vs with-herd-protection and estimated how often inclusion of herd-protection led to crossing of the cost-effectiveness threshold (of an assumed societal-willingness-to-pay) of $50,000 for more-developed countries or X3GDP/capita (WHO-threshold) for less-developed countries. We identified 35 CEA studies (20 pneumococcal, 4 meningococcal, 8 rotavirus and 3 influenza vaccines) with 99 ICER-analyses (55 per-QALY, 27 per-LY and 17 per-DALY). The median ICER-absolute differences per QALY, LY and DALY (without minus with herd-protection) were $15,620 (IQR: $877 to $48,376); $54,871 (IQR: $787 to $115,026) and $49 (IQR: $15 to $1,636) respectively. When the target-vaccination strategy was not cost-saving without herd-protection, inclusion of herd-protection always resulted in more favorable results. In CEAs that had ICERs above the cost-effectiveness threshold without herd-protection, inclusion of herd-protection led to crossing of that threshold in 45% of the cases. This impacted only CEAs for more developed countries, as all but one CEAs for less developed countries had ICERs below the WHO-cost-effectiveness threshold even without herd-protection. In several analyses, recommendation for the adoption of the target

Cold Nuclear Matter effects on J/psi production at RHIC: comparing shadowing models

Energy Technology Data Exchange (ETDEWEB)

Ferreiro, E.G.; /Santiago de Compostela U.; Fleuret, F.; /Ecole Polytechnique; Lansberg, J.P.; /SLAC; Rakotozafindrabe, A.; /SPhN, DAPNIA, Saclay

2009-06-19

We present a wide study on the comparison of different shadowing models and their influence on J/{psi} production. We have taken into account the possibility of different partonic processes for the c{bar c}-pair production. We notice that the effect of shadowing corrections on J/{psi} production clearly depends on the partonic process considered. Our results are compared to the available data on dAu collisions at RHIC energies. We try different break up cross section for each of the studied shadowing models.

Comparative cost-effectiveness of Option B+ for prevention of mother-to-child transmission of HIV in Malawi.

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Tweya, Hannock; Keiser, Olivia; Haas, Andreas D; Tenthani, Lyson; Phiri, Sam; Egger, Matthias; Estill, Janne

2016-03-27

To estimate the cost-effectiveness of prevention of mother-to-child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') compared with ART during pregnancy or breastfeeding only unless clinically indicated ('Option B'). Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. Individual-based simulation model. We simulated cohorts of 10 000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterized the model with data from the literature and by analysing programmatic data. We compared total costs of antenatal and postnatal care, and lifetime costs and disability-adjusted life-years of the infected infants between Option B+ and Option B. During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared with 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account.

Cost-effective cloud computing: a case study using the comparative genomics tool, roundup.

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Kudtarkar, Parul; Deluca, Todd F; Fusaro, Vincent A; Tonellato, Peter J; Wall, Dennis P

2010-12-22

Comparative genomics resources, such as ortholog detection tools and repositories are rapidly increasing in scale and complexity. Cloud computing is an emerging technological paradigm that enables researchers to dynamically build a dedicated virtual cluster and may represent a valuable alternative for large computational tools in bioinformatics. In the present manuscript, we optimize the computation of a large-scale comparative genomics resource-Roundup-using cloud computing, describe the proper operating principles required to achieve computational efficiency on the cloud, and detail important procedures for improving cost-effectiveness to ensure maximal computation at minimal costs. Utilizing the comparative genomics tool, Roundup, as a case study, we computed orthologs among 902 fully sequenced genomes on Amazon's Elastic Compute Cloud. For managing the ortholog processes, we designed a strategy to deploy the web service, Elastic MapReduce, and maximize the use of the cloud while simultaneously minimizing costs. Specifically, we created a model to estimate cloud runtime based on the size and complexity of the genomes being compared that determines in advance the optimal order of the jobs to be submitted. We computed orthologous relationships for 245,323 genome-to-genome comparisons on Amazon's computing cloud, a computation that required just over 200 hours and cost $8,000 USD, at least 40% less than expected under a strategy in which genome comparisons were submitted to the cloud randomly with respect to runtime. Our cost savings projections were based on a model that not only demonstrates the optimal strategy for deploying RSD to the cloud, but also finds the optimal cluster size to minimize waste and maximize usage. Our cost-reduction model is readily adaptable for other comparative genomics tools and potentially of significant benefit to labs seeking to take advantage of the cloud as an alternative to local computing infrastructure.

Comparative effects of red and white grapes on oxidative markers and lipidemic parameters in adult hypercholesterolemic humans.

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Rahbar, Ali Reza; Mahmoudabadi, Mohammad Mehdi Shakouri; Islam, Md Shahidul

2015-06-01

The present study compared the effects of consuming red versus white whole grapes on oxidative and lipidemic indices in people with hypercholesterolemia. Sixty nine patients were randomized into three groups. The two treatment groups consumed 500 g of either Condori red grapes or Shahroodi white grapes daily for 8 weeks, and the third group served as a control. Plasma glucose, triacylglycerol (TG), cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), thiobarbituric acid reactive substances (TBARS) and total antioxidant capacity (TAC) were determined by colorimetric methods at baseline and at the end of the study. In addition, the polyphenol and fiber content of the two grape varieties was measured. TBARS was reduced in both study groups compared to the control group, and the reduction was greater in the group that consumed red grapes compared to the white grapes. TAC was increased significantly in both red and white grape consuming groups compared to the control group. Total cholesterol and LDL-C were decreased in the red grape group compared to the control group. No significant changes in fasting blood glucose, TG or HDL-C were observed among the groups. The results of this study suggest that consumption of the whole fruit of red grapes has more potent anti-oxidative and hypolipidemic effects compared to the white grapes in hyperlipidemic adult humans. Hence, the whole fruit of red grapes may be an excellent fruit choice not only to prevent oxidative stress related metabolic disorders but also cholesterol related cardiovascular diseases, particularly in hyperlipidemic adult humans.

Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness.

Science.gov (United States)

Cohen, Steven P; Peterlin, B Lee; Fulton, Larry; Neely, Edward T; Kurihara, Connie; Gupta, Anita; Mali, Jimmy; Fu, Diana C; Jacobs, Michael B; Plunkett, Anthony R; Verdun, Aubrey J; Stojanovic, Milan P; Hanling, Steven; Constantinescu, Octav; White, Ronald L; McLean, Brian C; Pasquina, Paul F; Zhao, Zirong

2015-12-01

Occipital neuralgia (ON) is characterized by lancinating pain and tenderness overlying the occipital nerves. Both steroid injections and pulsed radiofrequency (PRF) are used to treat ON, but few clinical trials have evaluated efficacy, and no study has compared treatments. We performed a multicenter, randomized, double-blind, comparative-effectiveness study in 81 participants with ON or migraine with occipital nerve tenderness whose aim was to determine which treatment is superior. Forty-two participants were randomized to receive local anesthetic and saline, and three 120 second cycles of PRF per targeted nerve, and 39 were randomized to receive local anesthetic mixed with deposteroid and 3 rounds of sham PRF. Patients, treating physicians, and evaluators were blinded to interventions. The PRF group experienced a greater reduction in the primary outcome measure, average occipital pain at 6 weeks (mean change from baseline -2.743 ± 2.487 vs -1.377 ± 1.970; P occipital pain through 3 months (mean change from baseline -1.925 ± 3.204 vs -0.541 ± 2.644; P = 0.043), and average overall headache pain through 6 weeks (mean change from baseline -2.738 ± 2.753 vs -1.120 ± 2.1; P = 0.037). Adverse events were similar between groups, and few significant differences were noted for nonpain outcomes. We conclude that although PRF can provide greater pain relief for ON and migraine with occipital nerve tenderness than steroid injections, the superior analgesia may not be accompanied by comparable improvement on other outcome measures.

Comparative placental transfer, localization, and effects of radionuclides in experimental animal and human pregnancies

International Nuclear Information System (INIS)

Sikov, M.R.; Traub, R.J.; Meznarich, H.K.

1992-01-01

Estimating radiation doses to the human embryo/fetus from radionuclides and predicting effects requires extrapolation of data from studies of laboratory species with scaling for species-specific developmental stage and gestational time relationships and maturities at birth. Combinations of fetal-to-maternal ratios of concentrations, patterns of deposition, transfer kinetics, and compartmental and physiologic models are used to predict radioactivity levels and radiation doses to the conceptus. There is agreement between values expressing fractional transfer across the placenta with values for fractional absorption from gastrointestinal tract or lung for most substances. Information about three elements - cesium, strontium, and iodine - serve to present comparative approaches to predicting radiation dose and effect. 25 refs., 11 figs., tab

Comparing the Effects of Negative and Mixed Emotional Messages on Predicted Occasional Excessive Drinking

Directory of Open Access Journals (Sweden)

Pilar Carrera

2008-01-01

Full Text Available In this work we present two types of emotional message, negative (sadness versus mixed (joy and sadness, with the aim of studying their differential effect on attitude change and the probability estimated by participants of repeating the behavior of occasional excessive drinking in the near future. The results show that for the group of participants with moderate experience in this behavior the negative message, compared to the mixed one, is associated with higher probability of repeating the risk behavior and a less negative attitude toward it. These results suggest that mixed emotional messages (e.g. joy and sadness messages could be more effective in campaigns for the prevention of this risk behavior.

Comparing the effects of negative and mixed emotional messages on predicted occasional excessive drinking.

Science.gov (United States)

Carrera, Pilar; Caballero, Amparo; Muñoz, Dolores

2008-01-01

In this work we present two types of emotional message, negative (sadness) versus mixed (joy and sadness), with the aim of studying their differential effect on attitude change and the probability estimated by participants of repeating the behavior of occasional excessive drinking in the near future. The results show that for the group of participants with moderate experience in this behavior the negative message, compared to the mixed one, is associated with higher probability of repeating the risk behavior and a less negative attitude toward it. These results suggest that mixed emotional messages (e.g. joy and sadness messages) could be more effective in campaigns for the prevention of this risk behavior.

Comparative and Mixture Effect of Cynodon Dactylon, ElectroMagnetic Field and Insulin on Diabetic Mouse.

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Nafisi, Saeid; Nezhady, Mohammad Ali Mohammad; Asghari, Mohammad Hossein

2012-12-01

New investigations are in progress to find some alternative treatments for diabetes mellitus. Herbs are some of the interesting medications in this regard. Cynodon dactylon (C.d) is a potential plant to be considered as a new medication. On the other hand, the effect of the Electromagnetic Field (EMF) on bio organisms is becoming clearer. In this study, the effect of C.d, EMF and insulin have been investigated on the diabetic mouse. Diabetes was induced by a combination of ketamine (60 mg/Kg) and xylazine (10 mg/Kg) which induces a sustained hyperglycemia. Mice were divided into 12 groups: 1) control, 2) normal saline, 3 and 4) 50mg/Kg C.d, 5 and 6) 100 mg/Kg C.d, 7) insulin, 8) insulin and C.d, 9) EMF (110 KHz, 700±20 mG), 10) insulin and EMF, 11) EMF plus C.d and 12) insulin plus C.d and EMF. Blood glucose level was measured after 5 and 60 minutes in C.d administrated groups, and 5 minutes in the other groups by a glucometer set. The data were analyzed by ANOVA and different means were compared by Tukey and Bonferroni tests (p<0.05). According to results, both dosages of C.d had significant lowering effect on blood glucose level. The first dose was more effective than the second, and its impact was just like insulin. The 6(th), 9(th) and 10(th) groups were significant, also. However, they did not show a higher effect than insulin or C.d. The application of EMF had a significant effect compared to the second group, but it did not reduce the glucose level to the normal range. The effect of the 8th group was very impressive and the mean glucose levels in this group were lower than the control group. Considering the data, C.d is a good alternative medication for diabetes mellitus.

Comparing the Effects of Four Instructional Treatments on EFL Students' Achievement in Writing Classified Ads

Science.gov (United States)

Khodabandeh, Farzaneh

2016-01-01

The current study set out to compare the effect of traditional and non-traditional instructional treatments; i.e. explicit, implicit, task-based and no-instruction approaches on students' abilities to learn how to write classified ads. 72 junior students who have all taken a course in Reading Journalistic Texts at the Payame-Noor University…

Comparative evaluation of antiplatelet effect of lycopene with aspirin and the effect of their combination on platelet aggregation: An in vitro study.

Science.gov (United States)

Sawardekar, Swapna B; Patel, Tejal C; Uchil, Dinesh

2016-01-01

The objective was to compare antiplatelet effect of lycopene with aspirin and to study effect of combination of the two on platelet aggregation in vitro, using platelets from healthy volunteers. Platelets were harvested; platelet count of platelet-rich plasma adjusted to 2.5 Χ 10(5)/μL. Aspirin (140 μmol/L) and lycopene (4, 6, 8, 10, and 12 μmol/L) were studied in vitro against adenosine-5'- diphosphate (ADP) (2.5 μM/L) and collagen. All the concentrations of lycopene (4-12 μmol/L) exhibited reduction in maximum platelet aggregation induced by aggregating agents ADP and collagen (P Lycopene at concentration 10 μmol/L showed maximum platelet inhibition (47.05% ± 19.56%) against ADP, whereas lycopene at concentration 8 μmol/L showed maximum platelet inhibition (54.26% ± 30.71%) against collagen. Four μmol/L of lycopene combined with 140 μmol/L and 70 μmol/L aspirin showed greater inhibition of platelets as compared to aspirin 140 μmol/L alone, against both ADP and collagen. The study favorably compares lycopene and aspirin with respect to their antiplatelet activities against ADP and collagen. Lycopene can be considered as a potential target for modifying the thrombotic and pro-inflammatory events associated with platelet activation.

Comparing effectiveness of top-down and bottom-up strategies in containing influenza.

Directory of Open Access Journals (Sweden)

Achla Marathe

Full Text Available This research compares the performance of bottom-up, self-motivated behavioral interventions with top-down interventions targeted at controlling an "Influenza-like-illness". Both types of interventions use a variant of the ring strategy. In the first case, when the fraction of a person's direct contacts who are diagnosed exceeds a threshold, that person decides to seek prophylaxis, e.g. vaccine or antivirals; in the second case, we consider two intervention protocols, denoted Block and School: when a fraction of people who are diagnosed in a Census Block (resp., School exceeds the threshold, prophylax the entire Block (resp., School. Results show that the bottom-up strategy outperforms the top-down strategies under our parameter settings. Even in situations where the Block strategy reduces the overall attack rate well, it incurs a much higher cost. These findings lend credence to the notion that if people used antivirals effectively, making them available quickly on demand to private citizens could be a very effective way to control an outbreak.

Comparing Usage and Cost- Effectiveness Analysis of English Printed and Electronic Books for University of Tehran

OpenAIRE

Davoud Haseli; Nader Naghshineh; fatemeh Fahimnia

2014-01-01

Libraries operate in a competitive environment, and this is essentially needed to prove its benefits for stockholders, and continuously evaluate and compare advantages for printed and electronic resources. In these cases, economic evaluation methods such as cost- effectiveness analysis, is one of the best methods, because of a comprehensive study of the use and cost of library sources. The purpose of this study is to discovery of use and cost- effectiveness analysis of English printed and ebo...

Comparative effects of partial rootzone drying and deficit irrigation on growth and physiology of tomato plants

Directory of Open Access Journals (Sweden)

Savić Slađana

2009-01-01

Full Text Available The effects of partial rootzone drying (PRD, deficit irrigation (DI, and full irrigation (FI on tomato physiology were investigated. In PRD and DI plants, leaf water potential values and stomatal conductance were significantly lower, while xylem ABA concentration was greater compared to FI plants. Photosynthesis was similar for all treatments. Water use efficiency was improved by PRD and DI, which reduced fruit dry weight, but had no effect on dry weight of leaves and stems.

Comparative Effectiveness of Smoking Cessation Medications: A National Prospective Cohort From Taiwan.

Directory of Open Access Journals (Sweden)

Po-Yin Chang

Full Text Available Relative effectiveness of smoking cessation medications-varenicline, bupropion and nicotine replacement therapy (NRT-remains unclear among smokers in real-world settings. Evidence in females and smokers with light/moderate nicotine dependence is particularly insufficient. This study compared the effectiveness of varenicline, bupropion or NRT gum relative to NRT patch, in achieving abstinence among recent quitters.In a national smoking cessation program in Taiwan (2012-2015, a cohort of 11,968 participants received varenicline (n = 5,052, bupropion (n = 823, NRT gum (n = 1944 or NRT patch (n = 4,149. The 7-day, 1-month or 6-month point-prevalence was calculated based on self-reported last smoking event via telephone interview after 6 months. Logistic regression modellings estimated odds ratios (OR and 95% confidence intervals (CI for achieving abstinence using different modalities (NRT patch as referent. Models included age, sex, education, marital status, geographic region, smoke-years, nicotine-dependence level, medical institution, number of clinic visits and medication use duration. Analyses were further stratified by sex and dependence severity.Participants were predominantly male (83% with a mean age of 43.7±12.6 years. Varenicline users were more likely than NRT patch users to achieve abstinence, based on 7-day point-prevalence (OR = 1.30, CI: 1.19-1.44, 1-month point-prevalence (OR = 1.36, CI: 1.24-1.50 or 6-month point-prevalence (OR = 1.30, CI: 1.14-1.47. Compared with NRT patch, varenicline was associated with greater odds of being abstinent in women (OR = 1.29, CI: 1.01-1.65, men (OR = 1.31, CI: 1.18-1.46, those with light/moderate dependence (OR = 1.42, CI: 1.24-1.63 or smokers with severe dependence (OR = 1.19, CI: 1.04-1.37, based on 7-day point-prevalence. Differences in effectiveness were not observed between users of bupropion, NRT gum and NRT patch.In smoking cessation clinics in Taiwan, varenicline users reported higher

Smoking-Cessation Interventions for Urban Hospital Patients: A Randomized Comparative Effectiveness Trial.

Science.gov (United States)

Sherman, Scott E; Link, Alissa R; Rogers, Erin S; Krebs, Paul; Ladapo, Joseph A; Shelley, Donna R; Fang, Yixin; Wang, Binhuan; Grossman, Ellie

2016-10-01

Hospitalization is a unique opportunity for smoking cessation, but prior interventions have measured efficacy with narrowly defined populations. The objective of this study was to enroll smokers admitted to two "safety net" hospitals and compare the effectiveness of two post-discharge cessation interventions. A randomized comparative effectiveness trial was conducted. At two New York City public hospitals, every hospitalized patient identified as a smoker (based on admission records) was approached. Inclusion criteria were: smoked cigarettes in the past 30 days; spoke English, Spanish, or Mandarin; had a U.S. phone number; not discharged to an institution where follow-up or smoking was limited; and not pregnant/breastfeeding. Of 18,797 patients identified as current smokers between July 2011 and April 2014, a total of 3,047 (16%) were discharged before being approached, 3,273 (17%) were not current smokers, 4,026 (21%) had no U.S. phone number, 2,831 (15%) were ineligible for other reasons, and 3,983 (21%) refused participation. In total, 1,618 (9%) participants enrolled in the study. During follow-up, 69% of participants were reached at 2 months and 68% at 6 months. At discharge, participants were randomized to multisession telephone counseling from study staff (n=804) or referral to the state quitline for proactive outreach and counseling (n=814). Self-reported abstinence at 6 months was measured. Analyses were conducted in late 2015. One quarter of participants were homeless or in unstable housing, 60% had a history of substance abuse, 43% reported current hazardous drinking, and half had a psychiatric diagnosis other than substance abuse. At follow-up, the rate of abstinence (30-day point prevalence) was higher in the intensive counseling arm than the quitline arm at 2 months (29.0% vs 20.7%; relative risk=1.40; 95% CI=1.13, 1.73) and 6 months (37.4% vs 31.5%; relative risk=1.19; 95% CI=1.01, 1.40). Intensive counseling was more effective than referral to the

Comparative Cost-Effectiveness of Stereotactic Body Radiation Therapy Versus Intensity-Modulated and Proton Radiation Therapy for Localized Prostate Cancer

International Nuclear Information System (INIS)

Parthan, Anju; Pruttivarasin, Narin; Davies, Diane; Taylor, Douglas C. A.; Pawar, Vivek; Bijlani, Akash; Lich, Kristen Hassmiller; Chen, Ronald C.

2012-01-01

Objective: To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer. Methods: A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publicly available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY) gained between treatments. Analyses were conducted from both payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed. Results: Compared to intensity-modulated radiation therapy (IMRT) and proton beam therapy (PT), stereotactic body radiation therapy (SBRT) was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost-effective in 75% and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75% and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusion: Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer.

Science.gov (United States)

Alawadi, Zeinab; Phatak, Uma R; Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy; Kao, Lillian S; Massarweh, Nader N; Feig, Barry W; Rodriguez-Bigas, Miguel A; Skibber, John M; Chang, George J

2017-04-01

Although the safety of combination chemotherapy without primary tumor resection (PTR) in patients with stage IV colon cancer has been established, questions remain regarding a potential survival benefit with PTR. The objective of this study was to compare mortality rates in patients who had colon cancer with unresectable metastases who did and did not undergo PTR. An observational cohort study was conducted among patients with unresectable metastatic colon cancer identified from the National Cancer Data Base (2003-2005). Multivariate Cox regression analyses with and without propensity score weighting (PSW) were performed to compare survival outcomes. Instrumental variable analysis, using the annual hospital-level PTR rate as the instrument, was used to account for treatment selection bias. To account for survivor treatment bias, in situations in which patients might die soon after diagnosis from different reasons, a landmark method was used. In the total cohort, 8641 of 15,154 patients (57%) underwent PTR, and 73.8% of those procedures (4972 of 6735) were at landmark. PTR was associated with a significant reduction in mortality using Cox regression (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.44-0.47) or PSW (HR, 0.46; 95% CI, 0. 44-0.49). However, instrumental variable analysis revealed a much smaller effect (relative mortality rate, 0.91; 95% CI, 0.87-0.96). Although a smaller benefit was observed with the landmark method using Cox regression (HR, 0.6; 95% CI, 0.55-0.64) and PSW (HR, 0.59; 95% CI, 0.54-0.64), instrumental variable analysis revealed no survival benefit (relative mortality rate, 0.97; 95% CI, 0.87-1.06). Among patients with unresectable metastatic colon cancer, after adjustment for confounder effects, PTR was not associated with improved survival compared with systemic chemotherapy; therefore, routine noncurative PTR is not recommended. Cancer 2017;123:1124-1133. © 2016 American Cancer Society. © 2016 American Cancer Society.

CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials.

Science.gov (United States)

Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

2011-03-01

Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of knowledge about patients' lifestyle behaviors that may affect cancer's progression and recurrence, and limited ability to compile and interpret the wide range of variables that must be considered in the cancer treatment. This lack of data integration limits the potential for patients and clinicians to engage in fully informed decision-making regarding cancer prevention, treatment, and survivorship care, and the translation of research results into mainstream medical care. Particularly important, as noted in a 2009 report on CER to the President and Congress, the limited focus on health behavior-change interventions was a major hindrance in this research landscape (DHHS 2009). This paper describes an initiative to improve CER for cancer by addressing several of these limitations. The Cyberinfrastructure for Comparative Effectiveness Research (CYCORE) project, informed by the National Science Foundation's 2007 report "Cyberinfrastructure Vision for 21(st) Century Discovery" has, as its central aim, the creation of a prototype for a user-friendly, open-source cyberinfrastructure (CI) that supports acquisition, storage, visualization, analysis, and sharing of data important for cancer-related CER. Although still under development, the process of gathering requirements for CYCORE has revealed new ways in which CI design can significantly improve the collection and analysis of a wide variety of data types, and has resulted in new and important partnerships among cancer researchers engaged in

Big data, advanced analytics and the future of comparative effectiveness research.

Science.gov (United States)

Berger, Marc L; Doban, Vitalii

2014-03-01

The intense competition that accompanied the growth of internet-based companies ushered in the era of 'big data' characterized by major innovations in processing of very large amounts of data and the application of advanced analytics including data mining and machine learning. Healthcare is on the cusp of its own era of big data, catalyzed by the changing regulatory and competitive environments, fueled by growing adoption of electronic health records, as well as efforts to integrate medical claims, electronic health records and other novel data sources. Applying the lessons from big data pioneers will require healthcare and life science organizations to make investments in new hardware and software, as well as in individuals with different skills. For life science companies, this will impact the entire pharmaceutical value chain from early research to postcommercialization support. More generally, this will revolutionize comparative effectiveness research.

Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.

Science.gov (United States)

Saffari, Elnaz; Mohammad-Alizadeh-Charandabi, Sakineh; Adibpour, Mohammad; Mirghafourvand, Mojgan; Javadzadeh, Yousef

2017-01-01

This triple-blind trial examined the effects of Calendula officinalis vaginal cream on the treatment of vaginal Candidiasis (primary outcome) and sexual function (secondary outcome). Married women aged 18-45 years with vaginal Candidiasis (n = 150) were recruited from April to October 2014 and randomized into Calendula and clotrimazole groups, using 5-g vaginal cream every night for seven nights. Clinical and laboratory assessments were conducted at 10-15 and 30-35 days after intervention and the female sexual function index was assessed at 30-35 days. Six women were lost to follow-up. The frequency of testing negative for Candidiasis in the Calendula group was significantly lower at the first (49% vs. 74%; odds ratio (OR) 0.32; 95% confidence interval (CI) 0.16-0.67) but higher at the second (77% vs. 34%; OR 3.1; 95% CI 1.5-6.2) follow-up compared to the clotrimazole group. The frequency of most signs and symptoms were almost equal in the two groups at the first follow-up, but were significantly lower in the Calendula group at the second follow-up. Sexual function had almost equal significant improvement in both groups. Calendula vaginal cream appears to have been effective in the treatment of vaginal Candidiasis and to have a delayed but greater long-term effect compared to clotrimazole.

Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

OpenAIRE

Yavarikia, Parisa; Shahnazi, Mahnaz; Hadavand Mirzaie, Samira; Javadzadeh, Yousef; Lutfi, Razieh

2013-01-01

Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.

Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

OpenAIRE

Parisa Yavarikia; Mahnaz Shahnazi; Samira Hadavand Mirzaie; Yousef Javadzadeh; Razieh Lutfi

2013-01-01

Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.Methods: This w...

Comparing the effects of reflexology and foot bath on sleep quality in the elderly

OpenAIRE

Seyyedrasooli

2015-01-01

Introduction: Sleep disturbances are common mental problems reported among elders. It seems some non-pharmacological interventions, can improve their sleep quality. The aim of this study is to compare the effectiveness of two interventions, reflexology and foot bath, on sleep quality in elderly people. Methods: This is a clinical trial without control group, conducted on 46 elderly men in two groups of reflexology and foot bath. Written informed consent was completed by subjects. Reflexolo...

A short-term cost-effectiveness study comparing robot-assisted laparoscopic and open retropubic radical prostatectomy

DEFF Research Database (Denmark)

Hohwü, Lena; Borre, Michael; Ehlers, Lars

2011-01-01

OBJECTIVE: To evaluate cost effectiveness and cost utility comparing robot-assisted laparoscopic prostatectomy (RALP) versus retropubic radical prostatectomy (RRP). METHODS: In a retrospective cohort study a total of 231 men between the age of 50 and 69 years and with clinically localised prostate....... An economic evaluation was made to estimate direct costs of the first postoperative year and an incremental cost-effectiveness ratio (ICER) per successful surgical treatment and per quality-adjusted life-year (QALY). A successful RP was defined as: no residual cancer (PSA ... high volume urology centres and utilise the full potential of each robot....

A comparative study of the antacid effect of raw spinach juice and spinach extract in an artificial stomach model.

Science.gov (United States)

Panda, Vandana Sanjeev; Shinde, Priyanka Mangesh

2016-12-01

BackgroundSpinacia oleracea known as spinach is a green-leafy vegetable consumed by people across the globe. It is reported to possess potent medicinal properties by virtue of its numerous antioxidant phytoconstituents, together termed as the natural antioxidant mixture (NAO). The present study compares the antacid effect of raw spinach juice with an antioxidant-rich methanolic extract of spinach (NAOE) in an artificial stomach model. MethodsThe pH of NAOE at various concentrations (50, 100 and 200 mg/mL) and its neutralizing effect on artificial gastric acid was determined and compared with that of raw spinach juice, water, the active control sodium bicarbonate (SB) and a marketed antacid preparation ENO. A modified model of Vatier's artificial stomach was used to determine the duration of consistent neutralization of artificial gastric acid for the test compounds. The neutralizing capacity of test compounds was determined in vitro using the classical titration method of Fordtran. Results NAOE (50, 100 and 200 mg/mL), spinach juice, SB and ENO showed significantly better acid-neutralizing effect, consistent duration of neutralization and higher antacid capacity when compared with water. Highest antacid activity was demonstrated by ENO and SB followed by spinach juice and NAOE200. Spinach juice exhibited an effect comparable to NAOE (200 mg/mL). ConclusionsThus, it may be concluded that spinach displays significant antacid activity be it in the raw juice form or as an extract in methanol.

A comparative study of effect of sevoflurane on intubating conditions with rocuronium in neurosurgical patients

Directory of Open Access Journals (Sweden)

Saikat Mitra

2015-01-01

Full Text Available Background and Aims: Rocuronium may not always be the preferred relaxant for rapid sequence intubation. When 2% sevoflurane is used in conjunction with rocuronium, it may reduce the time required for achieving complete skeletal muscle relaxation with the intubating dose of rocuronium. Methods: This study was prospective, randomised, double-blind in nature and compared the effect of sevoflurane on intubation time and intubating conditions when used along with rocuronium. Thirty adult patients belonging to American Society of Anesthesiologists physical status Grades 1 and 2, of either gender aged between 30 and 65 years undergoing neurosurgical operations were randomly allocated into two equal groups: Group R received 0.8 mg/kg rocuronium, and Group RS received 0.8 mg/kg of rocuronium with 2% sevoflurane. Onset time of intubation was assessed using train-of-four stimuli. The intubating conditions were compared using the Cooper scoring system and the haemodynamic responses were compared between the two groups. Results: The onset time of intubation was 101.73 ± 10.28 s in Group R and 60.4 ± 4.1 s in Group RS (P < 0.001, with excellent intubating conditions in both groups and without any adverse effects. Significant differences in heart rate and mean arterial pressure were seen immediately after intubation, at 1 and 3 min (P < 0.05 between the two groups. Conclusion: Rocuronium 0.8 mg/kg along with 2% sevoflurane provides excellent intubating conditions within 60-66 s from its administration.

Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis.

Science.gov (United States)

Hung, Chen-Yu; Hsiao, Ming-Yen; Chang, Ke-Vin; Han, Der-Sheng; Wang, Tyng-Guey

2016-01-01

Increasing evidence has supported the use of dextrose prolotherapy for patients with osteoarthritis. However, the real benefits may be affected by differences in injection protocols, comparative regimens, and evaluation scales. PubMed and Scopus were searched from the earliest record until February 2016. One single-arm study and five randomized controlled trials were included, comprising 326 participants. We estimated the effect sizes of pain reduction before and after serial dextrose injections and compared the values between dextrose prolotherapy, comparative regimens, and exercise 6 months after the initial injection. Regarding the treatment arm using dextrose prolotherapy, the effect sizes compared with baseline were 0.65 (95% confidence interval [CI], 0.14-1.17), 0.84 (95% CI, 0.40-1.27), 0.85 (95% CI, 0.60-1.10), and 0.87 (95% CI, 0.53-1.21) after the first, second, third, and fourth or more injections, respectively. The overall effect of dextrose was better than control injections (effect size, 0.36; 95% CI, 0.10-0.63). Dextrose prolotherapy had a superior effect compared with local anesthesia (effect size, 0.38; 95% CI, 0.07-0.70) and exercise (effect size, 0.71; 95% CI, 0.30-1.11). There was an insignificant advantage of dextrose over corticosteroids (effect size, 0.31; 95% CI, -0.18 to 0.80) which was only estimated from one study. Dextrose injections decreased pain in osteoarthritis patients but did not exhibit a positive dose-response relationship following serial injections. Dextrose prolotherapy was found to provide a better therapeutic effect than exercise, local anesthetics, and probably corticosteroids when patients were retested 6 months following the initial injection.

Effectiveness of tramadol/paracetamol compared with etoricoxib as ...

African Journals Online (AJOL)

paracetamol combination when compared with etoricoxib as postoperative analgesia following day care surgery. Design: This was a prospective, randomised, single-blind study. Setting and subjects: Sixty-two patients were randomised to receive ...

Comparing the Effects of Teen Mentors to Adult Teachers on Child Lifestyle Behaviors and Health Outcomes in Appalachia

Science.gov (United States)

Smith, Laureen H.; Holloman, Christopher

2013-01-01

Childhood obesity prevalence rates in the United States are the highest in the rural Appalachian areas. Teens mentoring younger children to reverse obesity health risks are an understudied approach. This randomized-controlled trial compared the effects of two curriculum delivery methods and assessed the mediating effects of the number of sessions…

Propensity score estimation to address calendar time-specific channeling in comparative effectiveness research of second generation antipsychotics.

Directory of Open Access Journals (Sweden)

Stacie B Dusetzina

Full Text Available Channeling occurs when a medication and its potential comparators are selectively prescribed based on differences in underlying patient characteristics. Drug safety advisories can provide new information regarding the relative safety or effectiveness of a drug product which might increase selective prescribing. In particular, when reported adverse effects vary among drugs within a therapeutic class, clinicians may channel patients toward or away from a drug based on the patient's underlying risk for an adverse outcome. If channeling is not identified and appropriately managed it might lead to confounding in observational comparative effectiveness studies.To demonstrate channeling among new users of second generation antipsychotics following a Food and Drug Administration safety advisory and to evaluate the impact of channeling on cardiovascular risk estimates over time.Florida Medicaid data from 2001-2006.Retrospective cohort of adults initiating second generation antipsychotics. We used propensity scores to match olanzapine initiators with other second generation antipsychotic initiators. To evaluate channeling away from olanzapine following an FDA safety advisory, we estimated calendar time-specific propensity scores. We compare the performance of these calendar time-specific propensity scores with conventionally-estimated propensity scores on estimates of cardiovascular risk.Increased channeling away from olanzapine was evident for some, but not all, cardiovascular risk factors and corresponded with the timing of the FDA advisory. Covariate balance was optimized within period and across all periods when using the calendar time-specific propensity score. Hazard ratio estimates for cardiovascular outcomes did not differ across models (Conventional PS: 0.97, 95%CI: 0.81-3.18 versus calendar time-specific PS: 0.93, 95%CI: 0.77-3.04.Changes in channeling over time was evident for several covariates but had limited impact on cardiovascular risk

A cost-effectiveness analysis of radon protection methods in domestic properties: a comparative case study in Brixworth, Northamptonshire, UK

International Nuclear Information System (INIS)

Coskeran, Thomas; Denman, Antony; Phillips, Paul; Tornberg, Roger

2006-01-01

Building regulations in the UK have since 1992 required that radon-proof membranes be installed in new domestic properties to protect residents against the adverse effects of radon. This study compares the cost-effectiveness of the current regulatory regime with an alternative that would entail new properties being tested for radon after construction, and being remediated if necessary. The alternative regime is found to be more cost-effective for a sample of properties in Brixworth, Northamptonshire, UK. For this regime, the central estimate of cost per quality-adjusted life-year gained, the measure of cost-effectiveness used, is Pounds 2869 compared to Pounds 6182 for installing membranes, results suggesting a case for re-examining the current regulations on radon protection in new properties. Pilot studies will, however, be needed to consider how different means of protecting residents of new properties against radon might operate in practice and to provide improved evidence on their relative cost-effectiveness

Effects of lidocaine and droxicainide on myocardial necrosis: a comparative study

International Nuclear Information System (INIS)

Faria, D.B.; Cheung, W.M.; Ribeiro, L.G.; Maroko, P.R.

1983-01-01

Lidocaine has been shown to protect ischemic myocardium, but the degree of its effectiveness is not yet well established. Therefore, in this study, the effects of this drug on ultimate infarct size were examined quantitatively. Another member of the same class of drugs, droxicainide (ALS1249), DL-N-(2-hydroxyethyl)-pipecolinyl-2,6-dimethylanilide hydrochloride, is a new antiarrhythmic agent that has shown a good therapeutic index in the initial experimental studies. Accordingly, the effects of this drug on ultimate infarct size were examined and compared with those of lidocaine. Coronary artery occlusion was performed on 29 dogs. One minute later, technetium-99m labeled microspheres were injected into the left atrium for assessment of the hypoperfused zone (the zone at risk of infarction). Fifteen minutes after occlusion, the dogs were randomized into three groups: 9 dogs served as a control group, 10 were given lidocaine and 10 were given the same dosage of droxicainide. Six hours after occlusion, the dogs were sacrificed and the hearts cut into 3 mm thick slices and incubated in triphenyltetrazolium chloride to delineate the area of myocardial damage. Autoradiography of the same slices provided images of the areas of myocardial hypoperfusion. Thereafter, in each dog, the percent of hypoperfused area that evolved to necrosis was calculated. In control dogs, it was 85.6 +/- 2.0%; in lidocaine-treated dogs, 68.1 +/- 4.1% (p less than 0.01), a reduction of 20%; and in droxicainide-treated dogs, 50.1 +/- 5.3%, a reduction of 41% (p less than 0.001 versus control and p less than 0.005 versus lidocaine)

A comparative study of neuroprotective effect of angiotensin converting enzyme inhibitors against scopolamine-induced memory impairments in rats

Directory of Open Access Journals (Sweden)

Talha Jawaid

2015-01-01

Full Text Available The comparative study of neuroprotective effect of angiotensin converting enzyme inhibitors against scopolamine-induced neuroinflammation in albino Wistar rats was studied. Male albino rats were administered with scopolamine to induce memory impairment. The standard nootropic agent, piracetam (200 mg/kg b.w., [i.p.], perindopril (0.1 mg/kg b.w., [i.p.], enalapril (0.1 mg/kg b.w., [i.p.], and ramipril (0.1 mg/kg b.w., [i.p.] were administered in different group of animals for 5 days. On 5 th day, scopolamine (1 mg/kg b.w., i.p. was administered after 60 min of the last dose of test drug. Memory function was evaluated in Morris water maze (MWM test and pole climbing test (PCT. Biochemical estimations like glutathione (GSH, malondialdehyde (MDA, and acetylcholinesterase activity in the brain were estimated after completion of behavior study. All three test groups shows improvement in learning and memory in comparison to control group. Perindopril treated group showed a more effective significant decrease in escape latency time and transfer latency time compared to enalapril and ramipril treated group on day 4 in MWM test and PCT, respectively. Perindopril shows a significant reduction in MDA level and acetylcholinesterase activity and a significant rise in GSH level compared to enalapril and ramipril. The finding of this study indicates that Perindopril is more effective in memory retention compared to enalapril and ramipril.

Comparative Potential Protect Effect of HSCAS, Diatomite and ...

African Journals Online (AJOL)

mdenli

bentonite (Rosa et al., 2001), zeolite (Miazzo et al., 2000), hydrated sodium calcium aluminosilicate. (HSCAS) ... Due to these properties diatomite was selected for use in this experiment to compare ..... Aflatoxins in animal and human health.

The effective atomic numbers of some biomolecules calculated by two methods: A comparative study

Energy Technology Data Exchange (ETDEWEB)

Manohara, S. R.; Hanagodimath, S. M.; Gerward, L. [Department of Physics, Gulbarga University, Gulbarga, Karnataka 585 106 (India); Department of Physics, Technical University of Denmark, Lyngby DK-2800 (Denmark)

2009-01-15

The effective atomic numbers Z{sub eff} of some fatty acids and amino acids have been calculated by two numerical methods, a direct method and an interpolation method, in the energy range of 1 keV-20 MeV. The notion of Z{sub eff} is given a new meaning by using a modern database of photon interaction cross sections (WinXCom). The results of the two methods are compared and discussed. It is shown that for all biomolecules the direct method gives larger values of Z{sub eff} than the interpolation method, in particular at low energies (1-100 keV) At medium energies (0.1-5 MeV), Z{sub eff} for both methods is about constant and equal to the mean atomic number of the material. Wherever possible, the calculated values of Z{sub eff} are compared with experimental data.

The effective atomic numbers of some biomolecules calculated by two methods: A comparative study

International Nuclear Information System (INIS)

Manohara, S. R.; Hanagodimath, S. M.; Gerward, L.

2009-01-01

The effective atomic numbers Z eff of some fatty acids and amino acids have been calculated by two numerical methods, a direct method and an interpolation method, in the energy range of 1 keV-20 MeV. The notion of Z eff is given a new meaning by using a modern database of photon interaction cross sections (WinXCom). The results of the two methods are compared and discussed. It is shown that for all biomolecules the direct method gives larger values of Z eff than the interpolation method, in particular at low energies (1-100 keV) At medium energies (0.1-5 MeV), Z eff for both methods is about constant and equal to the mean atomic number of the material. Wherever possible, the calculated values of Z eff are compared with experimental data.

Cost-effectiveness analysis of metformin+dipeptidyl peptidase-4 inhibitors compared to metformin+sulfonylureas for treatment of type 2 diabetes.

Science.gov (United States)

Kwon, Christina S; Seoane-Vazquez, Enrique; Rodriguez-Monguio, Rosa

2018-02-01

Patients with type 2 diabetes (T2D) typically use several drug treatments during their lifetime. There is a debate about the best second-line therapy after metformin monotherapy failure due to the increasing number of available antidiabetic drugs and the lack of comparative clinical trials of secondary treatment regimens. While prior research compared the cost-effectiveness of two alternative drugs, the literature assessing T2D treatment pathways is scarce. The purpose of this study was to evaluate the long-term cost-effectiveness of dipeptidyl peptidase-4 inhibitors (DPP-4i) compared to sulfonylureas (SU) as second-line therapy in combination with metformin in patients with T2D. A Markov model was developed with four health states, 1 year cycle, and a 25-year time horizon. Clinical and cost data were collected from previous studies and other readily available secondary data sources. The incremental cost-effectiveness ratio (ICER) was estimated from the US third party payer perspective. Both, costs and outcomes, were discounted at a 3% annual discount rate. One way and probabilistic sensitivity analyses were performed to evaluate the impact of uncertainty on the base-case results. The discounted incremental cost of metformin+DPP-4i compared to metformin+SU was $11,849 and the incremental life-years gained were 0.61, resulting in an ICER of $19,420 per life-year gained for patients in the metformin+DPP-4i treatment pathway. The ICER estimated in the probabilistic sensitivity analysis was $19,980 per life-year gained. Sensitivity analyses showed that the results of the study were not sensitive to changes in the parameters used in base-case. The metformin+DPP-4i treatment pathway was cost-effective compared to metformin+SU as a long-term second-line therapy in the treatment of T2D from the US health care payer perspective. Study findings have the potential to provide clinicians and third party payers valuable evidence for the prescription and utilization of cost-effective

Comparative Tuberculosis (TB) Prevention Effectiveness in Children of Bacillus Calmette-Guérin (BCG) Vaccines from Different Sources, Kazakhstan

Science.gov (United States)

Favorov, Michael; Ali, Mohammad; Tursunbayeva, Aigul; Aitmagambetova, Indira; Kilgore, Paul; Ismailov, Shakhimurat; Chorba, Terence

2012-01-01

Background Except during a 1-year period when BCG vaccine was not routinely administered, annual coverage of infants with Bacillus Calmette-Guérin (BCG) in Kazakhstan since 2002 has exceeded 95%. BCG preparations from different sources (Japan, Serbia, and Russia) or none were used exclusively in comparable 7-month time-frames, September through March, in 4 successive years beginning in 2002. Our objective was to assess relative effectiveness of BCG immunization. Methods/Findings We compared outcomes of birth cohorts from the 4 time-frames retrospectively. Three cohorts received vaccine from one of three manufacturers exclusively, and one cohort was not vaccinated. Cohorts were followed for 3 years for notifications of clinical TB and of culture-confirmed TB, and for 21 months for TB meningitis notifications. Prevention effectiveness based on relative risk of TB incidence was calculated for each vaccinated cohort compared to the non-vaccinated cohort. Although there were differences in prevention effectiveness observed among the three BCG vaccines, all were protective. The Japanese vaccine (currently used in Kazakhstan), the Serbian vaccine, and the Russian vaccine respectively were 69%, 43%, and 22% effective with respect to clinical TB notifications, and 92%, 82%, and 51% effective with respect to culture confirmed TB. All three vaccines were >70% effective with respect to TB meningitis. Limitations Potential limitations included considerations that 1) the methodology used was retrospective, 2) multiple risk factors could have varied between cohorts and affected prevention effectiveness measures, 3) most cases were clinically diagnosed, and TB culture-positive case numbers and TB meningitis case numbers were sparse, and 4) small variations in reported population TB burden could have affected relative risk of exposure for cohorts. Conclusions/Significance All three BCG vaccines evaluated were protective against TB, and prevention effectiveness varied by

Comparative tuberculosis (TB prevention effectiveness in children of Bacillus Calmette-Guérin (BCG vaccines from different sources, Kazakhstan.

Directory of Open Access Journals (Sweden)

Michael Favorov

Full Text Available BACKGROUND: Except during a 1-year period when BCG vaccine was not routinely administered, annual coverage of infants with Bacillus Calmette-Guérin (BCG in Kazakhstan since 2002 has exceeded 95%. BCG preparations from different sources (Japan, Serbia, and Russia or none were used exclusively in comparable 7-month time-frames, September through March, in 4 successive years beginning in 2002. Our objective was to assess relative effectiveness of BCG immunization. METHODS/FINDINGS: We compared outcomes of birth cohorts from the 4 time-frames retrospectively. Three cohorts received vaccine from one of three manufacturers exclusively, and one cohort was not vaccinated. Cohorts were followed for 3 years for notifications of clinical TB and of culture-confirmed TB, and for 21 months for TB meningitis notifications. Prevention effectiveness based on relative risk of TB incidence was calculated for each vaccinated cohort compared to the non-vaccinated cohort. Although there were differences in prevention effectiveness observed among the three BCG vaccines, all were protective. The Japanese vaccine (currently used in Kazakhstan, the Serbian vaccine, and the Russian vaccine respectively were 69%, 43%, and 22% effective with respect to clinical TB notifications, and 92%, 82%, and 51% effective with respect to culture confirmed TB. All three vaccines were >70% effective with respect to TB meningitis. LIMITATIONS: Potential limitations included considerations that 1 the methodology used was retrospective, 2 multiple risk factors could have varied between cohorts and affected prevention effectiveness measures, 3 most cases were clinically diagnosed, and TB culture-positive case numbers and TB meningitis case numbers were sparse, and 4 small variations in reported population TB burden could have affected relative risk of exposure for cohorts. CONCLUSIONS/SIGNIFICANCE: All three BCG vaccines evaluated were protective against TB, and prevention effectiveness

Comparative tuberculosis (TB) prevention effectiveness in children of Bacillus Calmette-Guérin (BCG) vaccines from different sources, Kazakhstan.

Science.gov (United States)

Favorov, Michael; Ali, Mohammad; Tursunbayeva, Aigul; Aitmagambetova, Indira; Kilgore, Paul; Ismailov, Shakhimurat; Chorba, Terence

2012-01-01

Except during a 1-year period when BCG vaccine was not routinely administered, annual coverage of infants with Bacillus Calmette-Guérin (BCG) in Kazakhstan since 2002 has exceeded 95%. BCG preparations from different sources (Japan, Serbia, and Russia) or none were used exclusively in comparable 7-month time-frames, September through March, in 4 successive years beginning in 2002. Our objective was to assess relative effectiveness of BCG immunization. We compared outcomes of birth cohorts from the 4 time-frames retrospectively. Three cohorts received vaccine from one of three manufacturers exclusively, and one cohort was not vaccinated. Cohorts were followed for 3 years for notifications of clinical TB and of culture-confirmed TB, and for 21 months for TB meningitis notifications. Prevention effectiveness based on relative risk of TB incidence was calculated for each vaccinated cohort compared to the non-vaccinated cohort. Although there were differences in prevention effectiveness observed among the three BCG vaccines, all were protective. The Japanese vaccine (currently used in Kazakhstan), the Serbian vaccine, and the Russian vaccine respectively were 69%, 43%, and 22% effective with respect to clinical TB notifications, and 92%, 82%, and 51% effective with respect to culture confirmed TB. All three vaccines were >70% effective with respect to TB meningitis. Potential limitations included considerations that 1) the methodology used was retrospective, 2) multiple risk factors could have varied between cohorts and affected prevention effectiveness measures, 3) most cases were clinically diagnosed, and TB culture-positive case numbers and TB meningitis case numbers were sparse, and 4) small variations in reported population TB burden could have affected relative risk of exposure for cohorts. All three BCG vaccines evaluated were protective against TB, and prevention effectiveness varied by manufacturer. When setting national immunization policy, consideration

A COMPARATIVE STUDY ON THE EFFECTIVENESS OF THE FILMSTRIP, SOUND FILMSTRIP, AND FILMOGRAPH FOR TEACHING FACTS AND CONCEPTS.

Science.gov (United States)

FINN, JAMES D.; MCBEATH, RONALD J.

THIS STUDY COMPARED THE RELATIVE EFFECTIVENESS IN FACTUAL LEARNING OF (1) A CAPTIONED FILMSTRIP, (2) A CAPTIONED FILMSTRIP WITH NARRATION, (3) A SOUND FILMSTRIP, AND (4) A FILMOGRAPH. (THE FILMOGRAPH WAS MADE BY PHOTOGRAPHING STILL PICTURES ON MOTION PICTURE FILM.) THE STUDY TESTED THE HYPOTHESIS THAT THE FILMOGRAPHY COULD TEACH MORE EFFECTIVELY.…

The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

NARCIS (Netherlands)

van de Streek, M.D.; van der Schans, C.P.; de Greef, M.H.G.; Postema, K.

2004-01-01

The aim of the present study was to compare the effect of a new prefabricated Thamert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the

Comparing the Effects of Negative and Mixed Emotional Messages on Predicted Occasional Excessive Drinking

OpenAIRE

Carrera, Pilar; Caballero, Amparo; Mu?oz, Dolores

2008-01-01

In this work we present two types of emotional message, negative (sadness) versus mixed (joy and sadness), with the aim of studying their differential effect on attitude change and the probability estimated by participants of repeating the behavior of occasional excessive drinking in the near future. The results show that for the group of participants with moderate experience in this behavior the negative message, compared to the mixed one, is associated with higher probability of repeating t...

Comparing the effects of negative and mixed emotional messages on predicted occasional excessive drinking

OpenAIRE

Carrera Levillain, Pilar; Caballero González, Amparo; Muñoz Cáceres, María Dolores

2008-01-01

In this work we present two types of emotional message, negative (sadness) versus mixed (joy and sadness), with the aim of studying their differential effect on attitude change and the probability estimated by participants of repeating the behavior of occasional excessive drinking in the near future. The results show that for the group of participants with moderate experience in this behavior the negative message, compared to the mixed one, is associated with higher probability of repeating t...

Comparative effectiveness of Calabadion and sugammadex to reverse non-depolarizing neuromuscular blocking agents

Science.gov (United States)

Haerter, Friederike; Simons, Jeroen Cedric Peter; Foerster, Urs; Duarte, Ingrid Moreno; Diaz-Gil, Daniel; Ganapati, Shweta; Eikermann-Haerter, Katharina; Ayata, Cenk; Zhang, Ben; Blobner, Manfred; Isaacs, Lyle; Eikermann, Matthias

2015-01-01

Background We evaluated the comparative effectiveness of calabadion 2 to reverse non-depolarizing neuromuscular blocking agents (NMBAs) by binding and inactivation. Methods The dose-response relationship of drugs to reverse vecuronium, rocuronium, and cisatracurium-induced neuromuscular block (NMB) was evaluated in vitro (competition binding assays and urine analysis), ex vivo (n=34; phrenic nerve hemidiaphragm preparation) and in vivo (n=108; quadriceps femoris muscle of the rat). Cumulative dose-response curves of calabadions, neostigmine, or sugammadex were created ex vivo at steady-state deep NMB. In living rats, we studied the dose-response relationship of the test drugs to reverse deep block under physiological conditions and we measured the amount of calabadion 2 excreted in the urine. Results In vitro experiments showed that calabadion 2 binds rocuronium with 89 times the affinity of sugammadex (Ka = 3.4 × 109 M−1 and Ka = 3.8 × 107 M−1). Urine analysis (proton nuclear magnetic resonance), competition binding assays and ex vivo study results obtained in the absence of metabolic deactivation are in accordance with an 1:1 binding ratio of sugammadex and calabadion 2 toward rocuronium. In living rats, calabadion 2 dose-dependently and rapidly reversed all NMBAs tested. The molar potency of calabadion 2 to reverse vecuronium and rocuronium was higher compared to sugammadex. Calabadion 2 was eliminated renally, and did not affect blood pressure or heart rate. Conclusion Calabadion 2 reverses NMB-induced by benzylisoquinolines and steroidal NMBAs in rats more effectively, i.e. faster, than sugammadex. Calabadion 2 is eliminated in the urine and well tolerated in rats. PMID:26418697

Comparative cost-effectiveness of stereotactic body radiation therapy versus intensity-modulated and proton radiation therapy for localized prostate cancer.

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Anju eParthan

2012-08-01

Full Text Available Objective. To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer.Methods. A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publically available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY gained between treatments. Analyses were conducted from both a payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed.Results. Compared to intensity modulated radiation therapy (IMRT and proton beam therapy (PT, stereotactic body radiation therapy (SBRT was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost effective in 75%, and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75%, and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusions. Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

A comparative study of radioprotective effect of several antioxidants on human blood lymphocytes

International Nuclear Information System (INIS)

Wang Mingsuo; Zhu Gengbai; Gu Xuandi

1992-01-01

By means of improved fluorometric method with 2-thiobarbituric acid (TBA) as the fluorometric agent, radioprotective effects of four kinds of antioxidants on 60 Co γ-ray induced lipid peroxidation (LPO) level, i.e. Malondialdehyde (MDA) content changes in human blood lymphocytes were in human blood lymphocytes were compared by using relative protective efficiency (RPE) as an indicator. The LPO level in human lymphocytes which had been treated with an antioxidant at an concentration of 5 x 10 -3 g/L for 1 hr was measured 2 hr after exposure to 4 Gy of γ-rays, and the RPE values of antioxidants were calculated under these conditions: SOD, 38.23; VE, 23.75:VC, 19.32 and Se +4 , 18.27, thus the anticipation that the compounds, superoxide dismutase (SOD), 2-tocopherols (VE), ascorbic acid (VC) and Na 2 SeO 3 (Se +4 ) had radioprotective effects was confirmed. It was found that the radioprotective beneficial sequences of four kinds of antioxidants were arranged as SOD>VE>VC,Se +4 . The results show that radioprotective effects of exogenous antioxidants on radiation induced LPO damage are dependent not only on irradiation dosage, but also especially on property of antioxidants, drug concentration, pretreatment and monitoring time, etc. The mechanism of these antioxidants effecting as radioprotectants on human lymphocytes is discussed in connection with LPO damage and radioprotection

Decomposing the trade-environment nexus for Malaysia: what do the technique, scale, composition, and comparative advantage effect indicate?

Science.gov (United States)

Ling, Chong Hui; Ahmed, Khalid; Binti Muhamad, Rusnah; Shahbaz, Muhammad

2015-12-01

This paper investigates the impact of trade openness on CO2 emissions using time series data over the period of 1970QI-2011QIV for Malaysia. We disintegrate the trade effect into scale, technique, composition, and comparative advantage effects to check the environmental consequence of trade at four different transition points. To achieve the purpose, we have employed augmented Dickey-Fuller (ADF) and Phillips-Perron (PP) unit root tests in order to examine the stationary properties of the variables. Later, the long-run association among the variables is examined by applying autoregressive distributed lag (ARDL) bounds testing approach to cointegration. Our results confirm the presence of cointegration. Further, we find that scale effect has positive and technique effect has negative impact on CO2 emissions after threshold income level and form inverted U-shaped relationship-hence validates the environmental Kuznets curve hypothesis. Energy consumption adds in CO2 emissions. Trade openness and composite effect improve environmental quality by lowering CO2 emissions. The comparative advantage effect increases CO2 emissions and impairs environmental quality. The results provide the innovative approach to see the impact of trade openness in four sub-dimensions of trade liberalization. Hence, this study attributes more comprehensive policy tool for trade economists to better design environmentally sustainable trade rules and agreements.

Comparative effects of metal oxide nanoparticles on human airway epithelial cells and macrophages

International Nuclear Information System (INIS)

Rotoli, Bianca Maria; Bussolati, Ovidio; Costa, Anna Luisa; Blosi, Magda; Di Cristo, Luisana; Zanello, Pier Paolo; Bianchi, Massimiliano G.; Visigalli, Rossana; Bergamaschi, Enrico

2012-01-01

Among nanomaterials of industrial relevance, metal-based nanoparticles (NPs) are widely used, but their effects on airway cells are relatively poorly characterized. To compare the effects of metal NPs on cells representative of the lung-blood barrier, Calu-3 epithelial cells and Raw264.7 macrophages were incubated with three industrially relevant preparations of TiO 2 NPs (size range 4–33 nm), two preparations of CeO 2 NPs (9–36 nm) and CuO NPs (25 nm). While Raw264.7 were grown on standard plasticware, Calu-3 cells were seeded on permeable filters, where they form a high-resistance monolayer, providing an in vitro model of the airway barrier. Metal NPs, obtained from industrial sources, were characterized under the conditions adopted for the biological tests. Cytotoxicity was assessed with resazurin method in both epithelial and macrophage cells, while epithelial barrier permeability was monitored measuring the trans-epithelial electrical resistance (TEER). In macrophages, titania and ceria had no significant effect on viability in the whole range of nominal doses tested (15–240 μg/cm 2 of monolayer), while CuO NPs produced a marked viability loss. Moreover, only CuO NPs, but not the other NPs, lowered TEER of Calu-3 monolayers, pointing to the impairment of the epithelial barrier. TEER decreased by 30 % at the dose of 10 μg/cm 2 of CuO NPs, compared to untreated control, and was abolished at doses ≥80 μg/cm 2 , in strict correlation with changes in cell viability. These results indicate that (1) CuO NPs increase airway epithelium permeability even at relatively low doses and are significantly toxic for macrophages and airway epithelial cells, likely through the release of Cu ions in the medium; (2) TiO 2 and CeO 2 NPs do not affect TEER and exhibit little acute toxicity for airway epithelial cells and macrophages; and (3) TEER measurement can provide a simple method to assess the impairment of in vitro airway epithelial barrier model by manufactured

Comparative effects of metal oxide nanoparticles on human airway epithelial cells and macrophages

Science.gov (United States)

Rotoli, Bianca Maria; Bussolati, Ovidio; Costa, Anna Luisa; Blosi, Magda; Di Cristo, Luisana; Zanello, Pier Paolo; Bianchi, Massimiliano G.; Visigalli, Rossana; Bergamaschi, Enrico

2012-09-01

Among nanomaterials of industrial relevance, metal-based nanoparticles (NPs) are widely used, but their effects on airway cells are relatively poorly characterized. To compare the effects of metal NPs on cells representative of the lung-blood barrier, Calu-3 epithelial cells and Raw264.7 macrophages were incubated with three industrially relevant preparations of TiO2 NPs (size range 4-33 nm), two preparations of CeO2 NPs (9-36 nm) and CuO NPs (25 nm). While Raw264.7 were grown on standard plasticware, Calu-3 cells were seeded on permeable filters, where they form a high-resistance monolayer, providing an in vitro model of the airway barrier. Metal NPs, obtained from industrial sources, were characterized under the conditions adopted for the biological tests. Cytotoxicity was assessed with resazurin method in both epithelial and macrophage cells, while epithelial barrier permeability was monitored measuring the trans-epithelial electrical resistance (TEER). In macrophages, titania and ceria had no significant effect on viability in the whole range of nominal doses tested (15-240 μg/cm2 of monolayer), while CuO NPs produced a marked viability loss. Moreover, only CuO NPs, but not the other NPs, lowered TEER of Calu-3 monolayers, pointing to the impairment of the epithelial barrier. TEER decreased by 30 % at the dose of 10 μg/cm2 of CuO NPs, compared to untreated control, and was abolished at doses ≥80 μg/cm2, in strict correlation with changes in cell viability. These results indicate that (1) CuO NPs increase airway epithelium permeability even at relatively low doses and are significantly toxic for macrophages and airway epithelial cells, likely through the release of Cu ions in the medium; (2) TiO2 and CeO2 NPs do not affect TEER and exhibit little acute toxicity for airway epithelial cells and macrophages; and (3) TEER measurement can provide a simple method to assess the impairment of in vitro airway epithelial barrier model by manufactured nanomaterials.

The cost-effectiveness of rotavirus vaccination: Comparative analyses for five European countries and transferability in Europe.

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Jit, Mark; Bilcke, Joke; Mangen, Marie-Josée J; Salo, Heini; Melliez, Hugues; Edmunds, W John; Yazdan, Yazdanpanah; Beutels, Philippe

2009-10-19

Cost-effectiveness analyses are usually not directly comparable between countries because of differences in analytical and modelling assumptions. We investigated the cost-effectiveness of rotavirus vaccination in five European Union countries (Belgium, England and Wales, Finland, France and the Netherlands) using a single model, burden of disease estimates supplied by national public health agencies and a subset of common assumptions. Under base case assumptions (vaccination with Rotarix, 3% discount rate, health care provider perspective, no herd immunity and quality of life of one caregiver affected by a rotavirus episode) and a cost-effectiveness threshold of euro30,000, vaccination is likely to be cost effective in Finland only. However, single changes to assumptions may make it cost effective in Belgium and the Netherlands. The estimated threshold price per dose for Rotarix (excluding administration costs) to be cost effective was euro41 in Belgium, euro28 in England and Wales, euro51 in Finland, euro36 in France and euro46 in the Netherlands.

Towards Building a Bridge between Community Engagement in Research (CEnR) and Comparative Effectiveness Research (CER).

Science.gov (United States)

Ahmed, Syed M; Nelson, David; Kissack, Anne; Franco, Zeno; Whittle, Jeff; Kotchen, Theodore; Meurer, John R; Morzinski, Jeffrey; Brandenburg, Terry

2015-04-01

A major national priority is establishing an effective infrastructure for translation of scientific discoveries into the community. Knowledge and practice continue to accelerate in health research yet healthcare recommendation adoption remains slow for practitioners, patients, and communities. Two areas of research placed in the later stages of the translational research spectrum, Community Engagement in Research and Comparative Effectiveness Research, are ideal for approaching this challenge collaboratively. The Clinical and Translational Science Institute of Southeastern Wisconsin convened academics and community-based organizations familiar with these fields of research in a 1-day workshop to establish an initial dialogue on similarities and differences with a goal of exploring ways to operationalize a collective effort. Participants represented four academic institutions and twelve other healthcare and community-based service organizations. Primary fields of study included community engaged research, comparative effectiveness research, psychology, clinical research, administration, nursing, public health, education, and other professionals. This initial report outlines the results of this diverse discussion and provides insights into the priorities, diverging issues, and areas for future examination and practice. Key discoveries reveal clear crosscutting issues, value in philosophical and provocative discussions among investigators, a need for practice and lessons learned, and bidirectional exchange with community representation. © 2014 Wiley Periodicals, Inc.

Comparative effects of vitamin K2 and vitamin E on experimental arteriosclerosis.

Science.gov (United States)

Seyama, Y; Hayashi, M; Takegami, H; Usami, E

1999-01-01

The comparative effects of vitamin K2 and vitamin E on aortic calcium (Ca) and inorganic phosphorus (P) levels in the aorta and the elastin fraction (fr.) were investigated in male rats after experimental arteriosclerosis was induced by vitamin D2 with atherogenic diet. Both vitamin K2 (100 mg/kg b.w.) and vitamin E (40 mg/kg b.w.) inhibited the increase of Ca and P in the aorta and the elastin fr. from the arteriosclerotic rats. Vitamin K2 (50 mg/kg b.w.) also suppressed the deposition of Ca and P in the aorta, but there was no change due to vitamin K3 or geranylgeraniol (side chain of vitamin K2) administration. Both vitamin K2 and vitamin E showed lipid radical scavenging activity in the in vitro experiment. However, neither vitamin K3 nor geranylgeraniol exhibited anti-arteriosclerotic or radical scavenging activity under the above experimental conditions. It is suggested that vitamin K2 and vitamin E promoted an antiarteriosclerotic effect by radical scavenging activity. These actions of vitamin K2 are required in the structure of 2-methylnaphtoquinone and its side chain (geranylgeraniol).

Comparative research on decommissioning disposal effect of two uranium mines at home and abroad

International Nuclear Information System (INIS)

Shi Yuke; Peng Daofeng; Liu Qingcheng

2014-01-01

Taking two typical decommissioned uranium mines at home and abroad for an example, disposal means and effects of two uranium mines were compared and analyzed in three aspects of waste dump disposal, mine sealing treatment, and wastewater disposal. The results showed that two uranium mines were basically identical in the disposal standards and disposal means, but the works in the source survey, wastewater disposal and long-term supervision done by oversea uranium mine were more detailed than domestic uranium mine. (authors)

Comparative effects of partial root-zone irrigation and deficit irrigation on phosphorus uptake in tomato plants

DEFF Research Database (Denmark)

Wang, Yaosheng; Liu, Fulai; Jensen, Christian Richardt

2012-01-01

The comparative effects of partial root-zone irrigation (PRI) and deficit irrigation (DI) on phosphorus (P) uptake in tomato (Lycopersicon esculentum Mill.) plants were investigated in a split-root pot experiment. The results showed that PRI treatment improved water-use efficiency (WUE) compared...... to the DI treatment. PRI-treated plants accumulated significantly higher amounts of P in their shoots than DI plants under organic maize straw N fertilisation, whereas similar levels of shoot P accumulation were observed under mineral N fertilisation. Thus, the form of N fertiliser, and thereby...... the different plant N status, affected the accumulation of P in shoots, as reflected by a higher plant N:P ratio following mineral N fertilisation than after organic N fertilisation. Compared to the DI treatment, PRI significantly increased both the physiological and agronomic efficiencies of P-use under...

The effectiveness and cost-effectiveness of intraoperative imaging in high-grade glioma resection; a comparative review of intraoperative ALA, fluorescein, ultrasound and MRI.

Science.gov (United States)

Eljamel, M Sam; Mahboob, Syed Osama

2016-12-01

Surgical resection of high-grade gliomas (HGG) is standard therapy because it imparts significant progression free (PFS) and overall survival (OS). However, HGG-tumor margins are indistinguishable from normal brain during surgery. Hence intraoperative technology such as fluorescence (ALA, fluorescein) and intraoperative ultrasound (IoUS) and MRI (IoMRI) has been deployed. This study compares the effectiveness and cost-effectiveness of these technologies. Critical literature review and meta-analyses, using MEDLINE/PubMed service. The list of references in each article was double-checked for any missing references. We included all studies that reported the use of ALA, fluorescein (FLCN), IoUS or IoMRI to guide HGG-surgery. The meta-analyses were conducted according to statistical heterogeneity between studies. If there was no heterogeneity, fixed effects model was used; otherwise, a random effects model was used. Statistical heterogeneity was explored by χ 2 and inconsistency (I 2 ) statistics. To assess cost-effectiveness, we calculated the incremental cost per quality-adjusted life-year (QALY). Gross total resection (GTR) after ALA, FLCN, IoUS and IoMRI was 69.1%, 84.4%, 73.4% and 70% respectively. The differences were not statistically significant. All four techniques led to significant prolongation of PFS and tended to prolong OS. However none of these technologies led to significant prolongation of OS compared to controls. The cost/QALY was $16,218, $3181, $6049 and $32,954 for ALA, FLCN, IoUS and IoMRI respectively. ALA, FLCN, IoUS and IoMRI significantly improve GTR and PFS of HGG. Their incremental cost was below the threshold for cost-effectiveness of HGG-therapy, denoting that each intraoperative technology was cost-effective on its own. Copyright © 2016 Elsevier B.V. All rights reserved.

Antiproliferative effects of an analog of curcumin in Hep-2 cells: a comparative study with curcumin.

Science.gov (United States)

Kumaravel, Mohankumar; Sankar, Pajaniradje; Latha, Periyasamy; Benson, Chellakan S; Rukkumani, Rajagopalan

2013-02-01

Curcumin, the major active principle of Curcuma longa, is one of the promising, plant-derived, chemopreventive agents being studied for its anticarcinogenic and antioxidant properties. Hence, in our study, we aimed at testing the antiproliferative efficacy of an o-hydroxyl substituted analog of curcumin, bis demethoxy curcumin analog (BDMC-A), and comparing its efficacy with that of curcumin. BDMC-A was synthesised with a yield of 78% and 98% purity. Hep-2 cells and the MTT cell viability assay were used to examine cell proliferation. LDH assay and cell counts were performed to assess the cytotoxicity and anti-proliferative effects of the compound, respectively. Flow cytometry followed by Western blot were performed to investigate the cell cycle distribution. BDMC-A inhibited cell proliferation at a much lower concentration (IC50 20 microM) than curcumin (IC50 50 microM). Similar effects were observed in the LDH release and cell count assays. Flow cytometric studies using propidium iodide showed accumulation of cells in the G0/G1 phase and the arrest was further confirmed by immunoblotting of protein cyclin D1. BDMC-A was more potent in inhibiting the cells at a lower dose when compared with curcumin. Our results showed that the analog of curcumin is likely to possess more efficacy compared with curcumin in inhibiting cancer.

Comparing the happiness effects of real and on-line friends.

Directory of Open Access Journals (Sweden)

John F Helliwell

Full Text Available A recent large Canadian survey permits us to compare face-to-face ('real-life' and on-line social networks as sources of subjective well-being. The sample of 5,000 is drawn randomly from an on-line pool of respondents, a group well placed to have and value on-line friendships. We find three key results. First, the number of real-life friends is positively correlated with subjective well-being (SWB even after controlling for income, demographic variables and personality differences. Doubling the number of friends in real life has an equivalent effect on well-being as a 50% increase in income. Second, the size of online networks is largely uncorrelated with subjective well-being. Third, we find that real-life friends are much more important for people who are single, divorced, separated or widowed than they are for people who are married or living with a partner. Findings from large international surveys (the European Social Surveys 2002-2008 are used to confirm the importance of real-life social networks to SWB; they also indicate a significantly smaller value of social networks to married or partnered couples.

Ciclosporin compared with prednisolone therapy for patients with pyoderma gangrenosum: cost-effectiveness analysis of the STOP GAP trial.

Science.gov (United States)

Mason, J M; Thomas, K S; Ormerod, A D; Craig, F E; Mitchell, E; Norrie, J; Williams, H C

2017-12-01

Pyoderma gangrenosum (PG) is a painful, ulcerating skin disease with poor evidence for management. Prednisolone and ciclosporin are the most commonly used treatments, although not previously compared within a randomized controlled trial (RCT). To compare the cost-effectiveness of ciclosporin and prednisolone-initiated treatment for patients with PG. Quality of life (QoL, EuroQoL five dimensions three level questionnaire, EQ-5D-3L) and resource data were collected as part of the STOP GAP trial: a multicentre, parallel-group, observer-blind RCT. Within-trial analysis used bivariate regression of costs and quality-adjusted life years (QALYs), with multiple imputation of missing data, informing a probabilistic assessment of incremental treatment cost-effectiveness from a health service perspective. In the base case analysis, when compared with prednisolone, ciclosporin was cost-effective due to a reduction in costs [net cost: -£1160; 95% confidence interval (CI) -2991 to 672] and improvement in QoL (net QALYs: 0·055; 95% CI 0·018-0·093). However, this finding appears driven by a minority of patients with large lesions (≥ 20 cm 2 ) (net cost: -£5310; 95% CI -9729 to -891; net QALYs: 0·077; 95% CI 0·004-0·151). The incremental cost-effectiveness of ciclosporin for the majority of patients with smaller lesions was £23 374/QALY, although the estimate is imprecise: the probability of being cost-effective at a willingness-to-pay of £20 000/QALY was 43%. Consistent with the clinical findings of the STOP GAP trial, patients with small lesions should receive treatment guided by the side-effect profiles of the drugs and patient preference - neither strategy is clearly a preferred use of National Health Service resources. However, ciclosporin-initiated treatment may be more cost-effective for patients with large lesions. © 2017 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

Comparing treatment effects of oral THC on simulated and on-the-road driving performance: testing the validity of driving simulator drug research.

Science.gov (United States)

Veldstra, J L; Bosker, W M; de Waard, D; Ramaekers, J G; Brookhuis, K A

2015-08-01

The driving simulator provides a safe and controlled environment for testing driving behaviour efficiently. The question is whether it is sensitive to detect drug-induced effects. The primary aim of the current study was to investigate the sensitivity of the driving simulator for detecting drug effects. As a case in point, we investigated the dose-related effects of oral ∆(9)-tetrahydrocannabinol (THC), i.e. dronabinol, on simulator and on-the-road driving performance in equally demanding driving tasks. Twenty-four experienced driver participants were treated with dronabinol (Marinol®; 10 and 20 mg) and placebo. Dose-related effects of the drug on the ability to keep a vehicle in lane (weaving) and to follow the speed changes of a lead car (car following) were compared within subjects for on-the-road versus in-simulator driving. Additionally, the outcomes of equivalence testing to alcohol-induced effects were investigated. Treatment effects found on weaving when driving in the simulator were comparable to treatment effects found when driving on the road. The effect after 10 mg dronabinol was however less strong in the simulator than on the road and inter-individual variance seemed higher in the simulator. There was, however, a differential treatment effect of dronabinol on reactions to speed changes of a lead car (car following) when driving on the road versus when driving in the simulator. The driving simulator was proven to be sensitive for demonstrating dronabinol-induced effects particularly at higher doses. Treatment effects of dronabinol on weaving were comparable with driving on the road but inter-individual variability seemed higher in the simulator than on the road which may have potential effects on the clinical inferences made from simulator driving. Car following on the road and in the simulator were, however, not comparable.

Comparative effectiveness of family problem-solving therapy (F-PST for adolescents after traumatic brain injury: Protocol for a randomized, multicenter, clinical trial

Directory of Open Access Journals (Sweden)

Brad G. Kurowski

2018-06-01

Full Text Available Introduction: The objective of this manuscript is to describe the methodology that will be used to test the comparative effectiveness, feasibility, and acceptability of three formats of family problem solving therapy (F-PST for improving functional outcomes of complicated mild to severe adolescent TBI. Methods: Three-arm comparative effectiveness, randomized clinical trial (RCT design. We describe the protocol of a three-arm RCT comparing the effectiveness of three modalities of F-PST to reduce executive dysfunction and behavior problems following TBI in adolescence. The RCT will compare the relative effectiveness among face-to-face; online and self-directed; and therapist-supported online modes of treatment. Ethics and dissemination: It is anticipated that findings from this work will inform future clinical care practices, with implications for treatment of other patient populations of youth with psychological symptoms arising from neurological conditions. Institutional review board approval will be obtained from all sites prior to commencement of the study. Clinical Trials Registration: NCT:02368366, Keywords: Pediatric traumatic brain injury, Telehealth, Problem solving, Behavior, Executive function

Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine

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Claudia M. Witt

2012-01-01

Full Text Available The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER: (1 CER studies should be made a priority in this field; (2 stakeholders should be engaged at every stage of the research; (3 CER study designs should highlight effectiveness over efficacy; (4 research questions should be well defined to enable the selection of an appropriate CER study design; (5 the CIM community should cultivate widely shared understandings, discourse, tools, and technologies to support the use and validity of CER methods; (6 Effectiveness Guidance Documents on methodological standards should be developed to shape future CER studies. CER is an emerging field and its development and impact must be reflected in future research strategies within CIM. This stakeholder symposium was a first step in providing systematic guidance for future CER in this field.

Adverse effects in coronary angiography: a comparative study of different temperature contrast medium

International Nuclear Information System (INIS)

Zhou Peng; Wang Qiulin; Cai Guocai; Li Lu; Jiang Licheng; Yang Zhen; Huang Xiuping

2011-01-01

Objective: To investigate the correlation between different temperature contrast medium and the occurrence of adverse effects, including the chest discomfort, the changes of heart rate, ST segment and T wave, the operating time and the used dosage of contrast medium, in performing coronary angiography. Methods: According to the contrast medium temperature used in coronary angiography, the patients were randomly divided into two groups: room temperature group (n=521) and warm temperature group (n=522). The contrast medium used in warm temperature group was bathed in 37 ℃ water for 60 minutes when the coronary angiography was carried out. The T Wave amplitude changes ≥ 0.01 mv, ST segment depression ≥ 0.05 mv, changes in heart rate ≥ 10 times/min were brought into the positive accounting. The occurrence of adverse effects, such as palpitation, chest distress and pectoralgia, the operative time and the used dosage of contrast medium were recorded. The results were analyzed and compared between the two groups. Results: Statistically significant differences in the changes of heart rate, ST segment deviation, T wave change and operating time existed between the two groups (P<0.05). And the difference in the occurrence of adverse effects between the two groups was also statistically significant (P<0.05). Conclusion: When performing coronary angiography, warming of the contrast medium with water bath is greatly conducive to the prevention of cardiac adverse effects. (authors)

A tool for assessing the feasibility of comparative effectiveness research

Directory of Open Access Journals (Sweden)

Walker AM

2013-01-01

Full Text Available Alexander M Walker,1 Amanda R Patrick,2 Michael S Lauer,3 Mark C Hornbrook,4 Matthew G Marin,5 Richard Platt,6 Véronique L Roger,7 Paul Stang,8 Sebastian Schneeweiss21World Health Information Science Consultants, Newton, MA; 2Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA; 3National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; 4The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; 5Department of Medicine, New Jersey Medical School, Newark, NJ; 6Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA; 7Department of Health Sciences Research, Mayo Clinic, Rochester, MN; 8Johnson and Johnson Pharmaceutical Research and Development, Titusville, NJ, USABackground: Comparative effectiveness research (CER provides actionable information for health care decision-making. Randomized clinical trials cannot provide the patients, time horizons, or practice settings needed for all required CER. The need for comparative assessments and the infeasibility of conducting randomized clinical trials in all relevant areas is leading researchers and policy makers to non-randomized, retrospective CER. Such studies are possible when rich data exist on large populations receiving alternative therapies that are used as-if interchangeably in clinical practice. This setting we call “empirical equipoise.”Objectives: This study sought to provide a method for the systematic identification of settings it in which it is empirical equipoise that offers promised non-randomized CER.Methods: We used a standardizing transformation of the propensity score called “preference” to assess pairs of common treatments for uncomplicated community-acquired pneumonia and new-onset heart failure in a population of low-income elderly people in Pennsylvania, for whom we had access to de-identified insurance records. Treatment

Comparing Early Postoperative Period Analgesic Effect of Dexketoprofene Trometamol and Lornoxicam in Mediastinoscopy Cases

Science.gov (United States)

Sagiroglu, Gonul

2011-01-01

Objective: In this study, we aimed comparing early postoperative period analgesic effectiveness and the effects on opioid consumption of intravenous dexketoprofen and lornoxicam that are given preemptively. Materials and Methods: Forty patients, planned elective mediastinoscopy, were included in this prospective randomized study. These patients were classified in two groups, group D for dexketoprofene trometamol and group L for lornoxicam, randomly. 20 minutes before the operation 50 mg dexketoprofene trometamol and 8 mg lornoxicam were injected intravenously for group D and group L respectively. In postoperative intensive care unit, pain scores, mean arterial pressures, heart rates and peripheric O2 saturations of patients were recorded at 0, 10, 20, 60, 90 and 120th minutes. Results: When we evaluate the VAS score of the groups, there was a significant decrease in group D in all measured timesstatistically compairing to group L (p0.05). Conclusion: Since intravenous dexketoprofen, applied preemptively, has more potent analgesic effect and causing less opioid consumption in early postoperative period, is better than intravenous lornoxicam. PMID:25610155

Comparative effects of gamma irradiation and phosphine fumigation on the quality of white ginseng

Energy Technology Data Exchange (ETDEWEB)

Kwon, J.-H.Joong-Ho; Byun, M.-W.Myung-Woo; Kim, K.-S.Kang-Soo; Kang, I.-J.Il-Jun

2000-03-01

The hygienic, physicochemical, and organoleptic qualities of white ginseng were monitored during 6 months under accelerated conditions (40 deg. C, 90% r.h.) by observing its microbial populations, disinfestation, and some quality attributes following either gamma irradiation at 2.5-10 kGy or commercial phosphine (PH{sub 3}) fumigation. In a comparative study, both treatments were found to be effective for disinfecting the stored samples. Phosphine showed no appreciable decontaminating effects on microorganisms contaminated including coliforms, while 5 kGy irradiation was sufficient to control all microorganisms related to the quality of the packed samples. Irradiation at 5 kGy caused negligible changes in physicochemical attributes of the samples, such as ginsenosides, amino acids, fatty acids, and organoleptic properties, whereas phosphine fumigation was found detrimental to sensory flavor (P<0.01). Quality deterioration occurred in the commercially-packed samples was in the following order: the control, 10 kGy-, phosphine-, and 2.5-5 kGy-treated samples. Accordingly, irradiation at <5 kGy was found to be an effective alternative to phosphine fumigation for white ginseng. (author)

Stakeholder Priorities for Comparative Effectiveness Research in Chronic Obstructive Pulmonary Disease

Science.gov (United States)

Lindenauer, Peter K.; Au, David H.; Carson, Shannon S.; Lee, Todd A.; McBurnie, Mary Ann; Naureckas, Edward T.; Vollmer, William M.; Mularski, Richard A.

2013-01-01

Comparative effectiveness research (CER) is intended to address the expressed needs of patients, clinicians, and other stakeholders. Representatives of 54 stakeholder groups with an interest in chronic obstructive pulmonary disease (COPD) participated in workshops convened by the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) over a 2-year period. Year 1 focused on chronic care and care coordination. Year 2 focused on acute care and transitions in care between healthcare settings. Discussions and provisional voting were conducted via teleconferences and e-mail exchanges before the workshop. Final prioritization votes occurred after in-person discussions at the workshop. We used a modified Delphi approach to facilitate discussions and consensus building. To more easily quantify preferences and to evaluate the internal consistency of rankings, the Analytic Hierarchy Process was incorporated in Year 2. Results of preworkshop and final workshop voting often differed, suggesting that prioritization efforts relying solely on requests for topics from stakeholder groups without in-person discussion may provide different research priorities. Research priorities varied across stakeholder groups, but generally focused on studies to evaluate different approaches to healthcare delivery (e.g., spirometry for diagnosis and treatment, integrated healthcare strategies during transitions in care) rather than head-to-head comparisons of medications. This research agenda may help to inform groups intending to respond to CER funding opportunities in COPD. The methodologies used, detailed in the online supplement, may also help to inform prioritization efforts for CER in other health conditions. PMID:23155144

Comparative Study of the Effectiveness of Three Learning Environments: Hyper-Realistic Virtual Simulations, Traditional Schematic Simulations and Traditional Laboratory

Science.gov (United States)

Martinez, Guadalupe; Naranjo, Francisco L.; Perez, Angel L.; Suero, Maria Isabel; Pardo, Pedro J.

2011-01-01

This study compared the educational effects of computer simulations developed in a hyper-realistic virtual environment with the educational effects of either traditional schematic simulations or a traditional optics laboratory. The virtual environment was constructed on the basis of Java applets complemented with a photorealistic visual output.…

Disinfection of wastewater with peracetic acid: a review.

Science.gov (United States)

Kitis, Mehmet

2004-03-01

Peracetic acid is a strong disinfectant with a wide spectrum of antimicrobial activity. Due to its bactericidal, virucidal, fungicidal, and sporicidal effectiveness as demonstrated in various industries, the use of peracetic acid as a disinfectant for wastewater effluents has been drawing more attention in recent years. The desirable attributes of peracetic acid for wastewater disinfection are the ease of implementing treatment (without the need for expensive capital investment), broad spectrum of activity even in the presence of heterogeneous organic matter, absence of persistent toxic or mutagenic residuals or by-products, no quenching requirement (i.e., no dechlorination), small dependence on pH, short contact time, and effectiveness for primary and secondary effluents. Major disadvantages associated with peracetic acid disinfection are the increases of organic content in the effluent due to acetic acid (AA) and thus in the potential microbial regrowth (acetic acid is already present in the mixture and is also formed after peracetic acid decomposition). Another drawback to the use of peracetic acid is its high cost, which is partly due to limited production capacity worldwide. However, if the demand for peracetic acid increases, especially from the wastewater industry, the future mass production capacity might also be increased, thus lowering the cost. In such a case, in addition to having environmental advantages, peracetic acid may also become cost-competitive with chlorine.

U-Compare: share and compare text mining tools with UIMA

Science.gov (United States)

Kano, Yoshinobu; Baumgartner, William A.; McCrohon, Luke; Ananiadou, Sophia; Cohen, K. Bretonnel; Hunter, Lawrence; Tsujii, Jun'ichi

2009-01-01

Summary: Due to the increasing number of text mining resources (tools and corpora) available to biologists, interoperability issues between these resources are becoming significant obstacles to using them effectively. UIMA, the Unstructured Information Management Architecture, is an open framework designed to aid in the construction of more interoperable tools. U-Compare is built on top of the UIMA framework, and provides both a concrete framework for out-of-the-box text mining and a sophisticated evaluation platform allowing users to run specific tools on any target text, generating both detailed statistics and instance-based visualizations of outputs. U-Compare is a joint project, providing the world's largest, and still growing, collection of UIMA-compatible resources. These resources, originally developed by different groups for a variety of domains, include many famous tools and corpora. U-Compare can be launched straight from the web, without needing to be manually installed. All U-Compare components are provided ready-to-use and can be combined easily via a drag-and-drop interface without any programming. External UIMA components can also simply be mixed with U-Compare components, without distinguishing between locally and remotely deployed resources. Availability: http://u-compare.org/ Contact: kano@is.s.u-tokyo.ac.jp PMID:19414535

Comparing the effect of hypercapnia and hypoxia on the electroencephalogram during wakefulness.

Science.gov (United States)

Wang, David; Yee, Brendon J; Wong, Keith K; Kim, Jong Won; Dijk, Derk-Jan; Duffin, James; Grunstein, Ronald R

2015-01-01

Hypoxia has been postulated as a key mechanism for neurocognitive impairment in sleep-disordered breathing. However, the effect of hypoxia on the electroencephalogram (EEG) is not clear. We examined quantitative EEG recordings from 20 normal volunteers under three 5-min ventilatory control protocols: progressive hypercapnia with iso-hyperoxia (pO2=150mmHg) (Protocol 1), progressive hypercapnia with iso-hypoxia (pO2=50mmHg) (Protocol 2), and progressive hypoxia with a CO2 scrubber in the circuit (Protocol 3). Each protocol started with a 5-min session of breathing room air as baseline. In Protocol 1, compared to its baseline, iso-hyperoxia hypercapnia led to a lower Alpha% and higher Delta/Alpha (D/A) ratio. Similarly, in Protocol 2, the iso-hypoxia hypercapnia induced a higher Delta%, a lower Alpha% and higher D/A ratio. No difference was found in any EEG spectral band including the D/A ratio when Protocols 1 & 2 were compared. In Protocol 3, the Delta%, Alpha% and D/A ratio recorded during hypoxia were not significantly different from baseline. We found that hypercapnia, but not hypoxia, may play a key role in slowing of the EEG in healthy humans. Hypercapnia may be a greater influence than hypoxia on brain neuroelectrical activities. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A comparative study on the effective safety of nuclear technology in Korea

Energy Technology Data Exchange (ETDEWEB)

Soh, Young Jin [Daegu University, Daegu (Korea); Kim, Young Pyoung [Korea University, Seoul (Korea); Jung, Yoon Soo [Myoungji University, Seoul (Korea); Chung, Ik Jae; Choi, Byung Sun [Seoul National University, Seoul (Korea)

2001-12-01

The main purpose of this research is to analyze Korean perception of nuclear risk in comparison with other technological risks. In order to understand the characteristics of risk perception, the concept of 'effective safety' is clarified and defined. This research also covers such issues as relative riskiness of major risks, risk attitude, risk attribution, behavioral pattern for risky situation, and risk knowledge. A nation-wide survey was conducted for this study with a sample size of 1870. It was based on the purposive quota sampling to compare nuclear risk and other technological risks selected are 6 groups of risk; nuclear risk, environmental risk, traffic risk, chemical materials, industrial safety, and other recent risks. Accross these groups, a total of 25 risks are examined. 52 refs., 14 figs., 125 tabs. (Author)

Comparative Effectiveness of Three Occupational Therapy Sleep Interventions: A Randomized Controlled Study.

Science.gov (United States)

Gutman, Sharon A; Gregory, Kristin A; Sadlier-Brown, Megan M; Schlissel, Marcy A; Schubert, Allison M; Westover, Lee Ann; Miller, Richard C

2017-01-01

Although sleep intervention is within the domain of occupational therapy, few studies exist supporting practice. Effectiveness of three sleep interventions was compared: Dreampad Pillow®, iRest® meditation, and sleep hygiene. Twenty-nine participants were randomly assigned to the Dreampad Pillow® ( n = 10), iRest® meditation ( n = 9), and sleep hygiene ( n = 10) groups. In Phase 1, all participants used a 7-day sleep hygiene regimen to reduce poor sleep habits. In Phase 2 (14 days), 10 participants used the Dreampad Pillow® and sleep hygiene, nine used the iRest meditation and sleep hygiene, and 10 continued sleep hygiene only. At intervention-end, the iRest meditation group experienced statistically greater time asleep than both the Dreampad Pillow® ( p meditation ( p occupational therapy's domain.

Comparative Effectiveness of Treatment Choices for Graves' Hyperthyroidism: A Historical Cohort Study.

Science.gov (United States)

Sundaresh, Vishnu; Brito, Juan P; Thapa, Prabin; Bahn, Rebecca S; Stan, Marius N

2017-04-01

The optimum therapy for Graves' disease (GD) is chosen following discussion between physician and patient regarding benefits, drawbacks, potential side effects, and logistics of the various treatment options, and it takes into account patient values and preferences. This cohort study aimed to provide useful information for this discussion regarding the usage, efficacy, and adverse-effect profile of radioactive iodine (RAI), antithyroid drugs (ATDs), and thyroidectomy in a tertiary healthcare facility. The cohort included consecutive adults diagnosed with GD from January 2002 to December 2008, who had complete follow-up after treatment at the Mayo Clinic, Rochester, Minnesota. Data on treatment modalities, disease relapses, and adverse effects were extracted manually and electronically from the electronic medical records. Kaplan-Meier analyses were performed to evaluate the association of treatments with relapse-free survival. The cohort included 720 patients with a mean age of 49.3 years followed for a mean of 3.3 years. Of these, 76.7% were women and 17.1% were smokers. The initial therapy was RAI in 75.4%, ATDs in 16.4%, and thyroidectomy in 2.6%, while 5.6% opted for observation. For the duration of follow-up, ATDs had an overall failure rate of 48.3% compared with 8% for RAI (hazard ratio = 7.6; p < 0.0001). Surgery had a 100% success rate; 80% of observed patients ultimately required therapy. Adverse effects developed in 43 (17.3%) patients treated with ATDs, most commonly dysgeusia (4.4%), rash (2.8%), nausea/gastric distress (2.4%), pruritus (1.6%), and urticaria (1.2%). Eight patients treated with RAI experienced radiation thyroiditis (1.2%). Thyroidectomy resulted in one (2.9%) hematoma and one (2.85%) superior laryngeal nerve damage, with no permanent hypocalcemia. RAI was the most commonly used modality within the cohort and demonstrated the best efficacy and safety profile. Surgery was also very effective and relatively safe in the hands of

Autonomic, neuroendocrine, and immunological effects of ayahuasca: a comparative study with d-amphetamine.

Science.gov (United States)

Dos Santos, Rafael G; Valle, Marta; Bouso, José Carlos; Nomdedéu, Josep F; Rodríguez-Espinosa, José; McIlhenny, Ethan H; Barker, Steven A; Barbanoj, Manel J; Riba, Jordi

2011-12-01

Ayahuasca is an Amazonian psychotropic plant tea combining the 5-HT2A agonist N,N-dimethyltryptamine (DMT) and monoamine oxidase-inhibiting β-carboline alkaloids that render DMT orally active. The tea, obtained from Banisteriopsis caapi and Psychotria viridis, has traditionally been used for religious, ritual, and medicinal purposes by the indigenous peoples of the region. More recently, the syncretistic religious use of ayahuasca has expanded to the United States and Europe. Here we conducted a double-blind randomized crossover clinical trial to investigate the physiological impact of ayahuasca in terms of autonomic, neuroendocrine, and immunomodulatory effects. An oral dose of encapsulated freeze-dried ayahuasca (1.0 mg DMT/kg body weight) was compared versus a placebo and versus a positive control (20 mg d-amphetamine) in a group of 10 healthy volunteers. Ayahuasca led to measurable DMT plasma levels and distinct subjective and neurophysiological effects that were absent after amphetamine. Both drugs increased pupillary diameter, with ayahuasca showing milder effects. Prolactin levels were significantly increased by ayahuasca but not by amphetamine, and cortisol was increased by both, with ayahuasca leading to the higher peak values. Ayahuasca and amphetamine induced similar time-dependent modifications in lymphocyte subpopulations. Percent CD4 and CD3 were decreased, whereas natural killer cells were increased. Maximum changes occurred around 2 hours, returning to baseline levels at 24 hours. In conclusion, ayahuasca displayed moderate sympathomimetic effects, significant neuroendocrine stimulation, and a time-dependent modulatory effect on cell-mediated immunity. Future studies on the health impact of long-term ayahuasca consumption should consider the assessment of immunological status in regular users.

Cost-effectiveness of kidney transplantation compared with chronic dialysis in end-stage renal disease

Directory of Open Access Journals (Sweden)

Diego Rosselli

2015-01-01

Full Text Available To estimate the costs and effectiveness measured in quality-adjusted life years (QALY of kidney transplantation compared with dialysis in adults suffering from end-stage renal disease from the perspective of the Colombian healthcare system, we designed a Markov model with monthly cycles over a five-year time horizon and eight transitional states, including death as an absorbing state. Transition probabilities were obtained from international registries, costs from different local sources [case studies, official tariffs (ISS 2001 + 35% for procedures and SISMED for medications]. Data were validated by an expert panel and we performed univariate, multivariate and probabilistic sensitivity analyses. Effectiveness indicators were months of life gained, months of dialysis averted and deaths prevented. The annual discount rate was 3% and the cost-utility threshold (willingness to pay was three times gross domestic product (GDP = USD 20,000 per QALY. The costs were adopted in US dollars (USD using the 2012 average exchange rate (1 USD = COP$ 1798. The discounted average total cost for five years was USD 76,718 for transplantation and USD 76,891 for dialysis, with utilities 2.98 and 2.10 QALY, respectively. Additionally, renal transplantation represented 6.9 months gained, 35 months in dialysis averted per patient and one death averted for each of the five patients transplanted in five years. We conclude that renal transplantation improves the overall survival rates and quality of life and is a cost-saving alternative compared with dialysis.

Why does primary angioplasty not work in registries? Quantifying the susceptibility of real-world comparative effectiveness data to allocation bias.

Science.gov (United States)

Sen, Sayan; Davies, Justin E; Malik, Iqbal S; Foale, Rodney A; Mikhail, Ghada W; Hadjiloizou, Nearchos; Hughes, Alun; Mayet, Jamil; Francis, Darrel P

2012-11-01

Meta-analysis of registries (comparative effectiveness research) shows that primary angioplasty and fibrinolysis have equivalent real-world survival. Yet, randomized, controlled trials consistently find primary angioplasty superior. Can unequal allocation of higher-risk patients in registries have masked primary angioplasty benefit? First, we constructed a model to demonstrate the potential effect of allocation bias. We then analyzed published registries (55022 patients) for allocation of higher-risk patients (Killip class ≥1) to determine whether the choice of reperfusion therapy was affected by the risk level of the patient. Meta-regression was used to examine the relationship between differences in allocation of high-risk patient to primary angioplasty or fibrinolysis and mortality. Initial modeling suggested that registry outcomes are sensitive to allocation bias of high-risk patients. Across the registries, the therapy receiving excess high-risk patients had worse mortality. Unequal distribution of high-risk status accounted for most of the between-registry variance (adjusted R(2)(meta)=83.1%). Accounting for differential allocation of higher-risk patients, primary angioplasty gave 22% lower mortality (odds ratio, 0.78; 95% confidence interval, 0.64-0.97; P=0.029). We derive a formula, called the number needed to abolish, highlighting situations in which comparative effectiveness studies are particularly vulnerable to this bias. In ST-segment elevation myocardial infarction, clinicians' preference for management of a few high-risk patients can shift mortality substantially. Comparative effectiveness research in any disease is vulnerable to this, especially diseases with an immediately identifiable high-risk subgroup that clinicians prefer to allocate to 1 therapy. For this reason, preliminary indications from registry-based comparative effectiveness research should be definitively tested by randomized, controlled trials.

Internet surveillance, regulation, and chilling effects online: a comparative case study

Directory of Open Access Journals (Sweden)

Jonathon W. Penney

2017-05-01

Full Text Available With internet regulation and censorship on the rise, states increasingly engaging in online surveillance, and state cyber-policing capabilities rapidly evolving globally, concerns about regulatory “chilling effects” online—the idea that laws, regulations, or state surveillance can deter people from exercising their freedoms or engaging in legal activities on the internet have taken on greater urgency and public importance. But just as notions of “chilling effects” are not new, neither is skepticism about their legal, theoretical, and empirical basis; in fact, the concept remains largely un-interrogated with significant gaps in understanding, particularly with respect to chilling effects online. This work helps fill this void with a first-of-its-kind online survey that examines multiple dimensions of chilling effects online by comparing and analyzing responses to hypothetical scenarios involving different kinds of regulatory actions—including an anti-cyberbullying law, public/private sector surveillance, and an online regulatory scheme, based on the Digital Millennium Copyright Act (DMCA, enforced through personally received legal threats/notices. The results suggest not only the existence and significance of regulatory chilling effects online across these different scenarios but also evidence a differential impact—with personally received legal notices and government surveillance online consistently having the greatest chilling effect on people’s activities online—and certain online activities like speech, search, and personal sharing also impacted differently. The results also offer, for the first time, insights based on demographics and other similar factors about how certain people and groups may be more affected than others, including findings that younger people and women are more likely to be chilled; younger people and women are less likely to take steps to resist regulatory actions and defend themselves; and anti

Comparative International Management

NARCIS (Netherlands)

Sorge, Arndt; Noorderhaven, Niels; Koen, Carla

2015-01-01

The use of comparisons to explain, analyze and understand social and economic phenomena is recognized as a valuable social science tool. This textbook deals with the differences in management and organization between nations and their effects on multinational enterprises. In comparing management

Prospective comparative effectiveness cohort study comparing two models of advance care planning provision for Australian community aged care clients.

Science.gov (United States)

Detering, Karen Margaret; Carter, Rachel Zoe; Sellars, Marcus William; Lewis, Virginia; Sutton, Elizabeth Anne

2017-12-01

Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week. CMs were recruited via their organisations, sequentially allocated to a group and received education based on the group allocation. They were expected to initiate ACP with all clients and to facilitate ACP or refer for ACP. Outcomes were quantity of new ACP conversations and quantity and quality of new advance care directives (ACDs). 30 CMs (16 Facilitator, 14 Referral) completed the study; all 784 client's files (427 Facilitator, 357 Referral) were audited. ACP was initiated with 508 (65%) clients (293 Facilitator, 215 Referral; p<0.05); 89 (18%) of these (53 Facilitator, 36 Referral) and 41 (46%) (13 Facilitator, 28 Referral; p<0.005) completed ACDs. Most ACDs (71%) were of poor quality/not valid. A further 167 clients (facilitator 124; referral 43; p<0.005) reported ACP was in progress at study completion. While there were some differences, overall, models achieved similar outcomes. ACP was initiated with 65% of clients. However, fewer clients completed ACP, there was low numbers of ACDs and document quality was generally poor. The findings raise questions for future implementation and research into community ACP provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comparative antinociceptive and sedative effects of epidural romifidine and detomidine in buffalo (Bubalus bubalis).

Science.gov (United States)

Marzok, M A; El-Khodery, S A

2017-07-01

In this study, comparative antinociceptive and sedative effects of epidural administration of romifidine and detomidine in buffalo were evaluated. Eighteen healthy adult buffalo, allocated randomly in three groups (two experimental and one control; n=6) received either 50 μg/kg of romifidine or detomidine diluted in sterile saline (0.9 per cent) to a final volume of 20 ml, or an equivalent volume of sterile saline epidurally. Antinociception, sedation and ataxia parameters were recorded immediately after drug administration. Epidural romifidine and detomidine produced mild to deep sedation and complete antinociception of the perineum, inguinal area and flank, and extended distally to the coronary band of the hindlimbs and cranially to the chest area. Times to onset of antinociception and sedation were significantly shorter with romifidine than with detomidine. The antinociceptive and sedative effects were significantly longer with romifidine than with detomidine. Romifidine or detomidine could be used to provide a reliable, long-lasting and cost-effective method for achieving epidural anaesthesia for standing surgical procedures in buffalo. Romifidine induces a longer antinociceptive effect and a more rapid onset than detomidine. Consequently, epidural romifidine may offer better therapeutic benefits in the management of acute postoperative pain. British Veterinary Association.

Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

Science.gov (United States)

Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

2018-02-01

Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT. We identified all patients at a single large academic hospital who had undergone creation of either a one-stage or two-stage BVT between January 2007 and January 2015. Data evaluated included patient demographics, comorbidities, medication use, reasons for abandonment, and interventions performed to maintain patency. Costs were derived from the literature, and effectiveness was expressed in quality-adjusted life-years (QALYs). We analyzed primary and secondary functional patency outcomes as well as survival during follow-up between one-stage and two-stage BVT procedures using multivariate Cox proportional hazards models and Kaplan-Meier analysis with log-rank tests. The incremental cost-effectiveness ratio was used to determine cost savings. We identified 131 patients in whom 57 (44%) one-stage BVT and 74 (56%) two-stage BVT fistulas were created among 8 different vascular surgeons during the study period that each performed both procedures. There was no significant difference in the mean age, male gender, white race, diabetes, coronary disease, or medication profile among patients undergoing one- vs two-stage BVT. After fistula transposition, the median follow-up time was 8.3 months (interquartile range, 3-21 months). Primary patency rates of one-stage BVT were 56% at 12-month follow-up, whereas primary patency rates of two-stage BVT were 72% at 12-month follow-up. Patients undergoing two-stage BVT also had significantly higher rates of secondary functional patency at 12 months (57% for one-stage BVT vs 80% for two-stage BVT) and 24 months (44% for one-stage BVT vs 73% for two-stage BVT) of follow-up (P < .001 using log-rank test). However, there was no significant difference

[Comparative study of the central nervous system effect of the beta receptor blockaders pindolol and bisoprolol].

Science.gov (United States)

Görtelmeyer, R; Klingmann, I

1985-01-01

In a total of 36 volunteers with cardiac hyperreaction, investigations were carried out on the effect of bisoprolol (designated tradename: Concor), pindolol and placebo on central nervous functions with the aid of a reaction test, spiral aftereffect, tremor test and mood and sleep questionnaires. In the randomized double-blind study performed with 3 independent groups the volunteers received placebo, 2 X daily 10 mg of pindolol or 1 X daily 10 mg of bisoprolol for a period of 14 days. Bisoprolol is a new highly beta 1-selective adrenoceptor blocker with moderate lipophilia and without intrinsic sympathomimetic activity (ISA). When compared to placebo neither of the beta-adrenoceptor blockers induced any significant changes in mood, vigilance, tremor and reaction times. Moreover, under bisoprolol no negative effect on sleep quality or feeling refreshed after sleep was determined. Under pindolol, on the other hand, a significant impairment of sleep quality was observed after acute dosage and a decrease in feeling refreshed after sleep, continuing up to day 14 of treatment. It is presumed that, as bisoprolol and pindolol have comparable lipophilia, the different intensity with which the two preparations act on the central nervous system is connected with the ISA of pindolol. In the selected doses bisoprolol had a stronger effect on diastolic blood pressure and heart rate than pindolol and placebo.

Comparing two psychological interventions in reducing impulsive processes of eating behaviour : Effects on self-selected portion size

NARCIS (Netherlands)

van Koningsbruggen, G.M.; Veling, H.P.; Stroebe, Wolfgang; Aarts, Henk

2014-01-01

ObjectivePalatable food, such as sweets, contains properties that automatically trigger the impulse to consume it even when people have goals or intentions to refrain from consuming such food. We compared the effectiveness of two interventions in reducing the portion size of palatable food that

A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial

OpenAIRE

Wang, Chenchen; McAlindon, Timothy; Fielding, Roger A; Harvey, William F; Driban, Jeffrey B; Price, Lori Lyn; Kalish, Robert; Schmid, Anna; Scott, Tammy M; Schmid, Christopher H

2015-01-01

Background Fibromyalgia is a chronic musculoskeletal pain syndrome that causes substantial physical and psychological impairment and costs the US healthcare system over $25 billion annually. Current pharmacological therapies may cause serious adverse effects, are expensive, and fail to effectively improve pain and function. Finding new and effective non-pharmacological treatments for fibromyalgia patients is urgently needed. We are currently conducting the first comparative effectiveness rand...

The comparative effectiveness of persuasion, commitment and leader block strategies in motivating sorting.

Science.gov (United States)

Mickaël, Dupré

2014-04-01

Household waste management has become essential in industrialized countries. For the recycling programs to be a success, all citizens must comply with the developed residential procedures. Governmental bodies are thus dependent on as many people as possible adhering to the sorting systems they develop. Since the 1970s oil crisis, governments have called upon social psychologists to help develop effective communication strategies. These studies have been based on persuasion and behavioral commitment (Kiesler, 1971). Less common are studies based on developing participative communication (Horsley, 1977), a form of communication that relies on individuals to pass on information. After going through the main communication perspectives as they relate to the sorting of household waste, a comparative field study will be presented on the effectiveness of persuasive, committing and participative communication. Participative communication relied on users to pass along information to their neighbors. The results show that the participants who spread information in this way, along with those who made a commitment, changed their behavior to a greater degree than the other participants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Practical Implications of Using Real-World Evidence (RWE) in Comparative Effectiveness Research : Learnings from IMI-GetReal

NARCIS (Netherlands)

Makady, Amr; Stegenga, Heather; Ciaglia, Antonio; Debray, Thomas Pa; Lees, Michael; Happich, Michael; Ryll, Bettina; Abrams, Keith; Thwaites, Rob; Garner, Sarah; Jonsson, Páll; Goettsch, Wim G.

In light of increasing attention towards the use of real-world evidence (RWE) in decision making in recent years, this commentary aims to reflect on the experiences gained in accessing and using RWE for comparative effectiveness research as a part of the Innovative Medicines Initiative GetReal

Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness

NARCIS (Netherlands)

Dankbaar, Mary E W; Richters, Olivier; Kalkman, Cor J; Prins, Gerrie; Ten Cate, Olle T J; van Merrienboer, Jeroen J G; Schuit, Stephanie C E

2017-01-01

BACKGROUND: Serious games have the potential to teach complex cognitive skills in an engaging way, at relatively low costs. Their flexibility in use and scalability makes them an attractive learning tool, but more research is needed on the effectiveness of serious games compared to more traditional

Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness

NARCIS (Netherlands)

M. Dankbaar (Mary); O. Richters (Olivier); C.J. Kalkman (Cor); G. Prins (Gerrie); O.T.J. Ten Cate (Olle T. J.); J.J.G. van Merriënboer (Jeroen); S.C.E. Schuit (Stephanie)

2017-01-01

textabstractBACKGROUND: Serious games have the potential to teach complex cognitive skills in an engaging way, at relatively low costs. Their flexibility in use and scalability makes them an attractive learning tool, but more research is needed on the effectiveness of serious games compared to more

Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness

NARCIS (Netherlands)

M. Dankbaar (Mary); O. Richters (Olivier); C.J. Kalkman (Cor); G. Prins (Gerrie); O.T.J. Ten Cate (Olle T. J.); J.J.G. van Merriënboer (Jeroen); S.C.E. Schuit (Stephanie)

2017-01-01

textabstractBackground: Serious games have the potential to teach complex cognitive skills in an engaging way, at relatively low costs. Their flexibility in use and scalability makes them an attractive learning tool, but more research is needed on the effectiveness of serious games compared to more

Cellulose Nanocrystals vs. Cellulose Nanofibrils: A Comparative study on Their Microstructures and Effects as Polymer Reinforcing Agents

Science.gov (United States)

Xuezhu Xu; Fei Liu; Long Jiang; J.Y. Zhu; Darrin Haagenson; Dennis P. Wiesenborn

2013-01-01

Both cellulose nanocrystals (CNCs) and cellulose nanofibrils (CNFs) are nanoscale cellulose fibers that have shown reinforcing effects in polymer nanocomposites. CNCs and CNFs are different in shape, size and composition. This study systematically compared their morphologies, crystalline structure, dispersion properties in polyethylene oxide (PEO) matrix, interactions...

Adaptive iterative dose reduction algorithm in CT: Effect on image quality compared with filtered back projection in body phantoms of different sizes

Energy Technology Data Exchange (ETDEWEB)

Kim, Milim; Lee, Jeong Min; Son, Hyo Shin; Han, Joon Koo; Choi, Byung Ihn [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Yoon, Jeong Hee; Choi, Jin Woo [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

2014-04-15

To evaluate the impact of the adaptive iterative dose reduction (AIDR) three-dimensional (3D) algorithm in CT on noise reduction and the image quality compared to the filtered back projection (FBP) algorithm and to compare the effectiveness of AIDR 3D on noise reduction according to the body habitus using phantoms with different sizes. Three different-sized phantoms with diameters of 24 cm, 30 cm, and 40 cm were built up using the American College of Radiology CT accreditation phantom and layers of pork belly fat. Each phantom was scanned eight times using different mAs. Images were reconstructed using the FBP and three different strengths of the AIDR 3D. The image noise, the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) of the phantom were assessed. Two radiologists assessed the image quality of the 4 image sets in consensus. The effectiveness of AIDR 3D on noise reduction compared with FBP were also compared according to the phantom sizes. Adaptive iterative dose reduction 3D significantly reduced the image noise compared with FBP and enhanced the SNR and CNR (p < 0.05) with improved image quality (p < 0.05). When a stronger reconstruction algorithm was used, greater increase of SNR and CNR as well as noise reduction was achieved (p < 0.05). The noise reduction effect of AIDR 3D was significantly greater in the 40-cm phantom than in the 24-cm or 30-cm phantoms (p < 0.05). The AIDR 3D algorithm is effective to reduce the image noise as well as to improve the image-quality parameters compared by FBP algorithm, and its effectiveness may increase as the phantom size increases.

Adaptive iterative dose reduction algorithm in CT: Effect on image quality compared with filtered back projection in body phantoms of different sizes

International Nuclear Information System (INIS)

Kim, Milim; Lee, Jeong Min; Son, Hyo Shin; Han, Joon Koo; Choi, Byung Ihn; Yoon, Jeong Hee; Choi, Jin Woo

2014-01-01

To evaluate the impact of the adaptive iterative dose reduction (AIDR) three-dimensional (3D) algorithm in CT on noise reduction and the image quality compared to the filtered back projection (FBP) algorithm and to compare the effectiveness of AIDR 3D on noise reduction according to the body habitus using phantoms with different sizes. Three different-sized phantoms with diameters of 24 cm, 30 cm, and 40 cm were built up using the American College of Radiology CT accreditation phantom and layers of pork belly fat. Each phantom was scanned eight times using different mAs. Images were reconstructed using the FBP and three different strengths of the AIDR 3D. The image noise, the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) of the phantom were assessed. Two radiologists assessed the image quality of the 4 image sets in consensus. The effectiveness of AIDR 3D on noise reduction compared with FBP were also compared according to the phantom sizes. Adaptive iterative dose reduction 3D significantly reduced the image noise compared with FBP and enhanced the SNR and CNR (p < 0.05) with improved image quality (p < 0.05). When a stronger reconstruction algorithm was used, greater increase of SNR and CNR as well as noise reduction was achieved (p < 0.05). The noise reduction effect of AIDR 3D was significantly greater in the 40-cm phantom than in the 24-cm or 30-cm phantoms (p < 0.05). The AIDR 3D algorithm is effective to reduce the image noise as well as to improve the image-quality parameters compared by FBP algorithm, and its effectiveness may increase as the phantom size increases.

Comparative SPR study on the effect of nanomaterials on the biological activity of adsorbed proteins

International Nuclear Information System (INIS)

Mei, Q.; Chen, Y.; Hong, J.; Chen, H.; Ding, X.; Yin, Y.; Koh, K.; Lee, J.

2012-01-01

Bioactivity of proteins is evaluated to test the adverse effects of nanoparticles interjected into biological systems. Surface plasmon resonance (SPR) spectroscopy detects binding affinity that is normally related to biological activity. Utilizing SPR spectroscopy, a concise testing matrix is established by investigating the adsorption level of bovine serum albumin (BSA) and anti-BSA on the surface covered with 11-mercaptoundecanoic acid (MUA); magnetic nanoparticles (MNPs) and single-walled carbon nanotubes (SWCNTs), respectively. The immunoactivity of BSA on MNPs and SWCNT decreased by 18 % and 5 %, respectively, compared to that on the gold film modified with MUA. This indicates that MNPs cause a considerable loss of biological activity of adsorbed protein. This effect can be utilized for practical applications on detailed biophysical research and nanotoxicity studies. (author)

Field study comparing the effect of hydraulic mixing on septic tank performance and sludge accumulation.

Science.gov (United States)

Almomani, Fares

2016-01-01

This study investigates the effect of hydraulic mixing on anaerobic digestion and sludge accumulation in a septic tank. The performance of a septic tank equipped with a hydraulic mixer was compared with that of a similar standard septic tank over a period of 10 months. The study was conducted in two phases: Phase-I--from May to November 2013 (6 months); Phase-II--from January to May 2014 (4 months). Hydraulic mixing effectively reduced the effluent biological oxygen demand (BOD) and total suspended solids, and reduced the sludge accumulation rate in the septic tank. The BOD removal efficiencies during Phase-II were 65% and 75% in the standard septic tank and a septic tank equipped with hydraulic mixer (Smart Digester™), respectively. The effect of hydraulic mixing reduced the rate of sludge accumulation from 0.64 cm/day to 0.27 cm/day, and increased the pump-out interval by a factor of 3.

Genre Matters: A Comparative Study on the Entertainment Effects of 3D in Cinematic Contexts

Science.gov (United States)

Ji, Qihao; Lee, Young Sun

2014-09-01

Built upon prior comparative studies of 3D and 2D films, the current project investigates the effects of 2D and 3D on viewers' perception of enjoyment, narrative engagement, presence, involvement, and flow across three movie genres (Action/fantasy vs. Drama vs. Documentary). Through a 2 by 3 mixed factorial design, participants (n = 102) were separated into two viewing conditions (2D and 3D) and watched three 15-min film segments. Result suggested both visual production methods are equally efficient in terms of eliciting people's enjoyment, narrative engagement, involvement, flow and presence, no effects of visual production method was found. In addition, through examining the genre effects in both 3D and 2D conditions, we found that 3D works better for action movies than documentaries in terms of eliciting viewers' perception of enjoyment and presence, similarly, it improves views' narrative engagement for documentaries than dramas substantially. Implications and limitations are discussed in detail.

Comparative review of three cost-effectiveness models for rotavirus vaccines in national immunization programs; a generic approach applied to various regions in the world

NARCIS (Netherlands)

Postma, Maarten J.; Jit, Mark; Rozenbaum, Mark H.; Standaert, Baudouin; Tu, Hong-Anh; Hutubessy, Raymond C. W.

2011-01-01

Background: This study aims to critically review available cost-effectiveness models for rotavirus vaccination, compare their designs using a standardized approach and compare similarities and differences in cost-effectiveness outcomes using a uniform set of input parameters. Methods: We identified

Comparing effects of perfusion and hydrostatic pressure on gene profiles of human chondrocyte.

Science.gov (United States)

Zhu, Ge; Mayer-Wagner, Susanne; Schröder, Christian; Woiczinski, Matthias; Blum, Helmut; Lavagi, Ilaria; Krebs, Stefan; Redeker, Julia I; Hölzer, Andreas; Jansson, Volkmar; Betz, Oliver; Müller, Peter E

2015-09-20

Hydrostatic pressure and perfusion have been shown to regulate the chondrogenic potential of articular chondrocytes. In order to compare the effects of hydrostatic pressure plus perfusion (HPP) and perfusion (P) we investigated the complete gene expression profiles of human chondrocytes under HPP and P. A simplified bioreactor was constructed to apply loading (0.1 MPa for 2 h) and perfusion (2 ml) through the same piping by pressurizing the medium directly. High-density monolayer cultures of human chondrocytes were exposed to HPP or P for 4 days. Controls (C) were maintained in static cultures. Gene expression was evaluated by sequencing (RNAseq) and quantitative real-time PCR analysis. Both treatments changed gene expression levels of human chondrocytes significantly. Specifically, HPP and P increased COL2A1 expression and decreased COL1A1 and MMP-13 expression. Despite of these similarities, RNAseq revealed a list of cartilage genes including ACAN, ITGA10 and TNC, which were differentially expressed by HPP and P. Of these candidates, adhesion related molecules were found to be upregulated in HPP. Both HPP and P treatment had beneficial effects on chondrocyte differentiation and decreased catabolic enzyme expression. The study provides new insight into how hydrostatic pressure and perfusion enhance cartilage differentiation and inhibit catabolic effects. Copyright © 2015 Elsevier B.V. All rights reserved.

Cost-Effectiveness Analysis Comparing Pre-Diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program

Science.gov (United States)

Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S. Wendy; Hancock-Howard, Rebecca L.; Coyte, Peter C.

2015-01-01

Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario…

A comparative study of effect of sevoflurane on intubating conditions with rocuronium in neurosurgical patients.

Science.gov (United States)

Mitra, Saikat; Purohit, Shobha; Bhatia, Sonali; Kalra, Poonam; Sharma, Satya Prakash

2015-12-01

Rocuronium may not always be the preferred relaxant for rapid sequence intubation. When 2% sevoflurane is used in conjunction with rocuronium, it may reduce the time required for achieving complete skeletal muscle relaxation with the intubating dose of rocuronium. This study was prospective, randomised, double-blind in nature and compared the effect of sevoflurane on intubation time and intubating conditions when used along with rocuronium. Thirty adult patients belonging to American Society of Anesthesiologists physical status Grades 1 and 2, of either gender aged between 30 and 65 years undergoing neurosurgical operations were randomly allocated into two equal groups: Group R received 0.8 mg/kg rocuronium, and Group RS received 0.8 mg/kg of rocuronium with 2% sevoflurane. Onset time of intubation was assessed using train-of-four stimuli. The intubating conditions were compared using the Cooper scoring system and the haemodynamic responses were compared between the two groups. The onset time of intubation was 101.73 ± 10.28 s in Group R and 60.4 ± 4.1 s in Group RS (P Rocuronium 0.8 mg/kg along with 2% sevoflurane provides excellent intubating conditions within 60-66 s from its administration.

Comparing the Mass, Energy, and Cost Effects of Lightweighting in Conventional and Electric Passenger Vehicles

OpenAIRE

Hofer, Johannes; Wilhelm, Erik; Schenler, Warren

2014-01-01

In this work the effect of weight reduction using advanced lightweight materials on the mass, energy use, and cost of conventional and battery electric passenger vehicles is compared. Analytic vehicle simulation is coupled with cost assessment to find the optimal degree of weight reduction minimizing manufacturing and total costs. The results show a strong secondary weight and cost saving potential for the battery electric vehicles, but a higher sensitivity of vehicle energy use to mass reduc...

The comparative effectiveness of a team-based versus group-based physical activity intervention for cancer survivors.

Science.gov (United States)

Carter, Cindy L; Onicescu, Georgiana; Cartmell, Kathleen B; Sterba, Katherine R; Tomsic, James; Alberg, Anthony J

2012-08-01

Physical activity benefits cancer survivors, but the comparative effectiveness of a team-based delivery approach remains unexplored. The hypothesis tested was that a team-based physical activity intervention delivery approach has added physical and psychological benefits compared to a group-based approach. A team-based sport accessible to survivors is dragon boating, which requires no previous experience and allows for diverse skill levels. In a non-randomized trial, cancer survivors chose between two similarly structured 8-week programs, a dragon boat paddling team (n = 68) or group-based walking program (n = 52). Three separate intervention rounds were carried out in 2007-2008. Pre-post testing measured physical and psychosocial outcomes. Compared to walkers, paddlers had significantly greater (all p team cohesion, program adherence/attendance, and increased upper-body strength. For quality-of-life outcomes, both interventions were associated with pre-post improvements, but with no clear-cut pattern of between-intervention differences. These hypothesis-generating findings suggest that a short-term, team-based physical activity program (dragon boat paddling) was associated with increased cohesion and adherence/attendance. Improvements in physical fitness and psychosocial benefits were comparable to a traditional, group-based walking program. Compared to a group-based intervention delivery format, the team-based intervention delivery format holds promise for promoting physical activity program adherence/attendance in cancer survivors.

Comparative cost-effectiveness of antiviral therapies in patients with chronic hepatitis B: a systematic review of economic evidence.

Science.gov (United States)

Sun, Xin; Qin, Wen-Xia; Li, You-Ping; Jiang, Xu-Hua

2007-09-01

Economic efficiency of the alternative antiviral therapies for chronic hepatitis B has not been systematically investigated and their quality remains unknown. The aim of the present study was to systematically overview economic evidence of antiviral therapies for chronic hepatitis B. We searched six databases and eight major journals supplemented with screening references of eligible studies. Full economic evaluations comparing alternative antiviral therapies in patients with chronic hepatitis B virus infection were included. Two investigators assessed the study quality and transferability, independently. Data were analyzed qualitatively with adjustment when appropriate. Fourteen studies (six modeling vs eight trials and database analyses) were included. Quality was high in five studies, moderate in one US and five Chinese studies, and low in three Chinese studies. The major problems of quality are costing methods and analysis and the presentation of results. In Australia and Poland, lamivudine-preferred strategies dominated interferon (IFN)-alpha and its related strategy from the health-care sector perspective. In the US, adefovir salvage produced US$8446 per additional quality-adjusted life years (QALY) compared with IFN-alpha. In Spain, the cost of adefovir was US$34,840 for additional virological response. In Taiwan, the use of pegylated IFN-alpha (pegIFN-alpha) produced US$11,711.4 per additional QALY, compared with lamivudine. In China, the incremental cost-effectiveness ratios of combination therapy lamivudine ranged from US$2860 to US$22,160 per additional loss of hepatitis B e antigen (HBeAg), and IFN-alpha versus lamivudine ranged from US$2490 to US$8890 per additional loss of HBeAg. The cost-effectiveness frontiers of treatment alternatives vary and are influenced by the comparators and socioeconomic conditions of countries. Lamivudine-containing therapy is cost-effective when newer antiviral agents (e.g. adefovir/pegIFN-alpha) were not available

Comparative effects of 4-phenyl-3-butenoic acid and vorinostat on cell growth and signaling.

Science.gov (United States)

Burns, Timothy J; Ali, Amna; Matesic, Diane F

2015-02-01

4-phenyl-3-butenoic acid (PBA) is a small-molecule anti-inflammatory agent, which has been shown to inhibit growth, increase gap junction intercellular communication and modulate activation of p38 mitogen-activated protein kinase (p38 MAPK) and c-jun n-terminal kinase (JNK) in tumorigenic cells at concentrations that do not similarly affect non-tumorigenic cells. Vorinostat is an anticancer agent structurally similar to PBA. The purpose of this study was to compare the effects of these two agents on JNK and p38 activation, cell growth and gap junction intercellular communication (GJIC). Cell growth, GJIC and western blot analyses were performed utilizing tumorigenic WBras1 and H2009 human carcinoma cells, and non-tumorigenic WBneo3 and human bronchial epithelial (HBE) cells. Both compounds significantly inhibited WBras1 and H2009 tumorigenic cell growth and increased GJIC in WBras1 cells, as previously reported for PBA. Under similar conditions, both compounds increased phosphorylation of p38 MAPK in tumorigenic but not in non-tumorigenic cells and decreased phosphorylation of JNK in tumorigenic cells. However, a decrease in phosphorylation of JNK occurred in non-tumorigenic WBras1 cells following vorinostat treatment but not PBA treatment. Both compounds showed a selective growth inhibition of H2009 human carcinoma over normal HBE lung cells but, unlike PBA, vorinostat significantly decreased cell growth in WBneo3 cells. Overall, PBA exhibited similar effects to vorinostat in tumorigenic cells, while also showing reduced effects on JNK phosphorylation and growth in non-tumorigenic cells compared to ras-transformed cells. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study.

Science.gov (United States)

Tohen, Mauricio; Gold, Alexandra K; Sylvia, Louisa G; Montana, Rebecca E; McElroy, Susan L; Thase, Michael E; Rabideau, Dustin J; Nierenberg, Andrew A; Reilly-Harrington, Noreen A; Friedman, Edward S; Shelton, Richard C; Bowden, Charles L; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence A; Calabrese, Joseph R; Bobo, William V; McInnis, Melvin G

2017-08-01

DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV. Copyright © 2017. Published by Elsevier B.V.

Outcomes of the Smoker's Health Project: A Pragmatic Comparative Effectiveness Trial of Tobacco-Dependence Interventions Based on Self-Determination Theory

Science.gov (United States)

Williams, Geoffrey C.; Niemiec, Christopher P.; Patrick, Heather; Ryan, Richard M.; Deci, Edward L.

2016-01-01

A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory,…

Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: a cost effectiveness study.

Science.gov (United States)

Geitona, Maria; Kousoulakou, Hara; Ollandezos, Markos; Athanasakis, Kostas; Papanicolaou, Sotiria; Kyriopoulos, Ioannis

2008-08-28

To compare the costs and effects of paliperidone extended release (ER), a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone) over a 1-year time period. A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole) with a lower cost compared to the other therapies examined (euro 7,030 compared to euro 7,034 for olanzapine, euro 7,082 for risperidone, euro 8,321 for quetiapine, euro 7,713 for ziprasidone and euro 7,807 for aripiprazole). During the sensitivity analysis, a +/- 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Treatment with paliperidone ER can lead to lower total cost and higher number of stable days in most of the

Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: A cost effectiveness study

Directory of Open Access Journals (Sweden)

Papanicolaou Sotiria

2008-08-01

Full Text Available Abstract Background To compare the costs and effects of paliperidone extended release (ER, a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone over a 1-year time period. Methods A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. Results The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole with a lower cost compared to the other therapies examined (€7,030 compared to €7,034 for olanzapine, €7,082 for risperidone, €8,321 for quetiapine, €7,713 for ziprasidone and €7,807 for aripiprazole. During the sensitivity analysis, a ± 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Conclusion Treatment with paliperidone ER can lead to lower total cost

Comparative cost-effectiveness of the components of a behavior change communication campaign on HIV/AIDS in North India.

Science.gov (United States)

Sood, Suruchi; Nambiar, Devaki

2006-01-01

Numerous studies show that exposure to entertainment-education-based mass media campaigns is associated with reduction in risk behaviors. Concurrently, there is a growing interest in comparing the cost-effectiveness of HIV prevention interventions taking into account infrastructural and programmatic costs. In such analyses, though few in number, mass media campaigns have fared well. Using data from a mass media communication campaign in the low HIV prevalence states of Uttar Pradesh, Rajasthan, and Delhi in Northern India, in this article we examine the following: (1) factors that mediate behavior change in different components of the campaign, comprising a TV drama, reality show for youth audiences, and TV spots; (2) the relative impact of campaign components on the behavioral outcome: condom use; and (3) the cost-effectiveness calculations arising from this analysis. Results suggest that recall of the TV spots and the TV drama influences behavior change and is strongly associated with interpersonal communication and positive gender attitudes. The TV drama, in spite of being the costliest, emerges as the most cost-effective component when considering the behavioral outcome of interest. The analysis of the comparative cost-effectiveness of individual campaign components provides insights into the planning of resources for communication interventions globally.

Iohexol and iopamidol myelography in the dog: a clinical trial comparing adverse effects and myelographic quality

International Nuclear Information System (INIS)

Widmer, W.R.; Blevins, W.E.; Jakovljevic, S.; Teclaw, R.F.; Han, C.M.; Hurd, C.D.

1992-01-01

In a blind clinical trial, adverse effects after iohexol and iopamidol myelography were evaluated in 151 dogs. Eighty-one dogs were given iohexol (240 mgI/ml) and 70 dogs were given iopamidol (200 mgI/ml) by pre-determined assignment. Each dog was evaluated postmyelographically for seizures, hyperthermia, prolonged recovery from anesthesia and intensification of pre-existing neural signs. Myelographic quality was evaluated with a subjective scoring method. In comparing iohexol and iopamidol groups, there was not a statistically significant difference in the incidence of adverse effects or in myelographic quality. Iopamidol and iohexol appeared to be equally efficacious for routine canine myelography

Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference

Science.gov (United States)

Losch, Sabine; Traut-Mattausch, Eva; Mühlberger, Maximilian D.; Jonas, Eva

2016-01-01

Few empirical studies have used a randomized controlled design to evaluate the impact of coaching, and there are even fewer that have compared coaching with other interventions. In the current field study, we investigated the relative effectiveness of coaching as an intervention to reduce procrastination. In a randomized controlled study, participants (N = 84) were assigned to an individual coaching, a self-coaching, a group training, or a control group condition. Results indicate that individual coaching and group training were effective in reducing procrastination and facilitating goal attainment. Individual coaching created a high degree of satisfaction and was superior in helping participants attaining their goals, whereas group training successfully promoted the acquisition of relevant knowledge. The results for the self-coaching condition show that independently performing exercises without being supported by a coach is not sufficient for high goal attainment. Moreover, mediation analysis show that a coach’s transformational and transactional leadership behavior influenced participants’ perceived autonomy support and intrinsic motivation, resulting in beneficial coaching outcomes. The results may guide the selection of appropriate human resource development methods: If there is a general need to systematically prepare employees to perform on specific tasks, group training seems appropriate due to lower costs. However, when certain aspects of working conditions or individual development goals are paramount, coaching might be indicated. However, further research is needed to compare the relative effectiveness of coaching with other interventions in different contexts. PMID:27199857

Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference.

Science.gov (United States)

Losch, Sabine; Traut-Mattausch, Eva; Mühlberger, Maximilian D; Jonas, Eva

2016-01-01

Few empirical studies have used a randomized controlled design to evaluate the impact of coaching, and there are even fewer that have compared coaching with other interventions. In the current field study, we investigated the relative effectiveness of coaching as an intervention to reduce procrastination. In a randomized controlled study, participants (N = 84) were assigned to an individual coaching, a self-coaching, a group training, or a control group condition. Results indicate that individual coaching and group training were effective in reducing procrastination and facilitating goal attainment. Individual coaching created a high degree of satisfaction and was superior in helping participants attaining their goals, whereas group training successfully promoted the acquisition of relevant knowledge. The results for the self-coaching condition show that independently performing exercises without being supported by a coach is not sufficient for high goal attainment. Moreover, mediation analysis show that a coach's transformational and transactional leadership behavior influenced participants' perceived autonomy support and intrinsic motivation, resulting in beneficial coaching outcomes. The results may guide the selection of appropriate human resource development methods: If there is a general need to systematically prepare employees to perform on specific tasks, group training seems appropriate due to lower costs. However, when certain aspects of working conditions or individual development goals are paramount, coaching might be indicated. However, further research is needed to compare the relative effectiveness of coaching with other interventions in different contexts.

Superior Effects of High-Intensity Interval Training Compared to Conventional Therapy on Cardiovascular and Psychological Aspects in Myocardial Infarction.

Science.gov (United States)

Choi, Ha-Yoon; Han, Hee-Jun; Choi, Ji-Won; Jung, Han-Young; Joa, Kyung-Lim

2018-02-01

To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification. This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions. Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO 2max ), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO 2max was significantly (pHIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (pHIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.

Effectiveness and cost-effectiveness of an in-home respite care program in supporting informal caregivers of people with dementia: design of a comparative study.

Science.gov (United States)

Vandepitte, Sophie; Van Den Noortgate, Nele; Putman, Koen; Verhaeghe, Sofie; Annemans, Lieven

2016-12-02

Frequent hospitalization and permanent nursing home placement not only affect the well-being of persons with dementia, but also place great financial strain on society. Therefore, it is important to create effective strategies to support informal caregivers so that they can continue to perform their demanding role. Preliminary qualitative evidence suggests that community-based respite services can actually be important for caregivers, and that the level of evidence should be further established in terms of effectiveness. Therefore, a comparative study to assess the effectiveness and cost-effectiveness of an in-home respite care program will be initiated. This manuscript described a quasi-experimental study to assess (cost)-effectiveness of an in-home respite care program to support informal caregivers of persons with dementia. 124 informal caregivers and persons with dementia will be included in the intervention group and will receive an in-home respite care program by an organization called Baluchon Alzheimer. 248 dyads will be included in the control group and will receive standard dementia care. The primary outcome is caregiver burden. Secondary outcomes are: quality of life of caregivers, frequency of behavioral problems of persons with dementia and the reactions of caregivers to those problems, intention to institutionalize the care-recipient, time to nursing home placement, resource use of the care-recipient, and willingness to pay for in-home respite care. When the trial demonstrates a difference in outcomes between both groups, within-trial and modeled cost-effectiveness analyses will be conducted in a separate economic evaluation plan to evaluate possible cost-effectiveness of the in-home respite care program compared to the control group receiving standard dementia care. Finally, the model based cost-effectiveness analyses will allow to extrapolate effects over a longer time horizon than the duration of the trial. This study will have great added value

Comparative study on radon effects and thermal effects on humans in radon hot spring therapy

International Nuclear Information System (INIS)

Yamaoka, K.; Mitsunobu, F.; Hanamoto, K.; Tanizaki, Y.; Sugita, K.; Kohima, S.

2003-01-01

Full text: The radon therapy is used radon ( 222 Rn) gas, which mainly emits alpha-rays, and induces a small amount of active oxygen in the body. Because most of the diseases to which the radon therapy as well as the thermal therapy is applied are related to activated oxygen, in this study the effects of the radioactivity of radon and thermal effects were compared under the room or the hot spring condition with the similar chemical component, using as the parameters which are closely involved in the clinical for radon therapy. In the results, the radon and thermal therapy enhanced the antioxidation function, such as the activities of superoxide dismutase (SOD) and catalase, which inhibit lipid peroxidation and total cholesterol produce in the body. Moreover the therapy enhanced concanavalin A (ConA)-induced mitogen response, and increased the level of CD4, which is the marker of helper T cell, and decreased the level of CD8, which is the common marker of killer T cell and supresser T cell, in the white cell differentiation antigen (CD4/CD8) assay. Furthermore, the therapy increased the levels of alpha atrial natriuretic polypeptide (alpha ANP), beta endorphin, adrenocorticotropic hormone (ACTH), insulin and glucose-phosphate dehydrogenase (G-6-PDH), and decreased the vasopression level. The results were on the whole larger in the radon group than in the thermal group. The findings suggest that the radon therapy more contributes to the prevention of life style-related diseases related to peroxidation reactions and immune depression than thermal therapy. Moreover these indicate what may be a part of the mechanism for the alleviation of hypertension, osteoarthritis (pain) and diabetes mellitus brought about more radon therapy than thermal therapy

Effect of hemodialysis and peritoneal dialysis on redox status in chronic renal failure patients: a comparative study

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Mekki Khedidja

2010-09-01

Full Text Available Abstract Objective To investigate the effects of hemodialysis (HD and periotoneal dialysis (PD on oxidative stress in chronic renal failure patients (CRF. Methods 20 HD patients (M/F: 8/12, 36 ± 12 years and 20 PD patients (M/F: 10/10, 40 ± 8 years were compared with 20 end stage renal failure patients (CRF (M/F: 4/16, 61 ± 13 years. Results Thiobarbituric acid reactive substances (TBARS values were elevated in HD and decreased in PD compared to CRF (P 2 were decreased in HD and PD, compared to CRF (p 3 values between the three groups. Carbonyls were increased in HD (p Conclusion HD and PD aggravate oxidative stress generated by uremia. HD accentuates lipid and protein peroxidation, while PD aggravates protein oxidation. However, the activity of antioxidant enzymes was altered by both dialysis treatments.

[Comparative analysis: Effectiveness of nicotine addiction treatment in people with psychiatric comorbidity].

Science.gov (United States)

Godoy, R; Callejas, F J; Cruz, J; Tornero, A I; Tárraga, P J; Rodríguez-Montes, J A

2017-06-20

To determine whether or not nicotine addiction treatment was less effective in psychiatric than in the healthy population. A retrospective, descriptive and comparative cohort study was conducted in Albacete University Hospital during years 2008-2012 on all patients that attended the Tobacco Cessation Unit. The statistical tests used were Chi-squared, likelihood ratio, and the Student t test. Statistical significance P≤.05. The study included a total of 1,484 patients, of which 48.6% were female. The mean age was 46.8 years, and the mean age of starting smoking was 17.6 years. The mean number of previous attempts to quit was 1.48, and mean number of cigarettes smoked was 25.39. They had a mean Fagerström score of 6.04, a Richmond score of 8.13, and a mean carbon monoxide level of 16.65ppm. Most patients were referred from Primary Care (38.7%) and Chest Diseases department (33%), and the type of tobacco smoked was "light" in 75.8%. There was 15% with chronic obstructive pulmonary disease, 8% with asthma, and 9.4% with obstructive sleep apnoea syndrome. Furthermore, there was respiratory disease in 28.7%, cardiovascular disease in 4.6%, and both in 3.5%. Hiatus hernia was present in 7.2%, thyroid disease in 3.8%, hypertension in 19%, diabetes in 10.7%, and dyslipidaemia in 29.4%, Drugs were used by 7.1%, and 12.6% consumed alcohol. There was 39.3% psychiatric comorbidity (PC), and were comparable except in gender, age of onset, Fagerström, Richmond, source of referral, asthma, hiatus hernia, thyroid disease, hypertension, as well as drugs and treatment. Drug treatment was completed by 22.3% in the PC group, with no significant difference. There were differences in success (P=.008), but not in failure and relapse rates. Anti-smoking treatment in psychiatric patients is effective. An increase in the probability of treatment success is observed in patients without psychiatric comorbidity. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria

Endocrine effects of adjuvant letrozole + triptorelin compared with tamoxifen + triptorelin in premenopausal patients with early breast cancer.

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Rossi, Emanuela; Morabito, Alessandro; De Maio, Ermelinda; Di Rella, Francesca; Esposito, Giuseppe; Gravina, Adriano; Labonia, Vincenzo; Landi, Gabriella; Nuzzo, Francesco; Pacilio, Carmen; Piccirillo, Maria Carmela; D'Aiuto, Giuseppe; D'Aiuto, Massimiliano; Rinaldo, Massimo; Botti, Gerardo; Gallo, Ciro; Perrone, Francesco; de Matteis, Andrea

2008-01-10

To compare the endocrine effects of 6 months of adjuvant treatment with letrozole + triptorelin or tamoxifen + triptorelin in premenopausal patients with early breast cancer within an ongoing phase 3 trial (Hormonal Adjuvant Treatment Bone Effects study). Prospectively collected hormonal data were available for 81 premenopausal women, of whom 30 were assigned to receive tamoxifen + triptorelin and 51 were assigned letrozole + triptorelin +/- zoledronate. Serum 17-beta-estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Delta4-androstenedione, testosterone, dehydroepiandrosterone-sulfate, progesterone, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline and after 6 months of treatment. For each hormone, 6-month values were compared between treatment groups by the Wilcoxon-Mann-Whitney exact test. Median age was 44 years for both groups of patients. Letrozole + triptorelin (+/- zoledronate) induced a stronger suppression of median E2 serum levels (P = .0008), LH levels (P = .0005), and cortisol serum levels (P < .0001) compared with tamoxifen + triptorelin. Median FSH serum levels were suppressed in both groups, but such suppression was lower among patients receiving letrozole, who showed significantly higher median FSH serum levels (P < .0001). No significant differences were observed for testosterone, progesterone, ACTH, androstenedione, and dehydroepiandrosterone between the two groups of patients. Letrozole in combination with triptorelin induces a more intense estrogen suppression than tamoxifen + triptorelin in premenopausal patients with early breast cancer.

A comparative study on effective dynamic modeling methods for flexible pipe

Energy Technology Data Exchange (ETDEWEB)

Lee, Chang Ho; Hong, Sup; Kim, Hyung Woo [Korea Research Institute of Ships and Ocean Engineering, Daejeon (Korea, Republic of); Kim, Sung Soo [Chungnam National University, Daejeon (Korea, Republic of)

2015-07-15

In this paper, in order to select a suitable method that is applicable to the large deflection with a small strain problem of pipe systems in the deep seabed mining system, the finite difference method with lumped mass from the field of cable dynamics and the substructure method from the field of flexible multibody dynamics were compared. Due to the difficulty of obtaining experimental results from an actual pipe system in the deep seabed mining system, a thin cantilever beam model with experimental results was employed for the comparative study. Accuracy of the methods was investigated by comparing the experimental results and simulation results from the cantilever beam model with different numbers of elements. Efficiency of the methods was also examined by comparing the operational counts required for solving equations of motion. Finally, this cantilever beam model with comparative study results can be promoted to be a benchmark problem for the flexible multibody dynamics.

To Compare the Diagnostic Effectiveness of Transvaginal Ultrasonography, Sonohisterography and Endometrial Biopsy in Woman with Abnormal Uterine Bleeding

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Ahmet Kökden

2005-12-01

Full Text Available OBJECTIVE: To compare the effectiveness of saline sonohysterography in abnormal uterine bleeding with endometrial biopsy and transvaginal ultrasound. Design: Controlled clinical study. Settings: Bakirkoy Dr.Sadi Konuk Research and Training Hospital Patients: Total 51 pre and postmenopausal women age between 35 and 73 Interventions: Sonohysterography, endometrial biopsy, transvaginal ultrasound RESULTS: When we compared SIS with endometrail biopsy at the diagnosis of intracavitery lesions like myomas and polyps, endometrial biopsy diagnosed 7 on the other hand SIS diagnosed 12 of pathologies (p

Using primary care electronic health record data for comparative effectiveness research : experience of data quality assessment and preprocessing in The Netherlands

NARCIS (Netherlands)

Huang, Yunyu; Voorham, Jaco; Haaijer-Ruskamp, Flora M.

Aim: Details of data quality and how quality issues were solved have not been reported in published comparative effectiveness studies using electronic health record data. Methods: We developed a conceptual framework of data quality assessment and preprocessing and apply it to a study comparing

Comparative data on effects of leading pretreatments and enzyme loadings and formulations on sugar

Energy Technology Data Exchange (ETDEWEB)

Wyman, Charles [Univ. of California, Riverside, CA (United States); Balan, Venkatech [Michigan State Univ., East Lansing, MI (United States); Dale, Bruce E. [Michigan State Univ., East Lansing, MI (United States); Elander, Richard [National Renewable Energy Lab. (NREL), Golden, CO (United States); Falls, Matthew [Texas A & M Univ., College Station, TX (United States); Hames, Bonnie [Ceres Corporation, Thousand Oaks, CA (United States); Holtzapple, Mark [Texas A & M Univ., College Station, TX (United States); Ladisch, Michael R. [Purdue Univ., West Lafayette, IN (United States); Lee, Y. Y. [Auburn Univ., AL (United States); Mosier, Nathan [Purdue Univ., West Lafayette, IN (United States); Pallapolu, Venkata R. [Auburn Univ., AL (United States); Shi, Jian [Univ. of California, Riverside, CA (United States); Warner, Ryan E. [Genencor, Palo Alto, CA (United States)

2011-06-16

Dilute sulfuric acid (DA), sulfur dioxide (SO2), liquid hot water (LHW), soaking in aqueous ammonia (SAA), ammonia fiber expansion (AFEX), and lime pretreatments were applied to Alamo, Dacotah, and Shawnee switchgrass. Application of the same analytical methods and material balance approaches facil-itated meaningful comparisons of glucose and xylose yields from combined pretreatment and enzymatic hydrolysis. Use of a common supply of cellulase, beta-glucosidase, and xylanase also eased comparisons. All pretreatments enhanced sugar recovery from pretreatment and subsequent enzymatic hydrolysis substantially compared to untreated switchgrass. Adding beta-glucosidase was effective early in enzy-matic hydrolysis while cellobiose levels were high but had limited effect on longer term yields at the enzyme loadings applied. Adding xylanase improved yields most for higher pH pretreatments where more xylan was left in the solids. Harvest time had more impact on performance than switchgrass variety, and microscopy showed changes in different features could impact performance by different pretreatments.

[Comparative effects of ginkgo biloba extracts on psychomotor performances and memory in healthy subjects].

Science.gov (United States)

Warot, D; Lacomblez, L; Danjou, P; Weiller, E; Payan, C; Puech, A J

1991-01-01

The effect on psychomotor and mnesic performances of acute oral dose (600 mg) of 2 Ginkgo biloba extracts were evaluated in twelve healthy female in a dummy placebo-controlled double blind study. Tests were performed comprising: objective measures of vigilance [critical flicker frequency (CFF), choice reaction time (CRT)], memory tasks (pictures and Sternberg scanning tests) and self-rating evaluation (visual analogue scales). Tests session took place before and 1 hour post-dosing. No statistically significant changes from placebo were observed on CFF, CRT or subjective rating of drug effects. No differences between treatment were evidenced on Sternberg scanning test and pictures recognition. Comparing to baseline, free recall score, while decreasing under placebo and Ginkgo, remained the same under Tanakan. As the differences between treatment are localized on one test, it appears important to examine the reproductility in healthy subjects. In order to verify the clinical relevance of these results, they need to be replicated in older healthy volunteers with age-associated memory impairment.

Comparing the effects of relaxation technique and inhalation aromatherapy on fatigue in patients undergoing hemodialysis.

Science.gov (United States)

Hassanzadeh, Mohammadali; Kiani, Fatemeh; Bouya, Salehoddin; Zarei, Mohammad

2018-05-01

This study aimed to compare the effects of relaxation techniques on fatigue in hemodialysis patients. This clinical trial study was conducted on 105 hemodialysis patients. The subjects were categorized into three groups as: relaxation, aromatherapy and control. In the relaxation group, Benson muscle relaxation techniques were employed; in the aromatherapy group, the inhalation of two drops of 5% lavender essential oil used and the control group only received regular healthcare actions. Data collected by using brief fatigue inventory, before and after the intervention. Results of the current study indicated significant differences in the mean of changes in fatigue scores before and after the intervention between the relaxation and aromatherapy groups, but the difference was insignificant in the control group. Aromatherapy with lavender essential oil can decrease the level of fatigue in the patients undergoing hemodialysis compared to Benson relaxation techniques. Copyright © 2018 Elsevier Ltd. All rights reserved.

Learning effect of isokinetic measurements in healthy subjects, and reliability and comparability of Biodex and Lido dynamometers

DEFF Research Database (Denmark)

Lund, Hans; Søndergaard, K; Zachariassen, T

2005-01-01

The aim of this study was to examine the learning effect during a set of isokinetic measurements, to evaluate the reliability of the Biodex System 3 PRO dynamometer, and to compare the Biodex System 3 PRO and the Lido Active dynamometers on both extension and flexion over the elbow and the knee a...

Comparative evaluation of antibacterial effect of three commercially available herbal products against Streptococcus mutans: An In vitro Study

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Sharanya Sreekumar

2018-01-01

Full Text Available Background: In recent years, the researches concerning the use of herbal products have been vastly analyzed to decrease the disease burden caused by dental caries. It has been found that certain phytochemicals present in the plants have certain inhibitory effect toward Streptococcus mutans which is currently the main causative organism for dental caries initiation. Hence, in the present study, certain commercial herbal products have been tested for their antibacterial effect. Aim: This study aims to compare the antibacterial action of three commercially available herbal products against S. mutans. Material and Methods: An in vitro study was conducted with commercially available herbal products. They were Aloe Barbadensis Miller (Aloe vera, Ocimum tenuiflorum (Thulasi, and Stevia rebaudiana (Stevia. The antimicrobial effectiveness (zone of inhibition of herbal products was determined using agar well diffusion method. Pure strains of S. mutans MTCC 890 were procured from culture collection center, Imtech, Chandigarh. The culture was grown in Brain Heart Infusion Agar, and around 20 ml each was poured into sterile petri plates. Chlorhexidine (CHX was taken as positive control, and distilled water was taken as negative control. Statistical analysis was done using SPSS version 17 software. Results: All herbal products were found to be having variable antimicrobial activity against S. mutans. The mean zone of inhibition after 24 h incubation measured for Stevia, Thulasi, and A. vera was 22.33 mm, 11 mm, and 0 mm, respectively. The mean zone of inhibition of positive control CHX was found to be 13.6 mm. Conclusion: The antibacterial effect shown by Stevia was superior when compared with CHX and Thulasi. The Thulasi have more inhibitory effect than A. vera, and A. vera fails to show any zone of inhibition against S. mutans when compared with other herbal products. Thus, Stevia product can be strongly recommended as a caries preventing agent after

Ethnic differences in the effectiveness of cognitive behavioral therapy combined with medication: Comparing Asian American and white psychiatric patients.

Science.gov (United States)

Tang, Jennifer Y; Li, Chieh; Rodgers, Rachel F; Ballou, Mary

2016-12-01

Several meta-analyses have demonstrated the effectiveness of treatment utilizing cognitive behavioral therapy (CBT) combined with medication. There is, however, a paucity of research comparing the effectiveness of this combined treatment with psychiatric patients from different ethnic backgrounds. This study is the first of its kind to compare the effectiveness of CBT combined with medication for Asian American and White patients' psychiatric symptom severity levels of depression, anxiety, psychological well-being, and quality of life. The study examined the effects of CBT combined with medication for 43 Asian American and 43 White Non-Hispanic patients at an acute psychiatric partial hospital. A 2×2 between-within repeated measures analysis of variance was used. Results indicated significant improvement after treatment in all symptom categories assessed for the Asian American and White patients. The findings displayed trends over the course of treatment toward a greater decrease in anxiety symptoms among Asian patients but a larger increase in functioning level among White patients. In conclusion, the findings from this study provide preliminary cross-cultural support for CBT combined with medication as a treatment in partial hospital settings and suggest that the effectiveness of such treatments is similar across cultural groups. Copyright © 2016. Published by Elsevier B.V.

Effectiveness of Bilingual Education in Cambodia: A Longitudinal Comparative Case Study of Ethnic Minority Children in Bilingual and Monolingual Schools

Science.gov (United States)

Lee, Scott; Watt, Ron; Frawley, Jack

2015-01-01

There is little research in the developing countries of South East Asia on the effectiveness of bilingual education programmes that use first language instruction for ethnic minority children. This study investigated the effectiveness of a bilingual education programme involving ethnic minority children in Cambodia by comparing their performance…

Lessons from comparative effectiveness research methods development projects funded under the Recovery Act.

Science.gov (United States)

Zurovac, Jelena; Esposito, Dominick

2014-11-01

The American Recovery and Reinvestment Act of 2009 (ARRA) directed nearly US$29.2 million to comparative effectiveness research (CER) methods development. To help inform future CER methods investments, we describe the ARRA CER methods projects, identify barriers to this research and discuss the alignment of topics with published methods development priorities. We used several existing resources and held discussions with ARRA CER methods investigators. Although funded projects explored many identified priority topics, investigators noted that much work remains. For example, given the considerable investments in CER data infrastructure, the methods development field can benefit from additional efforts to educate researchers about the availability of new data sources and about how best to apply methods to match their research questions and data.

Investigation of flip-flop effects in a linear analog comparator-with-hysteresis circuit

International Nuclear Information System (INIS)

Roche, N.J.H.; Buchner, S.P.; Warner, J.H.; McMorrow, D.; Roig, F.; Auriel, G.; Dusseau, L.; Boch, J.; Saigne, F.; Azais, B.

2013-01-01

The impact of the positive feedback loop on analog single event transient (ASET) shapes was investigated for a comparator- with-hysteresis circuit. Simulation based on previous developed ASET simulation tool is used to model the impact of the power supply voltage, the input voltage level and the injected energy. Simulation results show that these kinds of circuits are sensitive to flip-flop effects. This phenomenon occurs if the input voltage is in the hysteresis band range. In this case, simulations show that the ASET can latch the output into a non-desired state by changing the state of the circuit on his transfer characteristic curves. Laser experiments were conducted and show that the simulation outputs are in agreement with the experimental collected data. (authors)

Comparative effectiveness of botulinum toxin versus non-surgical treatments for treating lateral epicondylitis: a systematic review and meta-analysis.

Science.gov (United States)

Lin, Yu-Ching; Wu, Wei-Ting; Hsu, Yu-Chun; Han, Der-Sheng; Chang, Ke-Vin

2018-02-01

To explore the effectiveness of botulinum toxin compared with non-surgical treatments in patients with lateral epicondylitis. Data sources including PubMed, Scopus, Embase and Airity Library from the earliest record to February 2017 were searched. Study design, patients' characteristics, dosage/brand of botulinum toxin, injection techniques, and measurements of pain and hand grip strength were retrieved. The standardized mean differences (SMDs) in pain relief and grip strength reduction were calculated at the following time points: 2-4, 8-12, and 16 weeks or more after injection. Six randomized controlled trials (321 participants) comparing botulinum toxin with placebo or corticosteroid injections were included. Compared with placebo, botulinum toxin injection significantly reduced pain at all three time points (SMD, -0.729, 95% confidence interval [CI], -1.286 to -0.171; SMD, -0.446, 95% CI, -0.740 to -0.152; SMD, -0.543, 95% CI, -0.978 to -0.107, respectively). Botulinum toxin was less effective than corticosteroid at 2-4 weeks (SMD, 1.153; 95% CI, 0.568-1.737) and both treatments appeared similar in efficacy after 8 weeks. Different injection sites and dosage/brand did not affect effectiveness. Botulinum toxin decreased grip strength 2-4 weeks after injection, and high equivalent dose could extend its paralytic effects to 8-12 weeks. When treating lateral epicondylitis, botulinum toxin was superior to placebo and could last for 16 weeks. Corticosteroid and botulinum toxin injections were largely equivalent, except the corticosteroid injections were better at pain relief in the early stages and were associated with less weakness in grip in the first 12 weeks.

Interpreting the quality of health care database studies on the comparative effectiveness of oral anticoagulants in routine care

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Schneeweiss S

2013-09-01

Full Text Available Sebastian Schneeweiss, Krista F Huybrechts, Joshua J Gagne Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Background: Dabigatran, an oral direct thrombin inhibitor, has now been available for 2 years in the US for the prevention of stroke in patients with nonvalvular atrial fibrillation, and direct Xa inhibitors are also starting to enter the market. Studies examining the effects of new oral anticoagulants in health care databases are beginning to emerge. The purpose of this study was to describe the validity of early published observational studies on the comparative safety and effectiveness of new oral anticoagulants in patients with atrial fibrillation. Methods: We identified published nonrandomized post-marketing studies (articles or conference abstracts or posters and critically appraised their internal validity, with a particular focus on their ability to control confounding and other biases. Results: Two full-length journal articles, three conference posters, two conference presentation abstracts, and a US Food and Drug Administration analysis form the basis of the early comparative effectiveness and safety experience with new oral anticoagulants. Some published studies exhibit substantial biases and have insufficient precision for several important endpoints. Several studies suffer from biases arising from comparing ongoing users of the older drug, warfarin, who seem to tolerate it, to initiators of the new treatment who may have switched from warfarin or have had no prior experience with anticoagulants. Analyses tended to not adjust or not adjust adequately for confounding, and unsound propensity score application was also observed. Several studies introduced selection bias by excluding patients who died during follow-up and by restricting the study population to those with continuous database enrollment following cohort entry. We

Comparative analysis of biological effect of corannulene and graphene on developmental and sleep/wake profile of zebrafish larvae.

Science.gov (United States)

Li, Xiang; Zhang, Yuan; Li, Xu; Feng, DaoFu; Zhang, ShuHui; Zhao, Xin; Chen, DongYan; Zhang, ZhiXiang; Feng, XiZeng

2017-06-01

Little is known about the biological effect of non-planar polycyclic aromatic hydrocarbons (PAH) such as corannulene on organisms. In this study, we compared the effect of corannulene (non-planar PAH) and graphene (planar PAH) on embryonic development and sleep/wake behaviors of larval zebrafish. First, the toxicity of graded doses of corannulene (1, 10, and 50μg/mL) was tested in developing zebrafish embryos. Corannulene showed minimal developmental toxicity only induced an epiboly delay. Further, a significant decrease in locomotion/increase in sleep was observed in larvae treated with the highest dose (50μg/mL) of corannulene while no significant locomotion alterations were induced by graphene. Finally, the effect of corannulene or graphene on the hypocretin (hcrt) system and sleep/wake regulators such as hcrt, hcrt G-protein coupled receptor (hcrtr), and arylalkylamine N-acetyltransferase-2 (aanat2) was evaluated. Corannulene increased sleep and reduced locomotor activity and the expression of hcrt and hcrtr mRNA while graphene did not obviously disturb the sleep behavior and gene expression patterns. These results suggest that the corannulene has the potential to cause hypnosis-like behavior in larvae and provides a fundamental comparative understanding of the effects of corannulene and graphene on biology systems. Little is known about the biological effect of non-planar polycyclic aromatic hydrocarbons (PAH) such as corannulene on organisms. Here, we compare the effect of corannulene (no-planar PAH) and graphene (planar PAH) on embryonic development and sleep/wake behaviors of larval zebrafish. And we aim to investigate the effect of curvature on biological system. First, toxicity of corannulene over the range of doses (1μg/mL, 10μg/mL and 50μg/mL) was tested in developing zebrafish embryos. Corannulene has minimal developmental toxicity, only incurred epiboly delay. Subsequently, a significant decrease in locomotion/increase in sleep at the highest

Calculation methods' comparative analysis of monorail hoist crane local bending effects

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Cvijović Goran M.

2016-01-01

Full Text Available The results of numerical and experimental researches of local bending problems, carried on classic and medium-wide I profiles, were a basis for the adoption of the current standards (EN 15011: 2014 which regulates the action of the local stress caused by the effect of cart wheels. Regarding the fact that IPB (HE-B wide flange profiles are largely used for production of the main carriers of monorail transport systems, this paper presents the results of the action of the local stress caused by the effect of cart wheels on the HE-A flange profile, using the methods and procedures of relevant researchers, the procedures prescribed by the standard EN 15011 as well as the results of calculations using finite element method. It has been revealed, based on comparative analysis of the results, that in the transition zone low flange / rib longitudinal local stress on the lower contour flange, determined using the above mentioned standards have tightening characteristic, while all other methods, including finite element method, give the pressing nature of the considered voltage. In addition, all of these procedures, except for the finite element method, adopt the assumption that absolute value of voltage, caused by local bending on upper and lower contour of the loaded flange, are the same, and there is no physical justification. Bearing in mind the fact that stress identification, caused by the flange local bending, is an extremely important phase proving the strength of monorail beams, we may conclude that the application of standard EN 15011 does not provide reliable results when it comes to wide flange profiles.

Probabilistic data linkage: a case study of comparative effectiveness in COPD

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Christopher M Blanchette

2013-10-01

Full Text Available Background: In this era of comparative effectiveness research, new, advanced techniques are being investigated by the research community to overcome the limitations of existing data sources. We describe the approach of probabilistic data linkage as a means to address this critical issue. Methods: We employed a historical retrospective cohort design. Patients aged 40 and older with a principal or secondary diagnosis of COPD (ICD-9-CM codes 491.xx, 492.xx, and 496 and at least 3 years of continuous enrollment between January 1, 2004 and April 30, 2009 were selected from two US-based commercial administrative claims databases. The index date was designated as the date of the first claim (defined by a 12-month wash-out pre-index period for the study drugs, for illustration purposes referred to as Treatment 1 or Treatment 2. The primary effectiveness measure was risk of any COPD-related exacerbation observed in the 12-month post-index period, with baseline characteristics being identified in the 12-month pre-index period. Results: The percentage of the study sample receiving Treatment 1 at index who had an exacerbation was 39.3% for Database A and 39.7% for Database B; for Treatment 2, the percentages were 46.3% and 47.1%, respectively. The event rate of hospitalizations in each database sample was nearly identical as were the odds ratio and corresponding confidence intervals from the adjusted logistic regression models (OR – Database A: 0.72, Database B: 0.74, Database A with imputed outcomes: 0.72. Conclusions: The probabilistic linkage demonstrated that patients from different databases matched on similar pre-index characteristics may demonstrate similar outcomes in the post-index period.

Comparative proteomic analysis of rice after seed ground simulated radiation and spaceflight explains the radiation effects of space environment

Science.gov (United States)

Wang, Wei; Shi, Jinming; Liang, Shujian; Lei, Huang; Shenyi, Zhang; Sun, Yeqing

In previous work, we compared the proteomic profiles of rice plants growing after seed space-flights with ground controls by two-dimensional difference gel electrophoresis (2-D DIGE) and found that the protein expression profiles were changed after seed space environment exposures. Spaceflight represents a complex environmental condition in which several interacting factors such as cosmic radiation, microgravity and space magnetic fields are involved. Rice seed is in the process of dormant of plant development, showing high resistance against stresses, so the highly ionizing radiation (HZE) in space is considered as main factor causing biological effects to seeds. To further investigate the radiation effects of space environment, we performed on-ground simulated HZE particle radiation and compared between the proteomes of seed irra-diated plants and seed spaceflight (20th recoverable satellite) plants from the same rice variety. Space ionization shows low-dose but high energy particle effects, for searching the particle effects, ground radiations with the same low-dose (2mGy) but different liner energy transfer (LET) values (13.3KeV/µm-C, 30KeV/µm-C, 31KeV/µm-Ne, 62.2KeV/µm-C, 500Kev/µm-Fe) were performed; using 2-D DIGE coupled with clustering and principle component analysis (PCA) for data process and comparison, we found that the holistic protein expression patterns of plants irradiated by LET-62.2KeV/µm carbon particles were most similar to spaceflight. In addition, although space environment presents a low-dose radiation (0.177 mGy/day on the satellite), the equivalent simulated radiation dose effects should still be evaluated: radiations of LET-62.2KeV/µm carbon particles with different cumulative doses (2mGy, 20mGy, 200mGy, 2000mGy) were further carried out and resulted that the 2mGy radiation still shared most similar proteomic profiles with spaceflight, confirming the low-dose effects of space radiation. Therefore, in the protein expression level

Compared performance of penetrometers and effect of soil water content on penetration resistance measurements

Directory of Open Access Journals (Sweden)

Edison Aparecido Mome Filho

2014-06-01

Full Text Available Modern agriculture techniques have a great impact on crops and soil quality, especially by the increased machinery traffic and weight. Several devices have been developed for determining soil properties in the field, aimed at managing compacted areas. Penetrometry is a widely used technique; however, there are several types of penetrometers, which have different action modes that can affect the soil resistance measurement. The objective of this study was to compare the functionality of two penetrometry methods (manual and automated mode in the field identification of compacted, highly mechanized sugarcane areas, considering the influence of soil water volumetric content (θ on soil penetration resistance (PR. Three sugarcane fields on a Rhodic Eutrudrox were chosen, under a sequence of harvest systems: one manual harvest (1ManH, one mechanized harvest (1MH and three mechanized harvests (3MH. The different degrees of mechanization were associated to cumulative compaction processes. An electronic penetrometer was used on PR measurements, so that the rod was introduced into the soil by hand (Manual and by an electromechanical motor (Auto. The θ was measured in the field with a soil moisture sensor. Results showed an effect of θ on PR measurements and that regression models must be used to correct data before comparing harvesting systems. The rod introduction modes resulted in different mean PR values, where the "Manual" overestimated PR compared to the "Auto" mode at low θ.

Greenhouse effects of the peat production and use as compared to coal, oil, natural gas and wood

International Nuclear Information System (INIS)

Hillebrand, K.; Wihersaari, M.

1993-01-01

This report examines the greenhouse effects of greenhouse gas emissions (carbon dioxide, methane and nitrous oxide) arising from certain production and utilization chains of peat and compares them with the corresponding effects associated with the production and utilization chains of coal, oil, natural gas and wood. In order to estimate the greenhouse effects of the peat production and utilization chains, the initial state of the peat bog together with the instantaneous and cumulative greenhouse effects associated with the production and burning of peat as well as subsequent use of the production area were taken into account. The initial state of the peat bog was taken to be either a bog in its natural sale, a forest-drained bog or a cultivated peatland. As regards alternatives for subsequent use of the peat production area, afforestation, paludification and lake formation were all examined

Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia

Directory of Open Access Journals (Sweden)

Hajheydari Zohreh

2009-01-01

Full Text Available Background: Finasteride, a type P-selective 5a-reductase inhibitor, as a causative agent of decreasing dihydroxy testestrone (DHT level, is effective in the treatment of male androgenic alopecia. Aim: We compared the local and oral finasteride in the treatment of androgenic alopecia. Method: This is a double blind, randomized clinical trial study of 45 male patients, who were referred with alopecia to the private clinics and departments in Boo-Ali Sina Hospital, in Sari. Patients with male androgenic alopecia were selected according to the history and physical examinations. The patients were randomly divided into two: topical finasteride (A and oral finasteride (B groups. Topical finasteride group (A received a topical gel of 1% finasteride and placebo tablets, while the oral finasteride group (B received finasteride tablets (1 mg and gel base (without drug as placebo for 6 months. The patients were followed by clinical observation and recording of side effects prior to the treatment and at the end of first week, and then by a monthly follow-up. The size of bald area, total hair count, and terminal hair were studied. Data were analyzed by descriptive and Chi-square statistical test. Results: The mean duration of hair loss was 18.8±23.10 months. Each month the terminal hair, size of bald area and hair count between the two groups were compared. There were no significant differences between the two groups as a viewpoint of hair thickness, hair counts and the size of bald area. Serial measurements indicated a significant increase in hair counts and terminal hair counts between the two groups. Conclusions: The results of this study showed that the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.

Effects of microwave oven exposed diet on spermatogenesis in testicular tissue of mice and comparative effects of mentha piperita and melatonin

International Nuclear Information System (INIS)

Naheed, K.; Qamar, K.; Jamal, S.

2017-01-01

Objective: To observe the effects of microwave oven exposed diet on spermatogenesis in the testis of mice and comparative effects of Mentha piperita and melatonin. Study Design: Laboratory based randomized controlled trial. Place and Duration of Study: Anatomy Department, Army Medical College Rawalpindi, in collaboration with National Institute of Health (NIH), Islamabad, from Apr 2015 to May 2015. Material and Method: Study comprised of 32 adult male mice (BALBc strain) weighing 25-30 gms. Selection criteria based on non-probability (purposive) simple random sampling. Mice were divided into four equal groups of 8 mice each. Group 1, taken as control, was given standard diet 5-10gm/animal/day daily for four weeks. Group 2 was given 5-10 gm/animal/day of microwave oven exposed mice pellets for four weeks. Group 3 received Mentha piperita leaf extract (1g/kg b.wt./day) along with microwave oven exposed mice pellets (5-10gm/animal/day) for 4 weeks and group 4 received oral dosage of melatonin 12mg/kg/day along with microwave oven exposed mice pellets (5-10gm/animal/day) for 4 weeks. After four weeks animals were dissected. The shape, color and any abnormal finding of the testis were observed. Testis were processed, embedded and stained for histological study. Spermatogenesis was assessed by the Johnsons scoring. SPSS 21 was used for statistical analysis. Chi square test was applied for intergroup comparison. Results: Spermatogenesis was suppressed and Johnsons score was decreased from normal spermatogenesis (10) to (6-8) in the experimental group 2 and was more improved in the Mentha piperita treated group as compare to the melatonin. Conclusion: Microwave oven exposed mice pellets suppressed spermatogenesis and Mentha piperita had better ameliorative effects than melatonin on the testis of mice. (author)

Study of the time course of the clinical effect of propofol compared with the time course of the predicted effect-site concentration : performance of three pharmacokinetic-dynamic models

NARCIS (Netherlands)

Coppens, M.; Van Limmen, J. G. M.; Schnider, T.; Wyler, B.; Bonte, S.; Dewaele, F.; Struys, M. M. R. F.; Vereecke, H. E. M.

In the ideal pharmacokinetic-dynamic (PK-PD) model for calculating the predicted effect-site concentration of propofol (Ce(PROP)), for any Ce(PROP), the corresponding hypnotic effect should be constant. We compared three PK-PD models (Marsh PK with Shuttler PD, Schnider PK with fixed ke0, and

Comparing the Effect of Intravenous Midazolam with Rectal Sodium Valproate in Controlling of Children with Refractory Status Epilepticus

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T Mahmoudian

2006-01-01

Full Text Available Background: Refractory status epilepticus usually defined as a seizure lasting at least 60 minutes which is uncontrollable by Diazepam, Phenytoin, or Phenobarbital. The aim of this study was to compare the effect of interavenous Midazolam and rectal Sodium valproate in controlling refractory status epilepticus. Methods: In this case-control study; 76 children with (mean age of 37± 20 months with refractory status epilepticus were randomly divided into two groups to receive IV Midazolam and rectal Sodium Valproate. The effect of the two drugs were compared in control of seizure during first 20 minutes of treatment. Results: In 84.2 percent of children treated with IV Midazolam, the seizure was under control within 4.5 ± 0.5 minutes, while in 63 percent of those receiving Sodium Valproate, the seizure was completely controlled within 16.5 ± 0.8 minutes (P < 0.00001. Conclusion: The IV Midazolam was more effective than Sodium valproate, but the latter can be used in hospitals or pediatric emergency wards without ICU for controlling of refractory status epilepticus. Key words: refractory status epilepticus, midazolam, sodium valproate

Comparative study of regenerative effects of mesenchymal stem cells derived from placental amnion, chorion and umbilical cord on dermal wounds.

Science.gov (United States)

Ertl, Juliane; Pichlsberger, Melanie; Tuca, Alexandru-Cristian; Wurzer, Paul; Fuchs, Jakob; Geyer, Stefan H; Maurer-Gesek, Barbara; Weninger, Wolfgang J; Pfeiffer, Dagmar; Bubalo, Vladimir; Parvizi, Daryousch; Kamolz, Lars-Peter; Lang, Ingrid

2018-05-01

Mesenchymal stem/stromal cells derived from human term placentas (PMSCs) are novel therapeutic agents and more topical than ever. Here we evaluated the effects of three types of PMSCs on wound healing in an in vivo mouse model: Amnion-derived MSCs (AMSCs), blood vessel-derived MSCs (BV-MSCs) from the chorionic plate and Wharton's jelly-derived MSCs (WJ-MSCs) from the umbilical cord. We topically applied PMSCs onto skin wounds in mice using the dermal substitute Matriderm ® as carrier and evaluated wound healing parameters. In addition, we investigated the effects of all PMSC types under co-application with placental endothelial cells (PLECs). After 8 days, we compared the percent of wound closure and the angiogenic potential between all groups. AMSCs, BV-MSCs and WJ-MSCs significantly induced a faster healing and a higher number of blood vessels in the wound when compared to controls (Matriderm ® -alone). PLECs did not further improve the advantageous effects of PMSC-treatment. Quantitative data and 3D analysis by high resolution episcopic microscopy confirmed a lower density of vessels in Matriderm ® /PMSCs/PLECs co-application compared to Matriderm ® /PMSCs treatment. Results indicate that all three PMSC types exert similar beneficial effects on wound closure and neovascularization in our mouse model. Using Matriderm ® as carrier for PMSCs propagates rapid cell migration towards the wound area that allows a fast and clinically practicable method for stem cell application. These promising effects warrant further investigation in clinical trials. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparative analysis of the radiation shield effect in an abdominal CT scan

International Nuclear Information System (INIS)

Kim, Seon-Chil; Kim, Young-Jae; Lee, Joon-Seok; Dong, Kyung-Rae; Chung, Woon-Kwan; Lim, Chang-Seon

2014-01-01

This study measured and compared the dose on the eyeballs and the thyroid with and without the use of a shield by applying the abdominal examination protocol used in an actual examination to a 64-channel computed tomography (CT) scan. A dummy phantom manufactured from acryl was used to measure the dose to the eyeballs and the thyroid of a patient during a thoraco-abdominal CT scan. The dose was measured using three dosimeters (optically-stimulated luminescence dosimeter (OSLD), thermoluminescence dosimeter (TLD) and photoluminescence dosimeter (PLD)) attached to the surfaces of three parts (left and right eyeballs and thyroid) in a phantom with and without the use of a shield for the eyeballs and the thyroid. Two types of shields (1-mm barium shielding sheet and 1-mm tungsten shielding sheet) were used for the measurements. The goggles and the lead shield, which are normally used in clinical practice, were used to compare the shield ratios of the shields. According to the results of the measurements made by using the OSLD, the shield ratios of the barium and the tungsten sheets were in the range of 34 - 36%. The measurements made by using the TLD showed that the shield ratio of the barium sheet was 6.25% higher than that of the tungsten sheet. When the PLD was used for the measurement, the shield ratio of the barium sheet was 33.34%, which was equivalent to that of the tungsten sheet. These results confirmed that the cheap barium sheet had a better shielding effect than the expensive tungsten sheet.

A comparative analysis of restoration measures and their effects on hydromorphology and benthic invertebrates in 26 central and southern European rivers.

NARCIS (Netherlands)

Jähnig, S.C.; Brabec, K.; Buffagni, A.; Erba, S.; Lorenz, A.; Ofenböck, T.; Verdonschot, P.F.M.; Hering, D.

2010-01-01

1. Hydromorphological river restoration usually leads to habitat diversification, but the effects on benthic invertebrates, which are frequently used to assess river ecological status, are minor. We compared the effects of river restoration on morphology and benthic invertebrates by investigating 26

Comparative effectiveness of budesonide/formoterol combination and tiotropium bromide among COPD patients new to these controller treatments

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Trudo F

2015-09-01

Full Text Available Frank Trudo,1 David M Kern,2 Jill R Davis,1 Ozgur Tunceli,2 Siting Zhou,2 Emma L Graham,3 Charlie Strange,4 Setareh A Williams1 1AstraZeneca Pharmaceuticals LP, 2HealthCore, Inc., Wilmington, DE, USA; 3AstraZeneca Pharmaceuticals LP, Alderley Park, Cheshire, UK; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA Background: Inhaled corticosteroid/long-acting β2-agonist combinations and/or long-acting muscarinic antagonists are recommended first-line therapies for preventing chronic obstructive pulmonary disease (COPD exacerbation. Comparative effectiveness of budesonide/formoterol combination (BFC, an inhaled corticosteroid/long-acting β2-agonist combination vs tiotropium (long-acting muscarinic antagonist in the US has not yet been studied.Methods: Using US claims data from the HealthCore Integrated Research Environment, COPD patients (with or without comorbid asthma ≥40 years old initiating BFC or tiotropium between March 1, 2009 and February 28, 2012 and at risk for exacerbation were identified and followed for 12 months. Patients were propensity score matched on demographics and COPD disease severity indicators. The primary outcome was time to first COPD exacerbation. Secondary outcomes included COPD exacerbation rate, health care resource utilization, and costs.Results: The Cox proportional hazards model for time to first exacerbation yielded a hazard ratio (HR of 0.78 (95% CI =[0.70, 0.87], P<0.001, indicating a 22% reduction in risk of COPD exacerbation associated with initiation of BFC versus tiotropium. A post hoc sensitivity analysis found similar effects in those who had a prior asthma diagnosis (HR =0.72 [0.61, 0.86] and those who did not (HR =0.83 [0.72, 0.96]. BFC initiation was associated with lower COPD-related health care resource utilization and costs ($4,084 per patient-year compared with $5,656 for tiotropium patients, P<0.001.Conclusion

An Internationally Comparative Study of Immigration and Adolescent Emotional and Behavioral Problems:Effects of Generation and Gender

DEFF Research Database (Denmark)

Stevens, Gonneke W J M; Walsh, Sophie D; Huijts, Tim

2015-01-01

psychosomatic symptoms than native adolescents. Effect sizes varied considerable for the different outcomes, and similar effects were found for first- and second-generation immigrant adolescents. Differences in these indicators of emotional and behavioral problems between immigrant and native adolescents did......PURPOSE: Although the potential consequences of immigration for adolescent problem behaviors have been addressed in many former studies, internationally comparative research is scarce. This study investigated the impact of immigration on four indicators of adolescents' emotional and behavioral...... not vary significantly with the receiving country. With two exceptions, effects of immigrant status were similar for boys and girls. Although no differences in psychosomatic symptoms were found between first-generation immigrant and native girls, first-generation immigrant boys reported less psychosomatic...

Postprandial lipemia detects the effect of soy protein on cardiovascular disease risk compared with the fasting lipid profile.

Science.gov (United States)

Santo, Antonio S; Santo, Ariana M; Browne, Richard W; Burton, Harold; Leddy, John J; Horvath, Steven M; Horvath, Peter J

2010-12-01

Studies examining the effect of soy protein on cardiovascular disease (CVD) risk factors have not taken advantage of the postprandial state as an adjunct to the fasting lipid profile. The American Heart Association has acknowledged the efficacy of soy protein in reducing CVD risk factors to be limited. We hypothesized that the postprandial state would be more sensitive to any favorable changes associated with consuming soy protein compared with the fasting lipid profile. Furthermore, the presence of isoflavones in soy would enhance this effect. Thirty sedentary males aged 18-30 years were randomly assigned to milk protein (Milk), isoflavone-poor soy (Soy-), or isoflavone-rich soy (Soy+). Usual diets were supplemented with 25 g/day of protein for 28 days. Serum samples were collected before and after supplementation in a fasted state and postprandially at 30, 60, 120, 240, and 360 min after a high-fat, 1,000 kcal shake. Triacylglycerol (TAG), total cholesterol, non-esterified fatty acids, apolipoproteins B-100 and A-I and glucose concentrations were quantified. Fasting concentrations were not different after any protein supplementation. Postprandial TAG and TAG AUC increased after Soy-consumption supporting the postprandial state as a more sensitive indicator of soy ingestion effects on CVD risk factors compared with the fasting lipid profile. Furthermore, the absence of isoflavones in soy protein may have deleterious consequences on purported cardio-protective effects.

Comparative Effectiveness of Conventional Rote Learning and ...

African Journals Online (AJOL)

This study investigated the relative effectiveness of Mnemonics technique (MNIT) and conventional rote learning technique (CRL) on the teaching-learning of physical features (Geography). A pre-test and post-test control group design was adopted for the study. A sample of ninety SS I students was randomly selected out of ...

Comparing the effectiveness of different displays in enhancing illusions of self-movement (vection

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Bernhard E. Riecke

2015-06-01

Full Text Available Illusions of self-movement (vection can be used in Virtual Reality (VR and other applications to give users the embodied sensation that they are moving when physical movement is unfeasible or too costly. Whereas a large body of vection literature studied how various parameters of the presented visual stimulus affect vection, little is known how different display types might affect vection. As a step towards addressing this gap, we conducted three experiments to compare vection and usability parameters between commonly used VR displays, ranging from stereoscopic projection and 3D TV to high-end head-mounted display (HMD, NVIS SX111 and recent low-cost HMD (Oculus Rift. The last experiment also compared these two HMDs in their native full field of view FOV and a reduced, matched FOV of 72×45°. Participants moved along linear and curvilinear paths in the virtual environment, reported vection onset time, and rated vection intensity at the end of each trial. In addition, user ratings on immersion, motion sickness, vection, and overall preference were recorded retrospectively and compared between displays. Unexpectedly, there were no significant effects of display on vection measures. Reducing the FOV for the HMDs (from full to 72×45° decreased vection onset latencies, but did not affect vection intensity. As predicted, curvilinear paths yielded earlier and more intense vection. Although vection has often been proposed to predict or even cause motion sickness, we observed no correlation for any of the displays studied. In conclusion, perceived self-motion and other user experience measures proved surprisingly tolerant towards changes in display type as long as the FOV was roughly matched. This suggests that display choice for vection research and VR applications can be largely based on other considerations as long as the provided FOV is sufficiently large.

A CLINICAL COMPARATIVE STUDY OF ANALGESIC EFFECT OF TRAMADOL AND PENTAZOCINE IN POST - OPERATIVE PATIENTS FOLLOWING UPPER ABDOMINAL SURGERY

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Jamuna

2015-06-01

Full Text Available The post - operative pain can be treated by various approaches. Aim of this randomised prospective study was to compare two drugs (Tramadol and Pentazocine . 100 adult patients of both sexes of ASA status 1 & 2 posted for elective upper abdominal surgery were randomly assigned into two groups of 50 each, where Group 1 received Tramadol intravenously and Group 2 received Pentazocine intravenously as post - opera tive pain management. The efficacy of the analgesic effect of intravenous Tramadol & Pentazocine was compared during post - operative pain management. It was observed that Tramadol has got more potent analgesic action compared to equianalgesic dose of Pentaz ocine.

A comparative study on effect of e-learning and instructor-led methods on nurses' documentation competency.

Science.gov (United States)

Abbaszadeh, Abbas; Sabeghi, Hakimeh; Borhani, Fariba; Heydari, Abbas

2011-01-01

Accurate recording of the nursing care indicates the care performance and its quality, so that, any failure in documentation can be a reason for inadequate patient care. Therefore, improving nurses' skills in this field using effective educational methods is of high importance. Since traditional teaching methods are not suitable for communities with rapid knowledge expansion and constant changes, e-learning methods can be a viable alternative. To show the importance of e-learning methods on nurses' care reporting skills, this study was performed to compare the e-learning methods with the traditional instructor-led methods. This was a quasi-experimental study aimed to compare the effect of two teaching methods (e-learning and lecture) on nursing documentation and examine the differences in acquiring competency on documentation between nurses who participated in the e-learning (n = 30) and nurses in a lecture group (n = 31). The results of the present study indicated that statistically there was no significant difference between the two groups. The findings also revealed that statistically there was no significant correlation between the two groups toward demographic variables. However, we believe that due to benefits of e-learning against traditional instructor-led method, and according to their equal effect on nurses' documentation competency, it can be a qualified substitute for traditional instructor-led method. E-learning as a student-centered method as well as lecture method equally promote competency of the nurses on documentation. Therefore, e-learning can be used to facilitate the implementation of nursing educational programs.

The comparative effect of fasting with and without caloric restriction in Rat on oxidative stress parameters

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Nurina Tyagita

2016-09-01

Full Text Available Introduction: Fasting, like Islamic Ramadan Fasting, has been associated with health benefits. Islamic Ramadan fasting, a form of caloric restriction (CR or alternate day fasting that. Studies suggest a comparable effect of ADF and caloric restriction. Despite the fact that fasting can be considered as a form of dietary restriction, fasters tend to have difficulty to reduce their food intake during non-fasting period by overeating leading to the excessive calorie intake. To compare the effect of fasting with and without caloric restriction in Sprague Dawley rats. Methods: The rats were assigned to one of three groups: ADF with 70 % calorie intake (30% CR, ADF with 100 % calorie intake (0% CR, and ADF with 140 % calorie intake (excessive calorie intake and AL (fed ad libitum. All groups were subjected to 6 hour fasting per day (9 a.m. until 3 p.m. or 15 days. The plasma sample was taken for MDA level assessment. Urinary 8-oxodG levels were determined by using ELISA. Results: ADF with 30% calorie restriction (F70 group had the lowest MDA level. Measurement of 8-oxodG level showed that group F70 had the highest production of 8-oxodG. There was an inverse relationship between MDA level and 8-oxodG level meaning the lower MDA level, the lower 8-oxodG levels were produced. Conclusion: ADF fasting with 30% caloric restriction reduce the MDA level but increase 8-oxodG levels. This study suggest the beneficial effect of fasting requires decrease in overall caloric intake.

The effect of organoclay type on morphology and mechanical properties of polypropylene films: comparative study

International Nuclear Information System (INIS)

Gama, D.B.; Calado, J.F.; Duarte, I.S.; Silva, S.M.L.; Andrade, D.L.A.C.S.

2012-01-01

This paper aims to compare the effect of the type of organoclay on morphological and mechanical properties of polypropylene films. Thus, were employed two organobentonite synthesized by NanoPol/UFCG (APOC and APOCF) and a organo montmorillonite Cloisite 20A (C20A) from Southern Clay Products (Texas/USA). The PP films and the PP/organoclay hybrids were prepared in a ChillRoll extruder - 16 AX Plastics and characterized by X-ray diffraction and mechanical properties. The results indicate that the incorporation of organobentonite (APOC and APOCF) and organo montmorillonite (C20A) resulted in the formation of PP nanocomposites with predominantly intercalated morphologies. Also indicate that the mechanical behavior of the films obtained with the three clays (APOC APOCF and C20A) was similar suggesting that the organobentonite, modified with national technology, raw material of low cost when compared to commercial organo montmorillonite, can be a viable alternative in the preparation of PP films. (author)

Effects of persistent insecticides on beneficial soil arthropod in conventional fields compared to organic fields, puducherry.

Science.gov (United States)

Anbarashan, Padmavathy; Gopalswamy, Poyyamoli

2013-07-15

The usage of synthetic fertilizers/insecticides in conventional farming has dramatically increased over the past decades. The aim of the study was to compare the effects of bio-pesticides and insecticides/pesticides on selected beneficial non targeted arthropods. Orders Collembola, Arachinida/Opiliones, Oribatida and Coleoptera were the main groups of arthropods found in the organic fields and Coleoptera, Oribatida, Gamasida and Collembola in conventional fields. Pesticides/insecticides had a significant effect on non-targeted arthropods order- Collembola, Arachinida/Opiliones, Hymenoptera and Thysonoptera were suppressed after pesticides/insecticides spraying. Bio-insecticides in organic fields had a non-significant effect on non targeted species and they started to increase in abundance after 7 days of spraying, whereas insecticide treatment in conventional fields had a significant long-term effect on non targeted arthropods and short term effect on pests/insects, it started to increase after 21 days of the spraying. These results indicate that insecticide treatment kept non targeted arthropods at low abundance. In conclusion, organic farming does not significantly affected the beneficial-non targeted arthropods biodiversity, whereas preventive insecticide application in conventional fields had significant negative effects on beneficial non targeted arthropods. Therefore, conventional farmers should restrict insecticide applications, unless pest densities reach the thresholds and more desirably can switch to organic farming practices.

Ethics and Regulatory Challenges and Opportunities in Patient-Centered Comparative Effectiveness Research.

Science.gov (United States)

Sugarman, Jeremy

2016-04-01

The Affordable Care Act includes provisions for the conduct of large-scale, patient-centered comparative effectiveness research. Such efforts aim toward the laudable moral goal of having evidence to improve health care decision making. Nevertheless, these pragmatic clinical research efforts that typically pose minimal incremental risk and are enmeshed in routine care settings perhaps surprisingly encounter an array of ethics and regulatory challenges and opportunities for academic health centers. An emphasis on patient-centeredness forces an examination of the appropriateness of traditional methods used to protect the rights, interests, and welfare of participants. At the same time, meaningful collaboration with patients throughout the research process also necessitates ensuring that novel approaches to research (including recruitment and consent) entail necessary protections regarding such issues as privacy. As the scientific and logistical aspects of this research are being developed, substantial attention is being focused on the accompanying ethics and regulatory issues that have emerged, which should help to facilitate ethically appropriate research in a variety of contexts.

Comparative study of native and irradiated crotoxin. Biochemical and pharmacological effects

International Nuclear Information System (INIS)

Nascimento, N. do.

1991-01-01

Ionizing radiation is able to detoxify several venoms, including snake venom, without affecting significantly their antigenic and immunogenic properties. In order to elucidate this phenomena, we conceived a comparative biochemical and pharmacological study between native and gamma irradiated (2000Gy) crotoxin, main toxin of south american rattlesnake Crotalus durissus terrificus. Crotoxin was isolated and purified from crude venom by molecular exclusion chromatography, pI precipitation and then irradiated. Immunodiffusion, electrophoresis and gel filtration showed that the molecular integrity was preserved after irradiation with some higher molecular weight aggregate formation and maintenance of its antigenic capacity. The antibodies induced by irradiated toxin had a similar titer to the antibodies induced by native crotoxin; however with higher protective effects in mice. Crotoxin toxicity became 15 times lower after irradiation, as determined by LD sub(50) in mice. Native and irradiated crotoxin biodistribution occurred with a similar general pattern, with renal elimination. In contrast to irradiated crotoxin, the native crotoxin is initially retained in kidneys. A later concentration (2-3hs) occurs in phagocyticmononuclear cells rich organs (liver and spleen) and neural junctions rich organs (muscle and brain). (author)

The effects of single-sex compared with coeducational schooling on students' performance and attitudes: a meta-analysis.

Science.gov (United States)

Pahlke, Erin; Hyde, Janet Shibley; Allison, Carlie M

2014-07-01

Proponents of single-sex (SS) education believe that separating boys and girls, by classrooms or schools, increases students' achievement and academic interest. In this article, we use meta-analysis to analyze studies that have tested the effects on students of SS compared with coeducational (CE) schooling. We meta-analyzed data from 184 studies, representing the testing of 1.6 million students in Grades K-12 from 21 nations, for multiple outcomes (e.g., mathematics performance, mathematics attitudes, science performance, educational aspirations, self-concept, gender stereotyping). To address concerns about the quality of research designs, we categorized studies as uncontrolled (no controls for selection effects, no random assignment) or controlled (random assignment or controls for selection effects). Based on mixed-effects analyses, uncontrolled studies showed some modest advantages for single-sex schooling, for both girls and boys, for outcomes such as mathematics performance but not for science performance. Controlled studies, however, showed only trivial differences between students in SS versus CE, for mathematics performance (g = 0.10 for girls, 0.06 for boys) and science performance (g = 0.06 for girls, 0.04 for boys), and in some cases showed small differences favoring CE schooling (e.g., for girls' educational aspirations, g = -0.26). Separate analyses of U.S. studies yielded similar findings (e.g., for mathematics performance g = 0.14 for girls and 0.14 for boys). Results from the highest quality studies, then, do not support the view that SS schooling provides benefits compared with CE schooling. Claims that SS schooling is particularly effective for U.S. ethnic minority boys could not be tested due to the lack of controlled studies on this question. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Comparing the effects of community service and imprisonment on reconviction

DEFF Research Database (Denmark)

Klement, Christian

2015-01-01

Objective This study compares reconviction rates for Danish offenders sentenced to community service and imprisonment. A large general sample of offenders (n=1602) is examined. Methods The study relies on a quasi-experimental design and uses propensity score matching as well as logistic regression...... Imprisonment is associated with a higher rate of recidivism and the result is statistically significant at conventional statistical levels. Conclusions Community service (CS) compared to imprisonment appears to cause a lower reconviction rate in general. Additional research is needed to shed light...

A comparative study of the effect of automobile pollution on pulmonary function tests of exposed cab drivers

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Amrith Pakkala

2013-01-01

Full Text Available Background: Urbanization is associated with an enormous increase in vehicular traffic emitting exhausts and polluting the atmosphere. Emissions from vehicular traffic constitute the most significant source of ultraparticle in an urban environment. Cab drivers who work near areas located in the vicinity of traffic junctions through which maximum number of vehicles passes are more prone to develop health issues pertaining to the respiratory system. The effect of this occupational hazard in this unorganised workforce is not adequately studied. This study is designed to determine the effect of air pollution on the pulmonary system in cab drivers exposed to automobile exhaust. Materials and Methods: This study was conducted by performing pulmonary function tests (PFTs on 20 cab drivers who are exposed to automobile exhaust by virtue of their work venue nearer to traffic junctions and comparing them with 20 age, gender-matched, and anthropometric profile cab drivers who work in a rural setting free from vehicular air pollution. PFT by computerized spirometer measuring forced vital capacity (FVC, forced expiratory volume (FEV 1 , FEV1/FVC, peak expiratory flow rate (PEFR, and forced expiratory flow (FEF 25%-75% were measured. Statistical analysis was done by Student′s t test (two-tailed, independent for intergroup analysis. Results: There was a statistically significant decline in dynamic pulmonary function parameters in the study group when compared. FVC, FEV in first second, PEFR, FEV 1 /FVC, and FEF 25%-75% were all found to be statistically significantly lower in cab drivers as compared to control group (P < 0.001. Conclusion: This study finds a significant decline in various PFT parameters recorded in the study group as compared with the control group. These suggests a tendency for obstructive lung disease among cab drivers exposed to a polluted urban environment.

Comparative analysis of four active compounds of Baikal skullcap and its classical TCM prescriptions according to different clinical curative effects

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Guang-Wei Zhu

2017-05-01

Full Text Available Objective: A sensitive HPLC-DAD detection method was established for the comparative analysis of the four active compounds (including baicalin, baicalein, wogonoside and wogonin of Baikal Skullcap and its classical TCM prescriptions according to different clinical curative effects. And analyze the relationship between compatibility of medicines, content and clinical curative effect.

Big Data and Comparative Effectiveness Research in Radiation Oncology: Synergy and Accelerated Discovery

Science.gov (United States)

Trifiletti, Daniel M.; Showalter, Timothy N.

2015-01-01

Several advances in large data set collection and processing have the potential to provide a wave of new insights and improvements in the use of radiation therapy for cancer treatment. The era of electronic health records, genomics, and improving information technology resources creates the opportunity to leverage these developments to create a learning healthcare system that can rapidly deliver informative clinical evidence. By merging concepts from comparative effectiveness research with the tools and analytic approaches of “big data,” it is hoped that this union will accelerate discovery, improve evidence for decision making, and increase the availability of highly relevant, personalized information. This combination offers the potential to provide data and analysis that can be leveraged for ultra-personalized medicine and high-quality, cutting-edge radiation therapy. PMID:26697409

Cost-effectiveness of dihydroartemisinin-piperaquine compared with artemether-lumefantrine for treating uncomplicated malaria in children at a district hospital in Tanzania.

Science.gov (United States)

Mori, Amani T; Ngalesoni, Frida; Norheim, Ole F; Robberstad, Bjarne

2014-09-15

Dihydroartemisinin-piperaquine (DhP) is highly recommended for the treatment of uncomplicated malaria. This study aims to compare the costs, health benefits and cost-effectiveness of DhP and artemether-lumefantrine (AL) alongside "do-nothing" as a baseline comparator in order to consider the appropriateness of DhP as a first-line anti-malarial drug for children in Tanzania. A cost-effectiveness analysis was performed using a Markov decision model, from a provider's perspective. The study used cost data from Tanzania and secondary effectiveness data from a review of articles from sub-Saharan Africa. Probabilistic sensitivity analysis was used to incorporate uncertainties in the model parameters. In addition, sensitivity analyses were used to test plausible variations of key parameters and the key assumptions were tested in scenario analyses. The model predicts that DhP is more cost-effective than AL, with an incremental cost-effectiveness ratio (ICER) of US$ 12.40 per DALY averted. This result relies on the assumption that compliance to treatment with DhP is higher than that with AL due to its relatively simple once-a-day dosage regimen. When compliance was assumed to be identical for the two drugs, AL was more cost-effective than DhP with an ICER of US$ 12.54 per DALY averted. DhP is, however, slightly more likely to be cost-effective compared to a willingness-to-pay threshold of US$ 150 per DALY averted. Dihydroartemisinin-piperaquine is a very cost-effective anti-malarial drug. The findings support its use as an alternative first-line drug for treatment of uncomplicated malaria in children in Tanzania and other sub-Saharan African countries with similar healthcare infrastructures and epidemiology of malaria.

Comparative Circadian Metabolomics Reveal Differential Effects of Nutritional Challenge in the Serum and Liver.

Science.gov (United States)

Abbondante, Serena; Eckel-Mahan, Kristin L; Ceglia, Nicholas J; Baldi, Pierre; Sassone-Corsi, Paolo

2016-02-05